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DR. ANNIE FENN is the founder of the Brain Health Kitchen, the only cooking school of its kind focused exclusively on brain health and helping people prevent cognitive decline through food and lifestyle. After twenty years as a board-certified ob-gyn, she traded in her stethoscope for an apron to pursue her passion for the culinary arts. But it was her mother's diagnosis with dementia that helped Dr. Fenn find her path and her new calling, one that enabled her to not only help her mother but also create significant and meaningful impact for others. Annie lives in Jackson, Wyoming with her husband and her two furry friends, Orzo and Livvie. When she's not spreading the word about Alzheimer's prevention, she enjoys hiking, all types of cycling and skiing, and foraging for wild huckleberries and mushrooms in the mountains. Contact Information: Physician, Chef, and Founder, Brain Health Kitchen Newsletter: Brain Health Kitchen Book: The Brain Health Kitchen: Preventing Alzheimer's Through Food Instagram @brainhealthkitchen At the Salon: Dr. Fenn updated our knowledge of brain-protective diets, including the latest information about the Mediterranean and MIND dietary patterns. She covered important new research regarding menopause, hormone replacement therapy (HRT), and Alzheimer's. And, she provided practical tips for making your recipes more brain healthy while keeping it all easy and delicious. Click here to view the salon powerpoint presentation. Click here to view the salon video.

This tofu scramble tastes just like scrambled eggs but it's tofu! So many tasty flavors in each bite! Tofu Scramble 1 Tablespoon oil l pound firm tofu, drained and patted dry ½ green bell pepper, small dice ½ onion, small dice 1 small carrot, grated or minced 2 Tablespoons nutritional yeast ½ teaspoon turmeric ¼ teaspoon cayenne pepper ½ teaspoon garlic powder ½ teaspoon ground cumin freshly ground black pepper, to taste 1 Tablespoon low-sodium tamari or soy sauce 1 teaspoon honey or agave syrup •Heat oil in a large skillet, non-stick if possible. Crumble tofu into pan and add diced green pepper and onion. Stir occasionally until most of the water released from the tofu has evaporated. •Add remaining ingredients (carrot, nutritional yeast, turmeric, cayenne, garlic powder, cumin, pepper, tamari, syrup); stir well and cook for 1 minute or until mixture starts to brown slightly. Remove from heat and serve. •This is delicious served with chopped cilantro and salsa.

This coffee nice cream is rich and creamy, just like real ice cream! The addition of instant coffee and chocolate chips are super yummy! Coffee Nice Cream 2-3 ripe bananas 1 packet of instant coffee (roughly 2 tsp) 1 TB nut butter 1 ½ TB chocolate chips •Cut banana into ½ inch rounds, put on a parchment lined baking sheet and put in freezer for approximately 1 hour. •Once frozen, remove bananas from freezer and allow to thaw for about 5 minutes. •Blend bananas until smooth in a food processor. •Add coffee, nut butter and chocolate chips and mix together.

These brownies are amazing and you don't know there are black beans in them! The black beans add a rich creaminess to the brownies, the coffee adds a nice zing and the cocoa nibs add a nice unexpected crunch. Black Bean Brownies 1 (15.5-ounce) can black beans, rinsed & drained ¾ cup almond butter ½ cup unsweetened applesauce ⅓ cup maple syrup 1½ teaspoons vanilla extract ⅓ cup unsweetened cocoa powder 1 teaspoon baking powder ½ teaspoon kosher salt 1 tsp cinnamon 1 tsp instant coffee ¼ cup semisweet chocolate chips melted for dough 1/8 cup cocoa nibs ¼ cup semisweet chocolate chips for topping Flaky salt for sprinkling on top, if desired •Preheat the oven to 350°F and line an 8x8-inch baking pan with parchment paper, leaving an overhang on at least two sides. •In a food processor or high-power blender, combine the beans, nut butter, applesauce, maple syrup, and vanilla. Purée until completely smooth, about 3 minutes. Scrape down the sides of the bowl and add in the cocoa powder, baking powder, salt, cinnamon and instant coffee. Puree’ for another 1 to 3 minutes, until totally combined. •Melt ¼ chocolate chips in microwave. Add to the batter and puree’ until combined. Add the cocoa nibs and mix by hand. •Scrape the batter into the prepared pan. Scatter the remaining chocolate chips on top. Bake for about 30 minutes. Sprinkle flaky salt on top if desired. Before slicing into 9 or 16 squares, let cool completely in the pan. You can speed this up by placing the pan in the refrigerator or freezer after cooling at room temperature for 30 minutes.

Beyond refreshing! The perfect combination of fresh strawberries, lime/lemon juice and mint, ahhh... delicious! Strawberry Mint Lemonade Inspired by @tablefortwo 1 cup fresh strawberries, hulled ½ cup water 2 tablespoons agave nectar ¼ cup fresh squeezed lime/lemon juice Mint leaves Crushed ice Rosé or sparkling water •In a blender, add strawberries, water, agave, and lime. Blend until smooth. •Divide strawberry mixture evenly amongst 3-4 glasses then add mint leaves. Using a muddler, muddle the mint leaves to release flavor. •Add crushed ice then fill the rest of the glasses with rosé or sparkling water. •Serve chilled.

Mass marketing campaigns from the food and supplement industries, social media influencers and even friends and family can be sources of unfounded nutrition information and guidance. Hearing myths about nutrition perpetuated by certain researchers or health professionals whose education is outdated and/or based on faulty science is particularly concerning. As a follow-up to our 2021 Insight about common health myths, let's look at the fallacies and evidence base behind four more common nutrition myths. Small, frequent meals are better for optimal health Coinciding with the increase in eating food away from home, many people today consume small, frequent meals spread throughout the day instead of three main meals. While their overall caloric intake may be the same, it is distributed across roughly six meals. This tactic is thought to promote satiety, prevent overeating, increase metabolism and maintain energy levels. However, those benefits don't necessarily hold true for everyone, and they may not be universal. A 2017 review for the American Heart Association concluded that meal frequency doesn't seem to affect energy metabolism (when caloric intake is held constant). While having more frequent meals may help to lower blood pressure and increase HDL (or "good cholesterol"), evidence for impacts on various other biomarkers is mixed. Increasingly, the evidence shows benefits to outcomes such as weight loss and blood sugar control resulting from patterns of time-restricted feeding and intermittent fasting (see this recent article)—which do not align with a more frequent eating pattern. Further, evidence shows it is preferable to eat a smaller meal in the evening and not eat too close to bedtime, which may be difficult to avoid if one eats smaller meals throughout the day (and into the evening). In reality, individual metabolic rates, chronic condition(s) and lifestyle factors facilitate or hinder a particular eating schedule. People with poor blood sugar control (including those with diabetes) may find that eating smaller and more frequent meals can help to stabilize blood sugar. It may also make it easier for people who have difficulty eating orally or who struggle with low appetite to eat enough throughout the day. People who frequently travel for work and have little time to sit down for a full meal (which may or may not be nutritionally balanced) may also find it more convenient to fit in wholesome "snacks"—even fruits and vegetables—throughout the day. The most important factor about your eating schedule is that it enables you to eat a balanced diet primarily consisting of unprocessed foods. It's also important to eat with minimal distractions—particularly avoiding screens—so that you can truly enjoy your food and respond to feelings of hunger and satiety. The precise number and schedule of meals are likely not paramount to determining your health. Depending on your goals, though, you may find it helpful to meet with a registered dietitian to help understand and implement the best dietary pattern for your body and lifestyle. Supplements are a waste of money Americans spend a lot of money on supplements. A 2021 report from the CDC stated that nearly 58% of American adults had used some type of dietary supplement in the last 30 days. Multivitamins are the most common, followed by vitamin D and omega-3 fatty acids. It is well known that the FDA only loosely regulates dietary supplements. Companies can begin to sell their products without first testing for safety, quality or efficacy (unlike the clinical trials required of pharmaceuticals). They must only provide "reasonable assurance" that supplements don't pose "a significant or unreasonable risk of illness or injury" when used as directed. (The FDA can remove a supplement from the market if deemed unsafe, though.) So, without some third-party verification, it's impossible to know whether a specific brand's supplement contains what is written on the label. Extensive data shows that many people are deficient in nutrients like fiber and vitamin D—and the connections between those deficiencies and myriad poor outcomes. However, the evidence base for supplementation to consistently improve outcomes (particularly when an individual is not deficient) is quite mixed. Nutrition research requires studies of sufficient duration to detect effects on health outcomes and ensure any benefits can be sustained; however, those long-term studies are resource-intensive and, therefore, rare. While it's certainly true that no supplement will be a cure-all, that does not mean supplements are always a waste of money. Factors such as baseline nutritional status, which food or medications are taken (or not taken) with certain supplements, dosage and the quality of a given supplement all play important roles in determining the body's absorption and utilization of a supplement once it is consumed. The most recent position statement from the Academy of Nutrition and Dietetics states that "…micronutrient supplements are warranted when requirements are not being met through the diet alone. Those with increased requirements secondary to growth, chronic disease, medication use, malabsorption, pregnancy and lactation, and aging may be at particular risk for inadequate dietary intakes. However, the routine and indiscriminate use of micronutrient supplements for the prevention of chronic disease is not recommended, given the lack of available scientific evidence." And the most recent recommendation statement from the US Preventive Services Task Force states that more research is needed before making any recommendations regarding the ability of most supplements to prevent cardiovascular disease or cancer. (It does recommend against taking vitamin E and beta-carotene for these purposes, though, based on proven harms.) So, if you're considering taking one or more supplements, talk with a registered dietitian or primary care physician to ensure you're taking a form of supplement that will be most effective for you. You can also refer to the ConsumerLab, Clean Label Project and US Pharmacopeia websites for information about the quality and safety verifications of different supplements to help you decide which brands to purchase. And keep in mind that no supplement—whether multivitamin, protein, fiber, herbal or anything else—will be fully able to make up for a poor diet. Foods high in cholesterol are unhealthy High blood cholesterol is a known risk factor for heart disease. More specifically, low-density lipoprotein, or LDL, is a molecule that carries cholesterol throughout the body. High concentrations—particularly of small, dense LDL molecules—are concerning for heart health. All animals manufacture cholesterol; therefore, humans make it and consume it in animal-based foods. Foods such as egg yolks, shrimp, liver and high-fat meats are particularly rich sources. Based on the theoretical connection between cholesterol in our food and our blood, health professionals have recommended limiting or avoiding foods containing dietary cholesterol for many decades. However, new evidence in the last few decades has shown the connection is more complex. Our bodies need cholesterol to complete functions like comprising cell membranes and forming hormones and vitamin D. Therefore, the body closely regulates cholesterol in the blood by controlling its production—i.e., the body makes more when consumption decreases and typically makes less when consumption increases. So, dietary cholesterol is not a direct driver of blood cholesterol for most people. Note that a small percentage of people have a genetic condition—such as familial hypercholesterolemia—that causes them to respond more acutely to dietary cholesterol intake. This specific population is often advised to limit their cholesterol intake. Instead, dietary trans and saturated fats are the primary drivers of high LDL in our blood. Trans fats are predominantly found in fried foods (the trans fats form in the oil during prolonged boiling) and commercial baked goods. Meat, eggs and tropical oils are leading sources of saturated fats. Not all saturated fats lead to increased LDL—and for those that do, the link to resulting heart disease is debated—but it is still advisable to keep portions small and opt for healthier oils as often as possible. Thus, the cholesterol in animal-based foods is not implicated in driving heart disease. Unfortunately, some physicians continue to recommend that patients limit cholesterol and food companies tout their cholesterol-free products as being healthier when this is not warranted. Cholesterol-containing foods can be harmful and raise the risk of heart disease, though, when 1) cooked at high temperatures (they form inflammatory molecules called oxysterols) and 2) conversion occurs of other components in animal-based foods into molecules called TMAO by our microbiota (refer to this previous article). Therefore, if you consume animal-based foods, it's best to eat them only occasionally, keep portions small and avoid cooking them over high heat for prolonged periods. Plant-based meat and dairy alternatives are healthier choices Improving health and reducing disease risk are among the top motivating factors for the increasing numbers of people following vegetarian or vegan diets. To meet this demand, companies are selling products made from isolated soy, wheat or pea proteins that are combined with myriad oils, gums, fibers, sugar and/or salt. They promote these products as healthier alternatives—thereby helping to fuel the rise of plant-based versions of dairy and meat (see this recent article). Eating a more plant-forward diet benefits most people's health, but that does not necessarily mean that all alternative products are healthier than their animal-based counterparts. Consider what may be included in plant-based alternatives: Dairy Plant-based milks can be much lower in essential nutrients like calcium, vitamin D and protein; even if the products are fortified, the micronutrients may not be as bioavailable. Some milks have nearly 20 grams of sugar per cup—80% of what the American Heart Association recommends for women and children daily. Many plant-based cheeses contain just as much saturated fat and sodium as dairy cheeses, providing essentially empty calories and increasing the risk of high blood pressure. Meat Plant-based meats can contain up to six times more sodium and three times more saturated fat than real meat. Bulking agents such as cellulose, genetically modified soy derivatives, refined sugar, oils (including palm oil) and starches may be included. Meat may contain negligible amounts of key vitamins and minerals (such as zinc). Also, while there are many benefits to consuming a vegetarian or vegan diet, they aren't necessarily the best choice for everyone. Older adults, people experiencing hypermetabolism due to injury or some acute conditions and certain other populations may find it impossible to consume enough key nutrients from plant-based sources. Preliminary research shows that plant-based meats may be preferable for heart health. However, long-term studies are still needed to assess the cumulative health effects over time and on different organ systems. Also, plant-based diets can be full of refined carbohydrates and oils and may be eaten in excessively large portions. Therefore, when considering plant-based alternatives to dairy and meat, try following these suggestions: Choose the products with the shortest ingredients list and the least added oil, sugar and salt. Also, opting for an alternative product with roughly the same amount of protein can help ensure you consume enough. When possible, make your own version at home. For example, soaked and blended cashews can make a delicious sweet or savory cheese substitute, and combinations of crumbled tofu or tempeh, chopped walnuts, lentils and mushrooms can make an umami-rich ground meat substitute. It's especially important for anyone being treated for a chronic condition, recovering from injury and/or taking medications that may impair absorption or deplete certain micronutrients (such as steroids, statins or ACE inhibitors) to talk with a registered dietitian about your dietary intake to ensure you're meeting your body's needs. (Of course, anyone could benefit from meeting with a dietitian!) We hope this article provides plenty of useful information and references for you to investigate further. Please share what you've learned with your friends and family to help clear up any confusion and ease them on a path to healthier habits. For more information about the latest nutrition science and recommendations, refer to resources such as the Berkeley Wellness Letter, Harvard Nutrition Source, and the websites of the Academy of Nutrition and Dietetics and the True Health Initiative. Resources Resources for this article 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/

Clia's teaching style incorporates both yin and yang elements into an aligned vinyasa practice. She believes the benefits of yoga and meditation are immense, and she teaches in order to share them while also introducing more calm, clarity and connection to and among mind, body and spirit. Clia emphasizes that we can learn to be more present, with awareness and compassion, through our yoga and mindfulness practices and to live our lives authentically. Clia's education and experience include an MA and certification in Educational Therapy, additional certifications with Yoga Alliance and Transform Coaching Academy and Mindful Schools' mindfulness curriculum training. She is currently completing her certification to become an Ayurvedic Health Counselor. She teaches yoga in person and through Zoom and works one-on-one with clients as a transformational life coach and meditation teacher. She also leads wellness retreats at her farm in Midcoast Maine. Clia lives in San Francisco with her husband and adorable dog, Leo. In her free time, she enjoys hiking, cooking, reading and spending time with friends and family. At the Salon: Clia took us through a practice that included both physical asana and mindfulness practices. The sequences are appropriate for all levels of interest—from first-timers to experienced yogis. The theme was "renew and rejuvenate," with the intention of learning something new that can be practiced at home. We included specific essential oils to support the practice. Contact Information cliatierney.com wrightscovefarm.com LinkedIn Click here to view and download the Ayurveda resource page.

Are you frustrated with doctors who are rushed or busy and often use prescription medicine as the primary solution? If you are searching for holistic, whole-person care that is healing-oriented and patient-centered, you may be interested in a doctor specializing in integrative medicine (IM). I maintain an integrative practice, yet I also work as a “regular doctor” in some well-intentioned facilities. Integrative medicine doctors receive the same training as traditional doctors. They then incorporate additional training in areas of interest such as traditional Chinese medicine and Ayurveda, meditation and mindfulness, supplements, exercise, nutrition, sleep and various other forms of therapy such as movement, yoga, music, dance and art. What is the difference between integrative and functional medicine? Functional medicine is a branch of integrative medicine that also requires specialized training (often through the Institute of Functional Medicine or another training group). Like IM, it also focuses on the whole person in the context of their environment and strongly emphasizes addressing the root causeof disease. While the two practice styles are similar, functional medicine doctors will usually take a deeper dive into specific laboratory testing, often analyzing hair, blood, urine and stool (sometimes in labs that are not FDA-approved, and therefore not approved by insurance). They may also interpret some of the lab results differently from conventional doctors (e.g., differing normal values for thyroid function, relying on blood tests [rather than biopsies] to diagnose H. pylori, etc.). Functional medicine doctors may also prescribe numerous supplements—often administered at the same time. Integrative medicine builds and improves upon conventional medicine Modern medicine has been—and always will be—lifesaving. However, it has some limitations. As an example, pain is a common complaint for patients. The traditional treatment model rules out any overt physical pathology, such as a malignancy or an inflammatory state, prescribes pain-relieving medicines and advises the patient to avoid known triggers for their pain. Sometimes, the accompanying fatigue, depression or anxiety may also be diagnosed and treated. This approach alone may be enough for some patients. The patients who find their way to an IM specialist often prefer not to rely on medications or be told to avoid activities. Instead, they want to reach a state of healthy living through nutrition, sleep, exercise, acupuncture, natural supplements and other means, which are often outside the norms of conventional medicine. Patients can easily incorporate these practices into their lives and begin to feel better. Patient values and interests are at the center of integrative medicine In my practice, when I ask children and their parents the question, “If I had a magic wand and could help you with one thing in your life, what would it be?” the whole tenor of the visit changes. Patients no longer feel they are being defined by an illness but rather by what is meaningful to them in their healthy states. An IM specialist, or any doctor who understands what motivates their patients, is better able to help their patients connect the dots of their own stories, guide their treatment plans, define successful outcomes of their therapies and empower them to return to a healthy state of being. Integrative medicine shifts the paradigm from disease to self-healing Patients seeking an IM specialist are eager to take a deep dive into understanding their pain and ailments and shift their mindset and habits to ones that promote hope, health and joyous recovery. In my practice, for instance, instead of fixating on fatigue, I ask my patients to engage in restorative or energizing activities. I encourage my patients with disordered eating to try to see foods as fun and nourishing. For others, instead of focusing on their depression, I ask what makes them sparkle and feel happy. Within a few sessions, my patients progress because they are ready to shift from a state of disease to a state of health. Integrative physicians will ask about a person’s whole life All physicians review their patient's systems, often by having them fill out a head-to-toe questionnaire that starts with “Check the box if you have experienced…” The questions concern weight loss, fatigue, pain, cough, etc. These are essential issues for doctors to know about, but an integrative physician will also review the patient’s lifestyle. My favorite way to gather information—and one that feels less like a “checkbox tool”—is to ask my patients to describe a typical day. As they walk me through their day, I hear about their sleep and dreams, what they eat, their relationships and friendships, what they do for fun, what they do to relax, their spiritual and religious practices, whether they exercise and whom they confide in. This kind of dialogue allows me to get a fuller picture of my patient and what makes them who they are. Integrative physicians spend time connecting with their patients Most initial visits with an integrative physician last 45 to 90 minutes— more than double or triple the time a conventional doctor spends with patients today. These extended visits give patients the time to tell their stories, and the physician can focus, engage and actively listen. The longer visit is arguably a highly valuable and productive use of time because the patient feels heard, the doctor learns more and they build trust, connection and rapport in the therapeutic relationship. A physical examination, laboratory recommendations and other preliminary suggestions or prescriptions may be included during this visit or postponed until the doctor collects medical records and better understands the patient. The frequency of follow-up depends on the patient. Bringing joy to practicing medicine for both doctors and patients In integrative medicine, each visit is unique and focuses on becoming healthy and centered. By exploring multiple paths to achieving health, IM brings joy to health and healing for both patients and physicians. Resources Academy of Pediatric Integrative Medicine Andrew Weil Center for Integrative Medicine Institute for Functional Medicine UCSF Osher Center for Integrative Health Ava Satnick, MD Ava Satnick, MD, is a pediatrician and integrative medicine specialist who is passionate about studying and applying all philosophies of medicine, healing and healthy living to her practice. She helps her patients reap the benefits from all that she has learned and integrated. She completed two fellowships in Integrative Medicine from the University of Arizona Andrew Weil Center for Integrative Medicine and, locally, at Stanford University. She holds additional certifications in lactation consulting, hypnosis, guided imagery and yoga. She recently completed a 200YTT Vinyasa flow/Bhakti immersion certification in India. Ava treats patients (until they’re 26) and their families as they navigate conditions like anxiety, depression, ADHD, headaches, abdominal pain/nausea and IBS pain. She offers lifestyle coaching, breastfeeding guidance and more at her office, Holbrook Health in Portola Valley. avasatnickmd@holbrookhealth.com avasatnickmd.com

Pamela Salzman is a cooking instructor, cookbook author, holistic health counselor and food blogger. Her first cookbook, "Kitchen Matters," was published in June 2017, and her second book, "Quicker than Quick," was released in April 2020. She is the Culinary Nutritionist for "Clean Eating Magazine" and a contributor to the Food Network Kitchen app. Pamela has appeared on numerous media outlets, including The Today Show, The Rachael Ray Show, Hallmark's Home and Family, dozens of local TV shows, GOOP, MindBodyGreen, ELLE magazine, Allure and many others. She shares her family-friendly recipes and nutrition tips on her website, pamelasalzman.com, and social media channels. Pamela lives with her husband and three children in Manhattan Beach, California. In her free time, she enjoys playing pickleball, reading, spending time with friends and—obviously—cooking and entertaining at home! At the salon: Pamela shared her tips on entertaining with ease and joy. She has some simple hacks and systems that are easy for anyone to adopt. She demonstrated some quick appetizers, discussed how to select a good entertaining menu and shared tips on accommodating guests with allergies and different eating styles. She also discussed what ingredients or components can be purchased and not made from scratch. Contact Information: Website: pamelasalzman.com Instagram: @pamelasalzman TikTok: @pamela_salzman Facebook: pamelasalzman Books: Quicker Than Quick and Kitchen Matters She has several courses, including one titled "Entertaining with Ease." She also has a monthly cooking class subscription (although you can purchase individual classes too) Click here to watch the salon video. Click here to view a pdf of the recipes and view the items Pamela suggested to always have on hand in anticipation of entertaining.

Research investigating the potential for psychedelic drugs to treat various forms of disease—particularly psychiatric disorders—has proliferated in recent decades. Indeed, leading health systems such as Massachusetts General Hospital, UC San Francisco, UT Austin and Johns Hopkins Medicine have established research centers worth millions of dollars in recent years to pursue such studies in neuroscience and psychiatry. While psychedelic drugs have been used medicinally and recreationally by cultures across the world for millennia, modern uses in America and other developed countries have been limited in the past several decades as the drugs have been made illegal. While the burden of mental and behavioral disorders on society and our healthcare system continues to increase, research yields more promising findings for treating them—potentially indicating new opportunities for therapeutic uses and incorporation into clinical practice. What are psychedelics? Psychedelic drugs are used to alter states of consciousness. While the term is sometimes used synonymously with “classical hallucinogens,” there are actually three different categories of hallucinogenic drugs: Psychedelics, which act on serotonin (a neurotransmitter that is involved in regulating mood, sleep and your digestive system) Dissociatives, which act on glutamine (the most abundant amino acid in the body) Deliriants, which act on acetylcholine (a neurotransmitter, to inhibit the parasympathetic nervous system) Psychedelics can cause users to see images, hear sounds and feel sensations that seem real but do not exist, leading users to report mystical, spiritual or transpersonal experiences. They may be used in religious or recreational settings. These experiences are typically known as “trips,” and the onset and duration of effects vary widely among drug types. They might lead to short-term effects such as increased blood pressure, breathing rate or body temperature, feelings of paranoia or sleep problems. Though rare, long-term effects may include persistent psychosis and hallucinogen persisting perception disorder (typically observed more often in people with a history of mental illness). Only certain psychedelics (e.g., phencyclidine) are addictive and can lead to tolerance. Psychedelics can be derived naturally from plants and fungi, or they can be manufactured in laboratories. Regardless of the source, most are currently illegal in the US. The most prominent forms include methylenedioxymethamphetamine (MDMA), psilocybin, ketamine, N, N-Dimethyltryptamine (DMT), D-lysergic acid diethylamide (LSD) and mescaline (additional details are presented in the following section). How can psychedelics be used as a form of therapy? Psychedelics are believed to reduce activity in the brain’s default mode network (DMN)—the habitual communication pathway between regions of the brain. Because the DMN is particularly overactive in certain mental health disorders, reducing its activity with psychedelics may help as a treatment to break habitual psychological patterns (and increase brain neuroplasticity and creativity). While it doesn’t directly correct neurochemical dysfunctions in the brain, psychedelic-assisted psychotherapy causes modifications in brain functioning and conscious experience. This, in turn, can lead to meaningful experiences that create emotional, cognitive and behavioral changes—and may lead to improvements in health. Scientific research is actively studying the potential for psychedelics to treat various diseases, including: Depression Anxiety Post-traumatic stress disorder (PTSD) Addiction Obsessive-compulsive disorder Eating disorders (e.g., anorexia nervosa) Research is still being conducted to determine how medications affect neural and physiological status before, during and after treatment and how different environmental conditions (such as light and music) affect status. Psychedelics are considered relatively safe. Indeed, LSD is regarded as one of the safest psychedelics—it’s also one of the most potent and restricted. Research suggests they can be used therapeutically, imposing minimal adverse side effects and without leading to addiction or tolerance. Once studies yield results to show which conditions can be best treated with these drugs (and under which conditions), the goal will be to seek FDA approval to sell them to healthcare providers or patients for clinical use. The most prominent psychedelics currently being researched, and their application areas, are listed in the table below. Psychedelics are distinct from other medical forms of treatment in that they require extensive psychological preparatory sessions, psychological support during the drug administration and integration sessions following the treatment. The integration sessions allow patients to solidify insights gained during their drug sessions and identify plans of action, leading to positive behavior change. The legal history of psychedelics Though research on the use of psychedelics to treat mental disorders began in the 1940s, concern over the adverse effects of non-medical use led to their being assigned as Schedule I under the United States Controlled Substances Act in 1970. (This class is the most restrictively regulated drug schedule and applies to drugs with no currently accepted medical use and a high potential for abuse.) This restriction has prevented their use for medical purposes since the 1970s. While it hasn’t overtly banned research, the restriction imposed significant barriers and delayed progress in research and the broader use of psychedelics in healthcare. However, in the 1990s, the research community renewed its interest in psychedelics, accelerating our understanding of their use in healthcare. The only psychedelic listed above that is legal for use in psychotherapy at this time is esketamine, a nasal spray version of ketamine for which the FDA granted approval for severe depression in patients who don’t respond to other treatments in 2019. Because of the potential for abuse and misuse of the drug and the potential risk of adverse outcomes resulting from sedation and dissociation, esketamine is only available through a restricted distribution system, with supervision from a healthcare provider and with a Risk Evaluation and Mitigation Strategy in place. In 2017, the FDA also granted breakthrough therapy designation for MDMA-assisted therapy for PTSD. This will help optimize the completion of clinical trials (currently being evaluated) to yield data about its suspected effectiveness and inform the agency’s decision-making about legalizing its use. Most recently, Oregon became the first state to legalize psychedelics widely. Ballot Measure 109, passed in November 2020, assigned the Oregon Health Authority to “license and regulate the manufacturing, transportation, delivery, sale and purchase of psilocybin products and the provision of psilocybin services” beginning in 2023. Oregon will become the only state where psychedelics may be legally administered for medicinal purposes (other than the current uses of ketamine across the US). Lobbyists are actively seeking to pass similar bills in other states. Washington, New York, Colorado and California are all currently considering a variety of approaches to legalization. Several cities (e.g., Denver, Ann Arbor, Oakland and Santa Cruz) are also decriminalizing psychedelics. Additionally, other states are researching the potential medical benefits of psychedelics. How does this impact your healthcare? Refer to the Drug Enforcement Agency’s fact sheets to read more about the uses (including the illegal uses for recreational purposes) of these and other drugs. To learn more and/or investigate opportunities to enroll in trials for any mental or behavioral disorders you may be experiencing, read more about the latest research into therapeutic applications from the Multidisciplinary Association for Psychedelic Studies or the specific research centers linked above. Visit the Psychedelic Legalization & Decriminalization Tracker to learn more about how psychedelics are restricted in your state. While these drugs have shown promising benefits for some conditions, none but the nasal spray form of ketamine (to treat depression) has been approved for use; therefore, they may not be used legally. Resources Resources for this article 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/

Have you noticed how food advertising is heavily focused on protein? All kinds of products on the market feature “added protein.” Where did this protein obsession come from? There have always been trends in eating patterns, and the food industry doesn’t waste any time capitalizing on them. But is the protein emphasis really necessary? Are we really that deficient in protein that we need it added to almost everything, including water? The answer for most people is no; you don’t need protein added to everything. Suppose you are a competitive athlete or have other health conditions that require a high-protein diet. In that case, you may need additional protein (but if that’s you, you are likely already aware of your individual requirements and are working with a specialist). But, for the average person following a well-balanced plant-based diet, no “added” protein is needed. Let’s explore why. What is protein? Amino acids are the building blocks of proteins. Protein is made of one or more long chains of amino acids. According to the FDA, an average adult should consume about 0.8 grams of protein per kilogram (1 kg = 2.2 pounds) of body weight per day. For example, a 130-pound (59kg) woman should consume about 47 grams of protein daily. Our protein requirements increase as we age as we combat a process called sarcopenia, or natural muscle loss associated with aging. Therefore, protein intake between 1.2 and 2.0 grams per kg per day or higher is recommended for those over 65. This additional protein recommendation is the same for athletes, yet their needs will vary depending on their training regimen (e.g., endurance training or building more muscle mass). We need 20 different amino acids, 11 of which our body can make on its own. The remaining nine amino acids need to be consumed through our food; they are called essential amino acids. It was once thought that some foods did not contain all nine essential amino acids. They were labeled “incomplete proteins,” and foods that contained all nine essential amino acids were labeled “complete proteins.” More recent science has shown that while some foods contain smaller amounts of certain amino acids, all plant- and animal-based proteins contain all nine essential amino acids. Because animal proteins are more similar in makeup to human proteins, they have an amino acid profile closer to the human body. However, you can get all nine essential amino acids from plant-based protein sources. Why do we need protein? Protein helps to repair and maintain the function of our cells. It helps to build and repair bones, muscles, hair and nails. Protein is also part of our immune system, hormones and enzymes (a vital component that helps reactions in our bodies perform quickly and appropriately). Protein is essential in periods of stress (such as during illness or treatment for certain diseases, like cancer) and periods of rapid growth, including adolescence, pregnancy and breastfeeding. What happens to a protein when it is digested? When a protein is digested, it is broken down into its components, amino acids. Depending on the body’s needs (building muscles, bone, hair, nails, aiding in the immune system and enzyme production), new proteins are formed from various amino acids. Once those new proteins are formed, they are shuttled throughout the body to serve the purpose needed. Any unused protein is excreted through the urine. Excess protein cannot be stored in our bodies like we can store carbohydrates or fats. All that added protein in our food or protein powders often just makes for expensive urine. Plant-Based Protein If you eat a diet of varied fresh foods, including animal protein, the amount of protein you consume in one day meets the FDA recommendation easily. However, if you follow a plant-based diet, below are some great options for meeting your protein needs. Ways to ensure you are getting enough protein in your daily diet Consume a variety of different proteins The variety will easily compensate for the deficit if a food item is low on a particular amino acid. For instance, enjoying lentils with green peas and tofu could provide over 20 grams of protein! Avoid the marketing hype of “added protein” in processed food Rather than buying processed food with “protein added,” concentrate on eating a variety of fresh vegetables, legumes, grains, nuts and seeds. This is a better way to ensure you are meeting your protein requirements. Make sure there is protein in every snack and meal Rather than reaching for a processed box of crackers, chips or a candy bar, consider whole grains, nuts and seeds as great plant-based protein sources. Planning and making snacks ahead of time is a wonderful way to ensure you will get protein in every snack/meal. Here are a few examples: Whole grain piece of bread or celery with nut butter Fresh cut-up vegetables with hummus Home-made granola with an array of nuts, seeds and grains. Plain yogurt and fruit Remember that eating processed and ultra-processed foods is never the best way to get any of your dietary requirements. Increasing your fresh food intake will make you feel better and healthier. Your body won’t miss out on any of that “added protein.” Save your money for the farmers market! Resources Baum JI, Kim IY, Wolfe RR. Protein Consumption and the Elderly: What Is the Optimal Level of Intake? Nutrients. 2016 Jun 8;8(6):359. doi: 10.3390/nu8060359. PMID: 27338461; PMCID: PMC4924200. ncbi.nlm.nih.gov/pmc/articles/PMC4924200/ Dietary Guidelines for Americans, 2015-2020. USDA. health.gov/sites/default/files/2019-09/2015-2020_Dietary_Guidelines.pdf The Nutrition Source, Harvard School of Public Health. hsph.harvard.edu/nutritionsource/what-should-you-eat/protein/ (Accessed Dec. 24, 2022) Nutritionx Track App. nutritionix.com/ (Accessed Dec. 24, 2022) Gardner, C. America’s Protein Obsession, Why? youtube.com/watch?v=Gj3o5A1wp5Q&t=75s (Accessed Dec. 24, 2022) Petre, I & Link R. The 18 Best Protein Sources for Vegans and Vegetarians. healthline.com/nutrition/protein-for-vegans-vegetarians#benefits-and-risks (Accessed Dec. 24, 2022) Phillips SM, & Van Loon LJ. Dietary protein for athletes: from requirements to optimum adaptation. J Sports Sci. 2011;29 Suppl 1:S29-38. doi: 10.1080/02640414.2011.619204. PMID: 22150425. pubmed.ncbi.nlm.nih.gov/22150425/ Erin Presant, DO, CCMS Erin Presant is a board-certified neurologist, fellowship-trained Movement Disorders Specialist and Certified Culinary Medicine Specialist who has practiced in both academic medicine and private practice settings. In 2021, she started Medicine of Yum, a new venture devoted entirely to culinary medicine. Through culinary medicine, Erin loves empowering people to make healthy choices with their food and giving them the tools to be healthier in their kitchens. Medicine of Yum brings evidence-based medical dietary and nutrition guidance to people through virtual teaching kitchens. Her favorite part of the Medicine of Yum teaching kitchens is seeing the dynamic change that happens when people learn and do for themselves in their own kitchens. Erin believes culinary medicine education will help bring about the social and public health changes needed to curb many of the chronic diseases that people struggle with today. medicineofyum.com erin@medicineofyum.com Instagram: @medicineofyum Facebook: medicineofyum

Shauna Shapiro, PhD, is a best-selling author, clinical psychologist and internationally recognized expert in mindfulness and self-compassion. She is a professor at Santa Clara University and has published over 150 papers and three critically acclaimed books, which have been translated into 16 languages. Dr. Shapiro offers a science-based roadmap for how to enhance personal and professional well-being, while building better lives and communities. Dr. Shapiro has presented her research to the King of Thailand, the Danish Government, Bhutan’s Gross National Happiness Summit and the World Council for Psychotherapy, as well as to Fortune 100 Companies including Google, Cisco Systems and LinkedIn. Her work has been featured in the Wall Street Journal, Oprah Daily, Mashable, Wired, USA Today, the Huffington Post, and the American Psychologist. Shauna is a summa cum laude graduate of Duke University and a Fellow of the Mind and Life Institute, co-founded by the Dalai Lama. Her TEDx Talk, The Power of Mindfulness, has been viewed more than three million times. Shauna lives in Mill Valley, CA, with her husband. Together they have four children. In her free time, she loves being out in nature, dancing, traveling, cooking, eating and reading historical fiction romance novels! At the Salon: Dr. Shapiro taught us about the powerful practices to live a happier, healthier more meaningful life. She shared recent discoveries in neuroscience and showed how we can re-architect the very structure of our brain to decrease stress, increase clarity and strengthen our sense of belonging and purpose. We learned how the practice of mindfulness deactivates the centers of the brain responsible for emotional reactivity and helps engage the rational part of your brain so you can make choices aligned with your deepest values. ​ Contact Information YouTube channel Instagram: @drshaunashapiro TedEx talk The Power of Mindfulness Click here to purchase Dr. Shapiro's book, Good Morning I Love You. Click here to purchase the guided journal that accompanies Good Morning I Love You.