Wellspring issue #19 by The Wellspring

WEALTH OF HEALTH CONFERENCE WITH NUTRITIONIST TANYA ROSEN OF TAP

OFF TO A GOOD START

Summer Project Part II: Is your child sleeping enough? Q&A with Miriam Manela, OTR, on teaching children with sensory issues about personal hygiene

CUP OF TEA WITH TAMAR FELDMAN, RDN, CDE The Gut Dietitian on digestive health

ASK THE NUTRITIONIST If I don't have an appetite during summertime, can I skip meals?

TEN QUESTIONS

GOOD FOOD INSIDE

Rabbi Yankie Meyer of Misaskim

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Editor In Chief Shiffy Friedman, MSW, CNWC Nutritional Advisory Board Jack Friedman, PhD • Moshe Weinberger Yaakov Goodman, CN • Shani Taub, CDC • Mimi Schweid Dr. Rachael Schindler • Tanya Rosen, MS CAI CPT Fitness Advisory Board Syma Kranz, PFC • Esther Fried, PFC Feature Editors Rochel Gordon • Liba Solomon, CNWC Copy Editors Gila Zemmel • Faige Badian Food Editor Esther Frenkel Food Styling & Photography Yossi & Malky Levine Creative Directors Miriam Bluming • Rivky Schwartz Art Director Chavy Lefkowitz Digital Marketing Simcha Nunez Store Distribution Motty Srugo 718-496-1364 Write To Us: 670 Myrtle Ave. Suite 389 Brooklyn, NY 11205 info@wellspringmagazine.com www.wellspringmagazine.com

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The Wellspring Magazine is published monthly by Maxi-Health Research LLC. All rights are reserved. Reproduction in whole or in part or in any form without prior written permission from the publisher is prohibited. The publisher reserves the right to edit all articles for clarity, space and editorial sensitivities. The Wellspring Magazine assumes no responsibility for the content or kashrus of advertisements in the publication, nor for the content of books that are referred to or excerpted herein. The contents of The Wellspring Magazine, such as text, graphics and other material (content) are intended for educational purposed only. The content is not intended to substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your health care provider with any questions you have regarding your medical condition.

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From the Editor

Dear Readers, A healthy lifestyle isn’t defined merely by smart choices in the plate. As you’ll read in this issue’s feature, which is Part II of the two-segment Summer Project series on implementing a healthy lifestyle in the home, it also involves ensuring that our children have a good night’s rest, engage in physical activity, take care of their personal hygiene, and that their emotional wellbeing is up to par. It’s ironic that I was busy putting the finishing touches on an issue whose feature is the importance of sleep on one of the most sleepless weeks of my life. For starters, I was baruch Hashem blessed to give birth to a beautiful baby boy, and being the mother of a newborn turns a good night’s sleep into a faraway fantasy. (There’s a reason I’m only writing this letter so close to when we go to print.) And on an entirely different, painfully devastating note, our close-knit community was struck by tragedy when my very close friend’s eighteen-month-old baby choked on a screw as Shabbos was coming in. After two sleepless, harrowing nights for her parents and the rest of our community, little Fradela passed away on Sunday morning, erev Rosh Chodesh Av, leaving us all reeling in shock, pain, and mourning. How does one sleep on nights like these? In the second verse of Eichah, the navi describes the intense pain of Yerushalayim that kept her up at night: “Bitterly, she weeps in the night, her cheek wet with tears.” As I was up in the wee hours of Shabbos morning, anxiously awaiting good tidings from my husband who did the 40-minute trek to the hospital and back, I thought of the many other women who were up together with me in various apartments on our block, also hoping to hear that everything had ended well. But it wasn’t meant to be. At the shivah, I was amazed to see the strength and composure of my dear friend, the bereaved young mother. Simply sitting in her presence comforted my soul. I watched as all those who’d come to comfort my friend left with an incredible sense of peace that emanated from her and filled the kitchen in which the charming little girl had cheerily eaten her meals less than a week before. When we’re struck by a tragedy of this magnitude, in which a young, healthy child is so suddenly taken from us, we gain a profound awareness of the transient nature of this life and a deeper appreciation of our own children. Hashem entrusts us with these precious neshamos, and the time we have with them is our opportunity to give them all we possibly can—a perspective that my dear friend, a mother who literally breathes for her children, truly lives with. Indeed, my memory of this child is of her on her mother’s hip—always—her hand on her mother’s heart, as all who knew her will concur. May the merit of our dedication to our children—to their spiritual, emotional, and physical health—as a result of this inspiration serve as an aliyah for the neshamah of Fradel bas Yaakov Yehoshua, a”h. Now that we enter the Shivah DeNechemta, the seven weeks of consolation, may we know of only simchos. May the rest of our summer be uneventful and beautiful in every way.

Best wishes,

Shiffy Friedman

shiffy@wellspringmagazine.com

Well-Put!

“During an enlightening conversation with my daughter’s camp nurse, she explained that a camper’s hoarseness is exacerbated by lack of sleep,” writes Bracha Rosen in this issue’s Inkwell. Read more about a solution for hoarseness on page 78.

Av 5777 | The Wellspring 7

Contents

AV 5777

AUGUST2017 The next issue of The Wellspring will appear iy”H on September 6th.

WELL INFORMED 15

WELLNESS PLATFORM By Rabbi Hirsch Meisels

TORAH WELLSPRING By Rabbi Ezra Friedman

HEALTH UPDATES IN THE NEWS By Liba Solomon, CNWC

FIGURES By Miriam Katz

WEALTH OF HEALTH Conference with Tanya Rosen, M.S. CAI CPT By Sarah Weinberger

DEDICATED TO HEALTH 10 Questions for Yankie Meyer By Chana Dunner

THE DAY AFTER THIS PAST PESACH, WE WERE SERVICING 79 SHIVAH HOUSES, COMPRISING OVER 300 AVEILIM, WITH ACCESS TO ONLY 24 SIFREI TORAH. -RABBI YANKIE MEYER OF MISASKIM

PAGE 32

32 LIVING WELL 28 30 32 54 56

Mazel Tov

UPON THE BIRTH OF HER BABY BOY!

Shiffy Friedman

ASK THE NUTRITIONIST Skipping Meals By Shani Taub, CDC IN GOOD SHAPE Fitness 101: Running Outdoors By Syma Kranz, PFC COVER FEATURE Off to a Good Start By Chevy Reichberg HEALTH PROFILE Client: Sari By Esther Steinmetz TRIED AND TRUE Up or Down? By Batsheva Fine MONTHLY DOSE Save Those Enzymes By Yaakov Goodman, CN

FAREWELL FOOD FOR THOUGHT

SOURDOUGH BREAD ISN’T ONLY GREAT FOR DIABETICS AND PEOPLE WHO ARE SENSITIVE TO GLUTEN, BUT FOR EVERYONE WHO WANTS TO ENJOY A MEAL THAT’S GOOD FOR THE GUT. PAGE 39

- ESTHER FRENKEL, SEASONED

EAT WELL WELLBEING 61

CLEAN SLATE Conquering the Feeling Phobia By Shiffy Friedman, MSW, CNWC

FROM THE GROUND UP 3 Years By Goldy Guttman, Ms. Ed.

EMOTIONAL WELLNESS You're Being Called By Esther Moskowitz, LCSW & Yocheved Rottenberg

HEALTH PERSONALITY Tamar Feldman, RDN, CDE By Shiffy Friedman

SEASONED Homemade and Wholesome By Yossi & Malky Levine

NUTRITION TIDBITS IN THE NEWS By Liba Solomon, CNWC

NUTRITION FACTS IN A SHELL This Month: Eggplant By Devorah Isaacson

AGE WELL

71 PARENTS SHOULD BE CAREFUL NOT TO LET THEIR IDEA OF APPEARANCES BE CONFUSED WITH CLEANLINESS FOR THEIR CHILD WITH SENSORY NEEDS. -MIRIAM MANELA, OTR, FEATURE

GOLDEN PAGE By Yaakov Goodman, CN

SENIOR CARE The Ins & Outs of Gout By Rena Milgraum, RN

SAGE ADVICE Never too Late By Aliza Simon

SERIAL DIARY Entry #9 By Malka Aronson

INKWELL 78

DIARY Shout-out to a Voice Solution By Bracha Rosen

PAGE 72

Av 5777 | The Wellspring 9

Springboard

Letters

Networking Quest for a health forum [Issue #17: Springboard] Dear Editor: Your letter to the editor from Tziri M. regarding a frum Google forum with a focus on health spurred me to action. My husband is a doctor of Acupuncture and Oriental Medicine who practices Traditional Jewish Medicine, in which he incorporates Chinese medicine and craniosacral therapy with other tools into a framework of what the Torah says about health and healing—and there is a lot! My husband recently gave a six-week course in Jewish Medicine in Los Angeles, where we are currently living (we move to Yerushalayim in August), and we had just started a WhatsApp group for Jewish Medicine when I read the letter to the editor. So I asked my husband if he would allow me to create a Google group forum for Jewish Medicine, parallel to the other group, since many Yidden either don’t use WhatsApp. I run a large forum for frum writers, so I have experience with Google groups and yes, it can be a drain on one’s time. Both of us are passionate about educating people about how the body works, how to keep ourselves healthy, and how to heal from what the conventional Western medical system calls disease and illness. My husband had the privilege of translating and editing Rabbi Shalom Arush’s book Hashem Rofecha into the English The Garden of

10 The Wellspring | August 2017

Healing. He wrote a set of appendices in the back of the book that describe the medicine he practices and what his general protocols are for healthy eating and living. I have done health mentoring as a side activity for about 10 years, and I’ll be completing a course in Functional Medical Health Coaching in early 2019. We would welcome the chance to help answer the public’s questions about healthy lifestyle, health, disease, and how to live a vibrant healthy life. Individual health questions will not be answered on the forum, but general and even specific health questions can be answered. The forum is there for support, not for dispensing medical advice. And we have a sister group on WhatsApp (and we will create a parallel email forum if there is enough interest) called Nourishkeit, which is about practical implementation of Traditional Jewish Medicine and general lifestyle/ natural medicine, complete with recipes and products and anything having to do with nourishing the body and soul. To join the Jewish Medicine forum, please send an email to JewishMedicine+subscribe@googlegroups.com. For further information, you can email me at yocheved@traditionaljewishmedicine.org. Yocheved Krems Frischman

Kashrus Alert Infested Fruits [Issue #17: Seasoned] Dear Editor: Your recipes of delicious and appetizing foods enhance our supper table many times. I’d like to raise awareness that fresh

blueberries are infested with insects and should therefore not be eaten. According to halachic psak, they can’t be cleaned at all, even if they’re washed. In addition, it’s worthy to note that there is only one way to inspect strawberries. They need to be peeled, trimmed, rinsed, and washed carefully. (Ask your Rav for exact instructions.) Grapes should be soaked and scrubbed, each piece individually. It’s best not to use infested fruits at all. Enjoy happy, healthy, and kosher meals minus the insects. M.W. Brooklyn, NY Editor's Note: Readers should consult with their halachic authority for directions regarding inspecting food for bugs.

Expressing Gratitude Fan Mail [Issue #18] Dear Editor: This is my first official letter to an editor. I just put down this week’s issue of The Wellspring, and I wanted to let you know that I thoroughly enjoyed it from cover to cover. The tips for helping kids achieve healthy eating habits were fantastic. The magazine was packed with so many great ideas and information. Since I had my baby, I haven’t really gotten to do much reading and this was a real treat for me. Thank you so much for this great read! A fan, E.W. Lakewood, New Jersey

invites readers to submit letters and comments via regular mail or email to info@wellspringmagazine.com. Please include your name, address and phone number. We reserve the right to edit all submissions and will withhold your name upon request. We will honor requests for anonymity, but we cannot consider letters that arrive without contact information.

Springboard

Letters

The Magic in Mother’s Milk Don’t underestimate its completeness [Issue #18: Conference with Joel Gross of First Choice] Dear Editor: I’m writing this letter as a holistic health practitioner certified by the AADP. Mother’s milk, which Hashem has created to feed and nurture newborns and babies, is awe-inspiring in its perfection. It provides complete nutrition for a child’s development. Children need amino acids, the broken down form of protein, to build their body. However, on page 23, in the article about baby foods, you included a sentence which is, in my eyes, bordering on kefirah, “from which mother’s milk doesn’t provide adequate amounts.” How can you write such words? Hashem knows exactly how much of everything to put into mother’s milk; we can’t be smarter than Him. Please, don’t let the glorification of a product confuse consumers that we need to supplement in order that our children should receive full nutrition. By nursing our children, mothers should be assured that their kids are fed directly from Above and receive all necessary nutrition. (I’m not referring to the very small percentage of mothers having difficulties with their milk supply.) Don’t make mothers worry; instead, assure

them that they are doing the best with by giving their infants the “manna” intended for them in the form of mother’s milk. Babies ages 6-12 months, on average, do not need to be supplemented with anything. They get everything from mother’s milk. In fact, such young children can’t even digest protein at this stage, so it’s basically a waste to give it to them. It just does damage by weakening their digestive system. Until two years of age, a child who is nursing does not need to eat anything more than fruits and vegetables. Of course, the mother needs to be on a good diet too. How can you know when a child is ready to digest food? The body shows this by producing teeth. Only when a baby has about 10 teeth is he ready and able to digest food. Before that, all protein rots in the body, causing damage to digestive organs. H.W. Joel Gross of First Choice responds: We agree with your message that mother's milk is clearly the best nutritional source for a baby and contains a fount of nutritional value. However, in the article, we were discussing nutrition for babies six months of age and older.The information provided was not promotional. It was based on research and professional input.There are numerous reputable research-based articles that assert that when a baby reaches six months of age the iron and protein content in mother’s milk is not enough.

This is why meats are so important, as well as iron-fortified cereals, as recommended by the American Academy of Pediatrics.

Summer Project Another tip for a healthier home [Issue #18: Cover Feature] Dear Editor: I absolutely loved the cover feature on how to bring greater health awareness into the home during the summer months. What a service to the community! My bungalow colony friends and I enjoyed discussing the mindfulness concept at our daily morning circle. As a health conscious mother of young children, I would like to add another tip that may be helpful to fellow mothers who would like to implement healthier choices into their family’s lifestyle. Since it generally takes more time to prepare healthy food choices, it’s very important to make them as accessible as possible. It takes an extra few minutes to cut up those fruits or vegetables before the kids return from day camp or school, but if we don’t do it, the kids will find their way to the cookies and snacks in no time. Keep up your great work, Frady H. Monticello, New York

Quick Question

New feature! Feel free to shoot us your health-related question to receive an answer from one of the health experts at the Wellspring. Question: My six year old is suffering through her fourth strep throat infection since January. She started out by taking amoxicillin, Duricef, Augmentin, and clindamycin. I am devastated that my child has been subject to so many and such strong drugs in such a short time. Any suggestions for a natural alternative? Response: Your child probably has a weak immune system that is being continually weakened by the strong antibiotics. Immune Support by Maxi Health will help build a healthy immune system for your child so she doesn’t catch every germ she’s exposed to. Start by giving a double dose for a week and then a regular dose for six weeks. A strengthened immune system won’t allow the strep to survive in her body and will help fight off any existing infection. Also, remove dairy and white flour from your child’s diet for an even stronger immune boost. You can spray the tonsils daily with Thieves Spray to help keep germs away. Have a safe and healthy summer, Mimi Schweid, nutritional advisor 12 The Wellspring | August 2017

Wellness Platform By Rabbi Hirsch Meisels

AWAY WITH THE PRESSURE

THE NATURAL SOLUTION FOR REDUCING HYPERTENSION

In previous columns, we mentioned that Hashem has provided us with a plethora of nutrients within the natural world to help ward off and remedy hypertension. Maxi Health’s Pressure Complex™ utilizes these nutrients to improve and maintain cardiovascular health from a purely natural approach. This powerful supplement contains potassium, vitamin B6, garlic, and inositol. Let’s now consider five more ingredients that ensure the efficacy of Pressure Complex™ in reducing hypertension. The amino acid taurine has been dubbed “the nutritional factor for longevity of the Japanese” for good reason. Taurine has been shown to reduce mortality rates in animals by a whopping 80%. Although the body naturally produces taurine, many people, especially those lacking adequate nutrition, cannot produce an optimal level of this crucial amino acid. Described as a “wonder molecule” by scientists thanks to its broad and extensive benefits, taurine promotes insulin sensitivity, weight loss, hearing function, and immune modulation, as well as reducing hypertension. Taurine reduces the resistance

14 The Wellspring | August 2017

PART 3

to blood flow in the blood vessel walls and minimizes nerve impulses in the brain that drive blood pressure up, having a powerful impact on the entire cardiovascular system. Until recently, only animal studies were published on this aspect of taurine’s potency, but the first rigorous clinical trial in humans, which involved 120 subjects, clearly highlights its positive effects on people as well. In the randomized, placebo-controlled clinical trial on subjects with high blood pressure, one group was given a placebo and the other a dosage of taurine for 12 weeks. Even in that short time span, taurine reduced blood pressure by a significantly larger amount of points (approximately 12) than the placebo. Juniper berry, yet another ingredient, has a diuretic effect on the body. By helping the body get rid of excess fluid, in the same way vitamin B6 operates, juniper berry helps remove the added pressure these fluids place on the arteries. Indeed, a clinical study revealed a 27% reduction in blood pressure through the intake of juniper berries. Parsley powder has the same diuretic effect on the body. In a study published in 2001, titled “Diuretic Effect in Mechanism of Action of Parsley,” the authors write that parsley has been used for centuries as a traditional cure for hypertension, and their work provides substantial evidence to support this claim. Uva ursi leaf powder, also known as “bearberry” since bears like eating it, has traditionally been used to heal urinary tract and bladder infections, way before the advent of medication, because of its powerful

antibacterial properties. But thanks to its molecular constituent known as arbutin, which has diuretic benefits as well, it also plays an effective role in reducing high blood pressure. Finally, the last ingredient in Pressure Complex™ is cinnamon. This spice is renowned for supporting healthy glucose levels, which are usually related to blood pressure. A study reported in Nutrition found that cinnamon—on its own—was able to significantly reduce the subjects’ diastolic pressure (upper number) by 5.5 points and the systolic pressure (lower number) by 2.5 points. In the same vein, three clinical trials studying cinnamon’s effect on high blood pressure in subjects with type 2 diabetes demonstrated that cinnamon is tied to significant decreases in diastolic and systolic numbers. But the most compelling results were reported in the European Journal of Medicine, supporting my theory that natural supplementation, in conjunction with diet and lifestyle changes, are our ultimate hishtadlus for better health. In this study on the effects of cinnamon and magnesium intake, as well as diet and lifestyle changes, the subjects who followed the intervention saw a decrease of a whopping 25 numbers in their blood pressure levels. So yes, you now know that with the help of Hashem, there is a highly effective natural way for you to bring blood pressure numbers down. In this column, Rabbi Hirsch Meisels, a renowned expert on healthy living, delivers vital health information culled from his years of experience as the founder and director of FWD, Friends With Diabetes. The information was originally transcribed from his lectures on his hotline, Kol Beri’im.

These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, prevent or cure any disease.

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Well Informed

Torah Wellspring: Emotional Health By Rabbi Ezra Friedman

AN OUTSTRETCHED HAND

A FLAWED PERCEPTION REGARDING OUR RELATIONSHIP WITH HASHEM (PART II)

HASHEM’S LOVE OF US, His children, is entirely unconditional. As we discussed in the previous article, the reason we distance ourselves from Hashem after transgressing a commandment is because we have a distorted view of our relationship with Him. This leads us to believe that once we’ve erred, His love toward us is not as strong as it was previously. The following passage from the Gemara in Ta’anis proves this point. The Gemara tells us that the Jews asked Hashem for something shelo kehogan, that was not correct, and Hashem responded in way that was correct. What was the topic at hand? The Jews requested that Hashem be like rain to them, and He replied that He would be like dew. According to the basic explanation as to why the Jews’ request was imperfect whereas Hashem’s response was not, commentaries note that there are times when rain is beneficial, such as for growing crops, and other times when it’s detrimental, such as for travelers on the way. Dew, on the other hand, is always welcome. However, a more profound difference between rain and dew contrasts our incorrect perception of Hashem’s relationship with us and the reality. Our sefarim explain that rain is formed when a cloud descends from the sky, absorbs moisture from below, and then rises back up. Dew, on the other hand, comes directly from above, with no interference or dependence on moisture from below. When the Jews requested that Hashem be like rain for them, they did not understand how Hashem’s relationship to us works. They erroneously thought that His feelings toward us are dependent on

our actions, on the “moisture” below. But Hashem opened their eyes by telling them, “I am like dew. I always love you, regardless of how you act.” A Rav who devoted himself to drawing young men closer to Yiddishkeit once went to a place where the players were immersed in a game of pool. As he approached the table, he heard two boys conversing in fluent Yiddish. Sadly, one of them was sporting a cross on his chest, r”l. The Rav’s request to play with the young man was met with laughter, but when he offered a $200 bet, the young man couldn’t resist. When the Rav won the game, the boy dutifully pulled the money from his pocket, but the Rav held up his hand. “I don’t need the money,” he told the boy. “Can you give me ten minutes of your time instead?” When the young man acquiesced, the Rav asked, “I understand that you removed your yarmulke, that you distanced yourself from Yiddishkeit, but a cross? Yiddishkeit is the religion of truth, but once you abandoned your religion, what attracted you to Christianity?” The boy thought for a moment, and then shared his tale. He admitted that he’d started slipping from the path many years earlier and soon became involved in substance abuse. Desperate to save his floundering son, his father took out a mortgage on his home so he could send him to a rehab center. Then, one day, when this young man was sitting dejected and empty in the rehab lobby, with no means to soothe his pain, he was approached by a woman. After a short introduction, she asked the young man, “Do you know that G-d loves you?” Of course, he answered in the negative.

“I’ve committed so many sins,” he admitted, “how could He?” And then the woman said the words that changed the direction of his life. “G-d loves you no matter what,” she said. Those were the words that empowered the young man to seek recovery, to move on, but those were the words of a Christian missionary. “I only left the fold because I knew that Hashem doesn’t love me,” the young man revealed. “She was the one who confirmed to me that my relationship with G-d is unconditional.” When we have a distorted view of our relationship with Hashem, when we don’t realize how fervently He awaits our return, we sadly end up distancing ourselves from the beauty of Yiddishkeit. “Atah nosein yad laposhim, You, Hashem, extend a Hand to sinners.” Not only doesn’t He distance Himself from us; He actually stretches His Hand toward us! “Lechu venashuvah el Hashem,” we’re the ones who have to return. Unfortunately, we’ve had too many spiritual fatalities as result of a corrupted perception of our relationship with Hashem. We must remember that even when our actions are unacceptable, we are always accepted. Our spiritual life is inherently bound to our emotional wellness. Only when we understand that we’re worthy of Hashem’s love regardless of our deeds will we find the courage to keep doing the right thing, no matter how many times we’ve stumbled. Then we will truly recognize that His Hand is always extended toward us, waiting to pull us ever closer. L’ilui nishmas HaRav Shlomo Meir ben Efraim Zvi, zt”l. Av 5777 | The Wellspring 17

Well Informed

Health Updates in the News By Liba Solomon, CNWC

BEWARE OF THE SANDBOX Germs may be lurking in there

Kids love to play in sandboxes, and it helps them develop motor and social skills, but have you ever considered what kind of germs might be lurking in that communal sand? Sandboxes are breeding grounds for bacteria, parasites, and other infectious germs, whether brought in by animals using them as litter boxes or by kids interacting with other kids, researchers say in a report published in the journal Zoonoses and Public Health. Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City, describes sandboxes as “swimming pools without disinfecting chlorine.” In a new study, researchers found that the particularly nasty bacteria Clostridium difficile (C. difficile) was present in nearly 53 percent of sandboxes tested in Spain. “We do not consider our paper as alarming,” says lead researcher Dr. Jose Blanco, from the department of animal health at Complutense University of Madrid. “We have a lot of pathogenic bacteria around us. We have to live with them, and learn to live with them,” he says, urging more studies to reveal the distribution of such bacteria in our communities. C. difficile can cause symptoms in humans ranging from mild diarrhea to life-threatening inflammation of the colon, Blanco explains. For the study, Blanco and his colleagues researched the presence of C. difficile in 20 sandboxes intended for children and 20 sandboxes used by dogs in and around Madrid. More than half contained various types of C. difficile; 9 of the children’s sandboxes and 12 of the dog sandboxes. Certain strains of the bacteria showed increased toxin production and some were resistant to antibiotics. But C. difficile is not the only germ hiding in the sand, according to the U.S. Centers for Disease Control and Prevention. Pinworms and roundworms also live in sandboxes. “This study shows that places of community and sharing also have to be considered as places of potential germs. A lot of attention has been paid to swimming pools, but if you think about it, sandboxes are worse, because there is no chlorine in them,” Siegel says. He advises that if you let your children play in sandboxes, make sure you wash their hands or at least use disinfecting wipes before and after they play. To help prevent getting sick after playing in a sandbox, the American Academy of Pediatrics recommends: • Keep the sandbox covered when it’s not in use to keep out insects and animals. • Let the sand dry before covering it, because wet sand is an ideal place for bacteria to grow. • Rake the sand regularly to remove debris, clumps, or other foreign material.

POLLUTION IN YOUR BUNGALOW? How dust affects fat cells in your body

Could something as simple as household dust be contributing to America’s obesity epidemic? Small amounts of household dust appear to contain many of the compounds that can spur fat cells to accumulate more fat — at least in lab settings, according to research published this week in the journal Environmental Science & Technology. The researchers took samples of indoor dust from 11 North Carolina homes and tested extracts from those samples in a mouse pre-adipocyte cell model. According to the researchers, extracts from seven of the samples triggered the cells to develop mature fat cells and accumulate fat. Extracts from nine samples spurred the cells to divide, creating a larger pool of precursor fat cells. Only one sample showed no effects. The researchers concluded that house dust is a likely source of chemicals that can derail metabolic health. The study, which is notably small, suggests that the conversation around reducing obesity, which is often anchored in questions of diet and exercise, needs to expand to incorporate a better understanding of environment and pollution. It doesn’t take much dust to see a negative impact, at least under lab conditions; dust amounts as small as 3 micrograms showed measurable effects, according to the researchers. Looking beyond simple household dust, environmental pollution poses a deadly threat to children worldwide. The World Health Organization estimates that 1.7 million children under the age of 5 die annually due to the effects of living in polluted environments. Get the duster out!

18 The Wellspring | August 2017

DOES THE NOSE KNOW? The sense of smell and its link to body weight

Would you be willing to give up the smell of fresh-baked chocolate chip cookies or a pizza right out of the oven if it meant slimming down? A new study showed that mice that lost their sense of smell did not gain weight even when they ate the same high-fat diet as mice that could smell. The mice that retained their sense of smell packed on twice their normal weight while the smell-deficient mice didn’t gain at all, scientists from the University of California, Berkeley, reported in the journal Cell Metabolism. A group of mice whose olfactory neurons had been genetically altered to take away their sense of smell were compared with another group of mice whose sense of smell had been enhanced. The “super-smellers” gained even more weight. “This paper is one of the first studies that really shows that if we manipulate olfactory inputs, we can actually alter how the brain perceives energy balance, and how the brain regulates energy balance,” said study author Céline Riera. The findings raise questions about whether or not the same would hold true for humans, Riera, a former UC Berkeley postdoctoral fellow and now an assistant professor at Cedars-Sinai Medical Center in Los Angeles, says. “The cool thing about olfactory nerves is that they are totally unique. They’re not in the brain; they’re in the nose. Maybe in the future, we can non-invasively block them in humans. Maybe if you can remove olfaction in the patients for several months, it could help them lose weight,” she said. In an article in Berkeley News, senior study author Andrew Dillin said, “Sensory systems play a role in metabolism. Weight gain isn’t purely a measure of the calories taken in; it’s also related to how those calories are perceived.” Researchers hope future work in this area could someday benefit patients who are morbidly obese, or overweight people with health problems like diabetes. Dillin, a professor of molecular and cell biology and Howard Hughes Medical Institute investigator, said that if the discovery proves true in humans as well as mice, it could offer new treatment options for obese patients thinking about stomach stapling or bariatric surgery. “For that small group of people, you could wipe out their smell for maybe six months and then let the olfactory neurons grow back, after they’ve got their metabolic program rewired,” he suggested. Those with food addictions, such as binge-eating disorders, might be helped, too. Riera said, “We hope to eventually find a way to do that in humans as well, and help them control their addictive behaviors and switch their metabolism to fat burning instead of fat storage.”

HALTING THE HEARTBURN But not with Prilosec

When you feel your heart burning after a good meal, do you reach for Prilosec or Prevacid? Read this first. It has been suggested that a certain class of heartburn drug used by millions of Americans is associated with a higher risk of death than other heartburn drugs, according to a new study in BMJ Open. However, people should talk with their doctor before stopping these medications, experts say. The drugs, called proton pump inhibitors (PPIs), reduce stomach acid and are available over-thecounter and by prescription. Other recent studies have linked PPIs to a range of potential health risks including kidney disease, stomach infections, heart disease, pneumonia, bone fractures, and dementia. Popular brand-name PPI medications include Prilosec, Nexium, Prevacid, and others sold over-the-counter or by prescription. With so many studies associating PPIs with other health risks, researchers from Washington University School of Medicine in St. Louis wanted to find out if people who took the drugs were at greater risk of dying. The scientists used a large database, combing through medical records from the U.S. Department of Veterans Affairs (which did not reveal the patients’ identities) to compare death rates among users of PPIs with people who took H2 blockers, another class of drugs that help reduce stomach acid that can cause conditions such as gastro-esophageal reflux. Researchers examined data from 275,933 people who had been prescribed a PPI and 73,355 who were prescribed an H2 blocker between October 2006 and September 2008, tracking deaths up to five years. The researchers found a 25 percent increased risk of death in the patients who took a PPI compared with the people who took H2 blockers — about one extra death for every 500 people taking PPIs for a year. “The results were very clear. We were startled by this. However we sliced the data or analyzed it, there was always a consistent relationship between PPI use and risk of death,” said study author Dr. Ziyad Al-Aly. If you are self-medicating with an over-the-counter PPI, you should talk with your health care provider about the pros and cons and be sure to follow the label and FDA directions and warning, the doctor said. He also advised that over-the-counter drugs should be used for only a brief period of time. Some patients may be able to manage heartburn drug-free by losing weight, cutting out tobacco, and changing some eating habits. “Reduce late-night eating two hours before you go to sleep,” says Dr. Folasade P. May, assistant professor of medicine at the Vatche and Tamar Manoukian Division of Digestive Diseases at UCLA, who also recommends heartburn sufferers elevate the head of their beds slightly. Av 5777 | The Wellspring 19

Well Informed

Figures By Miriam Katz

ON MOVEMENT AND SHUTEYE Physical Activity and Sleep Cycles in Children

of children aged 9–13 reported participating in free-time physical activity during previous 7 days in a nationally representative study

minutes, daily, recommended physical activity for people aged 6–17

of high school students had participated in at least 60 minutes per day of physical activity on each of the 7 days before the survey

29%

180 77%

minutes, or 3 hours, daily recommended active time for toddlers who can walk

15.2% of high school students had not participated in 60 or more minutes of any kind of physical activity on any day during the 7 days before the survey

The Wellspring | August 2017 20

7:00

PM ideal bedtime for most infants and children

11–14

HOURS

of childhood asleep

for infants 4–11 months

for toddlers 1–2 years

10–13

HOURS

40%

12–15

9–11

HOURS

A child spends

HOURS

Sleep recommendations for children:

for preschoolers 3–5 years

The average American child gets about

20%

for school-aged children 6–13 years

less sleep than recommended, according to the National Sleep Foundation

Av 5777 | The Wellspring 21

Well Informed

Wealth of Health By Sarah Weinberger

CONFERENCE WITH:

I CPT A C . N, M.S n by

OSE er of Nutritio R A Y TAN Own d line

d er an e TAP foo latbush, d n u F Fo th Park, roe, a and Tany NS: Boro nsey, Mon d o an TIO rg, M Heights, LOCA u b s m n Willia ood, Crow w be Lake ere. t and h m g d i o e w Wo 2004 e can lose l and fun. : E C N SI nyon s practica A : O T t’ MOT hen i w y h healt

As a nutritionist, Tanya Rosen saw the need for a line of healthy, tasty foods that would make weight loss a pleasurable experience for her clients and all consumers of the kosher market. In 2004, she launched the highly popular TAP line, which currently includes 10 products and is sold in over 60 stores. In this Conference, Tanya talks about the behind-the-scenes work it took to get the company off the ground.

WHAT MOTIVATED YOU TO ENTER THE FIELD OF NUTRITION? In 2004, after giving birth to my son, I had a lot of weight to lose. I was headed towards law school at the time, a dream I had since childhood. In the process of learning to eat healthy and falling in love with exercise, I completely changed my career path and shocked everyone by dropping law and studying nutrition instead.

WHAT WAS THE FIRST PRODUCT YOU PRODUCED? Muffins. Clients at my nutrition practice often told me that they wished they could have a muffin sometimes and still do well. I thought to myself, “Why can’t they have a muffin every single day and still do well? There must be a way.”

HOW LONG DID IT TAKE YOU TO BRING YOUR IDEA TO FRUITION? The process of creating the muffin from thought to finish was about six months. We kept testing out different recipes. I wanted one that didn’t taste dietetic at all. I also wanted to keep the muffin at a certain range of calories, fat, sugar, and carbs. When we finally perfected the recipe, we The Wellspring | August 2017 22

still had to come up with more flavors and develop them, as well. We now have 10 flavors. Rosh Hashanah time, we make apple ones too.

HOW MANY PRODUCTS ARE CURRENTLY PART OF THE TAP LINE? Close to 10, including soups and pizza, and growing. While I count the muffins and cookies as one of the 10, they each come in many varieties and are the most popular.

WHAT MAKES YOUR PRODUCT LINE UNIQUE? First, we don’t use any artificial ingredients or preservatives. We want all pregnant, nursing, and even just health conscious clients to feel comfortable eating them. Also, TAP products are low in calories and fat, and high in protein, without compromising on the taste. Most people are shocked that these products are “diet.” A third attribute that makes our products unique is their proven nutrition information. Unfortunately, many companies provide nutritional information for their products without actually verifying it. We lab test everything so it’s 100 percent accurate.

WHAT ARE SOME CHALLENGES YOU’VE FACED IN CREATING THE TAP LINE? Not many, Baruch Hashem. It’s always

a challenge to perfect a recipe or pick the right packaging, but these are fun projects that the entire staff gets involved with. We also had to figure out the wholesale aspect versus just selling at our locations. Working with stores is different from working with individual customers. We needed to create whole sale prices and figure out better packaging so that the products will arrive safely and intact. Another issue we had was getting all the stores to sell at similar prices so they don’t create competition for one another. Thanks to our amazing sales team, headed by Leah Russel, it works pretty smoothly now. TAP products are currently sold in 60 stores and counting.

WHICH PRODUCT WAS THE MOST CHALLENGING TO PRODUCE? Probably the blintzes, which is why they aren’t out yet. I also personally don’t like them, unlike the other products, which makes the production process harder. It’s super hard to get them to be healthy, filling, and low calorie.

THE TAP LINE INCLUDES POTATO KUGEL. WHY DO YOU BELIEVE THAT REGULAR POTATO KUGEL REQUIRES A HEALTHIER ALTERNATIVE? Regular potato kugel is very high in fat, calories, and carbs. The TAP version has zero oil, lots of protein, and very little carbs. It even tastes almost like real potato kugel. It passed the “men test.” I served it at a shiur for men in my house without telling them what it really was, and no one noticed. In fact, they complimented it.

HOW DID YOU MANAGE TO CREATE A HEALTHY YET TASTY VERSION OF THIS PRODUCT? Lots and lots of trial and error. When it finally came out, I literally said “Mazel Tov, it’s a kugel!”

TAP ALSO HAS A LINE OF JUICES. WHAT MAKES THOSE JUICES UNIQUE? All TAP beverages are organic, all natural, and healthy. Most drinks like

these on the market are high in sugar and non-organic, which means they often have pesticides in them. We currently have five flavors: lemonade; spicy lemonade; the spa refresher, which has edible rose petals; a fruit blend; and a vegetable blend. I would say the lemonade is most popular.

ARE THERE ANY OTHER PRODUCTS IN THE MAKING? We’re working on eggplant parmesan and pizza roll ups, among others.

CAN YOU SHARE SOME OF THE MEMORABLE FEEDBACK YOU’VE RECEIVED ABOUT YOUR PRODUCTS? A middle-aged woman I had never met before once came in to my Boro Park office. Without a single word, she gave me a huge hug and started crying. When she calmed down, she said, “I’m 48 years old. I’ve been dieting since I’m 14 and I never managed to stick to any plan until your products came along. They’re not cheap, but I am eating healthy and losing weight for the first time in my life.” When I saw how good she felt about her ability to finally take control, I started crying too. It was a bit of a scene.

HAVE YOU EVER RECEIVED COMPLAINTS FROM CONSUMERS REGARDING YOUR PRODUCTS? When people voice complaints about the price, we tell them that good food and healthy ingredients aren’t cheap. People realize that, but they wish our products were cheaper. We also get complaints when we run out of a product.

WHO ARE YOUR MOST UNIQUE CLIENTS? Medical patients. Many doctors recommend the TAP line for their patients because they know that we know our ingredients really well and that we can be counted on to guide them accordingly.

WHAT WAS THE MOST INTERESTING REQUEST YOU’VE RECEIVED? To open locations and sell our products in remote places, such as Panama, South Africa, Russia, a kibbutz in Israel, and even from a small community in China! And we’ve gotten requests for the creation of TAP foods like gala, kishke, and herring.

WHAT DO YOU BELIEVE IS THE KEY TO SUCCESS IN LAUNCHING AND RUNNING A HEALTH FOOD COMPANY? Passion, and practicing what you preach. Passion, because when you work twelve, fourteen, or sixteen hour days, you have to love what you’re doing and have the right energy for it. Practicing what I preach is just as important because that’s the authenticity behind my company. I run into clients everywhere, and they will always see me doing (food wise) what I would advise them to do. Whether it’s at a restaurant, a Pesach program, or a trip to the mall, I’m always stocked with TAP snacks in my purse. And one more: coffee! Av 5777 | The Wellspring 23

YOUR WELLNESS LIST

Supplements related to content in this issue that can improve your health and wellbeing To get a detailed understanding of the following nutritional topics, read more on the page numbers listed below.

MEL-O-DROPS™ Related to Feature pg. 32 As you’ve read in this issue’s feature, children need their required hours of shuteye every night in order to develop properly. Putting children to sleep can be a really daunting task, though, especially when they’re not on a regular schedule, such as during summertime or yamim tovim.Thanks to the creation of Mel-O-Drops™, you now have a natural, healthy way of increasing their melatonin levels so they can get the sleep they need in order to thrive. Every ten drops of this vanilla-flavored formula contains 1 milligram of melatonin.

MAXI DIGEST™ Related to Updates pg. 18

MAXI ACTIVE PRO-20™ Related to Cup of Tea pg. 66 As registered dietitian Tamar Feldman asserts, gut health affects the body in more ways than we can imagine, which makes maintaining it a real priority for everyone. In order to ensure the proper balance of healthy flora in your gut, take a daily dose of Active Pro 20™, which replenishes the probiotics in the digestive system. Packed with 20 billion beneficial bacterias, and composed of 15 different probiotic strains, each capsule helps restore the balance your gut requires for optimal functioning.

Is every one of your meals an invitation for heartburn? Instead of resorting to medication or over-the-counter antacids that research has shown to be detrimental to your health, reach for a natural solution.The chewable fruit-flavored supplement Maxi Digest™ is just what you need to ease heartburn and other digestive post-meal issues. Beneficial for the assimilation and utilization of foods, the supplement also facilitates a release of energy from the foods we eat.

GREEN SUPREME™ Related to Age Well pg. 69

OMEGA-3 CONCENTRATE™ Related to Tidbits pg. 48

If you’re suffering from gout, a notoriously painful form of arthritis, there’s no need to suffer any longer. When you take your daily dose of Green Supreme™, you get an excellent source of amino acids, minerals, vitamins, enzymes, and natural barley grass juice that help alleviate the pain and ease the symptoms.

The latest research reveals that fish consumption may help relieve the symptoms and onset of arthritis thanks to its high content of Omega-3 oils, but if you want to ensure that you’re getting the recommended amount of this crucial nutrient every day, supplementing is the way to go.The Omega-3 Concentrate™ is packed with the crucial Omega-3 fatty acids, along with EPA and DHA that support the brain, eyes, joints, mood, memory, and heart. Plus, it’s enteric coated, which helps more of the fat get absorbed into the system with no fishy aftertaste, breath, or gastrointestinal discomfort.

Ask for these products at your local health food store.

These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, prevent or cure any disease.

Selection Guide

Well Informed

Dedicated to Health By Chana Dunner

10 QUESTIONS FOR

RABBI YANKIE MEYER OF MISASKIM MISASKIM IN A NUTSHELL Misaskim provides support and assistance to individuals experiencing the loss of a loved-one by providing the grief-stricken with vital bereavement services during times of crisis or tragedy.

WHAT MOTIVATED YOU TO LAUNCH YOUR ORGANIZATION?

Many of our earliest volunteers were members of various chevrah kaddisha. We saw, on an almost daily basis, the void that exists when the malach hamaves enters a family’s realm, and we decided to act upon that. Nevertheless, we never dreamed Misaskim would grow to encompass so many major services. These include essential shivah needs for thousands of aveilim each year; care for the deceased when no family member will or can take charge; emergency disaster/recovery at accident and crime scenes; meis mitzvah intervention; miscarriage/stillborn interment; assistance to orphans and widows; and community-wide safety awareness.

WHAT IS YOUR CURRENT ROLE AT MISASKIM?

My responsibilities include overseeing the day-to-day delivery operations of bringing essential shivah-related items to the homes of aveilim (including low chairs, siddurim, Sifrei Torah, folding chairs and other portable furniture, a guide to the minhagim of shivah, and many other items of need). But that takes second place to dealing with the emergencies that pop up all too often, which is when I find myself in the office of the Medical Examiner trying to prevent an autopsy, with the goal of bringing the niftar to kevurah as soon as possible, as halachah dictates. As a side, but vital, benefit, our work at Misaskim helped develop a close relationship with secular law enforcement agencies. Misaskim is often the first call the police make when any crime-related issues surface that affect our community. We have gained their respect, and that is invaluable to all of us, maintaining close relationships with over 70 law enforcement agencies in the Tristate area. The Wellspring | August 2017 26

WHAT IS ONE GREAT CHALLENGE YOU FACE IN RUNNING THE ORGANIZATION?

At certain times, and we never really know when these will hit, we are inundated with an influx of new shivah homes to service; it sometimes feels like we are on a runaway train. The day after this past Pesach, we were servicing 79 shivah houses, comprising over 300 aveilim, with access to only 24 Sifrei Torah. And as many of these families were very large, we had to juggle equipment from neighborhood to neighborhood, to ensure we covered each and every avel in need of our services.

CAN YOU SHARE A STORY THAT STANDS OUT IN YOUR MIND?

In the wee hours of the morning, we had the unfortunate experience of having to handle all the arrangements for a SIDS (crib death) baby, only to be followed, just a few hours later, with an almost duplicate tragedy from another family. I actually saw the coroner shed a tear when we brought the second child in; we all did. The next day, Misaskim volunteers brought the parents of the first child to be menachem avel the parents of the second child. I will never forget that scene—the emotions that ran between the two couples. They understood each other’s pain, and it was a real nechamah for both of them.

Just a few weeks ago, we were informed of a woman who, returning from a family simchah in Eretz Yisrael, passed away on the flight back to New York. To make matters even worse, there were 18 family members traveling on the plane with her. The El Al flight landed on Sunday evening at 11:30 p.m. No one was permitted to deplane until the customs/immigration officials did their work. Port Authority police and detectives had to conduct an investigation, the CCD (Center for Communicable Diseases) had to give the all clear, and of course the NYC Medical Examiner had to release the body. Under ordinary circumstances, the time needed for all this takes many hours. However, with the governmental contacts Misaskim has nurtured over the past many years, we were able to meet the family at the aircraft door and provide them appropriate assistance as well as convince the authorities about the importance of expediting this process. Baruch Hashem, the funeral was held the very next morning at 9:30 a.m.

CAN YOU SHARE A POSITIVE STORY THAT YOU’VE RECENTLY EXPERIENCED?

WHAT WAS THE MOST INTERESTING REQUEST YOU’VE EVER RECEIVED ON BEHALF OF A FAMILY?

WHAT DO YOU WISH PEOPLE WOULD KNOW ABOUT THE WORK YOU DO?

That’s a tough one; but I would have to wish that everyone who was ever helped by Misaskim would realize that Misaskim doesn’t exist in a vacuum. The services we provide cost us a tremendous amount of money. Instead of working on new projects to help more people, we are sometimes paralyzed by the lack of operating capital.

WHAT’S THE BEST PART OF YOUR WORK?

The best part is knowing that we are an integral part of one of the pillars upon which the world stands—chessed. The second Mishnah in Pirkei Avos describes chessed as “visiting the sick, bringing joy to newlyweds, burying the dead, and comforting aveilim.” Well, that gives Misaskim two out of four, and that’s pretty satisfying.

It was 5:50 p.m. on a Thursday before bedikas chametz, as Erev Pesach that year fell out on Shabbos. An Israeli patient who was in the US for treatments was suddenly niftar, and the last flight before Pesach was 7:20 that evening. If we wouldn’t make it, the niftar’s kevurah would have been delayed by 5 days! A multi-pronged plan was put into place, with the knowledge that if any single part of this plan would go wrong, we would miss the deadline. The NYPD Highway Patrol escorted Misaskim volunteers to Manhattan to obtain a signed death certificate from the Health Department, and then to the Israel Consulate to fax over the necessary permits to El Al at JFK Airport. Hatzalah volunteers picked up the niftar from the chapel and transported him to JFK, again, with the cooperation of NYPD Highway Patrol. Misaskim volunteers were already on the way to El Al cargo to expedite the transfer of the niftar to the plane. Ordinarily, it would have been next to impossible to make all of these arrangements at the airport, but because the Port Authority chief brass were at the airport, preparing for the Pope’s arrival the next day, they all sprang into action to make this happen. And it did.

HOW DO YOU MANAGE THE STRESS THAT COMES ALONG WITH YOUR TAXING WORK?

I’m not sure I do. The sense of fulfillment that comes when we hear from orphans and their surviving parent how, thanks to Misaskim’s programs for them on Chol Hamo’ed and Chanukah, they no longer feel forgotten and that they are able to resume some sort of semblance of normal life, is definitely a stress remover. But there’s no time to dwell on it; we just have to keep going.

WHAT WAS THE BEST COMPLIMENT YOU’VE EVER RECEIVED?

If you asked me about criticism, it would be much easier to answer. The great late Agudah leader, Rabbi Moshe Sherer, z”l, was known to advise his staff that they should never expect compliments; that if a day passes and they don’t get insults hurled at them, they should consider it a great day. I just hope everyone would understand how hard this all is, and I daven that Hashem should give us the siyata d’Shmaya we need to help as many people as possible. Av 5777 | The Wellspring 27

Living Well

Ask the Nutritionist By Shani Taub, CDC

Skipping Meals Suppressed appetite in summertime

The joys of summer! I love this time of year, when we can enjoy the great outdoors and the colorful produce. I find that it’s a very productive time to reinforce my healthy lifestyle, but the question that comes up often during this season is what to do because of my suppressed appetite. When I don’t feel hungry, which happens quite frequently on hot days, should I just skip the meal? I know that skipping meals is generally not recommended, but perhaps this is the exception? — Summer Girl

Shani answers:

I’m glad you recognize the benefits summer offers for reinforcing a healthy lifestyle. I agree with you, as do most of my clients, that this is the season when we get to be most active and in the ultimate weight loss mode. Keep it up! Having a suppressed appetite during summertime is very normal. According to scientific research, the appetite decreases to allow the body to keep cool. The less work the body does, the greater its chances of keeping the temperature down. In addition, when we perspire, we lose water, as well as vitamins and minerals, which may contribute to chemical imbalances within the body that can suppress appetite. But does this mean that we should actually skip meals? The answer is an unequivocal no. Never skip a meal. After yom tov, when people want a cleanser, they ask the same question, arguing that they’re still “full” from all those heavy meals. I never advise or support that, however. (The exception may be when you’re really not hungry for supper and you’re going to bed anyway. In this case, you’ll get the

The Wellspring | August 2017 28

energy from sleep to carry you through the night.) It’s not for naught that skipping meals is heavily discouraged across all healthy lifestyle plans. For starters, when you do so, you often find yourself reaching a state of hunger that resembles starvation—a state at which you end up consuming way more calories than two meals combined, because you barely give your body the time it needs to realize that you’re eating. It takes 20 minutes for the brain to register that you actually ate, but if you’re eating while famished, you fill up before your brain has a chance to get that message. And meals like these are not very pleasurable either. Waiting for hunger to strike is a definite no-no. If skipping meals is not a good weight loss tactic when experiencing suppressed appetite, what is? When you don’t feel the need to eat, simply condense your calories. While I generally discourage people to shrink their meals, advising them instead to stretch, this is one notable exception. In other words, stretching a typical breakfast menu would

mean to have a separate serving of fruit, protein, and starch instead of combining them. But on a day when you’re not in the mood of eating, go for a blend. Combine oats with fruit and yogurt for a one-cup meal that includes all the necessary food groups. Condensed-calorie foods give you the nutrients and strength you need to carry on until the next meal. Instead of having “heavy” proteins like chicken or fish, keep your meals light and cool on hot summer days. By condensing your calories, you’ll ensure that your body gets what it needs, so you don’t get hungry too soon and you have the energy to remain active.

CONDENSED FOOD SUGGESTIONS

Here are some menu options for you to choose from on days that your appetite is suppressed. • nuts, nut butters (12 almonds/1 tablespoon is a protein) • yogurt-fruit blends •overnight oats • smoothies • string cheese (1 packet is a protein)

LONG SHABBOS AFTERNOONS: NO EXCUSES

I would like to address an issue that comes up often in summertime: how to stick to a healthy plan during long Shabbos afternoons. This past Shabbos, the sun was my friend. I sat outside with a tall glass of water and just enjoyed the pleasant weather. These long afternoons are a great opportunity to connect with family and friends, to enjoy a good book, or to take a calm stroll. When we don’t focus on food, we get to enjoy the true beauties in life. Many people find the long summer Shabbosos challenging in terms of weight loss because they have so much time on their hands and, often, junky food around. But I tell my clients to look at Shabbos as the same 12-hour day we have every day. The difference is that we don’t have the usual structure, which keeps us busy and turns the focus away from food. Perceived hunger often comes as a result of boredom. The mistake people make on Shabbos is that they turn to food as a form of entertainment. That should never be its purpose. Find other ways to entertain yourself. And for a healthy snack, prepare fruit-juice ices in cups. They will take you time to eat and enjoy. And when you’re hungry, even if it’s not the official shalosh seudos time, sit down for your meal. There’s no mitzvah to wait until you’re so hungry that you no longer have control over your food intake.

Please send your questions to the nutritionist to info@wellspringmagazine.com. Shani Taub, CDC, has been practicing as a certified nutritionist in Lakewood for almost a decade, meeting with clients in person and on the phone. She also owns the highly popular Shani Taub food line, which carries healthy, approved, premeasured foods and delicacies sold at supermarkets and restaurants.

Av 5777 | The Wellspring 29

Living Well

In Good Shape By Syma Kranz, PFC

Fitness 101: Running Outdoors That exercise is highly advantageous to the body is an indisputable fact. Among other excellent benefits, it helps with weight loss, builds muscle, improves metabolism, reduces the risk of many diseases, and enhances your mood and mental health. But you may be wondering how particular exercises score on this list—which is better for what. In this series, we take a look at the primary fitness workouts that are popular today and discuss the pros and cons of each. Workout Description Running outdoors doesn’t need much of a description, or even much persuasive talk, for anyone who wants to have fun in the great outdoors while keeping fit and burning calories. Now that the relaxing days of summer have come our way, if you have a chance to engage in this activity in a secluded, tzanua environment, go for it! Calories burned per workout: Depending on the weight and speed: A 125-pound person burns 113.5 calories running 5 mph for 15 minutes. In addition, aA 150-pound person uses uses 136 calories and a 175-pound person burns 154. A 125-pound person burns 191.5 calories running 8 mph for 15 minutes. A 150-pound person uses 229.5 calories and a 175-pound person burns 268. Areas targeted: thighs, glutes, and legs Style: Low-intensity/high-intensity depending on the elevation and speed

The Wellspring | August 2017 30

The Pros Ah, the great outdoors! You can’t possibly compare the benefits of running outdoors to scaling the treadmill belt, can you? For starters, you have the fresh air filling your lungs as you run. A research team from the Peninsula College of Medicine and Dentistry analyzed 11 trials including more than 800 adults and found that outdoor exercise was associated with increased energy and revitalization, as well as decreased confusion, anger, depression, and tension, when compared with exercising indoors. Outdoor exercisers also reported enjoying their workouts more and said they were more likely to repeat them than those who exercised indoors. While exercise in general is good for your confidence, outdoor exercise may be even better, as was proven in a study performed at the University of Essex. When you’re at the gym, it can sometimes feel like all eyes are on you; when you exercise in nature, only the trees are looking. And while unprotected overexposure to the sun’s ultraviolet rays can increase the risk of skin cancer, we shouldn’t overlook the many benefits of sunlight. When the sun hits our skin, it creates vitamin D3, important for bone health and metabolic function. In addition, exposure to sunlight during the day can help you sleep better at night, improve immune function, and increase endorphin production— those feel-good hormones circulating throughout your body. Plus, when you’re running outdoors, you have an endless number of routes to choose from, so a boring workout is rare. Especially if you have a running partner, this arrangement can give you a time to air out both physically and emotionally (but don’t forget to keep up your running pace). Have you ever heard someone call running their “drug?” Well, apparently, it is similar. A 2007 study in Physiology & Behavior showed that running causes the same kind of neurochemical adaptations in brain reward pathways as addictive drugs. All around, routine running provides all the regular benefits of exercise, such as increased heart rate, calorie-burning, and muscle building. It helps keep you in shape as well as prevent a slew of diseases and disorders, like diabetes and hypertension.

The Cons • It’s difficult to maintain a particular speed when running outdoors, as opposed to using a treadmill, which makes it impossible to keep track of calories burned (unless a tracker is used). • Running has some potentially serious disadvantages that you should consider before choosing to do it on a regular basis. In fact, the chance of injury is greater than for most other aerobic activities. Running traumatizes the body, especially joints in the legs, knees, and back, as well as the kidneys. However, you can minimize this possibility by taking several precautions. • Never run on concrete. If possible, run on cinder tracks or dirt paths. Asphalt is not as bad as concrete but not as good as dirt. • Always wear well-made running shoes designed to minimize shock to the joints, and get a new pair whenever your present ones start to wear out. • Warm up before you start a run, not by stretching but by running in slow motion. • Above all, listen to your body. If you develop pain in any joints, stop running or cut down on it until you determine the reason for the pain. Also, if you’re running when the temperatures are high, the extreme stress of running in heat can damage the body. Be sure to replace fluids if you run in hot weather and sweat a lot. The Program When you’re first getting moving, it’s important to just focus on getting into the exercise habit; making your run or walk a regular part of each day (or specific days), finding times and places to exercise that feel convenient and comfortable, and finding a way to enjoy it so you keep it up for the long term. As running becomes part of your routine and you want to up the ante, you can simply add time to your workout as you get stronger, or increase the distance you cover. Start your routine with walking slowly, then running slowly, and then maintain a running speed (ditto for trackers) for a nice ten-twenty minute stretch before slowing down again. Running at a too-high speed for a short amount of time will drain your energy and keep you from attaining the true benefits of this exercise.

Syma Kranz, PFC, is a certified aerobics, Pilates, and Barre instructor, as well as the fitness director at Fusion Fitness in Lakewood, New Jersey. What started out as a small exercise class in her home catapulted into a popular gym that prides itself with tzanua, professional instructors and an appropriate atmosphere with lyric-free music and proper attire. Syma specializes in training women to integrate fitness into their busy lives, paying special attention to proper form and alignment and specializing in core and pelvic floor strengthening.

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Living Well

Cover Feature By Chevy Reichberg

REVAMPING YOUR HOME TO MAKE IT A HEALTHIER SPACE HOW TO UTILIZE THE DOG DAYS OF SUMMER TO RAISE THE BAR ON YOUR FAMILY’S HEALTHY LIFESTYLE

The Wellspring | August 2017 32

n addition to establishing healthy eating patterns and an awareness of nutritional food choices, which we addressed in Part I of this two-part series, building a healthy core requires structure in other areas of life, as well, including good sleeping patterns, implementation of physical activity, an overall awareness of personal hygiene, and an environment that fosters healthy wellbeing.

TO A SOLID SLUMBER If talking about children’s sleeping patterns generates a sequence of yawns for you, rest assured that you’re not the only one. Countless surveys on the topic reveal that the majority of parents have a hard time not only establishing a healthy sleep routine for their children, but also ensuring that their children get an adequate amount of sleep on a nightly basis. In a review published in Pediatric Clinics of North America, findings showed that children and adolescents are chronically sleep-deprived, which affects their academic and behavioral success. At the annual SLEEP Conference, which takes place in Seattle, Washington, sleep experts from around the world gather to discuss newly-released research on the topic, as well as ideas that can be implemented to ensure that children receive their necessary shut-eye in order to lead healthier, happier lives. Here are some of the most crucial benefits of sleep the researchers most recently found: Sleep is when the brain flushes out, which is especially critical for kids. The latest discoveries in neuroscience show that there’s much more to sleep than just recovery. For example, scientists have long known that sleeping was critically important to the development of brain functions, such as learning

new information and storing long-term memories. But in a recent study, a team of scientists at the University of Rochester found that during sleep the brain cleanses itself, essentially flushing out its own waste. It does this through a network of specific channels similar to a plumbing system, which fully “open up” in a state of sleep. Researchers think that this cleanup process is energy-expensive, and that’s why the brain may be waiting until bedtime to take out its own trash. Other recent research reinforces the idea that uninterrupted nighttime rest is particularly vital for kids, because the growth hormone needed for tissue and muscle development is released primarily during sleep. “Growth hormone is produced mainly overnight, especially from midnight to 6 a.m., so it’s important that kids sleep soundly,” says Shalini Paruthi, fellow of the American Academy of Sleep Medicine and director of the Pediatric Sleep and Research Center. “We don’t want them awake for prolonged periods.” Sleep debt as well as lack of quality sleep can cause ADHD-like symptoms, obesity, and many behavioral and emotional problems. In fact, children can be misdiagnosed with ADHD merely because they aren’t spending enough time in slumberland, says Paruthi. A

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Living Well

Cover Feature

study that surveyed almost 2,500 kids ages 6 to 15 confirmed that kids with sleep problems are more likely to be hyperactive, impulsive, and aggressive — all of which are symptoms consistent with ADHD. Another study presented at SLEEP supported the findings that sleep disturbances may, at least in part, be the cause of some ADHD symptoms. The same study also pointed out that motor skill learning in children with ADHD benefits from more shuteye. Unlike tired and sleepy adults who grow slow and listless, kids become hyperactive and explosive as they try to compensate for their exhaustion. A number of SLEEP studies also researched how chronic sleep debt contributes to obesity and diabetes. Sleep modulates the neuroendocrine system and glucose metabolism, so when youngsters don’t snooze enough, these vital processes may go haywire. Insufficient sleep can also affect the immune system, leaving kids more vulnerable to illness. “When given a vaccine, sleep-deprived people didn’t develop enough of a response to it, compared to people who had enough sleep,” says Paruthi. Given the vital benefits that sleep provides, how can parents ensure that their children get enough of it? While adults generally require about 7to 9 hours of sleep, newborns need more than 16 hours per day. Children fall somewhere in between, with teens needing 9 to 10 hours per day and preschoolers 11 to 12 (this amount can include naps). One quick rule of thumb: If your child wakes up fairly happy and easily in the morning and does not have a meltdown in the late afternoon from being over-tired, he or she is probably well-rested. In an ideal arrangement, proper sleep training begins when the child is still an infant. “I usually start training babies as early as five weeks to get them into a good sleep routine,” says Tziporah Sonnenschein, of Cleveland, Ohio, a specialist in sleep training for over a decade. “It’s so important for babies to get a good deep sleep for 12 hours at night and naps during the day. Of course, they wake up to eat at that young age, but it’s the routine that’s important to start with. Babies that are trained into a routine are almost always on a good sleep routine as toddlers and children. Their bodies are used to feeling tired and responding to that with going to sleep. It’s just as natural and simple as that.” Many factors affect a child’s sleep routine as he grows, such as anxiety. The more aware he becomes of the world around him, the more security he needs. How can parents step in to ease the child into a calm sleep at such times? “If a child isn’t yet on a good routine, there are things that mothers can do,” advises Tziporah. “Preparation for bed should include a winding down period. Don’t allow sugar or screens for an hour before bedtime (between 6:30-7:30 for most toddlers and young children) and engage in relaxing activities such as reading books together.”

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According to Tziporah, if the child usually needs a parent to stay with him until he falls asleep, a system must be put in place where the parent weans herself out of that. The mother can tell her child, “I will lie down with you for ten minutes and then I will leave the room.” Discussing it before bedtime helps the child understand and prepare for the process. For a child who’s old enough, a chart for staying in bed can be very helpful, as well. It’s important, however, that such charts or any programs parents choose to implement measure very small successes at a time—not all or nothing. Getting a sticker or check for every five minutes that the child stays in bed or doesn’t call his mother is very doable, whereas rewarding only if the child sticks it out for the entire night may be too hard as a starter. The key, says Tziporah, is to discuss and get the child excited about the program before implementing it. For the anxious or scared child, the parent can say, “I’ll come check on you in five minutes.” She can even set a timer. The parent can also say, “I’m staying right here outside your door,” and then make sure to pop her head in within five minutes and smile. “Don’t trick the child by not showing up,” she cautions, “Your presence reassures and comforts the child at the same time that it teaches him to stick it out on his own.” For some children, simply reassuring them that Mommy is thinking of them even while she’s washing the dishes or working in the next room is enough to give the child the calm sensation that will allow him to doze off. She can even call to him every few minutes and say, “Sweetie, I’m still thinking of you. Good night!” Quite possibly the simplest thing parents can do to help ease their children into a solid sleep routine is to make sleep a priority in their children’s lives. Avoid scheduling activities at times that would delay bedtime (or nap time for younger children) so they get to go to bed around the same time every day. Another great way to help ensure that your child gets enough sleep is to create a routine. It’s easier for kids to wind down if there’s a predictable bedtime routine to follow. In the book Food Fights, the authors suggest the 4 B’s of bedtime: bathing, brushing teeth, books, and bedtime. Even for adults, curling up with a good book can often mean that slumber will follow close behind. It can also be helpful for kids to keep sleep and wake times roughly the same (within an hour or so) each day, even on weekends. Experts recommend that kids get at least an hour of exercise per day every day. While daytime exercise can contribute to sleeping better at night, vigorous exercise too close to bedtime may just keep kids awake, so try to plan your child's physical activity accordingly. Another easy lifestyle change is the nighttime snack. If you’re looking for a bedtime snack for your kid, select one that’s high in protein and low in sugar. Eating sweets near

bedtime causes a spike in blood sugar followed later by a drop, which leads to a feeling of hunger and may leave kids awake in the middle of the night. Replace the sugary snack with a high-protein one — say, a spoon of almond butter, adding a cracker or two if necessary.

PHYSICAL ACTIVITY Of all the things children require in order to build a healthy core, physical activity is probably the easiest to check off the list. Thankfully, most children take pleasure in being active, and having them use their muscles to do the recommended one hour of exercise daily doesn’t necessitate much coaxing. Because we’re privileged to live in a society in which screen time isn’t encouraged, our young ones end up spending much of their free time, especially during the summer, playing sports and active outdoor activities. However, even on rainy days or when the summer comes to an end, we can still do our part in encouraging physical activity when the kids rather prefer lounging around or playing a board game. As part of the morning or evening routine, parents can do some basic developmentally-appropriate exercise moves with their children, such as 20 jumping jacks, 20 hops, etc. Simply turn on the music to get the movement rolling. Children also love using different equipment to stay fit. Invest in jump ropes, hoola hoops, and jingle jumps to ensure that your kids stay active all year long.

PERSONAL HYGIENE Having good hygiene habits involves more than just hand-washing. Teaching your kids to have a healthy hygiene routine when they’re young can create habits that last throughout their lives. Often, the reason children don’t appreciate instructions regarding the maintenance of good personal hygiene is because of the uncomfortable sensations the movements may cause. When a child suffers from sensory integration issues, simple routines become not only a hassle, but a pain—for both child and mother. According to occupational therapist Miriam Manela (see Q&A below), many of the things we demand from children with sensory overload are not necessarily vital to their personal hygiene—just standards we set for them that may be too high. By focusing on the bare basics for children like these, we can eliminate the friction and the ensuing discipline and relationship repercussions. Here’s a basic outline of what healthy hygiene includes: The Bath Most young children can get away with washing their hair two or three times per week. Washing hair too often can dry out young scalps, making them more prone to dan-

druff. As kids enter their tweens and teens, the hormonal effects of puberty take hold, sometimes making their hair greasy. Washing their hair with shampoo may be necessary at least every other day. Does your child make a fuss when it’s time for the bath? Young children either love the bath or hate it, so he’s surely not the only one. On non-shampoo days, you can make a thorough bath into a fun game. Place your child into the tub with a washcloth, a bowl of warm, soapy water, and a bowl of warm water for rinsing. Make sure they know to put the washcloth into the soapy water before scrubbing a body part and then into the rinse water before repeating. Oral hygiene Clean teeth and gums can prevent a wide range of health issues, including bad breath, cavities, and heart disease later in life. Your child should brush and floss at least twice per day. Younger children can help you time the full 2 minutes that a good brushing requires. Hand-washing Hand-washing is an integral piece of good hygiene. Washing before and after meals, after playing in the dirt, and after being in contact with someone who’s sick is the best way to eliminate germs. Tell your child about the importance of scrubbing with soap for the amount of time it takes to sing “Happy Birthday” twice. Hand sanitizers aren’t as effective as soap and water, so use them only in a pinch. Nail Clipping Fingernails are a breeding ground for bacteria. The germs that live under your child’s nails can easily transfer to their eyes, nose, and mouth. Invest in a good nail brush and help your child scrub the dirt out from under their nails before bedtime. A weekly clipping will help get rid of dirt and reduce the possibility of painful ingrown nails. Emotional Wellbeing A series on a healthy childhood would not be complete without mention of the importance of a child’s emotional wellbeing. While parents the world over place admirable focus on having their children eat healthy, sleep properly, and take care of their physical activity and personal hygiene, children require a stable emotional environment in order to thrive. The basic emotional checklist for a healthy parent-child relationship includes spending quantity and quality time with the child on a daily basis, allowing the child to express her pain instead of encouraging repression, and a general absence of emotional negativity in the home.

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Living Well

Cover Feature

An Inside View:

Q&A with Miriam Manela, OTR MIRIAM MANELA, OTR IS THE AUTHOR OF THE PARENT-CHILD DANCE. SHE USES AN INNOVATIVE APPROACH TO HELP CLIENTS OVERCOME BEHAVIORAL, ACADEMIC, SOCIAL, AND EMOTIONAL CHALLENGES.

HOW WOULD YOU DEFINE SENSORY ISSUES? Sensory Integration is the brain’s ability to absorb information from our senses, organize it, and respond appropriately. In essence, it is the organization of the senses that provides each of us with an understanding of ourselves and the world. Sensory overload is when one or more of the body’s senses experiences over-stimulation from the environment. There are many environmental elements that impact an individual, such as urbanization, crowding, noise, mass media, technology, and the explosive growth of information, and these elements affect the person’s ability of sensory integration. Sensory Processing Disorder (SPD), the medical term for “sensory issues,” is a condition in which the brain has trouble receiving and responding to information that comes in through the senses. WHAT ARE THE DIFFERENT LEVELS OF SPD – WHAT IS CONSIDERED NORMAL FOR YOUNG CHILDREN AND WHAT ARE THE SIGNS THAT PROFESSIONAL INTERVENTION IS NECESSARY? Within Normal Limits (WNL) is when a child is slightly sensitive but can adapt to his environment, calm himself down, and go with the flow most of the time. When a child cannot regulate (control his activity level and state of alertness, as well as his emotional, mental or physical responses to senses) or adapt to his environment, and the parents and/or the school are at a loss as to how to deal with it, then I’d recommend an OT evaluation. IS THERE A GENETIC COMPONENT IN SENSORY INTEGRATION ISSUES? WHAT MAY BE THE CAUSE? There is no single definitive cause. There are a variety of causes, including premature birth, birth trauma, genetics, exposure to toxins, high-stress and trauma, attachment disorders, and so on, but nothing is certain. DO YOU BELIEVE THAT CHILDREN WITH SENSORY ISSUES CAN BE TAUGHT TO TAKE CARE OF THEIR PERSONAL HYGIENE? Yes, but the parent may need to be flexible about how they accomplish this and how often. When I use the term “hygiene,” activities such as taking a bath or brushing teeth come to mind. Often, parents have a more complex idea of what hygiene is; it may mean upholding a certain appearance bordering perfectionism. Ensuring that the child has a matching headband and socks, with a clean, pressed dress,

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does not fall under my idea of what hygiene is. Children with sensory issues should be taught that brushing their teeth, combing their hair, or taking a bath, whether it is twice a week or daily, is important. But, parents should be careful not to let their idea of appearances be confused with cleanliness for their child with sensory needs. IF A CHILD CONSTANTLY EXPRESSES DISCOMFORT WHEN HE COMES INTO CONTACT WITH WATER, WHAT CAN HIS MOTHER DO DURING BATH-TIME? The temperature of the water is often more of the problem than the feeling of the water itself. Using a sensory brush and deep pressure before bath time or a natural bristle brush helps. Some kids prefer showers over baths, and bubble baths can sometimes be more or less comfortable. Some children like more water versus less water. It’s a matter of trial and error until the child feels comfortable. WHAT ABOUT CHILDREN WHO DON’T LIKE TO HAVE THEIR HAIR BRUSHED? IS THAT A SENSORY ISSUE? Not enjoying getting your hair brushed can be a sensory issue, although it could also be a behavioral issue. There are specialized soft brushes and detanglers that can assist in this matter. In addition, there is a soft rubber brush that can be used in the bath that is sometimes more acceptable to the child. HOW PERSISTENT SHOULD A MOTHER BE REGARDING THE CHILD’S PERSONAL HYGIENE? IF A CHILD IS PUTTING UP A FUSS, SHOULD SHE LET IT GO? We need to distinguish between basic personal hygiene and the mother’s need for the child to look a “certain way.” What is basic is a necessity.What is extra—in order for the child to look perfect—is where parents must let go. HOW CAN A MOTHER PERSUADE HER CHILD TO HAVE HIS NAILS CUT OR TURN IT INTO A PLEASURABLE ACTIVITY IF EVERY NAIL-CUTTING EPISODE TURNS INTO A FIGHT? I often suggest icing the tip of the finger or toe before cutting the nail because it numbs it, so children who are sensitive don’t feel it as much. In addition, some distraction such as singing or talking about something exciting at the same time as you are icing it can be helpful. For some children, it may not be possible to turn nail-cutting into a pleasurable activity. But, it is possible to make it

a less stressful experience for the child. WHAT ARE SOME BASIC TECHNIQUES MOTHERS OF SENSORY CHILDREN CAN EMPLOY TO EASE THEIR GENERAL DISCOMFORT? Tune in to find what types of sensory information is creating stress in your child. Does he tend to act up during or right after noisy situations such as free play time in class or being at a populated party? Does he like certain types of touch such as deep touch or light touch to give him chills? Which types of touch does she avoid or defend herself against? A few quick ideas: 1. Hand hugs, from my book, The Parent-Child Dance, are a great way to decrease sensory discomfort. 2. Wearing pre-washed cotton clothing 3. Try to avoid situations that are very stimulating, such as taking the child to shul, the mall, or birthday parties which can cause sensory overload to a sensitive child.

Words of Wisdom Which kid doesn’t love a good story? Here’s some fun and inspiring reading material that you can use at story time, mealtime, or bedtime to encourage healthy habits. Shimmy Shambone Will NOT Take a Bath, by Yael Zoldan (Feldheim Publishers) Shimmy Shambone Will NOT Go To Bed, by Yael Zoldan (Feldheim Publishers) I Can’t Fall Asleep! by M. Jakubowicz (Israel Bookshop) Levi and the Little Loaf, by Menucha Fuchs (Judaica Press) The Sleep Sheep Story, by Devorah Kay (Feldheim)

More on Sleep The Ferber Method Pediatrician Richard Ferber is the founder and former director of the Center for Pediatric Sleep Disorders at Children’s Hospital in Boston. Since the publication of his book Solve Your Child's Sleep Problems in 1985, he’s become known as a leading – and controversial – expert on children's sleep. Chances are you’ve heard about Ferber’s method of teaching babies to soothe themselves to sleep – a method so closely associated with him it’s often called “Ferberizing.” This method and its variations are also referred to as “cry it out,” although Ferber himself never calls it that. Over the years, Ferber’s method of sleep training has sparked controversy among parents, pediatricians, and sleep experts alike: Some live by the Ferber approach, while others claim that it creates lifelong emotional scars. It's also often exaggerated and misunderstood. In a nutshell, Ferber says you can teach your baby to soothe himself to sleep when he’s physically and emotionally ready, usually between 3 and 5 months of age. He recommends following a warm, loving bedtime routine, which includes a relaxing bedtime routine (bath, feeding, lullaby, etc.) and then putting your baby in bed awake and leaving him (even if he cries) for gradually longer periods of time. Putting a child to bed awake, says Ferber, is crucial to teaching him successfully to go to sleep on his own. Parents are instructed to pat and comfort their baby after each predetermined period of time but not to pick up or feed their baby. This routine is called “progressive waiting.” The suggested waiting time, which Ferber charts in his book, is based on how comfortable you are with the technique, how many days you’ve been using it, and how many times you’ve already checked on your child that night. The theory goes that after a few days to a week of gradually increasing the waiting time, most babies learn to fall asleep on their own, having realized that crying earns nothing more than a brief check from you.

Let off some steam Sometimes it helps to let your toddler get any pent-up energy out of her system before you try to settle her down for the night. So feel free to dance around with her to a favorite song, give her a “horsey” ride, or let her bounce in the bouncer if she’s in the mood. As long as you follow up any rowdy play with something calmer and quieter – like a bath and bedtime story – before she goes to sleep, it can be the first step toward bedtime. Give her a soak One of the most popular parts of many bedtime rituals is a bath. Sitting in warm water can be a soothing experience, and getting your baby warm and clean and dry is a great way to ease him into bedtime. If your baby gets excited during baths or doesn’t enjoy them, though, it’s probably better to leave them out of the nighttime ritual. Babies don't need a bath more than once or twice a week, so don’t feel bad about forgoing it if it’s not a pleasure for you both.

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one glass

high fructose CORN SYRUP

flavors

calories PER SERVING

SERVINGS OF FRUIT

fruit

70% vitamin

PER SERVING

zero grams FAT

icial

artif

42% of consumers DRINK 100% JUICE EVERY DAY

80% of people SEE 100% JUICE AS HEALTHY, NATURAL, AND TASTY

67% of consumers

WANT TO BUY ALL NATURAL PRODUCTS

flavors

added

ISSUE 19 AUGUST 2017 AV 5777

Homemade and Wholesome Make your own pasta, sourdough bread, and cream cheese!

EAT WELL: ADD EGGPLANT DIP TO YOUR SHABBOS NACHAMU MENUâ&#x20AC;&#x201D;GUILT-FREE

Eat Well

Recipes

Dear Cooks,

We‘re not preparing the Nine Days dairy dinners anymore, but it‘s still summer—and who doesn‘t like their summer meals light? Whether you‘re hosting a breakfast for your summer friends or serving dinner on the deck, a good pasta always makes for the perfect meal base. Just add some rolls, salads, spreads, and coffee and you‘re good to go. But what happens if you want to keep the meal wholesome? In this issue‘s Seasoned, we‘re excited to show you how you can actually enjoy your pasta—and cream cheese and sourdough bread—the healthy, homemade way. It does take some more work than ripping open the plastic bag and dumping noodles into a pot, but the incredible results make it worth the effort. Time to party! Enjoy the rest of your summer, -Esther

Nutrition Nuggets -Dr. Rachael Schindler

Sourdough Bread I love sourdough bread. The trick is not to eat too much. If you're sensitive to cheeses, vinegars, and wine, or you're sensitive to nightshades like eggplant and tomato, it may be hard to stop yourself from wanting more. Enjoy a nice piece and call it a day.

Homemade Cream Cheese This recipe is rich in antioxidants and antimicrobials. For a more probiotic effect, use plain kefir. If you like parve cream cheese or have issues with dairy, soak 2 cups of cashews overnight in water, blend with a little coconut oil, and add the herbs for a delicious healthy spread.

Homemade Pasta If you're watching your carbs or sugar intake, replace some of the whole wheat flour with tapioca starch for a more low glycemic pasta with the same great texture.

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Eat Well

Recipes, Styling & Photography By Yossi and Malky Levine

Homemade Whole-Wheat Pasta

You can choose to create only the pasta on your own and add marinara sauce and cheese, or to go all out and whip up the fabulously creamy sauce as well. Well worth the extra step! 4 eggs 3 1/2 cups whole-wheat flour 2 tsp salt 2 Tbsp oil handful of fresh basil, chopped handful of fresh scallions, chopped

1 sweet potato, cubed 1 small onion, sliced 2 garlic cloves 1 tsp salt, or to taste 10 oz. plain Greek yogurt 1 cup milk

Add eggs, oil, and salt to a mixer and beat until well combined. On a low speed, slowly add flour until a dough forms. Refrigerate for 30 minutes. On a floured surface, roll out the dough to 1/8 inch thick. Use a sharp knife (not serrated) to cut thin strips (approx. 1/2 inch). Fill a large pot halfway with water. Add oil and salt and bring to a boil. Add pasta and cook for 2-3 minutes until ready. Drain pasta while letting cold water run over it to prevent sticking. Add chopped basil and scallions, mix and set aside. Add sweet potato, sliced onions, garlic cloves, and a dash of salt to a saucepan. Cover with water and bring to a boil. Cook for 15 minutes until fork tender. Drain the water. Use a fork to mash the cooked vegetables. Add yogurt, milk, and salt to taste if necessary. To serve, pour sauce over herbed pasta. Yield: 6-8 servings

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Eat Well

Recipes

Homemade Flavored Cream Cheese

Caveat: Make this cream cheese once and youâ&#x20AC;&#x2122;ll have a hard time going back to the store-bought version. Itâ&#x20AC;&#x2122;s that good! 4 cups milk 3 Tbsp lemon juice salt, to taste

Flavors: scallions carrots

celery jalapeno pepper garlic

In a saucepan, heat milk on medium-high flame, stirring constantly until it starts to simmer. Reduce heat to medium and slowly add lemon juice, 1 Tbsp at a time. Let it simmer until mixture curdles. Stir constantly until the mixture is completely separated, it should take just a few minutes. There will be liquid on the bottom and thick curdles on top. Remove from heat. Lay a cheese cloth (or wrap and boil bag) over a large bowl. Pour the curd mix over it and let the liquid drain and cool for 15 minutes. Transfer curds to a food processor, or use hand blender. Add a pinch of salt and process until smooth and creamy (3-4 minutes). Now you can add herbs or vegetables to create a flavor of your choice. Some options include: Chopped scallions, grated carrots and celery, blended jalapeno pepper and garlic.

Eat Well

Recipes

Homemade Sourdough Bread

Sourdough bread has been gaining prominence lately—and for good reason. This fermented dough is loaded with good-for-you nutrients, as well as all available amino acids without the protein that forms gluten. This bread isn’t only great for diabetics and people who are sensitive to gluten, but for everyone who wants to enjoy a meal that’s good for the gut. 2 Tbsp whole-wheat sourdough starter

3.5 oz. mineral water

7 oz. whole-wheat flour

Add all ingredients to a loosely sealed container. Place in closed oven for 4 hours or overnight until bubbly. Test if it’s ready by placing a spoonful of the mixture into a bowl of water, and see if it stays afloat. 1¾ cup mineral water 7 oz. sour dough (above mixture)

5 cups whole-wheat flour 12 grams kosher salt

Add water and sour dough to a large bowl, and mix until well combined. Slowly add the flour until a sticky dough forms. Let it rest for 30 minutes. Add salt and splash of water to the dough and mix to combine. Knead by hand or mixer on a low speed for 10 minutes. Place dough in a large covered bowl or sealed container and let it rest for 4 hours in a warm, dark place. (You can place the container in a black shopping bag.) Flour your work surface and remove dough from bowl. Start building tension in the dough by folding the dough into the center (as if making an envelope), and repeat several times to form a rough ball of dough. With seam down, cover dough with saran wrap, and let it rest for another 30 minutes during which the dough will flatten a bit. Fold the dough again to the center several times until it feels like a tight ball. Line a bowl with a towel. Generously sprinkle flour on the towel. Place the dough, seam upward, into the bowl, put it into a large shopping bag and refrigerate overnight. Remove from fridge and let it sit for an additional 2 hours in a warm environment. Preheat oven to 480 degrees. Add a pan of hot water to the bottom rack of the oven and wait until it steams. Flip the dough (seam down) onto a lightly floured pan. Use a pastry brush to remove all excess flour from the dough, and score with razor blade on low degree angle to create slits. Place pan in the oven and immediately lower heat to 420 degrees. Bake for 15 minutes. Remove water and lower heat to 350 degrees. Bake for an additional 30 minutes. Remove bread from oven. Knock on the crust and listen for a hollow sound. Let the bread cool for 30 minutes and enjoy!

Eat Well

Nutrition Tidbits in the News By Liba Solomon, CNWC

L’CHAIM—ON COFFEE Is coffee the new secret to long life? If your definition of breakfast is a cup of coffee, here’s some good news for you. While previous research has linked drinking moderate amounts of coffee to a decreased risk of Alzheimer’s disease, diabetes, heart disease, and several types of cancer, two new studies show that people who drink coffee appear to live longer. The research cannot prove that coffee leads to a longer life, but experts say it is consistent with other studies that have shown potential beneficial effects of regularly drinking coffee. “We cannot say drinking coffee will prolong your life, but we see an association,” Veronica W. Setiawan, lead author of the one of the studies and an associate professor of preventive medicine at the Keck School of Medicine at the University of Southern California, said in a statement. “If you like to drink coffee, drink up!” Setiawan’s research, published in the journal Annals of Internal Medicine, found that drinking one cup of coffee a day was associated with a 12 percent decrease in risk of death. The link was even stronger for people who drank two to three cups a day; that group saw an 18 percent reduced risk of death. The benefit was seen regardless of whether people drank regular or decaffeinated coffee, suggesting the effect comes from the coffee itself, not caffeine, the researchers said. For the study, the Setiawan and her team analyzed data on more than 215,000 adults ages 45 to 75 from a variety of ethnicities. Specifically, 17 percent of the participants were African-American, 29 percent Japanese-Americans, 22 percent Latinos, 25 percent whites, and 7 percent Native Hawaiians. “This study is the largest of its kind and includes minorities who have very different lifestyles,” Setiawan said. “Seeing a similar pattern across different populations gives stronger biological backing to the argument that coffee is good for you whether you are white, African-American, Latino, or Asian.”

FISH FOR GOOD HEALTH Another reason to eat your slice of salmon A new study in Arthritis Care and Research has revealed that we should eat fish twice a week both because it is good for general health as well as helping to relieve the symptoms of arthritis. The finding showed that people who consume fish twice a week suffer less from swollen or tender joints than those who never eat it. In addition, people who eat more than two servings of fish are less likely to suffer from rheumatoid arthritis. Researchers have already established that fish oil supplements, such as those high in Omega 3 fatty acids, also relieve joint pain. As per the reports, Dr. Sara Tedeschi, lead author of the study said that fish consumption has been noted to have many other beneficial health effects. For the study, around 176 rheumatism patients living in Baltimore estimated how often they ate fish over the past year and how big the portion was. Fish with high Omega 3 oil content were selected: tuna; salmon; sardines; raw fish such as sashimi and sushi; as well as grilled, steamed, and baked trout, sole, and halibut. In the study, fried fish were not included, as frying reduces Omega 3 content, said researchers. The levels of inflammation, when measured by tests of a marker in the blood, were significantly lower among those who eat fish twice a week or more, compared to those who never eat it. Even if the Nine Days are over, make sure to keep fish on your menu all year long. The Wellspring | August 2017 48

SUGAR OR SWEETENERS? Stevia may not be as sweet as you think Two-thirds of Americans are overweight, and those who diet sometimes turn to alternative sweeteners — including aspartame, sucralose, and stevioside — to cut calories. A new review of many studies suggests that doing so might not be the best idea. The scientists took a comprehensive look at more than 11,000 studies and found that for overweight individuals, or those with high blood pressure (hypertension) or diabetes, the benefits of consuming zero-calorie “non-nutritive sweeteners” were modest to nil. For other people, there was an increased risk of weight gain, type 2 diabetes, hypertension, stroke and heart disease. “Overall, the evidence does not support the intended purpose of weight loss and suggests that there might be adverse effects in the long term,” said Meghan Azad, lead author of the review and an assistant professor at the University of Manitoba. Previous research had suggested that non-nutritive sweeteners were not the healthiest choice, but those studies were smaller in scope than the new review, and tended to focus on one outcome at a time, said Azad, who researches the development of chronic diseases. “They would look only at weight gain, or only at diabetes,” Azad told Live Science. “But we wanted to be really comprehensive and look at the whole panel of cardio-metabolic diseases.” To do so, Azad and her team screened 11,774 published papers, looking for studies that specifically evaluated the consumption of non-nutritive sweeteners in people ages 12 and older. Some of these studies were randomized controlled trials, which provide the strongest scientific evidence. In the trials, half of the participants were asked to consume the alternative sweeteners and the other half were asked not to, and the scientists looked for differences between the groups. Turns out that sweeteners aren’t that sweet after all.

WORTH ITS SALT? Misconception: Iodized salt is a necessary choice in order to provide the body with enough iodine. Truth: According to the National Institutes of Health’s Office of Dietary Supplements, tests prove that the population in the United States is “iodine sufficient.” Most Americans who eat a varied diet get enough iodine, even if they don’t use iodized salt. They are at little risk of iodine deficiency, which can lead to goiters (swollen thyroid glands in the neck) and dwarfism and is a leading cause of mental impairment. However, some pregnant women are at risk of low iodine levels, which potentially endangers their babies. The need for iodine increases during pregnancy, and women who do not eat dairy products or do not take the vitamin supplements that doctors typically prescribe are at risk. Other than iodized salt, sources of iodine include fish, dairy products, grains (including bread), and fruits and vegetables. Fish get iodine from the ocean floor and seaweed, and plants get it from growing in soil that contains iodine. Iodine is thus present in the grass that cows eat, and consequently present in cow’s milk and dairy foods.

Av 5777 | The Wellspring 49

Eat Well

Nutrition Facts in a Shell By Devorah Isaacson

Here’s the place to check out nutrition labels for the nutrition-laden produce that come in their natural peels-just so you know what wholesome goodness you’re feeding your family and yourself!

This Month:

Eggplant

How do you like your eggplant? While most people associate eggplant with high-caloric dishes, because they’re breaded and fried all too often, this vegetable actually contains an impressive amount of nutritious benefits. Let’s get acquainted. Eggplant, a member of the night shade vegetable (along with potatoes and tomatoes) and Solanaceae plant family, is considered by researchers to be a part of a group of valuable vegetables, due to their anthocyanin antioxidant compounds, which can be seen in eggplant’s rich purple colors. Researchers continue to learn more about the health benefits of eggplant nutrition, but eggplant has been enjoyed for thousands of years as part of the healthy, traditional Middle Eastern and Mediterranean diet. Luckily, cooked eggplant, which is normally the type that people eat, as opposed to raw eggplant, has been shown in studies to have even more benefits. Cooking eggplant results in it having more available antioxidant content and biological activity of beneficial properties, as the thermal effect further releases eggplant’s disease-fighting compounds. Principle

Nutrition Value

Percentage of RDA

Energy

24 Kcal

Carbohydrates

5.7 g

Protein

Total Fat

0.19 g

Cholesterol

0 mg

Dietary Fiber

3.40 g

22 µg

5.5%

Vitamins Folates

Selection When looking for eggplants to purchase, look for a solid shape that appears to have no serious dents and bruises. Many eggplants will appear brightly colored and glossy, with shiny skin; this is perfectly normal. Considering that that’s where many of the nutrients of eggplant are actually stored, consuming the skin is highly encouraged by health experts.

In Your Plate!

Of course you love eggplant parmesan, but are there other low-calorie ways to enjoy this nutritious vegetables? • According to an Australian study, eggplant absorbs Pyridoxine 0.084 mg 6.5% more fat in cooking than any other vegetable. When reRiboflavin 0.037 mg 3% searchers deep-fried a serving of eggplant, they found that Thiamin 0.039 mg 3% it absorbed 83 grams of fat in just 70 seconds—four times Vitamin A 27 IU 1% as much as an equal portion of potatoes—adding more than Vitamin C 2.2 mg 3.5% 700 calories. Try one of the many other cooking options Vitamin E 0.30 mg 2% instead of frying or sautéing. • Because of its long shape, eggplant strips make for exVitamin K 3.5 µg 3% cellent wrappers. Simply spray oil on vertical slices of eggElectrolytes plant on both sides and brush with spices. Bake uncovered Sodium 2 mg 0% for 10–15 minutes, until soft. Once the eggplant is cooled, Potassium 230 mg 5% spoon any mixture (vegetables and rice, cheese, etc.) into Minerals the middle of each strip and roll around the filling to form Calcium 9 mg 1% a blintz-like dish. Use a toothpick to hold together. Copper 0.082 mg 9% • Stew eggplant to make the popular dietetic dish rataIron 0.24 mg 3% touille. Add slices of squash and tomato sauce for a delicious side dish. If you want to make it a one-dish meal, add Magnesium 14 mg 3.5% ground meat or chicken as well. Manganese 0.250 mg 11% • If you want eggplant parmesan without the unnecesZinc 0.16 mg 1% sary added calories, bake eggplant strips as in the above recipe and then cover with tomato sauce, spices, and a sprinkling of mozzarella cheese. Bake until cheese is melted and enjoy with a salad for a light dinner. • Here’s a veggie side dish that’s highly popular in our house. It goes especially well with challah on Friday night. The great news is that it’s purely vegetables, rendering it a guilt-free treat. Place cubed eggplant and pepper strips on a baking sheet, spray with oil, and sprinkle spices liberally (up the flavor with spices like Cajun and thyme). Bake for about half an hour, until the vegetables are soft. Niacin

0.649 mg

Pantothenic Acid

0.281 mg

The Wellspring | August 2017 50

Eggplant is not as high in many nutrients as some of the superfoods out there, but it is unique. Eggplant contains a somewhat rare and extremely beneficial type of antioxidant known as nasunin. Nasunin is a type of anthocyanin antioxidant found in all types of eggplant varieties in addition to other deeply colored fruits and vegetables. Like other antioxidants, it has the ability to fight free radical damage in the body, which is often the cause of disease development and the mechanism at which our bodies’ age. Most of the nasunin present within eggplant is found in its purple skin, so consuming the entire vegetable including its peel is important in order to reap all of eggplant’s health benefits. According to studies, nasunin is a potent fighter of inflammation and oxidative stress, acting as an oxygen scavenger, and also an iron “chelator,” which can protect against lipid peroxidation. It is used to help iron become absorbable by the body and also to bind molecules to poisonous metal agents such as mercury, arsenic, and lead, which can then be carried out of the body, resulting in a detox. Studies have shown that eggplant can be beneficial to heart health due to its ability to fight inflammation and oxidative stress, leading to healthier arteries and more balanced cholesterol levels. Eggplant nutrition has been shown to be beneficial in maintaining healthy blood cholesterol levels because of its phytonutrients’ ability to improve circulation and reduce plaque buildup in the main arteries, including the aorta. While the body does need a certain amount of cholesterol, consuming eggplant is correlated with balancing the amount that is held within blood vessel walls and improving blood flow. Eggplant is largely made up of water, which is why it’s so low in calories. Consuming vegetables that have a high content of water, fiber, and nutrients helps to flush out waste and toxins from the digestive tract. The digestive tract and colon need to be well hydrated in order to push stool through the intestines and out of the body. Eating plenty of fresh, whole foods, in addition to drinking enough water, is crucial for allowing the digestive system to expel toxins and excess water weight. Because of the known benefits of eggplant nutrition, eggplant is included in the GAPS diet—a diet especially helpful in correcting digestive disease, neurological issues, reducing inflammation, and healing autoimmune conditions. Due to the fiber and water content that it has, eggplant is also useful in helping to achieve weight loss. Because it provides an array of vital phytonutrients, vitamins, and minerals yet is very low in calories, eggplant is a great addition to any lowcalorie healthy diet. The fiber in eggplant helps to make you feel full so you’re less likely to overeat.

Fun in the Kitchen!

Grilled Eggplant If you’re a fan of smoked eggplant dip (chatzilim/babagnoush) but want to enjoy it the healthy way, here’s how you can do it in your own kitchen. 1 large eggplant (about 1 pound) 1 clove garlic, minced 1/4 tsp salt 1/4 cup finely chopped fresh flat-leaf parsley, plus more for garnish 2 Tbsp tahina 2 Tbsp lemon juice Preheat oven to 450°F. Prick eggplant with a fork, and place it on a cookie sheet lined with foil. Bake the eggplant until it is soft inside, about 20 minutes. Let the eggplant cool. Cut the eggplant in half lengthwise, drain off the liquid, and scoop the pulp into a food processor. Process the eggplant until smooth, and transfer to a medium bowl. On a cutting board, work garlic and salt together, with the flat side of a knife, until it forms a paste. Add the garlic-salt mixture to the eggplant. Stir in the parsley, tahina, and lemon juice. Season with more salt, to taste. Garnish with additional parsley.

Just for Fun!

Thomas Jefferson, who experimented with many varieties of plants in his Virginia garden, is credited with introducing eggplant to North America. In various parts of Europe, people suspected that eggplant consumption caused madness, not to mention leprosy, cancer, and bad breath, which is why eggplant was used mostly for decoration in England and the United States nearly up to the 20th century. Florida produces the bulk of the domestic harvest, and New Jersey is a major supplier during the summer months. Av 5777 | The Wellspring 51

hand made in wood fired ovens

Tuscanini For The Pizza Aficionado In a small village in Northern Italy where pizza is taken very seriously, individual pies are lovingly prepared in the time honored traditional way. This authentic pizza is carefully made with hand stretched dough, topped with the finest and freshest toppings, and baked in a wood fired oven the way pizza was meant to be made. From that village in Italy, pizza is brought straight to your table…

Amount/ Teneur

Total Fat/Lipides 9g

% Daily Value*

14%

Amount Per Serving

% Daily Value*

Sodium/Sodium 700mg

29%

20% Total Carbohydrates / Glucide 45g 15% Serving Size 1/3 Pizza /Par 133g Saturated Fat/Saturés 4g Servings per Container About 3 / Monounsaturated Fat/Monoinsaturés 1g Dietary Fiber / Fibre 2mg 8% Portions par Contenant Environ 3 Polyaturated Fat/Polyinsaturés 1g Sugars/Sucres 2g Calories/ Calories 300 Trans Fat/Trans 0g Protein/Protéines 13g Calories from Fat/ Calories des Lipides 80 Cholesterol/Cholestérol 20mg 7% Vitamin A/Vitamine A 4% • Vitamin C/Vitamine C 3% • Calcium/Calcium 13% • Iron/Fer 0%

* Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs. Calories 2,000 2,500 Less than 65g 80g Total Fat Less than 20g 25g Sat Fat 300mg Cholesterol Less than 300mg Less than 2,400mg 2,400mg Sodium 300g 375g Total Carbohydrate 25g 30g Dietary Fiber Calories per gram: Fat 9 • Carbohydrate 4

•

Protein 4

R’ Hazzan here need symbol YOSHON

INGREDIENTS: DOUGH 55%: Soft Unbleached Wheat Flour, Water, Salt, Sunflower Oil, Yeast, Malted Wheat Flour. TOPPING: TOMATO SAUCE 20% (Tomato Paste, Water, Sunflower Oil, Salt, Sugar, Oregano, Black Pepper), MOZZARELLA CHEESE 25% (Pasteurized Milk, Salt, Starter Culture, Coagulant). CONTAINS WHEAT AND MILK. MADE IN A FACILITY THAT PROCESSES EGGS, FISH AND NUTS INGREDIENTS: PÂTE: Farine de Blé Doux Non Blanchie, Eau, Sel, Huile de Tournesol, Levure, Farine de Blé Malté. GARNITURE: SAUCE TOMATE (Pâte de Tomates, Eau, Huile de Tournesol, Sel, Sucre, Origan, Poivre Noir), FROMAGE MOZZARELLA (Lait Pasteurisé, Sel, Culture Démarreur, Coagulant). CONTIENT DU BLÉ ET DU LAIT. FABRIQUÉS DANS UNE USINE QUI TRAITE ŒFS, POISSON ET LES NOIX

Manufactured for: Kenover Marketing Bayonne NJ 07002 / Distribué au Canada par Altra Foods Inc. Montreal, QC H1E 6W5 / PRODUCT OF ITALY/PRODUIT D'ITALIE

Best Before

KEEP FROZEN UNTIL USE

M A D E I N I TA LY

gourmet pizza

Tuscanini

PREMIUM HANDMADE

Margherita Classic Italian Pizza,

PREMIUM HANDMADE

Nutrition Facts/ Valeur Nutritive

Buon Appetito!

gourmet pizza

Remove pizza from all wrappings and thaw at room temperature. Bake at 420°F (215°C) for about 8 minutes until all the cheese has melted. Drizzle with extra virgin olive oil, if preferred. COOK THOROUGHLY. NOT SUITABLE FOR MICROWAVE OVENS.

Margherita Classic Italian Pizza,

2898ZP

HEATING INSTRUCTIONS:

Tuscanini

PREMIUM HANDMADE

gourmet pizza

authentic italian flavor b e c a u s e i Margherita t’s made in italy Classic Italian Pizza,

Margherita Classic Italian Pizza,

Tuscanini M A D E I N I TA LY

Personal pizza pie

KEEP FROZEN

net wt./poids net 14.3oz (400g) PREMIUM HANDMADE

gourmet pizza

M A D E I N I TA LY

Tuscanini

GOURMET PIZZA

Margherita Classic Italian Pizza,

M A D E I N I TA LY

Tuscanini

Serving Suggestion / Enlarged to show texture

PREMIUM HANDMADE WOOD FIRED

PROMOTION

IN THE KNOW

Ice Cream for Everyone Wish you could enjoy a nice serving of soft ice cream without messing up your calorie count? Confetti had you in mind when they created their newest hot item— Peanut Butter Lite Ice Cream. Bursting with the peanut butter flavor we all love, this individual frozen treat is only 130 calories and is approved by nutritionist Tanya Rosen. Find Peanut Butter Lite Ice Cream in your local supermarket’s freezer and enjoy every lick without having to worry about calories or sugar—there’s no sugar added!

Bring on the Coconut Looking for that perfect gluten-free snack that leaves you with a sweet taste in your mouth and is fun to eat? Made with 94 percent real coconut, Gefen’s coconut chips are baked with no oil added, and are a great source of fiber. Their soft, nutty flavor with a slight hint of sweetness, along with their chewy texture make them the perfect healthy treat. Available in original and chocolate flavors, Gefen’s coconut chips are a great base for coconut milk, and they make for a tasty addition to homemade granola bars and cookies.

Away with the Ticks and Bites Tick borne disease is on the rise. Ticks in the New York area have been found to carry rare and debilitating viruses and bacteria. Protect yourself and your children before hiking, playing in grassy areas, or entering the woods by using Ticsaway, an all-natural tick repellent made of essential oils like geranium, cedarwood, peppermint, and lemongrass, that have been proven to be effective in repelling ticks. Its witch hazel base makes Ticsaway especially gentle on the skin and gives it a pleasant scent. Ticsaway can be sprayed on skin and clothing and protects for up to 6 hours. A similar product, Biteaway, was formulated for protection against mosquitos and wasps. This all-natural spray contains citronella, lemongrass, rosemary, and more, and is safe for children's skin. Ask for both products at your local health food store.

Medical Care at Midnight In the days of old, if your child was pulling his ears and crying miserably at 8 p.m., you knew he would be in pain until the next morning, when the doctor’s office finally opened its doors. And if you needed a culture because your throat was on fire, you had no choice but to wait it out too. Thanks to Chai Care, those days are over for Williamsburg residents. Since the state-of-the-art medical center opened its doors at 735 Bedford Avenue, patients are welcome until 12 a.m. every evening, until 8 p.m. on Friday, and until 1 a.m. on Motzaei Shabbos. No need to push through the hours until morning anymore. Av 5777 | The Wellspring 53

Living Well

Health Profile By Esther Steinmetz

In this fun column, The Wellspring readers get acquainted with a fellow reader’s health profile, getting a glimpse into the role that health and wellness play in her everyday life and the tidbits of advice that Chana Roness, nutritional counselor at the popular Nutrition by Tanya, offers for improved quality of life.

SARI

Age: 33 Location: Brooklyn, NY Weight: 158 lbs Height: 5’2” Marital Status: Married Kids: 6 Occupation: Mommy and part-time bookkeeper from home I find that working from home isn't easy. It requires a lot of discipline and time management—important skills that you can apply to dieting, as well. Favorite health food: Who can choose? I love them all. That’s amazing! Makes healthy eating and weight loss so much easier. Favorite junk food: I really don’t care for candy or chips, which I know is a blessing. If I do indulge, it will be on ice cream, or chocolate, or homemade baked goods (which is why I stopped baking). Favorite exercise: I used to love jogging and doing workout DVD’s, but I’m too exhausted lately to even think about it. It doesn’t sound like you don’t like doing workouts anymore, rather that it’s not working out for you time-wise because you may be leaving it for when you’re already drained. Can you find a better time to incorporate a workout into your routine? Favorite nutritious dish: Sautéed artichokes Recipe: Sauté 3 tsp fresh garlic in 1 tsp olive oil, add sliced frozen artichoke bottoms. Add 1/4 cup lemon juice, salt, pepper, and 1/4 cup water. Cover and cook until soft, stirring occasionally, for about 45 minutes. My usual bedtime: 12:00 a.m. My usual wake-up time: 6:30 a.m. My biggest meal on a usual day: Dinner, because I make a variety to please the picky eaters in the house. I’ve been trying to eat early, but sometimes I’m too busy. If I don’t officially sit down to eat, I end up eating at 7:30 with my husband, which is bad because I’m starving by then and have likely been picking on food. If you eat correctly throughout the day and drink enough water, you shouldn’t be famished by then. It is also helpful to have cut up fruit and veggies accessible to munch on while waiting for dinner to be ready. The soups I usually make: chicken soup, vegetable lentil, minestrone (no pasta), butternut squash. My usual dinner menu: I always make a protein, (chicken, fish, meat) a vegetable (salad, string beans, steamed broccoli) and a carb (pasta, rice, potato), but I rarely eat the carb unless it’s brown rice or sweet potatoes, and then, carefully portioned. Sounds like a smart menu to me!

The Wellspring | August 2017 54

My weight loss saga: My baby is 7 months old and I still have twenty pounds from the pregnancy that won’t budge, plus ten from the previous pregnancy. I am eating really carefully but my metabolism is slow. I just got blood work done and my thyroid is low/borderline in a few hormones. So now I know for a fact that it’s not just me, but I have no idea how to get it back up to help me shed this extra weight. Medication can definitely help you. Did your doctor prescribe Synthroid®? Greatest weight loss challenge: Staying motivated even when I’m not seeing results. The time of year when I find it hardest to watch my weight: Whenever the kids are out of school. Who has time to make themselves special food when everyone is eating pizza? (Which btw, I haven’t eaten in years, except the odd leftover.) Don’t let the kids being off from school sabotage your healthy eating routine. Plan ahead and order food for yourself if you have to, but recognize that the disruption in routine is just an excuse. I always hear from people that they don’t touch pizza but only eat the kids’ leftovers, which is why pizza is officially on our plan once a week, so you can eat it like a mensch. The extent I’ve gone to implement a healthy lifestyle in my home: There are so many foods that the kids know Mommy would never eat. If the kids get pizza, bagels, or shawarma, I either order a salad or make my own dinner. Sometimes I make the same food for myself as I’m making for my family’s dinner, but in a different way (e.g., breaded for them and not breaded for me), or I’ll make an easy dinner for the kids but make myself a healthy option. I spend so much time in the kitchen that I’m frustrated. Feeling frustrated can dampen your motivation to continue this system. Perhaps you can come up with a way to prepare your meals more efficiently, such as cooking more at one time so you can have a day off, so you don’t lose your drive to prepare healthy meals. What I do in my downtime: Catch up on organizing, shopping. How about shopping in a mall? This will get you to walk around. One place I would love to visit: I haven’t been to Niagara Falls and I’d love to see it. My weight/lifestyle goals: I would like to get down to a healthy and attractive weight (around 140), but mainly I want to feel stronger and more energetic. I feel like I'm dragging myself around. I’m the kind of person who runs around all day from morning to night, and my energy levels aren’t keeping up. How I would treat myself if I achieve this goal: Book a vacation with my husband.

Chana Roness is a nutrition counselor at Nutrition by Tanya which has locations in Boro Park, Flatbush Williamsburg, Monsey, Lakewood, Five Towns, Monroe and Crown Heights. To be interviewed for this column (anonymously) please send your contact information to info@wellspringmagazine.com.

Av 5777 | The Wellspring 55

Living Well

Healthy Home Habits By Batsheva Fine

Tried and True Up or Down?

Grade placement for children on the threshold Our five-year-old daughter just graduated Pre 1A. Because her birthday is in December, at the threshold of the academic year, the school has given us the option of either putting her up to First Grade or allowing her to repeat Pre 1A. I’ve observed her over the past few weeks, and I see that she’s gravitating toward younger children during playtime. Should we base our decision on her social preferences, or on the fact that she did very well academically this past year and that she’ll eventually acclimate to being with older girls? I would love to hear from parents who’ve had to make this decision to benefit from their wisdom.

Sury Flatbush mother of six: One of my daughters had that option, and I chose to keep her back a grade and let her be the oldest. Now she’s going up to fifth grade and is the star of the class. Of course, I can’t know if she wouldn’t be that way as the youngest, but I highly doubt it. When she goes on playdates, I get feedback from the mothers how mature she is, but it could simply be because she is older. On the other hand, you need to take into consideration that for a child who is older than their peer group, physical maturity issues will many times precede their classmates (especially important for girls), and not every child knows how to deal with it. If the child is taller and broader than their age group, they may feel clumsy and out of place as well. It’s also important to take into account the child’s personality. A child who is lively and has a strong personality might find it difficult to be in an environment with children who are less mature, and also needs more social and intellectual stimulation.

Mindy Montreal, Quebec mother of four: I didn’t want to “push” my child too hard and kept her to be the oldest of the class. That turned out to be the wrong decision by far. She needed to be put up a grade mid-year; the school didn’t even wait for the year to end. Chany Williamsburg, Brooklyn mother of seven: My general take on the topic is to leave your kid behind. But, and it’s a big but, do it in nursery/kindergarten. Don’t wait for Pre 1A when the whole year is geared to “going up” to First Grade, and your kid will feel bad to be left behind. It goes without saying that the older the kid, the more self-conscious she will feel when staying behind. Why do I advise to leave a child down? I believe that a child who is the youngest of the class and is immature in comparison to her peers always gets the feeling that she is “lagging” behind, and this can damage her self-esteem. My daughter, who was born in November, stayed down a class the year before Pre 1A. From the very first day of the term, she took on the role of “big girl” and looked askance at the girls who were crying when their mothers left, which was exactly what she had done every year beforehand without fail..., and she never looked back after that. The Wellspring | August 2017 56

Generally, it’s better to put a child with the younger class, as it’s always beneficial for children to play more, and they gain many skills by doing so. Also, there’s no point in pushing kids to sit in desks for so many hours a day before they need to. However, there’s always the exception to the rule: the student who is both academically bright and socially savvy, who may lose out when placed with younger kids. Judging on the basis of academics alone is not a good enough reason to push a child ahead. In such a case, the student is on a high level academically but is socially immature. It’s hard to go through school without friends on your social level. Ann Highland Park, New Jersey mother of seven: My twin daughters’ birthday was just at the cut-off date, and we were advised to leave them an extra year in pre 1A before going to first grade. They were both very mature and quick to learn, so I don’t really think there was any need to keep them back. It’s very difficult to know if they benefited socially, because we can’t know what would have happened if they had started a year earlier. Also, the teacher used to “complain” that it was like having two inspectors with her the entire year, constantly correcting her and telling her that she’d done things differently the previous year. Baila Lakewood, New Jersey mother of five: My general take has always been that kids have enough challenges as it is, so why not give them every advantage by having them be the oldest? But then when my own born-on-the-deadline kid turned five, I consulted with the late educational specialist Ziva Krieger a”h. She evaluated him and recommended that he start school at five and we not hold him back. She said he was ready, and “wasting” a year wouldn’t be good for him. We have never regretted the decision. I would just add that “ready” means not only academically or regarding their skills, but also socially. The moral of my story is that generally, start older, but evaluate each situation individually. Like everything else in life! Gina Passaic, New Jersey mother of eight and a teacher: I think this very much depends on the maturity of the child. I speak as a teacher who has taught both children who were born at the end of the year yet joined the higher class and those who stayed with the lower class. Even if the child joins the higher class and is on par academically, or even above the average level of the class, it is important to take into account that the emotional level of the child may be below par, and she may find it difficult to integrate socially. This is a potential problem for a number of years, as many children in the class will be nearly a whole year older in terms of maturity. Something that educational establishments (and many parents, I may add) do not seem to realize, is that EQ (emotional maturity) is as important, if not more important, than IQ. In contrast, kids who stay with the younger year have a natural advantage as the oldest of the class, and it usually works to their benefit, with both social and academic experiences being much easier for them. That said, a parent usually knows their own child best, and as long as whatever you’re doing is not merely to “keep up with the Joneses” but is done with your child’s (and not just your own) best interest at heart, with much siyata di’Shmaya and an informed choice, you will be giving your child the school experience that has been charted out for them Up There. Next up: I try to limit my toddler’s intake of junk food. He barely has any candy or stuff like that. His best treat is grapes, and when he asks for a snack he gets pretzels or rice cakes. Very soon, though, he will be attending playgroup. Is there any way to control the amount of junk he consumes once he starts having Shabbos parties every week and all other candy-related celebrations? Have a health question for the Wellspring community? Let us know what it is and we’ll do our work to get the conversation rolling in your favor! Av 5777 | The Wellspring 57

These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, prevent or cure any disease.

Eva Brooklyn, NY school director:

Living Well

Monthly Dose By Yaakov Goodman, CN

SAVE THOSE ENZYMES HOW YOU CAN PREVENT DIGESTIVE ENZYME LOSS

Enzymes are a vital component of the digestive process, essential to the body’s absorption and digestion of food. Our ability to make enzymes diminishes with age, and some scientists believe that humans could live longer and be healthier by guarding against this loss. Enzymes are responsible for every activity of life; even thinking requires enzyme activity. There are two primary classes of enzymes responsible for maintaining life functions: digestive and metabolic. The primary digestive enzymes, amylases and lipase, help break down protein, carbohydrates, and fats. Raw foods also provide enzymes that naturally break down food for proper absorption. In this article, we will focus on the role of digestive enzymes and how you can guard against their loss. The foods we eat cannot be absorbed into the bloodstream without the action of powerful digestive enzymes that break them down in order to extract vital nutrients. Without this breakdown of the food matrix, undigested food passes into the colon, where it can lead to bloating, gas, diarrhea, and cramping symptoms, related to more serious digestive orders such as Irritable Bowel Syndrome and Crohn’s disease. Problems with the Modern Diet Because the modern diet consists primarily of cooked, processed foods, versus raw foods that provide enzymes, our bodies need to rely almost exclusively on our own natural digestive enzymes. The problem is that factors such as aging and poor lifestyle choices result in production of fewer and few The Wellspring | August 2017 58

er of these vital enzymes necessary for healthy digestion, which makes it difficult for our bodies to properly break down food. In addition, the simple cooking process of food in heat over 118 degrees Fahrenheit destroys the enzymes in the food, leaving what is commonly consumed by the modern person as an “enzymeless” diet. This is how, by the time we reach middle age, we become metabolically depleted of enzymes. The glands and major organs, including the brain, suffer most from this deficiency. The brain may actually shrink as a result of a cooked, over-refined diet devoid of enzymes the body so desperately needs. Not surprisingly, poor oral health, even just wearing dentures, can reduce the efficiency of chewing, putting an extra burden on already-taxed digestive enzymes. For reasons like these, Maxi-Health formulated the Premium Enzymax® supplement— not just for healthy digestion but for general good health. What is the efficacy of a digestive enzyme supplement? In an eight-week trial, subjects with irritable bowel syndrome (IBS) taking a digestive enzyme supplement had significant improvement in abdominal pain and bloating, whereas patients taking a placebo had no notable improvement. In another clinical trial, subjects with Crohn’s disease taking a digestive enzyme supplement had a greater decrease in total Crohn’s Disease Activity Index (CDAI, a scale evaluating disease activity) and a greater drop in the number of liquid-like stools at 30 and 60 days, compared with individuals taking a placebo. Impressively, four out of five subjects in the probiotic group were able to stop taking anti-diarrheal medications, compared with no improvement in the placebo group. If you find yourself reaching for

drugs like Alka-Seltzer® or Pepto-Bismol® to relieve chronic digestive problems, you may have bigger health problems than you realize. Those OTC drugs might temporarily ease your symptoms, but they’re doing absolutely nothing to target the underlying cause of the problem. If that underlying cause goes unchecked, you may be setting yourself up for a host of health issues that are much more devastating than gas or bloating, such as food intolerance and malnutrition. Drugs like Prilosec® and Prevacid® suppress stomach acid secretion, but do so at the expense of proper digestion. Even when stomach acid production is blocked, gastric contents and bile secreted by the liver can still reflux back into the esophagus and cause heartburn and irritation that lead to serious disease. Those who suffer esophageal reflux don’t want undigested food remaining in the stomach any longer than it has to. Once again, supplementing with the right digestive enzyme formula facilitates more rapid digestion that helps resolve common digestive discomforts. In his book Enzyme Nutrition, one of America’s pioneering bio-chemists and nutrition researchers, Dr. Edward Howell, cites numerous studies showing that subjects who are fed diets deficient in enzymes suffer from enlargement of the pancreas, as huge amounts of pancreatic enzymes are squandered in digesting foods that are devoid of natural enzymes. The result of this wasteful outpouring of pancreatic digestive enzymes is a decrease in the supply of crucial metabolic enzymes and impaired health. How Enzyme Deficiency Affects Overall Health Enzyme deficiency plays a significant role in the body’s general health.

For starters, organs that are overworked enlarge in order to perform the increased workload. For instance, those with congestive heart failure or aortic valve disease often suffer from an enlarged heart. When the pancreas enlarges in order to produce more digestive enzymes, there’s a deficiency in the production of life-sustaining metabolic enzymes, as available enzyme-producing capacity is used in digesting food instead of supporting cellular enzymatic functions. For a good part of the 20th Century, European oncologists have included enzyme therapy as a natural, non-toxic therapy against cancer. Almost all of the leading alternative cancer specialists treating Americans prescribe concentrated enzyme supplements as primary or adjuvant cancer therapies. Nicholas Gonzalez, M.D., a New York City cancer specialist, uses very high doses of supplemental enzymes as a primary anti-tumor therapy. Dr. Gonzalez’s clinical successes have led conventional drug companies to seek to duplicate these natural therapies and offer them as adjuvant drug therapies. One might assume that if pancreatic enzymes are effective in treating existing cancers, maintaining a large pool of these precious enzymes in the body would help prevent cancer from developing in the first place. Epidemiological studies on human populations show that those who eat fresh fruits and vegetables that are loaded with natural enzymes have dramatically reduced levels of cancer and other diseases. Whether the high enzyme content of these foods is partially responsible for their anti-cancer effect has not been proven, but the evidence is compelling. Dr. Arnold Renshaw, from Manchester in England, reported in Annals of the Rheumatic Disease that he had obtained good results with enzyme

treatment of over 700 patients with rheumatoid arthritis, osteoarthritis or fibrositis. “Some intractable cases of ankylosing spondylitis and Still’s disease have also responded to this therapy.” He went on to say that of 556 people with various types of arthritis, 283 were found to be much improved, and a further 219 were improved to a less marked extent with enzyme treatment. Of 292 cases of rheumatoid arthritis, 264 showed improvement of various degrees. The longer the duration of the disease, the longer time before improvement was observed, although most started to show improvement after just two or three months of enzyme therapy. Despite these favorable findings, digestive enzyme therapy in conventional medicine has been reserved to those diseases that directly result in a pathological deficiency of pancreas-derived digestive enzymes. Preventing Enzyme Loss If foods are eaten uncooked, fewer of the body’s digestive enzymes are required to perform the digestive function. The body thereby adapts to the plentiful, external supply by secreting fewer of its own enzymes, preserving them to assist in vital cellular metabolic functions. Frying is one of the worst cooking methods since it occurs at a much higher temperature than boiling, damaging protein as well as destroying en-

zymes. Many digestive disorders such as bloating may be related to an enzyme deficit that begins in middle age. Enzymes can also be wasted by lifestyle factors. Enzymes do more work with increasing temperatures, and they are used up faster. For example, a fever induces faster enzyme action and hence is unfavorable for bacterial activity. Enzymes have been found in the urine not only after fevers but also after strenuous athletic activity. Though considerable evidence exists to support the beneficial effects of enzymes, the downside with many common enzyme supplements is that they contain only a few specific enzymes. Maxi Health’s Premium Enzymax®, however, is one of the most broad spectrum digestive enzymes on the market today, encompassing a wide variety of enzymes effective for breaking down fats, proteins, carbs, and dairy, and can be helpful for those suffering from conditions such as Irritable Bowel Syndrome, Crohn’s, and digestive symptoms such as bloating and gas. With proper enzyme supply, the digestive system can run like a welloiled machine. The food is completely broken down by the time it reaches the end of the small intestine, leaving few undigested food molecules to pass into the colon. The result is a well-nourished body that continuously renews itself and a comfortable sensation following a meal.

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These statements have not been evaluated by the FDA. These products are not ibntended to diagnose, treat, prevent or cure any disease.

The foods we eat cannot be absorbed into the bloodstream without the action of powerful digestive enzymes that break them down in order to extract vital nutrients.

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Wellbeing

Clean Slate By Shiffy Friedman, MSW, CNWC

CONQUERING THE FEELING PHOBIA Are you afraid to feel?

Think back to the last time you made a comment or thought something like, “I can’t believe I just finished that,” or “I really wasn’t hungry, so how did this happen?” At the core of that binge, we can safely assume, was an avalanche of emotion. You may have been coming home from the pool after having had a conversation that triggered something unpleasant inside you. You may have had an argument that got too heated with someone really important in your life. You may have spent too much time trying to figure something out or getting your child to obey, frustrated at yourself for having failed. It’s a niggling feeling inside your heart, one that you’re trying desperately to escape. And what’s your magical escape mechanism—the partner in crime that gives you short-term relief from that unpleasant emotion? It’s food. Emotional eating occurs when you can’t face your feelings. Instead, you stuff the feelings down with food. There are four different kinds of events which trigger the feelings that make people overeat. These events turn on the imaginary hunger switch in your brain, leaving you feeling desperate for “good food,” while what your emotional self really wants is for you to healthily tackle your emotion— to face it. Before we discuss how we can learn to face our emotions instead of escaping them and allowing them to fester and conquer our lives, let’s first examine the four kinds of triggers. Events Emotionally difficult events trigger uncomfortable feelings. “I know that Sunday family reunions should be such fun,” says Gitty, “but for me they aren’t—and we have them every week in the summer. We gather together on my parents’ deck every Sunday afternoon for a nice barbecue. Somehow, I always get triggered by this one’s perfection or that one’s spunk, and al-

though I put up a nice show while I’m out there on the deck, I feel miserable as we ride back to our place.” Although she hasn’t specified which part of the event triggers which emotion, Sunday parties are clearly ticking Gitty off in the wrong direction. If you understand how emotional eating works, you wouldn’t be surprised to learn that Gitty spends Sunday evenings, after the kids are asleep, at the pantry, or even baking her favorite cookies and then wiping the baking sheet clean. For some people, events that trigger them are business meetings, social outings, PTA, weddings, school functions, or even a shiur. And in each individual, the reason the event brings on certain unpleasant feelings varies. But the common denominator of these events and their results is that they compel you to interrupt the feelings by overeating. Think of the most recent event that triggered an unpleasant emotion in you and ask yourself, “How did that make me feel?” A feeling means exactly that—a feeling. It’s not, “It made me feel like two cents.” Identify the underlying feeling that was niggling there. Did it make you feel sad, unloved, guilty? It’s important for emotional eaters to make the connection that negative feelings lead to overeating in order to know how to deal with such feelings in the future. People Uncomfortable feelings come most frequently from friction in relationships, especially when dealing with those closest to you. When someone criticizes you, misunderstands you, judges or manipulates, the feeling of rejection or unworthiness weighs heavily on your heart. Some people get set off when others don’t trust them; others when they feel underestimated.

As the negative emotion arises, or afterward when you want to identify how the chain of reactions went, face the feeling. “When my sisters-in-law talk about things that don’t pertain to me, it makes me feel rejected and unworthy of their acceptance,” “When I get scolded by my boss, it makes me feel incapable and thus untrustworthy.” Realize that the feelings are not anger or jealousy, or anything to that effect, because the goal of this exercise is to look inward, not to connect the feeling to another person. If the feeling you come up with is angry or jealous, continue to dig deeper to find out what that is leading you to feel about yourself because it’s not the anger or jealousy that’s bothering you— it’s something deeper. Also, it’s not that the other party is making you feel one emotion or another (“they make me feel”), but rather “it makes me feel,” because, once again, the goal is to realize that we’re the ones being triggered, regardless of who or what is triggering us. Facing the feeling is a courageous thing to do. For years, you may have been conditioned to escape the pain or mask it. “Don’t cry,” many children are told. “It doesn’t hurt.” After getting the message for so many years that experiencing emotions is scary, childish, or unnecessary, we learn to resort to various tactics, such as emotional eating, as an escape mechanism. However, the liberating feeling that comes from allowing yourself to experience the emotion is priceless. It tastes infinitely better than your favorite flavor of ice cream—and it’s so, so healthy. In this column on emotional eating, Shiffy Friedman, MSW, CNWC, discusses the journey toward a healthy relationship with food from a Torah-based, psychological, and personal perspective. Av 5777 | The Wellspring 61

Wellbeing

From the Ground Up By Goldy Guttman, Ms. Ed.

Watch my Growth 3 years

Welcome to the wonderful world of preschooler—your child is now three years old. You may feel that you’re more active than ever, since your child definitely keeps you on your toes at this age! You never know what he will come up with next, and it is extremely important to make sure the entire house is childproof. NOTE: All children at this age tantrum. All children at this age kvetch. Phew! Your child is normal. He will be okay. Now that we got that out of the way, let’s focus on the checklist of the skills your child should possess by the age of three.

Social skills: Your child is no longer a toddler and has become more independent. He should be able to share toys, and altogether be less aggressive than when he was two.

Also, he should be: • more responsive to other children and able to develop friendships • capable of taking turns and sharing toys • more interested in structured games, but he won’t be able to sit still for extended periods of time • aware of his daily routine and will try to figure out the routines of others (e.g. he might ask “You go to sleep now?” when it is dark outside) • able to understand his own place in the family and is able to view you as a separate person. (Mommy, Totty, brother, sister, baby…) • exhibiting a feisty attitude on occasion

Motor skills: Your toddler is now probably losing his baby fat, developing more muscle, and growing taller. Hold onto those chubby hands just a little longer, for soon they will be gone! By the age of three, your child: • can catch a ball with arms extended • will jump down from an object 18-inches high, e.g., the bottom step. • will be interested in tools, such as scissors, paper, and crayons • can walk up and down stairs while alternating feet • can bend over and not fall down • can draw a circle

Language skills: Probably the most adorable skill to watch develop is your child’s speech. You’ll want to have a recorder ready at all times to catch the adorably funny things he says. Write them down, because even if you think you will always remember, you won’t.

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By the age of three, your child: • will have mastered the basic rules of language and should have an active vocabulary • should be able to say his name • answers the question, “How old are you?” • uses plurals and pronouns (he, she, etc.) • may mispronounce words and will become extremely frustrated when he is not understood

Activities to boost development: At the age of three, although the initial development stage is over, your child is learning about his environment in order to sharpen his brain and build skills. Here are some activities you can do to help him develop into a more expressive, perceptive child.

Matching Advancing from cards and pictures, you can take the matching idea all over the house. The focus now is on objects that are the same. How to Play: Collect one of a set of objects that has a matched pair and ask your child to find the other one. Some examples are a sock, a shoe, a barrette, a candlestick, a pencil, or pen. A variation of this game is to match big items with their smaller versions. Suggested items are a pencil, a shoe, a shirt, a sock, a pillow, etc. Playing Detective This one is great for those times you are waiting. You can do this at home, in a restaurant, in a doctorâ&#x20AC;&#x2122;s office, or at any place where you have unexpected time to pass. How to Play: Choose a category like a color or a shape. Then take turns finding an example in the place. At first there may seem that there are only one or two examples in sight. However, once you get used to the play, both of you are likely to find many more. Numbers This is a great time to start introducing your child to the world of numbers. Beginning skills in counting, adding, subtracting, and dividing can become a part of everyday conversations. How to Play: Look around your house for groups of items, e.g., two candlesticks, seven pencils, three hats, or a dozen roses. Take the time to count such items. A popular plaything is paper cups. Take ten of these and then have fun as you count them, stack them, build with them, or even hide items under them. You can also add them, subtract them, and even divide them.

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Wellbeing

Emotional Wellness By Esther Moskovitz, LCSW & Yocheved Rottenberg

you're being called Writing as a means of self-growth

Walk into a wedding hall in the midst of dancing; stand there and just listen. Listen to the pounding drums, thundering music, singing, and the clamor of loads of people talking at once—and then try to say a quiet “Hello.” That’s how your authentic self feels at times. We’re all made up of many parts, each with a voice of its own. And they all chatter in our heads as we go about our daily lives. There’s the voice of the parts that feel worthy and precious, and the voice of those that feel threatened and insecure. There’s the voice of our public persona; maybe our sophisticated exterior, maybe our inner people-pleaser. We’ve got the voices of our fears, our hurts, and our joys. And then there is, in each of us, a still small voice—the voice of our authentic self—and, like all things sacred and sublime, it’s often the quietest one of all. But that still small voice is powerful. It wants us to listen it, and it will never give up trying to get our attention. Even if it is drowned out by the tumultuous noise of inner critics, outer stress, daily overwhelm, and perhaps even fear, it will do whatever it takes to

be heard. Sometimes, when you are very disconnected from it, the voice of your authentic self shakes things up to get your attention. It may make you anxious, putting all your worries into one obsession, or it may scream for attention by

There are numerous ways we can hush the outer noise so that we can stop and listen to the voice within. sapping your energy, making you feel depressed. Sometimes it may turn to your body to get your attention. Perhaps the migraines, backaches, stomach pains (and worse) will force you to stop and listen. And all it wants is to tell you who you really are. It wants to tell you about the incredible strength that you were born with, that you didn’t even realize you have. It wants to reveal your true fears, deep vulnerabilities, and powerful dreams that you haven’t acknowledged. It wants to share with you the amazing answers and guidance that it has for you every step of the way. It wants to give you the strength you need to be

yourself. There are numerous ways we can hush the outer noise so that we can stop and listen to the voice within. One method is through writing. There are many tools and techniques to access our inner voice through writing, but the most powerful one is “Don’t think.” When you sit down and write quickly, without paying heed to the voices that want you to stop and give them attention, you will eventually reach into your authentic self. You can sit down with a piece of paper and write on top of the page, “Why I’m Scared” or “Today I am Grateful For,” “How I Feel Now” or “What I Wish.” And then just begin to write—quickly, quicker, and even quicker. Let the handwriting be messy, let the writing seem silly, and if you don’t know what to write, just write that—“I have no idea what to write but I’m going to keep on writing.” After doing this for a few minutes straight, you may well reach a breakthrough. You will know when you’re hearing the voice of your authentic self. It just feels like truth. The pay-off is huge. There’s nothing like knowing you’ve reached the truth— that you are in tune with your authentic self. Because there’s no greater feeling of connection—to yourself, to the world, and to Hashem, than being the closest version of who He intended you to be.

Esther Moskovitz, LCSW, specializes in challenges faced by adults raised by narcissistic or emotionally undeveloped parents using EMDR and the work of Pia Mellody. Her practice is in Monsey, NY and she has an active telephone practice, as well. Yocheved Rottenberg is a certified Journey to the Self Facilitator. She leads group workshops in Jerusalem and helps women internationally use writing to heal and express themselves. Both therapists can be reached through The Wellspring.

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Wellbeing

Health Personality By Shiffy Friedman

A CUP OF TEA WITH... TAMAR FELDMAN, RDN, CDE

LOCATION OF PRACTICE: Lakewood, New Jersey OCCUPATION: Dietitian/nutritionist YEARS IN PRACTICE: 11 PASSION: Helping restore balance, wellness, and health through nutrition and other natural means WISHES PEOPLE WOULD KNOW THAT: a weight loss plan is a waste of time if it is not a sustainable and enjoyable way of life, and that Crohn’s disease and colitis symptoms can be improved or even successfully put into remission through nutritional interventions.

WHAT MOTIVATED YOU TO ENTER THE FIELD OF DIETETICS? I was raised by a very health-minded mother who was ahead of her time. She didn’t allow margarine, MSG, and nitrates into the house at a time when nutritional knowledge was still in its infancy. At five years old, I already knew what a protein was. Of course, we weren’t eating quinoa just yet, but the consciousness to stay away from foods that can be detrimental to health definitely had an impact on me and accompanied me as I matured. As I grew up, I developed a greater interest in the relationship between the foods we eat and the effects they have on our bodies. I was intrigued by the possible connection between nutrition and skin conditions, hormone imbalances, and disease prevention. I also became disillusioned with the excessive negative focus on food, particularly with the thin-minded young women in our community. It made sense to me that if Hashem created so many wonderful foods and flavors for us to enjoy, food should be viewed positively. I wanted to bring that awareness to people, to help them to not just focus on eating less, but rather on eating smart and right.

WHAT TYPE OF TRAINING DID YOU UNDERGO? I did the standard registered dietitian program, which includes 4 years of schooling, as well as 1,000 hours of super The Wellspring | August 2017 66

vised practice in hospitals and other settings prior to receiving my license.

THAT’S A LOT OF TRAINING—VERY DIFFERENT TO A SIMPLE NUTRITION COURSE. HOW WOULD YOU EXPLAIN THE DIFFERENCE BETWEEN A DIETITIAN AND A NUTRITIONIST? I’m not really familiar with the various certificate programs available to confer the title nutritionist. However, if someone wants to be licensed to work in a hospital and to accept insurance, she must go through the official schooling system. An RD is the gold standard credential in the field, deemed competent enough to deal with many various nutritional concerns. Registered Dietitians are able to individualize weight loss plans taking into account factors affecting calorie requirements, such as pregnancy or nursing, individual body size and other specific requirements. As a recognized RD, I am also generally the go-to professional for more complicated medical cases, such as tube feeding, diabetes pump patients, and more rare diseases that interplay with nutrition. Nutrition therapy for many diseases requires higher level skill sets. For example, if we’re seeing a patient with advanced kidney disease, we have to take into account the patient’s adjusted electrolyte and fluid needs, sometimes even

limiting their potassium and protein intake.

HOW DOES YOUR EDUCATION HELP YOU GUIDE PEOPLE WITH WEIGHT MANAGEMENT? Any Registered Dietitian is eminently qualified to design a tailored and nutritionally sound plan that will be effective for weight loss. I think Registered Dietitians are more knowledgeable about the negative repercussions that can result from designing plans too low in calories or that restrict entire food groups, and therefore we generally design safe and sustainable plans that take into account individual calorie requirements. My three major principles for weight loss are: 1. Give the body fewer calories than it expends (I utilize formulas based on height, weight, age, gender, activity level, and nursing/pregnancy status), but not too much less. 2. Eat every few hours to keep metabolic rate active (every 3-4 hours), including protein at each meal. 3. Consume a significant amount of calories from protein, which has a metabolism boosting effect. Diet plans that are too restrictive and/or are too low in calories can result in a weight loss plateau from insufficient caloric intake, frustrated individuals who cannot stick to such a restrictive plan long term, and in the case of nursing mothers, a loss of milk supply. I also think that when choosing a dietitian/nutritionist, it is important to find someone who views food from a positive perspective, and who believes that food should be one aspect of life, and an enjoyable one, rather than its main focus. I particularly believe in allowing people the flexibility to fit the foods they enjoy into their diet at times, even if this may not be the best choice from a calorie standpoint, since this helps them find the plan more sustainable, giving them greater success in the long term.

A DIETETICS PROGRAM IS PROBABLY VERY INTELLECTUALLY STIMULATING BECAUSE IT DELVES DEEPLY INTO THE ANATOMY OF THE HUMAN BODY, RIGHT? Very much so. I’m attracted to learning complex things, so it really worked for me. That’s also the reason why, after being a dietitian for five years, I also trained as a certified diabetes educator.

WHAT’S A CERTIFIED DIABETES EDUCATOR? Essentially, a dietitian is qualified to work with all diseases related to the digestive system, but I wanted to understand the elements of diabetes in particular on a deeper level so I advanced my training. As a certified diabetes educator (CDE), I’m able to figure out why a patient’s glucose level is high or low based on how he’s eating. People with difficulty controlling their blood sugar, whether or not they take insulin, will usually turn to a RD CDE for guidance in regulating their diet. Doctors will refer their patients to me if they see they need help in figuring out the right amount of carbs and carb types to achieve good blood sugar control. Until two years ago, when I started to focus more on gastro-intestinal (GI) work, this was my specialty.

SO LET’S TALK ABOUT YOUR WORK IN THE GI FIELD. WHAT ATTRACTED YOU TO THIS DOMAIN OF NUTRITION? I was intrigued by the cases in this field that another dietitian shared with me. I also had some friends and family members who wanted help with GI concerns, and in the process of my research on their behalf, I realized I had found my calling. When I had first gone into the field of nutrition, I wanted to help heal more complicated diseases through food, so this really spoke to me. I embarked on this journey by taking lots of advanced webinars and courses and getting connected with practitioners who practice what we call functional medicine (also known as integrative medicine).

WHAT IS FUNCTIONAL MEDICINE? In a nutshell, functional medicine looks at the root cause of illness and tries to cure it utilizing some aspects of conventional medicine, but from a more holistic approach. I would say it incorporates the best of both worlds. For example, in a Crohn’s disease case, conventional medicine says that the immune system is attacking the small intestine, so the solution would be to give medication to reduce the immune system function. Functional medicine, on the other hand, asks the question, “Why is the immune system attacking the small intestine and how do we change that response?” And the answer is by curing the underlying cause. This is not to say that medication isn’t effective, but why would we want to suppress the immune system and thus increase the individual’s risk of other diseases?

WHAT IS THE UNDERSTANDING OF FUNCTIONAL MEDICINE BASED ON? What speaks to me most about functional medicine is that it’s evidence-based. There’s hard data for almost everything we recommend. Many practitioners worldwide are doing rigorous research in the field. When we recommend a specific supplement or diet as being helpful in healing the gut, it is all backed up by evidence. Functional medicine almost always looks at the gut as the root of illness, particularly autoimmune diseases. It sees the health of the intestine as the determinant of the health of the body as a whole. It also looks at stress and the way the body is affected by it.

WHAT EXACTLY IS THE GUT? The gut encompasses both the small and large intestine. It takes over the digestive process after the food (then called chyme) exits the stomach. The small intestine absorbs the solid parts, whereas the large intestine absorbs fluids.

THERE’S A LOT OF TALK ABOUT HOW BACTERIA IN THE GUT AFFECTS GENERAL HEALTH. WHAT’S YOUR TAKE ON THAT? Based on the powerful research that is constantly emerging, there is most definitely a strong association between the two. Gut health is definitely a defining factor in the state of health of the entire digestive tract. I call myself the Gut RD Av 5777 | The Wellspring 67

Wellbeing

Health Personality

because I’m a dietitian who focuses on the gut in order to heal disease.

DO YOU BELIEVE THERE’S A BRAIN-GUT CONNECTION? There’s no question about it. You can see it for yourself when you’re nervous. If you’re scheduled to give a speech one day, how does your stomach feel in the morning? It works the other way around, too. For example, gluten fragments that aren’t digested properly can end up traveling into the bloodstream, causing brain fog. Research has demonstrated the connection between poor gut health or bacterial imbalance in the gut and anxiety and depression, as well.

WHICH ASPECTS OF CONVENTIONAL MEDICINE PRACTITIONERS OF FUNCTIONAL MEDICINE RELY ON?

We utilize a lot of mainstream lab work. Blood work as well as stool testing, tells us a lot about the body.

YOU’VE BEEN WORKING WITH CROHN’S DISEASE, COLITIS, IBS, AND OTHER GASTRO-INTESTINAL DISEASES. HOW DO YOU SUCCESSFULLY TREAT THESE CONDITIONS? First, I never claim to “cure” people. I have had astounding success in some cases, but I like to be realistic about our goals, and I don’t allow people to mistakenly believe they will be weaned off their medication. I utilize a lot of the principles of functional medicine, which I’ve found to be highly effective, but I am honest about its current limitations, and that there is still a lot we do not know. Most times we are able to reduce dosages of medications or discontinue them completely as the gut heals, however there are some situations where that is not possible. I still consider those cases successful if symptoms improve with our intervention. I incorporate food sensitivity testing and elimination diets, interventions to test for and alter the types of bacterial strains in the gut, as well as replacing deficient enzymes and other components required for proper digestion.

DO YOU ADVISE YOUR CLIENTS TO FOLLOW A SPECIFIC DIET, SUCH AS GAPS, PALEO, OR SCD? I utilize SCD very often, and GAPS and Paleo on occasion as well. While these one-size-fits-all gut repair protocols do work for some people, others find them too restrictive and cannot stick to them. If that’s the case, we can still achieve success by testing for food sensitivities and eliminating specific foods from the diet. In addition to diet guidance, we also incorporate other elements of the gut repair evidence-based protocol, such as using different supplements and botanicals, and balancing out the bacteria. Every small change will cause some improvement, so it doesn’t have to be an all or nothing solution.

HOW DO YOU TEST FOR FOOD SENSITIVITIES? Mostly through stool testing, and sometimes through blood testing. I work with several labs across the country.

WHAT DO YOU TEST FOR? Blood IGG antibodies, which are markers for an immune The Wellspring | August 2017 68

response that’s more delayed and less severe than allergies. In other words, people who have these antibodies to certain foods will experience a reaction that’s similar to allergies, but not as severe and more delayed. I also utilize a test for IgA antibodies in the stool to specific foods.

DO ALL PEOPLE WITH DIGESTIVE ISSUES HAVE A DIAGNOSABLE DISEASE? Some people suffer only from sensitivities—not officially diagnosed diseases—but their treatment plan may be very similar due to the intensity of their issue. Many people with IBS, for example, have an underlying condition called SIBO (small intestine bacterial overgrowth), which can manifest itself as intense gassiness and bloating post-meal with concurrent diarrhea and/or constipation. SIBO is treated with antibiotics or herbal antibiotics combined with either a low FODMAP diet or a reduced carbohydrate diet.

HOW DO YOU BELIEVE ANTIBIOTICS AFFECT GUT HEALTH? Antibiotics definitely serve a vital purpose, but when they’re overused, such as for babies with recurrent ear infections or children with monthly rounds of strep who keep being re-prescribed, they may cause long term imbalances in gut bacteria, which can increase the child’s risk of autoimmunity and developing allergies. From a functional medicine perspective, I would want to see what the child is lacking that’s making him so susceptible to illness.

CAN YOU SHARE A CASE OF A GI PATIENT WHO WAS HELPED THROUGH YOUR WORK IN FUNCTIONAL MEDICINE? Responses to treatment are varied, but almost everyone will see improvement. I recently treated a woman with severe joint pain who had psoriatic arthritis. We did an intense gut repair protocol, eliminating food sensitivities, and within six months she started taking the injection that she used to take every 2 weeks only every 4-6 weeks. Once she healed her gut completely, she hardly had any pain at all.

WHAT ARE SOME GENERAL TIPS THAT PEOPLE CAN FOLLOW TO HAVE A HEALTHIER GUT? Limit the use of antibiotics unless absolutely necessary. Consume fermented foods such as yogurt and sauerkraut. If you suspect that there’s a genetic predisposition to gluten sensitivity, such as if you’re experiencing brain fog, or if there’s Crohn’s disease or colitis in the family, get yourself tested via a functional medicine practitioner to determine whether you have antibodies for gluten sensitivity. This can prevent a full-blown autoimmune issue later on, G-d forbid. And, of course, sticking to a healthy diet overall—with lots of fruits and vegetables— creates a nice balance of beneficial bacteria in the gut. Learning how to manage stress correctly also plays a role, because the stress hormone cortisol is associated strongly with many gut disorders and has been proven to upset the balance of bacteria in the gut. Once we do what we can to keep the gut healthy and strong, we can increase our odds of preventing disease, and can enjoy a more vibrant, healthy life.

AGE WELL ISSUE 19 AUGUST 2017 AV 5777

The Ins and Outs of Gout Dealing with the notoriously painful form of arthritis SAGE ADVICE 5 GREAT WAYS SENIORS CAN DO THEIR EXERCISE AND ENJOY IT TOO

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Golden Page By Yaakov Goodman, CN

IMPROVE YOUR MOOD

A SOLUTION FOR SENIORS WITH DECLINING SEROTONIN LEVELS Serotonin is a compound in the brain that promotes feelings of security, relaxation, and confidence. A serotonin deficiency can result in sleep disturbance, anxiety, depression, and a propensity to overeat, particularly carbohydrates like simple sugars. Startling research reveals that serotonin levels decline as we age. These findings provide a biochemical rationale to explain common age-related disorders, such as depressed mood and sleep difficulties. Based on these discoveries, aging people may appreciably improve their health by restoring serotonin to youthful levels. The amino acid tryptophan is needed to produce serotonin in the brain.Tryptophan is one of the eight essential amino acids found in the human diet. Essential amino acids are defined as those that cannot be made in the body and therefore must be obtained from either foods or supplements. While the amount of tryptophan in a typical diet may meet basic metabolic requirements, it often fails to provide optimal brain serotonin levels, due to the competition of other amino acids for transport through the blood-brain barrier. Even eating tryptophan-containing foods like turkey may not always provide the body with enough of this essential amino acid. Moreover, aging people make enzymes that rapidly degrade tryptophan in the body. Given all we now know about the difficulty in maintaining adequate tryptophan status, is it any wonder that so many aging humans suffer from the disorders with a serotonin deficiency? L-tryptophan converts into serotonin, primarily in the brain. Since serotonin is a neurotransmitter involved in controlling moods and appetite, tryptophan supplementation has been recommended for individuals suffering from a variety of conditions associated with decreased serotonin levels, including sleep disorders, depression, fibromyalgia, eating disorders, and problems with endocrine regulation. L-tryptophan serves as a precursor not only to serotonin, but also melatonin and niacin. There are two possible sources for L-tryptophan: diet and tissue proteins, from which L-tryptophan has been recycled during protein turnover. Aging, chronic inflammatory diseases, and HIV infection are associated with tryptophan depletion, even in the absence of dietary tryptophan deficiency. Tryptophan and its metabolite 5-hydroxytryptophan (5-HTP) are taken up into the brain across the blood-brain barrier by a transport system that is used by all the large neutral amino acids, causing competition between them for entry into brain. In fact, the best predictor of a given meal’s effect on brain tryptophan-serotonin levels is the serum ratio of tryptophan to the pool of large neutral amino acids. For the last 30 years, tryptophan has been researched as a solution for sleep disorders. It is known that L-tryptophan depletion negatively impacts sleep. A significant decrease in serum tryptophan levels after a tryptophan-free amino acid drink was associated with an adverse effect upon sleep parameters (stage

1 and stage 2 time, and rapid eye movement sleep time). Improvement of sleep normalcy has been noted at doses as low as 1,000 mg. Increased stage 4 sleep has been noted at doses of 500 mg tryptophan. Significant improvement in obstructive sleep apnea has been noted in a group supplementing at bedtime with 1500mg, with those experiencing the most severe apnea demonstrating the best response. While many sedative medications have opioid-like effects, L-tryptophan use does not limit cognitive performance or inhibit arousal from sleep. L-tryptophan is not associated with tolerance or difficulty with morning wakening and has been shown to be efficacious for sleep in several clinical trials of various designs and dosages. As previously mentioned, L-tryptophan is essential for the brain to synthesize serotonin. Several studies have shown that acute tryptophan depletion can cause a depressive state in humans, especially patients who are in remission from depression. In a study of the effects of acute tryptophan depletion on healthy women and patients with bulimia nervosa, both groups were given amino acid mixtures to consume to decrease their plasma tryptophan levels. In both groups an increase in depression occurred. Plasma L-tryptophan levels can be raised through supplementing with L-tryptophan. In a study involving recovering alcoholic patients, it was found that the participants had severely depleted L-tryptophan levels accompanied by a high level of depressive state. When the patients were given supplemental doses of L-tryptophan over a short period of time, their depressive state lessened significantly. Many obese people consume carbohydrate-rich foods frequently and preferentially, because they have a persistently low plasma tryptophan ratio, as well as low tryptophan uptake into the brain. Serotonin levels are enhanced by carbohydrate ingestion, as insulin release accelerates the serum removal of other amino acids that compete for transport through the bloodbrain barrier. Increasing the L-tryptophan levels in blood plasma is known to have an appetite-suppressing effect that mainly impacts carbohydrate consumption. The supplemental tryptophan can enhance the release of serotonin from brain neurons to diminish appetite for carbohydrates. In one study, when obese patients were given doses of L-tryptophan one hour before meals to raise the amount of tryptophan relative to the large neutral amino acids, a significant decrease in caloric consumption was observed. When Maxi-Health formulated its tryptophan supplement, only the highest quality pharmaceutical grade L-Tryptophan was used, and at the potent dosage of 500mg per capsule. For those who suffer from any number of the conditions caused by serotonin depletion, Maxi L-Tryptophan 500™ is a choice supplement. Always ask your healthcare practitioner if you are concerned about drug interactions, or to find out if supplementation is right for you. Av 5777 | The Wellspring 71

These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, prevent or cure any disease.

Age Well

Senior Care By Rena Milgraum, R.N.

The Ins and Outs of Gout Gout is a notoriously painful form of arthritis afflicting over eight million American seniors. But unlike arthritis, which is often triggered or worsened by wet weather, gout is largely caused by accumulation, not precipitation. What does that mean? It means that gout is caused by the buildup of tiny urate crystals inside your joints, not by how much moisture there is today in the atmosphere because it’s about to rain. Besides accumulating in joints and causing terrible pain, urate crystals can also create deposits under the skin, or even kidney stones and joint stiffness. Men are likelier to get gout, but women become increasingly susceptible after mid-life changes. Most men with gout get it in their 40s and 50s; female patients are typically stricken later in life. By following certain basic steps, you can reduce inflammation and the resulting pain of gout, and also greatly reduce your risk of getting gout. All about gout The majority of gout cases strike at the base of the big toe joint, causing sudden and severe pain, along with tenderness and visible redness. You’ll know it’s gout if it feels like your toe is on fire and you can’t handle even the slightest touch without excruciating pain. Gout can also strike other joints, like heels, ankles, knees, hands, fingers, wrists, or elbows.

When gout strikes, it is often without any warning. The pain will be worst for the first 12 to 24 hours. Without treatment, an attack usually fades away within three to ten days. It’s also not unusual for there to be only one attack, with the next one happening months or even years after the first. The bad news is that without treatment, later attacks are likelier to last longer and affect more joints—and untreated gout can even cause permanent joint and kidney damage. Diagnosis Any suspected gout—sudden, intense joint pain—should be diagnosed and treated immediately by your doctor. Untreated, the pain will only worsen and possibly damage the joint, even permanently. That’s especially true if the joint pain comes with fever and inflammation, which could mean an infection, too. To confirm that it’s gout, your doctor or a rheumatologist may do a blood test or a joint fluid test to check uric acid levels or joint crystal levels. Diet The first step in preventing gout is to reduce the intake of foods whose natural ingredients make the body produce more urate crystals. Foods that you should limit to a maximum of six ounces a day include meat, fish, wine, and poultry. Gout is often referred to as “Rich Man’s Disease,” because its symptoms are often triggered by these “rich man’s foods.” Avoid alcohol, eat a moderate amount of healthy protein (from low-fat or fat-free dairy, eggs, nut-based butters, or tofu), and drink at least eight cups of fluid a day (preferably more). At a minimum, half of that fluid should be plain water. The gout diet is now sufficiently comparable to mainstream healthy eating guidelines that are important for everyone to follow, not just gout victims. However, it is important to note that a gout diet does not treat gout; it only helps control attacks of gout and its accompanying symptoms. Medications Today there are new medications that assist in treating gout, alongside the dietary limitations that minimize the foods that trigger gout. The first recommended medical treatment is to take non-steroidal anti-inflammatory drugs (NSAIDs). These are over-the-counter medications, such

Men are likelier to get gout, but women become increasingly susceptible after mid-life changes.

Complications

People with gout can develop more-severe conditions like: —Recurrent gout. Some people may never experience gout signs and symptoms again. But others may experience gout several times each year. Medications may help prevent gout attacks in people with recurrent gout. —Advanced gout. Untreated gout may cause deposits of urate crystals to form under the skin in nodules called tophi (TOE-fi). Tophi can develop in several areas such as the fingers, hands, feet, elbows, or Achilles tendons along the back of the ankle. Tophi usually aren’t painful, but they can become swollen and tender during gout attacks. —Kidney stones. Urate crystals may collect in the urinary tract of people with gout, causing kidney stones. Medications can help reduce the risk of kidney stones. 72 The Wellspring | August 2017

as Advil, Motrin, and Aleve. If these don’t work for you, and you feel that you need something stronger, ask your doctor for a prescription medication to provide relief. But note that these are a last resort, as they are often accompanied by serious side effects such as nausea, vomiting, and diarrhea. Prevention Uric acid levels are often no indicator of whether you’ll get gout or not. In fact, many people have high levels of uric acid in the blood without having gout, and many people with gout do not have high levels of uric acid in the blood. But if you suspect gout, speak to your doctor about your specific symptoms to see if doing a blood test or a joint fluid test is necessary. There are several prescription drugs that can lower uric acid levels in the blood—with an eye towards preventing attacks and otherwise reducing the risk of getting gout. Common anti-gout uric acid “lowerers” include the prescription drugs Aloprim, Lopurin, Zyloprim, and Uloric.

The Anti-Gout Lifestyle?

The “gout diet” doesn’t always work, with some people still getting gout—or their gout not improving— despite the diet. But whether you have (or get) gout or not, chances are that these suggestions will leave you feeling better overall, gout or not—with any minuses of the gout diet far outweighed by the problem-prevention pluses of the “anti-gout lifestyle.” —Limiting intake of meat heavy in purines, which cause a build-up of uric acid, can also make a big difference in heart health. —Keeping your fluid intake high, so as to help prevent the build-up of crystals in your kidneys and bloodstream, also helps prevents dehydration, kidney stones, malnutrition, and other conditions—as long as it’s primarily just water, not sodas, fruit juices or other sugary or chemical-laden drinks, which are not healthy. —Limiting or avoiding alcohol won’t just help prevent gout, it’ll free you from a host of alcohol-related problems, too. —Eating a balanced diet including fruits, vegetables, whole grains, and fat-free or low-fat milk products will pretty much guarantee you’re getting your daily necessary vitamins and minerals, not just your daily “anti-gout shot.” —Exercising regularly and maintaining a healthy body weight—well, need we list the myriad positive “side effects” of that gout-prevention measure?

Their side effects can include rash, nausea, reduced liver function, and low blood counts—and all too often, new gout attacks if taken before a recent attack has totally cleared up. But risk of that serious side effect is often significantly reduced when these drugs are taken simultaneously with a short and low-dose course of Colcrys. The medication Probalan can boost the kidneys’ ability to clear uric acid from the body and may therefore reduce gout risk. Side effects can include rash, stomach pain, and kidney stones. What is the bottom line? Eat and exercise right, take your pills as prescribed by your doctor (if needed at all), and work closely with your doctor to develop the right Plan of Care for you. With this, you should feel no “shout out” from your gout.

Rena Milgraum, R.N. is Director of Patient Services at HamaspikCare, a home-care agency serving seniors and others across New York. She may be reached through the Wellspring.

Av 5777 | The Wellspring 73

Age Well

Sage Advice By Aliza Simon

Never Too Late to Stay in Shape 5 fun exercises for seniors

Few things are more important for the health of an older adult than exercise. Still, many seniors find themselves unable to do as many physical activities as they used to. Frustration often ensues, and this can create a vicious cycle that leads to even less activity, more health problems, and in some cases, immobility. But it doesn’t have to be that way. Seniors shouldn’t feel that they are limited in the activities available to them. Quite the contrary; there are many exercises for seniors, many of which are non-traditional, low-impact exercises that limit stress on the body and risk of injury. Here are five exercises that are sure to keep you engaged at every age.

1. Go for a swim. Few things are healthier, and as low-impact, than a water workout. And you don’t have to swim laps. Water aerobics and aqua jogging are great ways to get low-impact exercise and also socialize with friends. Water aerobics have been shown to improve body composition and reduce lower back pain, according to research published in the Journal of the Physical Therapy Science.

2. Garden on your patio. If you love to garden, but your joints scream from all that bending, you can still get benefits by creating a garden of raised pots and containers on your deck or patio. Raising tomatoes or herbs in pots combines fun with creating a healthy meal.

3. Go window shopping. Of course, walking anywhere is good, but an indoor mall provides a great walking opportunity in a convenient location. Walking inside an air-conditioned mall provides a safe and cool environment, reducing the risks of ill effects due to the weather.

4. Weight-train with groceries Just as you don’t need a nature trail to walk, you don’t need a gym to lift weights. You can use items in your pantry or refrigerator to pump some iron. For example, use canned vegetables or a half-gallon milk jug to do bicep curls, tricep kickbacks, and some overhead pushes to work those shoulder muscles. You can also do some lower body work with nothing more than a chair. While seated, extend your lower legs out and up, so that the leg is fully extended, and lower it back down.

5. Make child’s play of exercise. As any grandparent can attest, one of the easiest and most enjoyable ways to get exercise is to chase the grandkids around.

74 The Wellspring | August 2017

Age Well

Serial Diary By Malka Aronson

Spreading Myself Thin Life in the Sandwich Generation

Entry #9: Getting the Words Out “The talk” started off exactly as I’d imagined. Because I caught my mother in a very lucid moment, she complimented me on the tea and showered me with her love in the way I always knew her. It was just incredible, and I wished to freeze that moment forever. With my heart beating in my chest, though, I knew it was time to finally address the issue we had been tiptoeing around for much too long. Not only did we find Mommy under her bed after that intensive, heart-wrenching search, but lately she’s starting to forget what we’re talking about in the middle of a conversation. Word retrieval is getting very hard for Mommy. The other day, we were discussing the upcoming wedding in the family—my sister Chaya’s daughter will be getting married out of town so we’ll be traveling together—and she couldn’t re-

member the word “passport” when we spoke about the preparations. It took a few awkward seconds until I filled in for her, and by then she had forgotten the next word she wanted to say. It’s scary to admit, but she’s really losing her mind—literally. And in the moments that it returns, I can see how uncomfortable this new reality makes her feel. So when I finally geared myself up to address her situation, I was a bundle of nerves. How do I talk to my mother about something that must be so painful for her to face? Denial, I realized, though, wasn’t the solution. It was time. “It was quite frightening for us today,” I said softly after we finished our small talk, “to search for you for about twenty long minutes and then find you under the bed.” As soon as the words were out, I wished I could magically pull them back. Seeing my mother’s reddened face and her downward glance made me want to kick myself. But, I just kept telling myself that bringing the situation out in the open would ultimately be for her good, and that’s what kept me going during this torturous talk. “It was scary,” my mother agreed, her voice like a shy child. I knew she had gone there for a reason, and I safely assumed it had something to do with a hiding place. “But Mommy,” I quickly said, “You know we’re here to take care of you no matter what. We’re here to make your life as beautiful and pleasant as possible. We love you so much.” Her eyes lit up as I said the words she needed to hear, and I realized that my openness helped coax out her feelings as well. “When I have the episodes,” she said candidly, “it’s as if I’m in a different world, and it frightens me so much as well. Suddenly, I don’t recognize the people around me and I find myself going back in time, especially to times I’d prefer to forget. It’s comforting for me to know that you’re there for me, waiting for me to come back to you. It means the world to me, Malka.” Hearing those words from the woman who had turned from my caregiver to my “child” was a balm to my soul. At that moment, I knew that wherever my mother’s disease would take us, I would be there at her side, until the very end. Our hearts were eternally intertwined, and I wouldn’t give up that bond for any discomfort or pain in the world. To be continued…

As soon as the words were out, I wished I could magically pull them back. 76 The Wellspring | August 2017

Diary By Bracha Rosen

Shout-Out to a Voice Solution Now that summer

is in full swing, with most of my kids away at sleep-away camp, I’ve found the time to share my experience. Shopping for camp began the day the girls finished school, and we spent many hours in the stores crossing off those endless lists. When the girls finally left, I breathed a sigh of relief; now my vacation could begin. Then came the phone calls. The caller ID screen clearly displayed my daughter’s camp number, but the voice sounded as if it belonged to someone else. “What happened?” I asked in alarm. If I heard correctly, my daughter was saying that camp was great and that she had invested her all in cheering on the head counselors when another girls’ camp came to visit. But everything she said came out in a croaking whisper. I think I also heard her talk about a sunrise trip, practicing for cantata, and not sleeping at all. Her voice was barely audible, and because she could not swallow due to throat pain, she confessed that she was subsisting on ices only. The croaking voice I heard over the telephone was begging for relief and help. As soon as our conversation ended, I made my way to the health food store and shipped off a bottle of Voice and Throat Support™ along with some bags

of herbal Ricola candies and a note of instructions to my daughter to turn the volume down. Two days after her package arrived and of taking the supplement, my daughter experienced a marked improvement in her symptoms. She was regaining the strength in her voice, and the soreness in her throat was dissipating. When she showed Voice and Throat Support™ to the camp nurse and described her successful experience with it, the nurse was duly impressed. She now dispenses the formula to voiceless campers in need. During an enlightening conversation with the camp nurse, who called to thank me for introducing her to the product, she explained that the hoarseness is exacerbated by lack of sleep. She told me she stocks up on Mel-O-Chews™ before the start of the summer and dispenses the tablets as needed, with permission from the parents. Some campers, she explained, have a hard time falling asleep despite their exhaustion after a full day of action, especially if they’re homesick. Mel-O-Max™, which contains the calming herbs of valerian root and passion flower, also works wonders for homesick campers who are simply unable to relax and fall asleep. She said the parents were so grateful to her that she was taking the natural route with helping their children feel better. Now that I can enjoy a conversation with my daughter again, and she can maximize on her fun experience in camp, I’m grateful that I was able to help her with such a simple, natural solution.

How has your health and wellbeing improved thanks to Maxi Health? To receive a free bottle of the supplement that changed your life, send a 50-100 word description of your story to info@wellspringmagazine.com. We reserve the right to end this promotion at any time, without notice.

The Wellspring | August 2017 78

These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, prevent or cure any disease.

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