Happy Healthy Long Life

Hit With a Triple Punch All In One Week--a Cold, Disabling Back Pain, and a Cold Sore. What Worked? What Didn't?

 

The Cold-The Back Pain-The Cold Sore

If you are receiving this post via email click here to get to the web version.

Can't remember the last time I had a cold.

What people describe as: "My back went-out" or "Disabling Back Pain".  It's never happened to me.

Can't remember the last time I missed work because of illness.

And I've never had a cold sore or fever blister in my life.

That is until the week of December 7-14!

Here's what happened to me--the week I turned into the Very Unhealthy Librarian

1.  First I got a cold, because I ignored the early signs and was too busy to do anything about it. 

Don't do what I did.  Read and pay attention to my mostly-no-fail-cold-prevention plan. My Research-Backed Advice on How to Prevent Colds - Knock Them Out Quickly - or Shorten Their Duration. 

At the first sign of a cold--don't be lazy like I was.  Make the time to use a neti pot (I use Sinucleanse), take Zicam Cold Remedy RapidMelts or Cold-Eeze (my fave Zicam nasal gel is now off the market), and get plenty of sleep!  Even though I waited for my cold to surface before I did anything about it, luckily, I still managed to knock it out quickly with this method.

Or avoid the cold in the first place by paying attention to: Advice From the Experts on How to Protect Yourself From Colds and Flu. How to Boost Your Immune System and Avoid Germs. What Foods and Supplements Will Help the Most?

2. Then my back "went out" and I quickly learned what it feels like to be disabled. Thankfully, I only missed a day of work, but I soon realized that you can't do anything when you can't move your body.  What good is a day off of work when there's nothing you can do?

Don't do what I did.  Read and pay attention to my post: Why Sitting In A Chair Hurts Your Back - What You Can Do To Prevent Back Pain. 

I made the big mistake of sitting in a chair for over 5 hours straight without getting up, tightening up my hip flexors and twisting my torso to the left for way too long while I worked on my computer.

"Sitting all day is the worst thing in the world you can do for your back, " said Dr. Joel Press, the medical director of the Spine & Sports Institute at the Rehabilitation Institute of Chicago.

Then I went off to a spinning class where I continued to tighten up my hip flexors as I rode for a hour in a crouched-over-the-handle bars position.  Later that evening, when I bent down to unload the washing machine--bingo--"my back went out".  Seriously, "out".  I could barely walk up the stairs, get up from the toilet, get in and out of bed, get dressed, sit in a chair, or do anything that involved moving my body.  I had instant empathy for anyone with an incapacitating injury or disability.

3.  Then I got a cold sore/fever blister for the first time in my life.  Not such a big deal, but it's ugly, embarrassing, uncomfortable, and to make matters worse, I couldn't wear any lipstick--and I always wear lipstick. I  didn't want to contaminate it.

Don't do what I did--I ignored the tingly, prickly feeling in the corner of my mouth.  The first sign of a cold sore. That's how it starts.  I never paid any attention to it until it was a full blown rapidly growing yellowish pus pocket in the corner of my mouth.  My husband suggested I just pop it--like a pimple.  Big mistake. Do not do that!

The whole embarrassing ugly mess could have been avoided all together if only I had known the symptoms, paid attention, and dabbed the corner of my mouth with Abreva--the miracle ointment that will nip a cold sore in the bud.  At least that's what everyone tells me--friends & relatives who were once plagued with unsightly painful cold sores--before Abreva came on the market.  To read more about the causes, the symptoms, and preventive steps for cold sores, check out what the Mayo Clinic and WebMD have to say.  Click here for Mayo. Click here for WebMD.

Besides using Abreva, I discovered a great lip balm at my hospital pharmacy, called Carmex.  Click here to read more. It kept my lips comfortable & moist, and I could squeeze it out of a tube--and apply with my finger--rather than contaminate a lipstick-type balm.

So how did I get a cold sore?

Impossible to know.  Initially, you catch it from someone else--and it's highly contagious.  Afterward, an outbreak is often triggered by lack of sleep, stress, a cold, the flu, the sun, or any of the usual suspects that lower our immunity. Some of which happened during the days before my cold sore surfaced.  Who knows, maybe the virus had been lying dormant for years--or maybe I just caught it.

How I "Fixed" My Achy Breaky Back in Twenty-Four Hours

1.  I acted quickly. 

2.  I immediately took an anti-inflammatory.  In my case I took a Celebrex (a prescription anti-inflammatory that doesn't irritate the stomach).  Ibuprofen is irritating to me, and thanks to my husband we had some Celebrex at home. 

3.  As uncomfortable as I was, I managed to get on the floor and do some very gentle hip flexor stretches. This helped to stretch out my super-tight hip flexors that apparently had irritated my piriformis muscle.  Fortunately, my niece Jamie, a 3rd year physical therapy PhD student, had previously shown me some good stretches to do--so I was prepared!

"One muscle which is often thought to be the cause of pain when sitting is the piriformis. You have two piriformis muscles, running horizontally from the lower spine to the top of each thighbone (femur). The piriformis runs over the sciatic nerve, and when the muscle becomes tight or spasms and places pressure on the sciatic nerve. This can cause pain in the lower back and/or pain that radiates to the buttocks and down the leg. Pain is often made worse by sitting." Rakel. Integrative Medicine.  2nd ed.  2007

 

 

• Sit in a chair with both feet flat on the floor.
  
  
• Place the ankle of the affected leg above the knee of the opposite leg. Rotate the hip so that the knee faces outward.
  
  
• Keeping your back straight, lean forward until you feel a stretch.

 

• Lie on your back with your unaffected leg bent so that the foot is flat on the table/floor.
  
  
• Place the ankle of the affected leg above the knee of the opposite leg.
  
  
• Rotate the hip so that knee faces outward.
  
  
• Place your hands around the hamstring of the unaffected leg and gently pull back until you feel a stretch. *The foot will lift off the table/floor at this point.

4.  What I didn't know to do was to immediately (recommended by Janet--my physical therapist friend)  put an ice pack on my back for 10 minutes at a time, for the first 24-72 hours.  I did it 12 hours after my back "went out" and it really felt good.

5.  Other tips from Janet--the physical therapist:

• If you are in a lot of pain, just get on your back and get into a neutral position--the same as if you were standing.
• Hold each of the hip flexor/piriformis stretches for 30-60 seconds.
• She also recommends this stretch: lie on a bed or at table with your hips 8 to 10 inches from the edge.  Pull one thigh into your chest just enough to press your your lower back down lightly.  Slowly lower your other leg over the edge, easing it down.  Hold for 30-60 seconds.  You should feel a gentle stretch.  Then switch positions.  Here's what this stretch looks like:

• What ever you do--do not lie in bed all day.  Move around.  Get blood flowing into the muscle to help speed recovery.
• My back "went out" on Thursday evening.  I stayed home from work on Friday--which Janet said was the best thing I could have done.  Driving to work, sitting in a car, sitting at work all day would have extended the injury.  By Friday evening I could move around comfortably.  Bottom line: act quickly, don't push yourself to "carry on as usual".
• On Saturday morning I asked Janet when I could go back to spinning class.  She said that as long as I felt fine, and I did, I could start exercising on Sunday, but she advised me to take it easy, pay attention, don't overdo, and stop if I had pain.  I actually worked out very well for me. 

6.  Honestly, I can't believe how quickly the back pain, and any residual soreness just went away.  Now I'm religiously stretching my hip flexors daily, and avoiding sitting at a desk for any longer than 1 hour.  Then, I stand up, and with my hands on the small of my back I gently bend slightly backwards.  At work I'm doing the "in the chair" hip flexor stretches that are pictured above.  See Dr. Vijay Vad's short video for an explanation of the back stretch.

My Advice--Watch this short video Strengthening the Core: The Science of Back Pain (only 3 minutes) & you'll finally understand why our backs can seemingly "go out" on us at the most random of times.

In the video Dr. Vijay Vad (the guru of back pain prevention) clearly explains how we unwittingly abuse our backs, and what we can do to prevent injury.  I first heard of Dr. Vad from a co-worker who swears by the exercises in this book: Back Rx: a 15-minute-a-day yoga & pilates based program to end low back pain.  Gotham, 2004.

Since my "back incident" I've made it a point not to skip yoga classes--they really help to improve flexibility and prevent injury.

As for the cold sore, it's still with me, but on it's way out.  Since I was clueless and unsuspecting when the symptoms first appeared I didn't act immediately at the first tingle of pain, so now I'm stuck with going the full 1-2 week usual course.  Next time, I'll be prepared.

Bottom Line When It Comes to Colds, Back Pain, and Cold Sores:

Prevention and attention rule. Get enough sleep.  Wash your hands often.  Eat well.  Don't Overdo it.  Don't sit at a desk too long.  Do preventive hip flexor stretches if that's the cause of your back problems.  At the first sign of a cold--get out that neti pot (Sinucleanse).  At the first sign of a cold sore, zap it with Abreva.

10-Minute Quick-to-Fix Vegan Dinner. The Healthy Librarian's Arugula Pear "Steak" Salad with Dried Cranberries and Walnuts

Super Fast Arugula Pear "Steak" Salad with Walnuts and Cranberries

If you receive this post via email click here to get to the web version

Back when I was eating meat, a favorite quick-to-fix dinner was sliced grilled flank steak with roasted vegetables over mesclun greens--with a little sprinkle of chopped nuts, and maybe some goat cheese.  But that was almost 2 years ago.

Last Saturday night Joyce and Ron whipped up an "Arugula and Pear Salad with Maple Vinaigrette" in about 10 minutes.  It was fabulous, and I became an instant arugula fan. 

On Sunday I stopped at Trader Joe's and picked up 2 bags of organic arugula--where they had purchased theirs.  I brought an arugula salad to work on Monday, and made this one for dinner on Tuesday night.

Good-bye mesclun greens.  Hello arugula.  I always thought of it as a seasonal snooty fancy shmancy salad green.  But there it was at Trader Joe's, reasonably priced, organic, and looking beautiful. 

Now that I know it's in that super-healthy family of chicory greens it's got even more credibility.  Don't forget about the 3-new-to-me super foods I wrote about last week:  black raspberries, broccoli sprouts, & chicory-family greens!  Click here if you want a refresher.

Why Does Shari Lieberman, Ph.D., D.N.S, F.A.C.N. Have Arugula on Her Top Ten List of Favorite Foods?

• It's loaded with minerals and antioxidants
• It's a delicious cruciferous vegetable that helps to protect us against toxins like xenohormones--the hormone disruptors in pesticides, plastics, and pollution.
• It protects against cancer because its loaded with the anticarcinogenic indole-3-carbinol. (click here for: Sarkar, FH, Li, Y. "Harnessing the fruits of nature for the development of multi-targeted cancer therapeutics"  Cancer Treatment Reviews, 2009 Nov;35(7):597-607. Epub 2009 Aug 5---just one of many articles on the benefits of the indole-3-carbinols.

Why Does Jonny Bowden Ph.D., C.N.S. Have Arugula on His List of the 150 Healthiest Foods on Earth?

• For only 5 calories a cup you get a generous amount of eye-healthy carotenoids, like lutein and zeaxanthin, plus folate, and vitamin A.
• It's also loaded with calcium and Vitamin K--essential for building strong bones--and 1 cup of arugula has 62 mcg of vitamin K.  The recommended daily intake is: 90 mcg for women and 120 mcg for men.
• What's the calcium/vitamin K connection?  Vitamin K helps the body transport calcium and metabolize it into our bones.  Several studies (including the very large Nurses' Health Study) have found that high intake of Vitamin K (at least 110 mcg a day) boosts bone mineral density in postmenopausal women and reduces hip fractures by 30%.  Click here and here to read more.
• It has glucosinolates--the same cancer-fighter as found in broccoli sprouts--that neutralizes cancer cells, and also inhibits cancer cell growth.

Dr. Joel Fuhrman ranks arugula 11th on his ANDI Scale (aggregate nutrient density index)--right under greens like kale, watercress, Swiss Chard, and broccoli sprouts.

 

Super Fast Arugula Pear "Steak" Salad with Walnuts and Cranberries

You'll have this on the the table in less than 10 minutes!

Serving size: 1 salad 

Ingredients:

2 cups of arugula

1/3 thinly sliced pear

1 TBS. chopped walnuts or pecans

1 TBS. dried cranberries

9 slices of either Trader Joe's Beef-Less Strips (aka Gardein)  If you don't have a Trader Joe's nearby,  use Morningstar Farms "Beef" Meal-Starters found in your grocer's freezer.  Note: *TJ's Beef-Less Strips come in 3 serving packages.

A couple of shakes of Durkee Grill Creations Kansas City Style Steak Seasoning

I drizzled this on as salad dressing:

1 tsp. Olive Tap Blood Orange Fusion Olive Oil  click here 

2 tsp. Olive Tap Tangerine Balsamic Vinegar  click here

Directions:

Quickly brown 1 Package of Trader Joe's Beef-Less Strips in a frying pan.  Sprinkle strips with the Grill Creations Steak Seasoning.  One package of strips makes 3 servings. 

Rinse arugula.  Pile a dinner plate with the greens.  Top with the olive oil and flavored vinegar--or the dressing of your choice--see Joyce & Ron's Maple Vinaigrette below.

Top with the sliced pears.  Sprinkle on the chopped nuts & cranberries, and enjoy.

Save the left-over strips--one package contains enough for 3 salads.  Note:  Tal Ronnen uses these strips for a "Steak Sandwich" served on a ciabatta or focaccia square, layered with watercress, red pepper, sliced red onion, and horseradish mayo.

NOTE: Want to cut calories & fat?  1 TBS. of walnuts=4.8 g of fat/52 calories; 1 tsp. olive oil=4.6 g of fat/40 calories.   Cut 92 calories & 9.4 gr of fat when you leave them out!

Nutrition Facts Healthy Librarian's Arugula, Pear, "Steak" Salad wt Cranberries & Walnuts
Serving Size: 1 recipe
Amount Per Serving
Calories	345
Total Fat	11.5g
Saturated Fat	1.2g
Trans Fat	0g
Cholesterol	0mg
Sodium	346mg
Carbohydrate	37.9g
Dietary Fiber	5.4g
Sugars	26.5g
Protein	23.3g
Vitamin A 42% Vitamin C 26% Calcium    20% Iron 38%

What's in Trader Joe's Beef-Less Strips?

These are vegan, but, alas, not gluten free.  I don't like to use faux meats very often--but occasionally--why not?

Ingredients: water, vital wheat gluten, isolated soy protein, natural flavors, barley malt, expeller pressed canola oil, garlic powder, yeast extract, onion powder, organic evaporated cane juice, red bell pepper flakes, sea salt, citric acid, spices, pea protein, carrot fiber, organic beet root fiber, sunflower oil.

Nutritional info for 9 strips.  Calories: 120; Total Fat 2g;  Sat Fat & Trans Fat 0g; Cholesterol 0g; Sodium 310 mg; Total Carbs 5 g; Fiber 1g; Sugars 1g; Protein 20g.

Joyce & Ron's Arugula and Pear Salad with Maple Vinaigrette  (from Real Simple Magazine)

Serves 4

Hands-on Time: 20 minutes.  (they made the dressing ahead of time, and it took 10 minutes to assemble)
Total Time: 20 minutes

Ingredients
    •    1 tablespoon maple syrup
    •    1 teaspoon Dijon mustard
    •    1 tablespoon red wine vinegar
    •    1/4 teaspoon kosher salt
    •    1/8 teaspoon black pepper
    •    2 tablespoons extra-virgin olive oil  (consider lowering this amount to 4 tsp.)
    •    8 cups arugula leaves
    •    1  pear, unpeeled, thinly sliced
    •    1/2 cup (3 ounces) blue cheese, crumbled  (optional--leave out for the vegan version)

Directions

1. In a small bowl, whisk together the maple syrup, mustard, vinegar, salt, and pepper. Whisking constantly, slowly add the oil; set aside.
2. Arrange the arugula on individual plates and top with the pear and cheese. Drizzle with the vinaigrette.

Tip

For a warm salad, heat the vinaigrette in a small saucepan over medium heat for 1 minute, and substitute spinach for the arugula.

Nutritional Information
Calcium 185.47mg; Calories 183.58; Calories From Fat 65%; Carbohydrate 11.91g; Cholesterol 15.95mg; Fat 13.3g; Fiber 1.96g; Iron 0.88mg; Protein 5.83mg; Sat Sat Fat 4.92g; Sodium 410.06mg

NOTE: The higher fat and sat fat in this recipe is from the blue cheese and olive oil.

*Source of information about Shari Lieberman & Jonny Bowden:  The 150 Healthiest Foods on Earth.  by Jonny Bowden.  Gloucester, MA:  Fair Winds Press, 2007.

Will You Still Need Me, Will You Still Feed Me, When I'm 64? Take a Look at the Future Through the Statistics of the National Social Life, Health and Aging Project

Around Thanksgiving my husband turned 60.

Around New Year's I'll be joining him.

Back in 1967 when I first heard the Beatle's song, "When I'm 64" the thought of getting to that age seemed like a million years away.  And now I'm almost there.  Yikes!  How does that happen so quickly?

1970

2009

When I get older losing my hair, many years from now.

Will you still be sending me a valentine,
birthday greeting, bottle of wine?

Will you still need me,
Will you still feed me,
When I'm sixty-four?

Speaking of turning 60--check out Ben Schott's Op-Chart  (it's easier to read than my reproduction) in the December 14th New York Times. Pretty interesting statistics about what life looks like at age 57-85.

His chart data was collected by the University of Chicago's  National Social Life and Health Project.

Schott has done a fantastic job of summarizing much of the NSHAP data that was recently published in the Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, vol. 64, Suppl. 1, November, 2009.

According to the NSHAP: "The health of older adults is influenced by many factors. One of the least understood is the role that social support and personal relationships play in health and aging."

It certainly looks like the Beatles were right back in 1967 when they wrote, "We Get By With A Little Help From Our Friends".   If you doubt it, check out who lives the longest and happiest of lives, in:  "Longevity Lessons: It's Not Just Exercise & Diet - It's Friends, Empathy, Cooperation & A Laid-Back Attitude"

Who says it's got to be all downhill from here?

The Healthy Librarian's Top Picks for Healthy Holiday Gifts

This week I received a pre-holiday email from MD Anderson Cancer Center at the University of Texas.

It said:  "Share the Health: M.D. Anderson's Holiday Gift Guide - This holiday season, experts at M.D. Anderson encourage shoppers to purchase gifts that offer health benefits for recipients."

If you get receive this blog via email, click here to get to the web-version

It was a pretty good list:

1. Gym membership - they recommend 30 minutes a day to lower the chance of getting cancer
2. Active gear for kids - they say kids need 60 minutes a day of activity to lower their risk of getting cancer as adults
3. Dark chocolate - look for at least 65% cacao - and boxes with small serving sizes--all you need is 1 ounce a day to get a daily shot of delicious antioxidants
4. Green tea sampler - studies show that green tea antioxidants protect against cancer by stopping cancer cells from growing.
5. Fruit of the month club - tons of antioxidants and plant chemicals that help the body fight cancer.
6. Steamer - cook vegetables without oil or butter and eliminate extra fat and calories, and encourage the likelihood of getting 5-9 servings of fruit and vegetables a day.
7. Sun protective clothing - look for UPF clothing for an easy & reliable way to get sun protection that lasts through many washes - for runners, gardeners, or anyone who spends a lot of time outdoors

But I got to thinking.  I've got plenty of good gift suggestions to add to this list. 

Great gifts of health that I've received.  Great gifts of health that I've given to others.  Great gifts of health that I've bought for myself.  So here goes.

The Healthy Librarian's List of Favorite Healthy Holiday Gifts

In no particular order:

1. Vitamix 5200 - I've written about this so much, I'm even boring myself--but there is no denying that it's one of the best ways you can ensure that you eat 7-9 fruits & veggies a day.  We use it everyday to make green smoothies, to instantly blend vegetable soups, to make humus, fruit sorbet, or even Tal Ronnen's cashew cream.  Honestly, you can't compare its power to a blender's.  And clean-up is a breeze!  We've given Vitamixes to each of our kids for a 1-gift-fits-all Chanukah, Birthday, & Anniversary/Apartment-warming present.  It's a "BIG" gift--as in a $400-$450 gift!--but I can't think of any better "gift of health" for someone you love!  To read more, click here, here, here. Told you I can run off the mouth on this!
2. Exercise heart rate monitor - My husband gave me my first Polar F6 Heart Rate monitor 3 years ago.  Now they have a women's model that fits my skinny wrist better.  This is one of the best gifts I've ever gotten.  Honestly, I don't like to exercise without it.  It lets me know if I'm working hard enough--or too hard.  It keeps me in aerobic range, counts the calories I've burned, and keeps track of my weekly workouts.  It's just plain motivating, and you can set it up to reflect your age, weight, sex, and your exercise abilities.  Retail $119, but you can probably find it for $100.  Don't skimp--buy Polar.  To read more click here and here.
3. IPOD Nano - I love my 2 year old Nano, but the newest version rocks.  Not only can you download 8GB of music, audiobooks or podcasts, you can shoot and store 8 hours of beautiful video. If that weren't enough--it now has an FM radio that lets you pause it midway, and then return to listen to up to 15 minutes of what you missed.  How is a Nano a gift of health?  It makes solitary exercise fun and great music is motivating.  Not to mention that music can be used as medication--violins instead of Vicodin.  Check out this NPR story.  Click here.  (thanks for the tip, Les) Retail: $149, but they're cheaper at Costco.  Click here and here to learn more.
   
4. Calphalon One Infused Anodized 7-Quart Sauteuse with Lid - This is one of the best gifts I-never-knew-how-much-I-needed-it-until-I-got-it!  It's a beautiful 7 quart, 15" wide, 3" deep lidded pan that you can use on the stovetop, in the oven, or under the broiler.  It's perfect for dinner-sized stir-fries, sauteing vegetables, making any one pot veggie concoction, and it works for just about any dinner recipe I'm making.  My husband just made the best potato latkes, ever, in this pan. It's large enough to hold all the ingredients without spilling over the sides! And it's safe with metal utensils, too.  Cost is about $99.  Click here for more info.
5. Hot-Air Popcorn Popper - This is so 70's, but I recently bought one for $20 (with a coupon) at Bed, Bath, & Beyond.  It has completely satisfied our need for a salty crunchy evening snack.  Thanks go to my husband, who has perfected a "genius" method of adding flavor to this fat-free snack.  Here's the deal: Use a giant bowl with a lid, and as the popcorn starts filling the bowl, spray it with about 4 or 5 sprays of olive or canola oil.  When finished give a few good shakes of popcorn salt--which is super-fine & sticks to the popcorn.  Cover the bowl, and give it a good shake.  You eliminate all the chemicals found in microwave popcorn--and it's done in 1/2 the time.  We pop 1/2 cup of kernels at a time--but I'm thinking that 1/4 cup would probably work better if your bowl isn't gigundo!  Click here for more info.
6. Phillips Sonicare Flexcare 2 Handle Toothbrush All-in-one Sanitizing Charging and Storing Unit - OK, I admit it, who wants to get a toothbrush for a gift?  But, once you use this toothbrush, you'll understand its value in keeping your teeth--and more importantly--your gums in tip-top shape.  There is no way can you manually brush your teeth as well or as long as the oscillating Sonicare can.  Set it to Max mode, and it goes for 3 very long minutes.  The best part: it comes with a built-in ultra-violet light sanitizer that kills up to 99% of E. Coli & streptococcus Mutans, not to mention assorted cold viruses.  If you store your toothbrush in the bathroom--and your toilet lid is up--a closed sanitizer is a plus! It also includes a handy travel charger & case--perfect for when you leave town.  Geeky, yes!  But it's healthy.  I'm getting all A's on my dental report card since using the Sonicare.  Cost is about $140 with a Bed, Bath, and Beyond coupon.  Click here for more info.
7. Olive Tap Flavored Vinegars - This Chicago-based company makes fabulous specialty flavored olive oils and vinegars.  Since I try hard to cut back on oil, I'm recommending their vinegars.  I discovered this company at my hospital's weekly Farmer's Market.  Their booth seems to have the longest line.  What do you do with flavored vinegars?  They are fantastic on salads, pasta, or vegetable dishes with their deep & rich taste.  They are thick and not acidy tasting.  A sample of their 22 flavors: Sicilian Lemon Balsamic, Tangerine Balsamic, Cinnamon Pear Balsamic.   Add a dash of one of their flavored olive oils, too.  Cost: $14.50 a bottle.  click here for all 22 specialty vinegars.
8. Gourmet Cocoa Powders for Hot Chocolate - Cocoa is loaded with healthy flavanoids that will lower inflammation, blood pressure, and improve arterial function--with the added plus that it's fat-free. My all-time favorites are: Scharffen Berger Natural Cocoa Powder (click here) and Ghiradelli Chocolate All Natural Unsweetened Cocoa Click here)  Both cocoas are made without alkaki--meaning they are non-dutched--which is a good thing--because it preserves the phytochemicals.  Hot Chocolate is great evening snack, and if you don't want cow's milk, make it with soy, hazelnut, or almond milk.  Cost: $5.95-$9.95
   
9. Games for your brain, and for belly laughs.  Bananagrams.  I learned about this game from my daughter-in-law who's a word game maven.  This one won the TOTY 2009 Best Game award.  It's a fast and fun word game, that will get you thinking in new ways--and it exercises your brain.  It's actually recommended for use as a brain workout. Kids love it.  Adults love it.  As far as I'm concerned, it beats Scrabble hands down. Cost: about $15.00   Click here to learn more.  Last Word.  This is a fast fun easy-to-learn game, that works as well for 2 players as it does for 8.  I've played it with just my husband.  I've played it with a group--and we had a blast!  It's a word game that's not intimidating--or will make anyone feel left out.  Anyone can win--because when the random timer goes off--whoever said the "Last Word" wins.  Even the usual non-game players in my family enjoyed this one.  Cost:  about $20.00. Click here to learn more.
10. My Favorite Vegan/Vegetarian Cookbooks

• The Conscious Cook:  Delicious MEATLESS recipes that will CHANGE the WAY you EAT. by Tal Ronnen. So far everything I've made from this cookbook has been delicious.  But, definitely cut the fat in half! "The Conscious Cook shows readers that avoiding the health risks and ethical dilemmas of eating meat and dairy does not mean sacrificing taste and appetite. This is not a cookbook of sprouts and tofu burgers, but of mouth-watering, hearty meals that keep the protein at the center of your plate."  Read my review here.

• Clean Food:  A Seasonal Guide to Eating Close to the Source.  With more than 200 recipes for a healthy and sustainable you. by Terry Walters.  From NPR's Top 10 Cookbooks for 2009:  "Recent years have seen more and more vegan cookbooks hitting the mainstream, and this one bristles with crossover charisma. Sure, there are a few ingredients your average omnivore will never buy — the ume plum vinegar, the agar powder, to name two — but in a year when there was no other significant vegetable book, Clean Food excels: You could call it a graduate course in meatlessness."   Arranged by season, focusing on what's available seasonally--This winter I'm ready to try Spicy Coconut Pumpkin Soup and Goodness Soup--a pumped-up version of mushroom barley soup with hulled barley, lentils & beans. Lots of new-to-me background information on the healthiest of ingredients, and the best ways to cook beans and grains.  Walters explains why grains can be difficult to digest--and how to fix that problem by soaking them and cooking them with a little kombu--a sea vegetable.
  

• Raw: the UNcook Book.  New Vegetarian Food for Life.  I recently received this book as a gift and it's unlike any cookbook I have--of course--it's raw!  Juliano has a famous San Francisco restaurant--and having recently sampled some raw dishes, I'm ready to give it a whirl.  It's definitely going to be a cooking adventure.  Juliano is a big fan of sprouting seeds for their superior nutritional value (and after writing about broccoli sprouts--I'm ready to give it a try),  and dehydrating food.  Not to worry--a low oven (150 degrees) can substitute for a dehydrator. Those who have tried his recipes are raving.  Read more here.

• Any Jeanne Lemlin cookbook.  Lemlin's books are my go-to source for never-fail-always-delicious soups, salads, and main dishes.  They're vegetarian, so if you are eating vegan, just substitute ingredients.  My favorites are: Simple Vegetarian Pleasures.  Quick Vegetarian Pleasures.  Vegetarian Classics.  They are all still in print.  Click here to read more

   11.  Slow-cooker/crockpot - This is my new favorite appliance for healthy food prep. It's fantastic for making overnight rib-sticking-healthy steel cut oatmeal.   Mix up the ingredients before you go to sleep, and wake up to a kitchen filled with the cinnamon nutmeg scent of delicious oatmeal.  You can make enough for 2-6 servings, and refrigerate the rest for easy-peasy-just-take-it-to-work-and-heat-it-up-oatmeal.  And don't forget that crockpots make it so easy to cook your own beans, soups, and chilis. No more worries about BPA-lined cans.  Cost: About $15.00 for a 3 quart cooker.  Click here for my recipe for overnight fruited steel-cut oatmeal.  Click here for the BPA in cans report.

  12. A book or CD about meditation - I asked my husband what he would add to the list and he said, "Definitely a book or CD to learn meditation."  Want something easy, straightforward, and non-sectarian?  Try The 8 Minute Meditation: Quiet Your Mind--Change Your Life.  by Victor Davich.  for info on the book or guided meditation CD click here.

I know you all have some great suggestions to add to the list.  Please let me know what would be on your favorite healthy gift list!

Dr. Bruce Hollis' NIH Vitamin D in Pregnancy Study is Now Complete. High Dose Vitamin D (4000 IUs) Significantly Improved Health & Outcomes for Moms and Babies. And Harvard Researchers' Theory of a Vitamin D - Autism Connection.

"I'm telling every pregnant mother I see to to take 4000 IUs and every nursing mother to take 6,400 IUs of Vitamin D. 

I think it is medical malpractice for obstetricians not to know what the Vitamin D level of their patients is.  This study will put them on notice."

-Dr. Bruce W. Hollis, Professor of Pediatrics and Biochemistry and Molecular Biology, Director of Pediatric Nutritional Sciences at the Medical University of South Carolina in Charleston, SC-

If you are pregnant, planning to become pregnant, or know someone who is pregnant--do them a huge favor and pass this information on to them!

OK, I admit it.  I'm a wild and crazy cheerleader for Vitamin D.  Anyone who is paying attention knows that unless you are regular sunbather (and who is?), or you're religiously taking a Vitamin D supplement of at least 2000 IUs a day, you are probably woefully deficient in this important hormone--that we all think of as a vitamin.

Why does Vitamin D have such an important influence on our health? 

Since the Human Genome Project, we now know that Vitamin D is responsible for regulating over 10% of our genes.  It's not just responsible for skeletal health--but cells throughout the entire body are dependent on Vitamin D in order to work properly.

Which is exactly why Dr. Bruce Hollis decided back in 2000 to figure out how much Vitamin D pregnant women and babies optimally need!  When it comes to a developing fetus, and a fast growing infant--there is no more important time to make sure that all our cells and systems are getting exactly what they need to work & develop properly.

I'm talking  about brain function, nerve function, immune function, skeletal function--all dependent on adequate supplies of Vitamin D--including its important role in preventing 14 types of cancer, heart disease, autoimmune disease, diabetes, inflammation/inflammatory diseases, infection, and osteoporosis. Yep, I'm a Vitamin D cheerleader!

Pregnancy and breastfeeding is a unique time in development when getting enough Vitamin D has a direct impact on both the mother and baby's bone health, cardiovascular health, immune function and glucose metabolism. 

Research continues to mount about its important role in brain development and in preventing brain disorders.

Recent theories (Harvard scientists publishing in Jan. 2010 in Medical Hypotheses) speculate that Vitamin D deficiency might be linked to autism--and adequate supplementation might have a role in preventing it.

Target tissues for Vitamin D--Curr Opin Clin Nutr Metab Care 10:12-19, 2007

 

So, when I heard about the exciting results of Dr. Hollis' just completed NIH Study on the Evaluation of Vitamin D Requirements During Pregnancy, I couldn't wait to blog about it.

Drs. Bruce W. Hollis and Carol Wagner just presented their study results at the 14th International Workshop on Vitamin D, in Bruges, Belgium--and I'm doing my part to get the word out. 

It will probably take years before the academic pediatric and obstetric associations modify their recommendations to reflect the study's high level of supplementation.  In fact, before beginning this study, Dr. Hollis had to first get FDA approval in order to use 4000 IUs of Vitamin D as an "investigational drug".  In November Hollis sent his findings to the pediatric academic associations--so we'll have to wait & see if their Vitamin D guidelines are changed as a result.

Just so you know--Dr. Hollis is one of the world's leading authorities on Vitamin D--with a keen interest in making sure pregnant woman and infants get a "full supply" of this critical vitamin.

Here's What You Need to Know About Hollis'  Vitamin D in Pregnancy Study

• 600 pregnancy women were enrolled from January 2004-December 2008--including African Americans, Hispanics, and whites.  Because dark pigmented skin prevents adequate absorption of Vitamin D from sunlight--it was important to include multiple races in this study.  For the details of the study proposal click here.
• Vitamin D supplementation began at 12 weeks and continued until the end of the pregnancy.  The control group took the usual standard recommendation of 400 IUs; one group took 2000 IUs of Vitamin  D; one group took 4000 IUs of Vitamin D--which is 10 times the recommended amount.

How Did Increased Vitamin D Benefit the Moms & Babies?

• Women taking the 4000 IUs increased their vitamin D level by about 50%--to a normal level of 40 ng/mL.
  
• Premature births and premature labor were reduced by 50% at both 32 and 37 weeks in those taking the highest levels.
• Fewer babies were born "small for dates"--which means smaller than expected for the time spent in the womb.  This is a little-known pregnancy complication of taking inadequate amounts of vitamin D.
• Women in the 2000 & 4000 IU groups reduced their number of infections throughout pregnancy by 50%: including respiratory infections, like colds and flu, as well as fewer vaginal and periodontal (gum) infections.
• The common complications of pregnancy like gestational diabetes, increased blood pressure, and pre-eclampsia were reduced by 30%.
  
• The babies born to moms getting the highest vitamin D levels had fewer colds and less eczema.

The Infection Connection and Vitamin D

• The 50% drop in maternal infections for moms receiving 4000 IUs of Vitamin D did not surprise Hollis at all.  Vitamin D is in charge of firing up our "Rapid Response" immune function.  When we get enough Vitamin D--it works optimally--quickly nipping infections in the bud.

• According to Dr. Michael Holick, moms who got adequate Vitamin D during pregnancy reduced the risk of wheezing disorders in their children by 61%.

Dr. Michael Holick's Two Cents on the Benefits of Vitamin D During Pregnancy

• Vitamin-D deficient infants will never attain their genetically preprogrammed bone density or height.  That's one scary thought!
• A Boston study looked at 40 mother-infant pairs--the moms took the recommended 400 IU/day Vitamin D in their prenatal vitamin and drank 2.3 glasses of milk a day--at birth, 76% of moms were Vitamin D deficient--81% of newborns were deficient.  Exactly what Dr. Hollis found out in his study.
• Higher Vitamin D levels decreased the likelihood of preeclampsia, and reduced the need for C-sections.  Exactly what Dr. Hollis found out in his study.
• Breast-feeding moms need to be vigilant that their babies are getting enough Vitamin D.  The breast milk of moms who are not getting enough Vitamin D has a paltry 25 IUs of Vitamin D per liter (1 quart, 2 ounces).  Not even close to the 400 IUs their babies need.  It would take 4000-6400 IUs/a day for a breast-feeding mom to get enough Vitamin D into her breast milk to meet the baby's requirement of 400 IUs a day.  But according to Holick, until more studies are done, "it's not something we're recommending."  Hopefully, we'll be able to in the near future."  In the meantime--breast-feeding moms need to make sure their babies are getting 400 IUs/a day of a Vitamin D supplement.

Drs. Bruce Hollis & Carol Wagner on the Importance of 6400 IUs of Vitamin for Breastfeeding

• Infants exclusively breastfed, without sun exposure or supplementation have an increased risk of developing Vitamin D deficiency, unless their moms have more than adequate supplies of Vitamin D.
• Darkly pigmented infants--living in Northern latitudes--are more at risk because dark skin only absorbs 50% of the sun's Vitamin D.
• Recent studies show that in order for the Vitamin D in a mom's milk to reach adequate levels--mom's need to supplement to a level of 4000-6400 IUs of Vitamin D.
• Drs. Hollis & Wagner are currently conducting a NIH trial on the effect of High Vitamin D on breastfeeding moms & their babies.  The results of their pilot trials were shocking.  Only the infants whose mothers supplemented at the highest level--6400 IUs--had Vitamin D levels equivalent to those of infants who received 300 IUs/day of Vitamin D drops.
• Hollis & Wagner strongly advocate for moms to supplement at high levels, rather than relying on infant supplement drops.  Why?  Because it is the only way to insure that both the mother & baby are adequately supplied. 
• The Current Catch-22 Situation:  Until the large studies on high-dose Vitamin D for breastfeeding are completed, no one can officially recommend high-dose Vitamin D for breastfeeding moms.  Which means, in the meantime--infant supplementation is in order.  American Academy of Pediatrics now recommends 400 IUs for infants.
• Gold standard:  pregnant & nursing moms need to get an inexpensive 25-hydroxy-Vitamin D level test to see just how adequate their Vitamin D supply is.  It's the only way to know!
• To read an excellent review of scope of Vitamin D in pregnancy & lactation, click here. Breastfeeding Medicine 3(4):239-50, Dec. 2008. Wagner, CE, Taylor, SE, Hollis, BW. "Does Vitamin D Make the World Go 'Round'?"

The Recent Vitamin D-Autism Connection Theory

Remember, this is all theory right now.  But the theory recently came to my attention through a forthcoming paper in Medical Hypotheses 74:102-106, January 2010, "Environmental risk factors for autism: Do they help cause de novo genetic mutations that contribute to the disorder?", by Dennis Kinney, et al. 

When five Harvard researchers publish a hypothesis--it's worth reading.  And they are not the first to speculate about this connection. 

For an easy-to-understand version of this theory, click here to read:  "What If Vitamin D Deficiency Is A Cause of Autism?  A few researchers are turning their attention to the sunshine vitamin as a culprit, prompted by the experience of immigrants that have moved from their equatorial country to two northern latitude locations.  Scientific American News.  April 24, 2009.

In a nutshell here's how the dots are being connected with Vitamin D & autism:

• A number of De Novo (meaning, "new" not copied from the parents) genetic mutations are risk factors for autism.
• The Harvard researchers theorize that environmental & urban chemicals like mercury, cadmium, nickel, trichloroethylene, and vinyl chloride might trigger the genetic mutations responsible for autism. It turns out that children from areas exposed to higher levels of these contaminants have significantly higher rates of autism than children living in areas of low exposure.
• Vitamin D plays a tremendous role in repairing DNA damage--and protecting against oxidative stress--which is a key cause of DNA damage.
• Vitamin D deficiency can lead to higher rates of mutation and impaired DNA repair--conversely, adequate Vitamin D appears to prevent DNA mutations.
• Here's the vitamin D connection: Higher rates of autism exist in areas where there is less sun, in areas of higher precipitation (lots of rain)--where people spend more time indoors, and where Vitamin deficiency is highest.
• The Centers for Disease Control found higher rates of autism for children living in northern latitudes (less sun) compared to those living in southern states.
• Recent reports surfaced about the high incidence of autism found in the children of new Somali immigrants (dark-skinned Africans) who moved to northern latitude cities in Minnesota and Sweden.  In Minnesota, these rates are 2 to 7 times greater than the rates for non-Somalis.
• Autism was unheard of in these families when they lived in Africa--and only surfaced after moving to Minnesota and Sweden.  Dark skin makes Vitamin D absorption extremely difficult at northern latitudes--added to which many of these Somalis are Muslim, and the women are wearing burkas.
• The Harvard researchers cite the work of Cannell, Chatterjee, and Bao that demonstrates how adequate Vitamin D has the ability not only to prevent genetic damage, but to repair damage that has occurred.
• They recommend that we begin controlled clinical trials  of Vitamin D supplementation for adults living in areas where Vitamin D deficiency is prevalent (U.S. & northern Europe)--who are planning to conceive children in a few years.  In other words--if you are considering having a baby any time soon--prevent potential problems now--start supplementing with Vitamin D.
• For another perspective on the Vitamin D/autism connection, read Dr. John Cannell's (one of the originators of the theory) review of the Medical Hypotheses article.  Click here. 

Coming Next Week:

More on what Dr. Bruce Hollis has to say about the importance of Vitamin D for adults--how it affects autoimmune diseases like rheumatoid arthritis, multiple sclerosis, cancer, bone pain and heart disease.

In the meantime, how much vitamin D does Dr. Hollis take?  He's an international expert on Vitamin D who lives in sunny Charleston, SC.

4000 IUs a day.  This consistently gets his blood levels up to around 60 ng/mL. After years of study he has never seen any adverse effects with higher doses of Vitamin D, as long as the level does not exceed 10,000 IUs/day. 

He strongly believes that sufficient levels of Vitamin D are what we would naturally have if we could be fully sun-exposed--and he's found this level to fall somewhere between 50 ng/mL to 70 or 80 ng/mL.   Current recommendations now put the normal level anywhere over 30 ng/mL.  Do yourself a favor and get your vitamin D level tested.

My past posts on Vitamin D:

Everything You Ever Wanted to Know About Vitamin D from the Expert, Dr. Michael Holick. How Much Do We Need? Why Is It So Hard to Get Enough? What About Breast-Fed Babies? Why Is It So Important for Good Health?

Why is Vitamin D my favorite? Let me count the reasons.

Caroline Adams Miller's Ten Non-Negotiable Pearls to a Life Well-Lived - Successful Balanced Happy. And the Possible Dementia Vitamin D Connection

Straight from the Experts at Ohio State University, Johns Hopkins University, & Canyon Ranch: Three "New-to-Me" Super Foods: Black Raspberries, Broccoli Sprouts, & Chicory-Family Leafy Greens

Super Food: Black Raspberries

(if you receive this post via email--click here to get to the web version)

"First, berries (black raspberries in particular) are an easy way to consume a concentrated source of vitamins, minerals, fiber, and hundreds of other cancer-fighting phytochemicals."

"Second, they are anti-inflammatory, anti-proliferative, anti-metastatic, anti-angiogenic, and they are anti-oxidants.   We're talking about preventing tumor formation and progression on a microscopic level."

-Christine L. Sardo, MPH, RD, Canyon Ranch Institute, and former manager the Cancer Chemoprevention Clinical Trials at The Ohio State University Comprehensive Cancer Center in Columbus, Ohio

Super Food:  Broccoli Sprouts

"We identified a food that, if eaten regularly, might potentially have an effect on the cause of a lot of gastric problems and perhaps even ultimately help prevent stomach cancer."

"Broccoli sprouts have a much higher concentration of sulforaphane than mature heads [broccoli]."

"We know that a dose of a couple ounces a day of broccoli sprouts is enough to elevate the body's protective enzymes. That is the mechanism by which we think a lot of the chemoprotective effects are occurring."

"We knew [sulforaphane] knocked the heck out of the bacteria in the test tube, but now we've shown in this pilot clinical study that it works on infected humans too."

Jed Fahey, nutritional biochemist in the Lewis B. and Dorothy Cullman Cancer Chemoprotection Center at the Johns Hopkins University School of Medicine, Cancer Prevention Research, April 2009

Super Food: The Chicory Greens 

The Latin name for dandelion--Taraxacum officinale--"loosely translated, means, "official remedy for the disorders".

Dandelions rank in the top four green vegetables in overall nutritional value.  Which may be the reason for its reputed cancer prevention abilities.

Dandelions are nature's richest green-vegetable source of beta-carotene, with high concentrations of lutein, and the third richest source of vitamin A of all foods.

--adapted from Jonny Bowden's "The 150 Healthiest Foods on Earth"--

Bags of frozen black raspberries.  Boxes of Brocco Sprouts.  A bunch of dandelion greens.  A bag of escarole.  Yep, those are the new everyday additions to my refrigerator!

Here's why:

About three weeks ago I spent about 3 1/2 hours at a Barnes & Noble Starbucks soaking in everything that my friend Cheri had learned from her 5 day visit to the Canyon Ranch health and wellness spa in Arizona. 

She was there for Livestrong week, which was co-sponsored by the Lance Armstrong Foundation, and the entire week was devoted to diet, exercise, lifestyle changes that can prevent or modify cancer.

It was one of those life-changing-mind-altering-diet-and-habit-changing weeks for Cheri, and I was thrilled that she shared so much of what she learned from her 5 day adventure.

She met and talked to the top preventive medicine experts in the country, including Dr. Richard Carmona, the 17th U.S. Surgeon General, Christine Sardo, a nutrition expert in cancer chemoprevention, and Dr. Andrew Weil.

There's just way too much to share in one post, but I wanted to quickly pass on the 3 new super foods I've now added to my fridge as a result of our morning talk.

Black Raspberries

All the black raspberry research is coming out of Ohio State University, and it's lead by Dr. Gary Stoner--who is the man who discovered that ellagic acid inhibited tumor growth.  For a list of Dr. Stoner's articles on black raspberries, click here.

Turns out that black raspberries have been successful in preventing both oral, colon, mammary & esophageal cancers in Stoner's lab rats. 

Right now, the human trials are underway, and Stoner's enrollees are slurping down black raspberry smoothies or sucking on black raspberry lozenges--hoping to prevent cancer in patients with pre-cancerous or early stage lesions of the esophagus, mouth, and colon. 

Early studies show that the berries slow tumor growth, and reduce cancer risk significantly.

Here's the black raspberry advantage:

• They are the richest source of ellagic acid: an effective anti-tumor agent. It's found mostly in the seeds of the berry & to a lesser degree in the pulp.  Forget about the juice!
• They have the highest anti-oxidant activity of any other berry--loaded with hundreds of highly active phytochemicals, like carotenoids & polyphenols, that work synergistically.
• They are high in anthocyanins, potent anti-oxidants and anti-inflammatories--and this is what gives the berries their dark purple color.
• Berries just might be the natural counterpart to synthetic drugs like Tamoxifen
• For the amateur gardeners out there:  the Jewel variety of black raspberries has the highest levels of ellagic acid & anthocyanin--and that's what Stoner uses in his lab.  By the way--Stoner's berries came from the Stokes Berry farm in Wilmington, Ohio--grown on a 1 acre plot.

How much do you need to eat?

• Dr. Stoner's patients are given 2 ounces of freeze-dried black raspberries  daily, the equivalent of about a pound of berries a day. 

• Christine Sardo recommends 2 cups of whole berries, eaten 3 or more times times per week to take full advantage of black raspberries health benefits.  That's the human equivalent of the amount found to be beneficial in lab rats.

• I've been enjoying the berries in my daily green smoothie, or as an evening snack.  You will definitely notice the seeds in this berry!

Where can I get black raspberries?

• Whole fresh berries are hard to find, available only 1-2 months out of the year, and they rot quickly.

• I found 12 ounce packages of frozen black raspberries at Trader Joe's for $1.99 a package--which contains 2.5 cups of berries.  I couldn't find freeze-dried berries anywhere, but I didn't look online.

• Fiber content:  7 grams;  Calories for 1 cup:  80;   Vitamin C for 1 cup:   60% of daily requirements.

• Can't find black raspberries?  Don't worry, strawberries and blackberries work as well in chemoprevention.  Unfortunately, blueberries aren't a worthy substitute.

Broccoli Sprouts

What's so great about broccoli sprouts?

• Discovered by Johns Hopkins scientists back in 1997-- three-day old broccoli sprouts have 20-50 times the chemoprotective compounds of mature broccoli.  To read more click here.
  
• Sulforaphaneglucosinolate (SGS) is the magical ingredient in broccoli sprouts, and numerous studies have shown it to neutralize cancer-causing chemicals before they can promote cancer.  Johns Hopkins scientists identified this chemical in 1992.
  
• Reduces exposure to cancer-causing chemicals in tobacco, environmental carcinogens, & harmful chemicals from food.
• Increases the body's defense system against carcinogens--neutralizing cancer-causing chemicals, and free radicals before they can cause damage to the body.
• Animal studies have shown SGS to block tumor development in breast cancer, prostate cancer, and bladder cancer.  Recently, SGS has been shown to reduce arterial inflammation. Human studies are ongoing and have shown to be effective in arresting H. pylori (the bacteria responsible for stomach ulcers), gastritis, asthma, chronic obstructive pulmonary disease, and preventing UV skin damage.  For a list of studies click here.

Are raw sprouts safe to eat?

• Not to worry.  Buy only the brand Brocco Sprouts brand that's produced by Brassica Protection Products LLC--created, patented, and licensed by the Johns Hopkins University School of Medicine.  They ensure that the sprouts have the highest levels of SGS, and they follow the highest safety practices.  To read more click here.

How do the sprouts taste?  Where can you find them?  How much do they cost?

• The taste is mild.  My Thanksgiving visitors loved them on sandwiches.  My friend Cheri puts them on salads.
• I found them at Whole Foods where they sell pre-packaged salad greens.  Check your grocery store.  Only trust the Brocco Sprouts variety, with the Johns Hopkins University Seal!
• These are not cheap--around $4.99 for a 4 ounce box, which contains 4 servings--the amount recommend by the Johns Hopkins researchers.

For the original Johns Hopkins Broccoli Sprouts story on video, click here if you can't see the video:

The Chicory-Family of Greens

What's the deal with chicory greens?

• The dietitians at Canyon Ranch rave about, and recommend eating salad greens from the chicory family.  That means:  arugula, dandelion greens, radicchio, escarole, chicory (if you can find it) and endive.
• They're high in vitamin C, folate, and calcium.  Leafy chicory--if you can find it--has the highest nutritional content of them all--with dandelion greens coming in a close second.
• According to Dr. Jonny Bowden (author of 150 Healthiest Foods on Earth), dandelion greens contain taraxacin, which benefits the digestive system, and aids the liver--think clearing out toxins. 
  
• One cup of cooked dandelion greens contain  147 mg of calcium, 244 mg of blood-pressure-lowering potassium, 203 mg of bone-building vitamin K, 3 grams of fiber, 10,000 IU of vitamin A, and about 5,000 mcg of lutein & zeaxanthin--which protect against macular degeneration.
• According to Canyon Ranch's Christine Sardo, in 1 cup of cooked greens in the chicory family you'll get over 600% of your daily vitamin K, over 150% of your daily vitamin A, and 65% of your daily vitamin C--plus a host of anti-oxidants that are essential for cancer prevention.  Plus their high folate content protects against colorectal polyps and colorectal cancer.
  

My Favorite Dandelion Greens Recipes

• I LOVE this easy-to-make, nutritional powerhouse of a soup.  And I'm making it tomorrow when my sister comes to visit!  Provencal Greens Soup, from Martha Rose Shulman.

• This winner comes from sister-in-law, who is a fantastic cook:  Rachel Ray's Dandelion Greens Gumbo with Good Thyme Rice.  Cut the oil way back, & use brown rice!

My Question to All of You:
Would you have preferred a much shorter post with just a brief mention of my new 3 favorite super foods--without all this detail?   It certainly would have taken me a lot less time to write!

I really want your feedback on this!

Drug Safety and Drug Benefits--The FDA Information That Never Reaches Doctors & the Public. Dr. Lisa Schwartz & Dr. Steve Woloshin Discover the Data That Gets Lost in Transmission

'

Dartmouth Medical School Professors & consumer watchdogs, Dr. Lisa Schwartz & Dr. Steve Woloshin

"FDA approval does not mean that a drug works well.  It means only that the agency deemed its benefits to outweigh its harms."

"Much critical information that the FDA has at the time of approval may fail to make its way into the drug label and relevant journal articles."

--Drs. Woloshin & Schwartz, "Lost in Transmission--the FDA Drug Information That Never Reaches Clinicians"   New England Journal of Medicine 361(18):1717, Oct. 29, 2009--

"To market a medication, all you have to do is prove that it's better, on average, than a sugar pill.  A drug that works 20% of the time, for instance, may be considered effective--even though it does nothing for 80% of patients."

--Mark Gibson, deputy director of the Center for Evidence-Based Policy at Oregon Health & Sciences University--

Call me naive.  I just assumed that when I took a prescription drug it was going to do the job it was approved to do--at least 80% of the time.  I didn't know that FDA approval sometimes only means the benefits outweigh the harms.

Call me naive.  I just assumed that my doctors clearly knew the effectiveness of the drugs they were prescribing.  I didn't know that sometimes critical information on harmful effects, and a drug's effectiveness might never be communicated to doctors.

I definitely had a lot to learn.  After reading Dr. Steve Woloshin's and Dr. Lisa M. Schwartz's article, "Lost in Transmission--FDA Drug Information that Never Reaches Clinicians" (NEJM 361(18):1717, Oct. 29, 2009) I will never take a drug's effectiveness and safety profile for granted again.  Click here for the article.

Schwartz & Woloshin argue that the FDA needs to communicate clear-easy-to-understand drug information on every prescription label:

• How effective was the drug in research trials?  Let's see the statistics.
• What are the harms of this drug?  What are the benefits?
• What were the concerns of the experts who reviewed the drug?  Let's see them.
• They want the FDA to write the drug labels and include complete information.  Currently, the labels are written by the drug companies--and critical information is sometimes left out--as you'll see below.
• The drug companies have a vested interest in their products--they shouldn't be writing the labels.
• Schwartz & Woloshin want the FDA to provide a standardized Prescription Drug Facts Box on every drug label--with a data table of benefits and harms.
  

How Did Drs. Schwartz & Woloshin Discover "Missing Information" on Drug Labels?

This super watchdog duo, who teach at The Dartmouth Institute for Health Policy and Clinical Practice, scoured the FDA's extensive drug reviews for three particular drugs in order to figure out what important information never made its way to the drug label, and into physicians' hands:

• Lunesta--the sleeping drug approved for chronic insomnia--the floating moth ads
• Rozerem--the sleeping drug approved for chronic insomnia--the weird Abraham Lincoln ads
• Zometa--a drug prescribed for abnormal calcium in the blood of some cancer patients

Hidden away in lengthy review documents--that can be anywhere from 80-400 pages long--is all the information that expert FDA reviewers compile about each drug during the lengthy evaluation process.

In these documents you can find all the statistics on how well the drug actually works--what are the risks & side effects--as well as what concerns the reviewers have about approving this drug.

But, remember, as long as a drug's benefits outweigh its risks, it can get approved.

Once it's approved, the pharmaceutical industry writes the labels, although the FDA can negotiate & approve the label. 

The Problem:  the drug label often omits critical information that never makes its way into journal articles, or into the hands of clinicians. 

It could be because the drug industry can decide what it "wants" to go into the label.  They want the drug to sell, after all.

1. It can leave out how well the drug did in trials against a placebo or another drug.

2. It can leave out certain mortality & risk data.

3. It can leave out the concerns or skepticism of the FDA expert reviewers.

Lunesta FDA Report Data That Do Not Appear in the Label

Lunesta sales reached $800 million last year, and there is no way for doctors, let alone patients, to know that this drug only helps you fall asleep 15 minutes faster, or sleep 37 minutes longer, than you would with a placebo. 

There's no way to know that patients had no improvement in next-day alertness or functioning.

Would you be willing to risk side effects, no matter how minor, or pay for a prescription with this level of effectiveness?

Currently, there's no way for doctors to know from looking at the label which drugs the reviewers endorsed enthusiastically, and which ones they were skeptical about.  Isn't it possible that because the drug industry is writing the labels, certain negative information might be left out of the labeling?

Rozerem FDA Report Data That Do Not Appear in the Label

Rozerem ads are all over the TV & print media.  With an Abe Lincoln-type character in its ads, could there be a little Honest Abe subliminal messaging here?

Nowhere on the label is there information about how well Rozerem works.  No wonder they left it out.  For young adults, it helped you to fall asleep 14 minutes faster.  Older adults fell asleep 7 minutes faster.  This information would not be helpful to sales.

There were no subjective improvements in sleep time, sleep quality--nor did patients even feel like they fell asleep faster.  No improvement in falling back asleep, number of awakenings, total sleep time, or sleep quality.

No one even noticed any benefits in two phase-3 outpatient trials.

And it gets worse.  The medical review team leader said the team struggled about whether or not to approve this drug--whether it had any benefit at all.  There were also several safety concerns because of side effects. 

Nowhere on the label are the drug's lack of effectiveness, nor the reviewers' concerns communicated.

How Can You Access the FDA's Medical Reviews on Approved Drugs?

 1.  Go to Drugs@FDA.  Click here.

 2.  Search for the drug you are interested in.

 3.  Select the correct drug.

 4.  Click on Approval History

 5.  Click on Review

 6.  Click on Medical Review.  Then you'll get read the lengthy PDF with all the information from the expert reviewers.

Does the FDA Plan to Fix This Serious Truth-in-Labeling Problem?

• Sort of
• The FDA has recognized this labeling problem, and in 2006 it added a "highlights" section that emphasizes the drug's indications and warnings.
• The FDA has strongly "encouraged" the drug industry to include information on how effective the drug was in clinical trials--but the labels for Lunesta & Rozerem haven't changed.
• The FDA's Risk Advisory Committee has recommended adoption of clear "Prescription Drug Facts Boxes" that include a data table of benefits and harms.
• The FDA is now deciding whether or not to use these boxes--and if they should go on drug labels.

Thanks to Schwartz & Woloshin my eyes are now wide open when it comes to realizing how little we know about the actual benefits & risks of the prescription drugs we take.  Next time I get a prescription (hopefully, that won't be anytime soon) I'm going straight to the FDA Medical Review document, and get the real scoop on what exactly I'm about to take.