Inside Health A Better You Starts With What’s Inside
I n s i d e H e a l t h M a g a z i n e . c o m
Keri Glassman Dietician to the Stars
Tips&
Trends
Gut I nstinct How Amie Valpone Overcame a Toxic Situation
Tune up the
Digestive Symphony Recipes
Gluten Free!
Inside Health
Contents
4Woodson A Letter From... Merrell, MD
15 Immune Health and Your Digestive Tract
5Tips & Trends 6HowGutAmie Instinct– Valpone
16 Heartburn? Choose Natural Solutions
Overcame a Toxic Situation
9Digestive Tune Up the Symphony 12 Keri Glassman Celebrity Dietician
17 Stress and Digestion 18 Recipes You Can Make Tonight 22 Erica Dermer– My Life With Food Sensitivities
Takes on Food Intolerance Belvoir Media Group, LLC, 535 Connecticut Avenue, Norwalk, CT 06854-1713. Robert Englander, Chairman and CEO; Timothy H. Cole, Executive Vice President, Editorial Director; Philip L. Penny, Chief Operating Officer; Greg King, Executive Vice President, Marketing Director; Ron Goldberg, Chief Financial Officer; Tom Canfield, Vice President, Circulation. ©2016 Belvoir Media Group, LLC.
Letter from Woodson Merrell, MD It’s All About Balance
Woodson Merrell, MD, ScD (hc), a graduate of Columbia University’s College of Physicians and Surgeons is one of the nation’s leading authorities on integrative medicine. He is on staff at a medical school and two academic medical centers in NYC. In 2000, he founded one of the country’s premier academic programs in integrative medicine. Since 1985, he has maintained a high profile private practice in integrative internal medicine and acupuncture on Manhattan’s Upper East Side. He is the author, with his wife Kathy, of The Source / Power Up: Unleash Your Natural Energy, Revitalize Your Health, and Feel 10 Years Younger (Simon & Schuster) and in 2013 of The Detox Prescription (Rodale Press)
I am pleased to introduce the inaugural issue of Inside Health, a journal dedicated to giving you the latest health information—with a particular focus on gut health—to help you regain your balance and restore your vitality. This is an exciting time in medicine and in the wellness community, as it seems almost daily we learn more about how to improve our health through lifestyle and natural therapies. Inside Health aims to provide insight into this fast-evolving new world of well-keeping. There are five relatively new words and phrases you’ll be hearing a lot about—that will increasingly form the basis of how medical practitioners look at health, wellness and disease in the future. • Personalized lifestyle-based medicine • Precision medicine • Genomics • Epigenetics • Microbiome Inside Health will help you navigate these developments and incorporate them into your personal health practices. We now have the ability to sequence our genome. The first run took 14 years and nearly $1 billion. Now it can be done in a day for less than $1,000. Geneticists are rightfully ecstatic at this dawn of a new era---ushering in the most precise information we can get about our genetic make-up. But we are not just our genes. In fact, many scientists look at our genome—our DNA—as the hardware. And this hardware is controlled more by the molecules that surround it—the epigene—than by the gene itself. Our environmental influences give messages to our epigene to tell our genes what to do (as well as helping repair the genes). Through lifestyle changes we are able to turn on and off many of our genetic susceptibilities. Indeed, experts now say that up to 70% of our health and disease is a product of how we interact with our environment. The air we breathe, the food we eat, our emotional life, the toxins that flood your system on a daily basis—all this adds up. Too often this results in a toxic internal stew—a mixture of bad thoughts, stress, and processed food with multiple artificial ingredients that utilize way too much energy to process. Couple this with constant exposure to pollutants such as plastic and pesticide-related chemicals that are hormone disruptors, which have been shown to create disease, and you can
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understand how our bodies are under constant attack from the modern lifestyle. Diet is another battle we are losing. We are known as a “meat-sweet” nation, which refers to our collective overconsumption of saturated fat from animal protein and sugar coming from way too many refined carbohydrates and junk food. Advertisements everywhere scream out at us to get more of it. This has created an epidemic of overweight and obese people (>70% of U.S. population!) who are unhealthy and, to add insult to injury, consequently have a much more difficult time repairing the damage they are doing to themselves on a daily basis. Junk in-junk out---we are what we eat; this is literally the case. A year from now most every chemical and molecule in our body will be completely replaced, this is the natural process of life. Whole organs turn over into new versions of themselves, and what the body uses to create this new system is what we consume—the air we breathe, the water and other liquids we drink, the substances that come in contact with our skin and especially the food and other chemicals we ingest. These are the building blocks of our bodies day in and day out. I am pleased to be working with Inside Health to help you build a better body. In addition to giving you the inside scoop on creating a healthier lifestyle, Inside Health will show you how to jump-start your digestive balance: including whether and how to use nutritional supplements in addition to whole foods to help improve your microbiome and digestive health, notably probiotics (and pre-biotics that encourage the growth and function of the healthiest bacteria) and enzymes that allow for proper digestive function, immune health and healthy inflammation. When we say we are what we eat, we refer not only to our physical selves, but also to our emotional selves. The gut produces more of the “feel-good” chemical serotonin than the brain. The work of Columbia University’s Michael Gershon and others has highlighted that the gut even has its own nervous system---the phrase “listen to your gut” is actually physiologically true. There is so much we have to learn about this interplay. Inside Health will help guide us through this wild and crazy and exciting new era. It will focus on our digestive system, teaching us how to refocus and retrain what we put into our inner world. It will look at this via all the newer lenses: Genomics, Epigenetics, Microbiome, Precision Medicine, and Personalized LifeStyle Medicineputting in perspective our relationship with all digestive and other lifestyle factors that can allow each of us to reach our optimal wellness potential.
Tips&
Trends
Look and feel Great!
Tips for Eating to Age Well Build a healthy microbiome As we age, the microbiome—bacteria and other microbes that live in our gut—tends to decrease in diversity and shift towards more harmful species. Besides supporting your microbiome with probiotic supplements, consider natural food sources like yogurt and eat a wide variety of vegetables and fruits to provide material to nourish good bacteria. It may be one reason why eating more produce has been linked to longevity.
A multi-vitamin a day keeps the… The importance of vitamins and nutrients in supporting the normal function of our body are well recognized. The multi-vitamins of today are very different from those in the past. Look for a multi-vitamin sourced from whole food, which your body is more likely to recognize as food and more easily absorb. Some of the best whole food multi-vitamins on the market also include guaranteed potency probiotics, enzymes and superfoods.
Eat raw When food is cooked, many of the nutrients and all digestive enzymes contained within are destroyed. Try to incorporate some raw food into every meal, and consider converting 2 or 3 meals a week into a raw meal. In addition, raw food contains ATP (Adenosine triphosphate), a key molecule that transports energy within the cell.
Have heart
Skip soda; drink water Sugary sodas cause inflammation and damage that may shorten telomeres—the protective caps on the ends of DNA. Short telomeres have been shown in conjunction with premature aging and a wide range of other health challenges. A December 2014 American Journal of Public Health study of 5,300 healthy adults found that drinking 20 ounces of sugary soda daily sped up biological aging by 4.6 years, which is comparable to the effects of smoking.
The cardiovascular system is one of the primary areas of the body that can become challenged with age. With this in mind, incorporate heart-healthy foods into your diet. Some favorites include fish high in omega-3s (salmon, tuna, mackerel, herring and trout), healthy nuts like almonds and walnuts, or tomatoes, which provide lycopene, vitamin C and alphaand beta-carotene. Looking for a supportive supplement? Consider the enzyme nattokinase, which has been shown to break down fibrin (clots) in blood, which encourages healthy circulation.
INSIDE HEALTH • 5
Gut I nstinct
How Amie Valpone Overcame a Toxic Situationand Emerged Healthy and Whole by Terri Trespicio
Empowered!
Amie Valpone doesn’t saunter through Central Park; she moves. A petite sparkplug of a woman, she walks fast, talks fast, is quick with a joke—and just as quick to laugh at yours. You can learn a lot from her in a short period of time: How to whip up a grain-free butternut squash pizza crust; how to bake delectable brownies without flour, dairy, eggs, or even sugar for that matter; how to make a DIY surface cleaner that’s so safe you can drink it. She’s the picture of a healthy American woman (blonde hair, glowing skin)—and a career success story, having left the corporate world to launch her own popular food blog, TheHealthyApple.com, and start her own business as a recipe developer, food stylist and photographer. In addition to contributing to major publications and serving as a brand ambassador for brands you know well, Amie’s also a newly minted author: Her forthcoming cookbook is Eating Clean: Detox, Fight Inflammation, Reset Your Body, and Get to the Root Cause of Illness (Houghton Mifflin 2016), which gives readers the tools and inspiration for detoxing their lives from top to bottom, and eating more healthfully and happily than ever before (and features a foreword from functional medicine celeb Mark Hyman, M.D.). Inside you learn something about Amie you’d never know by looking at her: That for the past 10 years she has struggled with severe chronic illness, and been diagnosed with everything from Lyme to PCOS to chronic candida, and more than once lay on the floor of her Manhattan studio, in pain, crying, unable to eat a thing or even move. What started one day in her early 20s as unexplained swelling in her legs (40 pounds of water weight that left her unable to wear anything but spandex) and was misdiagnosed as leukemia, spiralled out of control. At one point, during countless visits to hospitals and clinics, she picked up Clostridium difficile (known as C. diff ), a harmful bacteria, and was given 24 hours to live. Her belly, beset by an overgrowth of bad bacteria, swelled to the point where people started asking her if she was pregnant. She went on disability for a year, schlepped in and out of medical facilities all over the country, including the famed Mayo Clinic, racking up nearly half a million dollars in uncovered medical expenses, and giving the equivalent of her body weight in blood every few weeks for years. And after five years of western medicine (including numerous bone marrow biopsies, CT scans, MRIs, colonoscopies, and more) that yielded no real answers, she discovered integrative and functional medicine and embarked on years of self-study into detox, as well as every holistic modality you can think of—plus earned a degree in integrative nutrition. She also created a team of integrative M.D.s (more than 20) who helped her identify the root cause and supported her efforts to get well.
6 • INSIDE HEALTH
Enzyme fast Facts
• Food enzymes are destroyed easily by heat or processing • Enzymes are found in all raw foods • Enzyme production naturally reduces with age
But the question that kept spinning through her head the whole time was why? When she looked back at her childhood to see what could have possibly caused this mess, she came up empty handed. “I couldn’t understand it. It’s not like I grew up downwind of a power plant,” she says. “I was lactose intolerant, but that was about it.” She’d always been a healthy girl, with a healthy appetite, eating what’s considered a healthy American diet. Raised in Sea Girt, New Jersey, a sleepy beach town about an hour outside of New York City, Amie is the oldest of two daughters; her mother, Joann, was a high school guidance counselor, and her father, Tony, worked for IBM. Amie played on varsity soccer and lacrosse growing up, and was involved in everything from student council to volunteering. She went on to earn a bachelor’s in marketing from Boston University, and avoided alcohol, drugs, and fast food as a way of life. “I was such a ‘good’ girl,” she recalls. “I couldn’t imagine how this had happened.” As part of this massive integrative effort, she went through a battery of highly sensitive tests that picked up on things that Western docs had missed (Lyme, PCOS, candida, heavy metal accumulation, mold toxicity, hypothyroidism, SIBO and more). One genetic test was particularly telling, as it revealed that Amie was missing a gene called methylenetetrahydrofolate reductase (MTHFR), which 35 percent of people are missing. Carriers of this gene are unable to detoxify as efficiently as everyone else, and as a result, toxins accumulate, causing irritable bowel, arthritis, even cancer. When you’re missing this gene, you’re also more susceptible to environmental toxins (herbicides, pesticides, antibiotics, heavy metals), which then bind to fat receptors and compromise your methylation, the process by which your body repairs DNA and keeps inflammation in check. You need methylation to stay healthy, and she was not methylating, period. In Eating Clean, Amie goes into great detail about MTHFR testing, as well as a list of the most trusted resources for integrative and functional tests that you and your doctor can use to chart your best next steps—something Amie wishes she’d had handy 10 years ago. “It would have saved me a ton of money, time, and frustration,” she says.
Detox Overhaul Having an integrative medical team was key—but she knew that in order to heal, and especially given her genetic disadvantage, she had to transform the way she was living to give her body a fighting chance. So in addition to the treatments administered by her integrative docs, she did her homework and went to town on her diet and lifestyle. In other words, it was time for a detox, in the truest sense of the word—not a trendy 2-day juice cleanse. We’re talking a serious and intentional effort
to scrutinize everything you put in and on your body with an eye toward dramatically reducing your exposure to environmental toxins. “Those toxins come from countless places— from processed foods and pesticides, car exhaust and other pollution, and cosmetics,” Amie explains. While the word detox is thrown around a lot, says Amie, it’s often misunderstood. Rather than a quick fix you use when you’re coming off a bender, the goal of a true detox is to reset your digestion and dramatically reduce and remove your exposure and intake of environmental toxins. Of course, any detox effort starts with food. So Amie cut out many ingredients that lurk in even the most benign of American meals: gluten, dairy, soy, refined sugar, corn, eggs, as well as pretty much anything in a can, box, or bag. No processed foods, preservatives, fillers, emulsifiers, or dyes. She went on a 21-day food elimination diet (which she lays out step by step in her book) to help her identify what foods were causing inflammation in her body (and this varies from person to person, she’s quick to add). She filled her fridge with fresh organic food—and took out almost everything else. For a while, when her leaky gut was so bad, she subsisted on veggies and protein powder blended in a food processor, and at one point, baby food. But detox didn’t stop with food—what went on her skin mattered too. So she started drinking filtered water only (no plastic bottles). She tossed all her “healthy” conventional beauty products in favor of cleaner personal care products such as coconut oil for eye makeup remover and toothpaste (it’s been shown to inhibit cavity-causing bacteria and is free of harsh chemicals). She soon started to feel better—a lot better. “I’ve experienced first hand the effects of toxicity in my body,” she says. “And while I had the benefit of great doctors on my team, you also in some ways have to be your own doctor because you know your body better than anyone else.” But is it a bummer to have your food, and your life, so limited? Not to hear Amie tell it. “There are plenty of foods I can’t eat,” says Amie. “But do I miss them? Honestly? No.” She developed over 200 plant-based recipes for Eating Clean, all of which are gluten, dairy, egg, refined sugar, corn, peanut, and soy-free. “I want to make delicious, clean, healthy food easy for everyone,” she says. “But more than that, I’m on a mission to empower and inspire other people who feel lousy and don’t know why. I want to help them feel amazing again, and show them how fulfilling and flavorful their food, and lives, can be.” INSIDE HEALTH • 7
When people ask her if she wishes she could go back to when this all started, and change some things, maybe prevent it altogether, her response is always the same: “No way—I couldn’t have, and I wouldn’t.” Amie recalls one day when she pulled up to the hospital, feeling sick and confused, and saw a group of construction workers hanging out, smoking, drinking soda and eating fast food, having a great time. “I thought, how is this fair?” But since then she has learned two things: “One, that I had to change my mindset, and see that this was happening not ‘to’ me, but for me,” she says. “The other thing is to be happy in the present moment. That’s the kind of hope and peace I wish for everyone.”
As for what she’s looking forward to next? Eating Clean may be her first book, but it’s certainly not her last. An avid and enthusiastic speaker, she’s also excited about sharing her story at live events and on TV. She wants to inspire others to take control of their health and their lives so that they can feel normal again. “Normal, trust me, is a wonderful thing. There isn’t a day that goes by that I’m not grateful for just that.”
eating
CLEAN The 21-Day Plan to Detox, Fight Inflammation, and Reset Your Body
amie valpone
creator of thehealthyapple.com
foreword by MARK HYMAN, MD
Amie’s Clean Eating Manifesto 1. There is no one ideal diet. Everyone’s diet will be a little different, based on your individual makeup. “This isn’t about putting a label on yourself,” she says. “The most important thing is to eat whole, organic, fresh foods that make your body feel good.”
2. If a food makes you feel lousy, it’s not for you. Forget the trends or whatever the buzziest superstar is doing. “You are the expert on what you can eat, and no matter what anyone says, if something doesn’t make you feel good when you eat it, chances are it’s causing inflammation in your body.” Real, clean food should never make you lethargic, bloated, or irritable. 3. Feed your body, not just your belly. “You do not subsist on calories alone,” Amie says. “You need a whole spectrum of nutrients and vitamins to feed you on a cellular level.” A 100-calorie snack pack is not the equivalent of 100 calories of an avocado. One is pro-inflammatory and the other is anti-inflammatory. Choose foods with one ingredient, such as an avocado, and you’ll be feeding your body, not just your hunger pangs. For more resources and recipes on clean eating, visit Amie’s website TheHealthyApple.com.
Shop smarter Knowing how to buy food is almost as important as figuring out what to buy. Here are Amie’s favorite ways to shop smart and simple: Be realistic. This is the best way to not only end up with a fridge full of groceries that you’ll want to eat, but also to save money. Don’t buy quick-to-spoil items in bulk and be mindful of foods you know in your heart you’ll never eat. Streamline. Organize your shopping list by where you’ll find those items at the store, such as produce, gluten-free whole grains, spices, frozen veggies, etc. Stick to the list and avoid making spur-of-themoment impulse buys. Improvise. You might have kale on your shopping list, but collards are on sale. Go for it; sometimes you have to let your wallet do the talking. Stock your freezer. Keeping ready-to-eat homemade foods in your freezer is like finding ten bucks in your coat pocket, and saves you time and money. Roast or grill veggies and freeze in small batches. Keep berries frozen for morning smoothies. Take risks. Try one new whole food ingredient each week; it will encourage you to get a little creative with your meals. And who knows, you may find a new ingredient you love!
Amie’s Top Clean Picks Earthbound Farm® Spinach. Conventionally farmed spinach is on the dirty dozen list. Earthbound’s products are committed to clean organic greens—this brand of fresh greens is a staple for everyone’s kitchen. Living Now® Gluten-Free Organic Quinoa Pastas are a great source of protein and taste and cook just like traditional pasta without gluten, soy, eggs, corn and dairy. They’re made from only three ingredients – organic rice, organic quinoa and organic amaranth. Barlean’s Forti-Flax feature lightly-milled, organic flaxseeds that provide a cornucopia of naturally occurring nutrients, including valuable Omega-3, fiber, amino acids and amazing antioxidants that is easy to add to your daily diet. Navitas® Naturals make organic, delicious gluten-free snacks made via methods such as freeze-drying and low temperature processing to preserve nutrition and flavor. Nutiva® Coconut Manna is a melt-in-your-mouth puréed organic coconut butter made of pure, dried coconut flesh that can be used in cooking or straight from the jar. Branch Basics created 100% non-toxic cleaning solutions including a pure soap concentrate that can be diluted with water to replace virtually every cleaner in the home. Erbaviva offers premium organic personal care products (including an effective organic deodorant) that blend organic ingredients with European artisanal quality. Enzymedica produces high-potency enzyme products that are free of any fillers and work great to help you break down your food and feel better after your meal.
Photos of Amie Valpone by Vladimir Weinstein 8 • INSIDE HEALTH
Terri Trespicio is a New York–based writer, editor, and host. Visit her at territrespicio.com
Energy & Brainpower
Tune up the
By Woodson Merrell, MD INSIDE HEALTH Science Advisor
Digestive Symphony Your body is a factory fueled by food, and its chief product is energy and brainpower. Making the factory run right begins with a fascinating process called digestion. Everything starts with the mere thought of eating. This is when you have the power to make a decision that will either be toxic (a burger with chips and beer?) or healing (Wild Arctic Char and Roasted Radicchio and a Hot Tomato Juice?). As soon as you think about food, your body starts to generate salivary enzymes and digestive hormones. The digestive process begins with the mere thought of a good meal. The next step in the process is pure aromatherapy. Unlike all the other nerves in your body, which have multiple checkpoints that slow messages down, the smell receptors in your nose are hardwired straight to the brain—no filter. You smell the food, you feel hungry (or react to foods in some pre-patterned—both positive and occasionally negative—ways). A cascade of digestive enzymes and hormones is unleashed—not just in the mouth, but throughout the body. Your body recognizes that dinner is coming and in its infinite intelligence is getting itself ready to receive the food—not just to enjoy the experience, but also to use it for all it’s worth. Don’t bypass this crucial step of digestion—stop, look, and smell before you dig in.
Chew, Chew, Chew Take the time to chew. First and most obviously, this is where a lot of the sensory enjoyment of food happens. But even more important, chewing kick-starts the chemical and physical processes of digestion. The teeth grind and pulverize the food—a critical step, as food should never leave the mouth in anything chunkier than a gruel consistency. The jaw provides brute force that will be hard for the body to make up for later. Chewing a good 20 or 30 times makes sense—maybe 12 if you’re in a hurry or the food is soft. But three or five bites won’t cut it, and could wreak havoc later. . . as you will see. As you chew, the salivary glands release key enzymes to help break down the food into even smaller chunks. Chewing your food, obviously, exposes them to these enzymes longer, allowing them time to do their work. It’s also a good reason to chew everything, even if you don’t think you need to. If there is nutrition in it, the act of chewing will help your body unlock that nutrition. It is worth the extra 10 seconds of work—you might even be surprised to find that during the process of chewing these kinds of liquids, you discover a
INSIDE HEALTH • 9
new world of flavors in them. You’ll slow down in general, allowing more time for your body to register that it is full. Moreover, chewing triggers the release of the hormone CCK (cholecystokinin) in the stomach, which signals ahead to the pancreas and gallbladder to get busy doing their work: Dinner is coming!
Down the Hatch Once the food is pulverized, nice and moist (another key role of saliva), and ready to go, you swallow—it’s down the esophagus and into the stomach. This is a one-way ride, unless something is wrong and you have a condition like gastro esophageal reflux (GERD) and the esophageal sphincter relaxes too much, allowing food and acid to make an unwanted and unpleasant return. The stomach works as an agitator to literally grind the food it takes in—it is composed of smooth muscle, built to churn. This mechanical action isn’t
“paying forward” a heavier load for the rest of the digestive system to handle and reducing absorption of nutrients that need acid to prepare them for absorption (e.g., calcium). Meanwhile, the stomach lining is busy, too. It’s producing the enzymes pepsin, which begins to cleave apart protein molecules, and gastrin, which stimulates the secretion of more HCl. It’s making mucin, which creates the mucous layer that protects the stomach lining from all that corrosive HCl. And it’s triggering the release of the hormone leptin, which reduces appetite and acts as an antagonist to the appetite-promoting hormone ghrelin.
Assimilation Assignation If all has gone well and the stomach has done its job, it moves the food in a (hopefully) gruel-like pulp called chyme through the valve at the bottom of the stomach (the pyloric valve) into the
“you cannot help but be amazed at how magnificently the body has been designed in harmony with the natural world” as efficient or as effective as what the mouth can do, but so long as food is present, its muscular action is trying to break it down. Bigger hunks of food mean extra churning. There’s help for this churning, of course. The stomach has lots of chemical allies, chief among them hydrochloric acid, or HCl. If you made it through seventh-grade chemistry class, you might remember this one: It’s pretty brutal stuff, eats through (almost) anything, and can be problematic if you spill it where it’s not supposed to go (like onto your jeans or into the esophagus). In the stomach, if everything is going according to plan, the HCl is working to break food down into its tiniest particles and is killing any microorganisms that might have hitched a ride in on the food. HCl levels naturally decline as you age, unfortunately, leaving a little more work for the rest of the system to handle. If you suffer from GERD or gastric ulcers, a painful defect in the stomach lining, you may be prescribed acid-suppressing medications such as protonpump inhibitors (Zegerid, Nexium, Prilosec) or histamine-2-receptor antagonists (Zantac, Axid, Tagamet). If you take them, your symptoms will be relieved, but HCl levels will be suppressed, 10 • INSIDE HEALTH
duodenum. The duodenum is the first part (about 12 inches) of the small intestine, a small organ unto itself, with an incredibly important job. As chyme moves into the duodenum, the pancreas and gallbladder come into play—and digestion begins to overlap with assimilation. Most people think of the pancreas as the organ that produces insulin to handle our blood sugar, but that endocrine function is only half its job. Its other function, called exocrine, is producing the chemicals the duodenum needs to function properly. Perhaps first and foremost, the pancreas releases sodium bicarbonate (or bicarb), which neutralizes stomach acid. In the alkaline environment of the duodenum, the pancreas’s enzymes can then take over. Along with bicarb, the pancreas releases into the duodenum a host of enzymes, primary among which are amylase, which further breaks down carbohydrates; lipase, which breaks down fats; and trypsin, which breaks down proteins. Meanwhile, the gallbladder also squirts some bile, an alkaline greenish-brown fluid produced by the liver, into the duodenum to assist in the breakdown of fats (and it also carries some detoxified fat soluble substances from the liver for elimination out the intestines). Whereas
HCl acted as a machete to crudely hack apart hunks of food in the stomach, enzymes in the duodenum are more like scalpels, reducing food to its molecular components so that it can be absorbed in the small intestine. Vitamins, minerals, phytonutrients, amino acids, carbohydrates, fatty acids . . . all are released from the food and readied to be soaked in and used by the body. Hopefully, you’ve chewed well and your stomach has had a chance to do its job perfectly; if not, the duodenum will take up the slack. Here’s the rub: If larger chunks of food have gotten through, more enzymes and bile will be needed to process that food. That means more stress on the pancreas and ultimately the liver, which will kick up bile production and send it in via the gallbladder. Unfortunately, these two organs have other important jobs to do, namely regulating insulin (pancreas) and detoxifying the body (liver). Can you see how stressing the system day after day with unchewed, unprocessed, undigested food might result in some unpleasant side effects? Once food moves out of the duodenum and into the rest of the 20 feet of small intestine, coaxed along via peristaltic waves (rhythmic contractions of the smooth muscles), the heavy work of digestion should have been done, and assimilation gets going. The design and function of the small intestine (let’s call it SI) is truly marvelous—you cannot help but be amazed at how magnificently the body has been designed in harmony with the natural world, and how, even amidst our best efforts to undermine it, it keeps on chugging to serve us! To maximize the absorption area of the SI, it is lined with hundreds of thousands of small projections called villi, which also make a few more enzymes to further facilitate sugar breakdown. Here is where the most usable nutrition gets passed into the blood vessels through tightly packed cells (epithelial tissue) that line the villi, and what is not useful gets pushed on through the system and into the large intestine for disposal. The cells that line these villi are first of all guardians—they try to keep out anything harmful. In that way, they are the body’s first line of detoxification. Each of them has thousands of tiny channels that open and close to let in only selective nutrients that have been properly prepared. Between each cell, there is a tight junction that is meant to prevent leakage of anything into the body—specifically into the interstitial space behind the cells. This interstitial space is a soupy area where nutrients (including oxygen) come from the arterial capillaries to supply the cells. This is a heavy exchange zone, as processed toxins and other
waste and debris (including CO2) are moved into the lymphatics (which eliminate fats and heavier molecules) and venous capillaries, for elimination from the body. If the small intestine is damaged (by drugs, toxins, or free radicals) or diseased (as with celiac disease, infection, or inflammatory conditions such as Crohn’s disease), it can develop “leaky gut syndrome,” in which the normally tight junctions between the small intestine cells essentially have holes punched in them, allowing material to flow freely into this interstitial space and be circulated within the body—often creating big problems. This is a problem in celiac disease, when the gluten molecules enter into this space and are circulated—even as far away as the brain. It’s often hard to know for sure if you have leaky gut, though if you have food allergies or sensitivities, it’s likely that you do. If so, the treatment is to eliminate from your diet and lifestyle all things that might cause further trauma—such as food allergens, charbroiled beef, food additives, toxic plasticizers (to name but a few of hundreds)— and allow the gut to heal itself.
The Liver Spot Everything—and that means everything —that passes into the interstitial space from the small intestinal cells is absorbed into the portal vein. This is a big vein whose only purpose is to carry all absorbed things into the liver, which as you recall is the body’s main organ of detoxification. We’ve already said that the liver creates bile to help digest fats. It also produces many other molecules that are critical to maintaining human health, including clotting factors, most of the cholesterol your body needs to maintain cell membranes, and steroid hormones (among
other things). It also serves as a storage area, most notably for iron and vitamin B12, but also for fat. (Too much fat gums up the works; fatty liver disease is a scourge associated with obesity in Western culture. Science is now beginning to show how our overconsumption of fructose is linked to fatty liver.) Unless the liver is overloaded, toxins will get processed for elimination here.
Out You Go Once detoxified, there are a number of elimination routes out of the body for toxins. Most bound toxins are rendered water-soluble and released by the cell into the interstitial fluid. They make their way into the hepatic vein, up to the heart where they are pumped out, and eventually are excreted from the body via the kidneys. (Yet another good reason to keep up your water intake!) Some fat-soluble bound toxins (processed estrogens are a good example) are put by the liver into bile to be released into the intestines. There are two other eliminative organs: lungs and skin. The lungs only eliminate gases (mostly CO2)—along with whatever the lungs’ mucosal lining has been able to trap and move out. But every bit of tar you have ever smoked is still in the interstitial spaces, depleting the lungs’ oxygenabsorbing capacity—and, if enough of it is there, causing emphysema and cancer. (Any toxic gases you have inhaled have already either damaged the lung tissue directly or been absorbed into the circulation to wreak havoc elsewhere.)
The skin can release toxins via sweat and oil glands. Research on saunas has demonstrated their ability to excrete myriad toxins (including illicit drugs, toxic chemicals, and even antibiotics). The more you sweat, the more toxins are released. So try to sweat every day. All the substances that made it through the small intestine now need to be eliminated out the large intestine (aka colon). The colon has only a small role in active detoxification, by the cells lining its interior and by some of the bacteria. It functions mainly to package waste for removal. For this, the more fiber (and water) you have taken in, the better. Some of the fiber, besides soaking up water to give bulk for better bowel movements, has absorbed toxins from the small intestine for elimination. In the colon, friendly bacteria (probiotics) also play a role by trying to keep the more pathological bacteria at bay—thus reducing the amount of bacterial endotoxins released into the body from the colon.
Repair the Future By eliminating toxic exposures, introducing a few key mind-body practices to help you manage stress effectively, exercising/sweating regularly, resting sufficiently, and eating a nutrient-dense, plant-based diet, you can not only detox in the present but in the future, too. The nutrients that feed detox feed everything else that happens in the body—including DNA repair. You can quite literally eat—and act—your way to a brighter future. The growing field of epigenetics is showing how our choices today impact how our genes are interpreted tomorrow, and next month . . . and next year. Now we understand that our genes do not write our story—indeed, we write it ourselves with our lifestyle choices. We write our own code when we choose to exercise (or not), when we sleep (or not), when we connect with others (or not), when we relax (or not), when we eat nourishing foods (or not), when we breathe (or not). Every decision you make about your health will affect your health—will you decide for the good or not? I think that once you experience the benefits, you won’t be able to imagine living any other way. From THE DETOX PRESCRIPTION by Woodson Merrell, MD with Mary Beth Augustine MS, RDN, and Hillari Dowdle. Copyright © 2013 by Woodson Merrell, MD. Published by arrangement with Rodale, Inc., Emmaus, PA 18098. Available wherever books are sold.
INSIDE HEALTH • 11
Taking on Food Intolerance With Keri Glassman Do you hear people throw around the term “allergy” like we used to throw around the word “carb?” Many people think they have allergies but really they have something very different. They have an intolerance. There is a BIG difference. An allergy is an immune response and affects about 15 million Americans. An intolerance involves the digestion system. Chances are, someone you know has a food intolerance, and that person just might be you! Millions of Americans experience difficulties with
carbohydrates. In the stomach, the enzyme pepsin begins to break down proteins into smaller chains of amino acids. Food is then released into the small intestine, where the pancreas releases enzymes such as lipase, amylase and trypsin, which breaks food down further. Food intolerances can come from deficiencies in the enzymes needed to break down certain nutrients in particular foods.
“enzymes are your digestive tract’s best friends” digestion that are tied to specific compounds like gluten, lactose, casein and phenols. Gas, bloating, constipation...these and other symptoms are often the result of incomplete digestion of our food. Our body uses enzymes, proteins that help break down foods, during digestion and this helps us absorb nutrients. Many individuals simply don’t have enough of certain enzymes to break down their meal properly. When food doesn’t get broken down sufficiently, it begins to ferment (think being eaten by bacteria in the gut). This may cause gas, bloating or cramping. We’ve all been there, right? Enzymes are your digestive tract’s best friends by breaking food down into liquid form so we can absorb and use the nutrients found in those foods. Different types of enzymes exist to break down different nutrients. For example, proteases break down proteins, lipases break down fat, and lactase breaks down lactose. Our digestive process begins with our saliva, which is rich with amylase that break down starch and 12 • INSIDE HEALTH
While there are many foods that can lead to food intolerance, here are the most common.
Gluten: Gluten is a name for a protein found in wheat and gives elasticity to dough, helping it rise and keep its shape and gives the final product a chewy texture. Gluten is found in wheat, rye and barley. Digestive enzymes like DPP-IV can break down gluten to make it easier to digest. However, it is important to note that these products are not intended for individuals with celiac disease.
Dairy: Many individuals who are intolerant to dairy believe that lactose is to blame. Lactose is the form of sugar found in dairy and can be a problem for many. However, many other people also have digestive challenges associated with casein, a protein found in dairy.
Phenols: Phenols are compounds found in nearly all foods. Some foods contain a greater concentration of phenols, like nuts, berries, wine and chocolate. They can also be
found in
processed foods in preservatives, artificial flavors and artificial colors. In our diet, polyphenols function as antioxidants to scavenge free radicals and protect us from inflammation, cancer, cardiovascular diseases, diabetes, osteoporosis and neurodegenerative diseases. Some individuals are sensitive to these compounds and must follow a diet low in phenols by eating raw, unprocessed foods and removing the skin and seeds from fruits and vegetables. In children with phenol sensitivity, symptoms include hyperactivity, headaches and insomnia. In adults, symptoms include chronic fatigue syndrome, constipation, and diarrhea. Some people find that using enzymes may help with symptoms.
Beans and Veggies: While raw, vegetarian and vegan diets can be incredibly beneficial, fiber can often be difficult to digest. A wide variety of enzymes are often used to break down complex carbohydrates like fiber. There are two types of dietary fiber - soluble and insoluble. Soluble fiber dissolves in water and forms a gel, which helps bulk up stool and move things along. Insoluble fiber does not dissolve in water, is not digested, and acts like a broom to help move food out of the body. Cellulose, a common type of insoluble
Intolerance Misunderstandings 1. Food Intolerance is the Same as Food Allergy Keri says: Absolutely not! While some of the symptoms of food intolerance and food allergy are similar, they are very different. Food Allergies are immune reactions against certain foods. Intolerance is the result of incomplete digestion.
2. Lactose is the Biggest Problem With Dairy Keri says: Many individuals who think they are lactose intolerant actually have the most trouble with casein. Lactose is a sugar in dairy and casein is a protein.
3. I Should Just Eliminate the Foods That Give Me Trouble Keri says: Love what you eat! While elimination diets are necessary for some individuals, many people find support for their intolerance in supplemental enzyme formulas. fiber, is found in many vegetables. Bacteria in the large intestine use cellulose and other insoluble fibers as food and then release gas, which can cause gas and bloating. Cellulosedigesting enzymes may ease digestive discomfort. The enzyme alpha galactosidase is used for digesting sugars from beans, grains and raw vegetables. Studies are beginning to show that many individuals who have one food intolerance often have multiple. This is where digestive enzyme products may also help.
What Can I Do If I Have a Food Intolerance? The good news is that there are protocols in place for any food intolerance that can provide digestive relief and allow you to enjoy the foods you love. First, it’s important to know that there is an entire spectrum of intolerance reactions. Some individuals respond more severely to certain foods than others, so strategies for calming digestion will be different depending on the individual. For minor to moderate food intolerance reactions, digestive enzymes can be a huge help. Look for products that target the specific foods that you have difficulty with and give them a try. In some cases, all negative side effects may go away, and for others, these reactions may be lessened but may not go away entirely. For those with significant reactions from problem foods, sometimes the only solution is to eliminate those foods from your diet.
The most common enzyme deficiency is lactose intolerance affecting about 25% of us. There are many resources online and at my website, nutritiouslife.com for tips for avoiding these foods. Choosing the right elimination diet depends on your symptoms. Some may just need to eliminate gluten, while others may need to remove a wide range of foods, such as dairy, eggs grains, and food additives. Keep a food journal with symptoms for at least four weeks to see if symptoms worsen as foods are added back into the diet.
While eliminating problem foods from your cooking at home may be an approachable task, be careful when eating out. Those who are very sensitive to certain foods may experience difficulties with crosscontamination that may occur when foods are cooked on the same surface where a problem food has been cooked. When eating out, digestive enzymes may still offer a buffer, even if they might not normally eliminate all of your symptoms.
Don’t Let Intolerance Change Who You Are! We have all had embarrassing digestive challenges at different times of our lives. It is part of being human! With so many options available to conquer food intolerance, there is no reason to allow them to take over our lives. Keri Glassman is a nationally recognized celebrity nutritionist who knows her food! With a philosophy of living a Nutritious Life, Keri works with her clients to take a new look at nutrition through the eyes of total body health, wellness and beauty. Read more articles from Keri on her website, NutritiousLife.com.
How Do I Tell If I Have a Food Intolerance? 1. Keep a Food Diary Keep a list of everything you eat, and then track if you experience any digestive issues. Over time, patterns may emerge that can point you in the direction of a specific intolerance.
2. Try an Elimination Diet Eliminate a specific problem-food like gluten or dairy from your diet for four weeks. Then, reintroduce the food in a small way, with a single piece of toast or cheese. If you experience digestive issues, you likely have a food intolerance. Remember to introduce one food at a time so you are aware of the problem food.
3. Try a Digestive Enzyme Brands like Enzymedica offer a wide range of products for food intolerance. If you think you have trouble with a certain type of food, try a digestive enzyme when you eat and see if you still experience digestive challenges.
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14 • INSIDE HEALTH
Immune Health and Your Digestive Tract Natasha Trenev President & Founder Natren, Inc.
Your digestive tract is not only responsible for breaking down and absorbing the food you eat – it also acts as a barrier against foreign substances, including undesirable bacteria. Most people are surprised to learn that 70 to 80% of their immune system lies in their intestinal tract – but this shouldn’t be surprising at all. After all, your digestive tract is one of the main entry points for harmful substances, including bad bacteria, to get into your body. That means there has to be safeguards for making sure these undesirable microorganisms can’t take up residence in your gut or be absorbed into your blood stream. That’s where the immune system comes in. During birth your intestinal tract rapidly became colonized with gut bacteria from your mom and from the surrounding environment. If your mother was not in great health, you were born by Caesarian section (C-section), you were not breast fed or you were not a full-term baby the bacteria transferred may not have been the ideal bacteria for inducing health and establishing your immune system, and if your first exposure was the microbes found in the hospital room, it’s possible your health may be jeopardized. David Mills Lab at the University of California, Davis, recently published an astonishing research article on this very topic showing that one specific bacteria, Bifidobacterium infantis, dominates the healthy breast fed infant gut. When they provided it, as a probiotic, to premature infants it was restorative and protective for those poorly colonized babies. Properly selected beneficial bacteria, like those transferred from a healthy mom to a healthy baby during birth, defend against foreign invaders and prime the immune system, teaching it to recognize friendly bacteria from undesirable bacteria. Beneficial bacteria make it harder for undesirable bacteria and yeast to survive by establishing themselves along the intestinal lining creating a natural defense barrier
and “hogging” resources those undesirable bacteria need to survive. Based on this, it is easy to see why it’s important to maintain a healthy bacterial balance in your intestinal tract. When there’s an optimal balance of good bacteria, the immune system in your gut functions best and you have a better chance of keeping unwanted bacteria and yeast from gaining a foothold and causing problems. Plus, beneficial gut bacteria produce short-chain fatty acids (SCFAs), which have an anti-inflammatory effect. This anti-inflammatory effect keeps the immune response from over-reacting like we
in your gut. That’s where probiotic supplements come in. They seed your gut with good bacteria and help maintain a healthy digestive tract – and a healthy digestive tract is important for immune support and overall health. Unfortunately selecting the right probiotic bacteria can be difficult, especially today when the health store shelves are full of options, many of which do not adhere to or follow a published standard. Probiotics are live microorganisms so protective packaging and careful handling is imperative. Buy products that clearly list the potency (CFUs). Probiotics are the foundation of
see in some bowel disorders. In addition, a healthy population of gut bacteria aids digestion and nutrient absorption and is required for the synthesis of some vitamins, including certain B-vitamins and Vitamin K.
health for the 21st century; educate yourself and get to know the published standards to make certain you are getting the right product foryour money.
Unfortunately, a number of factors can upset the delicate balance of bacteria in your gut. Drugs can destroy unfriendly bacteria as well as good bacteria. This creates disharmony in your gut and produces an environment where resistant bacteria can take up residence. Eating a poor diet and physical and psychological stress are other factors that can cause gut bacteria to become unbalanced. The population of bacteria in your gut is very much influenced by what you eat and drink.
THE NATREN STANDARD
How can you restore peace to your digestive tract or maintain the peace? After all, it’s pretty hard to completely control factors like stress that can disrupt the normal balance of bacteria
• Non-porous, amber glass bottles protect against damaging light and moisture • Products are refrigerated at time of manufacture, and shipped second day air in thermally controlled boxes • Clearly listed potency (CFUs) of each strain guaranteed through an expiration date
www.natren.com UNIQUE & POWERFUL PROBIOTICS INSIDE HEALTH • 15
Heartburn? Choose Natural Solutions over common drug store meds
A recent study shows users of proton pump inhibitors like omeprazole (Prilosec) and others could be at risk for heart complications. More than 20 million Americans each year seek digestive relief from over-the-counter heartburn medicines, also known as Proton-Pump Inhibitors or PPIs. For years, an increasing number of studies have uncovered negative side effects from long-term use of PPIs—from increasing food allergies and fractures to dementia. Now a massive Stanford study funded by the NIH has uncovered a link between long-term PPI use and heart attacks. The study underscores the need for caution and concern regarding OTC heartburn relief drugs. Fortunately, there may be all-natural options available for many of these individuals experiencing occasional heartburn or indigestion.
Belly Smart
Be gentle to your digestive system, as it may not react well to certain foods. Hold the sriracha, put down the fried foods and make an effort to add healthy alternatives into your diet. Tomatoes and acidic foods are the worst, as well as alcohol, caffeine, and tobacco.
Heartburn Buster
Occasional heartburn and acid discomfort after a meal are often symptoms of impaired digestion resulting from a variety of factors including lifestyle and diet. Reach for a natural dietary supplement like an enzyme, papaya leaf and other botanicals.
Chew Well
The enzymes in your mouth and grinding action present the stomach with a pre-digested mush rather than large chunks of undigested food.
Elevate Yourself
A simple change you can make right away is to elevate your head and upper body while sleeping--helping prevent gravity from allowing backflow of acid into your esophagus. This small step can make all the difference in helping the flow of your digestive system.
Even though your grill may be overflowing with food for your summer bbq, be careful how much you overindulge. Your stomach will thank you.
16 • INSIDE HEALTH
While sometimes it is tempting to take a nap or lie down after eating, it is important to stay active. A healthy body is one that gets plenty of exercise and sleep.
Say Hi to Fiber
From eating plenty of fruits and vegetables, to high grain cereals and nuts, fiber is the engine that keeps everything in your digestive system moving.
Know When to Say When
Get Up and Move
Get Off the Booze Cruise
You know that too much alcohol is not good for you, but few understand the havoc it can have on digestion. Heartburn is often a result of over-indulgence; too much drinking can cause excess stomach acid and inflammation. Digestive issues are extremely common, and through these simple tips, natural solutions may provide you with the relief you’ve been looking for.
Recurring stress may result in changes of the brain-gut communication, leading to a host of digestive issues. Stress may contribute to lower HCl, lower enzyme production and poor mucosal integrity. Stress may also effect our sensitive gut microbiota. By Woodson Merrell, MD, Inside Health Science Advisor We’ve all had the experience of stress making us sick. Now, science has explained that this happens through the intelligence of our cells reacting to even just a stressful thought, with biological changes all the way down to the smallest particles of DNA. Today we are only beginning to understand the subtleties of mindbody medicine.
Good Stress vs. Bad Stress It is often your perception and handling of an event, and not the nature of the stressor, that determines its effect on you. For athletes and concert musicians, stress can lead to constructive outcomes—the adrenaline rush that releases a burst of energy before a game or performance can improve their playing. However, research has found that this is only true when a person has prepared thoroughly for a task. The more control you perceive yourself to have over a stressful situation the less damaging the stress will be. Nowhere is the perception of stress better illustrated than in the latest research on the link between Type A personalities and heart attack risk. For many years, scientists thought that all Type A personalities— hurried, high-achieving, risk-taking people—had a greater chance of developing heart disease than non-Type A personalities simply because Type As invite more stress into their lives. However, it turns out there are healthy Type As and unhealthy Type As—the difference is in their emotional coping style and how they perceive the stressors in their lives. Type A people with positive attitudes and optimistic coping styles live longer and have no greater risk of heart disease than the general population. The veil of emotions through which you perceive your stress to a large degree determines the toll it will take on health and energy.
Two Coping Strategies Move Your Tipping Point: The point beyond which cumulative exposure to stress causes fatigue and illness is a moving target. For each person, the
tipping point is different and it can vary from day to day. There are many stories about people who survive catastrophic emotional or physical situations and tragedies and go on to lead healthy lives. On the flip side we all know people who collapse at seemingly trifling stress (the cable guy never showed up). The point is that you simply cannot allow stress to accumulate, no matter which kind of stress affects you. Create the Perception of Control: The thought (even if it seems initially like an illusion) that you can exercise personal choice in a stressful situation has been found to be the single greatest predictor of effective stress management— regardless of whether or not you actually have control! Taking conscious steps to control your stress, even if it’s something as simple as taking calming breaths just before a major meeting, is an important part of the transformation toward a more energetic life.
A Guide to the Best Relaxation Exercises Practicing just one of the recommended relaxation techniques—whether it’s meditation, breath work, yoga, or tai chi—will bring positive energy into your life. Some of the techniques—such as breath breaks—simply trigger the relaxation response, while others like acupuncture have broader applications. It really doesn’t matter which technique you choose, numerous published studies have shown that all relaxation techniques—which promote an altered state of relaxed concentration or focused reverie— have beneficial effects, including a decrease in energy consumption.
Relaxation as a Therapeutic Intervention Establishing breath breaks: The supply of oxygen to your cells is a major determinant in how much energy you make. By simply increasing the oxygen supply in your blood with deep-breathing exercises, you will be able to make more energy and elicit the relaxation response, which simultaneously allows your body to utilize less energy. The goal is to take deeper, slower breaths, which allows a general deceleration of the metabolism and stress-response systems, along with a corresponding conservation of energy and improved alertness. The key to this profound breathing technique is to take abdominal breaths, which means that the abdomen, rather than the chest, expands as you inhale. (By involving the diaphragm, you draw oxygen deeper into the lung cells and recruit muscles and neurotransmitters that significantly enhance the effects.) It’s best to sit up straight with shoulders back to expand your lung capacity. You can take breath breaks any time—in the office, in the car, in a conference room, or on an airplane. By following these basic instructions you will unfailingly experience a softening of your upper body’s usual tension, and a slower, more relaxed breathing pattern—even after you finish the exercise. Studies of this technique show that it results in slower pulse, lower blood pressure, relaxed intestinal muscles, lower cortisol and blood carbon dioxide levels. The nervous system alone utilizes about 20 percent of the oxygen you take in, so by reducing the nervous system activity you preserve energy. From THE SOURCE by Woodson Merrell. Copyright © 2008 by Woodson Merrell, M.D. Reprinted by permission of Atria Books, a Division of Simon & Schuster, Inc. Content has been edited for brevity to fit available space.
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Recipes
You can make tonight!
It begins with fresh, healthy food and fun-to-make recipes. Vegetable Lasagna BY MARY CAPONE
This recipe is packed with good-for-you veggies.
Easy Marinara Sauce This quick sauce is simple and flavorful. Use high-quality canned tomatoes for best results. 2 (28-ounce) cans whole tomatoes in basil 2 tablespoons chopped fresh basil 1 tablespoon chopped fresh oregano 1 tablespoon sugar 1/4 teaspoon salt, more to taste ❧ Pepper, to taste 1/4 cup olive oil 2 cloves garlic, minced Place tomatoes with juice in a food processor or blender and process just until smooth. Transfer tomato puree to a saucepan and warm over medium heat. Stir basil, oregano, sugar, salt and pepper into warm tomato puree. Bring mixture to a slow simmer and cook about 15 minutes, stirring frequently, until tomato sauce resembles a thin oatmeal. Do not overcook. Taste and adjust seasoning accordingly. In a small pan, heat oil and add minced garlic. Cook until garlic is light brown or just beginning to color. Add oil and garlic to tomato sauce, stirring to combine.
Pasta 1 package gluten-free lasagna noddles Prepare lasagna noodles al dente according to package instructions.
Vegetable Filling 2 tablespoons olive oil 2 cloves garlic, minced 1 red, orange or yellow bell pepper, thinly sliced 1 pound crimini mushrooms, thinly sliced 1 medium zucchini, thinly sliced ½ teaspoon finely chopped fresh Italian flat parsley ½ teaspoon sea salt ❧ Pepper, to taste To make vegetable filling, heat olive oil in a large skillet over medium heat. Add garlic and sauté 1 minute. Add pepper slices and sauté, about 3 minutes. Add mushrooms, zucchini, parsley, sea salt and pepper. Sauté until mushrooms are golden brown and veggies are al dente.
Cheese Filling 8 ounces fresh mozzarella or dairy-free alternative 1 cup ricotta cheese or dairy-free alternative 3 tablespoons milk of choice 2 tablespoons fresh, finely chopped Italian flat-leaf parsley 1 cup finely grated Parmesan cheese or dairy-free alternative, divided ❧ Salt and pepper, to taste ❧ Pinch of ground nutmeg To make cheese filling, cut mozzarella into ¼-inch slices and set aside. In a medium bowl, combine ricotta cheese, milk, parsley, ¼ cup Parmesan cheese, salt, pepper and nutmeg. Mix together until creamy. Set aside.
Noodle-Licious! For gluten-free or allergy-friendly lasagna pasta, check out these products: DeBoles Rice Lasagna (deboles.com), Jovial Brown Rice Lasagna (jovialfoods.com), Tinkyada Brown Rice Lasagne (tinkyada.com). Not every product sold by every company listed is gluten-free or allergy-friendly. Read labels. Ingredients can change. When in doubt, confirm ingredients directly with the manufacturer.
18 • INSIDE HEALTH
Assembling the lasagna
mozzarella slices and cheese filling and remaining Parmesan cheese. Cover baking dish with lightly oiled foil.
1. Preheat oven to 375°F. 2. In a 9x13-inch baking dish, add ½ cup marinara sauce to baking dish. Place pasta end to end, covering the bottom of the pan. Layer ½ cup sauce over the pasta, 1/3 of the vegetable filling over the sauce and 1/3 of the mozzarella slices and cheese filling over the vegetable filling. Sprinkle ¼ cup Parmesan cheese over the cheese filling. Place more pasta over the Parmesan cheese and repeat the layering process. Top with more pasta, remaining ½ cup sauce, remaining
3. Place lasagna in preheated oven and bake 30 to 40 minutes or until lasagna is thoroughly heated. 4. Remove from oven and let rest uncovered 15 minutes. Cut into squares and serve. Makes 8 to 10 servings. Each serving with Easy Marina Sauce contains 396 calories, 23g total fat, 9g saturated fat, 0g trans fat, 87mg cholesterol, 969mg sodium, 32g carbohydrate, 3g fiber, 8g sugars, 17g protein, 17 Est GL.
Pork, Broccoli & Red Pepper Stir-Fry with Asian Brown Rice Noodles BY BETH HILLSON
It’s light but filling. Serve this with a salad of baby spinach, orange slices, toasted pumpkin seeds and diced avocado, tossed with olive oil and white balsamic vinegar. 2 teaspoons salt 4 ounces gluten-free Asian brown rice noodles or gluten-free spaghetti (not vermicelli) 2 teaspoons olive oil or sesame oil, optional 1 marinated and grilled pork tenderloin (about 1-1¼ pounds) 3 tablespoons olive oil, divided 1 medium onion, cut in thin wedges 2 teaspoons crushed or chopped ginger 2 cloves garlic, crushed 1 broccoli crown (about ½ pound), cut into bite-size florets 1 red bell pepper, seeded, cut into strips 2 tablespoons rice vinegar ¼ cup gluten-free chicken broth 2 tablespoons gluten-free soy sauce or tamari 1 tablespoon honey 2 teaspoons Sriracha sauce, optional
1. Place salt and 2 quarts of water in a large saucepan and bring to a boil. Place noodles in boiling water and cook according to package instructions. Drain and rinse with cold water. Toss with 2 teaspoons olive oil, if desired, and set aside. 2. While noodles cook, slice tenderloin and cut each slice into 3 strips. 3. In a large wok or skillet, heat 11/2 tablespoons the olive oil over medium heat. Add half the onion, ginger and garlic and sauté 2 minutes. Add the pork and sauté an additional 2 minutes. Remove to a plate. Add remaining oil, onion, ginger and garlic. Sauté 1 minute. Add broccoli and sauté an additional 2 minutes. Add red pepper and sauté another minute. Add vinegar and stir. 4. In a small bowl, combine broth, tamari, honey and Sriracha sauce. Mix well and add to ingredients in the wok. 5. Add pork and noodles. Bring mixture to a simmer and heat until noodles are warm, about 1 minute. Serves 4. Each serving contains 379 calories, 14g total fat, 2g saturated fat, 0g trans fat, 73mg cholesterol, 1835mg sodium, 35g carbohydrate, 2g fiber, 8g sugars, 27g protein, 20 Est GL.
Grilled Salmon with Balsamic Cherry Tomatoes BY LAURA B. RUSSELL
Cherry tomatoes offer little bursts of flavor in a salad so why not give them a leading role? In this recipe, the tomatoes are grilled for just a few minutes until their skins start to pop. The warm tomatoes soak in the balsamic vinegar, making them a bright, tangy topper for your salmon. A grill basket makes easy work of grilling tomatoes, keeping them from slipping through the grates. If you don’t have a basket, thread the tomatoes onto bamboo skewers. If you don’t eat salmon, this gluten-free recipe is delicious with grilled chicken, flank steak, pork and tuna. 2 cups cherry tomatoes 3 tablespoons olive oil, divided 1 garlic clove, smashed 1 tablespoon balsamic vinegar 1 teaspoon kosher salt, divided ¼ cup loosely packed shredded basil 1½ pounds salmon fillet, about 1-inch thick, cut into 4 pieces
1. Heat the grill to medium-high heat. Top the grate with a grill basket to keep the tomatoes from falling through the grate. 2. Put tomatoes in a bowl and toss with 1 tablespoon olive oil. Dump tomatoes into the grill basket and cook until they start to char and pop, 3 to 4 minutes. Return tomatoes to the bowl and gently toss with garlic, vinegar, ½ teaspoon kosher salt, 1 tablespoon olive oil and basil. Set aside. 3. Coat salmon with remaining 1 tablespoon olive oil and sprinkle with remaining ½ teaspoon salt. Place salmon on grill skin-side up and cook 4 minutes. Turn and cook until fish is just barely done, about 3 minutes longer. Fish will still be translucent in the center. (Grill a few more minutes if you like your salmon thoroughly cooked.) Serve fish topped with tomatoes. Serves 4. Each serving contains 458 calories, 33g total fat, 7g saturated fat, 0g trans fat, 92mg cholesterol, 685mg sodium, 4g carbohydrate, 1g fiber, 3g sugars, 35g protein, 1 Est GL.
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Chicken Tacos BY MARY CAPONE
Lightly battered in potato starch, lime juice and roasted spices, these crowdpleasing tacos can be made quickly. A delicious way to celebrate Cinco de Mayo, they’re great with either chicken or tilapia, if fish is tolerated. 2 whole chicken breasts, boneless, skinless, or 4-6 tilapia fillets, about 1 pound
¼ teaspoon allspice
2 teaspoons chili powder
1 lime, juiced
½ teaspoon ground cinnamon
2 tablespoons coconut oil or olive oil, for sautéing
1 teaspoon Mexican oregano or regular dried oregano
½ cup potato starch (not potato flour)
10 gluten-free tortillas
¼ teaspoon ground cloves 1. Rinse chicken or fish and pat dry. 2. In a small sauté pan, add chili powder, cinnamon, oregano, cloves and allspice to pan. Roast spices over medium heat until they begin to have a strong fragrance, about 2 to 3 minutes. Remove from heat and let cool. 3. In a medium-size bowl, blend potato starch with roasted spices.
Jules’ Homemade All-Purpose Flour Blend To make very fine rice flour, process regular rice flour in a food processor, blender or clean coffee grinder until very fine. 1 cup cornstarch, tapioca starch or arrowroot powder 1 cup potato starch, tapioca starch or arrowroot powder 1 cup very fine white rice flour, sorghum flour or buckwheat flour ½ cup corn flour, millet flour, sorghum flour or brown rice flour ½ cup tapioca starch, cornstarch or arrowroot powder 4 teaspoons xanthan gum or guar gum Whisk ingredients together in a large bowl until well combined. Refrigerate in a large zip-top bag or a sealed container until used. Makes 4 cups. Each cup contains 522 calories, 1g total fat, 0g saturated fat, 0g trans fat, 0mg cholesterol, 6mg sodium, 123g carbohydrate, 4g fiber, 0g sugars, 4g protein, 74 Est GL.
4. In separate bowl, place lime juice. Dip chicken pieces or fillets in lime juice and then in starch/spice mixture. 5. Heat oil in a pan and sauté fillets for 2 to 3 minutes on each side. Do not overcrowd the pan. For blackened chicken, cook 5 to 7 minutes per side or until meat is firm to touch. Remove from pan and serve with warm tortillas and your favorite toppings. Serves 6 to 10. Each taco with corn tortilla contains 171 calories, 4g total fat, 3g saturated fat, 0g trans fat, 22mg cholesterol, 30mg sodium, 23g carbohydrate, 0g fiber, 11g protein.
Rustic Apple Pie BY JULES SHEPARD
This home-style pie has a gorgeous free-formed crust that’s light, flaky and simple to make. The recipe calls for apples and tart cherries but use your favorite late-summer fruit.
Crust 1 cup Jules’ Homemade All-Purpose Flour Blend (see recipe, left) ½ teaspoon salt 2 tablespoons nonhydrogenated shortening or coconut oil 3 tablespoons butter or Earth Balance buttery sticks 2–3 tablespoons cold water or 2 tablespoons vodka + 1 tablespoon water Egg wash (1 egg + 1 tablespoon water), oil or milk of choice, for brushing on crust
Filling 1 tablespoon lemon juice 5 cups peeled, cored and diced tart apples (a mixture of apple varieties works best) 1 cup pitted tart cherries (drained, if using canned cherries) ¼ cup Jules’ Homemade All-Purpose Flour Blend ½ cup sugar 1 teaspoon ground cinnamon ❧ Demerara sugar or granulated sugar, for sprinkling on top 1. To make the crust, combine flour blend and salt in a large bowl or food processor. Cut in shortening and butter and process until mixture is crumbly. Add water gradually until dough forms into a ball. (Err on the side of dough being wetter rather than too crumbly.) Form dough into a disk, trying not to overwork it. Wrap it in plastic wrap and set aside 30 minutes while you make the filling.
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2. To make filling, mix lemon juice in a large bowl of water. Place apples in the water to coat them with lemon water. Then drain. Stir cherries into apples. Add flour blend, sugar and cinnamon, stirring gently to distribute. 3. Preheat oven to 400°F. Line the middle oven rack with aluminum foil to catch drips. 4. On a surface generously dusted with gluten-free flour, roll out dough to a diameter at least 1 inch larger than the diameter of a 9-inch or 10-inch pie pan. Gently lift an edge of the rolled out crust using a butter knife or bench scraper. Lay the edge over your rolling pin so that it is supported by the rolling pin as you lift the crust onto your pie plate. Gently pat the dough into place, allowing excess crust to hang over the edge of the pie plate. If the crust cracks, wet your finger and press edges back together.
Raspberry Strawberry Smoothie Cups BY MATTHEW KADEY, RD.
You don’t always have the time to gather up all the necessary ingredients to make a smoothie. These make-ahead smoothie cups are your answer to a quick, refreshing drink. When ready for a cold smoothie, just drop a couple into a blender with liquid and you’re good to go. For the easiest extraction of the smoothie cups, it’s best to use bendable silicone muffin cups. 2 cups unflavored hemp milk, rice milk or other milk of choice 1 tablespoon honey 1 tablespoon coconut oil 1 teaspoon pure vanilla extract 1 teaspoon orange zest ½ teaspoon ground cinnamon 2 cups raspberries 1 cup strawberries ❧ Grated dark chocolate, for garnish, optional
5. Place filling into crust and gently fold crust edges over toward the center of the pie. 6. Brush dough with beaten egg or milk of choice, reserving some. (This helps brown the crust as it bakes.) Cover the pie loosely with foil to prevent over-drying. 7. Place in preheated oven and bake 20 minutes. Remove foil, brush top with more egg wash or milk and replace the foil. Reduce oven temperature to 350°F and bake another 25 minutes. Remove foil. Bake an additional 10 minutes or until filling is thickened and bubbly and crust is lightly browned. Do not overbake or crust will become tough. 8. Remove pie from oven and cool on a wire rack. Sprinkle pie lightly with sugar, if desired. Serve warm. Serves 8. Each serving contains 254 calories, 9g total fat, 4g saturated fat, 0g trans fat, 38mg cholesterol, 158mg sodium, 44g carbohydrate, 2g fiber, 22g sugars, 2g protein, 23 Est GL.
Coconut Avocado Smoothie BY MATTHEW KADEY, RD.
Bursting with tropical flare, avocado gives this freshtasting smoothie a creamy richness and plenty of heart-healthy monounsaturated fat. 1 cup coconut water 1 cup coconut milk (carton, not canned) ❧ Juice of ½ lime 2 tablespoons fresh chopped basil
1 tablespoon honey ❧ Pulp of 1 ripe avocado 1 cup frozen mango cubes ❧ Dash of salt ½ teaspoon lime zest
switch hits
1. Place all ingredients, except lime zest, into a blender container in the order listed.
Replace strawberries with chopped plums, nectarines or peaches.
2. Blend until smooth. Add additional coconut water if the smoothie is too thick for your liking. Divide between 2 glasses and garnish with lime zest.
Try lemon zest instead of orange.
Serves 2. Each serving contains 304 calories, 17g total fat, 5g saturated fat, 0g trans fat, 0mg cholesterol, 190mg sodium, 38g carbohydrate, 10g fiber, 4g protein.
Use coconut water in lieu of dairy-free milk.
Gluten-Free Fruit-Tomato Smoothie BY LISA STANDER-HOREL
1. Place all ingredients into a blender container in the order listed. Blend until smooth, about 30 seconds. 2. Divide among 12 medium-size muffin cups and freeze until solid, about 4 hours. 3. Unmold smoothie cups and place in a zip-top bag for storage in the freezer. If you have trouble unmolding the frozen cups, try placing the bottom of the muffin tray in warm water for several seconds, being careful not to thaw the contents. 4. When ready to serve, place 1 cup liquid of choice and two smoothie cups into a blender container; blend until smooth. (If you don’t have a powerful blender, cut the frozen smoothie cups into quarters first.) Add additional liquid, if needed, to help with blending and to reach desired consistency. Serve topped with grated dark chocolate, if desired. Serves 6. Each serving contains 95 calories, 5g total fat, 2g saturated fat, 0g trans fat, 0mg cholesterol, 38mg sodium, 13g carbohydrate, 3g fiber, 1g protein.
Loaded with potassium, calcium and antioxidants, this smoothie is a healthy way to begin your day. It may become your new favorite breakfast drink. 1 cup cold pure tomato juice ½ cup frozen mixed mango and/or pineapple pieces ½ cup cold pomegranate juice ½ cup fresh or frozen raspberries or strawberries ¼ cup full-fat Greek yogurt or dairy-free yogurt of choice, optional 1 teaspoon honey, optional 1. Place all ingredients into a blender in the order listed and pulse until blended. Little pieces of frozen fruit will remain suspended in the smoothie. 2. Strain to remove seeds, if desired. Serve cold. Serves 2. Each serving contains 163 calories, 1g total fat, 0g saturated fat, 0g trans fat, 0mg cholesterol, 106mg sodium, 40g carbohydrate, 5g fiber, 31g sugars, 3g protein, 14 Est GL
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My Life with
Food Intolerance A Q&A with Erica Dermer, managing editor of Gluten Free & More magazine.
Enzymedica offer tailed enzymes to suit your digestive needs. There are enzymes inside that are specific to what you need to break down. Lactose is used for dairy intolerance to help digest milk. Xylanase helps break down certain types of fiber. High protein foods can be broken down with the help of protease enzymes. Fat can be broken down with the help of lipase. Amylase helps digest starchy portions of grains. There are so many enzymes that together help break down about anything you could eat.
What made you choose Enzymedica? They were an exhibitor at one of the first glutenfree expos I attended. They were handing out samples. I was quite impressed at how effective their enzymes were. Once I realized how well they worked, I become an advocate for their use.
Erica Dermer is a blogging machine. In a few short years she’s become one of the go-to bloggers in the natural food and supplement industry, based on her personal experiences as a celiac—but also as a person who has conquered her condition. We caught up with Erica recently to find out how she functions in her often topsy-turvy foodchallenged world.
What was the first time you thought you might need additional digestive support? To be honest, I’m pretty sure my life is just one big need for additional digestive support. I’ve always been a type A personality who’s been stressed pretty much all the time, and that definitely was felt in my gut. Nothing I ate ever felt that great, and it only got worse after celiac disease kicked in. One night, I got extremely sick after a night of wine and bruschetta with friends. My digestive tract never really recovered after that night, and I was stuck with years of digestive distress. Doctors tested me over and over again for what was wrong. I was treated for ulcers, which I ended up not having. I was tested for gallbladder issues with multiple HIDA scans. Finally, I was diagnosed with gastroparesis – delayed stomach emptying. Basically my food stayed in my stomach for way longer than it was supposed to – sometimes even days. My stomach had a hard time breaking down food, and my brain didn’t necessarily signal my food to empty into my intestines either. It was uncomfortable – I was nauseated and bloated and dealt with heartburn and gastritis every day, every hour. Anything I ate needed help and assistance to digest and deliver any nutrients to my body. I took multiple prescription medications to help my stomach to empty, but I believe that digestive enzymes were a big help in making me feel like my body was actually doing something with 22 • INSIDE HEALTH
anything that I ate – or attempted to eat. I was on a strict diet of easy-to-digest foods with low fiber, but as the medication kicked in, I added more and more food back into my diet. Only later, after visiting yet another doctor, did I find out that it was celiac all along, and the delayed stomach emptying was just a sign that things were really, really wrong in my body.
It’s clear you avoid gluten because of celiac, but what about other foods? Yes, I avoid beef, dairy, and eggs. These are food intolerances -- not food allergies. I’ve been tested for anaphylactic allergies and I’m clear. While I do my best to avoid the offending foods, sometimes I do cheat and crave an item made with dairy and eggs. I haven’t reintroduced them fully yet, and I’m not sure that I plan on doing so, but I at least know I can tolerate them in small doses with digestive enzymes.
How did you find out about digestive enzymes? One of my doctors recommended digestive enzymes for every day use for anyone with gut health problems. I started small by using papaya enzymes off the shelf at the grocery store. However, they weren’t specified for any particular food. It’s not specific for protein, beans, gluten, dairy, vegetables, etc. I learned that brands like
I like that the digestive enzymes I use contain no egg, dairy/casein, soy, wheat/ gluten, or yeast. In addition, they do not include preservatives, salt, sucrose, nuts, corn, potato, rice, artificial colors or flavors. They also offer enzymes plus probiotics, multivitamins plus enzymes, etc. It’s nice to have everything in one pill from a brand you can trust.
How did you know what type of enzyme to choose? With multiple intolerances, from eggs to dairy to gluten to beef, I decided on the Digest Spectrum for any time I eat something suspicious. I never ever cheat on a gluten-free diet, since I have celiac disease. I know my long-term ramifications if I choose to eat gluten as a celiac. However, I travel all of the time. I dine out with friends, family, and my partner. I understand that I will have to deal with cross-contamination at some point in my life – some months more often than others. I prefer to cover all of my bases and just take an enzyme, knowing that it will all sort itself out…inside. Besides Digest Spectrum, I also have Digest Gold and Digest Gold with Probiotics.
When do you typically take these enzymes? Any time I eat meat, or a difficult vegetable – like raw carrots, a lot of carbs, or beans, it’s a good time to take a few Digest Spectrum enzymes. I take a bottle with me on trips, and definitely take enzymes after eating out at new and unfamiliar restaurants.
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