Lap Band Dietary Recommendations

Lap Band Dietary Recommendations

Who is eligible?

1. Presence of morbid obesity persisted for at least 5 years, defined as either:
A. Body Mass index (BMI) exceeding 40 or;
B. More than 100 lbs over one’s ideal body weight.
C. BMI greater than 35 in conjunction with one of the following:
1. Severe cardiovascular Disease.
2. Diabetes Mellitus uncontrolled.
3. Obstructive Sleep Apnea.
4. Severe Pulmonary Disease.
5. Three or more of the following risk factors:
a. Hypertension (BP > 140 mmHg systolic and /or 90 mmHg diastolic).
b. Low high-density lipoprotein cholesterol (HDL < 40 mg/dL).
c. Elevated low –density lipoprotein cholesterol (LDL > 100 mg/dL).
d. Family history of early cardiovascular disease in a first degree relative (myocardial).
(infarction at age < 50 years in a male relative or at age < 65 years in a female relative).
5. Patient has completed growth (18 years of age or documentation of completion of bone growth).

NUTRITION GUIDELINES FOR LAP-BAND PATIENTS

Lap- band surgery was developed to induce weight loss. However, some patterns must be modified simultaneously in order to achieve and maintain the desire weight loss.

1. EATING METHODS
Eat slowly and chew foods until they reach a mushy consistency!
1. Set aside 30 to 45 minutes to eat each meal.
2. Actually count the number of times you chew each bite. Aim for 30.
3. Make an EAT SLOWLY sign and place it on the table in front of you.
4. Explain to family members the reasons why you need to eat slowly so they will not urge you to eat
faster.
5. Take small bites of food. You may want to try eating with a baby spoon or chop sticks.
6. Pay attention to taste. Learn to savor each bite, noticing its flavor, texture.
7. Chew well. Ground or very soft foods may be necessary if you have dentures.

2. STOP EATING AS SOON AS YOU ARE “SATISFIED”!
Try to recognize the feeling of fullness then stop eating at once.
Indication of fullness may be:
- A feeling of pressure or fullness in the center of your abdomen just below the rib cage, feeling of nausea, pain in your shoulder area, upper chest or jaw.
• If you start vomiting, stop eating solid foods and just sip clear liquids.
If intermittent vomiting continues for more than 24 hours, contact your doctor.

The causes of vomiting are:
- Eating too fast and not chewing properly.
- Eating too much at meal.
- Drinking liquids right after eating.
- Eating foods that do not agree with you.

3. SET ASIDE THREE MEALTIMES PER DAY AND EAT SOLID FOOD AT THESE TIMES!
- The LAP-BAND system creates a small pouch that can hold about half a cup (3-4oz) of food.
- You need to learn how much your stomach pouch can hold comfortably.
4. DRINK FOUR TO SIX CUPS OF LIQUIDS PER DAY BETWEEN MEALS!
- In order to replace normal body water losses and thus prevent dehydration.
5. DO NOT DRINK WHILE YOU ARE EATING!
- You should not drink anything for at least one hour after a meal.
6. SIP BEVERAGES SLOWLY!
- Sip from a medicine cup or shot glass instead of drinking from a regular glass.
7. ELIMINATE HIGH CALORIE DRINKS!
- Avoid carbonated liquids because they could increase the size of the pouch creating discomfort.
8. DO NOT EAT BETWEEN MEALS!
9. EAT A BALANCED DIET!
- Eating foods from each of the four food groups will provide adequate amounts of protein, vitamins and minerals for your needs.
10. EXERCISE AT LEAST 30 MINUTES A DAY!
- Start with simple activities such as walking and swimming.
- Gradually increase your activity level in the course of daily living.

PROGRESSION OF THE DIET DURING HOSPITALIZATION
- After surgery, in addition to water you will first be offered clear liquids.
- In time, your diet will include blended and pureed foods.

PROGRESSION OF THE DIET AT HOME

First week after surgery
• You’ll be on a clear liquid diet.
• Clear liquids include clear broth or soup (with no vegetables no meat and not creamy),jello, fruit juice(no nectars, no pulp), water, tea, coffee, non carbonated beverages.

Second week after surgery
• You’ll continue on liquids but adding liquids that have thicker consistency such as skim milk, low-fat yogurt, cream of wheat, oatmeal, creamy soups, fruit smoothies (nothing that you will have to chew), and tomato juice.
• Begin taking protein supplements such as Soyamax, Isopure.

Third week after surgery
• In addition to pureed food such as blended meat, meat paste, liverwurst, yogurt (no berries or other types containing seeds), you may begin to add cottage cheese, sliced cheese, cheese dishes (low fat), tofu, scrambled and hardboiled egg and fish.
• You may slowly add soft canned fruits and vegetables, baked potatoes (with no skin), rice, grits, macaroni, noodles, rice cereals, etc..

Fourth to sixth week after surgery
• You may begin to add meats that are ground after cooking, such as pork, veal, chicken, turkey and beef.
• After your checkup you can begin to experiment more with food.
• Sliced meats as well as raw fruits and vegetables may be tried (chew them well).
• If you fell hungry between meals, you may sip on low-calorie drinks and flat water.
• You may substitute one meal for a protein shake.

Something to remember!!!!
- It is important that you eat food high in protein at each of your three meals and drink 1-2 cups of milk between meals.
- Protein is needed to renew of body cells.
- The recommended daily dietary allowances (RDA) for protein is:
56g/day for men
46g/day for women
You should try to eat 50-70g of protein each day.
• Recommendation for protein intake:
- Lifeway organic brand low fat kefir drink.
- Energizer shake

ENERGIZER SHAKE!

Ingredients:
6 ounces of tofu (organic, soft or “silken” packed in water, rinse and drain) or ¼ cup nonfat dry milk powder or powdered egg whites (available at Whole Foods, in the baking section, Bob’s Red Mill brand)
6 ounces organic plain low fat yogurt (Fage 0% Greek Yogurt is best for lower carbohydrates to fit in the fruit carbs.)
1 small banana
½ cup strawberries
1 cup frozen blueberries
½ cup fruit of your choice (e.g. frozen peaches, mixed berries, or cherries)
4 cups of organic unsweetened soy milk (try “Silk” or Trader Joe’s brand)
Optional –for added fiber and omega-3 essential fatty acids, stir in a Tablespoon of ground flaxseed (try Organic Bob’s Red Mill whole ground flaxseed meal) to the cup you drink, so it doesn’t get rancid, you need to drink it right away.
Directions: In a blender, put all ingredients together. If you like a thinner shake, add water and use less milk. Put the top on the blender, chop, blend, and whip. You’re all set for an energizing breakfast or snack. Add a piece of whole wheat/grain toast or a small bowl of >5 grams dietary fiber cereal with the shake for even more sustainable energy. Make this shake the night before, keep it in the blender and store it in the refrigerator. The next morning, just press whip, and you’ve got a quick and easy “on-the-go” energizer.
Serving size: 1.5 cups
Total servings: ~4
Nutrition Analysis per serving:
239 Calories, 31 grams Carbohydrates, 16 grams Protein, 6 grams Fat.


CERTAIN FOODS MAY BE DIFFICULT TO TOLERATE!
-Through trial and error you will be able to recognize your tolerance to some food items.
Some of the food items that the digestive system cannot handle as well are:
• Tough meats, especially hamburger.
• Members of oranges or grapefruit.
• Core, seeds or skins of fruits or vegetables.
• Fibrous vegetables such as corn, celery or sweet potatoes.
• Bread.
• Chili or other highly spiced foods.
• Fried food.
• Milk.

CERTAIN FOODS MUST BE AVOIDED!
Concentrated sweets- filling up on these can prevent weight loss and can replace healthier foods in your diet with high calorie, high sugary foods.
Examples to high sugar foods:
• regular soft drinks,syrops,cakes,biscuits,sweets,jams,jellies,marmalade,honey,kool aid, sugared ice tea, dried fruits, fruit drinks, canned or frozen fruits in syrup, table sugar, sugar coated cereal, candy, doughnuts, regular jell-o, sugar gum, molasses, cookies, sherbet /sorbet, regular pudding, sweetened, fruited or frozen yogurt.
Examples to high fat foods:
• Whole milk, chocolate, chocolate milk, chips, pies, pastries, ice cream.
- Alcoholic drinks such as beer, wine, liquors, port, sherry, cocktails, and champagne should also be avoided as much as possible.

!! Some goals to achieve:
• Protein:70 grams per day
• Fluids: 64 ounces per day.
• Carbohydrate<100
• Fats<25

!!!! For successful weight loss after Adjustable Gastric Banding Surgery, a change in your habits is necessary. You will not be able to lose as much weight as you like if you eat continuously or if you stretch your stomach by eating large amounts of foods at one time. You will achieve your desired weight loss only if you are willing to control what you eat and the way in which you eat it.

High Five for Fiber- Your Best Friend for Weight Loss and Detoxifying!

High Five for Fiber! Aim for 5 grams of dietary fiber or above per meal, for keeping yourself satisfied and clean. People who have a high dietary intake of fiber appear to have a significantly lower risk for developing heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases. Fiber is your best friend for giving you more satisfaction per chew-key to weight loss and helps lower blood pressure and cholesterol levels. Increased intake of soluble fiber improves blood glucose and increases insulin sensitivity in people with or without diabetes. Adding fiber in people who are obese significantly enhances weight loss. Increased fiber intake also improves symptoms associated with gastroesophageal reflux disease, duodenal ulcer, diverticulitis, constipation, and hemorrhoids. Prebiotic fibers, such as inulin and chicory root appear to improve the immune function. Dietary fiber intake provides similar benefits for adults and children. The recommended fiber intake is 20 to 35 grams per day for healthy adults and age plus 5 grams per day for children. Majority of children and adults are eating less than half of the recommended levels.

Include both soluble and insoluble forms of fiber daily. Oats have the highest proportion of soluble fiber compared to any other grain. Foods high in soluble fiber include oat bran, oatmeal, psyllium, vegetables (e.g., broccoli, brussels sprouts and cabbage), beans, peas, rice bran, barley, citrus fruits, strawberries and apples. Soluble fiber has many benefits, including stabilizing blood glucose levels and lowering cholesterol. Insoluble dietary fiber sources include whole-wheat breads, wheat cereals, wheat bran, rye, flaxseed (get the most benefits by consuming grounded/milled flaxseed, keep it sealed in an opaque package and store in the refrigerator/freezer), whole grain breakfast cereals (look for 5 grams of dietary fiber or above on the label), and vegetables such as celery, beets, turnips, cauliflower and carrots. Insoluble fiber offers many benefits including decreased cardiovascular risk and slower progression of cardiovascular disease in people who are at high-risk, intestinal health, reduced risk of colorectal cancer, hemorrhoids, and constipation. Fiber’s best friend is water, keep drinking water throughout the day to help the fiber get through.

* Choose high fiber foods (3 grams or more of dietary fiber per slice of bread/per snack-e.g., crackers, sports bars, and 5 or more grams per serving of cereal or per meal).
* High fiber starches include: whole-wheat couscous, sprouted grain bread, oatmeal, quinoa, amaranth, barley, bulgur, brown rice, yams, or winter squash
* High fiber fruits: S or S fruits (edible skin or edible seeds fruit): e.g., apples, strawberries, blueberries or oranges (get bioflavinoids and fiber from the white part of the orange)
* High fiber vegetables: the darker the better, and think of eating all the colors of the rainbow (e.g., broccoli, spinach, tomatoes, chard, kale, collard greens, zucchini, red/yellow bell peppers)
* Have your 5-A-Day for better health: 2 to 4 servings of fruit a day and 3 to 5 servings of vegetables a day.

High Five For Fiber- Get More For Your Chew! (Aim for 5 grams of dietary fiber or greater per serving for increased satisfaction and choose organic most often). *When the dietary fiber is greater than or equal to 5 grams, subtract the total grams of fiber from the total grams of carbohydrate for actual grams of carbohydrate.

Instead of going on a fast to detox, eat high fiber foods, drink lots of water, eat organic produce and exercise- That's more seal proof to keep your body clean inside for long-term! Much better and more satisfying than having a concoction of apple cider vinegar, maple syrup and lemon or drinking juice all day!

Dietary Fiber in Foods: (in grams)

Acorn Squash (1/2 cup cubes, baked)
5 grams fiber

Apple (1 medium, with skin)
4

Artichoke (1 medium, boiled)
16

Avocado (1/8, a wedge)
3

Baked Beans (1/2 cup, cooked)
7

Barley (1 cup, cooked)
6

Beans (½ cup, boiled black, pinto, or lentils, etc.)
7

Beets (1/2 cup slices, canned, harvard)
3

Blueberries (1 cup)
4

Blueberry Bran Muffin (1, Zen bakery brand)
10

Bran, 100% Nabisco Cereal (1/3 cup)
8

Broccoli, (1 cup, steamed)
5

Brown Rice (1/2 cup, cooked)
3

Bulgur (1 cup, cooked)
8

Carrots (1 cup slices, steamed)
6

Collard Greens (1 cup, chopped, boiled)
4

Green Peas (½ cup, frozen, steamed)
4

Lima beans (½ cup, canned)
6

Oat Bran (1/2 cup, cooked, Mother’s brand)
6

Oatmeal (½ cup, cooked)
4

Orange (1, medium)
3

Pear (1, medium)
4

Persimmon (1, medium, Japanese)
6

Potato (1, medium (5 oz.) baked with skin)
5

Pumpkin (1/2 cup, canned, Libby’s Solid Pack)
5

Quinoa (1/2 cup, cooked)
3

Raspberries (1 cup)
8

Romaine lettuce (3 cups shredded, raw)
3

Shredded Wheat (2 biscuits)
5

Soybeans, green (edamame, ½ cup, steamed)
4

Sprouted Grain Bread (one slice, Ezekiel brand)
3

Strawberries (1 cup)
3

Sweet Potato (1, baked with skin)
3

Swiss Chard (1 cup chopped, steamed)
4

Taro (1/2 cup slices, cooked)
3

Tomato Paste (1/2 cup, canned)
5

Whole wheat couscous (2/3 cup, cooked)
7

Whole Wheat Crackers (5, Kaman brand)
3

Whole Wheat Pasta (1 cup, cooked)
6

Yam (1/2 cup cubes, baked)
3

Aim for a high fiber carbohydrate and a low fat protein at each eating time to keep yourself optimally fueled and sustained about every 4 hours!

Enjoy Liviting! :)

Your Livitician™ Coach,

Deborah A. Klein, MS, RD
http://www.livitician.com/

Livitician™ introduces LIVIT instead of diet!: Tips to Help Save Your Life!!!

http://www.amazon.com/SuperFoods-That-Will-Save-Your/dp/0071625755/ref=sr_1_1?ie=UTF8&s=books&qid=1261907435&sr=1-1

Tips to Help Save Your Life!!!

Liviticianisms™ from Deborah A. Klein, MS, RD: To Help Save Your Life! (quotes from Deborah A. Klein, MS, RD, Author of "200 Superfoods That Will Save Your Life"-available on Amazon: http://www.amazon.com/SuperFoods-That-Will-Save-Your/dp/0071625755/ref=sr_1_1?ie=UTF8&s=books&qid=1261907435&sr=1-1)

1.) “Keep sippin’ throughout the day to ensure you are meeting your water needs.”
2.) “The best way to tell whether you’re hydrated or not is to look at your urine, aim for pale yellow or clear like water.”
3.) “Overthrow the king, food is not your master, do not bow down to it, you are in charge of what goes on your throne.”
4.) “1 indulgence a day is part of the Livit™ plan.”
5.) “Food does not have a heart, mind or a soul.”
6.) “Think before you eat; are you physically hungry or emotionally hungry?”
7.) “Nourish your emotions with action rather than a knife and a fork.”
8.) “Have a meal free from TV, Books, and Papers.”
9.) “Keep your surroundings clean, one of the elements of health is a clean environment.”
10.) “Have plants around you, in your home at work, they add oxygen (life) into your life.”
11.) “Laugh daily, laughter increases your immune system, works your abs, and lightens things up.”
12.) “If something is bothering you, stressing you out, take care of it, ASAP, get the stress toxins out of you, by dealing with what it is, or with a massage, a cup of tea, or deep breaths.”
13.) “Eat mindfully.”
14.) “Respect Your Body-Rather Than Treat it Like a Dump.”
15.) “After you eat, DISTRACT, DISTRACT, And DISTRACT.”
16.) “The key to change is being receptive, even the slightest bit will do.”
17.) “Your health is in your hands.”
18.) “I don’t need another cookie, just dance, dance, and dance instead.”
19.) “Make time to MOVE, rather than think of needing to exercise, just think of moving.”

* Exercising 7 ½ minutes a week fights Diabetes. Spurts of high-intensity exercise can significantly improve factors such as insulin resistance and glucose tolerance linked to type 2 Diabetes risk. Research results showed 4 to 6 (30 second) sprints on a stationary bicycle every-other-day, can enhance insulin’s ability to clear glucose from the bloodstream after eating. (BMC Endocrine Disorders, Jan. 28 2009). For more calorie burning, 30 to 45 minutes, 5 to 6 times per week is more effective for weight loss.

20.) “Move away from the table and MOVE.”
21.) “Gimme 5 for better health, have at least 2 fruits per day and 3 servings of vegetables per day: fruit at snacks and veggies with lunch and dinner.”
22.) “3’s a charm, follow the 3 rule for low fat and 3 grams of fiber minimum per snack or slice of bread.”
23.) “Fiber gives you more for your chew.”
24.) “High 5 for fiber.” (Have at least 5 grams of fiber per serving for meals, look at the dietary fiber per serving on labels).
25.) “If you’re thirsty, you are already dehydrated.”
26.) “Keep healthy foods healthy.”
27.) “Shine after- it’s best to add oils after cooking for flavoring to prevent eating rancid oil.”
28.) “No puddles, just shine on the pan, when stir-frying, put a little bit of high heat oil, e.g., safflower oil, sesame oil or soybean oil, and use a paper towel to wipe off the excess.”
29.) “Put things in your life that makes life worth living.”
30.) “Have exercise be the same level of urgency as the need to urinate.”
31.) “Lift the fog, be present when you eat.”
32.) “Food is not your master, focus on other passions besides food. Food went on the throne when you lost sight of your other passions.”
33.) “The stomach is roughly 5% of your body; that is how much time our mind needs to think about food.”
34.) “Instead of going to the refrigerator when you are not hungry, move, laugh, sing, call a friend, read a book, have some tea, get your mind focused on something else.”
35.) “Put laughter into your day, 20 seconds of belly laughter is equivalent to a 2 minute abdominal workout.”
36.) “Think positive self talk, keep giving yourself positive words, people/things you are thankful for and keep laughing.”
37.) “Lighten up, keep things in perspective, relax, and move on.”
38.) “When you are stressed, take 3 deep breaths through the nose (filtered breathing), look outside, take a look at the sky, smell some flowers, enjoy a sunset, or just think of the ocean, see the waves.”
39.) “Talk to your kids or kids in your family, they keep you appreciating the little things in life.”
40.) “It doesn’t come out of the cow orange; choose white cheese rather than orange cheese.”
41.) “Follow the Deborah’s shine test when you are at buffets, selecting ready to eat foods- the shinier it is, the higher fat it is.”
42.) “If the food puts shine on your fingers, it will put shiny grease in your body.”
43.) “Eat within 1 ½ hours after waking and every 3 to 4 hours to prevent getting “over hungry” and to get your body into the burning mode.”
44.) “Need fuel to burn fuel, eat before you exercise.”
45.) “Part of the definition of eating is enjoying (never have to force food).”
46.) “Enjoy your dessert without guilt; it’s part of the plan-it’s all about balance.”
47.) “No one ever regrets going to the gym, it’s getting there that people have a hard time with- be in robot mode, rather than thinking about exercising, just do it, don’t let yourself think about it, move on auto pilot.”
48.) “Schedule a health appointment in your calendar, that’s your time to exercise; you have an appointment, you need to be there, it’s like a meeting with the President, you can’t cancel that.”
49.) “Low-fat cheese is fine as your protein source for a snack, but for a meal, cheese is not enough, have beans or fish present.”
50.) “Be on auto pilot, robot mode, when it comes to exercise, just do it, you do not have the prerogative to not exercise, you were given muscles for a reason, use them. Think of the urgency of exercise the same way as needing to go to the bathroom, you can’t say sorry bladder, I need to do this email, I need to make a call, your bladder won’t let you say no, the same with your muscles, they do not want you to ignore them, they want you to use them so they can express themselves, show their strength.”
51.) “Always have a pair of sneakers with you in your car or at the office, walk outside around the office, have moving meetings (talk on walk), go up and down some stairs.”
52.) “Your body was given to you on loan, be respectful of what was provided to you and responsible for your health, treat your body like your best friend.”
53.) “Respect your body; don’t treat it like a dump!”
54.) “Beans are the healthiest food on earth, high in fiber, protein and antioxidants, just rinse the cooked beans well before eating to prevent flatulence.”
55.) “This diet is such a success for me; I just have to go back on it-that is not success.”
56.) “Follow A Livit™, that is success- since you can stick to it for life.”
57.) “Little steps that you do make a huge difference.”
58.) “Each little thing you do differently can drastically change your body.”
59.) “Live a life of self-respect, honesty, and being real with your emotions.”
60.) “E-motion=energy in motion, every time you want more food when you are not hungry, before you eat, feel and analyze the reality of your emotion.”
61.) “Emotion is the state of motion, the more you move; the better you feel!”
62.) “Focus on the road rather than your blackberry when driving or walking!”
63.) “Eat a variety of foods; each food is its own state, we need the whole world to get all our vitamin and mineral needs met.”
64.) “Go to sleep before midnight, an hour of sleep before midnight is like 2 hours of sleep after midnight, you get much better sleep before midnight, based on our circadian sleep rhythm.”
65.) “Aim for 7 hours of sleep a night, a key to keep you lean, hormonally will hook you up to feel more satisfied throughout the day!”
66.) “Follow a version of the most effective study method, the Cambridge study method (30-10-2; 30 minutes of study, 10 minute break, and 2 minute review of what you studied in that previous 30 minutes). After working an hour, take a moving break, move for a couple minutes (e.g., march in place, do some jumping jacks, go up and down some stairs, walk around the block or your office building).” “When you return to your desk you will be not only burn more calories you will be much more productive, more ideas will come into your head stepping away and you’ll get a clearer perspective on your task at hand.”
67.) “Diet words: Can’t, don’t, won’t, never, deprived, starved, out of control, counting, bad foods, restrict, disrespect hunger cues, save points.”
68.) “Livit™ words: Can, yes, balanced, do, feel, think, listen, high fiber, satisfied, prioritize, move, enjoy, self-care, self-respect, health is in your hands.”
69.) “When you want to eat a food, it is healthier to eat it, then not to, even if it’s higher in fat, if you have it when you want it, it will help prevent you to overload on it later.”
70.) “Forget about what your chronological age is, what’s important is how you feel and act.”

Enjoy Liviting™! Enable your vision to become a reality. Live a life of fulfillment and passion!

Health, happiness and success to you,

Your Livitician™ Coach:
Deborah A. Klein, MS, RD
www.livitician.com, deborah@livitician.com
Please contact me if you have any questions; I am cheering you on to attain optimal health and live younger longer!

Endometriosis: Nutritional Recommendations!

A friend of mine was diagnosed with Endometriosis and she has been trying to get pregnant for over a year now, so I pray that these nutritional recommendations help her and those of you out there who have the same diagnosis. Thankfully the food choices you make, can have a significant impact! That hand to mouth action has a lot of POWER!!

Endometriosis- is the abnormal growth of cells that form in the uterine lining. Some of these cells, instead of leaving the body during the menstrual cycle, actually end up continuing their cycle elsewhere in the body. So, the material builds up and may attach itself to other organs in the lower abdomen, such as the ovaries or bowel. Several types of symptoms may result, such as pain in the uterus, lower back, and organs in the pelvic cavity prior to and during the menses; intermittent pain throughout the menstrual cycle; painful intercourse; excessive bleeding; nausea/vomiting/constipation during menses; difficulty passing stools; pain while urinating; and sometimes, infertility. Since menstruation is typically heavy, iron-deficiency anemia is common.


According to the Journal of the American Medical Association (JAMA.1999; 282: 2347-2354), an estimated 5 to 7 million American women have endometriosis. No one knows what causes endometriosis, one theory is that menstrual fluid backs up into the fallopian tubes and drops into the peritoneal cavity, where endometrial cells implant themselves and grow. Research has shown that exposure to two types of hazardous waste materials, PCBs and dioxin, can cause spontaneous endometriosis. These environmental pollutants: polychlorinated biphenyls (PCBs)- still present in many pre-1979 products, older fluorescent lights and by eating contaminated fish, meat, and dairy products. Catfish, buffalo fish, and carp usually have the highest PCB levels and dioxin, may account for the rising incidence of endometriosis in the last few decades. Because dioxins accumulate in fish fat, you can reduce your intake of dioxins by: removing the skin and fatty areas from fish filets, rather than fry fish, barbecue, broil, or bake fish on an elevated rack that allows fat to drip away. Throw away the drippings. You can also poach fish as long as you throw away the broth. Other ways to avoid exposure to dioxins: wash fruits and vegetables before eating and not breathing smoke and vapors given off from burning household waste.

Nutritional Recommendations for helping to keep endometriosis under control if diagnosed in the early stages:

Supplementation: Order at http://www.livetician.meta-ehealth.com/:

* Vitamin E: 200 IU daily (order: E-Complex 1:1™) -aids hormonal balance.


*Vitamin K or alfalfa: 200 micrograms daily- essential for normal blood clotting.


*Omega-3 fatty acids: 1,500 mg daily-EPA-DHA Extra Strength® Enteric-Coated (provides essential fatty acids that aids in hormonal balance.


*Iron: As directed by your MD- to prevent iron-deficiency anemia.


*Vitamin C with bioflavonoids:Ultra Potent-C® 500


*Zinc: 50 mg daily. Zinc A.G.™ -for tissue repair and immune function.


Calcium and Magnesium: Cal Apatite® Forte Capsules-To supply needed minerals.


*Juice Plus: Order at http://www.livitjp.com/ (great to use as your whole food multi-vitamin and mineral complex, great source of B-vitamins)


* Probiotics: Ultra Flora Plus® Capsules- helps with overall nutrient absorption and immunity.

Foods:


Eat predominately a high fiber diet, rich in whole soy foods, stay clear from soy protein concentrate or isolated soy protein or soy protein isolate, stick with: edamame, unsweetened soy milk, organic tofu, and soy yogurt. Focus on eating raw vegetables and fruits, whole grains and raw nuts and seeds. Also, eat Kelp (try wakame seaweed)- rehydrate in water and great to add in a soup or eat sushi with seaweed. Include "green drinks" made from dark green leafy vegetables.


Stay clear from: alcohol, caffeine, saturated (animal) fat, butter, whole milk dairy products (non fat or low fat dairy is ok, e.g., 0% greek yogurt and low fat ricotta cheese), fried foods, foods that contain additives, all hardened fats, junk foods or fast foods, red meats, poultry (except for organic, no hormones, skinless chicken/turkey breast), refined and processed foods, salt, shellfish, and sugar (except for raw agave nectar).


Keep yourself hydrated: Drink filtered water throughout the day, keep sipping-keep your urine clear like water.


Use a heating pad, hot water bottle or a hot bath with Epsom salts, to help relieve pain. The warmth relaxes your muscles.

Move daily- walk, take aerobic classes, stretch, do yoga, dance, swim- Aim for 45 minutes to an hour per day of moving, can spread it out by doing intervals of 15 minutes a few times per day. Schedule moving in your calendar, it's a health appointment, no one or nothing can get in the way. (According to research from the: (Am J Epidemiol 2003; 158:156-164)- strenuous exercise lowers the level of estrogen in the body, which may help suppress the symptoms of endometriosis).

See your OB-GYN regularly.



Enjoy Liviting! May all of you who want to get pregnant, get pregnant soon and L'chaim to a healthy pregnancy and healthy baby! :)

Your Livitician Coach,

Deborah A. Klein, MS, RD

http://www.livitician.com/
deborah@livitician.com

Radiation Clearance Recommendations: Detoxification

I had a patient this week, who was overexposed to radiation. Here's some recommendations that I provided her that may pertain to you if you are looking to remove (clear) radioactive materials from your body.

RECOMMENDATIONS FOR DETOXIFYING EXCESS RADIATION:
1.) Eat predominately a Macrobiotic diet:
a. Have your staple foods include: organic brown rice, miso and tamari soy sauce soup, wakame and other sea vegetables, pumpkin, and sea salt (available at a natural food store/Whole Foods).
b. Stay clear from sugar and sweets, except a teaspoon of raw agave nectar or raw honey per day is fine.
c. Eat organic fruits and vegetables exclusively. There’s no room for pesticide and toxic residues in your body.
2.) Also include the following foods for optimal health:
a. Organic Apples-good source of pectin, which binds with radioactive particles.
b. Eat buckwheat, which is high in rutin, a bioflavonoid (antioxidant) that protects against the effects of radiation.

Recipe for Buckwheat:
Kick it Up Kasha:
Ingredients: Choose all organic vegetables.
1 Tablespoon of cold-pressed safflower oil
1 large onion, chopped (1 cup)
1 celery stalk, chopped (1/2 cup)
1 large green/red/yellow- your choice-bell pepper-chopped (3/4 cup)
1 garlic clove, minced
1 teaspoon of oregano
½ teaspoon of cumin
1 teaspoon of mild chili powder
¾ cup buckwheat groats (kasha), optimally whole (available at Whole Foods in the grain/rice section)
1 (35-ounce) can tomatoes, coarsely chopped, liquid reserved
Freshly ground pepper, to taste
1 cup coarsely grated Monterey Jack (3 ounces) cheese
Directions:
1. In a large saucepan with a tight-fitting cover, heat the oil. Add the onion, celery, bell pepper, and garlic, and sauté the vegetables until the onion is soft, about 5 minutes.
2. Stir in the oregano, cumin, chili powder, buckwheat groats, and tomatoes with their liquid. Season the mixture with black pepper. Bring it to a boil, reduce the heat, cover the skillet, and simmer the kasha for 10 to 15 minutes or until the liquid has been absorbed and the kasha is cooked.
3. Sprinkle the kasha with cheese, cover the skillet, and let the kasha stand for another minute or so to melt the cheese.
Enjoy!!
c. Add avocados, lemons and cold-pressed safflower and olive oils, ground flaxseed (Spectrum or Trader Joe’s brand) and shelled hemp seed (Manitoba Harvest or Nutiva brand shelled hemp seed) for essential fatty acids. {available at a natural food store/Whole Foods, put a Tablespoon of ground flaxseed and a Tablespoon of shelled hemp seed stirred into cereal before you pour in the milk, or add it to yogurt or salad dressing or soup}. After opening, store the ground flaxseed and shelled hemp seed in it’s opaque packaging with a chip clip, in the freezer.

3.) Before going to sleep. Pamper yourself with a 20-minute baking soda (sodium bicarbonate) and sea salt bath (mixing half a pound of salt and half a pound of baking soda). Add the salt when the bathtub is somewhat filled for 3 days. Then take baths with Epsom salt, which has purgative qualities.
4.) Drink Echinacea, Kombucha and Green tea. Once a day have a cup to 3 cups of either of these suggested teas. Available at Whole Foods.
5.) Satisfy a sweet tooth with organic fruit instead of concentrated sugar/sweets/baked goods.
6.) Make a radiation clearing soup, have a bowl once a day:
Miso Healing Soup:
Ingredients:
2 Tablespoons safflower or vegetable oil
1.5 pounds yellow onions, thinly slices (about 5 medium onions)
¼ cup miso
4 ¼ cups water
8-inch piece of Wakame seaweed (available in the dried sea vegetable/asian cuisine aisle of natural food store/Whole Foods)
1.5 teaspoons of reduced-sodium soy sauce or Bragg’s Liquid Amino’s (available at natural food store/Whole Foods-low sodium soy sauce)
1 Teaspoon of Raw Agave Nectar or Raw Honey (optional)

Directions:
Heat oil in a large saucepan over low heat. Add onions, stirring to coat them with the oil. Cover and cook until the onions are tender, translucent, about 15 minutes. Add small amounts of water as needed, about a tablespoon at a time, to prevent sticking. Pour 4 cups of water into the saucepan, add the Wakame seaweed.
Place miso in a small bowl. Add the remaining ¼ cup of water from the ingredients list, stirring until mixture is smooth. Add to the soup mixture in the saucepan; add soy sauce/Bragg’s and the agave or raw honey (optional). Heat through, but do not boil.
Enjoy!
7.) Take your supplements daily:
i. Juice Plus (Orchard Blend and Garden Blend): order from www.LivitJP.com, take 1 capsule of each twice per day with a meal and a glass of water. For example, take the Juice Plus (red and green) with a glass of water at breakfast and dinner.
ii. Have Vitamin C (ester-C): 500 to 1,000 mg per day.
iii. Take your probiotics: Ultra Flora Plus Capsules or powder (1/4 teaspoon mixed with water): order from www.livetician.meta-ehealth.com (probiotic-friendly bacteria) once per day with breakfast and a glass of water.
iv. Take fish oil capsules. EPA-DHA extra-strength, enteric coated: order from www.livetician.meta-ehealth.com. One to 2 capsules per day with a meal and a glass of water.
8.) Keep yourself hydrated! Sip water throughout the day! Bring a water bottle with you everywhere you go. You know you are hydrated when your urine is clear or pale yellow. If you are thirsty or urine is dark yellow, you definitely are not drinking enough water. Staying hydrated is also a great way to prevent headaches.
9.) Move every day! Do a 30 to 45 minute walk daily or dance or swim or bike. Whatever you enjoy doing, put moving in on a daily basis. To keep your body oxygenated and the lymphatic fluid flowing-for great healing. Apply the Cambridge Study Method- the most effective way to study: 30/10/2- study for 30 mins., take a 10 min. break, review what you studied for 2 mins.- into your work day, take a moving break after sitting at your desk for 30 minutes to an hour.

Enjoy Liviting! Please contact me if you have any questions at deborah@livitician.com.
Your Livitician™ Coach,

Deborah A. Klein, MS, RD

Food Additive Intake and Impact on Health!

Food Additive Intake and Health Effects: A Comprehensive Review.
By: Deborah A. Klein, MS, RD

ABSTRACT
This review examines the health ramifications of consuming food additives in regards to toxicity effects to organ tissues, stimulation of hyperactive syndromes in children, carcinogenic repercussions, reproduction adversities, and possible effects related to obesity. The specific additives researched include, but are not limited to: artificial food colors (e.g., E100, amaranth-food red No. 2, FDC Red no 3, Sunset Yellow FCF, cochineal extract (also called carmine), metanil yellow, orange II, and caramel color III), preservatives (e.g., sodium benzoate, nitrites, sulfites and monosodium glutamate), ‘first generation’ sweeteners (e.g., saccharin, cyclamate and aspartame) and ‘new generation’ sweeteners (e.g., acesulfame-K, alitame, neotame, and sucralose). Food additives, researchers have stated, have “possible noxious effects on health” and are still continuously used within various food products (14). Regulations to avoid early exposures to particular food additives, especially during pregnancy and lactation may have a significantly positive contribution to the health of humankind.

INTRODUCTION
Food additives are not all harmful. The majority are safe and an effective way to preserve, fortify and add flavor to pre-packaged foods. Food additives include the basic components, such as salt, sugar, vinegar, baking powder and soda, vitamins and minerals, thickening agents (gums), flavorings and natural colorings. Additives are classified as “direct additives,” which are directly added to the food during its preparation, and “indirect additives,” which are substances that may be leached into the food from the packaging materials. Judiciously used, food additives are very helpful to maintain food safety, maintain food quality in regards to taste and consistency, and provide vitamins and minerals (increasing nutrient density). However, some ill effects from food additives can occur, such as inducing gastrointestinal discomfort, headaches, allergenic responses, carcinogenic effects, hyperactivity and effects on pregnancy and lactation.
Concerns about the neurotoxic effects of food additives have become a prominent public health issue and has resulted in demands for an increased level of assurance that efforts are being made to minimize the risk of neurotoxicity from human exposure to food additives (18). The FDA has addressed these concerns by revising the toxicity testing guidelines for food additives (18). To protect one’s overall health and prevent ill consequences from specific foods, the most important element is awareness. Thus, the purpose of this research review is to provide an overview of the research regarding food additives, enlightening the public on what to look for on food labels and know the possible consequences of eating foods with particular food additives.

ARTIFICIAL FOOD COLORS:
An extensive list of artificial colors has been added to foods and researchers continue to assess the impact these colors have on one’s health. Human studies indicate that food colors (natural and synthetic) can induce a vast range of allergic reactions especially in sensitive or atopic individuals (8). An exorbitant amount of reports have been made on the significant impact artificial colors have in relation to hyperactivity. Researchers, who conducted studies of 3 year old children, concluded that artificial food colorings do indeed show adverse effects on their behavior (4). Artificial colors in the diet, researchers report result in increased hyperactivity in children within the general population (12, 13). Studies demonstrate that eliminating artificial colors from the diet in children with attention deficit hyperactive disorder (ADHD) can be extremely beneficial in behavior in regards to helping them have a higher response rate (6).
In addition, consuming particular food colorings/additives have been reported as extremely detrimental and considered unsafe during pregnancy and breastfeeding. Current evidence suggests that food additives “induce alterations of the differentiation of several cell-types,” during pregnancy (16). For instance, E100 color additive, “is suspected to be embryotossic,” amaranth (food red No. 2) can result in reducing “olfactory orientation in F1 generation mice and beta-cyclodextrin produces a transient neonatal growth retardation in rodents” (16). Another food additive, methylmercury can cause neurotoxicity in breastfed babies from being excreted into the milk, while nursing (16). The genotoxicity of some synthetic red tar dyes, which are used as food color additives in many countries have been researched extensively and an association has been reported with inducing DNA damage (17). Amaranth (food red No. 2) and allura red (food red No. 40) assays in pregnant mice was shown to be positive in inducing DNA damage in the colon (17). Acid red (food red No. 106) did not induce any DNA damage in the test samples. The 3 dyes (amaranth, allura red, and new coccine-food red No. 18) induced DNA damage in the colon starting at 10 mg/kg in male mice (17). In addition, 1 mg/kg of N-nitrosodimethylamine induced DNA damage in the liver and bladder; it did not induce colon DNA damage. When F1 generation mice were given the color additive amaranth within their diet, their reproductive, developmental and behavioral parameters were influenced significantly (23).
The color additive Sunset Yellow FCF in the diet was measured in mice and assessed for reproductive and neurobehavioral parameters (19). Research data does demonstrate that Sunset Yellow FCF produces some adverse effects in reproductive and neurobehavioral parameters in male and female offspring during the early lactation period (19). Furthermore, the natural color additive cochineal extract (also called carmine) in food can produce some adverse effects in reproductive and neurobehavioral parameters in mice (21). Also, consuming “the color additive caramel color III (AC), may cause a reduction in total white blood cell counts in rats due to reduced lymphocyte counts” (22). The carmel color III suppressed thymus-dependent immunity, as demonstrated by “a decreased natural cell-mediated cytotoxicity in the spleen” (22). Other commonly used food colors, metanil yellow and orange II induced cell mutation at low concentrations (24).
PRESERVATIVES/OTHER ADDITIVES:
Extensive preservatives are added into a multitude of food products, several of them have been reported as resulting in increasing hyperactivity, contributing to cancer, and have ill effects during pregnancy and breastfeeding. With this knowledge in mind, these carcinogens and ill inducing additives are still being incorporated into the food supply. Specifically, diazoaminobenzene, which is “used as an intermediate, complexing agent, and polymer additive”, is “metabolized into known carcinogens benzene and aniline” (15). Sodium benzoate preservative contributes, similar to artificial colors, in increasing hyperactivity in children (13). Henceforth, researchers have predicted that diazoaminobenzene is a carcinogen (13).
Animal studies indicate that the food additive, monosodium glutamate (MSG) may be correlated with increasing one’s risk in becoming overweight, in regards to influencing energy balance, by inducing hypothalamic lesions and leptin resistance (26). Studies examining the relationship of MSG and excess body weight in humans showed a positive correlation. The prevalence of being overweight was significantly higher in MSG users compared to nonusers, independent of physical activity and total energy intake (26). In neonatal mice, MSG induced severe obesity with diabetes mellitus and/or non-alcoholic fatty liver disease (27). During pregnancy and development in rats, MSG administered orally, significantly affected hypothalamic control of various hormones, which in turn, increased appetite (10). High concentrations of MSG have demonstrated to “induce neuronal necrosis and damage in the retina and circumventricular organs” (9).
An additive in cosmetics that penetrates into the skin, butylated hydroxytoluene (BHT) has been shown to be tumor promoting. BHT is metabolized into carboxylic acid and glucuronide, which has been demonstrated in rat studies to result in renal and hepatic damage (11). BHT also when applied to the skin was associated with toxic effects in lung tissue (11).
ARTIFICIAL SWEETENERS:
Since the introduction of artificial sweeteners being added to a variety of foods and drinks, the public has been concerned about their effects on one’s health. Specifically, the mass media reports on the correlation of artificial sweeteners and possible increased risk for various types of cancer. Through extensive research via PubMed searches from the National Library of Medicine on articles about artificial sweeteners, the overall risk of inducing cancer seems to be negligible; however researchers are still reporting some ill consequences from artificial sweeteners. Epidemiological studies in humans showed no induction of bladder cancer from saccharin and cyclamate as reported in animal studies in rats (2). Case control studies showed an elevated risk of 1.3 from excessive artificial sweetener consumption (no specific substances were specified) equating to greater than 1.7 grams per day. New generation sweeteners have not been around long enough to establish any epidemiological evidence about possible carcinogenic effects. Animal bioassay results predict human cancer risks, and a recent animal study confirms that there is a potential carcinogenic effect from consuming aspartame (28).
However, human studies of both men and woman consuming aspartame daily from beverages for a year and over 5 years of follow-up showed that higher levels of aspartame intake were not associated with increased risk of overall hematopoietic cancer nor brain cancer (29) Overall research through 2004 showed that aspartame does not seem to pose a threat to promoting cancer, based on the acceptable daily intake of 40 mg/kg/day in Europe and 50 mg/kg in the United States, which equates to 10 cans of a drink fully sweetened with aspartame (1). “Intakes of over 1 g/day were needed to alter brain neurotransmitters and provoke seizures in monkeys” and randomized controlled trials of high doses in humans did not show any behavioral influence (1). However, other studies in 2006, suggest that “aspartame is a multipotential carcinogenic compound whose carcinogenic effects are evident at a daily dose of 20 mg/kg”, which is significantly less than the acceptable daily intake for humans (30).
Researchers speculate that an increase in lymphomas and leukemias may be related to one of the metabolites in aspartame, specifically methanol, which is metabolized in both rats and humans into formaldehyde. In long-term experiments both methanol and formaldehyde have demonstrated an increase in lymphomas and leukemias (30). As another perspective, artificial sweeteners can be beneficial in reducing body weight, for people who often drink regular sodas. “Drinking large volumes of aspartame sweetened soda, reduces sugar intake and thus may facilitate the control of calorie intake and body weight” (5). Please see Table 1 below for an extensive list of food additives and the negative influences on overall health.

Table 1: Specific Food Additives listed with their possible health effects.

Artificial colors/flavors– Yellow #5, Red #3, Blue #1, Green #3, etc. = some are suspected of being cancer causing, and may exacerbate hyperactivity (Journal Dev. Behav. Pediatrics 2004 Dec;25(6):423-34; Ann. Allergy 1994 May;72(5):462-8).
Artificial or processed sweeteners- Acesulfame potassium, Aspartame, Saccharin, Stevia, Splenda, sucralose, sorbitol, acesulfame, xylitol = may increase risk for cancer and stimulate appetite (Am J Clin Nutr 2003;78(suppl):843S-9S, Annals of Oncology 15(10):1460-1465, Oct 2004).
BHT - butylated hydroxytoluene (BHT) preservative= hepatotoxicity (liver toxicity) induced by the anti-oxidant food additive, may increase risk of cancer, and when BHT was applied to the skin, it was associated with toxic effects in lung tissue (Int. J. Toxicology 2002; 21 Suppl 2:19-94).
Caffeine = increases blood pressure, may cause insomnia if ingested late in the day, may affect the developing fetus, mildly addictive, can cause excess energy or hyperactivity in some people (Pediatrics 1989 Jan;83(1):7-17).
Carmine or cochineal extract - both are derived from female cochineal beetles, which are raised in Peru, the Canary Islands, and elsewhere. They provide a pink, red, or purple color to foods = may be declared as artificial color or color added on food labels and may be allergenic (www.cspinet.org/new/carmine).
Cocoa processed with alkali = processes out the benefits of cocoa, the antioxidants (catechins) are leached.
Dough conditioners – additives to help improve the quality of the finished dough= may include carcinogenic agents, for example, potassium bromate and may include emulsifiers such as mono-and diglycerides which include saturated fats.
Enriched, bleached flour = processed bread, destroys some of the nutrients originally present in the whole grains, enriched with some vitamins but not all those present in the original grain.
Flaxseed (whole not grounded), flaxseed oil = when the flax is whole, it goes right through, the body does not get the benefits of the omega-3’s; flaxseed oil may increase cancer risk due to high levels of alpha-linolenic acid (ALA) (Baillieres Clin Endocrinol Metab. 1998;12:691-705).
Ginseng (Panax ginseng) = Panax ginseng's most common side-effects is the inability to sleep. Other side-effects include nausea, diarrhea, euphoria, headaches, epistaxis, high blood pressure, low blood pressure, mastalgia, and vaginal bleeding.
Glycerol ester of wood resin = possible allergen, largely unabsorbed, some components are metabolized by the liver.
High fructose corn syrup, corn syrup solids = excess fructose can increase LDL (bad cholesterol level, clogs the arteries), is more readily converted to fat by the liver, increases the levels of fat in the bloodstream in the form of triglycerides (Am J Clin Nutr 1990;51:963-9).
Mono and diglycerides = those containing long-chain saturated fatty acids, especially stearic acid, increases blood cholesterol.
Monosodium glutamate (MSG) – flavor enhancer = may cause migraine headaches, chest tightness, wheezing, asthma attacks in those vulnerable, and increase appetite (Biomed Pharmacother 2006 Feb;60(2):86-91, An R Acad Nac Med (Madr) 2005;122(2):341-55).
Olestra- fat replacement = may cause diarrhea, loss of important fat-soluble vitamins.
Palm oil, palm kernel oil, fractionated palm kernel oil = saturated fat, increases LDL cholesterol.
Partially Hydrogenated and hydrogenated oils, trans fat = increases cholesterol level and is carcinogenic.
Polysorbate 60, 65- derived from sorbitol - an artificial sweetener = side effects include: Nausea, gas, diarrhea, stomach cramps or anal irritation.
Potassium bromate – may increase risk of cancer (www.cfsan.fda.gov).
Sodium nitrite, nitrites – meat preservatives = may increase risk of stomach cancer (Middleton’s Allergy: Principles and Practices. 5th ed. Mosby-Year Book, Inc.; 1998:1183-1186).
Sodium stearoyl lactylate- Sodium stearoyl lactate (and the similar calcium stearoyl lactate) - an emulsifier used as a dough strengthener in baked goods, is made by combining lactic acid and stearic acid, and then reacting the result with sodium
hydroxide or calcium hydroxide to make the sodium or calcium salt = stearic acid is a saturated fat (Baker’s Journal:November 2000).
Sodium sulfite, sulfites – provokes asthma attacks in those vulnerable, may increase risk for cancer.
Sorbitan ester of fatty acids - Mono-, di- and trisorbitan esters of palmitic, stearic, oleic, isostearic and sesquioleic acid = saturated fats.
Soy Protein Isolate, soy protein concentrate, isolated soy protein –isoflavones are weak estrogens = eating too much (more than 100 mg a day) could possibly increase risk of cancer (J. Nutrition 134:1229S-1233S, 2004).
Sucrose syrup = concentrated sugar
TBHQ (TERT-BUTYLHYDROQUINONE) = may induce free radical formation and erythrocyte membrane alterations (cell damage).
FUTURE RESEARCH
The emphasis of this review has been on isolated food additives. Since food additives are so vast, more research is needed on the effects of other food additives that were not included in this review. The development of standardized diagnostic criteria for hyperactivity would be helpful in identifying whether artificial colors and other additives indeed have a cause/effect relationship. More longitudinal prospective studies need to be done on food additives and influences on health (3). Further dietary research is needed that includes attention to adequate sample size, well designed criteria for subject selection, assurance of dietary compliance measures and consideration of synergistic effects of other dietary factors (3). More long-term studies relating to the effects of food additives would be useful information for the public. Any increased awareness on the consequences of consuming specific ingredients within food products, can have significant positive ramifications on human health and longevity. Rest assured, the food supply has never been better or safer, thank you to the regulatory agencies and public health authorities who are setting high standards for overall food safety (25).
REFERENCES
1. Lean, ME, Hankey, CR. Aspartame and its effects on health. BMJ 2004; 329:755-6.
2. Weihrauch, MR, Diehl, V. Artificial sweeteners-do they bear a carcinogenic risk? Annals of Oncology 2004; 15:1460-5.
3. National Institutes of Health Consensus Development Panel. National Institutes of Health consensus development conference statement: defined diets and childhood hyperactivity. Am J Clin Nutr 1983; 37:161-5.
4. Bateman, B, Warner, JO, Hutchinson, E, Dean, T, Rowlandson, P, Gant, C, Grundy, J, Fitzgerald, C, Stevenson, J. The effects of a double blind, placebo controlled, artificial food colorings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children. Arch.Dis.Child. 2004; 89:506-11.
5. Tordoff, MG, Alleva, AM. Effect of drinking soda sweetened with aspartame or high-fructose corn syrup on food intake and body weight. Am J Clin Nutr 1990; 51:963-9.
6. Boris, M, Mandel, FS. Foods and additives are common causes of the attention deficit hyperactive disorder in children. Ann Allergy 1994; 72(5):462-8.
7. Epstein, SS. The chemical jungle: today’s beef industry. Int J Health Serv. 1990; 20(2):277-80.
8. Babu, S, Shenolikar, IS. Health & nutritional implications of food colors. Indian J Med Res. 1995; 102:245-9.
9. Ortiz, GG, Bitzer-Quintero OK, Zarate, CB, Rodriguez-Reynoso, S, Larios-Arceo F, Velzquez-Brizuela, IE, Pacheco-Moises F, Rosales-Corral SA. Monosodium glutamate-induced damage in liver and kidney: a morphological and biochemical approach. Biomed Pharmacother. 2006; 60(2):86-91.
10. Fernandez-Tresguerres, Hernandez, JA. Effect of monosodium glutamate given orally on appetite control (a new theory for the obesity epidemic). An R Acad Nac Med. 2005; 122(2):341-55.
11. Lanigan, RS, Yamarik, TA. Final report of the safety assessment of BHT(1). Int J Toxicol. 2002;21:19-24.
12. Schab, DW, Trinh, NH. Do artificial food colors promote hyperactivity in children with hyperactive syndromes? A meta-analysis of double-blind placebo-controlled trials. J Dev Behav Pediatr. 2004; 25(6):423-34.
13. McCann, D, Barrett, A, Cooper, A, Crumpler, D, Dalen, L, Grimshaw, K, Kitchin, E, Lok, K, Porteous, L, Prince, E, Sonuga-Barke, E, Warner, JO, Stevenson, J. Food additives and hyperactive behavior in 3-year old and 8/9-year-old children in the community: a randomized, double-blinded, placebo-controlled trial. Lancet 2007; 370(9598):1524-5.
14. Petrescu, C, Aslau, DA, Doroftei, S, Vlaicu, B, Indrei, LL. Frequency of food additives in mass-consumed food products. Rev Med Chir Soc Med Nat Iasi 2003; 107(4):856-62.
15. Ress, NB. NTP Technical Report on the metabolism, toxicity and predicted carcinogenicity of diazoaminobenzene. Toxic Rep Ser 2002; 73:1-23.
16. Banderali, G, Carmine, V, Rossi, S, Giovannini, M. Food additives: effects on pregnancy and lactation. Acta Biomed Ateneo Parmense 2000; 71(Suppl 1):589-92.
17. Tsuda, S, Murakami, M, Matsusaka, N., Kano, K, Taniguchi, K, Sasaki, YF. DNA damage induced by red food dyes orally administered to pregnant and male mice. Toxicol Sci 2001; 61(1):92-9.
18. Sobotka, TJ, Ekelman, KB, Slikker W Jr, Raffaele, K, Hattan, DG. Food and Drug Administration Proposed Guidelines for Neurotoxicological Testing of Food Chemicals. Neurotoxicology 1996; 17(3-4):825-36.
19. Tanaka, T. Reproductive and neurobehavioral effects of Sunset yellow FCF administered to mice in the diet. Toxicol Ind Health 1996; 12(1):69-79.
20. Tanaka, T. Reproductive and neurobehavioral effects of cochineal administered to mice in the diet. Toxicol Ind Health 1995; 11(1):1-12.
21. Houben, GF, Penninks, AH, Seinen, W, Vos JG, Van Loveren, H. Immunotoxic effects of the color additive caramel color III: immune function studies in rats. Fundam Appl Toxicol 1993; 20(1):30-7.
22. Tanaka, T. Effects of amaranth on F1 generation mice. Toxicol Lett. 1992; 60(3):315-24.
23. Rastogi, PB, Thilly WG, Shirname-More L. Long-term low-dose mutation studies in human cells: metanil yellow and orange II. Mutat Res. 1991; 249(1): 265-73.
24. Newberne, PM, Conner, MW. Food additives and contaminants. An update. Cancer 1986; 58 (Suppl 8):1851-62.
25. HE, K, Zhao, L, Daviglus, ML, Dyer, AR, Van Horn, L, Garside D, Zhu, L, Guo D, Wu Y, Zhou, B, Stamler, J. Association of monosodium glutamate intake with overweight in Chinese adults: the INTERMAP Study. Obesity (Silver Spring) 2008; 16(8):1875-80.
26. Sasaki, Y, Suzuki, W, Shimada, T, Iizuka, S, Nakamura, S, Nagata, M, Fujimoto, M, Tsuneyama, K, Hokao, R, Miyamoto, KI, Aburada, M. Dose dependent development of diabetes mellitus and non-alcoholic steatohepatitis in monosodium glutamate-induced obese mice. Life Sci. 2009 Aug. 12.
27. Huff, J, LaDou, J. Aspartame bioassay findings portend human cancer hazards. Int J Occup Environ Health 2007; 13(4):446-8.
28. Lim, U, Subar, AF, Mouw T, Hartge, P, Morton, LM, Stolzenberg-Solomon, R, Campbell, D, Hollenbeck, AR, Schatzkin, A. Consumption of aspartame-containing beverages and incidence of hematopoietic and brain malignancies. Cancer Epidemiol Biomarkers Prev.2006;15(9):1654-9.
29. Environmental Health Perspectives, February 13, 2006.

MYTH: DON'T EAT FRUIT AFTER A MEAL!

QUESTION from Patient J.G.: I read on the internet that it's best to not have fruit after a meal, is this true?

ANSWER from Registered Dietitian, Deborah A. Klein, MS, RD:

Thank you for submitting your question. As a Registered Dietitian for 15 years with a Master's of Science in Foods and Nutrition, you are welcome to eat fruit after a meal that contains protein and very little carbohydrate to fit in the carbohydrate from fruit. It's best to eat fruit that is high in fiber, I call it "S and S fruits" (edible skin and edible seeds) fruit for more satisfaction and a slower digestion, fiber slows the absorption of the sugar in the fruit, helping you feel fuller longer. Carbohydrate foods including fruit, starch and dairy (milk and yogurt) are digested more quickly than protein. That's why I recommend eating fruit or any other high fiber carb (yams, whole grains, artichokes, etc.) with a dietary protein (which takes 4 to 5 hours to digest) to help you feel more sustained after eating (about 4 to 5 hours of sustainability). It's best to eat within an hour and half after waking and every 4 to 5 hours max throughout the day. Give yourself an hour and a half to 2 hours to digest before you go to sleep.

Every food needs to be digested to be utilized in the body. It's a good thing to have the fruit slowed down in regards to digestion from the fiber and the protein to help you feel fuller longer, it will not be fermented in your body, it will be utilized. Drink lots of water and take probiotics to help your body increase nutrient absorption.
Bottom line: eating a meal with high carbohydrates (pasta, bread or starchy vegetables) and then having fruit after that, I do not recommend, because that is overloading in calories which is not helpful for keeping a lean body and preventing disease. The whole concept of not eating fruit after a meal does help prevent overload. I do not recommend eating as much fruit as you want, since it does contain carbohydrate calories (1/2 cup fruit = 15 grams or carbs and 60 calories), excess fructose is excess calories (increasing body fat), excess fructose also increases LDL (bad cholesterol) (increasing risk for heart disease), and overworks the pancreas, stimulating excess insulin production, which increases risk for diabetes.

SENSA: Weight Loss Gimmick: Nutrition Expert Review

For all of you out there who are purchasing SENSA: Please do not waste your money on it or your time. Protect your body by not going down the SENSA route. As a Registered Dietitian, I do not recommend this product. It's a weight loss fiber sprinkles gimmick. It's just some fiber (maltodextrin- not the best fiber source) with artificial flavors, colors and carmine (the shell of a pregnant beetle). SENSA Ingredients: Maltodextrin, Tricalcium Phosphate, Silica, Natural and Artificial Flavors, FD&C Yellow 5, Carmine. Contains Soy and Milk Ingredients.

As your nutrition expert, I feel it is my duty to inform you that taking this product to help you lose weight is not the route to go. It's much better for you to have a couple Tablespoons of ground flaxseeds or raw wheat germ or chia seeds to add some dietary fiber sprinkles into your meals or snacks to help you feel full.

Yes, dietary fiber is key to lose weight, since it helps you feel fuller, gives you more for your chew! Dr. Alan Hirsch, M.D, F.A.C.P., a leading authority on smell and taste, the developer of SENSA has done fantastic research on helping people lose weight. Nothing against him personally. I think his research contributions to the weight loss arena is noteworthy. I just do not like the ingredients in his SENSA product. I want you to get lean by eating clean. As your Livitician, I want to help you lose body fat by putting clean ingredients in your body and develop a lifestyle that helps you attain optimal health and body weight in a way that you can live with for life. SENSA is not the optimal choice to accomplish your wellness goals.

Focus on eating within an hour to an hour and a half after waking and every 4 hours throughout the day (think before you eat, ask yourself if you are physically or emotionally hungry before you go for food). Eat a high fiber carbohydrate source with a low fat protein every eating time for optimal sustainability and satisfaction (e.g., apple with 1/4 cup of soy nuts, 1 cup of berries with 1/2 cup low fat cottage cheese, or a whole wheat slice of toast with 2 Tbsp. of all natural peanut butter). Add 2 Tbsp. of ground flaxseed to your organic cereal in the morning. Have vegetables with your lunch and dinner and fruit twice a day. Exercise (MOVE) 5 to 6 times a week for about 30 to 45 minutes, include weight lifting 2 to 3 times a week with cardio (dancing, walking, any type of moving you will do- schedule it in your calendar- make it a health appointment that you cannot break). Drink water throughout the day, fiber's best friend is water!

Enjoy Liviting! Email me if you have any questions: Deborah@livitician.com. I am here for you to help you achieve your weight goal in a long-term, enjoyable, and healthful way.

Health and happiness to you,

Your Livitician™,

Deborah A. Klein, MS, RD

Health Tips for Long-Term Lifestyle Change

Behavior Modification

A. Eating Tips:

1. Before you eat, take a couple seconds to do a mind-body check, ask yourself, “Am I hungry or am I stressed, anxious, depressed, etc.?”
2. Eat MINDFULLY! Eat and only eat = let the phone calls, reading, television watching wait until you’re done eating. Eating is the most constructive activity you can do to keep your body nourished.
3. Sit down while eating will promote enjoyment and aid digestion. Standing up while eating encourages MINDLESS eating, calories that we don’t get to relish.
4. Eat Slowly! Put your fork down between mouthfuls and chew your food ~ 20 times.
5. Pre-portion your plate with food, rather than rather than having serving plates or bowls on the table.
6. Assign ONE designated location for eating your meals and snacks.
7. Cut up your 3 to 4 ounce portion of meat or fish in small cubes or strips mixed with whole grains and lots of vegetables so you visually feel more satisfied.
8. Have a full plate when you eat by using a smaller plate (~8 inch) and fill it with lots of non-starchy vegetables.
9. Beautify your eating environment. Use nice pastel colored plates, a champagne or wine glass for your sparkling or flat water with lemon or lime, and in moderation as your indulgence for the day have your real wine or champagne. Use a linen napkin with a ring holder and a bouquet of flowers on the table.
10. Make your plate appealing. Attractively present food on your plate with a little parsley or mint leaf garnish and have lots of color with a multitude of vegetables. An unhealthy plate is all brown, definitely not appealing, e.g., fried chicken, french fries, mashed potatoes. A healthy plate is full of color.
11. If you are still feeling hungry after your meal, enjoy your “free foods” = non-starchy vegetables (e.g., ½ cup raw broccoli, cauliflower, cucumber/carrot/bell pepper sticks, pickles, jalapeno peppers, salsa), water, herbal teas, flavored sparkling waters or have a cup of hot cocoa with 1 Tbsp. unsweetened cocoa powder with hot water, tsp. cinnamon/vanilla extract and a dash of Agave Nectar.
12. Have 1 indulgence a day to prevent deprivation and promote mental satisfaction.
13. Good habit, eat before you leave the house and if you’re on-the-go all day, pack an insulated lunch bag with an igloo ice pack with some balanced snacks, e.g. fruit, part-skim milk cheese, trail mix.
14. After you eat your pre-portioned snack/meal, brush your teeth, which will help affirm the completion of that eating time.

B. Lifestyle Tips:

1. After eating your portioned amount, DISTRACTION, DISTRACTION, DISTRACTION = key to portion control! MOVE away from the table immediately and occupy yourself with another activity, e.g. talk on the phone, read a book, do the dishes, take a bath, let your food digest for about 30 minutes then go for a walk.
2. Keep yourself hydrated, to help you stay satisfied between eating times. Carry a water bottle wherever you go and snack on some vegetables, e.g., ½ cup of sticks of cucumbers, bell pepper, carrots, celery, and jicama.
3. GET UP OFF YOUR SEAT AND MOVE!! For every hour you work, make 5 to 10 minutes of it MOVING time, e.g., use a portable phone and walk, put your legs up and down, dance, do the pendulum abdomen workout.
4. Integral to your success, keep 3-day food diaries weekly and consistently.
5. Increase your physical activity, by parking further away from your destination and take the stairs instead of the elevator.
6. Write a list of non-food related pleasures, e.g., bath, painting, exercise, shopping, etc.
7. If you’re hungry ~every 3 to 4 hours, GOOD JOB, you are eating balanced and the right portion sizes. If you are not hungry after ~4 hours you probably ate too much at the meal prior or you are so occupied with what you’re doing you don’t realize that you are hungry, which sets us up for overeating.
8. Realize food does not have a heart/mind/soul, it is your fuel and physical nourishment. To have mental healing, focus on doing a recreational activity – RE-CREATION (hobbies, talk to an inspiring friend, meditate, write your thoughts down in a journal, and MOVE – emotion is the state of motion.

Enjoy Liviting!
Deborah A. Klein, MS, RD
deborah@livitician.com

Bone Friendly Foods!

Prevent Bone Fractures with optimal dietary choices including Vitamin D, Calcium, Magnesium, Vitamin K, Vegetarian Protein predominating, Low Sodium and Exercise!

In Illinois researchers randomly assigned 5,000 female Navy recruits at the Great Lakes Naval Training Center to receive either a placebo or Vitamin D (800 IU) plus calcium (2,000 mg) daily during basic training. After 8 weeks, 6.6 percent of the placebo takers had stress fractures compared to 5.3 percent of the calcium-plus-D takers; that is a significant 20 percent difference.

KEY: Make sure you are receiving enough calcium and D daily to help prevent fractures as well as doing weight bearing exercise (e.g., running, walking, dancing, weight lifting) most days, aim for 30 to 45 minutes of exercise 4 to 6 days per week. Have 1,200 mg a day of calcium and 1,000 IU a day of Vitamin D.

Calcium Sources: Almonds, Brazil Nuts, Caviar, Cheese, Kelp, Milk, Cottage Cheese, Ricotta Cheese (lower in sodium than cottage cheese, great on toast with cinnamon), Molasses,Canned Salmon, Canned Sardines, Shrimp, Soybeans, Tofu, Turnip Greens, Yogurt (Greek zero percent or two percent is great, get your protein and calcium without the sugar).

Vitamin D Sources: The best way to get your vitamin D is being out in the sunlight for 15 to 20 minutes a day, the ergosterol underneath our skin converts to vitamin D, stimulated by the ultra-violet rays. Not to worry, you can still wear your sunscreen to protect yourself from getting cancer and get your vitamin D formed. Even the best sunscreen cannot block all UV radiation. The amount that does hit the skin is enough to promote adequate vitamin D formation.

Smokers actually have some healthy habits; I know that sounds like an oxymoron, but they take time to give themselves a break throughout the day to go outside, get some sunshine and take some deep breaths. They just need to seriously learn to do all that without the cigarettes. However, we can learn from the smokers and set a good example for them by doing what they do without the cigarette and get our vitamin D. Let's take our breaks outside for phone calls, eating our snacks/meals, meditating breaks or just taking a few deep breaths and appreciating our surroundings.

Food sources of Vitamin D, include Cod-liver oil, Herring, Mackerel, Salmon (choose Wild whenever possible), Sardines, and Vitamin-D-fortified milk.

A Great Calcium Supplement that also has Vitamin D, Magnesium, and Vitamin K is Phytotherapy Liquid Calcium Softgels, available at Whole Foods.

Magnesium and Vitamin K are also important to maintain bone mineral density!

Magnesium Sources Include: Almonds, Cod, Halibut, Swordfish (is not kosher), Leafy Green Vegetables, Molasses, Nuts, Soybeans, Wheat Germ, Sunflower Seeds.

Vitamin K Sources Include: The main one is the plant form phylloquinone (green vegetables contain the highest level). Have dark-green, leafy vegetables, e.g., kale, parsley, spinach, cabbage, broccoli, brussel sprouts and lettuce. Soybean, canola and olive oils are relatively rich sources too.

Also eat predominately a vegetarian based, low sodium diet, have meat 1 time a day maximum and choose foods that have less than 150 mg of sodium per serving most often. Excess protein and sodium can increase calcium losses in the urine (Alternative Medicine Review 1999;4(2):74-85). "40 grams of animal protein (representing about 800 mg of elemental phosphorus) takes out about 40 mg of calcium," (Annals NY Academy of Sciences 1998;854:336-351). For more information on vegetarian eating and maintaining your bone strength. Contact The Livitician Network at (310) 247-0018.

Enjoy LIVITING,
Deborah A. Klein, MS, RD