We are in the era of the nutritionist. There is so much confusion around food and nutrition, and so much wacky advice flying around. This while Americans are just not able to make it to the basics of healthful eating. Nutrition-related chronic diseases continue to be the primary health issues, and each of us has our own variation of health and disease.
Because we are in a time when so much that sounds like nutrition is actually marketing and bluster, and so many who call themselves experts are so far from it, confusion reigns. Enter RDNs (Registered Dietitian Nutritionists) and MNT (Medical Nutrition Therapy). If you know me, you know that I am a mind-body therapist – I use things like meditation and gentle yoga practice as tools to help us cultivate the best of ourselves, and soothe us as we gather our courage and strength to sing our song, to sing our note.
What is MNT?
There is a large body of evidence that tells us how to manage a range of health and medical conditions with food and nutrition. MNT, or medical nutrition therapy, uses that evidence and through a qualified therapist, translates that evidence into healing. While there is a range of nutritionists operating today, with various levels of education and experience, and I honestly believe there is room for everyone, I am partial to those who have a 4-year science degree and access to the Academy of Nutrition and Dietetics Knowledge Center for working with people with a medical condition. I am biased for sure, being one who sweated through all that nutritional biochemistry and worked in an ICU (intensive care unit of a hospital) writing TPN (total parenteral nutrition) orders to keep people alive until they could eat. Then I taught at Kripalu for nearly a decade, watching how mind-body used skillfully helped people with the will and knowledge transform. The combination of clinical skills and experiential practice are, in my opinion, the sweet spot when it comes to healing nutrition-related issues.
What conditions are we talking about?
There are guidelines for a range of medical conditions. Those I am well-versed in include:
Weight gain – from adolescents to adults, and family-based, for any reason
Eating Disorders, emotional eating and disordered eating
Unexpected weight loss due to cancer, HIV/AIDS or other chronic condition
Pre-diabetes and diabetes
Cancer – prevention, management and prevention of recurrence
Heart Disease – prevention, management
High Blood Pressure
High Cholesterol
Digestive approaches to auto-immune conditions (Fibromyalgia, Rheumatoid Arthritis, and others)
Digestive distress due to:
Irritable Bowel
Crohn’s Disease
Colitis
Constipation
Reflux/Heartburn
Food Intolerance (lactose-intolerance, gluten, and others), and Allergies
I use an individualized approach. That includes an initial assessment of nutrition-related symptoms and medical history, review of nutrition-related labs and reports, and development of a custom way of eating that you enjoy and that adheres to evidence-based practice.
We then co-create a plan to get there – your way. There is no such thing as failure, no such thing as relapse in this world – but there is learning, through loving self-compassion, how to navigate your life in its fullness. It’s a dance of mindful skillful effort, and surrender (that’s yoga!).
Within that list, do you specialize?
While I can help address any of these conditions, and they all have relating threads, I particularly like to work with weight, women in midlife, and digestive issues. I have also had a personal experience with cancer, so helping people with that interests me.
How much does it cost?
Depends. I am a licensed nutritionist in the state of Massachusetts. If you have a medical condition and live in the great state of Massachusetts, or another state that does not have state licensure, it is worth it to give your insurance company a call to see if our work together can be reimbursed. For this, you will likely need a referral from your primary care doctor.
If you are not insured, in another state with licensure or your insurance doesn’t cover, then you are what clinicians call private pay. It’s likely that our work together could be included in your health spending account if you have one.
Bottom line, if you value your energy level and lifestyle, it’s worth it to have a skilled coach to help you move forward.
My rates are $150/hr, and most people I work with do an initial assessment, then a half-hour twice monthly for 2 months, then monthly for 4 months.
Tell me about telehealth
I’ve partnered with a practice-management group called Healthie. They provide an interface for us to work through, including journaling, billing and video conferencing. So, we can meet face to face in the comfort of your own home! I think telehealth is part of the future of medicine, and I am excited to be part of it.
Ready to make the change? Let’s do it – Make an appointment now .
Questions? I’m all ears.
Be well,
Annie
Potato head? Me too. Will work for mashed potatoes. While I think white potatoes have been much maligned in the era of glycemic (the degree to which foods act like sugar) awareness, many of us will overdo them left to our own devices. Enter cauliflower, that healthy brassica with the dubious distinction of, when well cooked and mashed, filling in for its starchier cousin the white potato. This is a bit of a have-your-cake-and-eat-it-too recipe. Here is a simple recipe using both spring red potatoes and plenty of cauliflower, along with water-carmelized onions. If you have some fresh green herbs, like chives, rosemary, or sage, that would make a lovely addition.
Ingredients
1 pound spring red potatoes – 1-2″ diameter, washed and sliced
1/2 yellow (Spanish) onion, chopped and skin removed
1 medium head cauliflower, washed, flowers separated or sliced
Black pepper and sea salt (less is more of any type of salt) to taste
Directions
Water-brown onions. Place chopped onions in a heavy skillet (cast iron is great), with 2-3 Tbsp water, at med-high heat. As the water dissipates, add another couple Tbsp, tossing so as to slowly brown the onions without burning them. When they are light golden brown (please don’t brown too much- browning is for taste, not health), remove from heat and put aside.
Boil spuds. Place sliced potatoes in a med pot with water to cover and bring to a boil, then lower heat to simmer. Once potatoes are soft when pierced with a fork, remove, drain (potato water is a great soup-stock, if you’re organized enough to take advantage of that), and set aside.
Water-saute cauliflower. Place cauliflower in the skillet you’ve cleaned after browning your onions, along with a few Tbsp water. Water saute over medium heat until soft.
Mash with olive oil. Place cooked potatoes, browned onions, and cooked cauliflower in a large bowl. Drizzle olive oil, and mash with a strong fork, potato masher, or pastry blender (a handy little kitchen tool).
Serve. Top with a dollop of grass-fed yogurt, and salt and pepper as needed. Sprinkle with fresh herbs if you have them. This is a great replacement for regular mashed potatoes.
I love black bean soup, and this recipe loves me (and you) too with nutrient dense vegetables, lime, nutmeg, pepper and chili for a touch of heat. And of course black beans, a fiber-protein power combo. This recipe makes a flavorful thick soup perfect for a snowy day.
I live with an unapologetic carnivore, so the addition of uncured bacon (which at least eliminates nitrites) or turkey bacon vs going for a vegan version (my preference for mind and body) is always a weighty decision. For this go-round, as my husband and I have been doing some happy-lovely bonding lately, it’s bacon! I used 3 trimmed slices of Applegate naturals uncured Sunday bacon. This recipe would still be thick and flavorful in it’s vegan version if you skip the bacon and sauté the vegetables in olive oil. I also used Full Circle organic vegetable broth as I’m just getting into the soup swing and don’t have my own made yet.
All vegetables are organic – important for these particular veggies as several of them are on the dirty dozen list.
3slicesuncured bacon or turkey bacontrimmed of fat and sliced (optional - for a vegan version, sauté vegetables in 1 Tbsp olive oil over low heat)
4med stalks of celerytops on, chopped
4med carrotschopped
1red onionchopped
1/2spanish onionchopped
1 3/4cupsorganic black beanssoaked overnight, rinsed several times
2cupsvegetable stock
4-6cupsclean water
1cupfrozen organic corn
1small bunch fresh cilantro
1-2tspground nutmeg
1-2tspfresh ground black pepper
juice of 1/2 lime
chili pepper heat to taste - I used a Tbsp Sambal Oeleka Thai chili paste - make sure you get one without sulfites if you are sensitive
Instructions
Toss bacon into heavy soup pot, add onions, carrots, celery and simmer over medium heat, stirring occasionally, until onions are soft and slightly golden - about 10 minutes. If you are skipping the bacon, sauté the above in a Tbsp of olive oil.
Add black beans, stock, nutmeg, black pepper and water. Simmer until beans are soft - 1-2 hours.
Add lime juice, corn and half of chopped cilantro.
Add chili to taste: add it slowly and taste until you reach desired heat. You can always make your soup more spicy, but once you overdo it, sorry you've got practice in tolerating extra heat.
Simmer all for another 10 minutes, top with remaining cilantro and enjoy warm.
Freezes well.
I would say the secret to this soup is the flavor combo of nutmeg, lime and chili – yum. What are your favorite ingredients for a black bean soup?
Tis the season to begin to think about making my fall batch of Ashwagnada sesame oil to warm our way through the fall.
Bows to my colleagues in the Kripalu School of Ayurveda (KSA). Several years ago I got to sit in on part of their training for Ayurveda Health Counselors and got a lovely intro to the Ayurveda way of herbs from Rosie Mann and the KSA faculty.
My husband and I both love this oil, and he has noticed how it is soothing and quiets his mind like it did mine the first time I practiced abhyanga (Ayurvedic oil self-massage) with it during my training. It does have a musky manly scent in sesame oil. We rub it on our feet at bedtime, and more widely when our minds get chattering too incessantly and we have time to relax (it can be a sedative, so I haven’t tried it on a workday yet).
Ashwa…what?
Ashwagandha is a root used in a number of Ayurvedic preparations. It’s a little famous for its aphrodisiac properties, but it is also calming and strengthening (ashwagandha means horse-smell in Sanskrit, after the musky scent of the root itself). Vata-pacifying, it is great for both my husband and I as we enter our hopefully wise Vata years of life.
Ashwagandha Sesame Oil Recipe
Ingredients
1/2 cup dried ashwagandha root
8 cups filtered water
2 cups organic sesame oil
Directions
You will need a strainer and cheesecloth, as well as a medium-large saucepan and a container for the oil.
1. Gather all ingredients and bless them. I say a little prayer over them like the one my teacher Pam taught me, then ask the root to bless us with its healing gifts.
2. Pour water into the saucepan, and add ashwagandha root. Gently stir clockwise (only clockwise) with a wooden spoon or whisk.
3. Heat medium-low until reduced to 2 cups. This takes 2-3 hours. There is a point where the ashwagandha will thicken into the fluid – the texture will shift.
I like to let my botanical concoctions spend some time on the alter. Prayers, alters, it is all about infusing what I am making with love and intentions. 4. Rinse saucepan. Strain the fluid through a sieve, then strain several additional times through a cheesecloth until you have a thick fluid.
5. Pour this mixture back into the saucepan, and add sesame oil. Heat at low-medium, occasionally gently stirring clockwise. Again, you will see the oil change as it absorbs the ashwagandha root. I found it became richer and a smidgen cloudy (but, if I had strained more thoroughly it may be more rich yet clear)…the batch I have from the experts is more clear.
6. Once you see the oil change (this took about an hour), let it cool, then strain the oil off of the remaining root-water, into a clean glass jar.
7. Enjoy as a daily oil massage (I would do a test on the weekend!), or rub on your feet and/or top of your head before bed.
Namaste!
Bread. Chewy crusty bread dipped in a fantastic olive oil and a bit of sea salt. Nutritional friend or foe?
Giving up bread, potatoes, pasta, and even beans because they are carbohydrate-rich foods is a decades-old strategy that’s been presented in a wide variety of popular diets, including Atkins, South-Beach, Paleo, UltraMetabolism, and now Bright-Line.
Just what is a low-carb diet, is it healthy for all, for some or no one?
If you ask 10 people just what a low-carb diet is, you’ll get 10 different answers. That’s because the real clinical data on just what a low-carbohydrate diet is and if, how and who it helps is cloudier than you’d imagine if you believe what you read in the popular press. So, let’s begin with what a low-carbohydrate diet is and is not.
Carb Basics
Carbohydrates break down into sugars and are the energy currency of the body. We need sugar (glucose) for brain function and energy. Most glucose (what the sugar carb breaks down to and the fuel for the body) comes from carbohydrate-containing foods, but the body can also convert protein and fat into glucose (inefficiently and with side effects).
The National Institutes of Health (NIH) set a recommendation of 130 g/day of carbohydrate, based on the amount of glucose needed by the brain and body. The Institute of Medicine (IOM) recommends that 45-65% of daily calories come from carbohydrate. The IOM also set a fiber intake recommendation of 25 g/day for women, and 38 g/day for men.
For comparison’s sake, one serving of carbohydrate (a small slice of bread, or half a banana) contains about 15 g of carbohydrate. If the bread is white bread, it will not have much fiber nor vitamins and minerals unless they are added in the process of fortification. The half banana has about 3 1/2 g of fiber and is a good source of vitamins B-6 and C, potassium and other minerals. So, the banana is what a nutritionist would call more nutrient-dense – that is, calorie for calorie, it gives you lots of nutrients – it’s a higher quality carbohydrate than the bread.
To understand why we’re so low-carb crazy, let’s look at the Standard American Diet (yes, SAD). American men are eating about 287 g of carb per day, and women about 177 g. One-quarter of this carbohydrate intake is from added sweeteners (sugar). Added sweeteners have no nutritive value – not one vitamin or mineral, yet are packed with energy (calories) and absorb very quickly from the gut into the blood stream. How rapidly sugar is absorbed is one of the problems with a highly refined diet high in processed foods (which often acts like just more sugar) and sweeteners – they make you hungry for more. Fiber (which slow the rate that sugar is absorbed from the gut into the blood stream) intakes are about 17 g for men, and 13 g for women. Please note that these intake numbers are changing and not in a more hopeful and healthy direction. Get the picture?
American are eating plenty of carbohydrates, and the type of carbohydrate we are eating is high in sugar and low in fiber. Really low quality, low-nutrition food and lots of it.
A Low-Carb Diet is…
More than the switch from flour and processed grains to whole grains. It’s more than giving up sugar.
A low-carb diet dips below that 130 g/day recommendation of carbohydrates. The most restrictive phase of the Atkin’s diet has 20 gm of carbs in it. When you head down to this level of carbs you are getting your energy from fat and protein. This puts you into ketosis, which is the creation of ketones. While not dangerous in the short term if you drink plenty of water to help your kidney’s flush the ketones out of your body, a common side effect is nasty (nail polish) breath and sweat. It makes you smell, but you’re losing weight and not hungry. My opinion is that over time, this is a very hard diet on your body, and there’s no good data that shows over time people lose more and are healthier from this strategy than others.
So, what do you give up to follow a low-carb diet?
Bread, flour, all grains, even whole grains 🙁 , all fruit :(, starchy vegetables 🙁 like sweet potatoes, corn, peas and squash, beans :(, usually alcohol and of course sugars and sweeteners.
What do you eat?
Lots of meat, fish. Lots of fat. Non-starchy vegetables (which I find many people forget). Usually nuts and nut butters. There are a slew of processed low-carb foods of questionable quality.
Ketosis is different from diabetic ketoacidosis which is a much more dangerous condition of too little insulin and resultant high blood sugar.
Does it work?
Like any highly restrictive elimination diet, low-carb will work because you are eating less. It’s energy-balance basics. What’s handy about low-carb diets is that when you increase your protein and fat intake, you are less hungry than if you ate carbohydrates. So, as a jump-starter to healthier eating and a means of feeling the promise of a lighter body, they can be helpful.
Over the long-term, though, this pattern suffers from what all weight-loss diet patterns suffer from – they are hard to stick with over the long-term and ultimately people struggle to maintain them. There are some additional concerns about this pattern, too. I’ve listed them below.
What the Low-Carb Proponents Forget to Mention
Your body adjusts to low carb and burning fat as fuel. When you eat a carb again you can become a super-efficient fat-producing machine. So, only do this if you are going to maintain it for the duration.
A risk for constipation increases – drink lots of water. Your poor kidneys are working triple-time. If you do low-carb, you’ve got to eat your non-starch vegetables, which is a source of fiber that will help prevent constipation. Drink drink drink water.
Low-carb diets tend to be extra high in saturated fat. While a bit of saturated fat, particularly if it comes from healthful sources like grass-fed organic dairy or grass-fed meats, can be fine, even healthful. When you are eating large amounts of poorer-quality saturated fats, however, the literature still says (despite what you’ve been told of late) you are increasing your risk of heart disease. Sorry. We really don’t know the long-term effects of managing your weight with this strategy. Regular mass-produced bacon, red meat, cream cheese, and butter in limitless qualities is just not healthy.
Because the glucose you get from carbohydrates is the brain’s (and body’s) preferred fuel source, many following this diet complain of low energy and foggy thinking.
Most of the quick weight you lose is from water – not fat.
When you eliminate whole categories of foods, you increase your risk for inadequate nutrition – and low-carb is usually low in a host of vitamins minerals, antioxidants, and fiber. I see this over and over again. Over time, you increase your risk for disease and undermine the smooth functioning of your body.
The Bottom Line?
If you have issues with blood sugar like pre-diabetes, or diabetes, low-carb can be a great strategy to get your blood sugars under control. I’ve seen it work quite a bit. If you know you are over-doing sugar and want a short-cut to moderating, a few days (I find 5 does the trick) of low-carb tends to reduce your cravings. Work with a qualified nutritionist to ensure your diet is rich in nutrients while you do this.
For most of us, let your carb-savvy diet be minimal in refined sugar and refined carbohydrates (cereals, breads, and sweets like cookies and cakes). We all live with or around families and friends, and if your family is anything like mine, cake is part of social events. Have a bite, or a slice and enjoy it. Then get back to your regular practice of whole-food plant-based eating.
The diet that has the most evidence for long-term health is a whole-foods, plant-based diet.
Enjoy nutrient-dense high-quality whole carbohydrates you tolerate like whole grains, whole fruit, vegetables including beans, sweet and white potatoes and other starchy vegetables. If you struggle with weight, have these higher carbohydrate foods with a meal that balances whole food carbohydrates, protein, and fat. A bit of each. The Oldways Ancestral plates do a good job.
We each have a balance of eating, managing stress (which I think is a major cause of weight gain today, in addition to poor-quality food), being physically active in ways you enjoy, and self-acceptance that works. If you struggle with weight, only do the lifestyle changes that you continue forever more. That add to your life rather than restrict. Over time, you will build a healthy and flexible lifestyle.
If you love bread (like I love bread), and are thinking about managing weight, have a little – just not every day at every meal. I think of bread like I think of dessert – it’s a special treat, not an everyday part of my diet.
My garden right now is filled with the sweet green goddess known as tulsi.
Tulsi is a type of basil that originated in India. There are several types, like sisters in a family. If you ‘do yoga’, love botanicals, AND you haven’t met tulsi yet, I’m happy for you. Your future includes meeting one of the most sweetly powerful and healing herbs in the canon. I have great sisterhood with this plant and feel that I am introducing you to one of my coolest and best friends. When I refer to her, I am referring to the big T – the green goddess herself – tulsi.
A distinguishing feature of tulsi is its fragrance – it’s rich, buttery and flowery with an undertone of funk. Tulsi (which translates as “incomparable one” in Sanskrit) occupies an auspicious place in yogic/Ayurvedic tradition. It is thought to be an embodiment of the goddess Lakshmi, she of abundant good fortune, of being held in esteem in a community, and of generosity. In India, many homes have a tulsi plant at their doorstep, and women (and I’m sure men) have a tulsi plant near their bed so that the gentle breeze carries the scent of tulsi to them as they sleep, bestowing them with ageless beauty.
In the Garden
Much like the goddess, my tulsi seems to have a mind of her own. She goes where she wants, comes up really late (late June this year – thank goodness I held her space!). I have not been successful at growing her from seed so that I can get a jump on the season – nope, not how she’d prefer to roll. Yet, tulsi comes rolling back, year after year in her own preferred manner my garden. I often smell tulsi and then oh, there’s a plant popping up amongst the roses or corn.
I never needed tulsi seeds, though I’ve purchased many packets. My original tulsi plant came to me auspiciously – from Sweetwater Sanctuary in VT. Pam Montgomery gave me and my fellow apprentices plants (in 2013), and mine has happily multiplied into tulsiville.
Culinary & Preserving
I’ve tried for years to make a good oil infusion of tulsi but have been only modestly successful at capturing that unique fragrance in oil. Drying, I find, works best for me. I’ll then drink it as tea through the cooler months. If I have a gathering of gal herbalists I may attempt herbalist Brittany Wood Nickerson’s yellow cake which she served once incorporating dried tulsi….magnificent. She’s just come out with a cookbook filled with scrumptious herbal fare, but the way, which I strongly recommend.
You can also make a pesto with tulsi.
To dry tulsi or any herb (I have mugwort, cilantro, lemon balm and mint drying now), gather a bunch of it, tie it into a bundle at the stem, and hang in a place that will be warm and dry. Attics are great if they are reasonably well ventilated, and you can find a place to hang your crop. After a couple dry weeks (challenging this year), cut the bundle down. For plants that I intend to use as a tea of spices, I pull the dry leaves off the stem and place them in glass jars. Between Mason and jelly jars, you have a jar for any quantity of herb.
Medicinal & Energetic
From a Western medical perspective, tulsi is an adaptogen and has been studied for a variety of uses. Adaptogenic activity means that, like ginseng, it contains a complex array of phytonutrients that act in different ways but tend to overall support homeostasis – or healthful balance. So, tulsi tea is a terrific drink through the fall when back-to-whatever stress and cool winds conspire to give us colds and other crud.
Energetically, I’ve done a number of shamanic journeys with tulsi and here’s what I learned. Tulsi embodies all the goddesses of tantra – she’s Lakshmi, Deva, and yes Kali and all the rest – all rolled into one. She just might be the MahaDevi – the mother goddess. This is my own perspective colored, no doubt by my study of the goddesses of tantra. I know and love them, and draw on them often. In my study, these goddesses represent parts of ourselves (even if you are a man – we each contain both divine masculine and feminine within us). So, interestingly, I’ve found tulsi is energetically adaptogenic as well. From my discussions with other herbalists in my tradition who work energetically with plants, my view is not unique.
You can increasingly find tulsi plants and seed at your local garden shop. If not, try Mountain Rose Herbal or Horizon Herbs.
Have a beautiful day.
