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Finally, a chink in the armour, a crack in the wall, a miniscule hole in the dike! All the major disease associations collectively have been saying for years that we should be eating lots and lots and lots of grains – that grains are supposedly the most important part of a healthy diet. We have been following that advice for years, and heart disease rates have climbed, diabetes rates have climbed, many kinds of cancers have climbed. Well, I am happy to announce that finally one association has put two and two together, and has broken ranks from the comforting solidarity of the other medical associations. Kudos to the American Diabetes Association for changing its food recommendations for Type 2 diabetics that need to lose weight. They are actually suggesting that lowering starchy carb intake for one year may be helpful. A rather meager start, but at least it’s something. Hopefully the American Medical Association, The Heart and Stroke Foundation, the American Heart Association, the US Food and Drug Admin, Health Canada etc. will see the light soon too.

I think it takes a lot of courage to put out recommendations that go against the flow so I can understand why they may not have wanted to push the envelope further. But low carb for one year only??? In the context of diabetes,
lowering starchy carbs should not be hyped only for weight control, but rather for lowering blood sugar, which is the bottom-line source of the problem in diabetes. Losing weight is the nice side benefit. One gets the feeling the ADA simply doesn't get it. The low-starch concept should be recommended for all diabetics, Type 1 or Type 2 (and all the rest of us too!) in order to control blood sugar. Eating a diet high in starchy carbs leads to high blood sugar levels, so more insulin is needed to transport the sugar into the cells. No matter how the insulin gets into the blood stream, whether it is injected, or whether the body produces it, whether diabetic or not, high insulin levels damage arteries. High insulin levels also lead to insulin resistance, so both sugar and insulin remain in the blood. High blood sugar levels are also very damaging to arteries as the sugar tends to glycate (caramelize). Damaged arteries need to be repaired, so cholesterol is dispatched to the area to plug the pits and tears, and so cardiovascular disease begins.

So, by reducing one’s consumption of sugar and starchy carbohydrates like bread, pasta, potatoes, corn, white rice etc., one reduces one’s need for insulin, which in turn leads to happier arteries and reduced insulin resistance. This is the way to
AVOID getting Type 2 diabetes in the first place, and to reduce one’s risk of getting cardiovascular disease as well.

Type 1 Diabetics used to be taught (I’m not sure what they are taught today) that they should eat some starch at every meal so that the injected insulin has some sugar to bring down. I simply don’t understand that. Why eat sugar to match the injected insulin? Why not reduce the insulin injected to match a lower sugar intake? It seems to me that keeping insulin levels low is health promoting. I am not a Type 1 Diabetic, so I have not had to live with the daily job of pin-prick glucose metering, and trying balance eating with insulin injections. Maybe if I lived that life I would change my tune. But to me it makes sense to eat lots of  above-ground veggies and sea vegetables that don’t turn into sugar in the body quickly, perhaps some legumes in moderation as they have more protein than grains do, and pasture fed meats, full-fat dairy, free-range poultry, and wild seafood. Contrary to Type 2 diabetics who are frequently overweight, losing too much weight may be a concern for Type 1 diabetics who tend not to be overweight, so they may not want to lower starch consumption. The counter to that would be to replace the starch with larger amounts of the other foods in the macronutrient ratio recommended by one's metabolic type. I would think that a diet that naturally keeps keeps blood sugar stable would require less insulin to be injected, which would not only improve health, but also the pocketbook.

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I was going to write about all the B Vitamins this week, but realized pretty quick that that would be WAY too involved for such a short post. So B12 it is, since it is the one in particular in which many people are deficient. Vitamin B12 deficiency comes in two forms – the more rare autoimmune problem which attacks the stomach cells and causes pernicious anemia, a potentially deadly blood disorder in which the red blood cells are immature, very large, and don’t carry oxygen well, or the more common inability to absorb food-bound B12. Unlike the other B vitamins in which excess is secreted daily in the urine, B12 is stored in the liver, so it may take a few years before symptoms of B12 insufficiency show up.

Vitamin B12 (also known as cobalamine) along with folate, is inversely related to homocysteine levels, and high homocysteine levels are not only associated with depression, but are much more closely related to cardiovascular disease than cholesterol is. More and more studies are backing up the idea that bringing B12, B6 and folate levels back up to optimum reduces homocysteine levels, arterial inflammation, and heart disease. I go back again to the fact that at around 1900 there was virtually no heart disease. Since that time we have lowered our intake of nutrient-dense foods (particularly quality meats and organ meats) and raised our intake of nutritionally-deplete processed foods. Drugs are not going to fix this problem, but eating nutrient-dense, quality food will.

B12 deficiency mimics the symptoms of Alzheimers, and some studies seem to indicate that bringing B12 levels back up to optimum can go a long way to improving memory in those with early cognitive decline. If the deficiency has gone on too long, nerve damage may result, and at that point B12 supplementation won’t help. Nerve symptoms such as tingling and numbness in the legs and arms, difficulty walking, and disorientation in addition to memory loss can occur, and a persistent insufficiency of B12 may eventually damage the myelin sheaths of the nerves. Gut function is frequently compromised with age, which may be why B12 deficiency is extremely common in those over 60, as are symptoms of dementia and cardiovascular disease, not to mention osteoporosis and hearing loss. Vitamin B12 plays a role in all of those issues, in addition to depression, asthma from sulfite sensitivity, low sperm count, diabetic neuropathy, shaky-leg syndrome, bells palsy, tinnitus, hearing loss, among others.

So why is B12 deficiency so common? The molecule is huge, and is very hard to absorb due to the many steps required in the process. So, if for any reason, one’s body does not have enough hydrochloric acid (very common), pepsin (the enzyme that breaks down protein), pancreatic enzymes, calcium, adequate good gut bacteria (take probiotics after antibiotics!!) and an enzyme called “intrinsic factor”, then B12 cannot be absorbed by the gut, even if it is consumed in adequate amounts.

Which brings me to the other reason many of us are deficient. The best food sources of Vitamin B12 are liver and kidneys, and unfortunately, those foods have pretty much disappeared from our plates. (I’m thinking I should write a cookbook – 100 Delicious Ways to Cook Organ Meats” – what do you think?) There are small amounts of B12 in dairy products, but it is exceedingly difficult for vegetarians to obtain adequate B12 from a plant-based diet. Furthermore, due to the fact that vegetarians tend to eat a diet high in green leafy vegetables, (a good thing!), they consume a great deal of folic acid or folate, and high amounts of folate decreases absorption of B12 even further.

And many medical drugs interfere with B12, especially those used to treat GERD, acid reflux, and peptic ulcers which decrease stomach acid in the gut (proton pump inhibitors like omeprazole and lansoprazole, and H2-receptor antagonists like Tagamet, Pepsid, Zantac). Other types of drugs that are problematic are cholestyramine, a drug to treat high cholesterol, metformin, a drug used to reduce blood sugar in type 2 diabetics, hloramphenicol and neomycin (antibiotics), and colchicine (anti-gout medicine).

Therefore, due to the lack of food sources, the problem with interfering drugs, and the poor absorption issue, especially for vegetarians, B12 supplementation is quite necessary. Monthly B12 shots or daily sublingual supplementation are the methods used, in order to successfully get the B12 into the bloodstream. Many people notice a significant boost in energy levels once supplementation has commenced. 2.8 mcg per day should cover the requirement for most people.

I think that B12 blood levels should be tested as part of a routine annual check-up, as so many problems would be avoided if low levels of this vitamin were treated.

I am teaching Diane Lee and LJ Lee's Connecting to Your Core course in Vancouver BC at the end of the month. If you have low-back pain, hip pain or pelvic pain, click here for more info and how to register.

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Well, after my post last week on hospital food, I was asked to take part in a short interview on the subject on Shelagh Rogers’ show, Sounds Like Canada on CBC radio. What a thrilling opportunity to discuss real food! The interview was fast-paced and over before I knew it. Here is some of what I did not have an opportunity to say:

Healthy people replace 2 million cells a second, and those that are sick, injured or recovering from surgery probably replace substantially more than that. The raw material that those new cells are made of is our food. If the food does not have the nutrition needed, the body takes the required materials from other parts of the body, like our muscle, if we don’t eat enough protein, and our bones, if we don’t get enough minerals in our food. So, we frequently see patients with muscle wasting, people losing weight, and probably if we checked, we would find bone degradation as well. No matter how hard our body may try, it can’t make tissue from drugs. So, I ask you. Why is the food budget in hospitals so low, when people really can’t get better without quality food? There needs to be a MASSIVE shift in priorities.

So, therein lies the problem. According to the hospital-food series running all week on CBC radio, the food budget per person is somewhere in the neighbourhood of $5-$8 per day. That is completely insufficient to provide the nutrition needed for people to heal. I’m not sure exactly what would be sufficient – probably triple that amount at least – but in my mind, a hospital should be providing the bare necessities for healing, and those hospitals with such low food budgets are actually doing more harm than good to their patients, as their bodies have to eat themselves to get the nutrition they are not getting from food. Reallocate the resources – take from where it is less necessary now to fix what is broken, but ultimately the whole body-system is degraded.

So, what do we do??? We need a completely different model for food services. (Personally, I think the name, “food services” has to go. It says “institution” through and through.) How about changing the name to “Nourishing Services”? Maybe then those involved will remember their key function. I was suggesting more hospitals adopt the hotel room-service model that some hospitals in Oregon are using, or at least use the idea as a jumping-off point for brainstorming. Patients should not pay for their food ever, but if the food is good enough, maybe family and friends that are visiting will order food from the menu rather than going downstairs to the McDonalds Restaurant or StarBucks in the hospital foyer. In this way, food bought by those visiting the hospital can subsidize the meals the patients receive. Having a varied menu would address the special diet issue as well as the cultural and food preferences aspect. The patient could order a meal when it is convenient so it would be tasty, fresh and hot – it doesn’t arrive just as he/she is being wheeled down for X-Rays. Nourishing food just might shorten hospital stays too, so there may be some cost savings there.

Each hospital needs a creative chef that understands how to prepare nourishing food in the tastiest of ways – knows about the healing powers of bone broths, fermented foods, sea vegetables, organ meats, raw foods, and the necessity of soaking grains before cooking them, the absolute need for good-quality saturated fats for the body, and the increased nutrition found in free-range rather than factory-farmed beef, poultry, dairy and eggs. The food needs to be prepared on site with local ingredients as much as possible, as they would be the freshest, not to mention the least expensive.

Here are some menu ideas (please note – I am NOT a chef!):

Breakfast
a) Fresh free-range eggs cooked to order served with steamed spinach, sprouted-grain toast and butter
b) Fermented oatmeal, whole milk or plain whole yogurt, chopped fresh fruit and raw nuts, soft-boiled egg optional
c) Half grapefruit, beef patty (made with a combo of ground beef and ground beef heart – can’t taste the difference) served with steamed kale and shallots, sprouted-grain toast and butter.

Lunch
a) Baked salmon, mixed salad, steamed zucchini, wild rice cooked in broth
b) Ham and split pea soup cooked with broth, grated raw cheese, raw veggie sticks
c) Chili con carn, wakame salad, crusty sourdough full-grain sprouted bread and butter.

Dinner
a) Liver and onions, REAL mashed potatoes, tomato boccachini salad with olive oil, balsamic vinegar dressing
b) Roast chicken, steamed collard greens with butter, brown rice cooked in chicken broth, raw carrot sticks
c) Baked cod, baked yam, creamed spinach or steamed broccoli

Some healthy Drink Options
a) Kombucha – a fermented black tea
b) REAL ginger ale made from ginger root
c) REAL apple cidre made from fresh organic apples
d) Lemon ginger honey tea
e) REAL rice milk – only healthy ingredients here!
f) Kvass – a fermented drink made from fruit

I am teaching Diane Lee and LJ Lee's Connecting to Your Core course in Vancouver BC at the end of the month. If you have low-back pain, hip pain or pelvic pain, click here for more info and how to register.

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I probably should have written this a year ago when I had an intimate look at hospital food at a large Vancouver hospital. Ya gotta wonder whether this hospital at least, knows that there is any connection between food and health! From what I could tell, the food was largely highly processed, cooked to death, and they always served a sweet packaged dessert! What’s with that??? We KNOW that sugar suppresses immune systems. So why is sugar fed to people that are trying to get well? And margarine and creamer/milker were on the menu each day. No butter or cream here! Important to get your daily dose of trans fats and hydrogenated oils, after all. Much better choice than saturated fat, which our bodies need to get the vitamins and minerals into our cells. Oh yeah. Food cooked to death so I guess there are no vitamins left to transport. No worries then – no transportation needed. By offering up trans fats, cell messaging will be blocked instead. That will help people heal.

Okay. All sarcasm aside, what I am trying to say is that we should not be feeding sick people manufactured fats that the body mistakes for saturated fats, and we needn't be frightened about eating good quality saturated fats. Our body actually needs them to make our sex and stress hormones and vitamin D, transport vitamins and minerals into cells, create bile, stiffen our cell walls, and for cell communication among other things. On the good side, the hospital did offer eggs for breakfast. I enjoyed the actual menus and comments from Sarah Leavitt's blog, who stayed at the hospital in Nov. '06.

For a good laugh, take a look at these Heart Healthy Food Choices put out by my local health authority. Love the recommendation for low-fat hot dogs. Low-fat everything! If fat has been removed, it ain't a whole food. Is it logical to think that we can improve upon what nature intended? Have you noticed that since the influx of low-fat everything, we seem to be getting fatter? That's because if it is low fat, it is probably high in sugar and/or starch. Fat doesn't make most people fat (most metabolic types) – starchy carbs, particularly processed ones, and sugar do. And it seems the nutrition pundits don’t realize that so-called "non-hydrogenated margarine" either actually does have hydrogenated oils in it but at a level that is low enough that they can label it as trans-fat free, or it is another form of manufactured fat (inter-esterified fat) which is equally harmful. And notice all the processed food recommendations. Angel food cake? Ginger snap cookies? Low-fat yogurt? Pretzels? Boy, the food companies have the public health system wrapped around their little finger!!! Food companies want to sell you their food, so they strip out nutrients that will cause the food to spoil, and fill it with preservatives in order to lengthen shelf life. Therefore processed food should not be recommended for anyone, let alone heart patients, and it certainly should NOT be given to patients in hospitals.

So, I cooked up a storm and brought in food made with home-made bone broths, grass-fed meats, free-range chicken, organic vegetables etc. and what wasn’t eaten was stored in the fridge in the hospital. The next day when I went to get it, the containers were there, but the food was gone. Turns out homeless people know that to find good food, don’t look at the hospital trays, but look in the fridge! Seems the hospital has a security problem too.

Hospital food doesn't have to be this way. It can be nutritious, delicious and sustainable. It is starting to happen in Oregon, for example, where some hospitals are offering hotel-style room service with delicious, healthy foods on the menu, cooked to order. Less food is wasted because it is actually eaten, and surprisingly, they have not increased their food budget. Food profits from cafeterias have gone up, due to the more food being served. Imagine patients asking for recipes! Imagine calling your hospital and then swinging by to pick up a take-out order! London England is also doing much to put healthier food into hospitals. Hospitals can and should be taking the lead on nutritious, sustainable food, and I'm glad to see it beginning to happen.

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www.wellnesstips.ca