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Few foods in the modern diet have such a shadow of confusion surrounding them as the egg. Though a rich and versatile source of protein and micronutrients, many people continue to be concerned about their saturated fat and cholesterol content. Navigating the latest nutrition research is indeed complicated. Many consumers are also concerned about the sustainability and animal welfare of egg production, struggling to understand the difference between labels like "antibiotic-free," "cage-free" and "pasture-raised." Can eating eggs be good for people and good for the planet? How are egg consumption patterns changing? Despite changing recommendations regarding the consumption of cholesterol—and eggs, in particular—eggs have remained dietary staples. Consumption fell slightly around the middle of the 20th century but is now somewhat stable, around 250 eggs per person per year. Average per capita egg consumption in the US, based on USDA Economic Research Service loss-adjusted food availability data. https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/; https://www.ers.usda.gov/publications/pub-details/?pubid=104507 Although chicken eggs are the most common, we also occasionally eat eggs from ducks, geese, quail and even fish (called roe). Varieties like duck eggs may be slightly higher in protein, omega-3 fatty acids and some vitamins, but overall, nutrient content does not vary widely among the different eggs. (Note that fish eggs are much smaller than bird eggs; a 1.5-tablespoon serving contains amounts of most nutrients comparable to those in bird eggs.) What are the nutritional benefits of eating eggs? Eggs are beloved as a quick and affordable source of protein. They can be purchased at most stores for low costs and at high-end farmers markets. It's typically possible to buy two organic eggs for less than $0.75, which is half the price of a serving of organic chicken that would provide the same amount of protein. A large batch of boiled eggs can last many days to feed one person, while a large pan of scrambled eggs can easily feed a crowd. Egg yolks are the most calorie-dense portion of eggs, but they also contain the richest source of micronutrients. Except for patients with genetic lipid disorders, the yolk should typically be consumed along with the white to maximize the nutritional benefits of eggs and minimize waste. In addition to protein (primarily found in egg whites), eggs are a source of many other essential compounds. Egg yolks are one of our richest dietary sources of vitamin D. Vitamin D plays several important roles in our bodies and it's challenging to obtain sufficient quantities through our diet. Two eggs provide 20% of our Recommended Dietary Allowance. So, when combined with a serving of full-fat dairy, fortified cereal and plenty of sunshine (protected with sunscreen, of course), eggs can provide a significant contribution toward a recommended daily dose of vitamin D in the diet. Egg yolks are also excellent sources of zeaxanthin and lutein, two carotenoids known for their role in promoting eye health by blocking blue light and reducing the risk of advanced age-related macular degeneration. Finally, eggs are known for providing a rich source of choline. This essential nutrient is involved in many metabolic and neurologic processes (including supporting memory) and is indeed an important part of the diet. You might recall reading this Insight about TMAO, suggesting that choline is one of several nutrients that increase the production of this atherogenic compound. Choline has also been shown to increase homocysteine in the blood; at high concentrations, this promotes inflammation and dyslipidemia (or elevated blood lipids). However, prospective studies have typically failed to find a significant relationship between choline intake and cardiovascular disease outcomes. Most experts believe that moderate consumption is indeed safe—and even beneficial. Nutrients found in egg white and yolk. Data source: https://fdc.nal.usda.gov/ How have recommendations about egg consumption changed? Until the last decade, health professionals and nutrition researchers typically recommended limiting egg consumption to avoid excess cholesterol. Since each large egg contains more than 180 mg of cholesterol, two eggs provide more than the daily limit of 300 mg previously recommended in the Dietary Guidelines for Americans. However, as we have learned that dietary cholesterol is not closely linked with serum cholesterol (except for in people with genetic lipid disorders and possibly those with diabetes), most researchers now believe eggs should no longer be limited solely due to their cholesterol content. Indeed, according to 2013 and 2020 meta-analyses, moderate egg consumption is not associated with an increased risk of heart disease. It has been suggested that some of the fats called phospholipids found in eggs have a somewhat protective effect against elevating blood cholesterol. A 2019 prospective cohort study in JAMA found the opposite: among U.S. adults, higher consumption of cholesterol or eggs was associated with an increased risk of heart disease and death. The relationship followed a dose-response pattern, meaning higher consumption was associated with a greater risk. A 2022 systematic review and updated meta-analysis also showed that greater dietary cholesterol and egg consumption were associated with increased risk of overall heart disease-related mortality. However, the increased risk was measured based on increments of 1 egg or 300 mg per day, which exceeds the average daily intake of eggs and total cholesterol. Therefore, the findings may not apply to Americans consuming less than this amount. Given the heterogeneity in these findings, recommendations about eating eggs in low to moderate amounts are therefore not likely to change in the near future, but it is important to be aware—as in all areas of nutrition research—that we very rarely know when we reach a sound conclusion. Indeed, a subsequent umbrella review of meta-analyses looking at egg consumption and human health in August 2019 found no association with adverse health outcomes. What are the healthiest ways to eat eggs? Cooking eggs has been shown to increase their protein availability. It also kills bacteria and makes them safe to eat. Since they contain plenty of fat already, they need only be cooked in enough oil to prevent sticking if fried or scrambled. As with many other foods, cooking destroys some micronutrients and other beneficial compounds, such as carotenoids. Overall, boiling seems to lead to less degradation than higher-heat methods like frying and scrambling. Since eggs cooked in water can only reach 212 degrees F, boiling and poaching may be the healthiest ways to eat them. Baked eggs have been shown to contain less vitamin D, which we already have a hard time getting in our diets. Finally, higher-heat cooking causes the cholesterol in eggs to oxidize, meaning they are more atherogenic and stronger contributors to heart disease. Keep in mind that ingredients added to eggs can also support the health benefits of your meal; cooking with extra virgin olive oil and/or adding spices will introduce various beneficial compounds, for example. What are some alternatives to eggs? People may want to find alternatives to eggs to reduce their environmental impact, ensure animal ethical treatment or for other reasons. Other plant-based sources of protein, such as nuts, seeds, legumes and fermented soy products, can be good substitutes (although they don't provide the same micronutrients). Because of their fiber content, ground flax and chia can serve as good binders for those interested in replacing eggs in baked goods. They also contain healthy omega-3 fatty acids and some protein. Aquafaba, which is the liquid in chickpea cans, can be whipped to serve as a leavening agent in baked goods and meringue. This article on egg substitutes offers various alternatives that can be incorporated into different recipes. Following the increasing availability of plant-based meat and dairy products on the market, various brands selling plant-based eggs in different forms have come to market in recent years. The most common versions are made of mung bean isolates and processed oil or soymilk powder and cellulose, though some newer versions have more wholesome ingredients like organic tofu or nuts. Note that most of these products are lower in almost all micronutrients than real eggs; some are also lower in protein. What are the best ways to incorporate eggs into my diet? Choose eggs from pasture-raised hens, if available. These hens can roam outside and have a more nutritious diet, meaning their eggs are also more abundant in nutrients (such as vitamins A and E, omega-3 fatty acids and more). Choosing organic eggs helps to ensure the feed was free of GMOs and antibiotics. The "hormone-free" label on eggs doesn't mean anything, since chickens are never fed hormones to promote growth. If possible, buy your eggs from a farmers market to ensure the farmer earns a decent profit and can vouch for his/her production practices. Two eggs provide 14 grams of protein, which is ample for a meal when incorporated with other components. Restaurants often serve omelets with much more egg than this, so they can be shared or provide plenty for leftovers. The latest evidence suggests it is probably fine to eat eggs a few times a week, but most people should probably not eat them in large quantities or every day. If you choose to avoid eggs (or animal products in general), plant-based sources can provide ample protein and fat. Just ensure you are getting enough vitamin A, vitamin D and other micronutrients from other sources and read the ingredient list to avoid those you don't recognize. Resources The full list of 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/

Nicole Harkin, MD, FACC is a preventive cardiologist who is board certified in Internal Medicine, Cardiology, Echocardiography, Nuclear Cardiology, and Clinical Lipidology. After graduating from Boston University School of Medicine, she attended Columbia University for Internal Medicine residency and New York University for Cardiology fellowship. She is the founder of Whole Heart Cardiology, a preventive tele-cardiology practice that provides cardiac optimization through precision and lifestyle medicine for patients in California, New York, and Florida. Passionate about preventing and treating heart disease through healthful, sustainable lifestyle changes, Dr Harkin works with her patients to create a proactive, personalized cardiac care plan. She is also the Chief Medical Advisor for PlateUp, a health tech start-up dedicated to improving health through nutrition, and is a member of Planted Forward, a comprehensive, multi-speciality telemedicine health team. She proudly serves on several committees, including the American Society for Preventive Cardiology Nutrition Working Group and the American College of Cardiology California Chapter Prevention Committee. She currently lives with her family in Tiburan, CA. When not doctoring, she spends the majority of her time with her three young children. She also enjoys cooking, yoga, Peloton-ing, hiking, and traveling. At the Salon: Join Dr Nicole Harkin, MD, FACC in a discussion about evidence-based, practical tips that you can implement to optimize your heart health. Go beyond the basics and learn what the latest research has to say about heart healthy nutrition, exercise, and more! Contact Information: wholeheartcardiology.com Instagram: @nicoleharkinmd Click here to view Dr. Harkin's presentation. Click here to watch the salon video.

Happy New Year! No, not like an actual new year, but it's the start of the school year and the beginning of another season of offerings from SOUL Food Salon. For as long as I can remember, I've associated September with renewal, fresh starts and light, even as the days start to get noticeably shorter. It's a nod to those back-to-school vibes from my childhood. I loved getting new school supplies, sharpening my pencils and gearing up for the forthcoming year. All these years later, it feels like the perfect time for turning over a new leaf. As with all new beginnings, it may be a good time to reflect on what is working for you, inspiring you, bringing you joy… and to think about what isn’t working for you, what’s draining you, not inspiring you or making you feel small. At the end of the calendar year, we often spend time reflecting and considering goals and resolutions for the new year to come. Since I feel that sense of beginning more keenly at the end of summer, I thought we could try to do that now—in September. I'd like to acknowledge that for many of us, this time of year can feel somber, thanks to the end of our carefree summer days. And it can be anxiety-provoking with thoughts of tight schedules, commitments, etc. that come with the return to school. If that's how September "hits" you, it's still a good time to take stock of how your year is progressing and perhaps make some necessary adjustments. Here are some reflective questions as we all begin our September New Year. I invite you to take this opportunity to find some quiet time to think and see what answers arise. You may want to write down or type out your reflections. This can be helpful because it allows you to look back upon your responses later. Does ­­­_____ support the life I am trying to create? How you spend your time shows you what you care most about. This question may help you focus on something you regularly do that truly does or doesn’t enhance your life. The bottom line is: do your best to spend your time intentionally. What makes you feel most alive? What excites you? What motivates you to get up in the morning? Foster whatever this is. Nourish it, water it and watch it grow. What is something you want to do more of? Perhaps something crafty? Or cerebral? Or maybe you want more time for self-care? Create space for these activities. What is something you need to do less of? What takes away your joy? Is it a toxic relationship? Ruminating about the past and/or future? What changes could you make so you’re doing less of this? What is your favorite way to refuel? Spending time with friends and family? Spending time alone? Spending time out in nature? Resting? Reading? Refueling is critically important for our overall well-being. If you don’t have enough energy for yourself, you won’t be helpful to others. What is something you want to learn this year? What are you curious about? Learning something new and exploring novel terrain can take you on a trip of expansive possibilities. Take a moment to sit back and think about what you notice in your responses to these questions. Have your answers surprised you? If so, maybe you can make some changes or tweaks to your patterns of behavior. I encourage you to focus more on growth setting rather than goal setting. Can you be more intentional about engaging in activities that make you feel alive and aligned? So, sharpen your pencils and gear up for a beautiful New Year! May it be interesting, engaging and full of joy. Jeanne Rosner is a board-certified anesthesiologist who practiced pediatric anesthesia at Stanford Medical Center for nearly 20 years. In 2011, she began teaching nutrition classes in her son's 5th-grade science class. It was an "aha" moment for her. She realized that learning and teaching about nutrition, health and wellness in her community was her destiny. Since retiring from anesthesia, she has been a nutrition educator at local middle and high schools throughout the Bay Area. She teaches students about the importance of eating food closest to the source, making good food choices and eating in a balanced and moderate way. Jeanne started SOUL (seasonal, organic, unprocessed, local) Food Salon in 2014. SOUL Food Salon's mission is to educate and empower people to be healthier. She holds events (salons) at which experts in the health and wellness community share their knowledge on how to lead a healthier life. www.soulfoodsalon.com jeanne@soulfoodsalon.com Instagram: @soulfoodsalon

Do you Wordle? What about Quordle? Who knew there were so many five-letter words! There’s such satisfaction from completing a daily word puzzle, but there’s more at play, too. It is also about connection and communication with others. I love sharing my daily Wordle results with friends and family—and equally enjoy seeing how they fared when they share their results. It’s also cerebral and challenging. And, for some, it’s a form of meditation—a short respite of focused concentration that is apart from your daily to-do list. There’s anticipation as you type in your starter word. Will all the tiles flip green on your second try? Or, will your adrenaline start pumping as you reach the fifth or sixth attempt? My Wordle friends and I cheer each other on. We applaud when one of us solves the puzzle within the first few tries and commiserate when it takes the full six shots. If you aren’t doing Wordle yet, give it a go. Not only will you enhance your brainpower, but you’ll enjoy the connection with your community. We use words every day, yet most of us don’t think about how truly powerful they are. I’ve been reflecting lately about how important words have become to me. Between playing Wordle and Spelling Bee and my unbounded appetite for reading, I feel I just can’t get enough words! I’ve always been a voracious reader. I love to curl up on the couch and become entirely absorbed in a good book. And I so enjoy sharing book recommendations with others, especially historical fiction—my favorite genre. Keeping with the theme of words and their power, check out this compelling book, The Rose Code by Kate Quinn. It is set during WWII, a short distance from London, and it tells the story of the very real Allied code breakers. I felt as if I was in the trenches with the code breakers as they worked to unlock the German war codes—the words were literally jumping off the pages. I’ve also been musing about how we can all use the power of words for good. One of my dearest friends Danielle is a master complimenter. She often stops complete strangers and enthusiastically tells them that she loves their shoes or how fabulous their hair looks. She’s been known to approach a group of women dining near her at a restaurant and tell them how beautiful their friendship appears. Imagine that. I marvel at this superpower of Danielle’s, and I try my best to emulate it. Using words to compliment has such power, and it impacts both the bearer and the recipient. Words also have context. Sometimes when I get a text or an email, I have to spend time thinking before I respond. Words can communicate emotions and thoughts in so many different ways. When they’re expressed in writing—without the benefits of seeing any accompanying body language and facial expressions or hearing the speaker’s tone—it is so different from when we are speaking in person. We have to consider at least some of these questions: What does the writer intend? How does this relate to any prior communication? What is this person like, and what might they mean by ____? If I misinterpret or miscommunicate, then what happens? Another thing I try to do is complete any circle of communication so that we each feel seen, heard and validated. And I try to use thoughtful words. The powerful words of others inspire me. They help me reflect on how I am in the world and/or how I want to be and grow. I may find something calming and instructive in them, as I often have in this quote from Rumi: “Yesterday I was clever, so I wanted to change the world. Today I am wise, so I am changing myself.” Have you ever picked a word to define a focused theme for your year? You might enjoy this exercise, which serves to emphasize something that you feel is important. There are no set criteria for your word choice; you can pick an adjective, a noun, an emotion—really, whatever you see fit. Some words that I have used over the years are balance, inspire and healthy. Consider using the same word in your mindfulness practices to help keep you focused throughout the year. Periodically referring back to it can become an accountability routine: how is your word informing your year? Words can transport us—they are incredible, inspirational and instructive. So enjoy them, play with them and use them wisely. Jeanne Rosner, MD Jeanne Rosner is a board-certified anesthesiologist who practiced pediatric anesthesia at Stanford Medical Center for nearly 20 years. In 2011, she began teaching nutrition classes in her son's 5th-grade science class. It was an "aha" moment for her. She realized that learning and teaching about nutrition, health and wellness in her community was her destiny. Since retiring from anesthesia, she has been a nutrition educator at local middle and high schools throughout the Bay Area. She teaches students about the importance of eating food closest to the source, making good food choices and eating in a balanced and moderate way. Jeanne started SOUL (seasonal, organic, unprocessed, local) Food Salon in 2014. SOUL Food Salon's mission is to educate and empower people to be healthier. She holds events (salons) at which experts in the health and wellness community share their knowledge on how to lead a healthier life. www.soulfoodsalon.com jeanne@soulfoodsalon.com Instagram: @soulfoodsalon

Spices are an essential component of any kitchen to support a healthy diet. They make food more interesting by adding variety and exciting colors and flavors. They can also act as a preservative. Finally, spices and herbs are potent sources of antioxidants, potentially conferring health benefits when used in cooking. However, recent studies have shown they can contain high levels of heavy metals, which can be harmful to health—especially for vulnerable populations. So, how can you enjoy and even benefit from using these basic cooking ingredients while also minimizing your risk of exposure to potentially toxic chemicals? Sources of heavy metals Metals exist throughout the environment, and we interact with them every day. Many are even essential for us to consume (in very small amounts) for our body to function properly; iron, copper and zinc, for example, are all important micronutrients to consume regularly. Those with relatively high densities or atomic weights are classified as heavy metals and are not beneficial to consume. While these heavy metals exist naturally in the soil, their relative concentrations vary by location. Anthropogenic (or human-caused) drivers such as soil erosion, coal burning and plastic production have enabled more metals to enter the water and air over time, leading to more integration into growing food crops and other materials made into products for human consumption. And they don’t just enter the food supply during agricultural production—they can also enter our food through processing equipment or packaging. As a result, we may encounter metals through industrial manufacturing, healthcare products, cosmetics and homewares, in addition to our diet. Unfortunately, they are still intentionally used in other consumer products, such as dental fillings and cigarettes. Health risks of heavy metals The four heavy metals of greatest concern for human health are lead, arsenic, cadmium and mercury. While minimal amounts of some metals may be tolerable, lead has been determined to have no safe minimum level. In the short term, ingestion of excessive amounts of heavy metals can lead to poisoning, with symptoms including confusion, numbness, vomiting, fatigue, etc. In the long run, metal exposure can also increase the risk of cardiovascular disease, cancer, reproductive failure, kidney disease and more. Children are at particularly high risk due to their developing brains; metals can act as neurotoxicants that impair brain development. Recent research also reveals links with neurodegenerative diseases, like Parkinson’s disease and Alzheimer’s disease, in adults. While the body can naturally remove some amount of these metals, they can accumulate over the years and be stored in the bone, brain and elsewhere for a long time. Metals in pregnant women’s blood can also accumulate in higher concentrations in their developing fetuses. Therefore, it’s important to minimize human exposure—especially for high-risk populations, such as pregnant women and young children. The FDA monitors metal levels in our food supply through its Total Diet Study and sets recommended limits in our food; these limits aren’t enforceable, though. Further, many types of food (including baby food) contain dangerous levels that exceed these limits. The limits also don’t account for potential harm from bioaccumulation (or build-up of substances in an organism) or possible synergistic effects. A Toxic Elements Working Group in the FDA’s Center for Food Safety and Applied Nutrition aims to reduce the public’s exposure by evaluating which products among those it is testing impose the highest risk, which populations are at the highest risk and what policies and actions it should consider to reduce exposure. However, ongoing reports of high metal concentrations in our food and water supply lead many to believe more action is needed. One example of progress comes from New York State, which has just lowered its limits for heavy metals in spices by almost five times to be the lowest in the US. This enables the Department of Health to recall or seize spices with even very small amounts of lead, cadmium or arsenic. Contamination in herbs and spices When evaluating exposure to harmful chemicals and making recommendations to patients and the public, health professionals (and especially dietitians) typically focus on foods and beverages consumed frequently and in large amounts—such as water, meat, dairy, grains and salad greens. However, herbs and spices can also contain harmful levels of heavy metals and should be considered as contributors to daily exposure. A 2019 study by the New York City Department of Health and Mental Hygiene, representing 10 years’ worth of data, showed that more than half of all spice samples contained lead, and more than 30 percent had more than the allowable limit for certain food additives. Further, spices sourced from abroad were most at risk of heavy metal contamination—sometimes 25 times higher than domestic varieties—and spices imported from Pakistan, Bangladesh, Nepal and Morocco had the highest concentrations of lead (these also happen to be areas with minimal regulation). While the US produces some of the spices we consume, the majority are imported because they rely on tropical or subtropical climates to grow. More recently, a widely publicized Consumer Reports study revealed that spices across 126 samples contained concentrations of heavy metals that were detectable and high enough to pose health risks when eaten in regular serving sizes. Herbs—especially thyme and oregano—tended to have higher levels than spices. Further, contaminated samples weren’t restricted to specific brands or non-organic varieties, either. Unfortunately, some spices may be adulterated, with manufacturers adding metals (especially lead chromate) to increase a spice’s weight and color. At least 13 brands of turmeric were recalled in the US between 2011–2017 due to high lead content. Following this increase in recalls, the FDA issued an important alert, allowing ports to detain future shipments from specific importers—especially from companies in Bangladesh and India that were of the greatest concern. As a more extreme example, a 2019 case report by the Southern Nevada Health District showed a two-year-old boy with a blood lead level of 48 μg/dL (compared to a reference range of <5 μg/dL as of October 2021) measured during his routine well-child visit. The high lead concentration was eventually attributed to the turmeric powder in his family’s home. These issues have led many researchers to call for the FDA to establish maximum allowable levels of metals in spices and educate clinicians and public health officials about the consumption of turmeric and other spices and herbs as a potential cause of heavy metal poisoning. Tips for minimizing your exposure Want to minimize your exposure and reduce the risk of potential harm from consuming heavy metals? There are several strategies you can use. Certain cooking methods may help to reduce our exposure to heavy metals in herbs and spices. However, the evidence is limited and somewhat contradictory. A better strategy is to minimize the foods that contain these heavy metals in your diet and be aware of potential adverse effects. When buying herbs and spices, choose ones grown in the US—and especially from reputable sources that have tested their soil or harvested products. The Consumer Reports study consistently recorded the lowest concentrations of heavy metals in the Simply Organic and Penzey's brands; on the other hand, brands like Great Value and Badia typically contained more. If you’re able, consider growing as many herbs as possible at home (even indoors in pots in the window). Herbs can then be harvested, dried and stored in glass bottles or jars on your spice rack. Minimize exposure to heavy metals through other parts of your diet by filtering your water, reducing rice consumption (and buying rice grown in California, India or Pakistan, when possible) and eating fish lower on the food chain (limiting large fish like swordfish, orange roughy and tuna), etc. If you are concerned about exposure to metals, talk with your doctor about having your blood checked. Children should already be checked for lead annually, helping parents know to take corrective action through dietary exposure if the level is concerning. Consider signing Consumer Reports’ petition to the FDA to limit heavy metals in our food products. Resources The full list of 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/

Linda Shiue is a practicing physician, chef and founder of Thrive Kitchen at Kaiser Permanente, San Francisco, a popular vegetable-forward teaching kitchen to inspire people to cook for health. She believes that the best medicine is prevention. Her cooking classes showcase seasonal produce, lavishly flavored with spices and fresh herbs. Her food writing has been published widely and she has been interviewed frequently on television and in print. ​ After she took her first French cooking class at age seven, it took almost 40 more years before she finally went to culinary school at the San Francisco Cooking School. In between, she studied anthropology and medicine at Brown, with fieldwork in rural Sichuan, China, and in uber-urban Singapore, continued her medical training at the University of California, San Francisco, and learned about plant-based nutrition at Cornell University. She has been known to play spin-the-globe to choose travel destinations. An enthusiastic eater, she inspires strangers to copy her order and restaurant chefs to send her a little something special. In addition to practicing medicine and running Thrive Kitchen, she is the mother of two teenage daughters in San Francisco. Spicebox Kitchen: Eat Well and Be Healthy with Globally Inspired, Vegetable Forward Recipes is her first cookbook. ​ At the salon: Linda shared her journey to practicing culinary medicine and founding a teaching kitchen for patients and her approach to healthy cooking, which focuses on flavor first. We learned about her debut cookbook, Spicebox Kitchen, which combines her training in medicine with her love of cooking and offers spice-filled recipes inspired by her travels. Dr. Shiue demonstrated a few recipes from Spicebox Kitchen. ​Contact information: linda_shiue@hotmail.com Instagram: @spiceboxtravels Follow Linda's culinary adventures at spiceboxtravels.com Click here to purchase Linda's cookbook Spicebox Kitchen Click here to get the recipes from this salon. Click here to see Linda's salon presentation.

Americans have recently stepped up their research into how to optimize their health—perhaps prompted, in part, by the ongoing COVID-19 pandemic. From our expanded interest in dietary supplements to paying more attention to what is in our food, we are re-examining the role that antioxidants play in preventing chronic and infectious diseases. While antioxidants can be found in many different foods and supplements, the potential health benefits of some of them have yet to be proven. What are the physiological roles of antioxidants? Our bodies form molecules called “free radicals” as a natural byproduct of metabolism and exposure to external factors such as environmental pollution, excessive sun exposure, cigarette smoke and unhealthy foods. These molecules are chemically unstable and can lead to uncontrolled cascades of reactions, resulting in damage in our DNA, lipoproteins (or molecules that transport lipids) and other molecules. A high presence of free radicals creates a state of “oxidative stress.” Eventually, this damage and stress can lead to heart disease, cancer, Parkinson’s disease and many other chronic medical conditions. The role of antioxidants is to help stave off this oxidative stress by giving up electrons to free radicals—which stops the process. See our previous post about oxidative stress for more information. Where are antioxidants found in our food? There are likely thousands of different types of antioxidants, each with very different chemical structures, functions and sources. These compounds may include certain vitamins, minerals or other chemicals found in plants (or phytochemicals). Some of the most familiar include vitamin C, beta-carotene and resveratrol. When we eat antioxidant-rich fruits and vegetables, we benefit from the antioxidant molecules that protected the living plants. Indeed, plant-based foods—ranging from green leafy vegetables to seeds to red fruits—are typically the richest dietary sources of antioxidants. A few, such as selenium and coenzyme Q10, are found in animal foods (like shellfish and organ meats). Refer to the table below for some of the antioxidants mentioned in this paragraph. Click here for a more complete list of antioxidants with their food sources and associated benefits. Spices and herbs can also be a great dietary source of antioxidants because they provide concentrated sources of the antioxidants found in fresh plant material. The five most concentrated sources are cloves, oregano, ginger, cinnamon and turmeric; interestingly, these all come from different parts of their respective plants. For example, cinnamon comes from tree bark, while ginger comes from a plant’s root. Thankfully for home cooks, scientists have found that spices retain most of their antioxidant properties when dried, making them nearly as nutritious as fresh varieties. Spices have been used for medicinal and functional purposes for many thousands of years; long before societies knew about their chemical composition, their antioxidant activity provided potent healing properties that made them valuable worldwide. Cooking methods that apply heat can destroy antioxidant content in foods, however. In general, cooking for less time with a dry heat method will help to retain the most antioxidants. Refer to our Instagram post on this topic to read more about the best cooking methods to retain nutrients (including antioxidants). What is the evidence for the impact of antioxidants from food and supplements on our health? Antioxidants have received public attention since the 1990s, and a significant amount of research continues to investigate their potential roles in promoting health and treating disease. While diets rich in foods containing antioxidants are commonly associated with reduced disease risk, there is little evidence to show that individual antioxidants can play a significant role in preventing chronic disease. In 2010, researchers from the USDA Nutrient Data Laboratory created a food database based on the Oxygen Radical Absorbance Capacity (ORAC) of Selected Foods scoring system. This assay, developed first in 1993, measures the extent to which the antioxidants inhibit oxidation in certain foods; a higher score indicates more benefit. Dried parsley has a score of 76730, for example, while a typical beer may have a score of 150. But while this system theoretically provides a handy method for ranking foods and making recommendations about foods to prioritize to patients and the public, scientists have since questioned its accuracy and usefulness. Their concerns are that the scores foods are given don’t necessarily translate to antioxidant activity in the body, nor does it account for other important nutritional factors such as fiber content. While many food companies capitalized on this rating system to market their products, such claims are not based on the latest evidence and can thus be misleading. Overall, researchers are still uncertain whether consuming large amounts of antioxidants in supplement form benefits health. There is also some concern that consuming antioxidant supplements in excessive doses may be harmful. The Food and Drug Administration doesn’t regulate dietary supplements for safety, purity, and effectiveness, so buyers must be aware of the potential variability in their quality. Overall, leading health organizations such as the National Cancer Institute and the American Institute for Cancer Research recommend consuming abundant antioxidants through food rather than isolated supplements to prevent potential negative effects and until further research can prove efficacy and safety. Further, antioxidants generally function best in combination with other chemicals—including other antioxidants—further indicating that whole foods are likely the optimal source. Food may also contain more diverse types of antioxidants than supplements; for example, alpha-tocopherol is the form of vitamin E commonly found in supplements, while in food, eight forms of vitamin E naturally exist. Each form can play a different role in the body, suggesting that we can benefit most from consuming a variety of forms. How can I incorporate more antioxidants into my diet? Aim to consume as much as you can through a plant-rich diet and talk with your dietitian or doctor about taking supplements if you have known deficiencies or cannot eat sufficient amounts through food. Try to eat foods as close to their whole form as possible to maximize the number of antioxidants you will consume. While you don’t need to eat all raw foods, eat foods prepared in a variety of ways (including some in raw form) to optimize intake of all important nutrients. Eat foods with as many possible colors (including white: onions, garlic) to ensure you’re consuming all of the antioxidants your body needs to protect itself. Use a variety of spices and herbs in your cooking every day to add additional sources of antioxidants. Enjoy the exciting flavors they add to your food, as well. When possible, choose wild foods—such as wild blueberries, dandelions and sockeye salmon—to maximize the potential antioxidant content of your meals. For more tips about choosing foods high in antioxidants, visit Eatwild.com. Resources Cao G et al. Oxygen-radical absorbance capacity assay for antioxidants. Free Radical Biol. Med. 1993; 14:303-311. pubmed.ncbi.nlm.nih.gov/8458588/ Harvard TH Chan School of Public Health. “Antioxidants.” hsph.harvard.edu/nutritionsource/antioxidants/. Linus Pauling Institute. “Lignans.” Oregon State University. Updated in 2010. . https://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/lignans. Medline Plus. “Antioxidants.” US National Library of Medicine. medlineplus.gov/antioxidants.html. National Center for Complementary and Integrative Health. “Antioxidants: In Depth.” nccih.nih.gov/health/antioxidants-in-depth. Tempest, M. Adding Spice for a Healthier Life—Evidence Shows Antioxidant-Rich Herbs and Spices May Cut Chronic Disease Risk. Today’s Dietitian. 2012; 14(3): 40. todaysdietitian.com/newarchives/030612p40.shtml. Tempest, M. Antioxidants—Research Continues to Reveal Their Health-Promoting Effects. Today’s Dietitian. 2011; 13(5): 32. todaysdietitian.com/newarchives/050311p32.shtml US Forest Service. “Tannins.” https://www.fs.fed.us/wildflowers/ethnobotany/tannins.shtml. 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/

Erin Gleeson is the New York Times bestselling cookbook author and artist behind the lifestyle brand "The Forest Feast." After working in New York as a food photographer, she left the city for a cabin in the woods, taking her work in a whole new direction. Inspired by local California produce, she has created five vegetarian cookbooks and a line of products that showcase her unique blend of photography overlaid with watercolor illustrations and hand lettering. Erin's latest book, The Forest Feast Road Trip, is about her culinary road trip through California. Her work has been featured in publications including The New York Times, Huffington Post, The San Francisco Chronicle, Food52, O, The Oprah Magazine, InStyle, MindBodyGreen, and People Magazine. Erin's goal is to inspire people to be creative at home, to cook more with vegetables and to share meals together. She lives in Woodside, CA with her husband, Jon, and their three kids. At the Salon: Erin shared stories about her California culinary road trip—visiting farms, wineries, ranches, farmers' markets and restaurants to create the 100 vegetarian recipes featured in the book. She discussed how she uses her own watercolor illustrations and photography to lay out the pages of her book. Erin also shared a few recipe demonstrations. ​ Contact Information The Forest Feast website theforestfeast.com Instagram: @theforestfeast Facebook: @theforestfeast TikTok: @forestfeast Newsletter sign-up: theforestfeast.com/subscribe Click here to purchase Erin's cookbooks. Click here to get the recipes from the salon.

When I counsel my clients on their nutrition and eating patterns, the topic of exercise always comes up. Adding movement to your daily routine can do wonders for your physical and mental health. However, there are many misconceptions about exercise and its benefits. Here are the top exercise myths that I discuss with my clients. Myth One: You need to exercise to lose weight Many clients tell me they are unable to lose weight because they don’t exercise. But, in fact, exercise plays a very small role in weight loss. In studies that examined weight loss from either diet or exercise, only 20% of weight loss could be attributed to exercise. Your metabolic rate determines how many calories your body burns in a given day. It comprises three components: your resting metabolic rate, physical activity and energy for food digestion and absorption. Your resting metabolic rate—the one you have very little control over—makes up most of your metabolic rate. How active you are accounts for just 15–30% of your metabolism. In addition, exercise does not burn many calories. On average, a moderate 30-minute workout burns around 120 to 400 calories, depending on the type of exercise and your body weight (more in this article). That calorie burn equates to one large banana or a plain bagel with cream cheese. The other side effect of exercise is that it makes us hungrier because of our body’s need to refuel and replace the energy that was lost. Focusing on what you eat can lead to the biggest weight loss gains. Myth Two: Weight training will make you bulky Women generally shy away from strength training because they believe that lifting weights will make them look bulky. While it is not impossible to get a bodybuilding physique, it takes a lot more time and energy than the average person spends in the gym to reach that potential. Another reason why women will not bulk up can be attributed to our hormones. Women have less circulating testosterone than men, and testosterone is directly related to muscle mass and strength. Therefore, one of the best benefits of weight training is building that lean muscle mass as it is a good way to raise your resting metabolic rate. Myth Three: There’s no such thing as too much exercise While movement has its benefits, too much exercise can be harmful. While low to moderate amounts of exercise can help reduce inflammation and reduce oxidative stress, too much exercise can have the opposite effect. This is known as the J-curve of exercise, which compares the intensity of movement to adverse health risks. Being completely sedentary clearly puts your health at risk. As the amount of exercise increases, the benefits to your health increase. However, there is an inflection point where increasing exercise intensity starts to become less beneficial for you. Too much exercise can: Suppress your immune system. Several studies on runners have shown that exercising more 1.5 hours can impair the body’s ability to fight infections. In fact, marathon runners are two to six times more likely to develop upper respiratory tract infections than non-marathon runners (see more here). Increase your stress hormones. Prolonged exercise or training at high intensities over a long period may cause your body to over-produce epinephrine and cortisol. When these hormones remain elevated, your body stays in a stressful state, affecting the sympathetic nervous system and increasing inflammation. Affect your gut. Runner’s diarrhea is real. This is because intense exercise redirects the blood flowing to your intestines to other areas of your body that need support (such as muscles and tissues). When this happens, the intestinal cells are basically starved of the nutrients they need to function. Additionally, exercise at or above two hours at a 60% VO2max may increase intestinal permeability, allowing potentially harmful agents to sneak into your circulation. Myth Four: Doing sit-ups will help you lose weight in your mid-section While having a strong core is important, performing abdominal exercises for the sole purpose of shrinking your belly is not an effective way to exercise. Fat may be broken down during exercise and used as energy, but those fat cells can come from anywhere in the body, regardless of the area being exercised. Several studies have shown that spot reduction does not work. Instead, it is more effective to combine strength and cardiovascular movement to both tone up areas and lose body fat. Myth Five: If the scale isn’t going down, I must not be exercising enough The number on the scale is just a number; it is not a reflection of your health. This concept is essential for anyone who is trying to improve their health by incorporating exercise. Exercise builds muscle, and muscle weighs more than fat. So, if you are working out and eating healthy, it is quite possible that your progress will not be reflected on the scale. Instead, try using other metrics to track progress, such as body measurements, labs and how your clothes fit. Fact: Exercise has MANY benefits that can help improve your health and wellbeing There are very few downsides to including moderate exercise in your daily routine. Some of the very important benefits of movement include: Strength exercises help boost your metabolism by building up lean muscle mass. Exercise can improve your blood sugar. This is because physical activity helps the cells absorb sugar from the bloodstream to lower your blood glucose more efficiently. In other words, exercise can help improve insulin sensitivity. Physical activity can boost your mood. Regular exercise can help you sleep better. One study found that 150 minutes of moderate to vigorous exercise per week for six months improved sleep quality for women diagnosed with insomnia. Exercise that uses either your own body weight (running, walking, dancing) or weights can help strengthen your bones and improve bone density. Moving your body can have a positive and powerful impact on your overall health. Just remember to: Combine healthy eating habits with exercise to make a bigger impact on your wellness goals. Focus on moderate exercise most of the time. Incorporate resistance training to support lean muscle tissue and boost your metabolism. Vary your exercises to build strength and cardiovascular health. Avoid using a scale to track your progress. Resources Borghouts LB, & Keizer HA. (2000). Exercise and insulin sensitivity: a review. International Journal of Sports Medicine;21(1):1-12. doi: 10.1055/s-2000-8847. thieme-connect.com/products/ejournals/abstract/10.1055/s-2000-8847 Costa RJS, et al. (2017), Systematic review: Exercise-induced gastrointestinal syndrome-implications for health and intestinal disease. Alimentary Pharmacology and Therapeutics, 46(3): 246-265. doi:10.111/apt.14157. onlinelibrary.wiley.com/doi/full/10.1111/apt.14157 Gleeson, M. (2007). Immune function in sport and exercise. Journal of Applied Physiology, 103: 693-699. doi/full/10.1152/japplphysiol.00008.2007. journals.physiology.org/doi/full/10.1152/japplphysiol.00008.2007 Hartescu I, Morgan K, Stevinson CD. (2015). Increased physical activity improves sleep and mood outcomes in inactive people with insomnia: a randomized controlled trial. Journal of Sleep Research, 24(5):526-34.doi: 10.1111/jsr.12297. onlinelibrary.wiley.com/doi/full/10.1111/jsr.12297 Harvard Health Publishing (2021). Calories burned in 30 minutes for people of three different weights. Retrieved from health.harvard.edu/diet-and-weight-loss/calories-burned-in-30-minutes-for-people-of-three-different-weights. O’Keefe, EL, et al. (2020). Training for longevity: The reverse J-curve for exercise. Missouri Medicine, 117(4): 355-361. ncbi.nlm.nih.gov/pmc/articles/PMC7431070/ Roberts, BM, Nuckols, G, Krieger, JW. (2020). Sex differences in resistance training: A systematic review and meta-analysis. Journal of Strength and Conditioning Research, 34(5): 1448-1460. Doi: 10.1519/JSC.0000000000003521. journals.lww.com/nsca-jscr/fulltext/2020/05000/sex_differences_in_resistance_training__a.30.aspx Sullen, SH, et al. (2012). The effect of 12 weeks of aerobic, resistance or combination exercise training on cardiovascular risk factors in the overweight and obese in a randomized trial. BMC Public Health, 12: 704. Doi: 10.1186/1471-2458-12-704. bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-704 Annie Rubin, MSN, RDN Annie Rubin is a registered dietitian and holds a Master’s degree in Nutritional Science. She completed her dietetic internship at Stanford Health Care. Before starting her private practice, Annie worked at Stanford as an outpatient dietitian in the Bariatric and Metabolic Interdisciplinary (BMI) clinic for surgical and non-surgical weight loss patients. She is currently the dietitian at The Wellness Studio at The Village Doctor. Annie is also an adjunct professor at San Jose State University in the Nutrition, Food Science, and Packaging Department. In her spare time, Annie loves to run, hike and spend time with her family. Contact: arubin@villagedoctor.com www.villagedoctor.com Instagram: @the.autoimmune.dietitian

Did you know that our gut bacteria are involved in regulating sleep and muscle function? While most of us now know that they play a role in gastrointestinal function and perhaps even that they contribute to immune function, there's much we're still learning about how our microbiome impacts our health. Let's look at some of the latest research into the microscopic organisms living all over our bodies—and how they affect our health. There are some exciting new findings. Overview of the microbiome The human body contains trillions of microorganisms, with unique composition in each body part. All of the genetic material in these microorganisms is referred to as the "microbiome," while "microbiota" refers to the organisms themselves. Most of the microorganisms are bacteria; there are also viruses, protists, fungi and archaea. These organisms play a role in digestion, vitamin synthesis, immune function (both in the intestine and elsewhere in the body), formation of new blood vessels—and more. The bacteria in our gut metabolize certain molecules from our diet, and the types of food we eat (as well as our other behaviors and environmental exposures) can encourage the growth of bacteria that tend to promote either good health or inflammation and disease. While we are born with distinct populations of bacteria, we can change our diet and other behaviors to encourage the growth of the health-promoting species. Phytonutrients Dietary recommendations to foster healthy microbiota have traditionally focused on eating fiber-rich foods (especially those containing prebiotics, or molecules that fuel beneficial bacteria) and fermented foods containing probiotics (or live beneficial bacteria). Recent research suggests that gut bacteria metabolize phytonutrients, which are the chemicals produced by plants that we have long known to be beneficial to our general health—indicating these chemicals are also an important fuel for our microbiota. A 2021 study showed that various types of carotenoids (one group of phytonutrients) were associated with a greater diversity of gut bacteria, which is typically a marker of good health. Microbiota may modify these phytonutrients and/or their metabolites to increase their bioavailability or functions in the body and lead to health benefits. Many of the foods rich in phytonutrients are also rich in fiber—e.g., brightly colored berries, leafy green vegetables, nuts, seeds, etc. However, this new evidence adds an additional avenue through which they benefit our health; it could also suggest that using cooking methods that maintain phytonutrient content (or even facilitate synergistic effects), taking supplements containing phytonutrients and eating heirloom plant varieties or foods grown with organic or regenerative practices can be additionally beneficial for our microbiota. Brain health The gut-brain axis is comprised of biochemical signaling between the gastrointestinal tract and the central nervous system (CNS) and has been well-described. Gut microbiota produce molecules that maintain the blood-brain barrier (the tightly packed cells in the blood vessels leading to the brain that block harmful substances from accessing the brain) and neurochemicals (such as serotonin, a hormone that stabilizes mood) that enable them to communicate with and affect the CNS. Dysbiosis (or microbial imbalance) leads to inflammatory conditions that can also drive various pathologies of the CNS (e.g., Alzheimer's disease, autism spectrum disorder). New information about specific areas of disease and promising interventions continues to be revealed. For example, a 2021 study demonstrated that Parkinson's disease—a disorder of the CNS that impairs movement—is associated with changes in gut microbiota composition. The onset of the disease hinders the bacteria's ability to break down fat and produce and process bile acids, which are needed to facilitate digestion and absorption of fats and fat-soluble vitamins in the small intestine. These findings suggest that bile acid production disturbances could be a potential indicator of the condition and that treatments targeting the microbiome and bile acids could help delay the disease progression. Of course, consuming an anti-inflammatory diet continues to be important to help prevent such diseases in the first place. Gut microbiota are also associated with sleep quality. Bacterial metabolites and their effects on the nervous and immune systems can regulate sleep; further, changes in gut microbiota composition have been shown to align with sleep disorders/disturbances in humans. These relationships suggest that dietary modifications—like increasing your intake of prebiotics and probiotics—may be appropriate treatments to improve your sleep quality. Pulmonary health The connection between the gut microbiota, lung function and disease is known as the "gut-lung axis." While they should typically exist in homeostasis (or equilibrium), the inflammation and other impairments to immune function caused by dysbiosis contribute to acute and chronic lung disease. SARS-CoV-2 infection, for example, has been shown to disrupt this relationship, and COVID-19 patients with gastrointestinal symptoms (which is indicative of dysbiosis) were more likely to also have acute respiratory distress syndrome—further suggesting a link between these two seemingly disparate areas of the body. New targets for treatment are arising from our growing understanding of these connections. More specifically, dietary interventions have been shown to reduce the risk of and improve the outcomes for several respiratory diseases. For example, a fiber-rich diet—which helps to modify the composition of the gut microbiota and increase the production of their beneficial metabolites—has been observed to reduce airway inflammation in asthma and chronic obstructive pulmonary disorder (COPD). Also, high fiber intake, specifically from grains and fruit, was associated with a reduced risk of COPD. Skeletal muscle and physical activity The gut microbiota are also connected to exercise and muscle mass and function. Results of a recent study by McCarthy et al. suggest that dysbiosis can impair the growth of skeletal muscles following exercise. While physical activity breaks down muscle, it is followed by a period of regrowth when sufficient nutrients are available. This subsequent regrowth is necessary to develop resilience and increase our capacity to withstand the activity in the future; healthy gut microbiota apparently support this process. A 2020 systematic review showed that physical activity (regardless of type) significantly affects the composition of the gut microbiota and the metabolites they produce. Unfortunately, there is currently insufficient information to generate any specific recommendations for physical activity to promote the healthy composition of the gut microbiota. Supporting a healthy microbiome Precision nutrition—or the application of evidence-based, personalized nutrition recommendations—has accelerated thanks to the advent of digital health technologies that collect data and the science informing the analyses of those data (including information about the microbiome). Notably, this is a nascent area, and it is not used frequently in clinical practice. Further, many of the technology companies that generate information about patients' microbiota (or other data) do not provide sufficient explanation, dietary advice or follow-on support to facilitate healthy behavior change based on the findings. Absent any such information, most people can follow the recommendations listed below to foster a thriving and diverse microbiome that maintains good health. Focus on consuming a nutrient-dense, diverse and plant-forward diet. Minimize processed foods, eat a mix of raw and cooked foods and try to consume fermented foods with probiotics (such as sauerkraut and miso) regularly. (Note that while a recent study from researchers at Stanford found that eating fermented foods may be even more effective in increasing microbial diversity and reducing inflammation than fiber-rich foods, both are important aspects of a healthy diet and can lead to myriad health benefits.) Complement this healthy diet with regular physical activity, quality sleep and minimal stress—and avoid unnecessary antibiotics. Consult a dietitian for more tailored guidance about making these changes to your own lifestyle and needs. Discuss any implications for (or interactions with) medications and comorbid conditions with your physician. Also talk with your doctor or dietitian if you're considering testing your microbiome. The first Soulful Insight about the microbiome was published in January 2018; it included a description of the carbohydrates that are metabolized by our gut bacteria and dietary and lifestyle recommendations to keep them healthy. The microbiome's connection to mental and behavioral health was reviewed in this Insight from January 2021. Resources Click here for the full 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/

Dr. Aly Cohen is triple board-certified in rheumatology, internal medicine and integrative medicine. Additionally, she is an environmental health expert in Princeton, New Jersey. Dr. Cohen is working to educate and empower the next generation to make safer, smarter lifestyle choices through the creation of en­vironmental health and prevention curricula for schools nationally. In 2015, she created TheSmartHuman.com to share environ­mental health, disease prevention, and wellness information with the public. She lectures nationally on environmental health topics for el­ementary/ high schools, colleges/ universities, medical schools, and physician- training programs and she is a regular expert guest for tele­vision, print, and podcasts. She has been the recipient of countless awards, including Top Docs NJ in rheumatology from 2016-2021, the NJ Healthcare Heroes Award in Education for The Smart Human educational platform in 2015, and the 2016 Burton L. Eichler Award for humanitarianism. Dr. Cohen has collaborated with the Environmental Working Group, Cancer Schmancer, and other disease-prevention or­ganizations. She is coeditor of the textbook, Integrative Environmental Medicine, part of the Oxford University Press Weil Integrative Medicine Library. She is also the co-author of the bestselling consumer guidebook, Non-Toxic: Guide to Living Healthy in a Chemical World. She lives on a farm in New Jersey with her husband, two sons, and lots of furry friends. ​Contact Information: Her TEDxtalk: “How to Protect Your Kids from Toxic Chemicals" Facebook @thesmarthuman Twitter @thesmarthuman Instagram @thesmarthuman Sign up for The Smart Human newsletter at TheSmartHuman.com Listen to her podcast The Smart Human Purchase Dr. Cohen's books here. ​At the salon: Dr. Cohen discussed evidence-based data on everyday chemicals that we put in, on, and around our bodies and how they contribute to human health conditions, such as obesity, thyroid disease, autoimmune disease, infertility, mental health disorders, and cancer. She addressed dietary approaches to reduce toxicity, clean drinking water, beneficial supplements, indoor & outdoor air quality, sleep hygiene, stress management, and safe use of cellular technology. Finally, she provided practical tips and resources to enable and empower us in ways to limit environmental exposures in order to prevent disease, better manage current conditions, and improve overall well-being! Click here to view the salon video.

The poet William Blake said it well: “Gratitude is the best way to keep on going. Gratitude is heaven itself.” In my personal experience with the never-ending challenges of Covid, it may be the best antidote to the struggles of lethargy and what Adam Grant calls “languishing.” The International Encyclopedia of Ethics defines gratitude this way, “Gratitude is the heart’s internal indicator on which the tally of gifts outweighs exchanges.” What a lovely way to think about this most important human endeavor. It basically says that gratitude is the willingness to recognize the incremental value of one’s life. And in doing so, we remember the best parts of ourselves and uplift our best selves. Said another way, in a favorite French proverb, “Gratitude is the memory of the heart.” Years ago, I was walking one evening through a park in Toronto, a place where homeless people hung out on benches. As I passed one particularly disheveled man, trying hard not to make eye contact, I suddenly felt compelled to look at him directly. He raised his eyes towards mine, and with the softest, most beatific look I have ever seen, said, “How do you not cry? It’s so beautiful.” With all I had—and all he clearly did not in terms of possessions, physical safety and comfort—he taught me in that one moment that gratitude is, indeed, an attitude. In fact, it’s more. Make gratitude a habit When Oprah says, “My practice is gratitude,” it is much more. To build a gratitude practice, we start by recognizing (as with any practice) that first, we must make it a habit. To make it a habit means we must be very intentional. And our intention is all about the choices we make. Simply put, like that homeless man on the bench, we can either choose to be grateful … or ungrateful. A beautiful model comes from the Maori of New Zealand. In their lodges, they always place two sticks. One is a straight stick and the other a crooked one. This is to remind all who enter that, every day, we have a choice of how we act and think. And the choice is to be in gratitude or not. The word “gratitude” comes from Latin grata or gratia, meaning “given” or “gift,” from which we get the word “grace” or “to be in God’s grace.” Grace is an aspect of gratitude and unearned; it’s a free gift, a moment of peace, comfort or ease. It implies we can choose happiness; we can choose gratitude—every day, in every moment and every breath. The problem is we often focus on what is not working. Researchers tell us we think between 12,000 and 60,000 thoughts a day—and that 80% of those thoughts are negative, as opposed to thinking about what is working. We choose to focus on the shadow, not the light, the hollow and not the ground on which we stand, the pain and not the joy. This focus is, at best, an illusion. Let’s consider today First, good news: You woke up. You’re back! Through some magic you don’t fully understand, you’re still breathing and your heart is beating, even though you’ve been unconscious for many hours. On this day, like almost every other, you awoke inside a temperature-controlled shelter. You have a home! Your bed and pillow are soft, and comfortable blankets cover you. As usual, you have electricity. Your many appliances around you are working flawlessly. The water you need comes out of faucets in an even flow, and it’s either hot or cold as you desire. It’s pure and clean. In your kitchen, appetizing food is waiting for you. Many people you’ve never met worked hard to grow it, process it and get it to the store where you bought it. This bounty is unprecedented in the history of the world. Let’s say it’s now 8:30 PM. You’ve been awake for 12-14 hours, and hundreds of things have already gone right for you. It’s as if there were a benevolent conspiracy of unknown people who are tirelessly creating hundreds of useful things you like and need. And that’s not even including the miracles of language, safety, transportation, freedom, family and friends. However, if three of those hundred things had not gone right—if your toaster was broken, the hot water wasn’t hot enough, your Zoom connection froze—you might feel that the universe was against you, that your luck was bad, that nothing was going right. And yet the vast majority of things still would be working with breathtaking efficiency and consistency. You would be deluded to imagine that life is primarily an ordeal. An alternative perspective of life through the lens of gratitude Instead, I offer you the alternative view, that gratitude is the understanding that the universe is fundamentally friendly—that life gives you exactly what you need, exactly when you need it. That if you pivot away from the question “Why did this happen to me?” and toward “Why did this happen for me?” you will end up in a more grateful place. This is not just New Age talk. It is in our self-interest to feel gratitude. Consider that recent studies have shown that people who describe themselves as feeling grateful to others tend to have better health, more optimism, exercise more regularly, suffer less stress and experience less clinical depression than the population as a whole—even when you factor in differences in age and income. Grateful people tend to be less materialistic and suffer less anxiety about status or the accumulation of possessions. Thus, they are more likely to describe themselves as happy or satisfied. Nigeria, one of the poorest countries on earth but one that is dedicated to gratitude practices, is, conversely, the happiest. The United States, the richest, ranks 17th on the happiness scale. What is true is that grateful people do not take a Pollyannaish view of the world. On the contrary, people who score highly on gratitude indicators also report a strong awareness of the bad in their own lives and in society. In fact, they can be slightly more cynical. But they can be aware of life’s problems yet still thankful for those who help lighten their load. To say we feel grateful is not to say that everything in our lives is necessarily great. It just means we are aware of our blessings. If you only think about your disappointments and unsatisfied wants, you will be prone to unhappiness. If, however, you’re fully aware of your disappointments, but at the same time you’re thankful for the good you have been given and for your chance to live, you will increase your chances for happiness. Conversely, the chief assailant of gratitude is envy. The more we compare our own lives with those of others, the less we feel for what we already have and the more we will diminish our own appreciation. Cultivating gratitude daily The most powerful thing you can do is to know that wherever you focus your energy is what the mind supports. The answer is simple yet effective. Replace what you don't want with what you do want. Start by saying thank you. Oprah has trained herself (and it is a training) to say "Thank you" as the first thing she does when she opens her eyes in the morning. This simple act sets her up for the rest of the day. The best way to grow gratitude is to generate thinking that eradicates envy and comparison and replaces it with thoughts reflecting our abundance. It begins with the renewal of a disciplined mind and a commitment to replace thoughts of envy or comparison with thoughts of what is working or of blessings that exist. When we do this, we enact what Cicero called "the highest of all virtues." To counter our addictions to the negative, try this: right before falling asleep, place one hand on your heart and the other hand on your belly. Then spend one to two minutes considering all the blessings and gratitudes from the day. Do this every day for 30 days, and you will begin to develop a deep gratitude attitude. Every day we have a choice about how we act and think. And the choice is to be in gratitude or not. We can choose happiness; we can choose gratitude, every day, in every moment and every breath. Resources Angeles Arrien, Living in Gratitude, Boulder, CO: Sounds True, Inc., 2011. Fetzer Institute, Resources on Gratitude Gratefulness.org David Baum, PhD, DMin For more than 30 years David has facilitated big conversations that create big change. With two doctorates—the first finding horizontal connections as a social psychologist and the second looking for vertical ones in divinity—he seeks the overlap. His why is always the same: create connection without dots. David has worked on conflict mediation in Northern Ireland, designed walking board meetings in the Middle East and large-scale change projects for Shell Oil, Barclays, GE and Fidelity Investments. His clients have won the Nobel Peace Prize, the Conrad Hilton Humanitarian Prize, the World Children’s Prize, the Malcolm Baldrige Award and the Clinton Global Citizen Award. He's also worked in a circus. No one has ever accused him of being boring. www.davidbaum.com david@davidbaum.com