Detoxification: Is it Important?

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by Filomena Trindade, MD, MPH

We live in a toxic world. Toxins are everywhere and affect every aspect of our health. Thus, the question we should all be asking is not ARE we toxic, but rather HOW toxic are we?  
The increasing rates of insulin resistance, diabetes, cancer, hormonal problems and obesity in the United States in large part is due to toxins.  This link has been studied by several researches and several studies explain the mechanisms (1, 2, 3, 4,10,12, 13). Many of these toxins are environmental xenobiotics or “endocrine disruptors” or toxins that act like hormones and which modify intercellular communication and function.  

Chemicals commonly detected in people including DDT, Polychlorinated biphenyls (PCB's), Bisphenol A, Polybrominated Diphenyl Ethers (PBDE's) produce a higher ratio of the 4 and 16 hydroxylated estrogen derivatives.  These are potentially more genotoxic by modifying members of the CYP450 enzyme family and thus contributing to hormonal dysfunction and cancer. Changes in DNA methylation (epigenetic modification) which can ultimately change estrogen receptor activity are thought to also play a role in cancer, obesity, and insulin resistance.  Low level arsenic exposure has also been reported to be associated with insulin resistance and diabetes (5). Exposure to heavy metal toxicants is almost unavoidable in today’s world. We are routinely exposed to heavy metal toxins through food, ground water, industrial waste and exposure to industrial environments. Heavy metals affect all our organ systems but particularly the cardiovascular and nervous systems (6,7).

The increasing rates of allergies, asthma, fibromyalgia, multiple chemical sensitivities, and neurological conditions—particularly movement disorders and tremors have also been linked to toxins (8,11, 13). This is in large part due to the effect of toxins on our mitochondria. The problem becomes even more daunting when you consider the exposure to toxins is happening before we are born. In a study spearheaded by the Environmental Working Group (EWG) in collaboration with Commonweal, researchers at two major laboratories found an average of 200 industrial chemicals and pollutants in umbilical cord blood from 10 babies born in August and September of 2004 in U.S. hospitals (9). Tests revealed a total of 287 chemicals in the group. The umbilical cord blood of these 10 children, collected by Red Cross after the cord was cut, harbored pesticides, consumer product ingredients, and wastes from burning coal, gasoline, and garbage.  

This study represents the first reported cord blood tests for 261 of the targeted chemicals and the first reported detections in cord blood for 209 compounds. Among them are eight perfluorochemicals used as stain and oil repellents in fast food packaging, clothes and textiles (including the Teflon chemical PFOA, characterized as a likely human carcinogen by the EPA's Science Advisory Board) dozens of widely used brominated flame retardants and their toxic by-products; and numerous pesticides.

Of the 287 chemicals detected in umbilical cord blood, we know that 180 cause cancer in humans or animals, 217 are toxic to the brain and nervous system, and 208 cause birth defects or abnormal development in animal tests. The dangers of pre- or post-natal exposure to this complex mixture of carcinogens, developmental toxins and neurotoxins have never been studied.

So, how do we know if toxins are responsible for the problems we are seeing? What signs do we look for?  What can we do about it? First, let’s review the signs of potential toxicity. Then we will go over a practical approach.    


Common symptoms indicating excessive toxins:

  • Fatigue
  • Depression
  • Headaches
  • Cognitive problems
  • Brain fog
  • Memory problems
  • Neurological issues
  • Balance problems
  • Tremors
  • Muscle aches/achiness
  • Breathing difficulties
  • Skin conditions
  • Autoimmune disorders
  • Chemical sensitivities


We must assume we are all toxic to some degree and tailor a detoxification program that can be incorporated into our daily routine. This means looking at our genetic predispositions if possible, our family history and our exposures throughout our personal history.  If we are not able to do genetic testing then we must implement a detoxification program that encompasses the most common genetic single nucleotide polymorphisms (SNPs). We need to be aware of our exposures and how to minimize them. Starting with our exposure to household cleaners, detergents, fabric softeners, personal care items including make-up, shampoos, creams and lotions.

For every synthetic, toxic cleaning supply there are more green alternatives including essential oils, vinegar and baking soda. Green alternatives can be found at several websites (14, 16, 17).  Look for natural alternatives to chemical weed and bug killers and take preventative measures such as mulching for weeds and using traps, barriers, fabric row covers, or plant-based repellents to get rid of pests. Limiting our exposure to processed and genetically engineered foods, high fructose corn syrup, pesticide laden fruits, vegetables and meats where the animal was treated un-humanely and with antibiotics and/or hormones. Limiting our exposure to plastics, especially the contact with our food and water is essential. We need to increase our consumption of cold water fish, free range meats, organic fruits and vegetables, nuts and seeds. Next, include a targeted personalized detoxification based on each individual’s unique gene-environment interaction that begins with the food we eat and the water we drink. Particularly we want to eat organic whenever possible and nutrient dense food with a high antioxidant load (15). Then add known ingredients/supplements/nutrients into our diet that help us eliminate toxins. Lastly, we implement lifestyle changes that help us not only detoxify - like exercise, massage, far infrared sauna - but also decrease our exposure to the stress chemicals our bodies produce.  We include supplements known to affect both phase 1 (oxidation) and phase 2 (conjugation) detoxification in the liver (18,19,20).

In summary, being aware of the effects of toxins on our physiology, identifying our sources and removing them as much as possible is a great way to start reducing our toxin load.  Next, we add clean, wholesome detoxifying foods to our diet that will improve detoxification and biotransformation. This is further augmented with personalized specific nutrients knows to aid in liver detoxification. Lastly, we implement lifestyle modifications that will not only help us detoxify but also help us process our stress hormones in order to further decrease our total body load.

Bibliography

1.  1. Latini et al., Mini-Reviews in Medicinal Chemistry, 2010, 10, 846-855.
2.  Soto, A. M. & Sonnenschein, C. Nat. Rev. Endocrinol. 6, 363–370 (2010).
3.  Alonso-Magdalena et al. Endocrine disruptors in the etiology of type 2      diabetes mellitus Nat Rev Endocrinol. 2011 Jun;7(6):346-53.
4.   Environmental Health Perspectives VOLUME 114 | NUMBER 11 | November 2006
5.  Navas-Acien A, Silbergeld EK, Pastor-Barriuso R, Guallar E. Arsenic exposure and prevalence of type 2 diabetes in US adults. JAMA 2008; 300: 814-22.
6.   http://www.emedicine.com/EMERG/topic237.htm .
7.  Houston MC. Altern Ther Health Med 2007;13(2):s128-33
8.  Exner N, Lutz AK, Haass C, Winklhofer KF. Mitochondrial dysfunction in 8.  Parkinson's disease: molecular mechanisms and pathophysiological consequences.  EMBO J. 2012 Jun 26;31(14):3038-62.
9.  http://www.ewg.org/reports/bodyburden2/execsumm.php.
10.  Acquavella J, et al.  A case-control study of non-Hodgkin lymphoma and exposure to pesticides. Cancer. 1999;85:1353-1360.
11.  Wang A, Costello S, Cockburn M, Zhang X, Bronstein J, Ritz B. Parkinson's disease risk from ambient exposure to pesticides.  Eur J Epidemiol. 2011 Apr 20.
12.  Havas, M. Electromagn Biol Med. 2008;27(2):135-46 .
13.  Havas, M.  Electromagnetic hypersensitivity: biological effects of dirty electricity with emphasis on diabetes and multiple sclerosis. Electromagn Biol Med. 2006;25(4):259-68.
14.  www.ewg.org.
15.  www.foodnews.org.
16.  http://www.thedailygreen.com/green-homes/latest/green-cleaning-spring-cleaning-460303
17.  http://www.thedailygreen.com/green-homes/latest/green-cleaning-spring-cleaning-460303#ixzz0S9ny6nP7
18.  Brown MD. Green tea (Camellia sinensis) extract and its possible role in the prevention of cancer. Altern Med Rev. 1999 Oct;4(5):360-70.
19.  Andrews GK. Regulation of metallothionein gene expression by oxidative stress and metal ions. BiochemPharmacol 2000;59(1):95-104.
20.  Lichtlen et al.. Bioessays. 2001;23(11):1010-7.  http://www.thedailygreen.com/green-homes/latest/green-cleaning-spring-cleaning-460303#ixzz0S9ny6nP7
18.  Brown MD. Green tea (Camellia sinensis) extract and its possible role in the prevention of cancer. Altern Med Rev. 1999 Oct;4(5):360-70.
19.  Andrews GK. Regulation of metallothionein gene expression by oxidative stress and metal ions. BiochemPharmacol 2000;59(1):95-104.
20.  Lichtlen et al.. Bioessays. 2001;23(11):1010-7.

Dr. Trindadeis a teacher, author, and international sought after lecturer in functional medicine. She is a graduate of the fellowship in Anti-Aging, Regenerative and Functional Medicine and teaches in the Fellowship which is also a master’s program. In addition she is faculty at the Institute for Functional Medicine (IFM). After obtaining her BA degree in Biology she went on to finish a master’s in Public Health in the area of environmental health and epidemiology before starting medical school. She graduated first in her class in family practice from the University of California Davis School of Medicine and did her residency training in family practice at the U.C. San Francisco/Santa Rosa Program. She has been in clinical practice for over 22 years. Before starting her own private practice in 2004 in functional medicine she was the medical director of a non-profit organization that catered to the underserved. Her work has been published in Townsend Letter, Guide to Anti-Aging & Regenerative Medicine, Saúde Actual, and the Border Health Journal. She is currently very active in developing teaching programs in Functional Medicine in the USA, Latin America and Europe. To learn more about working with Dr. Trindade, please visit her website

Intuitive Eating

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By Malu Trehan, RDN, MPH

When my daughter was about 5 years old, I would urge her to eat a little more before leaving the table. After all, how could she be full when there was so much left on her plate? “Five more bites please,” I said. She looked at me and I’ll never forget what she said. “I’ll eat ‘til it hurts if you want me to Mama.” My eyes welled up. I knew right then that I was going about this the wrong way.

“Clean your plate,” “eat just one more bite,” “people are starving in Burundi,” or whatever else we say to our kids to nudge them to eat more (even the healthy stuff), just doesn’t go hand-in-hand with helping them identify real hunger cues. Intuitive Eating, a term coined by Dietitian Evelyn Tribole,  is our natural way of eating. It means we eat when we’re hungry and stop when we are full; not the stuffed kind of full, but comfortable-full. We don’t eat because we are feeling sad, bored, or anxious. We don’t eat because it’s social. We don’t eat because the clock says it’s lunch time. We eat because we are genuinely hungry and in need of nourishment.

I know for some of us, this might be a difficult concept to swallow (pun intended), especially if we were raised differently. It also may not be convenient given our hectic lives. Intuitive Eating however is a healthy way to relate to food. Studies have shown that Intuitive Eating is linked to a lower BMI and better psychological health.(1)

To raise an intuitive eater, we need to remind our children to trust their bodies and “attune” or listen to the signals it’s giving them. Sure, the nutritionist in me is still going to teach my child which foods are better for the body. I’ll also continue to serve mostly nutrient dense foods, but I’ve stopped labeling food as “bad.” This neutral approach allows room for the occasional french fries or slice of chocolate cake without surrounding it with guilt or making it a coveted reward. If you’re looking for a place to get started, Evelyn Tribole’s 10 Principles of Intuitive Eating are a worthy read. I’ve never forgotten the lesson my daughter taught me that day, to trust our bodies. It has something to say, if we’re willing to listen.

A commitment to intuitive eating is a great start, but I also realize that it may not solve all the food challenges that you may have going on in your family, such as fussiness around the the table. I know it can be frustrating to have a child reject a meal you painstakingly took time to prepare; perhaps even a little discouraging. My previous post Exercising Patience and Creativity for the Picky Eater could address some of those concerns. If you think you or your child need more one-on-one support, feel free to contact me.

Have you tried practicing intuitive eating yourself or with your child? If so, please leave a comment below. I’d love to hear what has worked for you.

 

Ten Benefits of Pomegranate

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By Maggi Kaur

It is said that one Pomegranate can cure one hundred maladies. The fruit is packed with antioxidants, minerals and nutrients. To name a few, it contains ellagic acid, punicic acid and omega 5 polyunsaturated fatty acid, vitamin A, C and E, minerals like calcium, phosphorous, potassium, iron, folic acid, niacin, thiamin, folate and riboflavin.

While Pomegranate is still available in the farmer’s markets, it is time to put the fruit to the test.

Here are ten benefits of the fruit:

  1. Acne - Boil the peel of one pomegranate in 4 cups of water down to 1 cup. Allow it to cool, drain and store the liquid and use a cotton ball to generously dab it on as an astringent.
  2. Glowing Skin - Drinking pomegranate juice on a regular basis contributes to glowing skin and slows down the ageing process, reducing fine lines and wrinkles.
  3. Wound Healing - The astringent solution for Acne can also be used for healing minor wounds, cuts, bruises and scrapes.
  4. Reduces Cholesterol - Pomegranate is a heart friendly fruit and can be consumed by all ages. Two tablespoons of Pomegranate, while it is in season, clears the arteries, lowers cholesterol, and reduces the risk of strokes and heart disease.
  5.  Digestive - Consuming a tablespoon or two of fresh pomegranate seeds cures indigestion, flatulence, bloating, acidity, diarrhea, and dysentery.
  6. Anemia - Pomegranate is a natural source of iron, folic acid, folate and riboflavin and boosts RBC health.
  7. Feeling Depleted after a workout or long day? - A glass of fresh pomegranate juice or a bowl of fresh pomegranate seeds will immediately refresh, restore and rejuvenate.
  8. Arthritis - Pomegranate reduces the inflammation caused by Rheumatoid Arthritis and builds cartilage reducing the risk of osteoarthritis.
  9. Menstrual Problems - Regular consumption of pomegranate juice or seeds alleviates menstrual problems.
  10. Oral Hygiene - Pomegranate seeds and juice contribute to good oral hygiene and fresh breath. They also reduce dental plaque and build up.

So, go ahead, add pomegranate seeds and juice to your diet. Use the seeds as a garnish or put some in your tea. Just be sure, not to miss out on the benefits of this wonderful fruit while it is still in season.

Maggi Kaur is a Certified Ayurvedic Practitioner and a registered Yoga Alliance Yoga Instructor.

 

Mexican Quinoa

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Ingredients
 

1 clove garlic, minced

½ onion, diced

½ bell pepper, diced

1 tomato, chopped

½ cup frozen corn

1 (15-ounce) can black beans, drained and rinsed

2 tbsp cilantro, chopped (stems removed)

1 avocado, diced

1 lime

2 cup water or vegetable broth

1 cup quinoa

1 tsp smoked paprika

1 tsp chili powder

1 tsp cumin

1 tsp salt

2 tbsp olive oil
 

Directions

  1. Heat olive oil in a large skillet over medium high heat. Add onions and bell peppers, and cook, stirring frequently, until fragrant, about 1 minute. Add garlic and stir for about a minute more.

  2. Stir in quinoa, vegetable broth, beans, tomatoes, corn, chili powder, paprika and cumin and salt. Bring to a boil; cover, reduce heat and simmer until quinoa is cooked through, about 20 minutes.

  3. Fluff with fork, stir in avocado, lime juice and cilantro. Serve immediately.

Curried Butternut Squash Soup

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Here's a recipe of a classic soup with an Indian twist!

Ingredients

3 Tbsp olive oil
1 onion, diced
1 red bell pepper, diced
2 tsp salt
1 Tbsp ginger, minced
1 tsp turmeric
1 tsp garam masala (you can find this at most Indian grocery stores or Whole Foods)
½ a roasted butternut squash, skin peeled and cubed
1 carton vegetable broth
1 can coconut milk
½ lime

Instructions

  1. Heat olive oil in a large pot and add onions, bell pepper, and salt. Stir over medium-low heat until they begin to soften, about 5 min.
  2. Add ginger, tumeric, and garam masala. Cook for another minute.
  3. Stir in butternut squash and broth. Cover and bring to a boil. Boil for 12 minutes.
  4. Add coconut milk and take off the heat.
  5. Transfer to a blender and blend in batches. Puree until smooth.
  6. Transfer back to stock pot and reheat gently for a minute. Serve in bowls with a squeeze of lime.

Healthy Eating On the Go

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by Malu Trehan, RDN, MPH

I was super excited when my husband squared away tickets to Europe this summer, and well within our budget. To get the reduced fare, however, we needed to travel on a “no frills” airline. I didn’t realize until much later just how “no frills” it was; no food, no snacks, no water, and no pillow.

Needless to say, packing healthy meals and snacks was a must. Delayed flights and long layovers can make for cranky kids (and adults). Food choices at the airport are often limited and pricey. Here are a few options that are packed with protein, fat (yes, we need it), and are low in sugar.

Snack Ideas

Mary’s Gone Crackers - seed-based and gluten-free (careful with the jalapeño flavor… it made my eyes water)

Justin’s Nut Butter - these come in travel-friendly packets and can be found at our local Safeway and Costco

Wild Garden single-serve hummus - squeeze it onto crackers or pita chips (available on Amazon)

Fresh fruit - it’ll give you an immune boost - fresh strawberries, sliced apples, organic Sungold kiwi (available at Costco), and Pom Poms pomegranate seed cups (also available at Costco in packs of four) are great for travel

Vegetables - sliced peppers, baby carrots, and celery for munching on or dipping in hummus

Organic almonds

Pumpkin seeds

Dates or prunes

A snack bar with minimal ingredients. LÄRABAR is a good one.

Laughing Cow cheese

Turkey jerky - Krave has a good product

Salmon jerky by Vital Choice

Epic brand bars - seen these at Safeway

Got food that needs to stay chilled? Pack a sealable plastic bag and once you get through security, fill with ice from a soda dispenser. Don’t forget the reusable water bottle and stay hydrated throughout the flight. Skip the dehydrating cocktails or coffee and opt for seltzer drinks or herbal tea. Bring  some of your favorite tea bags and ask the flight attendant for hot water.  If you’re heading on a road trip, take a look at my previous post on snacks for road trips. With a little planning ahead of time, you can eat healthy on the go.

Three Tips For Handling Holiday Stress

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By Judy Brennan

It’s the most wonderful time of the year - or is it?

Holidays are supposed to be a time to gather family together to connect and enjoy each other’s company, but they can also be very stressful. It was only up until three years ago, I was able to host the family holiday meal calmly and with grace. It has taken me many years of practicing the tools I have learned as a Health and Wellness Educator, to truly be happy and live a more meaningful life, even throughout stressful times.

Here are three of my favorite tools, I use on a daily basis to help relieve stress and to navigate positively through the
holidays:
1. A technique called STOP
S: Stop. Stop whatever you are doing.
T: Take three deep breaths. Take a few deep, belly-filling breaths with long inhales and exhales.
O: Observe. Tune into your physical sensations, surroundings, and emotions. Notice what you see, hear, feel,
and taste.
Label your emotions (without judging them) and identify your thoughts.
P: Proceed. Then carry on with more awareness (and I like to add with kindness and gratitude).
Source
2. Live more in the moment
According to Psychology today, living in the moment makes people happier because most negative thoughts concern the past or the future.
As Mark Twain said, "I have known a great many troubles, but most of them never happened."
The hallmark of depression and anxiety is worrying about something that hasn't happened yet and might not happen at all. Worry, by its very nature, means thinking about the future—and if you hoist yourself into awareness of the present moment, worrying melts away.
The flip side of worrying is ruminating, thinking bleakly about events in the past.
And again, if you press your focus into the now, rumination ceases.
Source
Try practice being in the moment while driving, shopping, or talking with loved ones and notice how much more effective meaningful your moment will be. To me, this quote sums up living in the moment beautifully, "Forget yesterday - it has already forgotten you. Don't sweat tomorrow - you haven't even met. Instead, open your eyes and your heart to a truly precious gift - today.”
3. Lift the corners of your mouth
Yes, smile! You would be surprised how just putting a smile on your face can change not only how you feel but how those around you feel too. Make it a game and see how many people you can encourage to smile by sharing your own. I once tried this technique at a grocery store in my neighborhood and a woman on the receiving end came up and hugged me!

So, give it a try - STOP and take a breath, live more in the moment, and smile!
Wishing you peace and love during this holiday season,
Judy Brennan
www.yogaforlife.guru

Building a healthy plate

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Teaching 180 5th graders about health and wellness in under three hours is no small feat but that’s exactly what Arpita Doshi pulled off at Hidden Hills Elementary School on October 24. Arpita is Hidden Hills PTA Health and Wellness Chair, a mom, and a physician. She has a passion for helping kids make healthy choices. She’s hoping that by educating kids early, it’ll reduce their chances of  getting the chronic conditions she is seeing in her patients.

During the health fair, small groups of kids travelled from table to table learning about nutrition, healthy cooking, exercise, vision and dental care, mindfulness, and more.

At the nutrition table I hosted, we discussed how to build a healthy plate, emphasizing the importance of eating more plants. While few kids reported eating the USDA’s recommended serving of fruits and vegetables, some eagerly listed their favorite produce. According to these children, their parents prioritized fruits and vegetables in their families.

Tips to increase more fruits and vegetables for your child:

  • Keep fruit washed and ready to eat in plain sight

  • Serve salads often. You’re busy. I know! Buy the pre-washed bagged salad or triple-washed spinach and make the prep easy.

  • Serve a vitamin A rich food everyday- e.g. squash, carrots, mangoes, tomatoes, broccoli, or spinach

  • Serve a vitamin C rich food daily - e.g. citrus fruit, strawberries, tomatoes, broccoli, or kiwi.

  • Model it! Eats fruits and vegetables yourself.

Visit Super Healthy Kids for ideas on how to bump up the fruits and vegetables on your child’s plate.