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Food & Nutrition

Don’t Get Stoned this Summer

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Takeaway First

Kidney stones are on an upswing as the days get warmer. Quite a few of our patients are passing stones at our clinic in New York. There are many things you can do to prevent kidney stones, but above all: drink tons of water.

Kidney stone facts:

Kidney stones are most common in Caucasian men and least common among African-American females.

Calcium kidney stones are made of 80% calcium oxalate (CaOx).

It has been suggested that kidney stone risk increases in hot climates.

Frequent or intense exercise can cause an increase in kidney stone formation.

While only about 10% of men will develop kidney stones in their lifetime, that percentage goes up to 30% if there is a family history.

What exactly are kidney stones?

Kidney stones are exactly what they sound like. They are stones (little rocks, but sometimes not so little—ouch!) that form when minerals accumulate in your kidneys. Most of the time these stones pass through the system without causing much pain or discomfort. Other times, if the stone become bigger than 3 mm, they pass with excruciating pain.

I mean, EXCRUCTIATING PAIN. If you have ever passed a stone, you know what I’m talking about.

Women patients who have passed stones and delivered babies have said delivering babies is like a walk in a park compared to passing a kidney stone.

The pain often starts at the lower back (flank), and it radiates down to the groin. This pain is caused by pressure in a part of your body between your kidneys and bladder called the ureter, which itself is only 3-4 mm wide.

What increase your likelihood to make stones?

Other than genetic causes (where your body simply likes to make stones), there are two main causes: being overweight and dehydration.

So, yes, losing weight and drinking tons of water can really help.

What else can you do to stop making kidney stones?

Drink a ton of water. You should urinate 2 liters of urine every day.

Take 500 to 1000mg of magnesium citrate every day.

Take Vitamin B6—25 mg daily. A B6 deficiency increases urinary oxalate, which may lead to kidney stones.

When magnesium is used in conjunction with vitamin B6, it has an even greater effect.

Drink lemon juiceabout one-half cup of pure lemon juice (enough to make eight glasses of lemonade) every day. Lemon juice raises citrate levels in the urine which protects against calcium stones.

Drinks to avoid: orange and grape juice and soda. You do not need to avoid coffee and alcohol, but DO NOT need to be avoided, but remember that these cause dehydrationso drink, drink, drink (water, that is).

What to do if you are a kidney stone former (that you thought you shouldn’t do)

Forget about eating a low-oxalate diet. My patients who eat a lowoxalate diet become fat and increase their risk of heart disease and cancer. This approach is disastrous for overall health because many protective foods high in oxalates are vegetables, fruits and nuts – all things I highly recommend. In fact, recent research has demonstrated that a diet high in fruits and vegetables DECREASES the risk of kidney stones (Turney et al. 2014).

It has been suggested that people who form kidney stones should avoid vitamin C supplements, because vitamin C can convert into oxalate and increase urinary oxalate. Initially, these concerns were questioned because the vitamin C was converted to oxalate after urine had left the body. However, newer trials have shown that as little as 1 gram of vitamin C per day can increase urinary oxalate levels in some people, even those without a history of kidney stones.

In one case report, a young man who ingested 8 grams per day of vitamin C had a dramatic increase in urinary oxalate excretion, resulting in calcium-oxalate crystal formation and blood in the urine. On the other hand, in preliminary studies performed on large populations, high intake of vitamin C was associated with no change in the risk of forming a kidney stone in women, and with a reduced risk in men. This research suggests that routine restriction of vitamin C to prevent stone formation is unwarranted.

Bottom line on preventing kidney stones?

Drink 4 to 8 cups of lemonade made with a least a half a cup of freshsqueezed lemon.

Drink enough water, about 10 glasses a day, and aim to produce about two liters of urine.

Take magnesium citrate, potassium citrate and vitamin B6 supplements.

Avoid drinking grapefruit juice.

Eat plenty of ALL fruits and vegetables. If you get kidney stones frequently, then avoid only spinach and almonds which are very high in oxalates. But eat plenty of the others.

References:

Gershoff S, Prien E. Effect of daily MgO and vitamin B6 administration to patients with recurring calcium oxalate kidney stones. Am J Clin Nutr 1967;20:393-399.

Will E, Bijvoet O. Primary oxalosis: clinical and biochemical response to high-dose pyridoxine therapy. Metabolism 1979;28:542-548.

Turney BW1, Appleby PN, Reynard JM, Noble JG, Key TJ, Allen NE.Diet and risk of kidney stones in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC). Eur J Epidemiol. 2014 May;29(5):363-9.

 

What science still hasn’t told us about red meat

red meat

The Takeaway First

Despite the huge conversation that health professionals and consumers alike are having about the effects of consuming red meat on human health, scientific research hasn’t quite settled the score. A new paper (Klurfeld, 2015) published this past May highlights the many limitations of the studies we have done. So what do we have left…?

Study Details

  • David Klurfeld highlights some flaws in the current literature surrounding red meat. In order to know for sure whether red meat causes diseases long-term, for example, we would need a longitudinal study (where subjects are tracked for several decades) with an extremely large sample size. Not only have we not done this, but we can’t; it’s too expensive.
  • Besides, says Klurfeld, supposing we had the money, scientists can’t feed red meat to humans on the premise that it might cause them to become diseased. It’s unethical.
  • The nature of observational studies and the immense amount of data that researchers collect enables such studies to find (potentially) thousands of statistically significant correlations, many of which may simply be false positives.
  • Some influential studies that have found significant associations between meat consumption and colorectal cancer are clouded by confounding variables such as daily caloric intake and smoking.
  • While known toxins such as tobacco and alcohol increase risks of lung cancer and liver cirrhosis ten- to thirty-fold, eating meat does not increase the risk of any disease by more than 50 percent.

My Take on Meat

It seems from this paper that we should be cautious when we say that eating or not eating red meat poses a danger to our health. Not only are the data limited and easy to skew, but the data on the increased risk of disease forces us to ask, “How much of a difference does this really make?”

In my opinion, we should not be worried about meat so much as wheat and simple carbs like pasta, bread, cookies, and flour. Meat should only worry us when it’s in excess or excessively cooked, as one study has shown that charred meats contain carcinogens (Zheng et al. 2009).

Of course, I have long believed, and still believe, that individual differences can make or break a diet for anyone. This is why I design an individualized anti-cancer lifestyle plan for each of my patients. For patients whose baseline risk for disease is elevated due to heredity or past behavior, I adjust their plans accordingly.

What You Should Do

When our modern methods fail to provide satisfying answers to these questions, we can be sure of one thing: uncertainty about how much does not equal a license to let ourselves go. In other words, it would be detrimental to your health if you used uncertainty as an excuse for irresolution and made a habit of saying, “Well, since we don’t really know, I guess I’ll just stick to my usual breakfast of three fried eggs and half a pig.”

While we may have reasons to be skeptical about the “statistically significant correlations” that bring smiles to every researcher’s face, we cannot afford to be wishy-washy about our commitment to a balanced diet of whole foods. Balance, unlike meat, has well-known effects. Moderation in all things—that’s the key.

References

Klurfeld, D. M. Research gaps in evaluating the relationship of meat and health. Meat Science(0). doi: http://dx.doi.org/10.1016/j.meatsci.2015.05.022

Zheng, W., & Lee, S.-A. (2009). Well-done Meat Intake, Heterocyclic Amine Exposure, and Cancer Risk. Nutrition and Cancer61(4), 437–446. doi:10.1080/01635580802710741

On Juicing…

juicing

On Juicing

Overview

A common question I get asked daily is on the value of juicing.  I tell you, if you want to get a nice, constant and non-stimulant burst of energy, there is nothing like a nice squeezed fresh veggie juice. Try it and you will see what I am talking about.

The Downside of Juicing:

  1. It’s an acquired taste ( so is diet soda’s and lots of people drink diet soda – which is sooo nasty.) It’s worth getting used to.
  2. Can be a pain in the behind to clean the machine when made at home
  3. Can be expensive (anywhere between $7 to $9 of a 16-ounces juice)

The upside? Read on….

Why juice?

Juicing is a cornerstone treatment in many natural cancer therapies. Juicing provides cells with live enzymes and oxygen rich fresh food. It provides concentrated enzymes and nutrients that help detoxify the body and allow it to heal sufficiently to get rid of stored toxins.

  1. Rapid absorption. Juicing helps you absorb a large amount of nutrients and plant chemicals nearly instantaneously since the fiber is left behind in the pulp. Wait a minute, isn’t fiber important? Yes it is, however, the purpose of juicing is to get rapid aborptions of nutrients and therapeutic plant chemicals to flood your cells. You can ( should and will) get plenty of fiber from the consumption of whole fruits, vegetables and grains.
  2. Efficient consumption of vegetables. With one glass of vegetable juice you probably consume more vegetables than most people do in one week.
  3. It may help fight and prevent cancer. There seems to be hundreds of protective phytochemicals (plant chemicals) in all plants. Proanthocyanidins and caritnoids are just some of them. For example; broccoli contains indole -3 – carbinol that seems to have protective properties against prostate cancer. That is just one out of over one hundred protective chemical discovered and studied. Why wait for all phytochemicals to be discovered? Juice up and protect yourself.
  4. Gives you energy. Juicing is better than coffee or over the counter energy products for long-term sustained energy. Plus it helps you with the first 3 points of this list unlike energy products, which have detrimental effects.

Juicing is not all you need

Juicing has very no essential fat, no protein and no fiber. Unless you are doing a juice fast, you still need to eat wholesome meals. You can drink a fresh squeezed juice either before or after a meal.

Start slow

If what your juicing is too concentrated (like wheat grass , for example) it can be nauseating. You should feel good and experience more energy within a short-time.

Use Organic whenever possible. Farmer’s market produce is also good. Make sure to wash well. If organic and farmer’s market produce is not available use produce that are LEAST contaminated with pesticides.

If you cannot buy all your juicing vegetables and fruits organically – these are a must to buy organically: apples, celery, sweet bell peppers, peaches, strawberries, nectarines (imported), grapes, spinach, lettuce, cucumbers, blue blueberries, potatoes ( not for juicing either way) – In other words, AVOID for juicing unless they are organic or not from famer’s market.

NOTE: produce from farmer’s market is typically organically cultivated but they do not announce it because there’s a hefty price for the organic stamp from the USDA. They simply often do not want to pay the extra cost.

Juicing for starters

To enjoy juicing start with vegetables that are more pleasant tasting: Celery, cucumbers, carrots (not more that one or two sticks at time), apples ( not more than one apple) – all organic.

After you get used to juicing add: Red leaf lettuce, Green Leaf lettuce, Romaine lettuce, Endive, Escarole, Spinach, parsley, bok choy, cilantro.

Bitter vegetables to juice: Kale , Collard Greens , Dandelion Greens ,  Mustard Greens (probably the most bitter). Just two or three sticks should be enough

To make it appetizing: add lemon, lime half an apple and a small piece of fresh ginger (gives it a kick).

Do not store your juice for more than 24 hours. Instructions on storing fresh squeezed juices:

  • Put your juice in a glass jar with an airtight lid and fill it to the very top. Mason jars work just great. There should be a minimum amount of air in the jar as the oxygen will “oxidize” and damage the juice.
  • Immediately store it in the refrigerator and consume it through out the day. It is best to drink it as soon as possible or within 24 hours of juicing.

Making the juice vs. buying by the juice made

Either way is fine. Finding a reliable health food store that makes fresh, organic juices can be challenging in some places. If doing it yourself there are three main concerns: Buying a reliable juicer that is durable and juices well. 2. Finding one that is easy to clean. 3. One this is affordable. Good juicers run between $200 to $1000. I find the best ones to be around $300 or so.

If a juicer is a pain in the (beeeep) to clean – you’re likely not doing it.

I have two favorite juicers:  Omega J8005 Nutrition Center Single-Gear Commercial Masticating Juicer or the Breville 800JEXL Juice Fountain Elite 1000-Watt Juice Extractor ( like this one slightly more)

I like these juicer’s for a few reason’s:

  1. It makes juice at low temperature which helps retains enzymes and nutrients

  2. It’s relatively easy to clean

  3. It’s relatively inexpensive for the quality

 

 

Your Parents Were Right All Along: Why You Really Should Eat Your Broccoli

Boy-eating-broccoli

Your Parents Were Right All Along: Why You Really Should Eat Your Broccoli

The Takeaway First

In 2010 researchers discovered that sulforaphane, a chemical found in broccoli, reduces the risk of prostate cancer. The latest research adds that this broccoli-derived compound actively kills cancer stem cells. This and other research shows us that the powers of leafy, green vegetables extend further than we think.

The Details

According to a leafy greens review (Royston & Tollefsbol, 2015) published a few months ago in the journal Current Pharmacology Reports, broccoli and other cruciferous vegetables have incredible powers as preventive medicine. Diets high in these vegetables significantly decrease the risk of death from cancer and the risk of developing cancer at all.

This same article explains that eating broccoli is one easy way to create cancer-fighting chemicals in the body. Broccoli turns into glucosinolates, which turn into the sulforaphane. Sulforaphane attacks cancer stem cells and stunts them before they can even begin to metastasize.

On top of all this, eating leafy greens in the same family as broccoli has been found to reduce inflammation (Royston & Tollefsbol, 2015).

The authors of another recent article on sulforaphane (Labsch et al., 2014) recommend a high-sulforaphane diet for cancer-prevention and cancer-suppression.

Related to all this, a brand-new Korean study (Hwang & Lim, 2015) found that broccoli stems and leaves actually have a lot more sulforaphane than the florets (the tiny green buds that bloom from the stalk).

My Take On This

Remember when you were a kid, and the only thing left on your plate after dinner was a dark-green pile of stalky vegetables? If you still avoid these greens, now is the time to stop. Broccoli is one of those powerful, natural preventive medicines that I have come to love in my years of practice. I think of it alongside turmeric, pomegranate, and green tea as a major component to maintaining a cancer-unfriendly body.

And that is why I recommend eating broccoli and all cruciferous vegetables.

These are not exactly groundbreaking studies, but they do confirm the findings of a growing body of research that is uncovering the huge benefits of eating cruciferous vegetables—especially for men like you. In my last post on this topic, I mentioned a study where eating cruciferous vegetables decreased men’s risk of prostate cancer by 32% (Steinbrecher et al. 2009). Even after diagnosis, cruciferous vegetables knocked down another group of men’s risk of prostate cancer progression by 59% (Richman et al., 2011). These are not small numbers!

What You Should Do

OK, so chances are your parents did not know that broccoli had such an ability to decrease your risk of cancer, let alone prostate cancer, and I’m 99.9% sure they didn’t know that broccoli directly targets cancer stem cells by flooding your body with sulforaphane—but you have to admit: they were right.

I know you know what to do, but I’ll say it anyway: eat broccoli. Don’t just eat the thinner stalks and the florets; eat the big, chunky stems and the leaves, too. My juicer friends sometimes tell me they add kale and broccoli leaves to their morning smoothies. Make sure to steam them well, however. Raw broccoli contains chemicals called goitrogens which can cause thyroid problems down the road. Also, broccoli is tough to digest when raw. Skip the raw broccoli from the veggie platter at the next party. The carrots are fine to eat raw—and easy on the creamy dip! (I digress.) Personally, I prefer colorful fruits in my smoothies (pomegranate is powerful and delicious) mixed with leafy greens. I do not like broccoli in my smoothie, but you might. Supplements made out of broccoli extract also seem to help – I recommend them often. For your health and your gustatory pleasure (trust me, it’s a word): try one of my favorite recipes:

Creamy Cruciferous Soup by Marti Wolfson – Culinary Nutrition Educator
  • This luscious emerald soup is surprisingly rich sans the cream which many pureed soups contain. I especially love to make this soup transitioning from winter to spring. The liver reaps great benefit from the broccoli, cabbage and as well as aliums such as onions and garlic. You can swap your favorite greens like spinach, kale or dandelion greens or herbs like parsley, thyme, and rosemary.

    Serves 8

    Ingredients:

    • 1 T. olive oil
    • 1 medium onion, diced
    • 1 tsp. ginger, minced
    • 2 cloves garlic, minced
    • 4 celery stalks, chopped
    • 3 cups chopped broccoli, florets and stems
    • 1 head, fennel, chopped
    • 2 cups chopped savoy or napa cabbage
    • 6 cups water or stock
    • 1 tsp. sea salt
    • 1/8 tsp. ground black pepper

     

    Procedure:

    Heat the oil in a large pot on medium high heat. Add the onion and cook until the onions are translucent. Next, add the ginger, garlic, celery, broccoli, fennel, cabbage and a generous pinch of sea salt and continue to cook another 2 minutes. Add the water or stock, remaining sea salt and pepper.

    Bring to a boil, cover and reduce the heat, simmering for 20 minutes. Place the soup in a blender and blend until smooth and creamy. Taste for salt.

     

References

Hwang, J.-H., & Lim, S.-B. (2015). Antioxidant and Anticancer Activities of Broccoli By-Products from Different Cultivars and Maturity Stages at Harvest. Preventive Nutrition and Food Science, 20(1), 8–14. doi:10.3746/pnf.2015.20.1.8

Labsch, S., Liu, L. I., Bauer, N., Zhang, Y., Aleksandrowicz, E. W. A., Gladkich, J., . . . Herr, I. (2014). Sulforaphane and TRAIL induce a synergistic elimination of advanced prostate cancer stem-like cells. International Journal of Oncology, 44(5), 1470-1480. doi: 10.3892/ijo.2014.2335

Richman EL, Carroll PR, Chan JM.Vegetable and fruit intake after diagnosis and risk of prostate cancer progression. Int J Cancer. 2011 Aug 5.

Royston, K. J., & Tollefsbol, T. O. (2015). The Epigenetic Impact of Cruciferous Vegetables on Cancer Prevention. Curr Pharmacol Rep, 1(1), 46-51. doi: 10.1007/s40495-014-0003-9

Steinbrecher A, Nimptsch K, Husing A, Rohrmann S, Linseisen J. Dietary glucosinolate intake and risk of prostate cancer in the EPIC-Heidelberg cohort study. Int J Cancer 2009; 125: 2179–86.