Cherie Lester

                                                                                                                                  The Simple Idea That Is Transforming Health Care

A focus on quality of life helps medical providers see the big picture—and makes for healthier, happier patients

By LAURA LANDRO

A very simple question is changing the delivery of medical care: How is your health affecting your quality of life? Photo: Robert Neubeck/WSJ

A very simple question is changing the delivery of medical care:

How is your health affecting your quality of life?

For decades, numbers drove the treatment of diseases like asthma, heart disease, diabetes, and arthritis. Public-health officials focused on reducing mortality rates and hitting targets like blood-sugar levels for people with diabetes or cholesterol levels for those with heart disease.

Doctors, of course, are still monitoring such numbers. But now health-care providers are also adding a whole different, more subjective measure—how people feel about their condition and overall well-being. They're pushing for programs where nurses or trained counselors meet with people and ask personal questions like: Is your condition inhibiting your life? Is it making you less happy? Does it make it hard to cope day to day? Then the counselors offer advice about managing those problems and follow up regularly.

The logic is simple. People are more likely to manage their condition properly when they have more accessible, personal goals, like being able to do more at work or keep up with their kids, instead of focusing only on comparatively abstract targets like blood-sugar levels. And that, in turn, leads to much better health. Numerous studies show that when people have a higher sense of well-being, they have fewer hospitalizations and emergency-room visits, miss fewer days of work and use less medication. They're also more productive at work and more engaged in the community.

"Quality of life happens to be the element that is most important in motivating people to deal with an illness," says Noreen Clark, director of the Center for Managing Chronic Disease at the University of Michigan. "People aren't motivated to follow their clinical regimen if in fact it doesn't improve the way they function and get along with others and manage day to day."

Breathing Easier

Focusing on well-being might seem like a basic idea, but it is a departure from the traditional approach to public health, especially when it comes to chronic-disease sufferers. Many get brief checkups with a doctor a few times a year, and there isn't time for much beyond getting lab tests, a prescription and some directions to follow. And once patients leave the office, there is little that most doctors can do to make sure they stick to their regimen or help them with any problems or barriers to staying on the wagon.

For an idea of how the new emphasis works, consider Quentonia Ford. Struggling with severe asthma for 25 years, she found it hard to fully understand and manage her medications after brief doctor visits. Often gasping for breath, she had to curtail activities with her husband and family, and sometimes her symptoms got so bad she was hospitalized.

Last year, she took part in Women Breathe Free, a program under study at Dr. Clark's center at the University of Michigan that aims to improve the well-being of African-American women with asthma.

"They asked about my quality of life, my family support, whether asthma stopped me from going out and doing the things I liked to do, even how it affected my sex life," says Ms. Ford, 63 years old, who works as an administrative assistant for a hospice program. "No doctor ever asked me questions like that before."

Ms. Ford says the program's counselors, whom she spoke to over several weeks by phone, provided "a sounding board" about many concerns that were bothering her, and helped her understand her medications and how to use them more effectively. In the past, she would wait until her symptoms were severe, hoping things would get better; she now monitors herself more closely by keeping a diary of symptoms and using a device that monitors breathing to let her know if she is entering a danger zone.

Talking to a counselor regularly also helped her overcome fear and depression about her condition, and set reasonable goals for exercise and activity without fearing an asthma attack. In addition, she got the resolve to talk to her family about helping out more with things around the house and recognizing that she couldn't do everything they wanted. She has not been hospitalized since she started the program, and last month her doctor told her that her pulmonary-function tests were the best she has had since 2006. She credits the counseling for giving her the tools and is continuing to provide information to the program so they can monitor her progress. "I never had anyone to talk to who understood me or what I was dealing with," Ms. Ford says. "It has really helped me have more self-confidence and a better outlook about my quality of life."

Measuring Results

Programs like Women Breathe Free are gaining traction as chronic illness eats up 75% of the $2.6 trillion the U.S. now spends annually on health care—and evidence mounts about the importance of quality of life.

In a study used to develop Women Breathe Free, for instance, nurse health educators provided regular telephone counseling for patients, talking to them about their particular asthma concerns, such as problems related to household cleaning or laundry products, and the use of birth-control pills or hormone-replacement therapy, which can exacerbate symptoms. Compared with a group that didn't get the program, after two years the participants reported higher levels of asthma-related quality of life and a greater reduction in the use of certain medications. They also had a decrease of asthma symptoms with sexual activity and a greater reduction in missed days of school and work.

In the February issue of Population Health Management, a study found that higher self-reported well-being was associated with fewer hospitalizations, ER visits and medication use—and concluded that efforts to improve well-being are a promising approach to reduce future health-care use and spending.

Results like these have caught the attention of policy makers. The 2010 Affordable Care Act included $3 billion in funding for a new Patient-Centered Outcomes Research Institute, which will use quality-of-life measures as part of its evaluation of new treatments. And in a report issued in January, the Institute of Medicine, an independent group that advises the government on health policy, called for a new national action plan to identify programs that help those with chronic illness and the population as a whole "live well"—reflecting "the best achievable state of health that encompasses all dimensions of physical, mental and social well-being."

The Institute of Medicine's report "really pushed us into thinking about how health-related quality of life can be used to evaluate our program activities, in addition to looking at measures of mortality and the delivery of clinical services," says Wayne Giles, director of the division of adult and community health at the Center for Chronic Disease Prevention and Health Promotion, part of the Centers for Disease Control and Prevention. "If there are things we can do to reduce pain and increase function, we may help delay the proportion of people who need nursing-home care and see reductions in hospitalizations and medical visits." He adds: "And those are huge drivers of costs."

Growing Effort

To measure health-related quality of life, the CDC queries more than 430,000 people each year through its Behavioral Risk Factor Surveillance System, which measures the number of "healthy days" people have in a given month. Nationally, the trend isn't good: Newly released data show the number of physically unhealthy days has barely budged over a decade, rising slightly to 3.6 days in 2009 from 3.3 days in 2000. The number of people who reported 14 or more mentally unhealthy days rose to 10.6% of the population from 9.6% over the same period. Rosemarie Kobau, a public-health adviser on quality-of-life programs at the CDC, says the measures will be instrumental in reducing health disparities, identifying unmet needs and tracking progress toward the federal Healthy People 2020, goals set by the federal government to improve the health of Americans over the next decade.

"Well-being moves us closer to looking at health in a positive sense—as more than the absence of illness," Ms. Kobau says.

The measures are already being used to evaluate programs for care of those with widely prevalent diseases like arthritis, the most common cause of disability. Terry Brady, head of the CDC's arthritis program, says the Healthy Days measures helped when the agency decided to scale back its funding to 12 states from 36 in 2008, providing larger individual grants to fewer states. The states that continued to receive funding were those with the highest success in linking patients to community-based programs that helped them manage their own disease and improve function, pain and quality of life.

Measuring quality of life and well-being is also helping states and communities identify vulnerable populations and design interventions to help. A program sponsored by the Robert Wood Johnson Foundation, Mobilizing Action Toward Community Health, has been using such data to rank the health of counties around the U.S.

As rankings have been released publicly over the past few years, says Patrick Remington, co-director of the program and associate dean for public health at the University of Wisconsin School of Medicine and Public Health, media coverage of poor rankings "has gotten people to think about the health of their community not just by whether it has a high death rate or short life expectancy but maybe a place where the quality of life is not as good as it could be."

In 2006, Juneau County, Wis., was ranked as the unhealthiest community in the state—the lowest of 72—which county health officer Barb Theis says was a wake-up call. With a fairly rural population just under 28,000, nearly 30% of pregnant women smoked cigarettes, the teen birthrate was high, and nearly 40% of country residents hadn't visited a dentist in the past year.

Ms. Theis got help securing funding for women and children's services including a prenatal-care-coordination program and a dental clinic; she is now pushing for a mental-health clinic as well. In the 2011 survey, the county rank had risen to 52. "None of this would have happened without the rankings, because everybody here is taking ownership of improving the quality of life and health of our population," she says.

Ms. Landro is an assistant managing editor for The Wall Street Journal and writes the paper's Informed Patient column. She can be reached at [email protected].

Do You Need a Health Coach?

by Donna Fuscaldo

FOXBusiness                                                                                                              Reuters

When it comes to living a healthy lifestyle, it’s more than just what you eat and how you exercise. The quality and quantity of your sleep, how you deal with stress and your emotional well-being also play a role in your overall health. While doctors and physicians can diagnosis and treat illnesses, health coaches can teach preventative measures that thwart a visit to a doctor altogether.

“Physicians don’t have enough time to spend with their patients going over nutrition, lifestyle and stress reduction,” says Kerrie Martin, a holistic health and nutrition counselor and founder of health coaching practice Live In Rhythm. “Health coaches serve to fill that gap.”

Health coaches are a relatively new phenomenon in the health and fitness world and the practice differs from personal training. A personal trainer tends to tell clients how much to exercise and in some cases, what to eat, a health coach will do that plus discuss ways to reduce stress, increase rest, and focus on improving the overall quality of life—not just in the gym.

Health coaches are commonly found in corporate settings as part of wellness programs, but they are slowly infiltrating the private market. These coaching sessions, which can cost anywhere from $50 to $150 an hour, tend not to be covered by medical insurance, the growing demand and interest from doctors could change that down the road.

According toMelinda Huffman, principal at Miller & Huffman Outcome Architects and co-founder of the Notational Society of Health Coaches, demand for health coaches has grown exponentially, largely because research has found it’s more effective to discuss a treatment plan with a patient than to simply prescribe a medicine and hope that they take it.

“When you manage a patient you give them this or that information and send them on their way,” says Huffman. Health coaching gives patients the opportunity to figure out how a treatment plan will impact their life, she says.

For many people, health coaching is about how to eat better, lose weight or feel more energized. But it can also be used for more specific problems. According to Martin, people use health coaches for digestive problems, fertility issues and even chronic or terminal diseases like cancer or heart disease. “There’s so much conflicting information out there that a health coach can help individuals decipher all the information,” says Martin.

Health coaches aren’t for everybody. On top of the cost, which can get expensive the longer you see a health coach, people typically have to commit to more than one session. While a person can see a health coach just one time, many recommend entering a three to six month program—after all, change doesn’t usually happen overnight.

Health coaches aren’t doctors, which means they can’t prescribe medicine nor are they able to diagnosis illnesses. Many health coaches are certified through education programs like the Institute for Integrative Nutrition.

                                                      Nutrition Facts

Old School Cleaning: Baking Soda

That small yellow box in your fridge is more powerful than you might think: It's treated sick bodies and cleaned homes since the time of the Trojans. Even after all these years, it's just as effective. Clean your grill? Check. Remove stubborn coffee or tea stains? Check. Spot treat wallpaper, books and porcelain? Check! Check! Check! If that didn't already baffle you, see what else this super powder can clean:

 Originally Posted Thursday, April 12th 2012 at 5:00 am by Sayer Ji

Though Mother Nature's formulas are proprietary, she does not grant patents

~ Sayer Ji

Some of the most powerful medicines on the planet are masquerading around as foods and spices. While they do not lend themselves to being patented, nor will multi-billion dollar human clinical trials ever be funded to prove them efficacious, they have been used since time immemorial to both nourish our bodies, and to prevent and treat disease. So valued were these in ancient times that they were worth their weight in gold, and entire civilizations either rose to great power or collapsed as a result of their relationship to them. What is even more amazing is that many of these "plant allies" are found growing in our backyards, and often sitting there in our refrigerators and spice racks, neglected and under appreciated. In fact, many of us use these daily unaware that this is why we don't get sick as often as those who do not incorporate them into their diet. Let's look at a few examples….

1) Garlic – with the increasing prevalence of multi-drug resistant bacteria and the failure of the conventional, drug-based model to develop effective solutions against them (nor accepting responsibility for creating them), spices have regained their once universal reign as broad spectrum infection-fighters with sometimes life-saving power. Garlic, in fact, has several hundred therapeutic properties, confirmed by a growing body of scientific research, which you can view directly on GreenMedInfo.com.[i] One quick example of garlic's power, is in killing multi-drug resistant tuberculosis (MDR-TB), which the mainstream media has termed the "white plague," roiling the masses with a fear of drug-resistant (but not plant-extract resistant) they are made to believe they are defenseless against. Last year an article was published in a peer-reviewed scientific journal showing that garlic was capable of inhibiting a wide range of multiple drug resistant tuberculosis strains.[ii] The authors concluded "The use of garlic against MDR-TB may be of great importance regarding public health." Garlic's anti-infective properties do not end with MDR-TB, as it has been demonstrated to inhibit the following pathogens as well:

Amoeba Entamoeba histolytica (parasite)

Cholera

Clostridium

Cytomegalovirus

Dermatophytoses (a type of topical fungal infection)

Haemophilus Influenzae

Helicobacter Pylori

Herpes Simplex Virus Type 1

Herpes Simplex Virus Type 2

Klebsiella

Methicillin-resistant Staphylococcus A. (MRSA)

Parainfluenza Virus

Peridontal Infection

Pneumococcal Infections

Pseudomonas aeruginosa

Streptococcus Mutans

Streptococcus Infections: Group A

Streptococcus Infections: Group B

Streptococcus pyrogenes

Thrush (oral fungal infection)

This amazing list underscores how important it is to keep a supply of garlic close by!

2.) Honey – bees produce a wide range of therapeutic substances beyond honey, e.g. propolis, bee venom, royal jelly, beeswax, bee pollen, etc., but this sweet, sticky stuff that we all love to dip our paw into occasionally, is the most well-known and most copiously consumed of them all – and for good reason, it tastes great! But did you know that this sweet treat is one of nature's most powerful healing agents, as well? Here is just a smattering of some of honey's more scientifically researched health benefits and/or applications:

Aspirin-Induced Gastrointestinal Toxicity (honey coats the delicate linings of the stomach, preventing aspirin-induced lesions and bleeding)

Bacterial Infections

Burns

Candida infection (despite the fact that honey contains sugar, it demonstrates anti-fungal properties)

Conjunctivitis

Dental plaque (a recent study showed that Manuka honey was a viable alternative to chemical mouthwash in dissolving dental plaque)[iii]

Dermatitis

Diabetic Ulcer

Herpes-related ulcers

MRSA (especially for Manuka honey)

There are many more uses for honey than covered here. Needless to say, replacing synthetic sweeteners or highly processed sugars or high fructose corn syrup with a moderate amount of honey may be a great preventative health step to take.

3) Apples – an apple a day does in fact keep the doctor away, especially cancer specialists it would seem. For instance, one of the most well-established health benefits of consuming apples is to reduce the risk of colorectal cancer. The more apples you consume, the less likely you are to develop this potentially fatal disease. To view the 5 studies that reference this relationship, go to the GreenmedInfo.com apple research page where you will also find 50 other health benefits of apple or apple byproducts (e.g. apple vinegar) consumption which include:

Aging, Reduce Rate

Allergies

Allopecia (Hair Loss)

Diarrhea

Insulin Resistance

Liver Cancer

Radiation Induced Illness

Staphylococcol Infection

4) Sunlight – this one may throw some of you off, but sunlight possesses both energy and information with real, metabolic value and is therefore a source of usable energy for the body – and so, in a very real sense it can be considered a form of food that we consume through our skin by way of its built in, melanin-based "solar panels." Not only does adequate sunlight exposure result in the production of vitamin D, a hormone-like substance that regulates over 2,000 genes in the human body -- and as a result prevents or ameliorates hundreds of vitamin D deficiency associated health conditions -- but sunlight exposure itself has a unique set of health benefits not reducible to simply vitamin D production alone. One of the more interesting studies performed on sunlight exposure, based on data gathered from over 100 countries and published earlier this year in the journal Anticancer Research, showed that there was "a strong inverse correlations with solar UVB for 15 types of cancer," with weaker, though still significant evidence for the protective role of sunlight in 9 other cancers. Here are some additional benefits of sunlight exposure:

Alzheimer's Disease

Depression

Dopamine Deficiency

Dermatitis

Influenza

Multiple Sclerosis

Psoriasis

5) Turmeric - quite possibly the world's most important herb. Named "Kanchani," or literally "Golden Goddess," in the ancient Indian healing tradition, its healing properties have been deeply appreciated, if not revered for countless centuries. Turmeric has been scientifically documented to have over 500 applications in disease prevention and treatment. It also has been shown to modulate over 150 distinct biological and genetic/epigenetic pathways of value in health, demonstrating a complexity as well as gentleness that no drug on the planet has ever been shown to possess.

As there are too many health conditions that turmeric may benefit to list, we are listing the top 10 as determined by the GreenMedInfo algorithm which calculates both the evidence quantity (number of articles) and evidence quality (human study valued higher than animal, and so on). Also, the number in parentheses denotes the number of studies on the database demonstrating the beneficial relationship.

Oxidative Stress (160)

Inflammation (51)

DNA Damage (48)

Lipid Peroxidation (34)

Colorectal Cancer (24)

Breast Cancer (60)

Colon Cancer (52)

Chemically-Induced Liver Damage (34)

Alzheimer's Disease (34)

Tumors (23)

Sources:

[i] GreenMedInfo.com, Garlic Research Page: http://www.greenmedinfo.com/substance/garlic

[ii] Pak J Pharm Sci. 2011 Jan;24(1):81-5. PMID: 21190924

Allergy Friendly

Alternative Grain & Seed Guide

April 10, 2012

So what’s a wheat-free, gluten-free, allergy friendly shopper supposed to choose when shopping for grains in the supermarket? Well, luckily gluten free and wheat free are gaining shelf space in the supermarket, including breads, crackers and cookies, which are all notoriously ‘wheaty’ and gluten containing foods. So if these products do not contain wheat as their main ingredient, what do they contain?

Some examples of alternative grains and seeds used in gluten free baking include quinoa, sorghum, amaranth, teff, buckwheat, millet, and rice. Keep in mind if shopping for baked goods, many gluten free products use simple carbohydrates like white rice, tapioca flour, and corn rather than the many options in complex whole grain carbohydrates which are much more nutritious, full of fiber and help keep blood sugar stable. Here are some of SupermarketGuru’s favorite alternative grains. Amaranth dates back hundreds of years (similar to quinoa) to the Aztecs in Mexico. It contains a high quality protein and is high in fiber. Amaranth has a nutty flavor and is being used with other alternative flours in breads, pasta, pancakes and more. It boasts a superb nutritional profile and is a great source of calcium, iron, manganese and folate.

Buckwheat is another fabulous ancient seed, and is not in fact related to wheat at all! It has a mild flavor, but roasted or toasted, the flavor intensifies. Buckwheat can be ground into a flour like consistency and substituted for wheat flour. Buckwheat contains various flavonoids that provide powerful antioxidant protection against free radicals in the body. It is also a great source of fiber, manganese, magnesium, zinc and iron.

Ground flaxseeds can also be used to increase the nutrient profile of gluten free baked goods. Flaxseeds are rich in omega 3 and 6 fatty acids, phytochemicals, fiber and more

Millet is also considered an ancient grain, possibly the first cereal grain to be used for domestic purposes. Across the globe millet is still used today in various ways, in India flat thin cakes called roti are often made from millet flour, the Hunzas who live in the Himalayans use millet as a cereal, in soups and for making the whole grain bread chapatti. Millet is highly nutritious and in fact, it is considered to be one of the least allergenic and easily digestible grains available. It is nearly 15 percent protein, contains high amounts of fiber, B vitamins and vitamin E; and is particularly high in the minerals iron, magnesium, phosphorous, and potassium.

Quinoa an “ancient grain” (it’s actually a seed) was originally cultivated thousands of years ago in the South American Andes and known as “the gold of the Incas” and the “mother of all grains.” Quinoa is a very good source of magnesium, iron, and boasts a whole host of other nutrients and bioactive compounds as well as fiber. Quinoa can be ground into flour and used for baked goods or used in its whole form in place of couscous, rice or other grains in recipes.

Rice flour is a popular substitution in gluten free cooking. Brown rice flour is more nutrient dense than white rice flour, which is more commonly used to mimic white bread, cookies and cakes.

Sorghum is America’s third leading cereal crop, and in many parts of the world sorghum has traditionally been used in porridge, unleavened bread, cookies, cakes, and couscous – now it’s making its way into the gluten free aisle. Sorghum is rich in antioxidants, and is a good source of iron, fiber and protein. You may not have heard of teff, but it’s an ancient North African cereal grass and is a nutritional knockout. It is said to be the smallest grain in the world - about 100 grains are the size of one kernel of wheat. Teff contains high levels of calcium, phosphorous, iron, and thiamin and is also a great source of protein. Teff has a mild, nutty, and a slight molasses-like sweetness. By no means does this list include all of the gluten free substitutions – but does contain some of the most popular. Corn flour, almond flour, potato and tapioca flour are also popular gluten free substitutions.

Aloe Vera to the Rescue

Industrial factory farms and their chicken growing methods have been in the news quite a bit this week. Turns out, their product (I hesitate to use the word "food") has been fed the very medications we do our best to avoid. The studies released this week were conducted by Johns Hopkins University and Arizona State University. I've included links (and excerpts) below to two very well written articles on the subject. The purpose of these articles is not to scare or overwhelm - but to educate and inform, so we can make choices that are right for ourselves, and for our families. Cherie

An excerpt from Dr. Michael Greger's Article on One Green Planet.....

...The arsenic in apple juice is thought to come from arsenic-containing pesticides still in use in countries such as China, but how did arsenic get into the chicken? The poultry industry fed it to them.

Every year about two million pounds of arsenic-containing chemicals have been fed to chickens in the United States, one of the more than 20 drugs, antibiotics and supplements routinely fed to animals raised for slaughter in the United States. Why would the industry do such a thing? When tens of thousands of birds are crammed into filthy football field-sized sheds to lie beak-to-beak in their own waste they can become so heavily infested with internal parasites that adding arsenic to the feed to poison the bugs can result in a dramatic increase in growth rates. Arsenic can give the carcass a pinkish tinge, which consumers prefer. Just as farmed salmon are fed additives to color their grey flesh, the FDA approved arsenic-containing feed additive for “improved pigmentation.”

The full article can be read here: http://www.onegreenplanet.org/science/chicken-more-of-an-arsenic-risk-than-apple-juice/

An excerpt from Nicholas Kristof's Article in The New York Times.....

...Big Ag doesn’t advertise the chemicals it stuffs into animals, so the scientists conducting these studies figured out a clever way to detect them. Bird feathers, like human fingernails, accumulate chemicals and drugs that an animal is exposed to. So scientists from Johns Hopkins University and Arizona State University examined feather meal — a poultry byproduct made of feathers.

One study, just published in a peer-reviewed scientific journal, Environmental Science & Technology, found that feather meal routinely contained a banned class of antibiotics called fluoroquinolones. These antibiotics (such as Cipro), are illegal in poultry production because they can breed antibiotic-resistant “superbugs” that harm humans. Already, antibiotic-resistant infections kill more Americans annually than AIDS, according to the Infectious Diseases Society of America.

Understanding Food Labels, Written by Jeff Novick   

                        Cutting Through The Confusion... How to make sense of the food label.

Here are the basics of deciphering food labels, consolidated into ten quick-reference tips.

1. Never believe the claims on the front of the box.

What many think are health claims are actually just marketing pitches and advertisements. And government approved claims, like “low-fat” and “light,” often don’t tell you the whole story. These products may be high in fat as well as sugar, salt, and/or calories.

“Light” ice cream, for example, may still pack in 4 to 5 grams of fat per serving. And “light” and “regular” varieties of ice cream may not differ much calorically.

Never evaluate a product based on one item, such as its fat, cholesterol, sugar, carbohydrate, or salt content. Attempting to cash in on the latest diet or nutrition craze, many companies promote their products based on a single item despite other unhealthy aspects. (Remember “fat-free” foods that were full of sugar and calories?) To be truly healthy, a product must pass several criteria.

2. Always read the Nutrition Facts label and the ingredient list.

They contain information that can really help you determine how healthy a food is. Crackers, for example, may advertise on the front of the box that they’re “trans fat free,” but in the ingredient list you may find fats, like palm oil and coconut oil, that are just as artery-clogging as the trans fats they replaced.

3. Check the serving size.

Though the government standardized most serving sizes years ago, many products still post unrealistically small sizes. A serving of oil spray, for instance, is .25 grams. That’s about 120th of an ounce — far less than most people could, or would, spray on a pan with even just one squirt.

4. Check the amount of servings per package.

Decades ago, many products were in fact single servings. A bottle of cola was one serving. One small candy bar was one serving. Today, many products are “super sized” and contain multiple servings. A 20-ounce bottle of soda contains 2.5 servings, at 110 calories each. Now, in the real world, who’s going to drink just one serving of that bottle? Is it any surprise that many of us are super sized ourselves?

5. Check the calories per serving.

All too many people think the “110 calories” posted on that 20-ounce bottle of cola means they’re drinking 110 calories. Hardly. You’ve got to multiply the 110 calories by the total number of servings, 2.5, to realize that you’re actually downing a whopping 275 calories.

Don’t get too comfortable with “0s” either. Because some manufacturers use ridiculously small serving sizes (remember that 120th of an ounce of cooking spray?) and because the FDA states that manufacturers can “round down” to zero, some products advertised as calorie-free or fat-free are not. If you eat multiple servings — if, say, you coat an entire skillet with oil spray — you may be tallying up quite a few calories.

6. Check the calories from fat.

It’s on the Nutrition Facts label. Unfortunately, it doesn’t tell you “percent of calories from fat,” which is how all health guidelines direct us to limit fat. You’ve got to do a little math. Divide the number of calories from fat by the total calories. (If the serving’s 150 calories, 50 of which are fat, your product is 33 percent calories from fat.).

If division trips you up, go by grams. Use this easy rule. If a product has 2 grams of fat or less per 100 calories, its fat content is within these guidelines for processed foods: the fat, per serving, is 20 percent or less of total calories. You don’t have to be a mathematician to realize that 4 grams of fat per 100 calories is double the fat I recommend.

Don’t be fooled by claims like “99 percent fat-free” soup or “2 percent fat” milk. They’re based on percent of weight, not percent of calories. So that can of 99 percent fat-free soup may actually have 77 percent of its calories from fat, or more. And 2 percent fat milk actually has about 34 percent of total calories from fat; 1 percent milk has about 23 percent calories from fat.

7. Check the sodium.

Don’t bother with the percentage of Daily Value (DV) of sodium. Don’t bother with Daily Value percentages, period. They’re based on government standards, which are generally not the healthiest guidelines to strive for.

Instead, look at the number of milligrams of sodium the serving contains. A great rule of thumb: Limit the sodium in milligrams to no more than the number of calories in each serving. Your daily goal: less than 1,500mg of sodium.

8. Check the types of fat.

Make sure there are no saturated fats, hydrogenated fats, or tropical oils in the ingredient list, including lard, butter, coconut, cocoa butter, palm oils, shortening, margarine, chocolate, and whole and part-skim dairy products.

Polyunsaturated fats (like safflower, soybean, corn, and sesame) and monounsaturated fats (such as olive and canola) are less harmful and would be acceptable, but make sure the percentage of calories from fat are still in line — 20 percent calories from fat or less — or your waistline may start getting out of line. All oils, even “good” oils, are dense with calories.

9. Check the sugar.

Limit caloric sweeteners. Watch out for sugars and other caloric sweeteners that don’t say “sugar” but in fact are, such as corn syrup, rice and maple syrup, molasses, honey, malted barley, barley malt, or any term that ends in “ol,” such as sorbitol or maltitol, or “ose,” such as dextrose or fructose.

Try to limit all these added, refined, concentrated sugars to no more than 5 percent of total calories (essentially, no more than 2 tablespoons daily for most folks). Don’t be concerned about naturally occurring sugars in fruit and some nonfat dairy products. However, on the Nutrition Facts label, added sugars and naturally occurring sugars are all lumped together as “sugar.”

Your best bet: Look at the ingredient list. Try to avoid foods with added, refined caloric sweeteners in the first three to five ingredients. Because ingredients are listed in descending order of weight, the lower down the label you find added sugars, the better.

10. Make sure that any grain is WHOLE grain.

Many bread and pasta products claim to be whole wheat, but the first ingredient in the ingredient list is often wheat flour, which sounds healthy, but it’s really refined flour. Further down the list will be whole-wheat flour or bran. Scout out products that contain only whole grains. Also look for at least 3 grams of fiber per serving, which often ensures the product is mostly, if not all, whole grain.

If the product sounds too good to be true, it may be. Thousands of new products come out every year, many trying to cash in on the latest diet craze. As we’ve seen with the low-carb craze, many may not be carefully regulated (if at all). In 2001 the Florida FDA evaluated 67 diet products and found all 67 were inaccurately labeled; they contained more sugar and carbs than their labels stated. And recently, consumer laboratories evaluated 30 low-carb nutrition bars and found that 60 percent were inaccurately labeled. Most had more carbs, sugars, and salt than their labels claimed.

During your first few trips to the market, give yourself extra time to evaluate products. You’ll soon speed up! Once you’ve found products that you enjoy and that meet these healthy guidelines, shopping becomes quick and easy. Your health is worth it!

Remember, WHOLE, natural, unadulterated foods, not packaged and manufactured foods, are those foods that pack the nutrient punch. Even when you pick from the “acceptable” processed foods, it should be only a minor part of your diet.

  by Jerome Burne Medical Health Journalist As Featured in Food Matters Dr James Dowd, who works at the Arthritis Institute of Michigan, has been prescribing vitamin D to people suffering from chronic disorders. Just in case there were any doubts about the importance of vitamin D - the 'sunshine' vitamin - two major studies published last week confirmed just how essential it is for good health.

One study found that people with higher levels in their blood were more likely to survive cancer, the other that having very low levels increased your risk of cardiovascular disease. Previous research has linked high levels with fighting off infection and helping with all sorts of chronic problems. But there is a catch: we make most of our vitamin D when our skin is exposed to fairly strong sunlight and we can get more from oily fish and a few foods like cereals that have been fortified with it.

 Now a new and controversial book by an American doctor suggests that taking even higher levels of the vitamin - 10 to 15 times the recommended amounts - can work wonders. Dr James Dowd, who works at the Arthritis Institute of Michigan, has been prescribing vitamin D to people suffering from chronic disorders such as arthritis, back pain and headaches and the result, he claims, is a huge improvement in their symptoms.

 As Dowd explains: "In the past I would have given her anti-inflammatory drugs, pain medication, a pill to lose weight and drug treatment for hypertension." But several years earlier he himself began to suffer symptoms of joint pain and fatigue and after researching other treatments, devised a very different "and much more effective approach". The cure involves a high dose supplement of vitamin D and simple dietary changes, including cutting out wheat and cheese and encouraging a greater variety of fruit, vegetables and protein. It also involves a certain amount of exercise. "It sounds almost magical," Dowd admits, "but in fact it's just common-sense medicine based on good science; the sort that has eluded many physicians for decades." Vitamin D is essential for good bone health, but as research now suggests, it is also important in chronic conditions such as cardiovascular disease and cancer. Quite why is not clear. However, we do know that the level of vitamin D in our bloodstreams is dropping, partly because of concerns about the link between sun and skin cancer. It has been estimated that in America and the UK as many as 90 per cent of the population are not getting nearly enough vitamin D from the sun and diet can't make up for the shortfall.

                  Rock Creek Park, Washington, DC                         photo by Cherie Lester

The spring is a perfect time to reboot and re-charge your system after a long winter of comforting, and, sometimes heavy, wintertime foods. Juicing is a great way to shed winter pounds, helping to clear out the old and prepare your body for new healthy spring and summer foods (see my previous post on juicing). Ayurvedic medicine tells us that spring is a time to alkalize our bodies, suggesting bitter-roots, berries and sprouts to help clear allergy creating mucus. Anitoxidants foods (and yes, I'm currently obsessed with  ORAC values) - chlorophyll rich foods, help to fertalize our intestinal tract and cleanse our liver. A great Ayurvedic tip for spring: sipping Dandelion Root Tea. Dandelion contains potassium and helps us to gently cleanse our lymphatic system. Whatever you decide, enjoy the opportunity spring gives us to begin anew, Cherie 

A great quote about juice-fasting found on MindBodyGreen:

As the old saying goes, “good things come in small packages.” And in the kitchen, seeds are no exception. These tiny wonders are a staple in a healthy pantry: nutrient-dense and packed with disease-fighting minerals and enzymes, they can be used in just about any recipe. Here are three favorites that are easy to incorporate into your everyday diet.

1. Flax

What is it? Brown or golden, this seed comes from the flax plant and has a mild, delightfully nutty flavor.

Why we love it: Flaxseed is rich in fiber (aids digestion and cardiovascular health) and omega-3 fatty acid (provides anti-inflammatory benefits, strengthens skin cells and is also great for cardiovascular health).

Where to use it: When baking, replace ¼ cup of flour for ¼ cup of flaxseed; or, use as an egg substitute by mixing three tablespoons of flaxseed with ¼ cup of water, let sit for 15 minutes.

Special Instructions: To get the most from flaxseed, grind it first. Either buy the seed whole and grind it yourself, or buy pre-ground flaxseed meal and keep refrigerated.

2. Hemp

What is it? Hemp seeds come from the same Cannabis species as marijuana. However, they’re bred with much lower levels of the psychoactive chemical THC.

Why we love it: Hemp seeds are loaded with digestible, vegan protein: Just two tablespoons have 24% of your daily requirement (impressive, huh?). It’s a high-quality protein, too, with a balance of all the essential amino acids. They’re also loaded with fiber (yay, digestion!) and packed with other nutrients, such as omega-3 and omega-6, vitamin e, the b vitamins and folic acid.

Where to use it: Blend one tablespoon into your breakfast or post-workout smoothie for an extra hit of protein; or add a tablespoon on top of your salad for extra crunch.

Special Instructions: You can buy hemp seed whole or shelled (also called hulled). The shelled seeds taste milder and pack more nutrients; the whole seeds give you more crunch and fiber.

3. Chia

What is it? The seed from the chia plant (yes, the same seed that grows Chia Pets) is native to South America, where ancient Aztec warriors used it before going into battle or running long distances on foot. Chia seeds are prized for their energy inducing properties.

Why we love it: Contains 25% of your daily-recommended calcium. Omega 3, chia’s fiber, forms a gel that slows the absorption of sugar into the bloodstream, binds it to toxins in the digestive system, and helps eliminate waste. Due to this high fiber content, chia seed absorbs ten times its weight in water, making it an excellent source of hydration. This also means a slower conversion of carbohydrates to sugars, resulting in greater stamina and endurance.

Where to use it: In this DIY energy drink, called Chia Fresca, that’s favored by indigenous Mexican tribes: Mix one tablespoon of chia seeds with 1½ cups of water. Add a squeeze of lemon juice and a teaspoon of agave nectar.

Special Instructions: Unlike flaxseeds, chia seeds don’t need to be ground. They’re virtually tasteless.

10 Tips to Better Sleep Tonight!

By Casey Lorraine Thomas

                            There is nothing like a restless night of tossing and turning and poor sleep to make you irritable and over sensitive. Not to mention foggy, tired and did I already say cranky? Unfortunately, it is a common occurrence for people today, leaving many sleep deprived and stressed out. The good news is that there are many things to help yourself get a restful night of sleep without turning to sleeping pills. Below are some of my top tips to get that heavenly, rejuvenating slumber happening, and even what to do when the z’s just aren’t coming.

  1. Improve your diet. The poorer your health, the poorer your body will function in every way, including how well you sleep. Over time, improving your diet to include plenty of fresh fruits and vegetables and avoiding or minimising processed, refined, unnatural foods will change your body's chemistry and you will begin to sleep better as your body responds. Not only will your physical health improve, but your emotional and mental health will also be positively impacted and sources of stress will become easier to manage as your body balances from the changes to your diet. Better stress management equals better sleep quality.

  2. Stop eating at least two hours before bed. This is a good general rule of thumb to follow. This time allowance can vary greatly however, dependent on what you choose to eat for dinner. The heavier your food choices, the more time you should allow before you head to bed. If you are into a high raw, clean diet, then allowing even one full hour of being vertical before bed will be enough. If you are eating denser, heavier foods like meat or grains, aim for a minimum of two hours, preferably three hours before hitting the sack.

  3. Kick the caffeine habit, particularly in the second half of the day. If you are knocking back coffee, tea (even green or white tea as these still contain caffeine) or chocolate (raw or otherwise) throughout the day and not sleeping well, then it might be time to quit your habit. Try cutting out all sources of caffeine in your diet for two weeks and see whether your sleep quality improves. If nothing else, you will be avoiding the negative impacts on your health caused by caffeine. If you are consuming a lot of caffeine, start by just cutting down on how much you take in to avoid feeling the potentially aggressive side effects of caffeine withdrawal. Continue to decrease your consumption over time until you have eliminated it entirely from your diet.

  4. Turn off the TV! There's nothing wrong with watching a good DVD before bed or a favorite TV show if it's not one that will stimulate you, but turn off the drone of TV commercials, news and violent shows that will only leave your brain and body stressed, over-stimulated and certainly not ready for a peaceful night's sleep.

  5. Trade textbook for tale. I know how time-poor we all are, I'm right there with you. So it can be easy to get some educational reading in right before sleeping. If you also enjoy the subject matter it can seem even more ideal. However, if we are reading books to self-educate, we are further stimulating our brains and pushing them to stay awake. Switch to a novel or inspirational tale that instead allows your brain to change its tune, rather than feeding it more facts and figures.

    6. Meditate yourself to slumber. This strategy works for me 95% of the time, plus it helps me to fit in a regular meditation practice. Yes, it is ideal to stay awake while meditating and your meditation practice should ideally be built around doing it when sleep is not the target, however putting a guided meditation on and focusing on your breath once you're snuggled under your blankets at night, can be an excellent tool to induce sleep. Alternatively, you can purchase a self-hypnosis CD for sleep problems/insomnia and listen to that each night as you go to sleep. Not only will you be getting yourself into a peaceful sleep, the hypnosis will be changing your subconscious beliefs and healing your poor sleep habit while you are sleeping.

  7. Get the monkey off your back. Got something on your mind from your day? Had an argument or a nagging thought on your mind that you haven't yet resolved or expressed? Do it before you head to your bedroom to call it a night. Getting any lingering unrest or annoyance off your mind before you turn in for the night will pave the way for a better transition to a peaceful sleep. Plus, the way you end your day is typically the way your next day starts. If you go to bed angry or annoyed, not only will you be compromising your sleep quality (and asking for crazy dreams), it is also very likely you will wake up feeling disgruntled, unhappy and off balance. I know that I certainly don't want to kick start another day with a case of the grumpy pants!

  8. Keep a journal and pen next to your bed. This is a tried and tested strategy for expelling any thoughts, ideas, unhappiness, planning, or anything else at all that might distract you from a calm, clear, peaceful mind and thus sleep. Writing out your feelings if you have some turbulence going on in your brain (as per point 7) can really help to dissipate the energy that goes with those thoughts and feelings. It's also very helpful if you need to be "heard" but do not yet feel able to speak with the person your thoughts concern. Naturally, if it's an internal conflict, a journal is your perfect ally to put these issues to bed as you tuck yourself in. You can also use your journal to write out your list of things to do for the next day before going to sleep so that you are not thinking about it as you close your eyes. Having a journal handy also means that if you wake during the night and start thinking about the next day's plans, what happened yesterday, that thing you must not forget about next week, or what to get your sister for her birthday, you can reach over, grab your journal and quickly write down whatever is on your mind so you can then happily snuggle back into your pillow free of these thoughts.

  9. Make your bedroom your sanctuary. Environment is SO important to how we function. As I'm sure you are well aware, if you don't have a kitchen equipped and stocked to support a healthy lifestyle, or an office that is organised and inviting, you are far less likely to stick to your healthy eating routine or meet your work targets, and remain happy, clear and centred while doing so. The same applies to your bedroom. Get rid of clutter, distractions, colors, designs and anything else that doesn't support a peaceful, calming, inviting environment that focuses primarily on rest, relaxation and intimacy. For me, this means keeping my bedroom clutter free, keeping technology in the room to a minimum, having my journal and a pen handy always, a light read nearby and my iPod with a range of meditations ready to go. I always have ear phones plugged in to my iPod also so I don't disturb my partner and I can go into my own peaceful meditation world at any time.

  10. Get fresh air and move everyday. If you are staying indoors all day long and living a sedentary lifestyle as many of us do nowadays, we are naturally going to be less able to have a fitful night's sleep. Fresh air and movement regulate, balance and detoxify our bodies so that all of our bodies functions improve, including sleep. Get outside and take some deep breaths and take a walk everyday. Yoga and stretching are also great options and can be helpful to both wake you up and start your day and to help you wind down at the end of a night. Just keep them slow and gentle if you are doing them immediately prior to sleep. There is also a lot to be said for keeping a fairly regular routine each day. This will teach your body a pattern of when to wake and when to sleep that your body will get used to.

  Finally, if you still can't get to sleep, like I couldn't last night, my suggestion to you is to embrace the current moment and do something more productive with your time. It may just be that you want to put on a great film or read a fantastic textbook or novel that you've not had the time for. Maybe you could just get up in the middle of the night and do a yoga DVD or some free stretching. Or you could go wild and just throw yourself into the work that you can't get off your mind. Last night, at about 3am, I chose the latter. I got up and did two very productive hours of planning for my coaching services and when I got back into bed around 5.30am, I felt very satisfied. Sometimes, despite everything you can possibly do to help yourself sleep, you've just got to roll with the punches!

    Published March 20, 2012 at 7:40 PM on MindBodyGreen.com

I wanted to provide an excerpt from a recent article written by a well-known and well-respected physician, Dr. Mark Hyman - on the subject of Lead exposure. I was diagnosed with lead poisoning (and mercury and arsenic - they often go together) around 2002 after experiencing a range of unusual neurological symptoms. After several rounds of chelation therapy and Chlorella supplementation (a sea vegetable based natural chelator), I improved right away, leading to better liver function, and, my neurological symptoms went away. Environmental toxins are a serious issue but receive little attention. Having your blood, urine or hair tested (whatever your doctor recommends) can help determine if heavy metal exposure is contributing to (or causing) your illness. Cherie

to read the article in its entirety: http://tinyurl.com/7zrnv8w

excerpt from an article written by Dr. Mark Hyman:

WE ARE TOO HEAVY — and I don’t mean overweight. We’re heavy with metals, not fat. Nearly 40 percent of us have toxic levels of lead in our bodies. And we don’t even know it. But that doesn’t mean we don’t have symptoms …

You may have headaches, insomnia, irritability, a low sex drive, or tremors. You may have mood problems, nausea, depression, memory difficulties, trouble concentrating, poor coordination, or even constipation. Yet most of us attribute these symptoms to other problems. We don’t recognize that they may be caused by lead poisoning......

......High lead may also be responsible for kidney failure as well. A study in The New England Journal of Medicine found that using chelation therapy with EDTA to reduce lead levels in patients with kidney failure could prevent further loss of kidney function, save billions in healthcare costs, and eliminate the need for dialysis in millions of people. (iii)

Wow! Take a moment to digest that. Chelation therapy saves lives and billions of dollars. But your doctor probably isn’t offering this as standard treatment, because, as I have said many times, doctors, don’t learn two of the most important things in medical school: How to help people improve their nutrition and how to deal with environmental toxins.

Lead is not only linked to heart disease, high blood pressure, and kidney failure, it is also connected to the epidemic of children with ADHD, developmental and learning problems, and autism. Even though the “safe” blood levels of lead has been set as 10 micrograms/deciliter, recent studies show that the greatest drop-off in IQ scores in children occurs in those who have lead levels between just 1 and 10 micrograms/deciliter. (iv) This is particularly troubling, because more than 10 percent of poor and inner city children have lead exposure levels higher than 10 micrograms/deciliter!

I recently treated a young boy with extremely high lead levels who had Asperger’s syndrome, severe ADHD, and violent behavior. He likely got the lead from his mother, who had very low vitamin D levels and had developed osteoporosis, which released a lot of lead from her bones during pregnancy. This lead got into the boy’s body in the womb across his mother’s placenta. Thankfully, we got rid of his lead over time through chelation and nutritional support. Doing so dramatically improved his attention, behavior, and social skills.

This young boy is, unfortunately, not alone. We live in a sea of heavy metals. Lead is still found in our soil and water. In areas with a history of industrial pollution, people track lead into their homes from contaminated soil. The sad result is that regular house dust often contains 17 times the level of lead it once did. In Washington, DC, (*where I live - Cherie) the water was so contaminated with lead recently that the government had to provide free water filters for everyone in the city. Up to 20 percent of the city’s tap water may be contaminated.

So what can you do about this?

6 Tips to Help You Get the Lead Out

Luckily there are steps you can take to help you heal from lead poisoning if you have been exposed. Try the following:

Find out if you are lead-toxic. The easiest test is a simple blood lead test. Be sure the lab can measure VERY low levels of lead accurately. Anything higher than 2 micrograms/deciliter is toxic and should be treated. Unfortunately, the blood test only checks for current or ongoing exposures, so you must also take a heavy metal challenge test with DMSA, EDTA, or DMPS, which can be administered by a doctor trained in heavy metal detoxification. (See www.functionalmedicine.org or www.acam.org to find a qualified doctor.) Consider undergoing chelation therapy if your lead levels are high.

Reduce your exposures by having a “no shoes in the house” policy. A great deal of lead can be tracked into your house in the dust on the soles of shoes. Leaving your shoes at the door helps reduce the amount of contamination in your home.

Test your water for heavy metals. There are a number of home test kits available online. If you prefer to have a professional test your water, call your city water provider or look for labs in your area that will perform this kind of test.

Buy a carbon or reverse osmosis water filter for your drinking water. These filters remove lead and other toxic substances like PCBs. They are my favorite kind of filter and the type I use in my home.

Take 1,000 milligrams of buffered ascorbic acid (vitamin C) a day. This helps remove lead from the body.

Take 2,000 to 4,000 IU of vitamin D3 a day to prevent your bones from releasing lead into your bloodstream.

Even though many of us have toxic levels of lead in our bodies, there is a lot we can do to prevent it and treat it.

  About the author:

*I've learned first-hand how making the following changes can greatly impact your life! The mention of "exposure to sunlight" not only refers to the positive mental and emotional benefits sunshine offers, but, it also refers to maintaining proper levels of Vitamin D (low Vitamin D levels play a large role in disease development and have been closely associated with Multiple Sclerosis). Diet, stress-reduction and sunlight therapy are all great suggestions for relieving symptoms of this debilitating disease. Cherie

   Plant-Based Diet and MS Relief

A new study identifies a plant-based diet as a possible treatment for multiple sclerosis symptoms.

By Rashida Harmon | March 19, 2012