Wise Geek

So it has been a year.  And quite a year it has.

When I first started this blog I was a bright-eyed (yet lowly) dietetic intern.  Working for peanuts (maybe we ought to start working for walnuts) to get my license. 

I have my license now.

Way oh-way-back a' then I was interested in pursuing human nutrition from an alternative angle.  Mostly because I was bored silly.  Everything I learned in school was too cut-and-dry.  So I started questioning the very statements which my own licensing association held holy.  I believe it is the nature of my curiosity which keeps me involved in dietetics today.

Being a RD isn't all that easy.  Because at some point you have to stop regurgitating recommendations from textbooks and start thinking all on your own.  Mostly and more importantly, what's better for your patients?

Flux.  The field of medicine and nutrition is in constant flux.  Albumin is old news.  Pre-albumin + c-reactive protein is better news.  If you find yourself taking Warfarin, you don't need to run like a bat out of hell from a spinach salad.  We're improving our calcium intake but now vitamin D steals the spotlight.  What's next? 

It's old stuff.  Replaced today by superior knowledge.  Research which surely will be challenged tomorrow.  And that's exactly why I love science.   It's all in the method.  Science geek?  Check.

Stay tuned.  I have lots to say.

Paleo in a Nutshell Part 3: Sunshine

Paleo in a Nutshell Part 2: Exercise

JUST SAY NO

Consider me easy.  I'm completely fine with having instant coffee.  Cool with whatever the bar has available on tap.  I'm OK with drinking unfiltered water from the faucet (even though it does taste a bit off to me).  But God knows that there are certain things in this world that I will never, ever compromise on:

Imperfect tattoo ink color:  I'm sitting in the tattoo shop 30 minutes away from getting the Picasso Blue Dove permanently marked onto the nape of my neck.  While going over the details, my inker-guy says hurriedly, "I really wouldn't go with a navy blue ink for the lines of this design. The blue will fade too fast, especially in the sun.  Go with black ink instead for a cleaner look." Excuse me, Mr. Tattoo Parlor Guy?  I most definitely cannot 'just go with black' here!  Don't you get it? This is the Blue Dove here, man.  Picasso's Blue Dove above all things.  You can't just go about your business and change THEE Picasso's blue to black. Oh, and did I forget to mention the entire tattoo is symbolic of his "Blue Period?"  

Tequila wannabes:  Jose Cuervo's "Gold" Tequila: Jose, shame on you, you really missed the mark on this one. I don't like to drink Cuervo "Gold" anymore.  I mean, yes I will imbibe, but I will never ever order the stuff because it's not genuine tequila (short-changed!  Thinking back to all of those times in college when I proudly purchased a bottle of Cuervo and thought I was splurging on high quality booze; a total rip off in retrospect).  Real gold tequila gets its distinctive yellow hue from the aging process.  The tequila is "rested" (reposado) or aged in big oak barrels allowing for richer and complex flavors to develop.  Our friend Jose chooses to skip over that little step and just inject artificial yellow coloring instead.  No gracias.

And that's really it for me in the miscellaneous category. 

However, in the food category I'm not particularly easy.  I've got some serious grief.  Consider this me, airing out my laundry list of the "foods" which I refuse to ever ever let enter my body.  Not only "food", but also other food ingredients, chemicals, preservatives, pollutants, etc. running rampant in our food supply and which I refuse to compromise for.  Things that I, and things that I suggest you, just say no to:

Trans-fat. I don't eat trans-fat simply because I don't want to die prematurely.  If I see "partially hydrogenated oil" listed on the ingredient label I immediately put the Crisco...oops I mean item... back on the grocery store shelf. In my mind, eating trans-fat is no different than eating straight up cyanide.  The New England Journal of Medicine states  that "...the consumption of trans fats results in considerable potential harm but no benefit.  There is no safe level of trans fat consumption.  This is because any incremental increase in trans fat intake increases the risk of heart disease.
This study estimates that between 30,000 and 100,000 cardiac deaths per year in the United States are attributable to the consumption of trans fats."{click here for the top 10 foods highest in trans-fats.}
Soda pop.  If you think drinking soda is still OK for you and your health, please return back to Earth.
Processed meat.  Believe it or not, it's actually quite unnatural for ham, chicken, turkey, and beef to come in perfect sandwich-sized slices.  But processed meats will come with an increased risk of heart disease, diabetes risk, and cancer.  "Eating Red And Processed Meat Associated With Increased Risk Of Death.  ScienceDaily (Mar. 24, 2009) — Individuals who eat more red meat and processed meat appear to have a modestly increased risk of death from all causes and also from cancer or heart disease over a 10-year period..."

White flour, white rice, white pasta, and all of the other albino offspring of the far removed whole grain.  Why do such a terrible thing?  Why take the whole and pure natural grain in all of its earthly goodness and strip it down until it becomes void of all nutrients....and then go on and make Wonder Bread?  Just say no.

Eating avocado is cool, I do it because everyone else is doing it.

Nutritionist Q & A: determining the plausibility of death by avocado.

Question: I’m seriously OBSESSED with avocados. I literally eat at least one to two avocados a day (NO JOKE) .  I love ‘em any way-mashed up with garlic on toast or straight outta the skin with salt. Is this bad?? are they any good??? Am I gonna turn green and die?? I cannot describe my love for avocados.  – a very good friend of mine, and who I'll refer to as "KS" 

Answer:  I want to start a movement, an avocado movement. I want it to be considered cool to eat avocado anytime anywhere outside of with tortilla chips. I want it to be cool to eat them straight up. I want people to walk around snacking on avocados like they would apples.  Cool as in, "Hey Bob, what did you bring to the office today to munch on?" And I want Bob to answer "oh, you know, just the usual ol' avocado again to tide me over until dinner."

This question makes me incredibly happy.  Because KS is doing what I, as a nutritionist, try to get all my patients, clients, friends, and family to do every single day:  take advantage of the most nutritious foods on Earth and actually enjoy eating them.  Nutritionally speaking, the avocado is right up there as one of the world's finest fruits.  It's an excellent source of healthy fats, fiber, and twenty, yes, TWENTY additional vitamins and minerals. Not to mention a slew of antioxidants that will work to protect your skin from aging, work to prevent that nasty plaque from accumulating in your arteries, etc. etc. etc.  Thank God the science supports my here stated avocado manifesto.  Because I would just die a little bit on the inside if the research brought bad news.  And no, I'm not being dramatic, they are near and dear to my heart.

I'd also like to make this important point: Essentially, you were asking if it's healthy or not to eat avocados.  This is a fruit we're talking about here!  Listen, always remember that if it comes straight from the good Earth and goes directly into your mouth, whether it's avocados or potatoes to every whole fruit and vegetable in between, it will only work to enhance your health.  But if it comes straight from the drive-thru or has the unnatural hue of florescent blue and it jiggles, well, I'd say pass.  I've only seen research praising the wonders of all types of fruits.  And I've only seen research showing that fast food and junk food will harm your overall health and well being*.  


If you have high or even mildly elevated cholesterol, eat some avocado.  A myriad of research has shown including avocados in your diet (about 1-3 per week) can significantly lower your levels. 


The bottom line: I recommend eating at least 3 avocados a week, but up to 1 or 2 per day is just fine for your health oh and it would be cool, too.   Who's with me on my movement?

 Eating At Fast-food Restaurants More Than Twice Per Week Is Associated With More Weight Gain And Insulin Resistance In Otherwise Healthy Young Adults

"Young adults who eat frequently at fast-food restaurants gain more weight and have a greater increase in insulin resistance in early middle age, according to a large multi-center study funded by the National Heart, Lung, and Blood Institute (NHLBI) and published in the January 1 issue of The Lancet...[full article]"

Fast Food Increases The Risk of Obesity and Type 2 Diabetes

 "The results of this 15-year study will be published....and Researchers have shown a correlation between eating fast food, weight gain, and insulin resistance in what appears to be the first long-term study on this subject...[full article]"

Do I practice what I preach as a nutritionst?

I like to think so.  Well, I do now.  I absolutely did not while I was busy waiting tables at a Mexican restaurant  in lower Manhattan drowning myself in Sauza Tequila by night and subsisting off of extra-spicy guacamole by day.  And I will continue to believe in my perfect Thanksgiving Day fantasy where, just on that one day (it's all i ask!), calories cease to exist.  Really, all I want in the world to do on Thanksgiving Day is to wake up, walk to the couch, drink lots of beer, watch the Lions lose again, and eat until I reach that uncomfortably full point.  Love the holidays!

But now.  Ask any one of my three roommates (who are also nutritionists and one of whom is a registered nurse) and they'll tell you that I eat...well...that I eat pretty strange grub.  Take a glance into the fridge and you'll find that I am an absolute health nut. No, no, no, far more extreme than that.  I'm more like a radical-freak when it comes to what I eat.  But I'm cool with that self-administered label.

So, I'd like to take this time to answer that one particular question that at times drives me a little bit crazy:  "...and what is it that you do Karin?"
"Well, right now I'm working as a nutritionist at the University Health Center nutrition consulting and such."
"Oh! A nutritionist, are you!? Is this healthy!?" (as he or she gestures to either their drink in hand or their plate of food.  However, when I was working as a beercart girl at a local golf course, it would usually be a guy grabbing a hold of his big ol' beer belly).  And usually followed by, "I bet you eat so healthy." 
Yes, for the most part I do.  Not because I have to, because I love to.  I love the way real food is and I love the way real food tastes.  I'm incredibly attached to nutrition and fascinated by my career because I know I'll never truly learn all that there is about it.  Listen, I don't judge you when you want to swing by the Wendy's drive-thru (because I'm ordering a frosty while we're at it), but I only wish I can somehow transfer my passion for all things good, pure, and healthy about genuine food unto you.

Believe me, I was a Pop-Tart eating, Pizza Hut dialing, Super Mario addicted little kid just like the rest of um'.  I didn't have one of those free radical mothers who force fed me pureed tofu from a silver spoon.  As far as I can remember, we really had no diet restrictions in our household.  I can remember a time when my mother disdainfully purchased Mountain Dew after I threw a fit.  But honestly, no rules whatsoever about what my brother and I could or could not eat.
My interest in nutrition came naturally.  Little by little the pieces fell into place.  I started reading more about it, bought a few great cookbooks and developed a cooking habit, subscribed to Health Magazine and Shape, unsuccessfully tried the vegan thing (as inspired by The Food Revolution*), and well now, that junk food crap doesn't really even phase me.  I don't look at it as food.  Because it's not food.  Would you feed your dog a big bowl of coffee and doughnuts in the AM? Of course not!  Because if ya did, the poor dog would get pretty dang sick.  Why would you intentionally make your dog ill?.... So then why do we feed it to ourselves?

I am offering, for those who are really interested, a glimpse into my diet.  Honest as I can remember, here is what I ate today (5/14/2010):

Breakfast:  Was quite the mix-up this morning:  in a bowl I combined about 1 cup of canned organic butternut squash which I found recently at Target mixed with + 5 or 6 whole dates + 1 tablespoon of unprocessed honey form the Houston Farmers' Market (the lady convinced me it was full of bee pollen to crank up my immune system.  Does anyone know anything about this?) + a dash or whatever of cinnamon, cloves, and nutmeg + 1 heaping tablespoon of peach pecan butter and that's not all folks + a handful of unsalted sunflower seeds.  = eaten in my truck on my hurried way to the hospital.  Tasted like a pseudo-pumpkin pie of sorts.  All I do at work is drink tons of brewed tea.  Today I drank almost 5 tea bags of spiced chai, my new fav.

Lunch: half of a whole avocado [read about my avocado movement] eaten with a spoon and a little salt, 2 scrambled eggs I made in the microwave on a whole wheat tortilla with salt and pepper, 1 big and amazingly ripe pear, 1 organic graham cracker, and 1 small square of 90% dark chocolate
Dinner:  very good sized glass of chardonnay, sauteed garlic+ onions+broccoli+tofu+red beans mixed with a marinara sauce over red quinoa.
And dessert?  Yet to be determined.  Told ya it was going to be weird!

For those of you who are looking for a good read, I recommend John Robbins' Food Revolution - How Your Diet Can Help Save Your Life and Our World.  You know Baskin-Robbins ridiculously good ice cream?  John Robbins is the only son of the company's founder, Mr. Robbins himself!  You think the son of the most popular ice cream chain in the US would be shoveling in his 31 flavors of ice cream by the gallons daily and shouting out his 'I Love Ice Cream' manifesto from the roof tops.  But he actually forwent his fathers' request to take over the family ice cream business and get this - John Robbins is a VEGAN!  Nada ice cream for this guy.  John Robbins is simply a fantastic health advocate and food writer.  Reading his book has forever changed my life, and I believe if you read it with an open mind and heart, it will change yours too.  Visit his website or buy the book.

Don't judge those who eat yolks

To eat or not to eat the egg yolk is the question for today.
 Sitting in my office cubicle as the clock slowly approached noon, I began to delicately unravel the peel off of my hard boiled egg. I can feel my colleague's stark gaze. He's always a bit curious as to what will appear from my lunchbox. I'm one bite in and, sigh, just as I expected. I cannot decipher if it's shock, concern, or just disappointment in me as a nutritionist as he said "Karin, you are not actually eating the egg yolk are you?"
I nodded my head, swallowed, and replied "I like to live my life on the edge, you know?"
Now he's utterly disgusted. "No, seriously though, that's all fat and cholesterol. You really only should be eating the egg whites. They are 100% pure protein and no fat."

Relax. It's just an egg yolk. A tiny-little-insignificant-harmless egg yolk! Why do we not give the same amount of attention or show disdain when people bite into a Polish sausage, a fat laced T-bone, or double bacon cheeseburger, an ice cream sundae, a five piece chicken nugget with ranch dressing, french fries, a birthday cake, funnel cake? (can you imagine that?  We are up in arms about a little itty bitty egg but shovel in this at the same time without a second thought).

My office pal was correct that the yolk does contain all of the cholesterol and fat in an egg. Egg yolks have about 60 calories and 211 milligrams of cholesterol each. And a very trivial (2 grams) amount of "bad" fat. So is the yolk a significant health threat or what?

Cholesterol is a dietary enigma. Our bodies absolutely require cholesterol to function. We'd die without it. Every one of our body cells would break apart. We would fail to synthesize hormones, too. But our livers are capable of making all the cholesterol we need, so it's not essential to obtain it from foods. It's so tricky.  Some are very sensitive to dietary cholesterol and others are not. Genetically speaking, one egg yolk could really shoot up a person's cholesterol levels and on the other hand you find people who can eat upwards of ten egg yolks a day without a noticeable difference in blood cholesterol levels.  In fact, there are quite a few documented cases of heart attacks where the individual had a cholesterol level classified within the "normal range."

But what my friend doesn't know is the egg yolk is also a concentrated source of an array of beneficial nutrients that make an egg the "incredible, edible egg." Yolks are loaded with antioxidants that contribute to healthy eyes as well as some fat soluble vitamins, including vitamin D. Additionally, essential nutrients like choline, iron, folate, and even half of the wonderful protein is located in the yolk. I am in good health, he is in good health, too. In that case, one egg a day, yolks and all, does the body good.

The research supports "that consumption of up to 1 egg per day is unlikely to have substantial overall impact on the risk of cardiovascular disease among healthy men and women" and "in the majority of healthy adults, an addition of one egg per day to a normal fat diet could raise HDL-C (good cholesterol) levels. Therefore, egg consumption might benefit blood cholesterol" Finally, some researchers found eggs may actually improve blood pressure!

Now am I saying we should all go around eating egg yolks by the dozen? No, not really. The bottom line is if you have no underlying heart disease risk factors like high cholesterol or diabetes, 1 a day should be fine.

On the other hand, if you do have heart disease or the risk factors I stand by the American Heart Association to limit your dietary cholesterol intake to 200mg daily (remember an egg with the yolk has 211 mg of cholesterol). Cutting out the egg yolks is really the only way to stay bellow the 200mg per day. And you can still get the yolks myriad nutritional benefits from other heart-healthy foods like walnuts, pineapple, spinach, or _______ (Mad Lib: fill in the blank with any fruit or vegetable on the planet).

If you are trying to lose weight or are having difficulty staying within your daily calorie allowance, cutting out egg yolks is an easy way to cut out calories and still satisfy your craving for eggs. In that case, I would most definitely recommend using whites only, or go for products like Egg Beaters.

Now, back to the guy who works in the cubicle next to mine. Listen, I enjoy the way the egg yolk tastes, eat eggs in moderation, exercise and eat very healthfully. So back off! I would like to enjoy my lunch in peace :) And if you don't particularly care for the yolk, that's fine, too. But don't eat them because you think they are "bad" for you since the majority of the research states otherwise.

I've got a golden ticket: blueberries?

"Snozberry? Who ever heard of a snozberry? WE are the makers of the music. And WE are the dreamers of the dreams. Come along, everyone." - Willy

Wow, this picture from the old school Willy Wonka film is simply fantastic. This blog post, however, has nothing to do with Violet Beauregardes' three-course-meal gum fixation or even snozberries. I have yet to see scientific research on snozberries. But blueberries I have! In fact, I'm actually rife with research supporting their myriad health benefits. So let's talk blueberries, shall we?

Go get yourself some. If the season's not right I would suggest purchasing frozen (no sugar added) berries. Don't fret, frozen fruit and vegetables are healthy options. In fact, since they are often harvested at the peak of ripeness and immediately flash or "quick" frozen and directly shipped to the supermarket, they often contain MORE nutrients than fresh produce that traveled bicoastal, or transatlantic, or 5,000 miles abroad by boat, train, plane...whatever, you get the point.

Before I delve into some science, here are the blueberry basics and why they may be the next best thing to the fountain of youth:

Antioxidants: chuck full of 'um. Think of all of the things that make you feel and look old. Chronic diseases, wrinkles, sun damage, etc. Well, eating blueberries may slow all that unfortunate stuff down.

High in fiber: nutritionists love fiber. Therefore, nutritionists really, really love blueberries.

The science is also suggesting that:

"Blueberry Juice Improves Memory in Older Adults" 

"Blueberries Counteract Intestinal Diseases" 

"Natural Purple Pigments In Fruits, Vegetables And Berries, Such As Blueberries, May Help Prevent Obesity" 

"Getting Forgetful? Then Blueberries May Hold The Key" 

[for further research and articles in detail]

I myself strive to eat at least one frozen bag of berries weekly.  Be they blueberries, raspberries, blackberries, cranberries, what have you.  I get creative: oatmeal, cereal, with vanilla ice cream, smoothies, yogurt. Or, your know, just straight outta the bag and into my mouth is good too.

"Oompa, Loompa, doom-pa-dee-do

I have a perfect puzzle for you

Oompa, Loompa, doom-pa-dee-dee

If you are wise, you'll listen to me..."

Nutritionists should always be food advocates not supplement supporters. Unless, of course, you are talking about D.

Finally a little inspiration hit me for today's short and sweet blog post: Alas, vitamin D, also known in the nutrition and health community as the "sunshine vitamin". If there is only one supplement every single human on earth should be taking religiously, it is actually NOT a multi-vitamin/mineral. It is not even vitamin C (sorry, you cannot really kill a cold with megadoses of vitamin C). It isn't even vitamin E, or iron, or calcium (disclaimer: proceeding supplements do have their own time and place).
I fell very confident saying the chances are very high that you are living your life in a state of vitamin D deficiency. The reason I say this is because in every single research study I've read thus far, at least an estimated 75-90 percent of study subjects were found to have low blood levels of vitamin D. The world famous Dr. Oz even stated he takes vitamin D daily, so now you know it's important even if you are eating quite possibly the healthiest diet the planet.



How did this all happen? Well, put simply, human evolution and our ever-changing environment are working against one another. Since the only good, reliable source of vitamin D is from 15 minutes of daily sun exposure (up to an hour required for african americans), and we are all now working indoors on a 9 to 5 type gig, and wearing sun block and clothing, and the UV rays have a lot of smog to get through, we've pushed ourselves into a sunless species destined for a state of D-deficiency.

What about food? Not possible. You just won't meet your needs via food sources. Supplements are key (it is hard for a nutritionist to say it). Milk is a very poor source, fish is only reasonable, fortified cereals are marginal at best, and I'm betting your multivitamin/mineral probably only gives you less than half your daily requirement.

Next time you go in for a check-up, request to be tested for vitamin D deficiency. It's a quick and simple blood draw. With the results in hand, talk with your health care professional on what, if any, supplement would best suit your individual needs.

When you go supplement shopping, make sure you get what you pay for. There is a lot of junk out on the market nowadays. I recommend purchasing vitamin D in a dosage of 1000 IU's per capsule in the form of "D3" (D3 this is the biologically active form in humans). I take at least 1000 IU's of vitamin D daily for normal health and physiological requirements. But, your needs may be a lot more or less depending on what your lab values say.

What's so special about vitamin D? Everything! Almost every cell in the human body has a vitamin D receptor. "More than 50 genes in tissues throughout the body are known to be regulated by 1,25-dihydroxyvitamin D." The list of health benefits goes on and on and on and on and on and on....see for yourself.

Inadequate levels of vitamin D may significantly increase risk of stroke, heart disease and death

ScienceDaily (2009-11-16) -- Researchers found that patients with very low levels of Vitamin D were 77 percent more likely to die, 45 percent more likely to develop coronary artery disease, and 78 percent were more likely to have a stroke than patients with normal levels. Patients with very low levels of Vitamin D were also twice as likely to develop heart failure than those with normal Vitamin D levels. ... > read full article

This may be of particular interest for those of you out there dieting:

Successful Weight Loss With Dieting Is Linked To Vitamin D Levels

ScienceDaily (2009-06-12) -- Vitamin D levels in the body at the start of a low-calorie diet predict weight loss success, a new study found. The results suggest a possible role for vitamin D in weight loss. ... > read full article

Margarita on the rocks, no sal por favor

So far, so good. I'm so happy, having a fantastic day at work today.  You could hardly call it work:  a one-on-one relaxation exercise followed by an hour of yoga. The health center that I currently intern at is sponsoring an anxiety clinic for the students. Mostly, it’s to prevent undue stress for the ominous upcoming finals and just help them chill out a little.

Earlier this afternoon I worked with some great physicians on campus. There is just something one of the doctors mentioned to me and which I found so incredibly intriguing that I did a good hour of research on it. Oh, and it inspired this blog post, too.

While discussing hypertension, or high blood pressure, and its link to the American diet, he said something to the sorts of “it takes only 8.25 grams of dietary sodium (or salt) to cause you to retain one liter of body fluid.” YIKES!

Aside from walking around feeling totally uncomfortable and awfully bloated with an extra liter of water hanging out, there are some more serious health implications.

Let me explain.

Salt and water work as a pair.  You cannot really separate the two when discussed in the context of human physiology. So, let’s say your lunch is usually canned soup topped with Saltines while sipping on Gatorade. My best guess is that meal provided about 6 grams of sodium—6 grams! Daily intake should really be as low as possible (a good goal is less than 2.3 grams daily). So now your body has just been flooded with this salt and gets absorbed into the bloodstream. But, as I said before, the salt MUST be absorbed into your bloodstream along with its buddy, water (to keep your blood osmolality normal). Unfortunately you now have a little situation: an excess of salt AND water in your vasculature. With all of the extra fluid your heart is under some serious excessive stress.  Blood vessels and such are not really meant to deal well with extra fluid. The heart has to work harder, the kidneys take a hit, oh ad remember that you are walking around with some serious water weight. No good!

That’s why one of the very first dietary modifications for those with diagnosed high blood pressure is cutting out the added salt. When you do this, you will lose that extra fluid and thus put less stress on your heart and blood vessels for an improved blood pressure reading.

Almost all whole, natural, real, unprocessed foods are low in sodium. Up to about 75% of sodium in the American diet comes from processed foods. Basically, if it comes packaged it brings with it some adverse health consequences.

If you must celebrate Cinco de Mayo today with tequila— either in the form of a margarita or a straight up shot—remember to HOLD THE SALT.