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Americans' alcohol consumption has changed substantially in recent years, driven by factors such as new production technologies, a desire for improved health and environmental sustainability and, most recently, even the impacts of popular weight-loss medications on hunger and satiety. At the same time, new drinking options are becoming more widely available in stores and establishments. Amid these trends, research into alcohol's health effects continues and may drive potential changes in consumption guidelines. So, how can we follow healthy drinking behaviors that are sustainable for our lifestyles? How does drinking alcohol affect our health? Various alcoholic drinks contain different ingredients that have their own effects on flavor and our physiology, but they include one common psychoactive component called ethanol. This molecule affects the body in many ways — and our bodies' responses can vary based on our genes and other individual factors. Alcohol influences the functions of various organs, including the brain, gallbladder and liver. It affects various aspects of our metabolism, including reducing insulin secretion (which helps regulate our blood sugar) and increasing fat deposition in the liver. It can also affect mood, coordination, sleep quality, memory and other aspects of cognitive function. Alcohol is known to interact with many medications and even herbal supplements, so it is important to carefully read labels to avoid any potentially harmful effects before consuming it. Frequent overconsumption can also lead to addiction and behavioral problems that can negatively affect families and the broader society. While most people are aware of the adverse health effects of excessive alcohol consumption — and may have even experienced the negative mental and physical effects of alcoholism first- or second-hand — it's also been common belief (including among many health professionals) that moderate alcohol consumption can be beneficial for health for many people. Wine is a component of the often-touted Mediterranean diet, for example, and earlier studies — including meta-analyses — showed a lower risk of chronic conditions such as coronary heart disease among those who consume alcohol in moderation. (To read more about how alcohol affects the body and tips for healthy consumption, read this previous post.) However, more recent studies looking across the genomes of many thousands of adults have yielded new evidence about its potential harms, such as accelerating biological aging and posing as one of the top three modifiable risk factors for impaired cognitive health. This has led to conflicting recommendations about the safety or healthy frequency of alcohol consumption. Added to the existing evidence about alcohol's long-term health risks, such as dementia, various cancers and liver disease, experts have begun to question whether moderate consumption is indeed beneficial. How are Americans' drinking behaviors changing? Humans around the world have been drinking fermented beverages for thousands of years. In the US, drinking behaviors have changed substantially since our country's founding, with our overall per capita drinking volume declining precipitously for more than a century and then increasing gradually (particularly in the case of wine) since 1900. More recently, various publications showed that the stress and poor mental health caused by the recent pandemic led to a 3% increase in alcohol sales (which represented the most significant increase in more than 50 years), and roughly 25% of people drank more than usual. Liquor sales accounted for most of this increase. Notably, these recent patterns have not changed uniformly across our country's population. A recent University of Michigan study showed that 2022 reportedly saw "the highest prevalence of binge drinking ever recorded" among adults aged 35–50. But a 2023 Gallup poll showed that younger adults are now less likely to drink (though more likely to use marijuana and vaping products), with the share of adults aged 18–34 who say they ever drink dropping by 10% since 2001. To replace alcoholic drinks, this age group is eagerly turning to alternative beverages when they socialize and dine out and to enjoy at home. How are guidelines around alcohol changing? Our Dietary Guidelines for Americans (DGAs) provide advice about what to eat and drink to meet nutrient needs and prevent disease. They are updated roughly every five years based on reviews of the latest science. The 2020–2025 DGAs (published in 2020) state that adults of legal drinking age should limit intake to two drinks per day for men and one drink per day for women. At the same time, international guidelines are changing. Canada changed its guidance in 2023 to limit to two alcoholic drinks per week (down from the previous 15 weekly drinks for men and 10 for women) to reduce health risks associated with drinking. And the World Health Organization released a statement in early 2023 that there is no "safe" level of alcohol consumption that does not affect health. The 2025–2030 DGAs are currently under development. A review of the current scientific evidence on the relationship between the consumption of alcohol and health outcomes presently being conducted by an expert committee convened by the National Academies' Food and Nutrition Board in early 2024 will help inform their conclusions. It remains to be seen how the expert committee will determine the alcohol guidelines should change (if at all). What alternatives to alcoholic drinks exist? In the past, non-alcoholic versions of beer, cocktails and other alcoholic drinks were much less common and often thought to be unappealing. However, companies have recently come out with many new options, and people can enjoy them in restaurants, bars and at home. Examples of new products include: Zero-proof liquors Infused seltzers Non-alcoholic wine Sparkling hop water Non-alcoholic canned cocktails There are a few ways that non-alcoholic spirits can be made. Natural botanicals, flavorings and essences can be infused with water to replicate the flavor profiles of alcoholic spirits. Or, they can distill a full-proof spirit with all of the flavor of a traditional spirit, then distill it again to remove the alcohol. A less common method is to prevent alcohol from forming in the first place by stopping the fermentation process at an earlier stage and then diluting it with water. These products don't taste identical to the alcoholic versions, but many still find them appealing and a satisfying substitute for the alcoholic versions — especially when combined with bitters, mixers and other typical cocktail components. Cocktails can be made without non-alcoholic spirits, as well. Enjoying low- or no-alcohol drinks can be an opportunity to add beneficial ingredients to the diet. Mocktails can be made with herbs, flowers and fruits that provide polyphenols (plant compounds) that are beneficial to the diet. They can be very high in sugar; however, choosing or making drinks that derive most of their flavor and enjoyment from botanical ingredients or carbonation doesn't require large amounts of sugar. How can I modify my alcohol consumption and still enjoy being social? For most people, alcohol doesn't have to be entirely off limits, even if recommendations do continue to change. But, reducing your consumption and treating alcoholic beverages as occasional treats may prove to benefit your health (and can help reduce costs, too). Several ideas for moderating alcohol intake include: If you enjoy drinking when out, limit yourself to just one alcoholic drink at the restaurant or happy hour. Consider trying one of the growing number of low-alcohol options that many restaurants have been adding to menus instead of your typical go-to mixed drink. At home, save alcoholic drinks for occasional celebrations. For special occasions (such as a treat to celebrate the end of a busy workweek), try making a mocktail, like the recipe here, or one of these other ideas for fun drink recipes that are low in sugar and alcohol from FitOn, Nutrition Stripped and Everyday Health. If buying pre-made mocktails, look for lower-sugar varieties that contain little or no sweetened soda, tonic water or syrups. Remember that alcoholic drinks are made from grown and harvested ingredients, so consumers can choose varieties that are produced more sustainably. For example, wine grapes can be grown biodynamically, and spent grain can be diverted to compost or other edible products. Selecting forms of sustainably produced alcohol is also less detrimental to environmental health. Resources A list of resources can be found here. Christina Badaracco, MPH, RDN, LDN Christina Badaracco, MPH, RDN, LDN, works as a healthcare consultant, educator and thought leader, focusing on evidence generation and advancing the role of nutrition in healthcare. She also regularly writes, teaches and develops curriculum about nutrition, culinary medicine and sustainable agriculture — including publishing The Farm Bill: A Citizen's Guide in 2019 and five cookbooks with the Transamerica Institute and co-developing a culinary medicine elective at the Georgetown University School of Medicine. Christina previously worked for the EPA, Teaching Kitchen Collaborative, Oakland Unified School District, NIH Clinical Center and more. She is the incoming president of the DC Metro Academy of Nutrition and Dietetics, is on the board for Slow Food DC, supports the Teaching Kitchen Collaborative's nutrition working group and contributes to various other organizations. She earned her Master of Public Health from the University of California, Berkeley and her bachelor's degree in Ecology and Evolutionary Biology, with a minor in Italian Language and Culture, from Princeton University. She completed her dietetic internship at Massachusetts General Hospital. www.christinabadaracco.com www.linkedin.com/in/christina-badaracco/

In the dynamic health and wellness field, integrative medicine has emerged as a harmonious blend, combining the latest advancements of Western allopathic medicine with holistic insights from various complementary and alternative systems. This amalgam addresses the physical aspects of health and considers emotional, mental and environmental factors that contribute to our health, making it a comprehensive approach for the prevention and management of cancer. WHO data suggest that 30-50% of cancer deaths are preventable. In 2023, the US experienced 1.9 million new cancer cases. The lifetime risk of developing cancer was 40%. The need for effective prevention is evident. By focusing on the whole person and leveraging the strengths of diverse health systems, integrative medicine offers a proactive and personalized strategy for cancer prevention. Diet and Nutrition: A Cornerstone of Cancer Prevention Our dietary choices play a pivotal role in cancer prevention. A standout recommendation is the Mediterranean diet, which studies have found to reduce all-cause cancer mortality by 16% and overall cancer risk by 19%. This dietary pattern allows for flexibility based on individual culinary and cultural preferences. It emphasizes various vegetables and fruits along the entire color spectrum, especially those in the cruciferous family, like broccoli, cabbage and kale. The diet also includes nuts, seeds, healthy fats such as olive oil, whole grains, beans, legumes and an assortment of spices. And it incorporates oily fish (salmon, mackerel, anchovies, sardines, herring), which are rich in omega-3 fatty acids and have significant anti-inflammatory effects. For cancer prevention, it's also advisable to avoid foods such as processed meats (bacon, ham), which are Group 1 carcinogens, and red meat, a Group 2A carcinogen. Also, reducing the intake of sugar-sweetened beverages, trans fats, excess salt and oils with a high omega-6 to omega-3 ratio (like sunflower, corn, soybean, grapeseed and safflower oils) is beneficial for cancer prevention. Remarkably, meal timing can affect cancer risk. Eating evening meals earlier, preferably before 9 pm or at least two hours before bedtime, can reduce the risk of breast or prostate cancer by 20%, highlighting the importance of aligning mealtimes with natural circadian rhythms for cancer prevention. Beyond Fitness: How Diverse Physical Activities Shield Against Cancer Physical activity is another powerful tool in cancer prevention. Regular exercise reduces the risk of at least 10 types of cancer, including breast, colon, endometrial, kidney, liver, lung, ovarian, pancreatic, stomach and esophageal cancers. Insulin resistance, familiar in the context of diabetes, is also intricately linked to cancer. Excessive carbohydrate consumption and consequent high glucose levels in the blood can lead to an overproduction of insulin. Over time, cells may become resistant to insulin, leaving excess glucose and insulin in the bloodstream. This excess insulin stimulates the liver to produce insulin-like growth factors, promoting cell growth and potentially leading to cancer. Sleep: An Integral Component in Cancer Prevention Studies have consistently shown a correlation between sleep duration and cancer risk, particularly breast cancer. The ideal amount of sleep is around 7 to 8 hours per night. Shift work, which disrupts standard sleep patterns, presents a further risk. The irregular hours and altered sleep-wake cycles common in shift work have been linked to increased instances of breast cancer in women and prostate cancer in men. This increase is believed to be partly due to the disruption of melatonin production. Melatonin, a hormone produced in response to darkness, has protective properties against cancer. Therefore, anything that disrupts its normal production cycle, such as irregular sleep patterns or exposure to light during typical sleeping hours, may increase the risk of developing cancer. Vitamin D: A Vital Ally in Cancer Prevention Vitamin D plays a key role in cancer prevention and the outcomes of those with a cancer diagnosis. Ensuring normal levels of vitamin D not only reduces the risk of developing cancer but also decreases the likelihood of dying from it, particularly in cases of breast, colorectal and ovarian cancers. Regular monitoring and supplementation, if necessary, are essential. Infections and Cancer: The Link Certain infections, such as those caused by HPV, EBV, H. pylori, HIV, HHV-8, HTLV-1 and hepatitis viruses, are linked to increased cancer risk. Vaccinations and early treatments are effective preventive measures. Stress Management: The Mental and Emotional Facets of Cancer Prevention Addressing one's mental and emotional well-being — particularly managing chronic stress — is vital in cancer prevention. Chronic stress can lead to high levels of serum cortisol, weakening the immune system's effectiveness and reducing the body's natural ability to fight cancer. It can also cause DNA damage, increasing susceptibility to cancer, and contribute to persistent inflammation, creating an environment favorable for cancer growth. To counteract these effects, incorporating effective stress management techniques into our daily routine is essential and can improve our overall mental, emotional and physical well-being. Here are some key stress-management strategies: Breathwork: Deep breathing exercises are a simple yet powerful tool that has been shown to reduce cortisol levels, enhance relaxation and improve overall well-being. Mindfulness Practices: Mindfulness helps reduce the stress and anxiety that often result from dwelling on the past or worrying about the future. Techniques include focused attention on daily activities, mindful eating or practicing gratitude. Meditation: Regular meditation, even a few minutes daily, can lower cortisol levels, improve immune function and provide a sense of calm and balance. Time in Nature: Nature walks, gardening or simply sitting in a natural setting can help to reduce stress and promote a sense of peace. Mindset: The Power of Positivity in Cancer Prevention A positive mindset can be a potent tool in managing stress and reducing the harmful effects of chronic stress on the body. Furthermore, positivity is linked to healthier lifestyle choices. Individuals with a positive outlook are more likely to engage in activities that reduce cancer risk, such as regular exercise, healthy eating and adhering to medical advice and screenings. Feelings of hopelessness or helplessness are known to suppress the immune system, thus making it difficult to heal from cancer. Spirituality: A Pillar of Strength in Cancer Journies Spirituality is a deeply personal aspect of the human experience. It encompasses a sense of connection that extends beyond oneself to others, nature and, for some, a higher power. This connection offers meaning and purpose that are distinct from traditional religious practices. Spirituality and religious beliefs can reduce stress and enhance our sense of well-being. For cancer patients, spiritual well-being has been linked to a better quality of life and the ability to find joy amidst pain, fatigue and distress. Drawing on their spirituality, cancer survivors often experience profound personal growth despite the challenges of their diagnosis. Conclusion: Embracing Mindful Attention for Cancer Resilience Warding off the daunting threat of cancer doesn't necessarily require grand or exotic measures. The journey toward a healthier life and increased resilience against cancer lies in consistently paying mindful attention to numerous small yet significant lifestyle choices. A holistic approach that balances many facets of health reduces cancer risk and enhances overall quality of life. Our daily, mindful decisions — covering everything from what we eat to how we cope with stress — collectively pave our path to a more cancer-resilient life. Malathi Acharya, MD Dr. Malathi Acharya is the Founder of Ayur Integrative Medicine in Silicon Valley, CA. She is passionate about all elements of a holistic (integrative) approach to health and wellness, including nutrition, lifestyle, supplements, botanicals, mind-body treatments and treatments from alternate medical systems. With over 25 years of experience in the traditional Allopathic system, Dr. Acharya recognized the limitations of a disease-focused and medication-based model, so she pursued additional training in Integrative Medicine at the Andrew Weil Center. This transformative journey empowered her to maintain her well-being during the Covid pandemic. It inspired her to found Ayur Integrative Medicine, where she could apply and share her comprehensive health philosophy with others. She is a Diplomate of the American Board of Integrative Medicine and Board certified in Internal Medicine and Hospice and Palliative Medicine. She is also certified in clinical hypnosis and trained in medical acupuncture and Heart Math biofeedback techniques. In her free time, Dr. Acharya enjoys reading, growing (and, alas, killing many) houseplants, streaming shows on Netflix, and exploring new destinations. She enjoys travel as a way of connecting to nature. www.ayur.today facebook.com/malathi.acharya.7 linkedin.com/in/dr-malathi/ instagram.com/dr.malathi2023/

As the first stop along the digestive tract when we eat, the mouth plays several vital roles in initiating digestion. Our oral health is also closely linked to nutrition — a relationship that is exemplified through the known roles of sugar and acidic foods and liquids in increasing the risk of dental caries (or decay), vitamin C in promoting gum health and healing and fluoride in promoting tooth formation and preventing caries. Excessive fluoride exposure can be a cause for concern, though—particularly since most Americans are exposed to it through our dietary intake and in dental products. Since we are exposed to fluoride through our daily diets, how can we be careful to maintain a safe and beneficial exposure level? What functions does fluoride play in the body? Fluoride is an electrically charged (or ionic) form of the naturally occurring element known as fluorine. It helps with the structural stability of teeth and bones through interactions with calcium phosphates, molecules in our bones made of calcium, phosphorus and oxygen. Fluoride occurs naturally in the body in the form of calcium fluoride, which is primarily found in the bones and teeth. In the mouth, fluoride can inhibit bacteria that ferment sugars and produce acid, thereby preventing decay. It also helps to adhere calcium and phosphorus to enamel to promote remineralization, which is the process through which tooth enamel is rebuilt after it begins to decay. Through these processes, fluoride can help to prevent and even reverse tooth decay — particularly when applied topically. Elsewhere in the body, it stimulates the proliferation of osteoblasts (or bone-building cells), making it an important element for bone growth in children. Where do we get fluoride in the diet? Fluoride is naturally found in the soil and is taken up by many types of plants. As a result, foods derived from those plants, as well as meat and dairy from animals that eat those plants, contain trace amounts of fluoride. However, most of the fluoride we consume comes from fluoridated water, foods and beverages made with fluoridated water, and dental products (like toothpaste) that contain fluoride. Tea actually provides more fluoride than fluoridated water because tea leaves come from the Camellia sinensis plant, which also takes up some fluoride from the soil. All other foods and beverages are estimated to provide less than 1 mg of fluoride per serving. Examples of foods and drinks that contain measurable amounts of fluoride are shown below. Note that the beverages and grains listed are made with fluoridated water; versions with unfluoridated water would be much lower (and precise concentrations could vary widely). Some medications and multivitamins also contain fluoride. Since 1945, most community water systems in the US have added fluoride to water as a public health measure to reduce the incidence of dental caries. While the US Public Health Service reduced its recommended fluoride concentrations from 0.7–1.2 parts per million (ppm) to 0.7 ppm in 2015, variation across systems still exists. Notably, about 15% of American households get their drinking water from non-fluoridated wells. Also, some varieties of bottled water are made with fluoridated water, but it is impossible to tell based on the brand or label. How much fluoride do people need to consume? Adequate Intakes (AIs) for fluoride are based on levels estimated to maximize reductions in the incidence of dental caries without unwanted side effects. One of the primary side effects of too much fluoride is fluorosis, which refers to weakened bones and tooth damage that may appear as discoloration in tooth enamel. Our fluoride needs increase throughout childhood and stabilize once we hit adulthood. It's estimated that our bodies absorb more than 80% of the fluoride we ingest; of that amount, about 50% is retained, and the rest is excreted in the urine. Young children are estimated to retain more — up to 80% — of absorbed fluoride because their rapidly growing bones and teeth take up more of it. AIs and related considerations for safe intake are shown in the table below. What are the risks and benefits of augmenting fluoride in the water supply? The fluoride concentration in treated drinking water supplies is typically (but not always) controlled to be approximately 0.7 ppm, as the US Public Health Service recommends. The decision to fluoridate water was informed by epidemiological studies showing that people who lived where drinking water supplies had naturally occurring fluoride levels of at least 1.0 ppm had fewer dental caries than those who lived where fluoride levels were lower. Water fluoridation is intended to prevent tooth decay by providing frequent and consistent contact with low fluoride levels. Fluoridation has been widely accepted as the most practical and cost-effective method of delivering fluoride to all community members since everyone needs to use and drink water. There is disagreement, however, about the safety of fluoride and the necessity for fluoridation. Some groups (such as the Environmental Working Group) call for lowering the level of fluoride based on concerns about its potential risks, including: Fluorosis may develop when exposed to too much fluoride in the first eight years of life. Drinking water is an inexact delivery route because people consume widely different amounts from the tap and have varying exposures through other media. Accidental overexposure can lead to side effects such as nausea, vomiting, joint pain and skeletal fluorosis (or bone loss). Some studies in laboratory animals have suggested that high fluoride exposure may be neurotoxic; further, observational studies have found associations between exposure and impaired learning, memory and cognition. While community-level fluoridation became widely popular in the latter half of the 20th century, many organizations and agencies have adjusted their stance over the past decade. A 2015 Cochrane report, for example, found a dearth of quality research into the effectiveness of water fluoridation for preventing caries in adults. The report noted that dental caries have decreased equivalently in countries without water fluoridation, and they concluded that fluoridation is an unnecessary process. However, overall, the current body of evidence is insufficient to show causal relationships between the above observations. Most studies suggesting harm also focused on populations with exposures higher than those typically found in community-fluoridated water. Thus, most health professionals and public health associations continue to support routine fluoridation at the level currently deemed safe, along with following advised practices for fluoride-containing dental products. How can I make sure I'm consuming an appropriate amount of fluoride in my diet? Given these universal and often unavoidable means of exposure, it's essential to understand how — and how much — fluoride is entering your body. Consider reviewing the following sources of information: Most states participate in the My Water's Fluoride tool from the Centers for Disease Control and Prevention, enabling residents of those states to learn if their counties routinely fluoridate water and at what approximate concentration. You can also visit the Environmental Working Group's Tap Water Database to learn about utilities with the highest amounts of fluoride and other related details. To learn the precise level of fluoride in your water, you can take samples to a state-licensed testing lab (found by searching the EPA's Water Lab Network). You can also detect fluoride using home reactive testing kits or strips, which can be purchased at some home improvement stores or online (though the validity of their measurements is questionable). You can read more about testing kits reviewed by Consumer Reports or Good Housekeeping to make an informed decision. If you're concerned about high fluoride levels in your water, reverse osmosis systems, distillation units and certain water filters (but not carbon-charcoal filters) can remove significant amounts. Talk with your dentist if you're concerned about over- or under-exposure for either a child or an adult. Consider meeting with a dietitian for guidance about incorporating or removing foods and liquids that contain fluoride from your diet, based on your goals. Finally, you can talk with your physician about any possible fluoride content in prescription medications you may be taking. Resources Please visit here for a list of resources. Christina Badaracco, MPH, RD Christina is a registered dietitian and author who aims to improve access to healthy and sustainable food and educate Americans about the connections between food and health. She loves to experiment with healthy recipes in the kitchen and share her creations to inspire others to cook. Christina completed her dietetic internship at Massachusetts General Hospital and earned her Master of Public Health degree from the University of California, Berkeley. Previously, she graduated with a degree in Ecology and Evolutionary Biology from Princeton University, after conducting her thesis on sustainable agriculture and energy in Kenya. She has done clinical nutrition research at the National Institutes of Health, menu planning and nutrition education at the Oakland Unified School District and communications at the Environmental Protection Agency's Office of Water. She has also enjoyed contributing to children’s gardens, farmers markets and a number of organic farms. cbadarac@gmail.com www.linkedin.com/in/christina-badaracco/

Sara Bowling is a Family Medicine physician, medical acupuncturist, yoga teacher, athlete, amateur chef and mom of two little boys.  She is currently working at AC Wellness providing care for Apple employees and their families. Previously she was in private practice, incorporating acupuncture and culinary medicine into her day to day care. She graduated from Stanford University, completed medical school at University of Michigan in Ann Arbor, and Family Medicine training at University of Washington. Dr Bowling believes in the power of diagnostic tools and medicines, but also believes strongly in the power of food, physical activity, and community in creating long lasting health and wellness.  She loves to cook and shares recipes with others, and hopes to inspire her patients, friends and family to find foods that nourish, delight the senses, and provide a basis for a long and healthy life. When not working, you will find Dr Bowling spending most of her time with her husband and two boys 4 and 1.5, usually outside (rain, or shine) and often on bikes!  In her free time she loves mountain biking, gravel biking, running, skiing, traveling and of course, cooking! ​ Contact Information: Website: https://www.drbowlingskitchen.com/ Email: sarabowls@gmail.com ​ At the Salon: We all know by now that the food we eat directly impacts our health.  The risk of having a heart attack or developing diabetes, even certain cancers, has been shown to be related, in part, to the food we choose to eat on a daily basis.  In my experience, most people want to be healthy, they want to feel well, and take fewer medications.  They want to bring their cholesterol down without having to be on medication forever.  But what advice should they follow?  What should they cook for dinner?  In this salon, Dr. Bowling will discuss how she guides patients when they are first diagnosed with pre-diabetes and fatty liver disease, what foods to incorporate and strategies for doing so. Click here to access Dr. Bowling's slide presentation. Click here to watch the salon video. Click here to read Dr. Bowling's SOULful Insight- Fatty Liver: When Food Has the Power to Reverse Disease Click here to read Dr. Bowling's SOULful Insight- Culinary Medicine: What to Eat if You Have Prediabetes

Prediabetes is one of the most common conditions I see, affecting one in three Americans, 90% of whom don't know they have the condition. Prediabetes is usually diagnosed by a blood test called hemoglobin A1C, which measures the percentage of hemoglobin proteins in your blood that are coated with sugar. This value reflects an average of your blood sugar levels over the previous three months, and when this value is 5.7–6.4%, it indicates prediabetes. This means that the sugar levels in your blood are elevated and beginning to cause damage to blood vessels, increasing the risk of heart disease and stroke. However, the levels are not yet high enough to be considered type 2 diabetes. A diagnosis of prediabetes represents a fork in the road. If you do nothing to change how you eat or move your body, you will be likely to progress and develop Type II Diabetes in the next 5–10 years. However, with small, sustained changes to your routines, you have the power to reverse this disease and prevent type 2 diabetes. Source: American Diabetes Association via Centers for Disease Control The culprit is sugar: in the obvious form of juices, sugar-sweetened drinks and desserts, and in white bread, white rice, white pasta — or any food with a high glycemic index. The glycemic index of a food is a measure of how much a specific food raises your blood sugar compared to a reference food. Carbohydrates include high glycemic index foods (>70), moderate glycemic index foods (56-69), and low glycemic index foods (<55). High glycemic foods (like candy, potatoes, white bread or bagels) create large spikes in your blood sugar levels, which trigger insulin release. Produced by the pancreas, the insulin hormone acts like a key and "unlocks" muscle, liver and fat cells in our body to take sugar out of the bloodstream to be used for energy by the cells at a later time. If your blood sugars and insulin repeatedly spike, two things happen: #1: the cells stop responding and "unlocking" when they see insulin — thus leaving more sugar in the bloodstream; #2: your pancreas works on overdrive, producing more and more insulin, which is still not enough to remove all the excess sugar from your bloodstream. This is when diabetes develops. With low glycemic foods (e.g., most vegetables and whole grains like quinoa and pearled barley), your blood sugars rise and fall slowly, and this helps prevent diabetes, lower cholesterol and control weight and food cravings. In addition to the amount of sugar in the food, how fast the food is digested and the specific combination of proteins, fiber and carbohydrates you consume affect your blood sugar. There is no food you must eliminate entirely, but focusing on incorporating more lean proteins, vegetables and whole grains into your diet allows you to reverse the path toward diabetes. What to eat if you have prediabetes Proteins: Stick to lean and plant-based proteins, as these are lower in saturated fats, which reduces the risk of heart disease. Lean proteins include chicken, turkey, eggs, salmon, cod, tuna, shrimp, clams, lean cuts of pork (loin chop, tenderloin) and lean cuts of beef (flank, tenderloin). Great plant-based protein sources include tofu, tempeh, edamame, nuts/nut butters, beans and lentils. Keep in mind that while beans and lentils are high in carbohydrates, they still have a low glycemic load, given their protein and fiber content. Research shows reduced insulin resistance and improved blood sugar management in patients who regularly consume lentils and legumes. In one study, adding one cup of legumes daily (beans, chickpeas or lentils) lowered HbA1C, blood pressure and estimated cardiovascular risk. Vegetables: Most vegetables have a low glycemic index, and I recommend they make up 50% of your plate at every meal. Green salads, roasted root vegetables and adding kale or spinach to a morning smoothie are accessible and easy ways to achieve this goal. Buying frozen chopped veggies ready for roasting or prewashed spinach can help make it even more attainable. Other non-starchy vegetables include asparagus, broccoli, cabbage, Brussels sprouts, celery, cucumber, carrots, mushrooms, snow peas and peppers. Avoid starchy vegetables, such as yellow corn, green peas, plantains, squash and white potatoes, which all carry a substantial glycemic load. I encourage people to substitute cauliflower or broccoli for corn and sweet potatoes for white potatoes. These easy substitutions carry half the glycemic load of the starchier options. Fruits: Most people are concerned about the sugar content of fruits. While fruits contain natural sugars, they also have a lot of fiber, so they are digested very differently from highly refined sugars. Most fruits are low-glycemic foods. In fact, they can help stabilize blood sugars and are a great option as a snack for those with prediabetes. The exceptions include bananas, mangos and any canned fruits. I encourage people to substitute pears, apples, or frozen berries for bananas. If you buy or pick fruit at its peak season (when it's cheaper), you can freeze it and use it later in smoothies or on your morning oatmeal. Grains: Whole grains (couscous, bulgur wheat, pearled barley, quinoa, farro, old-fashioned oatmeal and wild rice) are packed with fiber, protein and nutrients. They lower cholesterol and reduce your risk of heart attack and stroke. They also increase satiety — keeping you feeling full for longer and reducing cravings for high-sugar snacks between meals. The exceptions include basmati and white rice, which both carry high glycemic loads. Of note: it DOES matter what you are eating with these grains. For example, traditional Mexican diets were based mainly on vegetables and legumes with a portion of rice, tortilla or corn. The fiber content of the vegetables and legumes helped to slow the digestion and sugar spike of the high glycemic carbohydrates in corn tortillas or white rice. Mexican fast food today, made up mostly of tortillas, rice and beef, and with few vegetables, is a totally different story. Breads: Breads like 100% white bread, English muffins and, especially, bagels have a very high glycemic load. Wheat bread is very similar to white bread. If you enjoy bread, pumpernickel or rye bread is a great option, with its higher fiber content. Thanks to its fermentation process, sourdough bread slows the release of sugar into the bloodstream and is also a delicious option! Whole-grain breads are also good choices, but beware of the "9-grain" or "12-grain" gimmick. You want 100% whole grain bread; most bread marketed as "12 grain" or "multigrain" is made of processed wheat flour rather than the whole grain (bran, germ and endosperm). The whole grain is what is rich in fiber, B vitamins, antioxidants and healthy fats. Snacks: I always recommend nuts (unsalted almonds or peanuts) as a snack rather than pretzels or crackers (which are often also packed with salt and will spike your sugar and drop you an hour later, leaving you craving more). Other great snack options include veggies and hummus, celery or apple with peanut butter, a piece of fruit, edamame or a small cup of soup. And of course, despite all this discussion about food, another crucial part of diabetes prevention is moving your body daily! If you are wondering if you are at risk for prediabetes and should be tested by your doctor, you can take this test. It's recommended that any person > age 35 with a BMI > 25 should have annual testing for prediabetes. If you have prediabetes, ask your healthcare provider about the National Diabetes Prevention Program lifestyle change program. These programs provide coaching, support groups and a structured plan to reverse this disease and are offered nationwide. In summary: Get tested for prediabetes if you are at risk; know where you stand Prediabetes is reversible with tiny, sustained changes Think lean, plant-based protein and legumes, legumes, legumes Think of non-starchy vegetables as taking up 50% of your plate at every meal; you can even do this at breakfast by adding spinach or broccoli to your smoothie Think 100% whole grains, explore the bulk food section of your local store Think ahead to keep high-fiber snacks with you like nuts, nut butters or an apple Take a short walk after eating a meal to help stabilize your blood sugar If you're looking for a healthy, simple weeknight meal that's ready in under 30 minutes, I invite you to try our family favorite: Honey Miso Sheet Pan Salmon with Broccoli. Resources Visit here for the list of resources. Sara Bowling, MD Sara Bowling is a family medicine physician, medical acupuncturist, yoga teacher, athlete, amateur chef and mom of two little boys. She works at AC Wellness, providing care for Apple employees and their families. Previously, she was in private practice, incorporating acupuncture and culinary medicine into her day-to-day care. She graduated from Stanford University, completed medical school at the University of Michigan in Ann Arbor and family medicine training at the University of Washington. Dr. Bowling believes in the power of diagnostic tools and medicines. She also believes strongly in the power of food, physical activity, and community in creating long-lasting health and wellness. She loves to cook and share her recipes with the hope of inspiring her patients, friends and family to find foods that lift the senses, nourish, delight and provide a basis for a long and healthy life. When not working, she spends most of her time with her husband and young boys, usually outside (rain or shine) — and often on bikes! She also loves mountain biking, gravel biking, running, skiing, traveling and, of course, cooking! Contact Information: Website: drbowlingskitchen.com Email: sarabowls@gmail.com Instagram: @drbowlingskitchen

I recently had the inspiring opportunity to lead a culinary medicine workshop at a conference for obesity medicine specialists. While this was novel material to be presented at an obesity conference, the content is certainly not new. Culinary medicine represents the intersection of the art of cooking and the science of medicine, and it has a vital role in treating obesity by improving dietary quality outcomes, food security, blood sugar control, hypertension and more. I was thrilled to have this opportunity to inspire healthcare providers who care for overweight patients to integrate further lifestyle interventions focused on healthy food and cooking. As we continue to see both health and cooking skills decline in our country, it is imperative that we integrate nutrition and cooking with medicine and grow the evidence base for using culinary medicine as an essential element of obesity treatment and weight loss maintenance. Stanford University Culinary Medicine Class Why is obesity treatment so important? Our country's growing obesity rate is a significant problem for individuals' health and our healthcare system more broadly. Based on 2021 data from the Centers for Disease Control and Prevention, the US adult prevalence of obesity — meaning the condition of having a body mass index (BMI) of at least 30 mg/kg — is 33%. This percentage ranges from 24.7% in Washington, DC, to 40.6% in West Virginia. And our country spends $147 billion annually on obesity-related healthcare. Many factors drive this chronic disease, including genetic predisposition, physical inactivity, excessive caloric intake and high stress. To prevent the problem from growing further, we must consider and implement evidence-based interventions in public and clinical settings. But interventions to treat the condition are also necessary — not only to reduce weight but also to improve the myriad associated health outcomes. What are the current options for medical obesity treatment? The hype in our country over the latest anti-obesity medications approved by the US Food and Drug Administration (FDA) in the past few years (GLP-1 agonists) may lead some to believe they are magical pills that can solve this major health crisis. Much of their popularity has been driven by evidence of higher effectiveness than earlier anti-obesity medication classes. They have become so popular that there are shortages in the supply that are expected to last into 2024. However, a few factors prevent them from being perfect fixes: Limited insurance coverage may prevent many eligible patients from accessing these drugs, and they are expensive. Multiple prescription medications have been developed, approved and recognized as safe and effective for long-term use in treating obesity. However, the Centers for Medicare & Medicaid Services has prohibited coverage of these drugs under Medicare Part D or the prescription drug benefit under Medicare based on a decades-old federal statute that excludes them. Many parties are now advocating for coverage based on their ability to improve other health outcomes — but that will surely not happen in the immediate future. Myriad adverse side effects — from nausea and diarrhea to stomach paralysis and bowel obstructions — may make many people think twice before taking them and/or cause them to stop taking them. Perhaps most importantly, these medications are not a permanent solution. If a patient stops taking them, the weight will come right back on if the patient hasn't also implemented healthier lifestyle behaviors. While anti-obesity treatments have been around for many centuries, the first generation of weight loss drugs was not available and FDA-approved until the mid-1900s. As of 2023, the FDA has approved seven medications to treat adults with a BMI of ≥27 kg/m2 with a weight-related condition or for those with a BMI of ≥30 kg/m2 and an inadequate response to lifestyle interventions. These medications have different mechanisms of action: Previous classes Reduce the amount of fat absorbed in the gut after eating (known as lipase inhibitors) Combine medications that include an antidepressant and an opioid antagonist (which blocks the effects of opioids) Newer classes Stimulate the GLP-1 receptor in the brain to suppress appetite and reduce caloric intake. Known as GLP-1 agonists, they have been shown to be even more effective than earlier medications in causing weight loss — sometimes up to 10–20% — and as effective as more intensive (and expensive) surgical interventions Reduce fat cell formation in the body Combine medications that include an amphetamine-like drug and an anti-seizure medication that suppresses appetite What does a comprehensive treatment approach look like? Despite the latest hype around medications, the most prominent obesity practice guidelines (from the American College of Cardiology/American Heart Association/The Obesity Society and the American Association of Clinical Endocrinologists/American College of Endocrinology) recommend a comprehensive treatment approach. The guidelines state that lifestyle therapy is the "cornerstone" of treatment for this disease but acknowledge that pharmacotherapy and metabolic and bariatric surgery can produce more significant and sustained weight loss than lifestyle changes alone. As with any effective treatment plan, a full assessment and evaluation of the patient provides data about their status, needs and preferences. The Obesity Medicine Association also supports a comprehensive and personalized approach to obesity treatment. This approach is based on four pillars, which should be considered and implemented in conjunction. They include: Nutrition therapy, which includes education (including through the delivery of culinary medicine) and counseling to create a negative caloric balance while maximizing nutrition density and diversity of dietary intake Physical activity, with a mix of cardio and strength training to increase metabolism and help develop lean muscle mass, which further contributes to fat-burning Behavioral modification through tactics such as cognitive behavioral therapy and goal-setting that address patients' psychological and emotional needs Medical interventions, including both anti-obesity medications and bariatric procedures How does this affect your healthcare? If you or a loved one are considering taking an anti-obesity medication, it's important to talk with your doctor about lifestyle changes — whether or not you decide to proceed with taking a medication. You should Meet with a registered dietitian, whom you can find by asking your physician for a referral, searching on eatright.org, or asking friends or family for a recommendation Learn about and practice healthier cooking skills, such as in a shared medical appointment, at a local community center like a YMCA, or even through a wellness program offered by your employer Engage in physical activity every day Adapt your home environment and surround yourself with a supportive community to help you sustain positive behavior changes throughout your weight loss journey Patients and citizens concerned about the access to and affordability of obesity care can also engage in policy advocacy by: Reading more about related policy issues and considering writing to your members of Congress about what you think they should support for the betterment of their constituencies. One example is the recently reintroduced Medical Nutrition Therapy Act, with versions introduced in both the House and the Senate. This bill would expand coverage for medical nutrition therapy, provided by an RDN, for Medicare patients to include additional diagnoses, including obesity. More members of Congress will need to support this bill before it can pass both chambers and be sent to the President for consideration Talking with your insurance company about the benefits you're seeking Having open dialogue with your physician about your preferences and goals of care Engaging in research and sharing information about evidence-based interventions with friends, family and colleagues We all benefit when we become more knowledgeable about our health and engaged in bringing about positive change in our healthcare system. Resources Resources can be found here. Christina Badaracco, MPH, RD Christina is a registered dietitian and author who aims to improve access to healthy and sustainable food and educate Americans about the connections between food and health. She loves to experiment with healthy recipes in the kitchen and share her creations to inspire others to cook. Christina completed her dietetic internship at Massachusetts General Hospital and earned her Master of Public Health degree from the University of California, Berkeley. Previously, she graduated with a degree in Ecology and Evolutionary Biology from Princeton University, after conducting her thesis on sustainable agriculture and energy in Kenya. She has done clinical nutrition research at the National Institutes of Health, menu planning and nutrition education at the Oakland Unified School District and communications at the Environmental Protection Agency's Office of Water. She has also enjoyed contributing to children’s gardens, farmers markets and a number of organic farms. cbadarac@gmail.com www.linkedin.com/in/christina-badaracco/

Brenna O’Malley is a registered dietitian and owner of The Wellful, a virtual nutrition therapy private practice based in San Francisco. Brenna specializes in a non-diet approach and helps clients recover from disordered eating to build a healthy relationship with food, their bodies, and themselves. Brenna is nationally recognized in the media and is regularly quoted in publications like Well+Good, Bustle, PopSugar, HuffPost about nutrition, food marketing, disordered eating and body image. She completed her Bachelor's degree in Nutrition and Dietetics from New York University and her dietetic internship training at Massachusetts General Hospital in Boston. When not seeing clients, she loves doing candle-lit yoga, biking to the beach, and exploring the Bay Area. ​ At the salon: What influences your food choices? How does your body image or number on the scale influence your eating throughout the day? Join registered dietitian, Brenna O'Malley, for an engaging and eye-opening presentation about developing a healthy relationship with food, your body and yourself. With so many conflicting messages about health, dieting and wellness in the media and our daily conversations, it can be hard to find what feels best for you. Brenna combines her nutrition expertise as an eating disorder dietitian with her media experience to support attendees in exploring sustainable, health-promoting mindset and behaviors around food. ​ Contact info: Website: thewellful.com Work with Brenna: schedule a discovery call Email: brenna@thewellful.com Phone: 925-725-2761 Click here to watch the salon video.

With the start of each new year, self-improvement and weight loss advertisements flood the airwaves. The $72 billion dollar weight loss industry bombards all of us with messages telling us our body is wrong and our food is wrong, leading to an ever-vicious cycle of food confusion and body dissatisfaction. Parents who might be struggling with their own body and relationship with food may desperately wish to help their kids develop a more peaceful relationship with food and body — but how? We caught up with dietitian Wendy Sterling, therapist Signe Darpinian and adolescent medicine doctor Shelley Aggarwal to hear how parents and teens can practice diet-free living and improve body image satisfaction. Can you explain what you mean when you encourage readers of Raising Body Positive Teens to have a "friendship with their body and food"? Friendship is the perfect metaphor for the relationship between one's body and food. A healthy friendship is generally defined by mutual respect, trust, joy and good listening skills. Our best friendships bring out a true enjoyment of each other's company. If we examine our relationship with food through the lens of respect, trust, joy and good listening, it's easy to conclude that many of us don't have the healthiest friendship with food. Raising Body Positive Teens takes aim at the unfriendly relationships we may have with food and our bodies. Our body is a skilled regulator — when allowed to be — and you can really learn to trust its wisdom. Treat your body with respect, even though you may not always like it. Looking again at friendships, we know that we can, at times, fall out of "like" with our friends. However, if we can continue to treat our friends with respect, it is easier to find our way back to our baseline relationship with them. This same principle can be applied to body image. What happens if you are not eating enough to meet your needs? Adequate nutrition is fundamental to healthy development and maximizing one's physical potential. Like a plant that requires sunlight, air, soil and water, bodies need food, vitamins, minerals, fats, carbohydrates, proteins and many other nutrients to grow. In addition to a variety of foods, we must eat enough food. Eating too little can interrupt growth and development and impact a child's current health and long-term health. Not eating enough food can affect cardiac, gastrointestinal, menstrual, hematological, immunological and psychological functioning. For instance, an athlete who is not properly fueling may find their performance falling off: they may feel slower, weaker, be more prone to injury and might not make progress despite extensive training. In addition, they may be more irritable and depressed and have decreased endurance and more trouble recovering. What is a non-dietary approach to health? A non-dietary approach to health looks at the whole person and the many factors that create one's well-being without emphasizing weight or dieting. Unfortunately, there is an overemphasis on weight in our culture, which is also embedded in the medical culture. A non-dietary approach looks at factors other than food that affect physical and emotional health. These can include stress, happiness, sleep, moving joyfully, mindfulness practices, support through and access to mental health resources, connections to others—and much more. Who is at risk of an eating disorder? Eating disorders affect people of all sizes, genders, races, ethnicities and ages. You don't have to be "emaciated" to have an eating disorder. In fact, fewer than 6% of those diagnosed with an eating disorder are considered clinically "underweight" (Flament et al. 2015). This means you can't tell just by looking at someone if they are sick or the degree to which they are sick. Many believe they "can't possibly be sick enough to warrant treatment." Or worse, their clinician misses the eating disorder altogether. Frequently overlooked populations include males, those in larger bodies, Black, Indigenous and people of color (BIPOC), and older folks. Cultural values or expectations around privacy and stigma around mental health, combined with a lack of knowledge and difficulties and inequities in accessing health care, all impact the likelihood that someone will receive the help they need. Delaying the recognition and/or treatment of an eating disorder makes it harder to treat and ultimately requires more intervention. What causes an eating disorder? There are many reasons why people develop eating disorders. It is often the result of a variety of factors like one's genetic makeup, personal characteristics (like whether someone is perfectionistic, anxious or depressed) and the impact of new medical diagnoses such as gastrointestinal issues. One's family life (e.g., divorce, death), trauma, social and environmental factors (like whether one's friends are dieting or bullying), weight stigma and the effects of a global pandemic can also play a role. It's so complicated. We also know that dieting is one of the biggest predictors of an eating disorder. So, the language used in the home, on the field or in school can be protective against the development of an eating disorder. What does having an eating disorder "look" like? Eating disorder characteristics can be categorized as follows: physical signs, behaviors around food, exercise, body image and cognitive/mood changes. Here are some warning signs to look out for: Increased interest in food and exercise (becomes a red flag when it turns into an obsession) Sorting foods into "good foods and bad foods" and talking about being "scared" or "fearful" of foods Increased focus on body and shape (some of this is normal during adolescence, but a high degree of distress and preoccupation would be concerning) Body checking (repeatedly touching, examining and dissecting the body in the mirror) Changes in weight Loss of menstrual cycle, unrelated to perimenopause/menopause. While considered "common" among athletes, it is not normal and is usually a sign that something is "off" physiologically Obsessive thinking Increased rigidity and lack of flexibility Using food to cope with emotions Lack of spontaneity around food Lack of variety in the diet—a change from an earlier diet Avoidance of social situations, especially where food is involved Compensatory behaviors (Defined as those used to eliminate the calories being consumed; it is a hallmark feature of Bulimia Nervosa but is also present in other types of eating disorders, such as Anorexia Nervosa or Binge Eating Disorder. Compensatory behaviors can take the form of vomiting after meals, exercising excessively, restricting food, or misusing laxatives, diuretics, diet pills and teas.) Social media can negatively influence body image. How should we navigate this? Apps like Instagram and TikTok can be harmful, depending on how they are being used. Social media influencers are often trusted, yet many are not credentialed and do not provide evidence-based information. Follow people who motivate and inspire you. Ask yourself whom you are following and why. How do certain accounts make you feel? Do you feel worse after looking at specific images? Or do you feel like you need to change something about yourself? It's well documented that many images are photoshopped, Facetuned and altered (or entirely generated by AI), presenting a false and unachievable appearance of body perfection, fitness and youth. Don't be afraid to click unfollow! Images, especially those promoting weight loss, diets and particular physiques, may offer dangerous "how-tos" for the development of disordered eating/eating disorders. It's helpful to diversify your feed to include a variety of body types, people and areas of interest in addition to beauty and exercise. Studies show that when people are exposed to images featuring a wide range of body sizes for a mere 20 minutes, their body size preferences shift to be more inclusive. You can follow accounts highlighting travel, hobbies, sports, art, nature, etc. Becoming a critical media viewer is a great way to build resilience against the barrage of messages about diet culture, beauty and health. Examine the TV shows and movies you watch. You can start by pointing out shows that make larger bodies the punchline when you see them — exposure matters. Look for TV shows that depict diverse bodies, such as Shrill (based on the book by Lindy West) or Lizzo's Watch Out for the Big Grrrls. How do you raise a body-positive teen if you, as a parent, have had lifelong body image, weight and eating concerns? The first step to raising a body-positive teen is to bring awareness to the issue. Awareness lets you choose whether and how you want to think, feel and/or behave differently. In our culture, we often react and speak unconsciously to messages about food and body—as if we are on autopilot. We are steeped in these messages through pop culture, images, music and day-to-day conversation, and we rarely question their validity or benefit. We then pass on these weight, shape and food concerns to our children. In our book, we encourage parents, as a first step, to bring awareness to how they engage with their own ideas of food and body. To get started, a family might commit to taking the morality out of food. This means including all types of food in the house and avoiding labeling foods as "healthy," "unhealthy" or "junk food." Similarly, families could consider creating a joyful movement routine. They might choose activities that sound fun over those that will "burn more calories." They can focus more on being together in nature than "earning the ice cream" after the hike. People of all shapes and sizes can have a positive body image and healthy self-respect. However, many cultures believe those who don't look a certain way shouldn't feel good about who they are. By rejecting constricted ideas of beauty and expanding the definition of what it means to be someone who is thriving and appreciative of their physical appearance, we can decrease our stress and create a more inclusive paradigm.  —Excerpted from Raising Body Positive Teens Resources For additional information and resources, please click here. Signe Darpinian, LMFT, CEDS, Wendy Sterling, MS, RD, CSSD, CEDS-S, & Shelley Aggarwal, MD Signe Darpinian is a Licensed Marriage and Family Therapist (LMFT), Certified Eating Disorders Specialist (CEDS) and host of Therapy Rocks!, a personal growth podcast. Signe is also the former president of the San Francisco Bay Area Chapter of the International Association of Eating Disorders Professionals and provides telehealth therapy services in California. www.signedarpinian.com Instagram @therapyrockspodcast and @noweighguide Wendy Sterling specializes in adolescent nutrition, eating disorders and sports nutrition. She is a Certified Eating Disorder Registered Dietitian and a Board-Certified Specialist in Sports Dietetics from the San Francisco Bay Area. She has consulted for the Oakland Athletics, Golden State Warriors, NY Jets and NY Islanders. She is the co-author of How to Nourish Your Child Through an Eating Disorder and How to Nourish Yourself Through an Eating Disorder. sterlingnutrition.com Instagram: @wendy_sterling and @platebyplateapproach X: @WendyMSRD Shelley Aggarwal is a physician, board-certified pediatrician and adolescent medicine sub-specialist. She treats medically complex teens and young adults and consults on youth-specific health issues, including adolescent development. Shelley has worked with premiere academic institutions and is on the teaching faculty with Stanford Children's Health and UCSF-Fresno. She is the medical director of clinics serving justice-involved youth.

Edward Park is the founder of NeuroReserve, a preventive health and nutrition company focused on healthy brain aging.  Ed's background spans over 15 years in the fields of nutritional therapeutics, biopharmaceuticals and medical devices.  Most importantly, Ed’s father struggled with dementia and Parkinson’s disease for almost two decades before passing away.  The impact of this experience on him and his family motivated him toward the field of brain health, where he realized the powerful role nutrition and dietary patterns can play in reducing the risk of Alzheimer's, Parkinson's and other neurodegenerative conditions. Ed often speaks on the topic of healthy brain aging and nutrition through podcasts, adult active living communities, corporate wellness, and talk radio – including Medium, the Travis Macy Show, MIT Business Showcase, Life Time Fitness, All About Parkinson’s, and our favorite, SOUL Food Salon!  Ed holds a PhD in chemical and biomolecular engineering from the Georgia Institute of Technology, where he was a National Defense Science and Engineering Graduate Fellow.  He also holds an MS and MBA from the Massachusetts Institute of Technology.  He is a board member of Alzheimer’s caregiver respite fund Mind What Matters and board advisor at the Martin Trust Center for MIT Entrepreneurship. Ed lives in Summerlin, Nevada with his wife Jenn and three children, where he swims, runs, and coaches youth ice hockey. Contact Information: Email: epark@neuroreserve.com Website: neuroreserve.com Instagram @neuroreserve / Facebook @neuroreserve At the salon: At this salon Ed taught us about the uniqueness of brain and cognitive health, its relationship to Blue Zones, and neuroprotective dietary patterns.  We then dove deeply into specific nutrients beneficial for long-term brain function and preventive health, and covered the latest in Alzheimer’s medications and what to expect about the future of dementia prevention and treatment – and the importance of cognitive testing. Elli Kaplan, co-founder of Neurotrack a digital screening test to help with early detection of dementia's shared more about the importance of early screening. Click here to view the salon presentation. Click here to view the salon video. Elli Kaplan from Neurotrack also spoke about cognitive brain testing and the importance of this modality for early detection of cognitive impairment. Check out their website here.

"Writing is an act of discovering what you think and what you believe."  –Dan Pink Recently, I have been spending more time writing. Typically, I write in my meditation journal each morning after time spent in silent meditation or while listening to whatever mantra I currently love. Lately, though, I have found myself jotting down thoughts, feelings, quotes, etc. randomly throughout the day. I LOVE it! This practice is making me more aware of what is important to me, what my intentions are for myself and how I spend my time. I am also finding this helpful for processing those swirling thoughts that seem to enjoy hanging out in my mind! Several times this month, I have taken time for a "mind dump" — writing down everything that is on my mind without editing — right before bed. This has been really supportive for a better night's sleep. Because this is such a nourishing practice for me, I want to share it with you all. My idea is to send a daily prompt — some question or contemplation that inspires my writing and, I hope, might inspire yours. Of course, you can always simply sit with your journal and free-write whatever comes to mind. If you decide to do this, I suggest setting a timer (I use the app Insight Timer daily) and writing for at least five minutes. Doodling counts. You may want to make journaling part of your existing meditation practice OR use this as a way to start a new meditation practice. If you are interested in joining "Journaling in January," please send me an email at cstierney@gmail.com, and I will add you to the list. Invite friends and family — simply forward this post to others; everyone is welcome! Your contact information will remain private and will not be shared. "Writing has so much to give, so much to teach, so many surprises. That thing you had to force yourself to do — the actual act of writing — turns out to be the best part." – Anne Lamott Tips for journaling: Invest in a journal and pen that you really LOVE. Create a routine that works for you. Perhaps choose a dedicated time and place to write each day. Or, carry your journal with you and write whenever you have a free moment. Maybe write while enjoying your morning coffee. Take time to write every day, even if it is just for two minutes at the very end of the day before nodding off to sleep. Use a prompt or experiment with different ways to journal: pictures, lists, quotations you love, etc. (Bullet Journals or Morning Pages are two additional methods). Remember that all new habits take practice. Celebrate successes and forgive lapses and start anew the following day. We'll start this journey on January 1, 2024. The hope is for this to be an inspiration for daily writing for the entire month. Who knows … perhaps we will continue this all year. Again, if you are interested, email me at cstierney@gmail.com to sign up. Resources WebMD on Journaling Kaiser Permanente on Journaling Healthline on Journaling Clia Tierney Clia Tierney is a Transformational Life Coach, Yoga and Mindfulness Instructor and Ayurvedic Health Counselor who helps her clients reconnect with their inner wisdom. She also hosts wellness retreats at her farm in Northport, Maine. 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 individuals of all ages identify and reduce their stress and struggle so that they can discover their purpose and confidently move forward. cliatierney.com

These cookies are the perfect combo of chocolate and spice, soft in the middle with a nice outer crunch. The addition of marshmallows adds a nice creamy element too.

Ahhh... nothing tastes better than the combination of chocolate and peppermint! These peppermint chocolate brownie cookies are thick, chewy and unbelievably delicious! They are wonderful for the holidays!