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SOULFUL Insights Archive

The Sound of Silence

In 2004, Everly Macario’s son, Simon Sol Sparrow, who was healthy until 1½ years of age, died very suddenly. It was not until a couple of months later that the cause of Simon’s death was confirmed to be community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), an antibiotic-resistant bacterium. Everly’s goals include raising awareness of antibiotic resistance, making the term “MRSA” as familiar a household term as AIDS, and serving as a catalyst for simple steps we can all take to reduce the overuse and misuse of antibiotics in both humans and animals. Everly has a doctorate in public health from Harvard and is committed to the fight to save antibiotics, on both a personal and professional level.

Saving Antibiotics: One Mother's Journey
Holidays, Alcohol and Weight Sabotage
Clia Tierney, MA
The Sound of Silence
by Clia Tierney, MA

I find myself surrounded by noise. Not just the obvious noise created by my family, friends, pets, cars, electronics, technology and the sounds of urban life, but by the very loud noise inside my head. There is almost constant chatter going on in my mind that is internally cataloging, planning, judging, comparing and creating. Often, much of my day is spent unaware of this internal noise. And, yet, it has the power to drown out everything. Does this sound familiar? I become most aware of this noise when I sit in meditation. Sometimes I am unable to shut it off, but at least meditation allows me to become aware of it.

Getting quiet in today’s world is a challenge. A challenge, I would argue, that is well worth the effort. In our busy, high-stress world, we ignore the language of silence. It is a language we all need to relearn. When we are able to become quiet and find silence and stillness, we can find the space inside ourselves to open ourselves up to new possibilities. These opportunities are bountiful: connection to our self, connection to other people, self-compassion and empathy for others, true listening, hearing the sounds of life around us, and finding space from which to be in the world mindfully. Essentially, sitting in silence allows us to be truly in the moment.
Thich Nhat Hanh, Vietnamese Buddhist monk, peace activist and author, writes, “Silence is essential. We need silence just as much as we need air, just as much as plants need light. If our minds are crowded with words and thoughts, there is no space for us.” According to Hanh, silence allows us to live more authentically and deeply. Silence allows us to just BE and by doing so, that will be ENOUGH. We need quiet to find that peaceful and content place inside ourselves that exists for each of us. When we become silent, we become present.
Chances are that we each have a practice that allows this but we may not have noticed the soul space it provides for us. Some of us are able to be silent in nature. We can step outside our home, take a deep breath, smell the air, take in the sights and sounds around us, feel the temperature and BE in the moment. If this is true for you, continue the practice and perhaps extend the amount of time before you rush into your day. Many of us may sit outside and feel peaceful. We garden or open the windows in our home. Try this in silence.

Some of us find silence and the break from internal noise through movement. We go for a walk or a run and are able to tap into a rhythm that promotes awareness of our senses or some spacious quality inside our bodies. If you have this practice already, see if you can be more intentional about the awareness of silence. If you do not move regularly, try going for a walk for a few minutes and see if you can focus on your breath or the sights and sounds around you instead of rehearsing a to-do list in your head.
I often find silence through the practice of yin yoga. This practice involves holding poses for a very long time (three to five minutes per side), creating discomfort by finding your physical edge in the pose, and then becoming still. There are so many physical and energetic benefits to yin yoga, however one tremendous benefit, both mentally and emotionally, is its ability to allow the stillness that brings a silence to internal chatter. Through physical stillness and focus on the breath, we can drop into a silent place and come home to ourselves. 

Try reconnecting to yourself, and therefore to the world, by spending part of today in silence. Just a few moments will make a difference. You can do this by finding a space in your home or workplace where you can shut down all of your senses and just be for a few moments. You can also try this while going from place to place, using the moving meditation practice, below.
Silent Awareness Practice

  1. Find a quiet place.

  2. Be still (standing or sitting) and close your eyes.

  3. Focus on your breathing.

  4. Notice silence by quieting your breath and listening for nothing.

  5. See if you can experience this silence in your body—notice how this feels.

  6. See if you can return to this embodied feeling of quiet when you are surrounded by any kind of noise.


Moving Meditation in Silence

  1. Walk slowly and purposefully with your gaze looking downward.

  2. Silently say something you are thankful for every time you take a step.

Eckhart Tolle advises, “When you lose touch with inner stillness, you lose touch with yourself. When you lose touch with yourself, you lose yourself in the world.” May your new year be filled with the sound of silence.



The owner of Asante Wellness Coaching, Clia Tierney helps women move past "stuck" into possibility. She coaches people to overcome obstacles and obtain clarity about their goals. Through the process, personal transformation takes place, resulting in greater well-being, life balance and fulfillment.

Clia's professional background and life experiences as a teacher, educational therapist, yogi, wife, mother of teenagers, daughter and sister have fueled her passion for helping women of all ages identify and reduce their stress and struggle so that they can discover their purpose and confidently move forward. 

Holidays, Alcohol and Weight Sabotage
by Joan Kent, PhD

Happy Holidays, right?
In one survey, 69% of people said their stress levels increase during the holidays. People listed crowds, long lines, weight gain, debt and lack of time among their top stressors. Ironically, people often use the festive food and alcohol that are everywhere at this time of year to cope with holiday stress. Naturally, that has a way of making seasonal weight gain worse.
Let’s look at exactly how alcohol can sabotage your attempts at weight management during the holiday season.
Alcohol is full of calories
My clients will tell you that I don’t necessarily hold to the “calories in/calories out” party line. Foods affect hormones, and those effects can, and often will, override simplistic caloric arithmetic. But we’ll start with basics. You may already know that alcohol has seven calories per gram, while carbohydrates and proteins each have four calories per gram. Only fat—with nine calories per gram—is more calorically dense. Adding alcoholic beverages to our food intake ups the calorie count quickly.

Alcohol triggers insulin
The hormone insulin inhibits fat utilization, making insulin an important marker of how much dietary fat ends up in the body’s fat stores. And alcohol is very effective at triggering insulin. This means that fats consumed at meals that include alcohol have a greater likelihood of being stored.
In susceptible people, high insulin can provoke reactive hypoglycemia, which is a glucose drop well below normal after the consumption of insulin-triggering foods such as sugar, white flour, potatoes and more. The issue is not how low glucose drops, but how quickly this drop occurs. It may bring on mood changes or cravings for more sugar, more alcohol or other junk.
Chronically high insulin—say, in response to a diet that includes lots of alcohol—may even induce insulin resistance. With insulin resistance, the pancreas secretes insulin, but the cells don’t respond to it as they should. Because the glucose remains in the blood and is unable to get into the cells, several compensatory processes are set in motion, starting with the production of extra insulin. This can eventually lead to a cluster of metabolic conditions that are known risk factors for heart disease: diabetes; high blood pressure; high triglycerides; and high LDL cholesterol and small, dense LDL cholesterol (these are likely to form arterial plaques), among others.
The primary site of insulin resistance is skeletal muscle. When muscle cells won’t accept insulin’s effects and the glucose it helps to transport, the glucose ends up in fat depots (rather than in the muscle cells) and affects weight. Insulin resistance is often described as a result of obesity or overweight. That’s true, but not the whole story. It can be the cause of obesity, as well.
Alcohol increases appetite
Alcohol activates the brain release of beta-endorphin. Beta-endorphin inhibits the action of the brain’s ventromedial hypothalamus (VMH), our primary satiety center. Satiety is the feeling that we’ve had enough food and don’t need to go back for more. With satiety blocked, appetite easily increases and meals may become larger as a result.

Alcohol makes us want different foods
Beta-endorphin release also creates changes in our food preferences; typically, it causes people to desire more sugars and fats. It may even make healthful foods seem unpalatable. Obviously, these are not helpful changes to put the brain through when holiday foods are everywhere.
Alcohol messes with your mind
Virtually any negative mood can provoke cravings, which may lead to self-medicating with food. Typically, junky foods are all too available at holiday time.
With chronic use, alcohol can initiate changes in brain chemistry that may lead to depression, anxiety or dysthymia (a mild, long-term depressive state which can be accompanied by feelings of sadness and hopelessness and also affect energy, productivity and sleep).
Low serotonin—another result of chronic alcohol use—can make us more impulsive. Normal serotonin levels “open the space” between thought and action. Violent offenders have been shown to have low levels of brain serotonin. Without a gap between thought and action, they think a violent thought and act on it. In similar fashion, low serotonin closes the space between craving and action. We may reach for the food we crave, or another drink, almost without thinking.
Alcohol disturbs sleep
Alcohol’s effects on sleep are multifactorial.

  • A late-night glass of wine is a common go-to relaxant, but this has drawbacks. Normal sleep includes light and deep stages, as reflected in brain waves. We cycle through these several times a night. Alcohol prevents the deeper stages (theta and delta waves) that are the most restorative. Until alcohol is fully metabolized—one ounce can take between 5.5 and 10 hours to leave the body, and additional drinks can add hours to that—we stay in lighter sleep (alpha waves). Alpha waves are not bad; meditation induces them. But they’re not deep enough for good-quality sleep. And women take longer to metabolize alcohol than men do, due to their smaller size and lighter body weight.

  • Those who are sensitive to insulin’s effects may wake up in the middle of the night due to the high insulin alcohol precipitates, unable to get back to sleep. It seems paradoxical that a glucose drop caused by high insulin would wake us rather than deepen sleep, but that’s what happens. Who might be sensitive to the insulin triggered by alcohol? Someone with a family history of alcoholism, diabetes, hypertension or certain types of obesity.

  • A significant consequence of poor sleep—whatever its cause—is the prompt release of ghrelin. Ghrelin is a hormone that increases appetite and lowers metabolic rate. It’s a terrible combination if you’re trying to manage your weight during the holidays.

  • Sleeping poorly and feeling fatigued may also make it difficult to get to early morning workouts, train as hard as you want to and/or stay motivated to exercise at all. It’s easy to see how combining that with the factors discussed above can make holiday weight management difficult.

Tips for managing holiday alcohol

  • Don’t drink on an empty stomach. Some people drink without having food in their stomachs because they want to feel alcohol’s effects more quickly, but doing so exacerbates both the insulin response and the speed with which alcohol reaches the brain. Since the stomach will empty faster with no food in it, the alcohol passes through the stomach quickly and is not broken down. As a result, more alcohol reaches the liver in need of detoxification. Overall, intoxication is increased and the alcohol’s other negative effects, including its addictive aspect and stress on the liver, can be, as well. 

  • Eat before going to a party or holiday dinner, especially a buffet. This will help to maximize your control over the alcohol’s effects and your food intake, especially all those holiday goodies that can sabotage your weight-management efforts. 

  • Eat protein before leaving home. This will raise levels of the neurochemicals that can help to stave off cravings and mood swings and help you limit your alcohol intake. Protein foods include fish, shrimp, crab, chicken, turkey, grass-fed beef, eggs and yogurt with 18 to 20 grams of protein per serving. Vegetarians and vegans, note that nuts are primarily wholesome fats, with only a small amount of protein. Quinoa is not high in protein, either; it’s a healthful starch with a small amount of protein. A suggestion I often give to my vegetarian and vegan clients is to mix a full serving of hemp or vegetable protein powder with water and drink it before heading to an event. 

  • Limit alcohol consumption. Avoid it, if possible. If you drink, alternate each drink with a glass of water. Keep alternating! An extra bonus is you’ll avoid the inevitable dehydration that alcohol causes.

  • Limit sugars. These include agave nectar, coconut sugar, honey, maple syrup, sauces, etc. All the effects of alcohol listed above also hold true for sugars.


Here’s to a happy—and healthy—holiday.




Joan Kent, PhD

Contact Information:

Joan Kent

Ph.D., Psychoactive Nutrition

M.S., Exercise Physiology

Speaker, Author, ACE-Certified Health Consultant


Joan Kent is a pioneer in sugar addiction and psychoactive nutrition. She was the first to document the neurochemical pathways of addiction to sugar, and to explain the sugar/fat seesaw, both neurochemically and hormonally. Joan has helped hundreds of clients with food addictions, mood disorders, inflammation, binge eating and metabolic syndrome, which leads to diabetes, hypertension, insulin resistance, heart disease, cancer, and a number of other conditions.

Joan’s philosophy stems from a quotation by Simone de Beauvoir: “Confidence in the body is confidence in the self.” People who struggle with food and health lose trust in the body. Because Joan’s psychoactive approach increases her clients' confidence and improves their quality of life, the quote has become her professional mission statement.


Joan has written two bestselling books. Stronger Than Sugar helps readers conquer their sugar addiction. The Sugar-Free Workout offers ways to fuel before, during and after workouts without relying on the sugary foods that often masquerade as “training fuel."

Saving Antibiotics:
One Mother's Journey
by Everly Macario, Sc.D.

Antibiotic-resistant germs (bacteria), including methicillin-resistant Staphylococcus aureus (MRSA), kill 23,000+ people and cause 2+ million illnesses each year in the United States. This is happening because these bacteria no longer respond to the antibiotics designed to kill them.

If I had no direct experience with the above statistics, I may glance at the numbers and continue with my day. Devastatingly, I am an example of the real and destructive effects of antibiotic resistance. My husband and I experienced every parent’s worst nightmare. On April 16, 2004, our toddler son, Simon Sparrow, woke up with a terrified scream, a fever and difficulty breathing. Less than 24 hours later, my beautiful cherub of a son was pronounced dead, without a precise cause of death. An autopsy revealed that Simon had contracted MRSA—specifically, a new strain called community-associated MRSA, a “superbug."

Simon Sol Sparrow died at 18 months of age after contracting an antibiotic-resistant bacterium

MRSA is a bacterium that causes hard-to-treat infections. It has traditionally been contracted in healthcare settings such as hospitals but is now found in community settings, including playgrounds, child-care centers, locker rooms, athletic facilities, jails, military quarters and student dormitories.
In 2004, I had never heard of MRSA—and I have a doctorate from the Harvard School of Public Health! Years later, I joined infectious disease experts to help form the MRSA Research Center at the University of Chicago to address the exaggerated demand for antibiotics by patients and the tendency to overprescribe antibiotics among doctors. Two-thirds of infectious disease doctors have treated patients with infections that did not respond to any antibiotics and half of all antibiotic use in humans is unnecessary or inappropriate.
Antibiotics and our food chain
Soon after starting my work at the University of Chicago, The Pew Charitable Trusts informed me that antibiotics are used in healthy animals to promote growth and prevent disease in crowded or unsanitary conditions. More than 34 million pounds of antibiotics are sold for use in food animal production. That’s four times the amount sold to treat sick people. This means that more than 70% of medically important antibiotics are sold in the United States for use in food animal production. The regular, sub-therapeutic (low-dose) use of antibiotics in food animal production is a perfect recipe for antibiotic resistance, as weaker bacteria are killed when faced with antibiotics, leaving stronger bacteria to survive and produce a next generation, continuing the cycle of superbug production.
Change is happening
Since 2012, I have advocated in Washington, D.C., for legislation that supports the judicious use of antibiotics. While getting legislation passed is a long and frustrating experience, we have seen concrete changes. As of December 2016 farmers can no longer use antibiotics for growth promotion (the policy does not say anything about disease prevention, however). Instead of over-the-counter availability, antibiotics added to water now require a prescription from a veterinarian, and antibiotics added to feed require a Veterinary Feed Directive. Previously, farmers could buy many antibiotics at feed stores or over the Internet.
The area in which I have witnessed the greatest change has been in consumer demand. In response to consumers’ voices, Tyson (a major producer of beef, chicken and pork) will eliminate antibiotics that are also used to treat human illnesses. McDonald’s, Chick-fil-A and Subway are all either reducing or eliminating antibiotics used by their suppliers. Perdue (another major producer of beef, chicken and pork) has agreed to process two-thirds of its chickens without antibiotics.

Raised sustainably in open pasture, grass-fed, grass finished, without antibiotics —

What can you do?
Antibiotic resistance is a problem that we can solve. What can you do?

  • At restaurants, supermarkets, hospitals and schools, buy or demand beef, poultry and pork from farms that do not use antibiotics in the raising of food animals.

  • Talk with your doctor about when it is medically necessary for you to use antibiotics and which antibiotics are appropriate for your specific illness.

  • When you do need antibiotics, make sure to use them exactly as prescribed, such as by taking all of the medication even if you are feeling better (if treatment stops too soon, the antibiotic may not kill all of the bacteria—the remaining bacteria may become resistant to the antibiotic).

  • Do not use other people’s “leftover” antibiotics.

Imagine a world in which we could no longer rely on antibiotics. Life would look similar to life in the early 20th century before Alexander Fleming discovered penicillin. Fleming himself warned in 1945, “There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug, make them resistant."
Scientists are not known for hyperbole, and that is why a 2014 World Health Organization (WHO) statement should catapult us into action: “A post-antibiotic era—in which common infections and minor injuries can kill—far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century." On November 7, 2017, WHO urged farmers to not use antibiotics to promote livestock growth, wait until animals are medically diagnosed with a problem before administering antibiotics and, when possible, select medications that are not important for human health. Unfortunately, these recommendations are not law.
We are now on the brink of a post-antibiotic era. I got a window into a post-antibiotic world when I witnessed my own toddler son die in my arms. Let’s not let another parent suffer that agony. Antibiotics are a precious gift that should only be used when absolutely necessary and as prescribed. To save antibiotics, we must stop using antibiotics inappropriately.


Everly Macario, Sc.D.
How our Food Choices Affect the Environment
The Trillions of Mouths You Feed Each Day
The Skinny on Fats
Eating for Energy and Focus
How Our Food Choices
Affect the Environment
by Jeanne Rosner, MD

An overview
Human survival is dependent on consuming food. What we choose to eat, however, can have an enormous impact on our environment. Twenty-thirty percent of manmade greenhouse gases are related to the food we eat. Our food choices also dramatically affect both our water resources and water pollution.

Of the three macronutrients in our diet: carbohydrates, fats and proteins, protein has the greatest impact on the health of our environment. Protein comes from both animal and non-animal sources.

Omnivore protein sources include animals; vegetarians can get some of their protein from items produced by animals (such as butter, eggs and milk); and vegans will not consume any animal sources, nor their products. They get their protein from vegetables, beans, grains, legumes, seeds and nuts.

The modern food chain
Greenhouse gas emissions occur every step of the way in our modern, industrial food chain: 

Production –> Processing –> Distribution –> Consumption –> Waste

Three gases are central to this process:

  • carbon dioxide (CO2)

  • methane (CH4)

  • nitrous oxide (N2O)

Each of these gases traps heat in the atmosphere to a differing degree. N2O does it with 300x more efficiency than CO2 does. CH4 traps heat nearly 25x more than CO2. The different gases are also emitted into the atmosphere in varying amounts, with CO2 contributing 76% of emissions, CH4 14% and N2O 8%.
Let’s look at the different protein sources and see how they impact CO2 emissions. This chart differentiates between pre-production CO2 impact and post-production CO2 impact.

Emissions Impossible, Environmental Working Group

The striking conclusion that one can draw from this chart is that animal sources of protein contribute significantly more to CO2 gas emissions than do non-animal sources. The sad consequence is that we are overloading the natural carbon cycle and emitting more greenhouse gases into the atmosphere than it can process, resulting in increasing temperatures. Even the smallest change in temperature wreaks havoc on the earth’s climate.

Deforestation, reliance on synthetic fertilizers and pesticides, enteric fermentation and manure production, transportation of feed, fertilizer and animals, and food wastage all contribute to greenhouse gas emissions. Let’s take a closer look. 

Huge swaths of land are being cleared of trees (our current storage depots for carbon) to plant monocrops of corn and soy as feed for the cows in concentrated animal farming operations (CAFOs). Without a reservoir of trees for carbon sequestration, the carbon is converted to carbon dioxide gas, which is subsequently released into the atmosphere.

Conventional modern farming relies on synthetic fertilizers and pesticides to do the work of nourishing soil and ridding it of pests, rather than relying on compost and cover crops to naturally perform these actions. These synthetic products contain nitrogen, which ultimately contributes to the emission of more greenhouse gases (N2O) into the atmosphere. They also create runoff—the gases enter our waterways, leading to the pollution of our oceans (see below about water impact).

A massive number of cows are raised in CAFOs. Their food source is grain, rather than grass, which is their preferred natural food source. Cattle have a unique digestive system that includes four stomachs, or rumens. In these rumens, enteric fermentation occurs, which results in an inordinate amount of burping. That belching emits large quantities of methane into the atmosphere as a greenhouse gas. Cow manure also emits methane and nitrous oxide. Anyone who has driven down Highway 5 in California knows all about CAFOs and the cows’ excessive belching and manure production. The horrible stench of methane can be detected miles away from these massive cattle complexes. 

Agriculture accounts for 70% of all our planet’s water usage. In the graphic below, you can see that animal sources of protein use a tremendous amount of water. Raising meat requires 20x more water than growing grains. The water is used to grow the animal’s feed as well as to hydrate the animal during its life cycle. 

Synthetic pesticides and fertilizers are often used to produce the animals’ grain food sources, making matters worse. The nitrogen and phosphorus from these synthetic products become agricultural runoff, which ends up in our water sources—typically oceans, but also lakes and rivers. The runoff has created large areas of oxygen-depleted water. These dead (or hypoxic) zones are unable to support marine life. Notable dead zones in the US are in the Gulf of Mexico and along the coasts of Oregon and Virginia. Fortunately, dead zones are reversible if their causes are reduced or eliminated.

What can you do?
What can we do to mitigate the environmental damage we do through our food production?

  • Eat locally sourced food.

  • Eat seasonally.

  • Eat less processed food.

  • Waste less food (food waste accounts for 40% of food lost, and 25% of our precious water is used to produce this food).

  • If you garden, do it organically. Don't use synthetic pesticides or fertilizers, do not till, use compost to help keep carbon in the soil. (Read more about organic farming here.) 

  • Eat more climate-friendly proteins (beans, nuts, seeds, grains and vegetables).

  • Move meat to the side of the plate instead of serving it as the main entrée.

  • If you eat meat, choose organic, grass-fed and grass-finished meat.

Remember, we have a choice about what we eat. Let’s be mindful of the impact our food choices have on the environment.




Jeanne Rosner, MD

Jeanne Rosner is a board-certified anesthesiologist who practiced pediatric anesthesia at Stanford Medical Center for nearly 20 years. In 2011, she began teaching nutrition classes in her son’s 5th-grade science class. It was an “aha” moment for her. She realized that learning and teaching about nutrition, health and wellness in her community washer destiny. 

Since retiring from anesthesia, Jeanne has been a nutrition educator in the San Francisco Bay Area, at Woodside Elementary School, Menlo School, the Boys and Girls Club of the Peninsula and Peninsula Bridge School. She teaches middle school children the importance of eating food closest to the source, making good food choices and eating in a balanced and moderate way. 
Jeanne started SOUL (seasonal, organic, unprocessed, local) Food Salon in 2014. SOUL Food Salon’s mission is to educate and empower people to be healthier. She holds small gatherings (salons) at which experts in the health and wellness community share their knowledge on how to lead a healthier life.

SOUL Food Salon is proud to partner with the Stanford University School of Medicine Teaching Kitchen. To learn more about their inspiring program, watch this video.

Eating for Energy and Focus
by Deborah Blake, NC

It’s late afternoon, your eyes start to glaze over and the yawning begins. Maybe you think a caffeine boost will help, or you unconsciously reach for some convenient carb-laden snack. This all-too-common routine could be avoided with the right fuel for your body, along with some beneficial lifestyle habits to support digestion and energy levels.

What should I eat for energy and focus?
Here are some general guidelines that will work for most people:

  1. Think SOUL food. As SOULFUL Insights reminds us, start with eating food that is Seasonal, Organic, Unprocessed and Local, if you can. Eating this way will ensure you are maximizing the nutrient density in your foods while avoiding harmful toxins, GMOs and pesticides that are found in processed and many conventionally raised foods.

  2. Eat three meals a day. One of the critical factors you can control to maintain a consistent energy level is your blood sugar: keep it steady. By eating three meals a day until you are 80% full, you help to ensure your blood sugar doesn’t drop too low as a result of not eating. It also helps prevent a sharp rise and abrupt drop in your blood sugar due to overeating.

  3. Build a balanced plate. Eating regularly throughout the day without attention to what you are eating is not enough to ensure optimal energy and focus. You need all three macronutrients (carbohydrates, protein and fat) in your diet. I recommended consuming each macronutrient at each meal to benefit from the full spectrum of nutrients while also allowing for a slow and steady release of energy that will tide you over until your next meal.

  • Start by featuring vegetables and maybe a little fruit occasionally as the “main dish,” making up 50% of your plate.

  • One-fourth of your plate can include whole grains and/or legumes. You don’t need to include grains and legumes at every meal or every day for that matter. Carbohydrates from vegetables alone may meet your needs for this macronutrient. 

  • One-fourth of your plate should include some protein (animal or plant-based).

  • Last, but certainly not least, are healthy fats to round out the meal. Not only do fats add flavor and lead to satiety, but fat is needed to absorb and metabolize fat-soluble vitamins (A, D, E, K), help to build hormones and for many other important body functions. Perhaps the most essential nutrient for the brain are Omega-3 fats (think, oily fish like Sardines and salmon or plant-based walnuts, flax seeds and pumpkin seeds). They help build your myelin sheath, which insulates your nerves. This, in turn, keeps nerve signals flowing so you stay alert and focused. Omega-3 fats are also anti-inflammatory and protect the brain from oxidative stress. Your body cannot make Omega-3 fats so you must consume them from food.


Eating a combination of carbohydrates, fats and protein at each meal (or snack if you really need one) is essential to maintaining long, steady energy. Macronutrients work together to convert energy continuously throughout the day, and their nutrients keep the body functioning at its optimal level. Remember to build your plate like the photo above. If you feel you need a second helping, help yourself to a little more of everything in similar proportions to keep your macronutrient ratios on target.

Foods to avoid for enhanced energy and focus
There is much debate about consuming caffeine for alertness and focus. While a cup of coffee can definitely provide you with a quick dose of sharpness, you can also overdo it and feel jittery and anxious, which then detracts from being focused. Additionally, the “boost” is short-lived. Ideally, it’s better to focus on sustained energy sources as discussed earlier in this post over a quick boost. If you must consume coffee, do so before 12 pm; the half-life of caffeine is six hours and could affect sleep if ingested after noon.
Sugar and alcohol also have adverse effects on energy and focus. They both cause blood sugar to spike and drop in unhealthy ways and require precious nutrients to process while adding no nutritional value. Aim to keep your daily sugar intake to less than eight teaspoons, or 30 grams.


Boosting energy and focus through lifestyle choices 
Now that you know what to eat at each meal, let’s focus on some healthy lifestyle choices that can boost your absorption and utilization of the nutrients you take in and thus positively affect your energy level and ability to focus. There are three primary lifestyle behaviors that directly influence your digestion:

  1. Sleep. On average, most adults need eight hours of sleep to fully repair and rejuvenate their muscles and brain. Sleep deprivation of even one hour a night can impair your ability to make healthy choices, stay focused and think quickly. Additionally, trying to sleep on a full stomach can interfere with sleep quality and repair time for your organs. Aim to finish eating at least two to three hours before sleeping.

  2. Stress management. Never eat when you are feeling stressed because your digestive system shuts down under duress. Taking a few deep breaths before you start a meal can be enough to shift the body into its parasympathetic mode and allow it to ready itself to receive food. Strategies to relieve stress throughout the day include regular deep cleansing breaths (especially when you notice stress coming on), exercise, laughing and meditation.

  3. Eat mindfully. Before taking any bite, ask yourself if you are, in fact, hungry. If you aren’t, think about why you are tempted to eat at that moment and address the emotion as appropriate. For example, try taking a quick walk to redirect and make a new choice. To improve digestion and avoid overeating, eat slowly and chew your food thoroughly. Aim for at least 20 chews/bite and try to lower your fork back to your plate between each bite. An average meal should take you at least 20 minutes to eat. Try to stop when you feel 80% full. Furthermore, don’t eat with distractions like watching TV or working on your computer, as this combination can lead to overeating and leave you feeling less satisfied than when you consciously enjoy each bite and take in all the flavors.

Other factors that can influence your energy and focus are undiagnosed, nutrition-related health issues such as food sensitivities, gut dysbiosis (an imbalance of your good and bad bacteria), metabolic syndrome or yeast overgrowth. Additionally, functional-related concerns such as hormone imbalances, autoimmune disorders or adrenal fatigue may be other avenues to explore. If you suspect one of these issues, seek the advice of a nutrition consultant or functional medicine practitioner for further evaluation and treatment of the cause.
Five things you can do today to improve energy and focus.

  1. Eat whole foods

  2. Get adequate sleep

  3. Eat mindfully

  4. Manage stress

  5. Eat three macronutrient balanced meals a day, mostly plants



Berg JM, Tymoczko JL, Stryer L. Biochemistry, 5th edition. Section 30.2, Each Organ Has a Unique Metabolic Profile. New York: W H Freeman; 2002. Web. Oct 17, 2017.
Davidson, Nancy, et al. (2013, April 03). “Living with diabetes: Stress, illness and high blood sugar.”, April 3, 2013. Web. Oct. 24, 2017.

Drake, Christopher, et al. “Effects of rapid versus slow accumulation of eight hours of sleep loss.” Psychophysiology, 38(6), Nov. 2001, 979-987. Web. Oct 24, 2017.
Goldstein, Andrea, et al. “Tired and Apprehensive: Anxiety Amplifies the Impact of Sleep Loss on Aversive Brain Anticipation.” Journal of Neuroscience. 26 June 2013, 33 (26) 10607-10615. Web. Oct 17, 2017.

“Healthy Eating Plate vs. USDA’s MyPlate.” The Nutrition Source, Harvard TH Chan, April 8, 2015. Web. Oct. 24, 2017.

Deborah Blake, NC

Deborah is a Nutrition Consultant in Menlo Park, California. She graduated in 2007 from Antioch University in Seattle with a Bachelor of Arts in Social Justice. Ever committed to working to improve the lives of others, she continued her education and recently graduated from the Nutrition Consulting program at Bauman College in Berkeley. Bauman is recognized for being at the forefront of the holistic approach to nutrition as it contributes to the prevention of illness and the promotion of optimal health.
Deborah is passionate about empowering clients with nutritional education and support so that they can create new habits to reach desired health goals. She offers one on one nutrition and wellness coaching, cooking demonstrations, as well as individualized meal planning.  

In addition, Deborah is the co-author of Bites Beyond Limits, a food blog dedicated to allergy-free eating.

The Skinny on Fats
by Martha Mejia, MD

Is butter really back? Can we eat bacon with abandon? These were the headlines in the popular media a few years ago—based upon a meta-analysis from 2014. These stories, with their click-bait titles, can be confusing and misleading. Let’s delve a bit deeper into the story about fat and clear up some of the confusion.

Our knowledge about food and nutrition continues to grow, reflecting an evolving body of evidence. We are far from reaching a definitive conclusion regarding the amount of fat intake that is optimal. However, there is growing clarity as to the type of fat that is healthy.
For many years, an anti-fat bias was entrenched in our thinking. The low-fat message helped usher in the obesity epidemic as manufacturers replaced fats with processed carbohydrates in many foods. The consumption of a diet heavy in starch leads to surges in insulin, storage of body fat and blood glucose fluctuations, which compel further sugar cravings and hunger. Long-term, this dietary pattern can lead to obesity and its dangerous sequelae of diabetes, high blood pressure, cardiovascular disease, fatty liver and even cancer.
It is difficult to pinpoint when fat became the enemy on our plates.
In the 1940’s, American physiologist Ancel Keys began to study the effects of dietary fat intake on cardiovascular disease. He launched the Seven Countries Study, which pointed out the relationship between dietary patterns and prevalence of cardiovascular disease (CVD) in Greece, Italy, Spain, South Africa, Japan, Finland and the US. Keys concluded that populations consuming large amounts of dietary fats had the highest cholesterol levels and the highest rates of CVD. Conversely, in cultures where diet was based on fresh fruits, vegetables, fish, whole grains and olive oil (Mediterranean countries), the heart attack rate was low. Still more interesting, he found that the people of Crete had the lowest CVD rate of all, despite a diet high in fat. The distinction was that their diet was high in polyunsaturated fats, like fish, olive oil, nuts and seeds. The story of dietary fat continues to evolve and is complex.

Understanding fats
All fats are not created equal; there are good fats and bad fats. The truth is that good fats are not only beneficial to your health, but they are necessary and essential for life.
Healthy fats are vital for many body functions, including:

  • Brain function: Fat provides the structural components for the cell membranes in the brain and myelin (fatty sheath surrounding axon of nerve cells). The brain’s composition is 60% fat.

  • Cell membrane function: Fat is the major constituent of the membrane that surrounds each cell of the body.

  • Energy production: Fat is the most efficient source of food and energy.

  • Hormone production: Fat is part of the prostaglandins that regulate many bodily functions. These substances also regulate sex hormones and are critical for fertility and reproduction.

  • Nutrient absorption: Fat is necessary for our intestines to absorb the fat-soluble vitamins A, D, E and K, as well as minerals.

  • Organ protection and function: Fat provides a cushion for our vital organs, and it provides the essential fatty acids necessary for many organs to function optimally.

  • Skin health: Healthy skin requires healthy fats, particularly essential fatty acids.

  • Inflammation: Fats are needed to produce hormones that regulate inflammation.

  • Blood Clotting: Fats are essential for clotting cascade.

  • Maintain body temperature: Fats provide insulation, which helps to maintain body temperature.


Types of fat
All fats have the same basic chemical structure, yet each varies by how many hydrogen atoms and double bonds it holds. The shape of the carbon chain helps determine the properties of the fat. Slight differences in structure can lead to crucial differences in function.
The three types of fats are:

1.   Saturated fats (typically solid at room temperature)

2.   Unsaturated fats

  • Monounsaturated: Food sources include olive oil, avocado oil, nuts, seeds and olives

  • Polyunsaturated: There are two primary types: Omega-3 (salmon, walnuts, flax seeds, etc.) and Omega-6 (processed foods and vegetable oils)

3.   Trans fats: Also known as partially hydrogenated oils. Found in commercially processed foods and solid margarines.


All foods contain a mix of fat types, but one type usually predominates. Click here to learn more about the various types of fats.


Focus on eating food, rather than “nutrients.” Some general rules to guide your consumption:

  • It is not the total fat that matters but rather the type of fat that one consumes. Not all fats are created equal.The healthiest fats to least healthy fats to eat are:  Seafood Omega-3 Fats—> Plant Omega-3 Fats —> Plant Omega-6 Fats—> Monounsaturated Fats —> Saturated Fats —> Trans Fats. Omega-3 fats, derived from marine sources such as fish and algae are the healthiest. The richest sources of Omega-3 fats are in fatty fish (think SMASH: salmon, mackerel, anchovies, sardines, herring). Next are the Omega-3 fats derived from plants: chia seeds, hemp seeds, algal oil, flax seeds, leafy greens, beans and cabbages. Then, plant Omega-6 fats found in corn, soy, safflower and sunflower oils. Next in line are monounsaturated fats such as nuts, avocados, olives and olive oil. Saturated fats, which are found mostly in animal foods such as cream, cheese, milk, butter and fatty meats, follow. If you choose to eat red meat, eat it in moderation and source it from grass-fed and grass-finished animals. At the bottom of the barrel are trans fats (also known as partially hydrogenated oils). They should be avoided because they are highly toxic. Trans fats are found in processed foods.

  • All fats can make you fat if too many calories are consumed. They all contain 120 kcal per tablespoon.

  • Eat fats mostly from plants and fewer fats from meat and dairy foods. Fats that are in liquid form (oils) at room temperature are unsaturated and plant-based.

  • Do not exclude fats when you are cooking because they are necessary to help transport needed vitamins and minerals to our cells and tissues. For example, when roasting vegetables, include a few tablespoons or more of olive oil to assure that the healthy nutrients are transported properly in the body. 

  • Keep intake of saturated fats to a minimum. Replacing saturated fats in the diet with polyunsaturated fats and whole grains will reduce your risk for heart disease. However, replacing saturated fats with refined carbohydrates (sugar and refined starches) and trans fats will increase your overall risk for heart disease. 

  • Low fat does NOT necessarily mean healthy. Often, if a food item is low in fat, it is also high in sugar, which helps make the food taste good.

  • Minimize the ingestion of fried foods, especially from fast food establishments. If you desire something fried, fry it yourself at home. Realize that when oils are heated to high temperatures their fat structure changes in unhealthy ways.


Eating whole foods that are unprocessed and in their natural form brings the most health benefits. Eat an abundance of plants with plenty of fruits, vegetables, whole grains, nuts, seeds and olive oil in the style of the Mediterranean diet.
Stay well, my friends.
Martha Mejia, MD


Martha Mejia, MD

Martha Mejia's love for learning about nutrition and bringing that information to the fore when treating patients has been a mainstay of her medical practice. It is her passion to disseminate information not only in a doctor-patient relationship but also in articles, group discussions and lectures. She is dedicated to providing comprehensive, up-to-date and holistic care, adding a more natural and nutritional approach to conventional medical treatments. Viewing and treating each person as an individual is her main priority.

Martha graduated from the Stanford University School of Medicine and completed a residency in Internal Medicine at Santa Clara Valley Medical Center followed by a Fellowship in Nephrology at Stanford. She has worked in urgent care and primary care clinics. Recently, she joined the Sequoia Medical Group after 20 years in internal medicine private practice.

The Trillions of Mouths You
Feed Each Day
by Erica Sonnenburg, PhD

Are your gut microbes more famished than you realize?
Our intestine is home to approximately 100 trillion bacteria. There are more microbes in a single teaspoon of intestinal content than there are stars in our Milky Way galaxy. It’s a humbling experience to realize that humans—with our highly evolved, complex brains that can build towering skyscrapers and compose fine works of art—are, in essence, bacteria-filled tubes. We are housing galaxies of microbes within our gut, and all of those microbes play a key role in regulating and maintaining our overall health. When they are not staving off disease, what are all these microbes doing there? Eating.
Your microbiota and you
The gut microbiota, also referred to as the microbiome, is the collection of microorganisms that call your intestines home. A major function of this community of bacteria is to consume carbohydrates. But not just any type of carbohydrates, a specific type called microbiota-accessible carbohydrates, or MACs. MACs are complex carbohydrates: the types found in fruits, vegetables, whole grains and legumes. When our gut microbiota consumes MACs it releases compounds into our gut that help our body regulate its immune system, keep pathogenic, or bad, bacteria at bay and even contribute to whether we are lean or obese. 

What happens if you haven’t eaten any MACs? Does your microbiota lie in wait, famished, hopeful that you will feed it again soon? Not exactly. When your diet doesn’t contain enough MACs, your microbes are forced to rely on the only other carbohydrate source it has left: you. Your intestine secretes a slimy coat of carbohydrates that line your intestinal wall, called mucus. This mucus lining is a rich source of carbohydrates that starving microbes can feast on when dietary pickings are slim.

Microbes within the colon located in the top left corner separated from colon cells (bottom right corner) by a layer of mucus (diagonal green across the image). Credit: Kristen Earle, Gabriel Billings, KC Huang, Justin Sonnenburg

Our gut microbes can have a bit of a Jekyll-and-Hyde type of personality. Provide gut microbes with plenty of sustenance in the form of MACs and they will happily convert them into molecules our body needs to be healthy. Starve them of dietary MACs and they will munch on your mucus lining, inching ever closer to your intestinal wall. The immune system is put on alert that a microbe is getting dangerously close to penetrating the protective wall your body has constructed to keep a safe distance between them and us. The long-term ramifications of this situation could be an immune system that’s on a hair trigger, impacting not only the health of your gut but your entire body.
While MACs are not denoted on a food’s nutritional label or ingredient list, they have a proxy that is labeled: dietary fiber. It’s the closest approximation we have for MACs. Consuming foods that are high in dietary fiber helps ensure the best nutrition for our microbial partners. Unfortunately, the evidence points out that Americans are not getting enough dietary fiber. The average American consumes a measly 15 grams of dietary fiber per day. This falls far short of the 30-38 grams recommended by the FDA, and it’s woefully short of the 100-150 grams of fiber consumed by modern-day hunter-gatherers. Much of the current scientific inquiry is looking at how dietary fiber consumption relates to the health of the microbiota throughout life and over generations.
A growing number of studies have revealed that the average Westerner has a microbiota with far fewer microbial species living in their gut relative to people living a lifestyle and eating a diet more similar to our early agrarian or hunter-gatherer ancestors. It appears that as our consumption of dietary fiber has decreased, so has the number of different types of bacteria living in our gut—stars in our internal galaxies flaming out. Scientists don’t yet know what the long-term ramifications of this gut microbial extinction might be. But the simultaneous stratospheric rise in diseases such as obesity, diabetes, heart disease, autoimmune diseases and even depression in our society points to a potential common thread underlying all these conditions. While these highly complex diseases are likely to be the result of several insults—death by a thousand cuts—more scientists are starting to view a diseased Western microbiota as a major knife-wielder.

New York Magazine–April 24, 2015, photo by Cody Pickens   

The Big MAC diet
How can you keep your microbiota healthy? While several factors affect the microbiota, diet appears to be a major lever we can control. Eating a diet filled with dietary fiber, a “Big MAC diet,” can help your microbiota focus on consuming food, and not you. In practice, this means each meal needs a healthy portion of fruits, vegetables, beans or whole grains so that you are consuming at least the 30-38 grams of dietary fiber per day recommended by the FDA.
For an example of what this would look like, the day could start with a bowl of steel-cut oatmeal with berries, then a kale salad sprinkled with nuts, seeds and dried fruit for lunch, and finally a dinner comprised of a veggie-filled Mediterranean bean soup. This type of diet ensures that our microbes have plenty to eat so that they can maintain a robust and thriving community within our gut.
Five ways to boost gut health

  • Feed your microbes lots of high-fiber foods (for example, beans, artichokes, berries, avocados, and whole grains)

  • Eat bacteria through probiotics or fermented foods

  • Don’t over-sanitize; regular soap and water is plenty

  • Avoid unnecessary antibiotics

  • Spend time outside to expose yourself to nature’s microbes

So, what have you fed your microbiota today?


  • De Filippo, C., et al. “Impact of Diet in Shaping Gut Microbiota Revealed by a Comparative Study in Children from Europe and Rural Africa.” Proc Natl Acad Sci U S A 107.33 (2010): 14691–6. Print.

  • Martinez, I., et al. “The Gut Microbiota of Rural Papua New Guineans: Composition, Diversity Patterns and Ecological Processes.” Cell Reports(2015): 527–38. Print.

  • Schnorr, S. L., et al. “Gut Microbiome of the Hadza Hunter-Gatherers.” Nat Commun 5 (2014): 3654. Print.

  • Smits, S.A., et al. “Seasonal Cycling in the Gut Microbiome of the Hadza Hunter-Gatherers of Tanzania.” Science 357.6353 (2017): 802–6. Print.

  • Yatsunenko, T., et al. “Human Gut Microbiome Viewed across Age and Geography.” Nature 486.7402 (2012): 222–7. Print.

  • This Week in Health: Inside your Microbiome by Harvard Public Health

Erica Sonnenburg, PhD

Erica Sonnenburg, PhD, is a senior research scientist at the Stanford University School of Medicine in the Department of Microbiology and Immunology, where she studies the role of diet on the human intestinal microbiota. She has published her groundbreaking findings related to the microbiota in prestigious journals such as The Proceedings of the National Academy of Sciences, Cell, and Nature.

She is the co-author, along with her husband, Justin Sonnenburg, of the book The Good Gut: Taking Control of Your Weight, Your Mood, and Your Long-Term Health. 

Fight Cancer With Your Fork
Fight Cancer With Your Fork
by Jocelyn Dubin, MS, RD

Day in and day out, I work with patients who have been diagnosed with cancer. One of my greatest joys as a registered dietitian is when I hear them say “I came in here feeling like there was nothing I could personally do to treat this disease but meeting with you has given me hope.” It is abundantly clear to me that you can indeed fight cancer with your fork, and that is how I give my patients hope. In no way, shape or form am I suggesting that nutrition alone serves as a comprehensive approach to cancer treatment. Rather, I am suggesting that what we eat has a profound effect on cancer cell growth. And it's backed up by the science. It makes sense. Eating is the thing we all do every day, multiple times per day, regardless of how busy our lives are. In tandem with a wide variety of treatment modalities (which should be determined with one’s healthcare team), nutrient-dense foods alter the oncological landscape inside our bodies and our quality of life throughout cancer treatment.

The cancer-fighting powerhouses
Curcumin is a nutrient found in turmeric. Its nutritional classification is a polyphenol. It makes up 2-3% of the turmeric root itself. Curcumin has been shown in multiple clinical studies to limit angiogenesis (the creation of blood vessels leading from a healthy cell to a cancer cell) and induce apoptosis (cancer cell death). This polyphenol activates enzymes needed to eliminate toxic compounds from the body and protects the body’s healthy cells against toxic, more invasive, cancer cells. By including turmeric in the diet, some curcumin will naturally be absorbed. However, since curcumin comprises such a small part of the turmeric root, adding small amounts of turmeric to food will not impart much benefit. To increase the efficacy of turmeric and the absorption of curcumin, pair it with black pepper. It increases the absorption of curcumin by 2000%. For many of my patients with cancer, I also recommend curcumin in supplemental form. But my approach is to get as much nutrition as we can from the foods and beverages we consume and use supplements only to fill in the gaps. This is critical given that many patients look to pills to play the role that medicinal foods should play and are confused when poor diet and a large quantity of supplements do not produce favorable outcomes. 

Cruciferous vegetables are also heavy hitters when it comes to fighting cancer with your fork. A key compound in this family of vegetables is indole-3-carbinol, which acts much like curcumin in that it is a potent detoxifying agent that aids the liver in removing chemical carcinogens from the body. It does this by inhibiting the Phase I detoxification enzymes and inducing the Phase II detoxification enzymes. Broccoli, cauliflower, Brussels sprouts, cabbage, bok choy, watercress, kale, collard greens, turnip greens, dandelion greens, kohlrabi, rutabagas, turnips, arugula, horseradish and radishes are all cruciferous vegetables that contribute to making the body an unfavorable environment for cancer to exist and thrive.

Mushrooms play a powerful role in the fight to eradicate cancer. In specific, Trametes versicolor, commonly known as turkey tail mushroom, plays a central role in my nutrition practice. This mushroom contains a starchy compound known as a beta glucan. The beta glucan studied most widely in human clinical trials is Polysaccharopeptide. This cancer-fighting compound changes the gene expression and transcription for those with specific types of cancer. This results in more immune support for cancer patients. In my practice, I see its effects most starkly in the increase in white blood cell counts among those who have had blood drawn before using turkey tail mushroom and, again, after we have begun a turkey tail mushroom regimen. Turkey tail mushrooms are available at some gourmet grocers and online, in dried form. If you buy them fresh, add them to a soup or sauté them. If you purchase dried turkey tail mushrooms, rehydrate them in hot broth or water for 30 minutes before eating them. Turkey tail mushroom supplementation may also be indicated for some patients. 

By Peter Sevens from Seattle  (Turkey tail mushroom)

While there are many other foods that aid us in the fight against cancer, the aforementioned ones are an excellent place to begin. By including curcumin, cruciferous vegetables and turkey tail mushrooms in your eating regimen, you can use the power of plants to become a proactive patient in the fight against cancer.

How much of each nutrient a person should include in their diet varies. In my practice, I customize every one of my nutrition recommendations to the individual. So rather than recommend 500 mg of curcumin or four cups of broccoli for every person—regardless of cancer type, stage, treatment modality, pre-existing condition or digestive issues—I recommend that you honor your unique self by working with a registered dietitian to determine the exact nutrients you should include. With personalized recommendations from your healthcare team and proper wielding of your fork, you can effectively fight cancer.




Jocelyn Dubin, MS, RD

Jocelyn Dubin, MS, RD has a Master’s in Nutritional Science from San Jose State University and is a registered dietitian with the Commission on Dietetic Registration. Before Jocelyn opened NOURISH with her husband, Victor, she developed a private practice and worked to improve the nutritional health of individuals in hospitals, clinics, nonprofit organizations, schools and private homes.
At NOURISH, Jocelyn provides telephone, Skype and in-office consultations, visits clients’ homes to perform kitchen makeovers, takes clients grocery shopping and teaches them how to order the healthiest items from restaurant menus. She also develops and delivers customized nutrition presentations for the public, corporations and nonprofit organizations. Jocelyn encourages her clients to use the power of their plates to be proactive about their health.

Oxidative Stress
Feed Your Family Without Losing Your Mind
Is Your Teen Athlete Eating Enough?
What is Oxidative Stress?
by Jeanne Rosner, MD

Have you ever wondered why apples or avocados turn brown a few minutes after you cut into them? Why do old cars start to rust? It’s thanks to a process called oxidation. When this same activity occurs in our bodies, it is referred to as oxidative stress. Over time, oxidative stress can be extremely harmful to the human body, leading to degenerative changes that accelerate aging and cause chronic disease. For true health to prevail, our goal should be to provide an environment where oxidative stress is minimized.
Oxidation is the process of removing electrons from an atom or molecule. Electrons normally exist in pairs. When they fly solo, they are highly unstable or reactive; in this state, they are also known as reactive oxygen species (ROS) or free radicals. Damage occurs when the free radical encounters another molecule and seeks to find another electron to pair with to become more stable. The unpaired electron pulls an electron off a neighboring molecule (often the donor is DNA, important structural or functional proteins, LDL cholesterol particles, or even cell membranes) causing the affected molecule to behave like a free radical itself—and a chain reaction occurs. In their wake, the free radicals create even more unstable molecules that then attack their neighbors in a domino-like chain reaction. Not surprisingly, the end result of this process can be highly destructive.

The production of free radicals can occur as a normal byproduct of metabolism. It also results from exposure to things like certain chemicals, cigarette smoke, pollution, radiation, increased sunlight exposure and tanning beds. The simple loss of electrons can subtly alter the function of, or even damage, DNA, proteins and cell membranes. Cumulative damage of this sort probably accounts for premature aging, many of the degenerative changes of aging and age-related diseases such as cancer and cardiovascular disease. 

Antioxidants help stave off oxidative stress. They can donate electrons and stop the spiraling domino effect. Interestingly, antioxidants are able to give up electrons to free radicals without turning into electron-scavenging substances themselves.

In addition to the presence of antioxidants in our diet, we are fortunate that our body can defend against oxidative stress in many other ways. Within cells, there are physical barriers that can help contain free radicals at their site of production. Enzymes in the body can help neutralize the dangerously reactive forms of oxygen. Programmed cell death (apoptosis) can occur when damage becomes excessive.
In general, however, when there are too many free radicals in the body and too few antioxidants and/or mechanisms to defend against oxidative stress, more damage occurs. As an example, free radicals can oxidize LDL cholesterol. When this happens, atherosclerotic plaques can form in blood vessel walls. Ultimately, this has the potential to lead to blood clots resulting in blood flow blockage in the heart and brain, causing a heart attack or stroke, respectively.

To help prevent an environment of oxidative stress, we should try to reduce free radical formation and help ensure an abundance of antioxidant support. The following are some tips to create this supportive environment.

1. Modify diet: Reduce consumption of trans fats, alcohol, high glucose-containing foods and fructose (not from fruit). These food items can overwhelm the metabolic capacity of the liver, resulting in free radical production. In addition, avoid deep-fried foods because they are notorious sources of free radicals, caused by the oil being continuously oxidized when it is heated at high temperatures.

2. Increase fiber intake: This helps reduce the rate at which the liver metabolizes energy; therefore it reduces the production of free radicals.

3. Increase antioxidant ingestion: Eat a diet full of fruits, vegetables, nuts and whole grains. The richer the color and more variety in these foods, the more nutrients and antioxidants they will provide. Each different color in fruits and vegetables represents a different nutrient and antioxidant. Research shows individual antioxidants in supplement form provide minimal benefit.

4. Increase mitochondrial formation and number through exercise. This allows better processing and metabolism of food items, thereby preventing the production of free radicals.
Trying to keep the “rust” out of our bodies is an important step in preventing the degenerative changes of aging as well as chronic diseases. To reduce your overall oxidative stress burden, make sure you’re eating a healthful diet, full of a wide variety of fruits and vegetables, and getting plenty of exercise.




Hyman, Mark. “Glutathione: The 'mother' of all antioxidants.”
Lobo, V. et al. “Free radicals, antioxidants and functional foods: Impact on human health.” Pharmacognosy Review. 2010 Jul-Dec; 4(8): 118–126. doi:  10.4103/0973-7847.70902.
Lustig, Robert. Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity and Disease. New York: Penguin, 2013. Print.
Uttara, Bayani et al. “Oxidative Stress and Neurodegenerative Diseases: A Review of Upstream and Downstream Antioxidant Therapeutic Options.” Current Neuropharmacology. 2009 Mar; 7(1): 65–74. doi:  10.2174/157015909787602823.

Jeanne Rosner, MD

Jeanne Rosner is a board-certified anesthesiologist who practiced pediatric anesthesia at Stanford Medical Center for nearly 20 years. In 2011, she began teaching nutrition classes in her son’s 5th-grade science class. It was an “aha” moment for her. She realized that learning and teaching about nutrition, health and wellness in her community was her destiny. 

Since retiring from anesthesia, Jeanne has been a nutrition educator in the San Francisco Bay Area, at Woodside Elementary School, Menlo School, the Boys and Girls Club of the Peninsula and Peninsula Bridge School. She teaches middle school children the importance of eating food closest to the source, making good food choices and eating in a balanced and moderate way. 
Jeanne started SOUL (seasonal, organic, unprocessed, local) Food Salon in 2014. SOUL Food Salon’s mission is to educate and empower people to be healthier. She holds small gatherings (salons) at which experts in the health and wellness community share their knowledge on how to lead a healthier life.

Is Your Teen Athlete Eating Enough?
by Katherine Hill, MD

Kayla is a 16-year-old competitive soccer player. Like many of her teammates, she has irregular periods—generally only a few times per year. Her coach told her that it is normal to have irregular periods, so she doesn’t think too much of it. Last season, she sustained a stress fracture and had to sit out the championship game. She describes herself as a healthy eater, focusing on fresh produce and lean meats, as she is trying to be “fit” to optimize her performance. She claims she eats “a lot” more than her non-athlete friends. She guesses that she eats about 2,000 calories a day because a fitness magazine told her this is a good number of calories for an active female. She denies any disordered eating and was told by her pediatrician that she is in the normal weight range. Kayla is just a healthy, athletic teen, right?

As a pediatrician specializing in adolescent medicine, I frequently see patients just like Kayla. Unfortunately, many teen athletes are getting inaccurate or just plain wrong information about their health. Despite her good intentions, Kayla is suffering from something called the Female Athlete Triad, which is a syndrome of three interrelated components: 1) decreased energy availability (eating too few calories to support calories burned), 2) irregular periods and 3) decreased bone density. This condition can negatively impact sports performance. In more severe cases, the Female Athlete Triad may place athletes at risk for dangerous medical conditions like cardiac arrhythmias, electrolyte abnormalities and poor mental health.

When athletes fail to meet their caloric demands, nearly all systems in the body can be affected. Below are some signs or symptoms that suggest inadequate caloric intake:

  • Fatigue 

  • Low blood pressure and fainting or near-fainting episodes or dizziness (also a sign of dehydration)

  • Cold hands and feet

  • Weight loss (*normal or even overweight individuals can still be malnourished if weight loss occurs too quickly)

  • Hair loss

  • Dry skin

  • Constipation

  • Low resting heart rate (*normal resting heart rate is around 60-80 beats per minute. Heart rate may be slightly less than 60 in athletes, but is almost never normally less than 45-50)

  • In girls, irregular or absent periods

  • Frequent injuries or stress fractures

  • Depression or anxiety



Common Myths

The Female Athlete Triad is a condition that only affects females
Yes and no. Males obviously cannot “qualify” for the irregular period component of the Triad. However, males who do not meet their nutritional needs experience the same physiological response, including the negative impact on bone health. Young male athletes have remarkably high caloric demands, which can make it difficult to meet their nutritional needs. Despite popular misconceptions, eating disorders are very common among young men, and boys often go many years before receiving a proper diagnosis.

2,000 calories per day is an appropriate caloric intake for a teen athlete
Caloric needs vary drastically between individuals depending on multiple factors, such as gender, body size, muscle mass, genetics and energy expenditure. We frequently see teen athletes in our clinic, particularly in endurance sports, with caloric needs of 4,000 calories per day, or more. It is common for teens to be inadvertently under-fueling their bodies. On the other hand, eating disorders, with intentional caloric restriction and an extreme desire for thinness, are also very common in athletes of all sports. If you have questions about your teen’s caloric needs, please seek the advice of a registered dietitian for an individualized assessment.

Athletes should only eat “healthy” foods

It is true that everybody should prioritize more healthful foods like fresh produce and lean meats and fish. However, these foods tend to be less calorically dense, so it can be challenging to meet a growing, active teen’s nutritional needs eating the most healthful foods alone. Healthy and calorically dense foods, such as avocados, nuts, oils, and whole milk yogurt are a great addition to the active teen’s diet. In addition, all teens should learn how to include treats in their diet in moderation. It will help set them up for a healthy relationship with food for a lifetime.

It is normal for female athletes to have irregular periods

In females, irregular periods may be normal in the first one to two years after having a first period. But after the first two years, irregular periods are never normal. While conditions like polycystic ovarian syndrome may be to blame, in female athletes, inadequate caloric intake is very often the culprit. When a female athlete does not meet her caloric needs, her body fails to produce the necessary hormones required to have menstrual cycles. These hormones are also necessary to help build peak bone mass. Without them, the risk of fractures and osteoporosis increases. The teen years are a critical period to increase bone mass. Bone mass is only accrued into the 20s, after which it must last a lifetime. If your teen daughter has not had her first period by age 15, or if she is having irregular cycles a couple of years after her first period, please seek a medical evaluation. 


If your teen is experiencing any of the above signs or symptoms, please seek care with a physician. Our Center for Adolescent Health is well equipped to evaluate and treat teens and young adults, ages 12-21, with concerns about their nutrition, as well as to provide comprehensive primary care to this population. 




De Souza MJ, Nattiv A, Joy E, Misra M, Williams NI, Mallinson RJ, Gibbs JC, Olmsted M, Goolsby M, Matheson G; Expert Panel. "2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013." British Journal of Sports Medicine. 2014 Feb;48(4):289.

Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP, & American College of Sports Medicine. "American College of Sports Medicine position stand. The female athlete triad." Medicine & Science in Sports & Exercise. 2007 Oct;39(10):1867-82.

Yu, Christine. "The Condition That's Quietly Sidelining Female Athletes." Outside Magazine. 15 Sep. 2017.

The Female Athlete Coalition:

Katherine Hill, MD, is a board-certified Stanford pediatrician with special interests in Adolescent Medicine and care of the teen athlete. She completed her undergraduate training at Stanford University, where she was a member of the Stanford women's varsity swim team. She then received her MD from the Stanford School of Medicine, and completed her residency training in Pediatrics at Stanford. Her research has focused on the Female Athlete Triad in collegiate athletes. She lives with her husband and young son in Belmont, California. She is currently accepting new patients at the Stanford Teen and Young Adult Clinic in Sunnyvale, CA.

Katherine Hill, MD

Stanford Center for Adolescent Health
1195 West Fremont Avenue
Sunnyvale, CA 94087
Clinic phone: 408-637-5959

Feed Your Family
Without Losing Your Mind
by Reshma Shah, MD, MPH

Increasingly, people realize that what we put on our plates can have more of an impact on our health than most pills or medical procedures. For some, making personal changes around food can be quite daunting. Add to that, the job of feeding an entire family, and it may feel downright impossible. Between picky eaters, demanding schedules and varying tastes, it’s easy to see how creating family meals that nourish both body and soul seem unattainable. Speaking on a personal level, I know that as I have transitioned to a plant-based diet, it hasn’t always been smooth sailing.

Here are some tips and lessons learned to help you embark on feeding your family with an emphasis on a plant-based diet.

  • Invite rather than impose. Nobody likes to be told what to do. If you’ve made some personal changes and are excited to share them with your family, don’t be surprised if everyone doesn’t jump on board right away. The first step may simply be to have a large salad at every meal, making sure to include ingredients that you know will be greeted with joy.

  • Be a role model! If your family sees you slurping down a juicy mango or eating crisp snap peas with delight, it’s going to look much more appealing. In short, walk the talk.

  • While it’s important to be a role model, remember that the focus should be on progress, not perfection. Simply leaning more towards plants, cutting back on processed foods and using animal products more as a condiment rather than the focus of a meal are great first steps.

  • Be patient and calm when introducing new foods. Remember, it can take upwards of 10 tries for a child to enjoy a new food. Try to keep the mood pleasant and avoid getting into food battles.

  • Don’t be sneaky. Nobody likes being told what to do, and nobody likes to be tricked. A few leaves of hearty kale covertly mixed into a morning smoothie could backfire. If little ones detect bitterness or a less sweet version of their favorite smoothie, they learn to distrust your offerings. A different approach could be to make a game of it: “I’ve added a secret ingredient, and I’m wondering if you can figure out what it is?” Or allow them to throw in as many leaves of spinach as they’d like and then gradually work your way up.

  • Make it fun and be creative. Turning anything into a “bar” (salad, taco, rice bowls, etc.) is a great way to get kids to try new ingredients or combinations. It also gives them some control over the meal by allowing them to add which and how much of each ingredient.

  • Bring your kids into the kitchen and to the market. I know it sounds cliché, but I do find it to be true that when kids are actively involved with the food (from menu planning and shopping to chopping and simmering), they feel more invested and a part of the whole process. A quick example that comes to mind is our family’s search for the perfect pesto. Many store-bought pestos contain dairy, and my son is allergic to tree nuts, so we cannot use them. So, my son decided he would search for a nut-free pesto recipe. We made a few small changes and, together, created a spinach-basil pesto that has become a family favorite (recipe here). Don’t feel pressured to have the kids involved with every meal. I like to think of it as an open-door policy—they are welcome anytime! Sometimes it’s as involved as helping cook an entire meal and other times it’s just wanting to have the fun of sautéeing some onions or giving a quick stir to a soup.  

  • Focus on the journey. I would argue that as important as it is to fuel our families with nutritious foods, we have an even greater responsibility as parents to teach our kids about food choices so that they can make good decisions away from our dinner tables. Pushing one more bite of greens or two more bites of anything is not the end goal. Don’t forget that food and family meals connect us. Yes, food should be nutritious. But, it should also be delicious and most definitely shared. It’s not always easy to do, but when we focus more on the conversation than on the number of bites of broccoli, everyone feels more relaxed.

  • Be kind to yourself and have patience. We are all just learning, experimenting and growing. When things don’t go smoothly or are downright disastrous, be willing to show flexibility and ask your troops for their ideas and help.



The ABCs of a Whole-Food, Plant-Based Diet
The Whole-Food, Plant-Based Diet and Animal Welfare
Forks over Knives recipes:
Nutrition Facts:
Plantrician Project:

Reshma Shah, MD, MPH

Dr. Reshma Shah is a board-certified pediatric physician. She obtained her undergraduate and graduate degrees from Johns Hopkins University and her medical degree from Drexel University College of Medicine. She has more than a decade of experience in primary care pediatrics and has served as an assistant clinical professor at a Rainbow Babies and Children's Hospital, a leading children's hospital in Cleveland, Ohio. She currently cares for patients at Santa Clara Valley Medical Center and is an affiliate clinical instructor at Stanford University School of Medicine.
In addition to clinical practice, Reshma has a strong interest in family health and wellness, with a focus on plant-based nutrition. She completed a certification program in Plant-Based Nutrition through the T. Colin Campbell Center for Nutrition Studies and eCornell as well as a Professional Plant-Based Nutrition Cooking certification through Rouxbe Cooking School. In her spare time, Reshma enjoys yoga, traveling with her family, and of course, cooking!

WFPBD & Animal Welfare
Unlock Your Someday Drawer
ABCs of a Whole-Food, Plant-Based Diet

Dr. Reshma Shah is a board-certified pediatric physician. She obtained her undergraduate and graduate degrees from Johns Hopkins University and her medical degree from Drexel University College of Medicine. She has more than a decade of experience in primary care pediatrics and has served as an assistant clinical professor at a Rainbow Babies and Children's Hospital, a leading children's hospital in Cleveland, Ohio. She currently cares for patients at Santa Clara Valley Medical Center and is an affiliate clinical instructor at Stanford University School of Medicine.

In addition to clinical practice, Reshma has a strong interest in family health and wellness, with a focus on plant-based nutrition. She completed a certification program in Plant-Based Nutrition through the T. Colin Campbell Center for Nutrition Studies and eCornell as well as a Professional Plant-Based Nutrition Cooking certification through Rouxbe Cooking School. In her spare time, Reshma enjoys yoga, traveling with her family, and of course, cooking!

The ABCs of a Whole-Food,
Plant-Based Diet
By, Reshma Shah, MD, MPH

Nutrition information these days can be overwhelming, if not downright confusing. Every expert seems to offer a different opinion. One day they proclaim that cholesterol is bad for our health and the next, there is a decree that “butter is back.”
With conflicting headlines like these, it’s easy to understand why we are all so confused in answering the simple question of what should I eat? The broader question, though, is what way of eating optimizes health? A diet that priortizes health should be nutritionally adequate, meeting our macro- and micro-nutrient needs, while at the same time reducing the risk of diet-associated disease.
There are lots of “diets” out there, ranging from vegetarian, vegan and raw, to South Beach, Atkins and Paleo. A vast amount of research overwhelmingly suggests that a whole-food, plant-based (WFPB) diet is the path to optimal health and well-being, not only for ourselves but our world.

The simplest definition of a WFPB diet is that it aims to maximize the consumption of nutrient-dense plant foods while minimizing processed foods, oils and animal foods. It encourages a lot of vegetables, fruits, beans, lentils, soybeans, seeds and nuts, and is generally low in fat.
Some people also refer to a WFPB diet as a vegan diet, but the two aren’t necessarily the same. If you eat a WFPB diet that is completely devoid of animal foods such as meat, fish, poultry, eggs and dairy, then you are also following a vegan diet. However, if you eat a vegan diet, again devoid of all animal-based products, you may not be following a WFPB diet. For instance, an Oreo cookie would be considered a vegan food because it is entirely devoid of animal products, but it would NOT be considered WFPB because it is heavily processed.
In terms of optimizing health, the term WFPB may be preferable to the term vegan, because it encompasses the foods to be included vs. focusing solely on the foods to be excluded. 
Personally, the journey towards adopting a plant-based diet has been slow going for me. It began, not in medical school or residency training as one might think, but as I began having children. I started paying more attention. I started becoming more curious. I started learning. I started making different choices. I decided to learn more about nutrition, and this growing awareness followed me into my patient exam rooms, and the way I spoke to families about food, nutrition and health also began to shift. This kind of shift can seem overwhelming and daunting, and so I aim to promote progress over perfection.
Simply deciding to lean in towards plants is a great first step. Transitioning to a plant-based lifestyle is a long-term solution that is health-promoting, sustainable and humane.


Health benefits of the WFPB diet
A vast amount of research has been conducted, from impressive cohort studies to randomized trials, supporting the extensive health benefits of a WFPB diet. Most of the leading causes of death in the U.S. are preventable and related to what we eat.
The number one cause of death in the United States for both men and women is heart disease. The standard American diet, which is full of saturated fat, processed foods and refined grains, is associated with an increased risk of heart disease. The best way to avoid heart disease when it comes to our diets is to prevent atherosclerosis by limiting the amount of saturated and trans fats as well as cholesterol in our diet and maximizing fiber: more plants and fewer animal-based foods.
In general, vegans and vegetarians have lower rates of heart disease. Switching to a plant-based diet has been proven to be an effective diet for patients already suffering from heart disease. 

The number two cause of death in the United States is cancer, and more than 1500 people die in the US each day from cancer. Many studies have elaborated on the protective role of a vegetarian or vegan diet in the risk of cancer development. Just last year, the World Health Organization (WHO) published a report that classified red meat as a probable carcinogen (in the same category as DDT and glyphosate) and processed meats as carcinogenic (in the same category as tobacco and asbestos).
Additionally, in one of the largest epidemiological studies on cancer, close to 70,000 people were followed to examine the link between dietary patterns and cancer incidence. The findings revealed that vegan diets confer the lowest overall risk of cancer.
Another major disease that affects a growing number of Americans and which is increasing in prevalence in developing countries is diabetes. It is a leading cause of blindness and the number one cause of kidney failure. Having diabetes doubles your risk of heart disease and stroke. The rates of diabetes in the U.S. are climbing quickly, and it is projected that by the year 2050, one out of every three Americans will have diabetes. The good news is that the WFPB diet (either vegetarian or vegan) can be hepful in treating Type 2 diabetes and can also be useful in preventing its occurrence in the first place.
There are many more health benefits to following a WFPB diet, including lower rates of obesity and lower blood pressure. Research suggests a WFPB diet also plays a beneficial role in preventing a variety of inflammatory diseases, depression, Parkinson’s and Alzheimer’s disease.
Stay tuned to learn more about additional advantages of the WFPB diet—to add to the myriad benefits I've already discussed—in my next posts.




Barnard ND, Cohen J, Jenkins DJ, et al. "A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial." The American Journal of Clinical Nutrition. 2009;89(5):1588S-1596S.

Centers for Disease Control and Prevention:

Esselstyn CB Jr, Gendy G, Doyle J, Golubic M, Roizen MF. "A way to reverse CAD?" The Journal of Family Practice. 2014 Jul;63(7):356-364b.
Orlich, Michael J, and Gary E Fraser. “Vegetarian Diets in the Adventist Health Study 2: A Review of Initial Published Findings.” The American Journal of Clinical Nutrition. 100.1 (2014): 353S–358S.
Ornish, Dean et al. "Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial." Lancet. 1990 Jul 21;336(8708):129-33.
Satija, Amika et al. "Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults."
Journal of the American College of Cardiology, Volume 70, Issue 4, July 2017

Tonstad S. "Vegetarian diets and incidence of diabetes in the Adventist Health Study-2." Nutrition, metabolism, and cardiovascular diseases: 2013;23(4):292-299.
World Health Organization, IARC Monographs Evaluate Consumption of Red Meat and Processed Meat:

Physician's Committee for Responsible Medicine:

Reshma Shah, MD, MPH

Dr. Reshma Shah is a board-certified pediatric physician. She obtained her undergraduate and graduate degrees from Johns Hopkins University and her medical degree from Drexel University College of Medicine. She has more than a decade of experience in primary care pediatrics and has served as an assistant clinical professor at a Rainbow Babies and Children's Hospital, a leading children's hospital in Cleveland, Ohio. She currently cares for patients at Santa Clara Valley Medical Center and is an affiliate clinical instructor at Stanford University School of Medicine.
In addition to clinical practice, Reshma has a strong interest in family health and wellness, with a focus on plant-based nutrition. She completed a certification program in Plant-Based Nutrition through the T. Colin Campbell Center for Nutrition Studies and eCornell as well as a Professional Plant-Based Nutrition Cooking certification through Rouxbe Cooking School. In her spare time, Reshma enjoys yoga, traveling with her family, and of course, cooking!

Unlock Your Someday Drawer
By Diana Silva

Do you have a someday drawer filled with dreams of being a world traveler, a best-selling author, an entrepreneur or ….? Have you made endless promises to yourself about opening it up when you have enough time, or enough money?
I, too, had an overstuffed someday drawer filled with ideas for my best-selling fiction and nonfiction books. I spent countless days daydreaming about my successful career as an accomplished and respected author while I commuted to my day job on Silicon Valley’s Highway 101. In my favorite dream, I sat opposite Oprah as she interviewed me about my sensational new book. I taught Oprah how to make my sweet Mama Rose’s delicious guacamole, one of the recipes from the book, and, of course, she loved it!
Two years ago, I got rid of my someday drawer. After decades of having it accumulate dust and cobwebs, I opened it up and banished its someday status. I finally put pen to paper and began writing my first book, Molé Mama; A Memoir of Love, Cooking and Loss.

It was challenging. I continued to work full-time and care for my teenage sons as I wrote away. But it was easier than the realization that I might live my whole life without making time to follow my dreams. I knew that I just couldn’t live another day waiting for someday. And I succeeded. My book was successfully launched in May 2017.
Here are some tips that I used to help me unlock my someday drawer:

  1. I gave myself guilt-free permission to invest the necessary time and money in my dream of becoming an author.

  2. I found that once I started working on my life’s passion, the most amazing people showed up to help. I know you’ve probably heard this before, but it’s true.

  3. Writing a book requires creativity and discipline. The creativity aspect was easy for me. The discipline came a little more slowly. The commitment to write regularly was a real struggle. Finally, a dear friend suggested to me that I create a daily writing practice. Being a punctual person who hates missing meetings or being late, I scheduled a daily one-hour meeting with myself at 5:30 am. When my phone alarm went off, the invite said, "Go to your writing space." I also had a note next to my bed that said, "How badly do you want it, Diana?"

  4. I committed to a 100-day challenge that inspired me to work on my book and my brand for a minimum of five minutes every day. This helped me integrate the book and its production into my daily life.

  5. If you feel like giving up, don’t. Ask for help instead. I wanted to quit writing several times. Thankfully, each time someone—my editor, a friend or a family member—encouraged me to keep going.

Perhaps your someday drawer is filled with questions. Should I change my career? How do I make my life more meaningful? Should I move? What’s my passion?

Here are some ideas that might help you to unlock your own “someday drawer.”

  1. Create a vision board. This may help you to see where your special interests and talents lie. It may help you answer lingering questions about your life’s passion and purpose.

  2. Consult with a life coach. A professional life coach is an objective person who often is a good questioner and a wonderful listener. They can encourage you to explore, be curious and dig deep into what truly drives you. A good coach will help you ponder questions like: What excites you when you wake up in the morning? What excites you when you are not working? What puts you in the “flow”? 

  3. Spend some time alone and think about this: Make a list of the things that make you happy. Make a list of the things you do every day. Finally, compare the lists and adjust accordingly. 

  4. Read Designing Your Life. How to Build a Well-Lived, Joyful Life by Bill Burnett and Dale Evans from Stanford’s Design School. Complete the exercises that are included throughout the book. Feel like taking it a step further? Take part in a Designing Your Life workshop (information at They hold day-and-a-half long weekend workshops just for women.

  5. Explore the offerings of groups like ReBoot Accel, which provides a suite of programs to get women current, confident and connected. Upcoming workshops include one titled How Do I Reinvent My Career? 


Holding my completed book in my hands for the first time was one of the happiest moments of my life. My dream is now my truth. I am an author.
I hope I have encouraged you to think about opening your someday drawer and taking the first step that will help you turn your dreams into your reality. You won’t regret it! Imagine delving into your someday drawer and finding more meaning and purpose in your life. You will likely feel satisfied, excited and inspired.

                 Twenty years from now you will be more

             disappointed by the things that you didn’t do

               than by the ones you did do. So throw off the

            bowlines. Sail away from the safe harbor. Catch

                             the trade winds in your sails.
                               Explore. Dream. Discover.
– Sarah Frances Brown


Silva, Diana. Molé Mama, A Memoir of Love, Cooking and Loss. Accessed 12 Aug 2017.
Burnett, Bill & Dave Evans, Designing Your Life. How to Build a Well-Lived, Joyful Life. Alfred A. Knopf, New York: 2016. Accessed 12 Aug 2017.
Designing Your Life:

ReBoot Accel:

Diana Silva

Diana Silva is a San Francisco-based home chef, author, video blogger and radio host. Her YouTube channel “Molé Mama Recipes” celebrates family recipes and cooking delicious meals at home with love. With a nod to her Latina roots, Diana uses techniques like her magical molcajete to imbue her food with the flavors of her grandmother’s Mexico. Diana and guest chefs explore recipes from around the world and the stories and traditions that keep them alive. 
Diana calls on us all to preserve our ancestors’ treasured recipes and stories for future generations. For many, cooking is the preferred love language, and that’s precisely why we cherish those recipes. The love that goes into each dish’s making has the power to transcend an ordinary recipe into magic.

To buy Diana’s book and learn more about Molé Mama go to:

You Can Always Begin Again
By Clia Tierney, MA

Practicing mindfulness is becoming aware in the present moment WITH COMPASSION. Sometimes when we cultivate this awareness and are able to be truly present, we don’t like what we find. When this happens, it is important to remember that mindfulness allows us to become increasingly comfortable with discomfort. We can practice awareness, becoming awake to what is happening right now and accepting WHATEVER it is that we find, with kindness and without judgment. In this acceptance of what we find — worry, anxiety, anger, impatience, and/or mental chaos — we can simply notice with objectivity, not assigning value to what we find. This is practicing self-compassion. We remember that we are not our thoughts, our feelings, or our physical sensations; we are the spaciousness behind all of that.

The Whole-Foods, Plant-Based Diet
and Animal Welfare
By Reshma Shah, MD, MPH

Previously, we talked about the health benefits of following a whole-food, plant-based (WFPB) diet. In addition to optimizing health, this way of eating also cares for our planet and goes a long way towards ending animal suffering.
Animal agriculture exacts a huge toll on our environment. It is responsible for up to 51% of all greenhouse gasses; it is the leading cause of rainforest destruction, species extinction, ocean dead zones and water pollution. In fact, livestock produces more greenhouse gasses than all the world’s vehicles combined. Animal agriculture is responsible for more than 90% of the destruction of the Amazon rainforest. Thirty percent of all water consumed is used for animal agriculture, which also uses up 45% of the earth’s ice-free land mass.
Looking at it from a slightly different perspective, a person eating the standard American diet would require roughly two football fields of land mass to produce a year’s worth of food, whereas those same two football fields could feed 14 people who were following a plant-based diet.
Additionally, 50% of the world’s grains are used to feed livestock, while close to one billion people go hungry every day.
A diet focused on animal foods has an enormous impact on our environment and is an inefficient use of our resources.

This brings me to the final benefit of following a plant-based diet – animal welfare. A poll conducted by the ASPCA (American Society for the Prevention of Cruelty to Animals) found that more than 94% of Americans agreed that animals raised for food on farms deserve to be raised free from abuse and cruelty. But, the reality is that the majority of the nearly 10 billion farm animals raised in the US each year suffer in disturbing and unthinkable ways. More than 99% of farm animals in the US come from factory farms, which are also known as Concentrated Animal Feeding Operations (CAFOs). These animals are stuffed in cages and suffer from overcrowding. They are unable to roam or sit, are deprived of sunlight, plagued with poor air quality and they aren't able to establish their natural sense of hierarchy and social order. The animals undergo painful mutilations and are bred to grow unnaturally large and fast to maximize meat, egg and milk production. Their bodies cannot support this rate of growth, and the animals suffer in painful and debilitating ways.
Eighty percent of all antibiotics in the U.S. are used for livestock. Hormone use is also rampant to produce faster maturation. This not only causes harm to the animals, but the drugs reach us in our food supply, leading to increasing strains of drug-resistant organisms.  In addition, the hormones potentially increase the risk of certain cancers, such as breast and prostate, as well as influence the progression of puberty.
While organic, cage-free and grass-fed labels seem more humane by claiming to provide the animals with natural pasture to graze upon, the reality is that these labels can be misleading. A great amount of suffering may still be endured by the animals in these environments. Even if we could, in fact, ensure that animals were raised humanely—allowed to roam and live without suffering—the simple truth is that we do not have grasslands vast enough to raise animals in this way such that it would meet the current demand for meat.
In the final post, I will share with you how easy it is to implement a whole-foods plant-based diet.



Environmental Protection Agency: Risk Assessment Evaluation for Concentrated Animal Feeding Operations, 2004.

Environmental Working Group: Meat Eater's Guide to Climate Change and Health.

Pimentel, D. and Pimentel M. Sustainability of meat-based and plant-based diets and the environment. Am J Clin Nutr 2003;78(suppl):660S–3S.​

Reshma Shah, MD, MPH

The Buddhist teacher Pema Chodron describes this remembering as compassionate abiding. She states:
The peace that we are looking for is not peace that crumbles as soon as there is difficulty or chaos. Whether we’re seeking inner peace or global peace or a combination of the two, the way to experience it is to build on the foundation of unconditional openness to all that arises. Peace isn’t an experience free of challenges, free of rough and smooth — it’s an experience that’s expansive enough to include all that arises without feeling threatened.
A question that has intrigued me for years is this: How can we start exactly where we are, with all our entanglements, and still develop unconditional acceptance of ourselves instead of guilt and depression? One of the most helpful methods I’ve found is the practice of compassionate abiding. This is a way of bringing warmth to unwanted feelings. It is a direct method for embracing our experience rather than rejecting it. So the next time you realize that you’re hooked — that you’re stuck, finding yourself tightening, spiraling into blaming, acting out, obsessing — you could experiment with this approach.

Practicing “compassionate abiding” or self-compassion allows us to start where we are right here and right now. And we can do this over and over again. This is such a gift to those of us who tend to get discouraged by not sticking to our routine of meditation, blowing our promise to be a kinder, gentler person when dealing with ourselves and others, sweating the small stuff and making mountains out of molehills.

We can cultivate this practice throughout our days by using mindful breathing. Simply pause, take a deep breath in and a long exhale out. Notice what is there — which physical sensations and emotions. Release any thoughts about what you observe and kindly return to the anchor of your breath. It is kind of like training a puppy: we tell the puppy to sit, it wanders away and we gently bring it back to sit, over and over and over again. Just as we are gentle with the puppy, we can be gentle with ourselves when we get caught up in a whirlwind of distraction or negative energy and/or thoughts.
Try this heart meditation for compassion:

  • Find a place to sit quietly. Put everything aside. Perhaps light a candle or wrap yourself in a yummy shawl.

  • Begin by taking a few deep breaths and releasing on the exhale. Inhale through the nose and exhale through the mouth — RELEASING — for at least three breaths.

  • The first step is offering. OFFER whatever it is you find in your heart: business, worry, desires, judgment, likes and dislikes. OFFERING outward begins to open your heart.

  • The second step is receiving. Allow yourself to RECEIVE compassion, love, joy, kindness, silence, space.

  • Focus your breath in and around your heart space. Offer with the exhale and receive with the inhale.

  • End with a gesture to connect to your heart; hold your hands together in namaste/prayer pose in front of your heart or with your palms, one over the other, on top of your heart, and receive one thought of love about yourself.


This practice can also be extended to others.
Another practice is a loving-kindness meditation. There are many versions of this but a very simple one you can do anywhere and anytime you need some KINDNESS goes like this….

  • Place the palm of your hand over your heart.

  • Take several deep breaths visualizing the breath entering IN and exiting OUT through the space in and around your heart.

  • SMILE.



To deepen your practice, try one of the following meditations:
Loving kindness
Mantras for difficult days
Compassion for others


A refresher for some helpful additional resources...

Clia Tierney, MA

The owner of Asante Wellness Coaching, Clia Tierney helps women move past "stuck" into possibility. She coaches people to overcome obstacles and obtain clarity about their goals. Through the process, personal transformation takes place, resulting in greater well-being, life balance and fulfillment.

Clia's professional background and life experiences as a teacher, educational therapist, yogi, wife, mother of teenagers, daughter and sister have fueled her passion for helping women of all ages identify and reduce their stress and struggle so that they can discover their purpose and confidently move forward. 

Mindfullness of the Body
Mindfullness of the Body
By Clia Tierney, MA

My working definition of mindfulness is this: being present and aware with kindness and compassion. It is about being awake to what is happening right now. It’s also about shifting energy in order to notice and rest in that brief pause at the top of the inhale and again at the bottom of the exhale. Here is where we can RESPOND with intention rather than REACT to something (this is big!).
One way to create an immediate shift in energy is through mindful awareness of the body. This means shifting attention out of the “thinking” self and into the “physical” self. When you notice/become aware of the energy in the body you will change the momentum of your mind. Spiritual teacher Eckhart Tolle says “We need an anchor for presence. The inner body is a wonderful anchor for the state of presence.”

Mindfulness-of-the-body practices
There are several ways to practice presence using mindfulness of the body. You can begin with assuming a “mindful posture.” Wherever you are and whatever you are doing, take a deep breath or two and imagine the crown of your head lifting while your tailbone descends (either sinking deeper in a seat or releasing downwards towards the ground). Soften and relax the tops of your shoulders and imagine your spine as a pathway for your breath to flow from the earth to the sky and back. This very simple shift of attention to your posture can immediately create more alertness, focus and presence.
When I catch myself slouching over my computer, I use this mindful posture practice to sharpen my focus. I also use it when I am standing in conversation; it makes me a more present listener.
Another simple practice that can be used any time is to shift your attention to where you are connected to the support of the earth. Becoming aware of the touchpoints of your physical body with the ground is an anchor to the NOW.

  • Take an intentional breath (or two or three). Make your exhale longer than your inhale to create a calming effect.

  • Notice the soles of your feet on the ground. Any sensations? Observations?

  • Notice your seat and/or your back on the chair; sink your weight deeper.

  • Notice all the places where some part of your body touches a solid surface.

  • Visualize your breath (like wind or vapor or some image that resonates for you) moving to those places where your body is connected/supported.

A third mindful-awareness-of-the-body practice is to do a body scan. I usually practice this with a guided meditation or on my own during savasana (the restful pose at the end of a yoga practice). A body scan practice involves relaxing the entire body, beginning with either the crown of the head or toes and moving down or up the entire body. During the scan, breathe naturally, as you are bringing your attention to and through the body. Notice any sensations you may feel as you scan each area of the body. Do not react to these sensations, simply notice them. 
I frequently use the Insight Timer app on my phone and listen to a guided meditation body scan when I am ready to fall asleep. Sometimes, if I wake in the middle of the night, to help me fall back to sleep, I will do a mental body scan. 
Try several different practices to find a voice and style that is RELAXING. Or try the three-minute body scan meditation in this article:

Here’s another, slightly longer, mindful breathing practice that might be to your liking:
By incorporating these mindfulness-of-the-body techniques into your daily practice, you will be giving yourself a real gift — and more able to greet the world with loving kindness.




Clia Tierney, MA

The owner of Asante Wellness Coaching, Clia Tierney helps women move past "stuck" into possibility. She coaches people to overcome obstacles and obtain clarity about their goals. Through the process, personal transformation takes place, resulting in greater well-being, life balance and fulfillment.

Clia's professional background and life experiences as a teacher, educational therapist, yogi, wife, mother of teenagers, daughter and sister have fueled her passion for helping women of all ages identify and reduce their stress and struggle so that they can discover their purpose and confidently move forward. 

Understanding Food Sensitivies
Understanding Food Sensitivities
By Deborah Blake, NC

Most of us know someone who is either allergic, intolerant or sensitive to certain foods. In fact, experts in the field of nutrition and digestive health estimate that 10-20% of us have a food sensitivity (Lipski, 2013) and the Centers for Disease Control and Prevention report that 4% of us have a food allergy (CDC, 2015.) To meet these realities, restaurants are increasingly providing gluten- and dairy-free options and allergen-free products are becoming more available in grocery stores. These are welcome changes.
Awareness is the first step towards making a change, so let’s learn a little more about the difference between allergies, sensitivities and intolerances, and how you find out if you might have one, or the other.
Food intolerances sit in their own category, as we’ll see in a minute. But many doctors and health practitioners don’t differentiate between allergies and sensitivities because they both prompt an immune reaction. Let’s take a look at how nutrition experts define the three different reactions to food.
Food allergies
A food allergy elicits an immediate immune response to a food and can be very serious. Allergic reactions include swelling of the throat, hives and/or anaphylactic shock, all of which can be life-threatening situations. While the symptoms come on suddenly, they also recede relatively quickly, typically within 24 hours. An allergic reaction to food often necessitates the use of histamine blockers and/or epinephrine to stop the reaction. A common food allergy we hear about today is peanuts. If you have a food allergy, you will realize it immediately after eating the food.
Food intolerances
A food intolerance does not cause an immune response. It occurs when the body lacks a specific enzyme to digest a particular sugar found in a food. When the food cannot be digested, it causes a lot of pain and discomfort in the gut. Lactose intolerance is a common food intolerance, affecting nearly 75% of the world’s population. At present, there is no “cure” for a food intolerance. Some people can supplement with digestive enzymes and feel fine, while others are simply better off avoiding the offending food completely.

Food sensitivities
Food sensitivity is the most elusive of the food-related conditions to diagnose. Symptoms vary widely, and one sensitivity may be resolved just as a new one begins. Since it’s estimated by nutritional experts that 2 out of 10 of us may have a food sensitivity (Lipski, 2013), let’s take a closer look at this category.

food sensitivity causes a delayed immune response of different antibodies (IgG) (remember, a true food allergy provokes an immediate reaction and involves the IgE antibodies). Symptoms are varied and can occur within a few hours, to up to a couple of days after ingesting the food. They can include digestive disruption (gas, bloating, diarrhea or constipation), headaches, difficulty sleeping, mouth sores, skin rashes and acne and mood swings, as well as joint aches and pains. When the offending food is eaten continuously, the IgG antibodies continue to be released and the damaged tissues in the body don’t have time to heal. All of this activity can lead to chronic inflammation.

How do I develop a food sensitivity?
 A number of factors can lead to a food sensitivity, such as:

  • Consuming foods that have been chemically altered (GMOs), contain additives or are contaminated with pesticides, which can cause a disturbance in the body.

  • Regularly eating foods that are known to potentially cause inflammation, such as sugar, wheat, dairy, soy, eggs, citrus, corn, pork and beef.

  • Gut dysbiosis (an imbalance in the gut from too many bad bacteria overcrowding the good bacteria), which can be caused by taking medications, parasites, candida or infections. Dysbiosis affects the body’s ability to digest food, thereby causing a food sensitivity. 


I think I might have some of these symptoms; how do I know which foods I might be sensitive to?
Lab tests are available that identify food sensitivities for delayed immune responses however, the methods are not standardized among labs, so reliability has come into question. Additionally, these tests are rarely covered by insurance, so they can be expensive.

Elimination and challenge diet
The best way to know which foods you might be sensitive to is to undergo an elimination and challenge diet. And, it’s free! This protocol, which doctors have had in their medical kits for decades, involves eliminating potential trigger foods from your diet for at least two weeks and then reintroducing a “challenging” item, one food at a time. Then, wait for 48 hours while monitoring your symptoms. After 48 hours the next food can be reintroduced, and so on. One must be diligent about eliminating the foods for two weeks and only reintroducing one food at a time. Only then will you have clear information about exactly which foods are causing your problems. If you do have a reaction to a particular food, leave it out of your diet for at least six months and then try it again. You may be able to reintroduce it again and enjoy it in moderate amounts.
Tips for healing from and preventing sensitivities

  • Eat a whole-foods diet free of processed foods, trans fat and refined sugar.

  • Rotate your diet so that you don’t consume the same foods every day.

  • Eat fermented foods to feed beneficial gut bacteria, or consider taking a daily probiotic.

  • Talk to a naturopath or functional medicine doctor about taking enzymes to ensure proper digestion.

  • Drink 2-3 cups a day of herbal tea to support your gut lining (roasted dandelion root, milk thistle or burdock are good choices).

If you have been experiencing symptoms that might be the result of food sensitivities, I encourage you to try an elimination and challenge diet and take charge of your health.




Deborah Blake, NC

Deborah is a Nutrition Consultant in Menlo Park, California. She graduated in 2007 from Antioch University in Seattle with a Bachelor of Arts in Social Justice. Ever committed to working to improve the lives of others, she continued her education and recently graduated from the Nutrition Consulting program at Bauman College in Berkeley. Bauman is recognized for being at the forefront of the holistic approach to nutrition as it contributes to the prevention of illness and the promotion of optimal health.
Deborah is passionate about empowering clients with nutritional education and support so that they can create new habits to reach desired health goals. She offers one on one nutrition and wellness coaching, cooking demonstrations, as well as individualized meal planning.  

In addition, Deborah is the co-author of Bites Beyond Limits, a food blog dedicated to allergy-free eating.

Why Meat?
Why Meat?
by Theresa Donovan Brown

A brief history of America's love affair with meat
Let's start with a fact: The average American consumes 210 pounds of meat and 15.5 pounds of seafood annually. That puts us at the top of the carnivore chart among nations.
Livestock production (its breeding, feeding, slaughtering and distribution) is an inefficient way to get protein in our diets. Animal protein demands far more of our scarce land, water and energy resources than does plant protein. Moreover, raising animals for meat increases the clear-cutting of forests for pastureland and feed-crop cultivation. An even more malodorous fact is that livestock production contributes 14.5% of global greenhouse gases.
Intellectually, it's pretty easy to see that we should eat less or no meat since we can obtain every essential amino acid that our bodies need to thrive from plants. And yet, only about 2% of Americans identify as vegetarian, and of these, five out of six will become ex-vegetarian flesh-eaters – perhaps consumed with guilt, but consuming animals nonetheless.
The question is, why? Part of the answer may relate to biological hard-wiring that predisposes us to carnivorous cravings.

Our meat-centric history
Our human ancestors ate meat 2.5 million years ago. Paleoanthropologists have evidence that our relatively large brains and small guts evolved because we had access to calorie-dense meat. In evolutionary terms, abundant animal protein causes people to mature earlier, and to reproduce earlier and more often. The aromas and flavors of cooked meat, particularly well-browned, fatty meat, get the saliva flowing, even in the mouths of dedicated vegetarians. It's that old survival-of-the-species thing.
Today, however, our species is surviving all too well, with a burgeoning global population and strained food-production resources. And, we know we can thrive on meatless diets. So, why don't we use our big brains to overcome our desire for meat? The answer lies in the food system that we have built. 
The Pilgrims brought with them from England the idea that meat-eating signified the wealth and privilege of the upper classes. Americans have carried this idea forward, associating copious consumption of meat with "the good life."
Up until about 1840, everybody in the United States ate meat like a locavore, meaning it was produced very near their homes. More than 90 percent of the population lived a rural life, where meat was as close as the side-yard pigpen. Then, as industrialization took hold, people flocked to new urban centers. City dwellers demanded meat, but they soon became tired of the herds of meat-on-the-hoof trampling through their neighborhoods. Slaughter was local, but animal waste and offal rotted in heaps and tainted waterways everywhere.
City officials soon realized that meat production needed to be centralized. Savvy brokers and, eventually, railroad investors, rallied around this idea. The Meat Trust was born. Even with the horrors of the meat trade exposed in 1906 by Upton Sinclair's The Jungle, consumers could not imagine a diet that was not meat-centric, and industrial suppliers were eager to provide it.
Meat as the main course was further rooted in American attitudes with new marketing techniques employed by the meat industry, including the convenience of refrigerated pre-cut meats, and frozen fish and meat in grocery stores.
Then came McDonald's, along with the other fast-food franchises, and the rest is well-known, fast-food-nation history.

How can we segue from the dominance of meat in the American food system to a more healthy, environmentally sustainable diet?

  1. Move meat off the center of the plate. Think of meat as an embellishment – a side dish or ingredient that heightens the flavors and textures of a meal.

  2. Cook high-flavor, high-texture, multi-colored, budget-friendly meals. These are easier to prepare than most people realize. Recipes abound that offer quick, inexpensive ways to put good nutrition and less meat on our tables. Here is a link to some great, accessible meal sites on SOUL Food Salon's website

  3. Look for selections that offer meat as a side or garnish when you eat at restaurants or order take-out or home-delivery meals. Such options are increasingly available, and we can vote with our eating-out dollars.

  4. Steer workplaces, schools, hospitals and retirement homes toward meals that do not rely on meat as the centerpiece. Top-down initiatives such as Menus of Change (a collaboration between the Culinary Institute of America and Harvard's School of Public Health) hold promise. By teaching culinary leaders to innovate away from meat-heavy meals, models like this will begin to take hold in the culture. We don't have to be high-end chefs to promote cultural change around food and lifestyle decisions. We can support initiatives like The Teaching Kitchen at the Stanford Medical School. This program teaches medical students (with their crazy, stressful schedules) how to cook simple, light-on-meat meals so that they can draw on their own experience to counsel patients toward healthy lifestyles.

  5. Seek out sustainable, cruelty-free, local options. Search the web for community-supported fisheries and farms in your area. Shop your farmers’ markets, if this is an option. Yes, these sources of meat and fish can be more expensive than the industrial feedlot or caged-chicken cuts, but you will be using far less of them, and eating environmentally friendlier, economically viable, nutritionally sound and delicious meals.


It's the way forward for America's food system.


Theresa Donovan Brown

Theresa Donovan Brown is the author of numerous books, both nonfiction and fiction, most recently co-authoring The Social Sex: A History of Female Friendship. Currently, she is working on a social history of America's foodways. Her current work marries her years researching nutrition and healthy lifestyles with her experiences as a trader and strategist in the financial sector and as principal of her own company. She developed a curriculum for teaching food science and nutrition to middle-school students, and taught nutrition for several years to students at high risk for Type II diabetes. She holds a BA from Stanford and an MBA from the UC Berkeley Haas School of Business.

The Power of Sleep
The Power of Sleep
By Alex Dimitriu, MD

I have often joked with my friends that I have to keep quiet about what I do for a living when I’m in social situations. Sleep and psychiatry, it turns out, are two things people have very much on their minds, and in today’s fast-paced society, everyone seems to be stressed by working too much and sleeping too little. I am amazed by the people I meet who exercise regularly, eat healthy, organic food and use meditation apps, only to tell me (in line at Starbucks) that they often only get five to six hours of sleep each night.
The tremendous importance of sleep to our well-being has been a lesson I have learned repeatedly in my career as a psychiatrist. I advocate that it should be a vital sign, along with blood pressure and pulse, recorded at every visit to indicate our general state of health. 

The effects of not getting enough sleep
Periodically, middle-aged patients come to see me and worriedly ask, “Doc, I think I have Alzheimer’s. I forget movies, words, and walk into rooms and forget why!” Much to everyone’s relief, it usually turns out to be a sleep problem. Sleep is so valuable because our minds package memories and practice for upcoming situations during that time. Myriad studies have tested people by asking them to memorize a list of words before giving them a chance to sleep. The studies consistently show that more sleep results in better recall and an improved ability to learn everything from word lists to emotional responses to swinging a golf club.
Let’s not forget that sleep deprivation is a form of torture. I’ve seen a good many people become emotionally “unstable” – tearful for no apparent reason, over-reactive and irritable – when they’ve had too little sleep. One man knew he needed to catch up on his zzz’s when, after a few nights of poor sleep, he began to cry over a dropped paper clip.
And then there’s the issue of energy – or depression. Do you feel like doing things, but lack the energy, or do you not feel like doing things at all? Fatigue can look very much like depression, and in many instances, there is a fine line between the two. Indeed, a vast proportion of people I have worked with, who have been diagnosed with attention deficit disorder, as bipolar, or with treatment-resistant depression, benefit tremendously from the optimization of sleep.

If you doubt the importance of sleep, consider this: several recent studies have found that sleep can be used as part of a protocol to reverse mild dementia and increase longevity.
One recent study at the University of Washington Medicine Sleep Center tested pairs of identical twins who had different sleep patterns. The study results showed that the twin with fewer sleep hours had a less-active immune system. The immune system and inflammation play crucial roles in chronic disease; therefore, enhancing sleep should be a priority for optimal health.
What can you do?
Sleep more and sleep better. Make sleep your health priority and aim to keep sleep on a regular schedule. Dim lights in the evenings, do not use electronics (especially before and during sleep, and immediately upon waking), keep your bedroom temperature on the cool side, and maintain an overall positive attitude towards sleep.
How much sleep is enough? Seven to eight hours per night is ideal, but in the end, the answer is enough sleep so you are not tired the next day (or needing to drink copious amounts of caffeine to help you stay awake and alert). While it is normal to be a little drowsy around 2-3 pm, an irresistible urge to doze off is not normal – this is a marker of fatigue.
In addition to the quantity of sleep, look at the quality of your sleep. Does your sleep feel light? How many times a night do you wake? Do you snore, or kick around a lot during the night? A great app to start this investigation is called SnoreLab (free on the iTunes store). It lets you record audio all night so that you can discover either how loudly you might snore, or what happens right before you wake at night. While this does not replace a sleep study, it is an easy way to get a rough idea of what happens at night.

Optimize your sleep hygiene
In the end, sleep is like a Chinese finger trap. The more you pull and force it, the harder it is to achieve. Many sleep hygiene recommendations focus on this concept.

Get your phone out of the bedroom!  It's too exciting and it trains you to wake quickly and turn your mind on immediately, which is not good for maintaining a restful sleep. Use an old-fashioned alarm clock; it's far less engaging – at both bedtime and wake time.
Do not toss and turn and stare at the clock, aggravated, hoping to fall asleep eventually. Most commonly, I tell my patients with insomnia to focus on their breath. Breathe in for 4 seconds, hold 4 seconds, breathe out for 7 seconds, hold 4 seconds. Repeat. Try this for 10-15 minutes.
If sleep is still eluding you, get out of bed, and do something relaxing. No tech! A calm book, in a dim light outside of the bedroom, until you start yawning again, then head for the bed. It’s classical conditioning – we need to associate the bed with sleep, not work, arguing, food, television or frustrating tossing and turning. Bed equals sleep, and maybe sex. But that is all.
You spend one-third of your life sleeping, and it affects every aspect of your waking life. From memory to mood, to immunity, to weight loss and diabetes, and even the risk of cancer, sleep has profound effects.

Here's to a good night's rest!





Morin CM, Hauri PJ, Espie CA, Spielman AJ, Buysse DJ, Bootzin RR. “Nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine review.” Sleep, Dec 1999: 1134-56.
Watson, Nathanial and Sina Gharib, et al. “Transcriptional Signatures of Sleep Duration Discordance in Monozygotic Twins.” Sleep, Jan 2017. DOI: 

Chronic sleep deprivation suppresses immune system. University of Washington Health Sciences, Jan 27, 2017.

Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills.

Alex Dimitriu, MD

Alex Dimitriu completed medical school and residency in psychiatry at SUNY Stony Brook, and continued his training at Stanford Medical Center with a fellowship in sleep medicine. He is currently in private practice in downtown Menlo Park. He sees patients with a wide variety of conditions, ranging from depression to anxiety, to insomnia and other sleep disorders. He practices an integrative model of psychiatry, which aims to improve various domains of people's lives. He has always believed in the power of the mind and the power of the spirit to heal the body. Practicing a collaborative model, he works with other doctors, therapists and alternative medicine practitioners to achieve truly outstanding outcomes. He works with some of the sharpest minds in Silicon Valley to achieve true optimization and self-improvement. 

1225 Crane Street, Suite 205
Phone: 650-326-5888
Website: Doctor Alex

Composting 101
Composting 101
By Lisa and Kathleen Putnam

As discussed in our previous posts, keeping your soil alive and nutrient-rich by using crop rotation and cover crops is paramount for a healthy garden. To further keep your soil vibrant, you need to replace what you are harvesting by adding compost several times during the year. If we remove 100 pounds of tomatoes, we need to replace that biomass with 100 pounds of a combination of compost, water and sun.
Making your own compost is easy and rewarding. There are various methods and techniques of composting:

  • Hot, or active, composting

  • Passive composting:

    • digging-a-hole method

    • tumblers

What is compost?
Compost is the key ingredient in organic gardening and helps to keep your soil alive with microbial life. It is essentially organic matter that has been decomposed and recycled as a fertilizer and soil amendment.

Compost is composed of four ingredients: carbon (browns), nitrogen (greens), water and air. The recipe for a perfect compost is 3 to 4 parts carbon, 1 part nitrogen, water to moisten, and air (which you add by turning the entire mixture). Typical browns include shredded newspaper or cardboard, dead leaves, wood shavings, straw and other carbon-rich organic matter. Typical greens are grass clippings, kitchen waste, green leaves, weeds (without seed heads) and farm animal waste. Materials you do not want to add to your compost pile include meat products, bones, dairy, oils/fats, or domestic animal (cat/dog) waste. Egg shells are okay.

Whether you are performing active or passive composting, the process for the decomposition of organic materials is ultimately the same.
Different microorganisms have distinct roles in the composting process. In the first phase, bacteria actively break down nitrogen; in fact, bacteria make up about 80-90% of the microorganisms in a compost pile, numbering in the billions in a single gram of compost. For the first 24 hours, the compost pile temperature will rise from mesophilic, or moderate temperature, to thermophilic, or high temperature. This thermophilic phase lasts about two to three weeks. The bacteria will produce heat, which will bring your pile temperature up to 140-160 degrees very rapidly.
When your compost pile reaches 140 to 150 degrees (you can measure the temperature with a compost thermometer), you will need to add air and water. To add air, you turn your pile by using a garden fork to move the pile (the top becomes the bottom). While you are turning it, have a hose handy to add enough water so when you squeeze it, a drop or two of water comes out. You want the pile to be moist, but not soaking wet. You will need to turn your pile and add water about four or five times during the thermophilic phase.  
The next phase is the cooling, or maturation, phase, which can last from several months to several years. This is when the fungi move in to break down the carbon material. During this phase, you do not need to turn your pile or add water. Your pile just sits there in ambient temperature and decomposes on its own. Your compost is ready to use when you cannot recognize any of the primary ingredients (apple core, etc.). The compost keeps getting better and more stable as it decomposes. It eventually turns into humus, which is a highly stable organic matter.

Hot (or active) composting
When building a pile for hot composting, you will want to make a pile that is at least three feet cubed. This is the minimum amount of biomass the bacteria need to begin breaking down the nitrogen. The process of hot composting is described above. Once you start your hot compost pile, you have officially started the thermophilic phase and you cannot add new material. If you have additional material, you will need to keep your scraps for your next pile.

Passive composting
Digging a hole
One passive method is simply to bury your kitchen scraps. The hole should be at least 8 to 10 inches deep to avoid any rodent activity. You simply dig new holes, fill them with scraps, cover them up with soil and then move to the next spot. This is an easy way to add organic matter and nutrients to your soil. We would do this for perennials, but not in a vegetable bed.
A tumbler is another handy way to deal with the incoming stream of yard waste and kitchen scraps. It is best to buy a tumbler on the larger side. This assures that it is easy to turn. Our experience is that tumblers make sticky and clumpy compost, but if you add more finely chopped-up carbon material, that should help.


Composting tips

  • There is no need to buy any specific products for your compost pile other than what we have already described. The microbes are plentiful and will do the necessary work for you. 

  • The smaller the pieces of raw material are that you add to your compost pile, the faster the decomposition will occur.

  • During the entire process, the compost pile should smell fresh, somewhat like a forest floor. If it does not, usually one of two things have gone off track. Either too much nitrogen is present, which means you need to add more carbon. Or it has become too wet and you should turn the pile to try and dry it out or add more dry carbon.

  • An easy way to promote composting in your home is to place a receptacle on your counter. After preparing meals at home, put the scraps in the container and take it out to your compost pile.

How to use your compost when it is ready
We like to put a two- to three-inch layer of compost on top of our vegetable beds. We do not roto-till it in as tilling disrupts the microbial community in the soil. We simply place it on top, and cover it with straw; however, you can work it into the top couple of inches of soil, without major disturbance to the life in the soil. After you place your compost, make sure you protect it by adding a layer of mulch (straw or grass clipping) over the top. Sun, wind and rain can be hard on the microbes in the soil and compost.
Composting is a win-win for everyone. It helps give plants that nutrient-rich, living humus — one of the healthiest ingredients around. It also keeps table scraps out of the garbage, easing the strain on our landfills. The Environmental Protection Agency (EPA) estimates that 30 million tons of food waste ends up in landfills each year, causing more than 3.5 billion tons of greenhouse gases.
Happy composting!

Lisa and Kathleen Putnam

Lisa has a BS in Agricultural Economics from UC Davis. She also studied nutrition science there. She currently operates a small sustainable organic farm in Woodside and is a lifetime gardener, a UC Master Gardener (1999) and Master Composter (2010). Lisa’s passions are composting and the Soil Food Web. She teaches both summer and winter vegetable gardening at Lyngso, Common Ground and several local garden clubs.

Kathleen is a professional organic vegetable gardener and an ISA Certified Arborist serving the Mid-Peninsula region. She has a degree in Environmental Horticulture from City College of San Francisco and is a UC Master Gardener. She teaches classes about vegetable gardening and fruit tree pruning throughout the Bay Area, at Common Ground, Lyngso, San Francisco Community Gardens, Los Altos Garden Club, Portola Valley Garden Club, San Mateo Master Gardeners and the San Francisco Professional Gardeners Association. 

Tips for a Successful Vegetable Garden

Kathleen is a professional organic vegetable gardener and an ISA Certified Arborist serving the Mid-Peninsula region. She has a degree in Environmental Horticulture from City College of San Francisco and is a UC Master Gardener. She teaches classes about vegetable gardening and fruit tree pruning throughout the Bay Area, at Common Ground, Lyngso, San Francisco Community Gardens, Los Altos Garden Club, Portola Valley Garden Club, San Mateo Master Gardeners and the San Francisco Professional Gardeners Association. 

Lisa has a BS in Agricultural Economics from UC Davis. She also studied nutrition science there. She currently operates a small sustainable organic farm in Woodside and is a lifetime gardener, a UC Master Gardener (1999) and Master Composter (2010). Lisa’s passions are composting and the Soil Food Web. She teaches both summer and winter vegetable gardening at Lyngso, Common Ground and several local garden clubs.

Planting Chart:
The most important chart we use every day is the UC Master Gardeners Vegetable Planting Chart. Although written for Santa Clara County, the guide is perfect for San Mateo County as well. If you live outside of the Bay Area, you can find similar planting guides for your state by contacting your state cooperative extension or your state or county Master Gardeners group. You can also go to your local plant store and ask them for a reference guide. Please feel free to contact Lisa for additional advice.
How to use the planting chart

  • Transplanting means planting your seedlings (baby plants) directly in the garden. This is best done on a cloudy day, or during the late afternoon; then water them in well after transplanting. 

  • Direct seeding means planting the seed directly into your garden bed. This is always done with root vegetables and can also be done with arugula, chard, beans, peas, spinach, lettuce and a few other vegetables.


Below is a sample of the vegetable planting chart. Find the full chart here.

The most important factor for successful gardening is living, healthy soil. Here's a review, in last week's post.
The second most important factor for successful gardening is SUN. Most vegetables – and all fruiting vegetables (summer veggies are fruits) – need eight hours of direct sunlight. Ideally, they need it year-round but they, most importantly, need that much sun in the summer. Getting that much sun can be tricky in yards that have buildings, trees or tall bushes near the vegetable beds. It is important to be honest with yourself about how much sun your garden will really get. As cumbersome as it is, it is best to go out in your potential garden spot once per hour during the day and see if direct sunlight is hitting it. This is important, because it is the only way the plants will get food, and it will help the plants avoid many pests and diseases.
The wonderful thing about living in the Bay Area is we can vegetable garden all year round. However, the difficult aspect of a vegetable garden can be having enough space for the overlapping crops. Your spring garden should be planted in February or March (kale, broccoli, cauliflower, cabbage, beets, chard, lettuce), but you need to save room for your summer vegetables, which should be planted in April or May (tomatoes, peppers, eggplant, zucchini, cucumbers, beans, etc.). How do you do that with limited space? You can interplant some plants, which may mean sneaking your tomatoes into your broccoli patch. With some thought and planning, you can make it work in our tight spaces.

Tips for a Successful
Vegetable Garden
By Lisa and Kathleen Putnam

Seeds and Starts
You can either plant your garden from seeds or from starts (baby plants are called seedlings or starts). We like to use seeds since there are a plethora of varieties available. When these seeds actually become seedlings they can then be transplanted into the garden at the correct time of the year (please see chart below).
Some crops must be started from seed, like root crops, because they do not transplant well. With your carrots, parsnips, radishes and beets (all examples of root crops), dig a shallow trench, sprinkle in your seeds, cover with soil and water. Some seeds need to be kept evenly moist for a long period of time. Carrot seeds, for example, need to be kept moist for 21 days. It's always best to seed root crops when rain is in the forecast. 
For many, buying starts/baby plants at a local nursery like Wegman's Nursery is much more convenient. You want to make sure the start is as wide as it is tall. Take one out of the six-pack to make sure it is not root bound (roots rotating around the circumference of the six-pack cell). 
Crop Rotation
When planning your year in the garden, it is best to rotate your crops, and not plant crops from the same family back-to-back. In other words, you don’t want to plant broccoli where you just had kale, since they are part of the same family. This practice helps to reduce insect and disease load, as many pathogens feed only on particular families of plants. This is especially important with the Solanaceae family, also referred to as the nightshade family (tomatoes, peppers, eggplant, potatoes). If you plant this family year after year in the same spot, your soil is at a greater risk of getting verticillium (a fungal disease that makes your plant wilt and eventually die). If this happens, you will not be able to plant any plants from the nightshade family in that spot for a long time, up to 20 years.

We recommend using drip irrigation because it provides slow, deep watering, right where the plant needs it. It also allows for less water usage and results in fewer weeds and less water runoff. During the summer, vegetables should be watered every two to three days. The best time for watering is in the morning because this helps control some of the slugs and other pests that prefer moisture at night, but really anytime is fine. It is most important to water when the top one to two inches of soil are dry. Just dig your finger down into the soil a couple of inches to see it the soil has dried out. Plants generally need about one to two inches of water per week. If the weather is hot or windy, the summer plants may require up to three to four inches of water irrigation per week.
Bugs and Weeds
Whenever we have a problem with insects or disease, the first place we look for support is UC Davis Integrated Pest Management, link below. But, in general, we do nothing. For example, aphids move in on brassica crops as these crops go to seed (when the plants bud, flower and produce a seed pod). This is a perfectly normal part of the plant’s life cycle. The plant pushes out its last new growth with a lot of nitrogen, which signals to the insect world, “I am on my way out,” and the insects come in to help it expire. 
With respect to weeds, we do a lot of weeding in February, before the weeds go to seed. If you do that regularly, and use a lot of mulch (wood chips on paths) in perennial garden beds, and grass clipping or straw in the vegetable beds, you can keep most weeds at bay.

If you have the room, it is also helpful to plant a hedgerow. Hedgerows are a grouping of shrubs, ground covers and perennials used to provide habitat and attract a variety of mammals, birds, reptiles, beneficial insects and pollinators. They are often drought-tolerant and beautiful.

Remember to harvest your crops! It takes a lot of time to harvest your bounty. Many vegetables, like beans and peas, need to be harvested on a continuous basis so they keep producing. The summer vegetables (tomatoes, peppers, eggplant, cucumbers and zucchini) also benefit from regular harvesting.
With single-serve vegetables, such as beets, carrots and lettuce, we like to harvest and direct sow (planting new seeds in the garden) at the same time, which provides for a continuous supply of plants.
Best Practices
The most important aspect of a successful vegetable garden is healthy soil. As our previous post emphasized, keep your soil alive and fertile by keeping it covered with mulch (living mulch, like plants, or ground mulch, like straw), always have plants growing in the soil to feed the Soil Food Web, grow a cover crop every second or third crop and add one to two inches of high-quality compost in between crops.
Happy gardening!




Lisa and Kathleen Putnam
It's All About the SOIL
It's All About the Soil
By Lisa and Kathleen Putnam

When we first started gardening, we were concerned about the chemistry of the soil — the amount of nitrogen, phosphorus and potassium in the soil. We soon figured out, though, that the chemistry would take care of itself if we focused on the soil’s biology: the microorganisms, or soil bugs, within. The soil is a living, breathing organism that needs to be nurtured. When you start feeding the soil, instead of the plant, you are well on your way to the foundation of organic gardening. 
The Soil Food Web
Through photosynthesis, plants convert light energy into chemical energy. That chemical energy is stored as carbon chains in the form of carbohydrates in the plant, especially in the roots. The plant will slough off extra carbohydrates, called exudates, to attract and feed surrounding beneficial microorganisms (bacteria, fungi, nematodes, etc.). In return, the microorganisms feed the plant nutrients.
Bacteria are like small bags of fertilizer containing nitrogen, phosphorous, potassium and other trace elements the plant needs to thrive. Fungal hyphae, a structure of hair-like filaments from the fungi, act as root extenders and literally go and find what a plant needs at any given time and bring that nutrient back to the plant. Scientists have found fungal hyphae five miles from a plant they were feeding.

The plants feed the people and the microbes and, in return, the microbes feed the plant. It is a wonderful symbiotic relationship!

How do you feed the soil and not the plant?
In your vegetable garden, the best thing you can do for your soil is to feed it a steady stream of high-quality compost and grow cover crops. After you add your compost, cover it up with some mulch, like grass hay or grass clippings. For your perennial borders, put down a 2- to 3-inch layer of wood chips as mulch to protect your soil. This slowly feeds the soil and protects it from the elements.
Cover crops: You always want to have something growing in your soil. As we just learned, the roots of plants feed your soil microbes, so you don’t want fallow/bare soil, which will not support life. Thus, when you are not growing a crop to eat, you should be growing a cover crop. We like to grow legumes as a cover crop, as they add nitrogen to the soil. A legume (fava beans, peas, clover, alfalfa, etc.) will take atmospheric nitrogen and store it in small nodules on its roots, and a microbe will convert the nitrogen into a plant-ready form. This is formally known as nitrogen fixation.

Synthetic fertilizers can provide some of these necessary nutrients, too, however, they ultimately will kill the life in the soil. They also will harm the environment. In addition, plants become dependent on humans (via synthetic fertilizers) to give them the nutrients they need vs. the Soil Food Web naturally providing them with their necessary nutrients.

No-till: If you are interested in sequestering carbon and keeping the carbon in the soil to feed the microbes, the best gardening/farming practice is “no-till.” When you rototill your soil, you slice and dice microbes and you release a lot of carbon into the atmosphere. No-till farming is gaining in popularity as farmers realize the benefits of keeping their soil alive and feeding the microbes as well as reducing the amount of carbon released into the atmosphere.

The DOs and DON'Ts


  • Grow a diversity of plants — this will attract a greater variety of microbes.

  • Feed your soil with compost and keep it covered with mulch — compost is rich with life, which will add more good microbes to your soil. The mulch will keep the microbes safe — it protects them from the beating sun and the compaction of the rain.

  • Rotate crops — this will increase the diversity of the microbes and reduce the chance that a pathogen will take hold; i.e., it reduces the inoculant of the pathogens.

  • Grow cover crops — always grow something in your soil. When you are not growing an edible crop, grow cover crops like fava beans, bell beans, alfalfa, clover, buckwheat, etc. This will keep roots in your soil, which will attract and feed the microbes. If your cover crop is a legume, you have the added advantage that it will fix nitrogen in your soil.



  • Don’t till your soil; it kills the fungal hyphae, destroys soil structure and releases carbon into the atmosphere.

  • Don’t step on your soil or compact it — this reduces oxygen in the soil and suffocates microbes.

  • Don’t over-water — the microorganisms need oxygen as well as moisture.

  • Don’t use chemical fertilizers, pesticides, herbicides or fungicides — these all kill microbes.

By feeding the Soil Food Web you will increase organic matter, soil organisms, water-holding capacity and infiltration, improve soil structure, and most importantly, the soil will feed your plant. Ultimately, this will result in plants that will be super healthy and able to fend for themselves against disease and pests, thereby eliminating the need for pesticides, herbicides, insecticides and fertilizers.
By optimizing soil integrity, more nutrient-dense plants result. Bountiful fruits, vegetables and legumes provide the healthiest way to nourish the human body and improve the health of our planet.




  • The Art of Composting:

  • Soil Solutions to Climate Problems, Narrated by Michael Pollan:

  • Mycelium Running: How Mushrooms Can Help Save the World by Paul Stamets

  • Soil Biology Primer.  Published by the Soil and Water Conservation Society in cooperation with the USDA Natural Resource Conservation Service

  • Teaming with Microbes: The Organic Gardener’s Guide to the Soil Food Web by Jeff Lowenfels & Wayne Lewis

Lisa and Kathleen Putnam

Lisa has a BS in Agricultural Economics from UC Davis. She also studied nutrition science there. She currently operates a small sustainable organic farm in Woodside and is a lifetime gardener, a UC Master Gardener (1999) and Master Composter (2010). Lisa’s passions are composting and the Soil Food Web. She teaches both summer and winter vegetable gardening at Lyngso, Common Ground and several local garden clubs.

Kathleen is a professional organic vegetable gardener and an ISA Certified Arborist serving the Mid-Peninsula region. She has a degree in Environmental Horticulture from City College of San Francisco and is a UC Master Gardener. She teaches classes about vegetable gardening and fruit tree pruning throughout the Bay Area, at Common Ground, Lyngso, San Francisco Community Gardens, Los Altos Garden Club, Portola Valley Garden Club, San Mateo Master Gardeners and the San Francisco Professional Gardeners Association. 

Hydration for the Athlete
Hydration for the Athelete
By Wendy Sterling, MS, RD, CSSD

Staying hydrated is an important nutrition strategy that can elevate your performance. Even a mild degree of dehydration can impair exercise performance as well as mental and cognitive performance. The best strategy is to be proactive with your hydration. This means you should begin hydrating upon waking up. 
Aim to consume about half of your body weight in fluid throughout the day. For example, if you weigh 170 pounds, aim for 85 fluid ounces per day. This is a general rule of thumb; the exact amount of fluid required will vary based on the type of exercise, duration and intensity of activity, body weight, and environmental conditions such as heat, humidity and altitude. 
Before your workout: Aim to ingest 16 ounces of fluid roughly two hours before starting your activity, which will allow enough time for absorption. 

While at practice, you will want to maintain hydration levels. This may be challenging because athletes are so often focused on the field that they can easily get distracted and forget to drink. Heat and the sun can blunt the thirst mechanism, so you may not even feel thirsty. If an athlete were to wait until he or she felt thirsty, they might already be mildly dehydrated, and that would be too late! Aim for 6-12 ounces of fluid every 15-20 minutes during your workout. 
To maximize performance and minimize cramping, strive to hydrate on a schedule in order to most effectively maintain hydration levels. 

The best way to determine exactly how much fluid you need during activity is to weigh yourself before and after practice. Your goal is to be “weight neutral,” meaning that your weight is the same before and after practice. If you are losing 2% or more of your body weight after a workout, you might be at high risk for dehydration and cramping, and you should expect that your performance will suffer. Another way to evaluate hydration is to assess your urine color. Hydrated urine will be pale yellow. Dark urine could reflect dehydration.   
After practice, rehydration is an important aspect of recovery. For every pound lost after practice, you should add 20-24 fluid ounces of a sports drink or water to rehydrate. You will want to continue hydrating throughout the day to properly recover and to ensure you are adequately hydrated for the next day’s practice.
Do I Need a Sports Drink?

Water is the preferred drink for athletes, except for athletes who are working out intensely and for longer than an hour. Under those two circumstances, a sports drink can be a helpful adjunct for adding electrolytes, hydration and fuel for depleted muscles.



Another important factor in preventing cramps and aiding in the hydration process is sodium. Sodium triggers your thirst mechanism and helps to reduce fluid losses from passing urine. Large amounts of sodium are lost through sweat. Sodium should be replaced if:

  • You sweat heavily

  • You lose more than 2% of your body weight through practice

  • You practice longer than one hour

  • You experience cramping (either during or after a workout)

  • You practice on a hot sunny day

Add Gatorade, pretzels, pickles and salty snacks to boost sodium consumption. Taking a salt supplement is usually unnecessary.    
In addition, adding calcium (as found in dairy products) and potassium (found in bananas, fruits and vegetables) may also help to reduce cramping. 


Bottom Line

  • Aim to drink water or sports drinks before, during and after all activity.

  • Don’t rely on thirst, because by then it might be too late!

  • Assess urine color to determine hydration; pale yellow (like lemonade) reflects good hydration, and dark yellow (like apple juice) reflects dehydration.

  • Weigh yourself before and after workouts. For every pound lost, add 20-24 ounces of water or a sports drink after a workout.

  • Add sodium from sports drinks, salty foods and snacks, if needed.

  • You can also try adding extra calcium from dairy sources (milk, cheese, yogurt) and potassium from fruits and vegetables to reduce cramping.





National Athletic Trainers’ Association Position Statement: Fluid Replacement for Athletes.

Wendy Sterling, MS, RD, CSSD

Wendy is a Registered Dietitian and a Board Certified Specialist in Sports Dietetics in the Bay Area in California.  She specializes in sports nutrition, eating disorders and weight management. 


Wendy is the team nutritionist for the Oakland Athletics and consults for the Menlo School and for The Healthy Teen Project. She has consulted for the Golden State Warriors, the New York Jets, and New York Islanders. She has been on the Clinical Advisory Board of Project HEAL, a nonprofit organization created to aid in the funding for the treatment of eating disorders since it was created in 2008. Wendy maintains a private practice in Menlo Park and Los Altos, California.

Phone: (917) 568-9695
Twitter: @WendyMSRD
Facebook: Sterling Nutrition

Nutrition for the Athlete
Nutrition for the Athlete
By Wendy Sterling, MS, RD, CSSD

There is no question that nutrition plays a key role in improving sports performance. A good sports performance diet can be a powerful solution for safely and naturally improving your energy, endurance, speed, reaction time and recovery. In the world of competitive sports, where winning and losing may come down to milliseconds, athletes need to examine all areas to see where they can improve. Grabbing a healthy pre-workout snack won’t help if there are holes in the rest of your diet. 

For adolescents specifically: Teens have a very high energy requirement, and when activity is added, the numbers are even greater. Adolescent males require ~2600-3000 calories per day, male athletes may require 3500-4000 calories. Female adolescents require 2000-2400 calories, female athletes can require 2600-3000 calories or more. 

Why a plate?
The plate model provides a  visual guide for athletes to easily understand how much food they need. It is not necessary to count calories or measure out portions. Using a 9” sized dinner plate, athletes can fill their plate according to the breakdown recommended below.  

Starches/Grains – 50% of plate:

  • Choose whole grain options when possible: whole wheat bread (3 grams fiber/slice), bran cereal, whole wheat waffles/pitas/rolls/wraps/buns.

  • Fiber should be at least 25 g/day.

  • It is an essential component of your sports diet. It helps assure that the brain, heart and muscles are getting enough energy to function.

  • Getting sufficient starches will help with the restoration of glycogen stores (the "energy tank") which will help with energy, endurance and recovery.


Proteins – 25% of plate:

  • Aim for a variety of proteins such as chicken, turkey, tuna, fish, grass-fed beef (*contains iron), beans, nuts, tofu, cheeses, Greek yogurt.

  • Aim to include some red meat in the diet. Chicken, turkey and fish do not contain a lot of iron.

  • Athletes need 1.0-1.5 grams of protein/kg/day. To calculate how many grams of protein are required each day, first convert your weight in pounds to kilograms by dividing the weight in pounds by 2.2. Then multiply that number by 1.0 (endurance training), or 1.5 (strength training).


Fruits/Vegetables – 25% of plate:

  • Aim for 5-7 servings per day.

  • Strive for plenty of colors with each meal; it allows for more variety.

  • Skins/peels contain the most fiber.

  • A high consumption of fruits and vegetables will help reduce the inflammation associated with training.

  • Fruits and vegetables will keep the immune system healthy.

  • If you have at least one serving of fruits or vegetables at every meal and snack, you will achieve the recommended servings total per day. This is a minimum requirement.



  • Choose monounsaturated fats such as avocados, nuts, olive oil, flaxseeds.

  • Fats are necessary to keep hormone levels in the normal range.

  • Fats help with absorption of fat-soluble vitamins A, D, E and K.



  • Choose sources such as low-fat milk, cheese and yogurt.

  • Aim for 3-4 servings/day.

  • Dairy-free alternatives include soy milk, hemp milk, almond milk, coconut milk and rice milk. *Soy milk is the highest in protein.

  • Dairy serves as another way of boosting protein consumption throughout the day (1 glass of milk is approximately 8 grams of protein; 1/2 cup of Greek yogurt is about 14 grams of protein, plus added calcium).

3 Meals + 2-3 Snacks: For low to moderate expenditure, aim for “3 + 2,” that is, three meals, plus two snacks. For higher-intensity sports like football, soccer and cross country, “3 + 3” might be necessary, which is three meals and three snacks. Snacks are an essential component of a sports diet, and together with three meals, will keep an athlete's metabolism working from the time they wake up to the time they go to bed. Adding snacks will give the athlete an extra boost of energy and can help meet weight goals. 

Quality: The food an athlete eats should be nutrient-dense, which will maximize vitamin, mineral, fiber and antioxidant consumption. Extra vitamins and minerals can help your body work more efficiently and recover faster. Look for whole foods versus processed foods, as these foods tend to have the most nutrients per bite.   

Variety: Eating a variety of foods every day ensures that an athlete is getting their necessary nutrients. For example, oranges are very high in vitamin C, however, they lack potassium. If someone is “always eating the same thing,” brainstorm together on new meal ideas, go food shopping together and explore new foods and recipes. This also helps to keep food fun!

Timing: Athletes should eat every 3-4 hours, which is optimal for keeping their metabolism firing, keeping blood sugar stable, providing energy to the muscles, fueling pre- and post-workouts, and providing fuel for their brains. Eating regularly has been associated not only with enhanced sports performance but also with improved mood, energy and concentration. 

Rest Days and Light Training: The plate can be adjusted based on the intensity of the athlete’s training. On recovery days, or for lighter workouts, the plate can be divided into equal thirds: one-third, grain/starch; one-third, vegetables/fruits; and one-third, protein.


Next week, I will explore the principles surrounding hydration for athletes. Optimal nutrition and hydration are critical and help ensure that the athlete can perform at their best.


Wendy Sterling, MS, RD, CSSD

Wendy is a Registered Dietitian and a Board Certified Specialist in Sports Dietetics in the Bay Area in California.  She specializes in sports nutrition, eating disorders and weight management. 


Wendy is the team nutritionist for the Oakland Athletics and consults for the Menlo School and for The Healthy Teen Project. She has consulted for the Golden State Warriors, the New York Jets, and New York Islanders. She has been on the Clinical Advisory Board of Project HEAL, a nonprofit organization created to aid in the funding for the treatment of eating disorders since it was created in 2008. Wendy maintains a private practice in Menlo Park and Los Altos, California.

Phone: (917) 568-9695
Twitter: @WendyMSRD
Facebook: Sterling Nutrition

Fiber is Your Friend
Fiber is Your Friend
By Jeanne Rosner
Are Your Skin Care Products Safe?
Jeanne Rosner, MD

Eat Food Close to Its Natural Source

As a nutrition educator, I teach throughout my community to middle school students and adults. The main tenet of my teaching is to eat food as close to its natural source—as close to nature—as possible. Foods like fruits, vegetables, whole grains, nuts, seeds and legumes. When you eat food close to the source, you are getting nutrient-rich food filled with vitamins and minerals as well as an abundance of fiber. 
Fiber is your friend!

So, what exactly is fiber? Fiber is the outer, structural part of plants. Humans lack the enzymes to break apart the bonds within the plant, which is why fiber is indigestible. As a result, fiber does not provide us with energy or many calories when used as a food source. Most, if not all, of the fiber we ingest flows through the digestive tract (esophagus, stomach and small intestine) untouched until it reaches the large intestine. In the large intestine, the fiber nourishes the microbial community that resides there, or it gets eliminated in our stool.
There are two types of fiber: soluble and insoluble, and each performs a variety of healthful functions in the human body. Examples of soluble fiber sources are oats, flaxseeds, avocados, legumes, Brussels sprouts, apples, strawberries, citrus fruits and blackberries. Insoluble fiber sources can be found in whole grains, legumes, nuts and seeds, and vegetables such as green beans, celery, cauliflower and carrots. It is important to eat a diet rich in both types of fiber to reap the many health benefits of this amazing nutrient.

I teach my students to try and minimize their intake of processed foods. I often say, “Eat an orange rather than drink the orange juice” (which is minimally processed). When you eat an orange, you are getting many vitamins, minerals and FIBER. When an orange is processed to orange juice you will still get the orange’s vitamins and minerals but the juice is lacking in all that beneficial fiber. The presence of fiber in fruit has the health benefit of limiting the fructose (fruit sugar) absorption. Additionally, the fiber is full of nutrients called polyphenols (phytonutrients with health-promoting effects), so when the fiber is removed in the juicing process, so too are these healthful polyphenols.


A few unique facts about fiber:

  • Fiber does not freeze or can well. 

  • Processed food lacks fiber because fiber reduces the shelf life of food. The food industry wants processed foods to be more shelf-stable and, with fiber, this goal is not achieved.

  • Fiber causes the cook time of food to be longer.

  • When grains are refined or processed, some nutrients are removed. Vitamins and minerals can be added back (enriched) to these processed food items. Fiber in its original form cannot be added back to a food source, but rather it is in the form of cellulose. Researchers still do not know whether the health benefits of added fiber can mimic those of fiber in whole grains, for example.


There are numerous health benefits attributed to eating a diet rich in fiber. These include:

  • Aids in blood sugar stabilization. Fiber slows glucose absorption in the small intestine, thereby reducing a rise in blood sugar levels. It also decreases the insulin response.

  • Lowers cholesterol in the body.

  • Most fiber passes intact through the digestive tract to the large intestine where the bacterial enzymes digest it. Fiber fuels the microbial community (microbiome) there. It increases microbial diversity, which ultimately protects us from Western diseases. Fiber gets fermented in the large intestine and promotes beneficial bacterial growth. In addition, short chain fatty acids are produced, which help nourish and keep our colonic cells healthy.

  • Can lower colon cancer risk (via the short chain fatty acids that nourish the colonic cells).

  • Aids in healthy digestion.

  • Helps with weight control by helping keep you feeling fuller for a longer time.

  • Can help prevent obesity.

  • Decreases heart disease risk.

  • May play a role in decreasing breast cancer risk.

  • May help lower risk for diverticular disease.

  • Reduces inflammation, which will help decrease the risk for chronic diseases.


The daily recommendations for fiber are as follows:
               19-50 years old: Men, 38 grams/day; Women, 25 grams/day
               > 50 years old: Men, 30 grams/day; Women, 21 grams/day

When eating a processed food item, pay attention to the nutrition facts label on its outer wrapper. Look at the number of grams of carbohydrates and the amount of fiber listed on the label. The ratio of grams of carbohydrates to grams of fiber is important to note. Aim for foods with a ratio that is < 5:1 to ensure the food is a good source of fiber. Try to limit foods that have higher carbohydrates-to-fiber ratios, as they lack sufficient fiber.

To illustrate this point, let’s look at the nutrition facts label of MultiGrain Cheerios. The per-serving listing shows that carbs are 24 grams and fiber makes up 3 grams. Calculate the ratio, C:F = 24/3 —> 8:1. With a ratio of 8, this food falls into the undesirable category. It is a food item that is lacking in sufficient fiber and should be eaten sparingly or not at all.
Keep in mind, there are a few medical conditions that preclude a fiber-rich diet, including diverticulitis; a narrowing of the bowel due to a tumor or an inflammatory disease; history of bowel surgery; or if you are undergoing treatment such as radiation that damages or irritates your digestive tract.
For most of us, eating food closest to its natural source will provide plentiful amounts of dietary fiber. Eat an abundance of fruits, vegetables, whole grains, nuts, seeds and legumes. Your body will thank you for it. Remember, fiber is your friend.




Lustig, Robert H. "Chapter 12: Fiber - Half the "Antidote" Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease. NY, NY: Hudson Street, 2013.
Weil, Andrew, MD. Eating Well for Optimum Health, The Essential Guide to Food, Diet and Nutrition: Alfred A. Knopf, 2000.

Mayo Clinic, Low-fiber Diet:

Michael Greger, The Five to One Fiber Rule, video:

Jeanne Rosner is a board-certified anesthesiologist who practiced pediatric anesthesia at Stanford Medical Center for nearly 20 years. In 2011, she began teaching nutrition classes in her son’s 5th-grade science class. It was an “aha” moment for her. She realized that learning and teaching about nutrition, health and wellness in her community was her destiny. 

Since retiring from anesthesia, Jeanne has been a nutrition educator in the San Francisco Bay Area, at Woodside Elementary School, Menlo School, the Boys and Girls Club of the Peninsula and Peninsula Bridge School. She teaches middle school children the importance of eating food closest to the source, making good food choices and eating in a balanced and moderate way. 
Jeanne started SOUL (seasonal, organic, unprocessed, local) Food Salon in 2014. SOUL Food Salon’s mission is to educate and empower people to be healthier. She holds small gatherings (salons) at which experts in the health and wellness community share their knowledge on how to lead a healthier life.


Are Your Skin Care Products Safe?
By Anita Pietrofitta, DAOM, L.Ac.

Your skin is a defensive barrier against the external elements we encounter daily. But it is also a porous surface. Therefore, when we apply products to our skin, they can be absorbed directly into our bloodstream.1 This is different from what we eat or drink, as our digestive system is designed to filter out and remove toxicants before they get to our bloodstream and cause problems. So, while we demand that our food be safe, what about the products we put on our skin?
Some chemicals in skin care may cause health issues.
It is important to know that the US FDA has banned only 11 chemicals in cosmetic products, whereas the European Union prohibits 1,328.2,3 These 1,328 chemicals are suspected of causing, or are known to cause, cancer, genetic mutations, reproductive harm or birth defects. Other potential impacts include neurological and immune system damage, as well as allergic reactions.4,5 The bottom line is that the health implications of the chemicals we put on our skin might be significant.
Your exposure may be more than you think.
Given this, think about how many products we are exposed to each day. We use shampoos, soaps, hair products, make-up, moisturizers, sunscreens, deodorants, oh my! One study found adult women use an average of 12 products with 168 ingredients, and men use six products with 85 ingredients — each day.6 This same study determined one of every 13 women, and one of every 23 men, is exposed to ingredients that are known or probable human carcinogens on a daily basis.

You may be thinking the dose of chemical ingredients in each application is so low that it can’t hurt you. But what about the cumulative effect of the many different chemicals we apply to our skin daily, in addition to what we eat, breathe and drink? The FDA tested red lipsticks and found lead in all of them, although at low levels, and deemed the values to be safe.7 But lead is a known neurotoxin.8 And what if you are applying lipstick many times a day, every day? When is the line crossed when it is no longer safe, particularly when experts say there is no safe level of lead in the body?
Many chemicals are circulating and stored in our body.
Without a doubt, many chemicals we are exposed to are circulating within our bodies. The Center for Disease Control and Prevention (CDC) has been measuring chemicals or their metabolites in random blood and urine samples of participants in the National Health and Nutrition Examination Survey (NHANES) since 1999; they publish their results in a report called the National Report on Human Exposure to Environmental Chemicals.9 This testing has found perchlorate and a flame retardant called BDE-47 in all, or nearly all, samples respectively. Additionally, many other combinations of chemicals, such as BPA and chemicals used to create non-stick cookware, were found in most samples (>90%). Another study found an average of 200 chemicals in 10 samples of umbilical cord blood.10 This last study emphasizes how important it is to decrease exposures before and during pregnancy.