Healthy Eating & Nutrition Blog

Welcome to Dianne Rishikof's healthy eating and nutrition blog. Check back frequently for weight loss tips, advice for healthy nutrition and therapeutic diet plans, delicious recipes and other cutting-edge functional medicine nutrition tips. If you would like to receive notifications via email when this blog is updated, simply enter your email address in the Blog Subscribe form to your right.



Food as a treatment for Acne

I receive this question a lot: Can what I eat cause pimples? The answer is yes. Of course, that isn’t the only thing that causes acne but why not eat to promote the healthy skin you want? Below is a short list of ‘yes’ and ‘no’ foods in regards to acne.

Things to eliminate:

  • Limit foods high in sugar with a high glycemic index (white bread, bagels, sweets), as those may promote the production of certain hormones linked to acne
  • Omega-6 fatty acids (refined vegetable oils, fried foods) are thought to contribute to inflammation
  • In a study comparing people with no or mild acne to those with moderate to severe, the ones with moderate to severe acne reported greater dietary glycemic index, added sugar, total sugar, number of milk servings per day, saturated fat, and trans-fatty acids, and fewer servings of fish per day

Things to include:

  • Low glycemic foods (whole foods, whole grains, legumes, eggs, fish, fruits and vegetables)
  • Certain vitamins and minerals are also crucial to include.
    • vitamin A: sweet potatoes, carrots, dark leafy greens, winter squashes, lettuce, dried apricots, cantaloupe, bell peppers, fish, liver, and tropical fruits.
    • vitamin D: salmon, mackerel, mushrooms, herring, sardines, catfish, tuna, cod liver oil, eggs, sunshine
    • zinc: lamb, pumpkin seeds, grass-fed beef, chickpeas, cocoa powder, cashews, mushrooms, spinach, chicken
    • copper: oysters, raw kale, shiitake mushrooms, sesame seeds, cashew nuts, chickpeas, prunes, avocados,
    • selenium: brazil nuts, oysters, tuna, sunflower seeds, pork, beef, lamb, chicken, turkey, mushrooms, whole grains
    • green tea: a great anti-inflammatory and antioxidant
  • Fish and seafood: May help prevent acne, most likely due to their Omega 3 content.
    • Omega-3 fatty acids: reduce inflammation with foods like nuts(walnuts), fatty fish, and eggs.
  • A good probiotic: anti inflammatory
  • Turmeric: anti inflammatory
  • Tamanu oil may be effective as a topical treatment or as part of a facial cleanser for continuous acne control. It’s anti-inflammatory, antibacterial, and antifungal.

Hope that helps!

There are many supplements, such as turmeric, Omega 3s, and probiotics on my online dispensary.

Why is BILE so important?

When I say bile, you probably think of that awful digestive fluid. Maybe you know what it is and what it does, maybe you don’t. While it seems inconsequential, it is anything but.

Bile is fluid made by the liver and stored in the gallbladder that helps digestion and absorption of fats (and fat soluble vitamins) in the small intestine. That’s the well-known function (in the health community). It turns out, bile does a lot more than that. It is anti-microbial, gets rid of waste in the body, regulates cholesterol homeostasis, and has now been shown to play a role in glucose metabolism.(1,2,3,4) In fact, bile acids are now regarded as important hormones and are emerging as regulators of the gut microbiome.(5,6)

If you know me and my work at all, you know how important the gut microbiome is. Our microbiome is supposed to be primarily in the large intestine. When microbes live and grow in the small intestine a whole host of unpleasant symptoms and consequences arise. This is SIBO, small intestine bacterial overgrowth. So, bile kills microbes in the small intestine (and then the bile gets absorbed before entering the large intestine, leaving the large intestinal microbiome alone). They have done experiments in mice and rats: normal bile, no bacterial overgrowth. Without bile, the mouse gets SIBO. Adding bile acids (as a supplement) back and the SIBO goes away again! (7). In summary, reduced bile acids in the gut are associated with bacterial overgrowth and inflammation.(5) We also know that bile helps to maintain the integrity and health of the gut lining (8).

There is also a chicken and egg dilemma happening. The lack of bile could be causing the microbial overgrowth, but the microbial overgrowth (from another root cause) can break down bile, causing fatty stools.

What affects bile acid production?

● Diet
● Antibiotics
● Various disease states

Symptoms and conditions related to low bile:

● Diarrhea
● Fat maldigestion and malabsorption
● Deficiencies in fat soluble vitamins A,D,E,K
● Interference with absorption of Coenzyme Q10 and beta-carotene
● SIBO
● IBS
● Poor liver function/disease
● Gallbladder removal

Consuming adequate amounts of healthy fats will help to stimulate bile production. For the average adult consuming an estimated 2,000 calories a day that translates to 25-35% of calories from fat or 44-78 grams a day.(9) Of course, the amount and sources will vary by person and individual tolerance to certain foods so always listen to your body and eat was feels good for you. A diet rich in fruits and vegetables is also key to feeding your good bacteria and promoting bile production.

What can you do? How to stimulate bile acid secretion and support a healthy gut:

● Consume adequate amounts of healthy fats like olive oil, eggs, avocado, and fatty fish
● Licorice root extract (10,11)
● Ensure healthy liver function
● Avoid foods that bad bacteria thrive on such as: refined foods and sugars and trans fats
● Consume probiotic foods that contain beneficial bacteria such as kefir/yogurt, greek olives, and other fermented foods
● Consume prebiotic foods that feed the good bacteria such as bananas, garlic, leafy greens and other foods high in fiber (a variety of fruits and vegetables)

How can we help? Nutrition therapy with a Registered Dietitian (who specializes in digestive disorders) is essential:

● Identify the root cause of the problem (what is causing low bile acid production or inadequate function?)
● Identify gut dysbiosis (microbial imbalance)
● Recommend supplements/enzymes to stimulate bile secretion and assist with fat absorption
● Recommend dietary strategies

References:
1. Bile. Wikipedia. 2017. Available at: https://en.wikipedia.org/wiki/Bile.
2. Bile. National Library of Medicine – PubMed Health. 2017. Available at: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022186/.
3. Goel. SIBO and Liver Diseases. BeyondDisease.com. 2015. Available at: http://www.beyonddisease.com/sibo-and-liver-diseases#32.
4. Staels B, Fonseca VA. Bile Acids and Metabolic Regulation: Mechanisms and clinical responses to bile acid sequestration. Diabetes Care. 2009;32(Suppl 2):S237-S245. doi:10.2337/dc09-S355.
5. Distrutti E, Santucci L, Cipriani S et al. Bile acid activated receptors are targets for regulation of integrity of gastrointestinal mucosa. Journal of Gastroenterology. 2015;50(7):707-719. doi:10.1007/s00535-015-1041-8.
6. Houten SM, Watanabe M, Auwerx J. Endocrine functions of bile acids. The EMBO Journal. 2006;25(7):1419-1425. doi:10.1038/sj.emboj.7601049.
7. Lorenzo-Zúñiga V. Oral bile acids reduce bacterial overgrowth, bacterial translocation, and endotoxemia in cirrhotic rats. Hepatology. 2003;37(3):551-557. doi:10.1053/jhep.2003.50116.
8. Fabian T. The Importance of Bile Acids: Part One. Microbiome Mastery. 2016. Available at: https://microbiomemastery.com/importance-bile-acids/.
9. Appendix 7. Nutritional Goals for Age-Sex Groups Based on Dietary Reference Intakes and Dietary Guidelines Recommendations – 2015-2020 Dietary Guidelines – health.gov. Healthgov. 2017. Available at: https://health.gov/dietaryguidelines/2015/guidelines/appendix-7/. Accessed October 26, 2017.
10. Sokol R, Devereaux M, Dahl R, Gumpricht E. “Let There Be Bile”-Understanding Hepatic Injury in Cholestasis. Journal of Pediatric Gastroenterology and Nutrition. 2006;43(Supplement 1):S4-S9. doi:10.1097/01.mpg.0000226384.71859.16.
11. Gumpricht E, Dahl R, Devereaux M, Sokol R. Licorice Compounds Glycyrrhizin and 18β-Glycyrrhetinic Acid Are Potent Modulators of Bile Acid-induced Cytotoxicity in Rat Hepatocytes. Journal of Biological Chemistry. 2005;280(11):10556-10563. doi:10.1074/jbc.m411673200.

Food Allergy? or Food Reaction? How to tell!

Most people have heard (or suffer from) “food allergies”. But sometimes it isn’t a true allergy that they are experiencing. They don’t have a food “allergy” they have a “sensitivity” or “intolerance”. These distinctions are possibly insignificant in the casual conversations with a friend. But as a medical health professional, they are very significant to me. They mean very different things about what’s going on in a person’s body and more importantly how I can fix it!

So, let’s flesh out the differences between these terms:

• Food allergy
• Food intolerance
• Food sensitivity

Food allergies

Food allergies cause an immune response by the body that occurs immediately after any amount of the food is ingested and can be serious and potentially life threatening. The key here is that it is ANY AMOUNT (think peanut breath from one person causing a reaction in another person across an airplane). An allergic response might be itching, hives, stomach cramps, diarrhea, swelling, anaphylaxis, and even death.

Food intolerance

Food intolerance is when digestive symptoms occur after a certain food is eaten and the response time can vary. The amount of food ingested can have an effect on the severity of symptoms. There is a threshold, where you can tolerate a small amount of the food but not a large amount. For example, some people with lactose intolerance are able to consume a small amount of dairy but if eaten in large quantities may experience symptoms. Yogurt and hard cheese are easier to digest because they contain low amounts of lactose. The key distinction here is that this is entirely a DIGESTIVE issue. There is no immune response going on. There are no symptoms outside the digestive tract. A food intolerance may result in nausea, stomach pains, bloating, vomiting, or diarrhea.

Food sensitivities

Food sensitivities are an immune response but a different type of immune reaction from an allergy. They can originate from the systemic immune or digestive immune system and the response can be delayed (up to 3 days!) or even undetectable. The amount of food that causes a response varies (again, a threshold) and symptoms include nausea, stomach pains, vomiting, bloating, diarrhea, headache, irritability, joint pain, eczema, lack of energy, and more.

There are tests for each of these. IgE blood tests, test for allergies (although the accuracy isn’t great). These can be done through an allergist. Breath tests can detect intolerances and are done through a gastroenterologist. There are a few tests for sensitivities but there is a lot of controversy about their validity. Blood tests can be done for IgG, IgA or MRT reactions. The results have been known to help some, but not others. These tests can only be done through properly trained nutritionists, dietitians, functional medicine doctors and the like.

So when someone comes to me and says they have an allergy to dairy because ingesting it causes eczema, I explain that actually that’s a sensitivity : )

Feeding the Brain: How to Protect the Brain Through Proper Nutrition

According to the National Institute of Health, as many as 5 million Americans age 65 and older may have Alzheimer’s disease and that number is expected to double for every 5-year interval beyond age 65. But Alzheimer’s is only one of many dementia disorders; an estimated 20 to 40 percent of people with dementia have some other form of the disorder. Part of the aging process will always include memory loss for older American men and women. Not every older American will be at risk for Alzheimer’s disease. A healthy lifestyle can play a part in improving your memory.

Foods That Induce Memory Loss

The foods that hinder memory are common staples in the American diet. White breads, pasta, processed meats and cheeses. Research has linked all of these foods to memory loss, dementia and Alzheimer’s disease.
There is a long list of food that may minimize memory function throughout life:

Processed cheese: American cheese, mozzarella sticks, Cheez Whiz and Laughing Cow- build up proteins in the body that are related to memory loss.
Processed meats: bacon, smoked turkey from the deli counter and ham- smoked meats like these contain nitrosamines- cause the liver to produce fats that are toxic to the brain
Beer: Most beers contain nitrites- linked to Alzheimer’s
White Foods: pasta, cakes, white sugar, white rice and white bread- higher consumption could send toxins to the brain
Microwave popcorn: contain diacetyl- a chemical that may increase amyloid plaques in the brain

Dietary modifications are not easy to make, but both DASH diet and Mediterranean diet are both beneficial to brain health and memory power. What are best ways to describe these diets? DASH diet means Dietary Approaches to Stop Hypertension, which makes it lower in sodium. The Mediterranean diet has the incorporation of healthy fats and supper foods.

DASH Diet

The DASH diet may assist dieters to reduce blood pressure by a few points in two weeks. A person’s systolic blood pressure could be lowered by eight to fourteen points, to make a substantial modification in possible health risks. The DASH diet has a focus in veggies, fruits, low-fat dairy foods, as well as modest amounts of whole grains, fish, poultry, and nuts.

Grains: 6 to 8 servings a day
Veggies: 4 to 5 servings
Fruits: 4 to 5 servings
Dairy: 2 to 3 servings
Lean Meat, Poultry and Fish: 6 servings or fewer in a day
Nuts, Seeds and Legumes: 4 to 5 servings a week
Fats and Oils: 2 to 3 servings a day
Sweets: 5 Servings or fewer in a week

The goal should be to make healthier choices with a wide variety of picks in different food categories. The variety of food choices keeps the daily diet nutritious and to avoid boredom or extremes.

Mediterranean Diet

The Mediterranean diet has a focus of fish, fruits, veggies, beans, high fiber breads and whole grains, nuts, as well as olive oil. Meat, cheese, and sweets are very limited. The Mediterranean diet, an average of 35% to 40% of calories comes from fat. The fats allowed in the Mediterranean diet are mainly from unsaturated oils such as fish oils, olive oil, and certain nut or seed oils (canola, soybean or flaxseed oil) and from nuts (walnuts, hazelnuts and almonds), which can be protective to the human heart.
A Mediterranean diet may:

• Prevent heart disease
• Lower the risk of a heart attack
• Lower cholesterol
• Prevent type II diabetes
• Prevent metabolic syndrome
• Stroke
• Alzheimer’s disease and other dementia
• Depression
• Parkinson’s disease

The customary Mediterranean diet calls for:

• Eating a variety of fruits and vegetables: grapes, blueberries, tomatoes, broccoli, peppers, figs, olives, spinach, eggplant, beans, lentils and chickpeas
• Eating a variety of whole grains: oats, brown rice, and whole wheat bread, pasta, and couscous
• Choosing healthy fats: nuts, olive oils, and certain nut or seed oils like canola, soybean, and flaxseed.
• Limit unhealthy fats: butter, palm oil, and coconut oil. Limit fats found in animal products, such as meat and dairy products made with whole milk.
• Eating mostly vegetarian meals: whole grains, beans, lentils, and veggies
• Eating fish: tuna, salmon, mackerel, lake trout, herring, or sardines
• Eating moderate amounts of low-fat dairy: milk, cheese or yogurt
• Eating moderate amounts on poultry and eggs
• Limiting red meat: a few times a month
• Limiting sweets and desserts: few times a week

A healthy lifestyle can play a part in improving your memory. The human brain needs healthy fats, fruits, veggies, lean protein, and sufficient vitamins and minerals. Food choices will always play a role in healthy brains.


This blog was written by guest blogger: Tracy Williams. She has her degree in Nutrition and Dietetics from Dominican University. She enjoys freelance writing and public speaking related to nutrition topics. Please feel free to connect with her at www.tracysplate.com.

Body Love

When we think about our bodies, we focus on how we look. When we focus on how we look, we usually focus on what we don’t like.

It is certainly a step in a positive direction to notice and appreciate what we do like about our appearance. Instead of zooming in on our saggy butt, we love our beautiful eyes. But this is not the body love I am talking about here.

We need to shift out of the appearance mindset altogether.

How does your body serve you?

It’s time to give your body the due respect it deserves for all it does for you. Your body is your home. It is also your vehicle for getting around in the world. It is an intricate machine that performs incredibly complicated biochemical processes millions of times, every single second of every day. (I can lend you my anatomy and physiology textbook if you don’t believe me).
Without your body, you couldn’t do anything.  You couldn’t walk, see, write, hug, laugh, hear music, or taste delicious food.

Every moment, your body is working for you. Even if you have a chronic illness or disability, there are still millions of things your body is doing right, all the time. It rises to the challenge this world puts on it. It surmounts obstacles and tries its best despite not always being fed the optimal fuel.

Aging also brings out negative feelings about appearance. But aging is just wear and tear, evidence of a life lived and a job well done.

Your body carries you. It allows you to participate in life. You only get one, so take care of it.

Healthy Snacks for Kids

One of the leading nutritionists for kids, Jill Castle, has released another masterpiece: The Healthy Snack Planner for Kids. 

You know that smart, strategic, nourishing, well-timed snacks are better than grazing on junk all day. But HOW do you plan smart snacks for your kids? She answers this question and as well as many others. How many snacks should your child eat? When and where should they eat them? What foods make healthy snacks? The most common snack mistakes that parents make. And she provides a snack planner to help you step by step. Plus there are 85 snack ideas in the back!

Get your copy here.

A weight loss plan as unique as your genes

There are a lot of sensible weight loss recommendations (and many non-sensible ones). I have a lot of success helping people lose weight thru cutting sugar and processed starch and raising their protein and healthy fats. If that doesn’t work, I dig deeper and look at their stress hormones, insulin sensitivity, thyroid function and various other medical reasons for lack of weight loss. If that doesn’t work, now I have another trick up my sleeve: genetics.

I have started using GxSlim by Genetic Direction. Through testing your DNA, we find out how your body processes foods and deals with exercise. Then we can develop weight loss recommendations based on your unique genetic profile.

There are 7 components that are discovered through this test:

  1. if your body is resistant to losing weight
  2. how well your body is able to process carbohydrates in your diet
  3. how much body fat you can lose through cardio exercise
  4. how well your body is able to absorb folate
  5. how sensitive your body is to the amount of fat in your diet
  6. how your body responds to strength training
  7. how sensitive your body is to the amount of protein in your diet

This can show us which kinds of foods you should or shouldn’t eat and how you should exercise to optimize your weight loss. Very exciting stuff!

Lyme Disease, what you haven’t heard

 

When you or your child gets a tick bite, fear goes straight to your heart. As well it should. Because some tick bites lead to Lyme disease. Lyme disease is caused by the bacteria borellia burgdorferi and it can wreak havoc on any and every part of your body, especially your gut and your immune system.

The symptoms of Lyme are widespread, and typically antibiotics are presented as the main and sole solution. Doctors hand out a prescription and send you on your way with no guidance on the healing. While antibiotics are necessary, they don’t provide a whole systems approach to recovery, which you definitely need. Additionally, antibiotics leave your microbiome in bad shape, and with a taxed immune system (from the Lyme), you won’t be able to fight out any bad yeast that cropped up during antibiotic treatment.

What does it look like?

It’s necessary to recognize the signs and symptoms of Lyme, as they are vast and could be masked under other diagnoses.

Early symptoms

  • bull’s eye type rash
  • fever and or chills
  • headache
  • stiff neck
  • painful muscles or joints
  • fatigue
  • swollen glands
  • symptoms can appear within 3-30 days after the bite

Advanced symptoms

  • fatigue (systemic exertion intolerance disease)
  • migratory joint and muscular pain
  • neck and shoulder stiffness
  • daily persistent headaches
  • neuropathies
  • tingling and numbness
  • disordered sleep
  • recurrent flu-like symptoms
  • cognitive dysfunction
  • mood and psychiatric dysfunctions
  • increased sensitivity to foods, smells, light and noise

Because the symptoms are so widespread, it makes sense that Lyme disease has a systemic burden, including ongoing inflammation, immune system exhaustion, cellular oxidative stress, and neurotoxin release.

What to do?

It is hopeful to know that the symptoms of Lyme can be attenuated through different lifestyle, diet, and supplemental protocols.

Sleep should be addressed within a holistic approach to Lyme disease. Sleep disturbances and chronic fatigue are prevalent with Lyme. And sleep is so necessary for healing and building the immune system up.

  • Arrange your schedule to allow for 8 hours of sleep.
  • Practicing good sleep hygiene is important: not using screens for a couple hours before bed, making sure you go to bed at the same time every night and sleeping in a cool dark room.
  • If falling asleep or staying asleep is a problem, there are numerous natural sleep aids: melatonin, passionflower, lemon balm, or GABA precursors.

Stress management is essential. External stress can further the stress inside your body and prevent recovery.

  • Meditation
  • Down time
  • Laughter
  • Deep breaths, taken throughout the day

Diet: the goals of being to reduce inflammation, rebuild the immune system, improve gut health (repair after the pathogens and antibiotics), and nourish the person.

  • Eat whole foods
  • Avoid high sugar and fat foods, such as processed starches, candy and junk food, fried foods
  • Increase intake of fresh vegetables, fruits, and grains
  • Choose organic when possible
  • Eat more anti-inflammatory foods (plant based, omega-3 fatty acids, Mediterranean diet)
  • Repopulate the gut with probiotic rich fermented foods (contraindicated in some people)
  • Address food sensitivities, such as gluten and dairy, as all food sensitivities can increase inflammation, weaken the immune system and worse Lyme symptoms

For gut health, we might need to kill off any yeast or other pathogens that are present. (There are many options for this, but I don’t recommend trying them without supervision from a qualified practitioner.) Then also heal the gut lining from any injury from the Lyme or other pathogens as well as reinoculate with probiotics.

Supplementation should be utilized in order to address and TREAT poor immune function, chronic fatigue, neurological symptoms, muscle spasms, joint pain, and gut and hormonal imbalances.

Some ideas to decrease overall inflammation and inhibit pro-inflammatory cytokine production:

  • Curcumin/turmeric
  • Quercetin
  • EPA/DHA (omega 3 fatty acids or fish oil)
  • Alpha lipoic acid
  • Tart cherry juice
  • Antioxidants
  • Coconut oil
  • Green tea

Some ideas to address chronic fatigue or neurological symptoms and boost general immune health:

  • High quality multivitamin
  • Co-Enzyme Q10
  • Acetyl L-Carnitine
  • Vitamin B Complex (with activated Bs)
  • Gamma linolenic acid (GLA)
  • Omega 3 EFA fish oil
  • Alpha lipoic acid
  • Magnesium

Here is a testimonial from a client of mine. She came to me, feeling like crap, after the doctor had put her on numerous rounds of antibiotics for the Lyme:

“My sophomore year of high school I was diagnosed with Lyme’s Disease. This led to multiple rounds of doxycycline and amoxicillin along with my 5 year battle of joint pain, fatigue, and the ever present stomach issues. I finally began seeking help, and was led to Dianne. She put me on a treatment plan, for the lifetime of stress my body’s been under due to the high amounts of antibiotics I had been on, and quickly began rebuilding my gut. Alongside the supplements Dianne recommended, I changed my diet and almost immediately began feeling a change! Within three months I felt like a new person. I have a new lease on life that I had never experienced before and began living a life without fearing of the pain that was coming. I am now studying abroad in France and have the freedom from suffering with fatigue, pain, or digestive issues.”

As you can see a functional approach to Lyme is much more comprehensive than what you will get from the doctor alone. Antibiotics kill the Lyme but don’t support the healing or clean up the mess that the Lyme (or the antibiotics themselves) created.

2 Things That Get Rid of Allergies

This time of year, every one of my clients starts their session with “My allergies are horrible, what do you recommend”

There are many natural anti-histamines, allowing for relief from allergies without the horrible side effects that the medicines bring.

There are two products I really like:

HistaEze by Designs for Health

This product has stinging nettle, an anti-inflammatory allergy remedy that has stood the test of time through centuries. It also has quercetin, a natural anti-histamine and mast cell stabilizer. It also contains Vitamin C. These ingredients, plus a couple others, balance your immune response during allergy season.

AllQlear by Integrative Therapeutics

This product is actually chewable, so it is fast acting anti-histamine relief. It is made from quail eggs to stabilize mast cells (which release histamine).

If you are miserable, you can try both. They have different ingredients so you wouldn’t be getting double the ingredients, just double the relief.

Both of these are high quality 3rd party tested supplements that can’t be found in stores, but can be bought online through a practitioner’s dispensary. Click here to set up an account and shop!

And this post wouldn’t be complete without mentioning the gut. Allergies are linked to the microbiome. So cleaning up your gut and regulating your immune system would help too!