Wellspring issue #24 by The Wellspring

WEALTH OF HEALTH CONFERENCE WITH SHALOM NADOFF OF FREEDOM BARâ&#x201E;¢

THE TOP 17 HEALTH TRENDS OF 2017 (and what our experts think of them)

SECRETS OF A KOSHER GIRL Cup of Tea with Nutritionist Beth Warren

LONG LIVE THE LIVER

SHANI TAUB ON CALORIE COUNTING Is this practice eating itself up?

NEW COLUMN! THYME FOR DINNER Visit Shiffy Friedman's kitchen for the Real Deal

STOP SLOUCHING!

Is yours in best shape?

4 Posture correction exercises

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Editor In Chief Shiffy Friedman, MSW, CNWC Nutritional Advisory Board Jack Friedman, PhD • Moshe Weinberger Yaakov Goodman, CN • Mimi Schweid Nutrition Contributors Dr. Rachael Schindler • Tanya Rosen, MS CAI CPT Shani Taub, CDC • Tamar Feldman, RDN, CDE 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 Nechama Zukin • Rivky Schwartz 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 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.

Find The Wellspring as a monthly insert in Ami Magazine or at your local pharmacy or health food store. For the PDF version and for back issues, visit www.wellspringmagazine.com Production:

From the Editor

Dear Readers, Health trends are not very different from fashion trends. I remember once, as a child, wearing a new dress when my grandmother had come to visit from overseas. She had me turn left and right, commenting on how beautiful I looked and how the color suited my eyes. “I had something very similar when I was a child,” she remarked. Then, taking me on her lap, she gave me a Fashion 101 that is somehow still vivid in my mind. I remember her talking of this big album in Paris that the designers use as a guide to determine the next season’s hot color. One year it’s gray, the next maroon, then brown, and when they reach the end of the book they flip it all the way back to the first page and start over again. As a child, I was mesmerized by the concept that some people in some faraway place were determining what I would be wearing for the rest of my life—and when I’d be starting the cycle all over again. Today, as an adult, I hope I have more clarity on the concept of trends and how they play a role in my life as a Jewish woman, but what I see as the underlying thread amongst all trends, whether related to fashion, health, fitness, or anything else, is simply masses of people seeking happiness. (Is that the therapist in me talking again?) One universal concept that binds all humans regardless of ethnicity, religion, or culture, is that we’re always seeking for the one right way toward happiness. Luckily for us, we have the privilege of being guided by the Torah’s timeless principles, principles that not only dictate how we should conduct ourselves with others and Hashem, but even steer us toward achieving health and wellness. Indeed, the Rambam’s age-old health principles guide us until today. Even when the world was saying no to fats and turning a blind eye to refined sugar, those who followed his guidelines enjoyed a life of good health. And now, when the tables have turned, his doctrine has been proven right once again. So yes, this issue’s cover feature about the top 17 health trends of 2017 is a fun read. You may be curious to know what took the world by storm, what people got excited about over the 365 days of a year gone by, as well as the comments from our incredible contributors who have dedicated themselves toward improving the health of our community. But, when you take a step back, you’ll realize that all these statistics tell the story of human beings who are simply trying different avenues towards leading a more fulfilling, healthier, happier life. In fact, two trends which we debated including in the list but then decided not to were charcoal and cryotherapy. For the uninitiated, people have started consuming activated charcoal, which colors the foods they eat a dark hue, as a detox ingredient. (Black ice cream, anyone?) And cryotherapy, yet another top trend, is immersing in intensely cold temperatures for several minutes to activate the metabolism and provide other health benefits. The writer of the article, as well as our editorial board, agreed that although these fads made it into the mainstream media’s top trend lists, none of us had seen any of it in our community (let me know if we’re wrong!). Perhaps it’s a sign that we don’t have to go over-the-top to find joy? I like to think that we have it right here, right now. To a happy, healthy winter,

Shiffy Friedman

shiffy@wellspringmagazine.com

Well-Put!

If you’ve been conditioned to believe that a change of weather causes aching bones, you may be surprised with the results of a recent study: It’s an old wives’ tale. Read more on this myth in Updates on page 18. Teves 5778 | The Wellspring 7

Contents

JANUARY 2018 - TEVES 5778 WELL INFORMED

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 Shalom Nadoff By Sarah Weinberger

DEDICATED TO HEALTH 10 Questions for Shloime Jacobs By Chana Dunner

LIVING WELL ASK THE NUTRITIONIST Calorie Counting By Shani Taub, CDC IN GOOD SHAPE Posture Exercises By Fraidy Friedman, NASM-CPT COVER FEATURE 2017 Health Trends By Tziporah Winter HEALTH PROFILE Client: Ruchama By Esther Steinmetz AT THE DIETICIAN Crohn's Disease By Tamar Feldman, RDN, CDE MONTHLY DOSE NAC By Yaakov Goodman, CN

26 28 30 58 60 62

FAREWELL HEALTH ED Probiotics By Judy Leiber, CNC 8 The Wellspring | January 2018

“ ” NOT HAVING ANY CROHN'S-SUITABLE OPTIONS TO SNACK ON MADE LIFE VERY DIFFICULT FOR ME.

-SHALOM NADOFF, PAGE 22

The next issue of The Wellspring will appear iy”H on January 31st.

EAT WELL

SEASONED Bowl for the Soul By Yossi & Malky Levine

THYME FOR DINNER By Shiffy Friedman

NUTRITION TIDBITS IN THE NEWS By Liba Solomon, CNWC

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

WELLBEING

“ ” THE COMBINATION OF GREENS IN THIS SOUP NOT ONLY PACK IN THE ANTIOXIDANTS BUT CREATE AN INCREDIBLE BLEND OF DEEP FLAVOR AS WELL.

-MALKY LEVINE, SEASONED, PAGE 41

66 68 70

FROM THE GROUND UP Personality Development By Goldy Guttman, Ms. Ed. HEALTH PERSONALITY Beth Warren, MS, RDN, CDN By Yocheved Grossman EMOTIONAL WELLNESS Terminating Therapy By Dr. David Rosmarin & Malky Berger, LMSW CLEAN SLATE Craving Inducer By Shiffy Friedman, MSW, CNWC

AGE WELL

GOLDEN PAGE By Yaakov Goodman, CN

SENIOR CARE By Rena Milgraum, RN

SAGE ADVICE By Aliza Simon

INKWELL

DIARY

By Riva G. Teves 5778 | The Wellspring 9

Springboard

Letters

Not Even One Bite

[Issue #23: Ten Questions for Yoel Drummer of JCCSG] Thank you for your recent interview with Mr. Yoel Drummer. As someone who suffers from Crohn’s, I can attest that everything written is extremely accurate. Mr. Drummer and his wonderful wife Malky provide an amazing wealth of knowledge and help. I urge anyone who needs any information, guidance, or support to contact their amazing organization. There is one thing that frustrates myself and many “Crohnies” (as we call ourselves) that was omitted from the article. Whenever you see someone with Crohn’s abstaining from eating, please don’t urge them to just cheat a little. They are not “on a diet.” One wrong bite can literally land them in the hospital. Thanks for a wonderful publication! S.L.

tion presented. Firstly, the idea that ten years ago there was no support network is simply untrue. Mrs. Rochel Weiss has been helping people achieve health through the SCD diet for far longer than that. Further, the attitude conveyed was that traditional medical care is the answer, and that “sometimes,” healthy eating and such suffices. This is simply untrue. In my husband’s case, there were several situations where the best of medical care could do nothing for him, but diet and natural supplements brought his health back. In fact, when he had a dangerous flareup while not on medication, his widely respected NYC gastroenterologist told him “don't kick yourself, it could have happened anyway.” T. S. Monsey, NY Mr. Yoel Drummer responds: Mrs. Weiss did and still does tremendous work for the Crohn’s and colitis community. On a daily basis, she helps people who specifically reach out to her and want to follow the SCD diet, and we always recommend her to those who reach out to us regarding the diet. She does a wonderful job in that arena. However,there hasn’t been any support for people who don't want to or cannot follow the diet, or newly diagnosed people in need of medical advice and referrals.

10 The Wellspring | January 2018

M. S. As a magazine that presents itself as devoted to health, it is totally irresponsible to recommend Splenda®, a neurotoxin that can contribute to cancer, eczema, digestive problems, diabetes and many other serious conditions. The only safe sugar substitute is pure, organic Stevia powder. Blessings, Miriam Adahan Editor’s note: We regret that content in this magazine wrongfully implied that we recommend Splenda®. Thank you for your concern.

Healthier Winter

[Issue #23: Monthly Dose]

Splenda is NOT okay

[Issue #22: Cover Feature] Kudos to Shiffy Friedman and The Wellspring staff for a beautiful and informative magazine. This week was the first time I read the entire publication and I was wowed. I especially loved your piece on codependency and overeating. It’s something I’ve learned about a lot but have never seen written about in frum publications. As the wife of a Crohn’s sufferer, I was eager to read the article about Yoel Drummer, founder of JCCSG. I actually knew very little about this organization, and I was greatly disturbed by much of the informa-

same issue were using Splenda too but they hadn't put two together. Although this is one very obvious side effect of Splenda, there are more. When I saw Goldy’s response as to why she uses Splenda, I felt obligated to send this letter. Many people reading it may have gotten the idea that Splenda is not so bad since sugar is worse. I really felt the need to to counteract that. Opting for a healthier sugar alternative is a far smarter choice. Although it’s more expensive, it’s anytime better than memory fog and other negative effects.

I feel an achrayus to let yidden know about the negative side effects of Splenda. I know someone who was suffering from foggy memory and was using the chemical. Once she did her research, she learned that many others who were suffering from the

As a mother of five beautiful children, I found myself dreading the winter cold and flu season. Every year, one after the other, the kids have to take days off from school, and I have to play Mommy nurse. Thus, I was very hopeful when I read last month’s “Monthly Dose” about Maxi Health’s Immune O Max™ chews. I was not able to use this supple-

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.

ment as a preventive measure as they already had the colds. However, I noticed a dramatic reduction in virtually all symptoms almost immediately after giving it to them. Thanks again for all the education! Leah G.

Medication Is a Must

[Issue ##23: Cup of Tea with Rocheli Sternheim] Rocheli Sternheim, LCSW, provided misleading information. Sleep apnea in adults is most often due to weight, neck circumference, and age factors that alter the amount of oxygen the person receives during sleep. When the oxygen level dips, the person wakes up. The most common form of treatment is a C-PAP. For a patient to be misled and think that they can be trained to sleep when their issue is medically based is irresponsible. In children, its cause is usually hypertrophic tonsils and/or adenoids, which cause the child’s oxygen level to dip, resulting in their arousal. Trying to teach sleep behaviors without taking into account the medical circumstances is not doable. Thank you, A therapist that who knows many in-

dividuals with this condition who were treated optimally with C-PAP or ENT intervention Rocheli Sternheim, LCSW, responds: You are right that sleep apnea needs to be treated medically and not behaviorally. People tend to think of the term insomnia as meaning not being able to sleep, when in reality there are many medical conditions, not limited to sleep apnea, that can cause a person to have difficulty sleeping. When people come to me for Cognitive Behavioral Therapy for insomnia, I encourage them to speak to their doctor to rule out a medical condition before starting behavioral treatment. Thank you for raising this important point.

Awareness Is Key

[Issue #23: Cover Feature] I always find The Wellspring to be informative and refreshing to read, but this issue’s feature on miracles was something else. It made me stop and realize how much I have to be grateful for, how Hashem is the one who runs my life with such kindness and love. It came at just the right time when we’re experiencing vari-

ous health-related challenges with two of our children. Thank you for the reminder, done in such a subtle, beautiful way. May we all merit refuos and yeshuos. Many thanks, H. Lipkowitz

You Realized My Dream [Issue #23]

For several years now, I’ve had this dream of publishing a health magazine for the frum community. The publication would include vital health information, recipes, fitness tidbits, health-related interviews, a section on emotional wellness, and fun reading material for any frum Jew who cares about her health. And then, one day last month when I was visiting from out of town, a friend introduced me to The Wellspring. As I flipped through the pages, one by one, I couldn’t believe my eyes. Here was my dream, in real time! What a fabulous job you’ve done at bringing it all together. A new fan, Sorah F. Chicago, Illinois

Quick Question

Feel free to shoot us your health-related question to receive an answer from one of the health experts at the Wellspring.

Question: I’d like to hear the take from a health expert on the flu shot. I’ve been reading in health columns that it is only about 10% effective this year. On the other hand, the flu is in the headlines every other day. What am I to believe, and what should I do? Response: You should follow your doctor’s advice on taking the flu shot. He will evaluate your health based upon your past history and current health condition and will decide if it’s beneficial for you, or not. At the same time, you can do your own hishtadlus and protect yourself from the flu and other viruses by taking natural supplements. Boost your immune system, which will help your body fight any viruses, including the flu and infections, with products such as Maxi Health’s immune booster Maxi Biotic®. Take 2-4 capsules daily with food. Vitamin C and D are great supplements for wintertime, as well, to help fight the common cold. Also, use a vaporizer with essential oils like eucalyptus or peppermint to humidify the air, which gets dried out through heating, especially central heating. To a healthy winter, Miriam Schweid, Nutritional Advisor

Teves 5778 | The Wellspring 11

Wellness Platform By Rabbi Hirsch Meisels

HEALTH INSIGHT An Eye on Your Vision

Because so many intricate details of the eye are involved in enabling healthy vision, possible eye conditions are equally numerous. The quest toward finding the ultimate nutrient that both supports all these details and also prevents the many visionrelated issues leads to omega-3 and the other vision-supporting minerals in Maxi Health’s Maxi-Omega-3 Eye Formula™. Nutrients like zinc, lutein, and zeaxanthin play a vital role in supporting healthy eyesight, especially for those in the elderly population, who are at greater risk of contracting vision-related diseases. Although I have been involved in the field of health research for many years, I am awed by the incredible studies I have encountered in my quest toward establishing a correlation between these nutrients and their efficacy in supporting healthy eyesight. For starters, the National Eye I n s t i t u t e conducted a study (the AREDS study) exploring the efficacy of various natural minerals on subjects at risk of

macular degeneration. Especially prevalent in the elderly population, macular degeneration can lead to blindness, G-d forbid, and the researchers in conventional medicine had given up on finding a cure. Thus, the National Eye Institute embarked on a quest to find the solution in the natural healing route. The first formula they created was an antioxidant formula that contained, among other ingredients, vitamins C and D, betacarotene, 80 milligrams of zinc, and a bit of copper. The results of their study, which they published in 2001, revealed that those subjects who were given the experimental formula over the placebo experienced a 25% reduced risk of macular degeneration progression. It’s important to note, however, that subjects who were at the early stages of the disease saw no improvement. Possibly, if they’d been followed over a longer period of time, different results would have emerged. Once the findings were published, antioxidant formula became the first and only solution for macular degeneration. Doctors started prescribing it to their patients, and nutritional supplement companies produced similar formulas to fill the need. However, one of the problems that emerged as a result of the first AREDS study was that, in smokers or former smokers, the beta-carotene in the formula increased their

risk of lung cancer. In addition, the zinc content appeared to be a tad too high, causing various negative side effects. Thus, in 2006, the researchers embarked on a second study, this time called AREDS 2. For this randomized large-scale study, they followed 4,000 subjects at different stages of macular degeneration over a period of 6 years. While some subjects were given a dose of the original formula, others were given an updated version in which the researchers omitted beta-carotene, decreased the zinc content, and included lutein and zeaxanthin, minerals that have been attributed to vision improvement. In May of 2013, the new results emerged to reveal that the group of subjects who had received the newer formula had the greatest reduction in their macular degeneration progression, as well as a decreased risk of lung cancer compared to those who received beta-carotene in their intervention. These results, of course, led the nutritional supplementation companies to tweak their eye formula in order to ensure optimal results, including the addition of lutein and zeaxanthin, which Maxi-Omega-3 Eye Formula™ contains. They also decreased the zinc content, too much of which can cause damage, but too little of which can lead to zinc deficiency, a possible cause of macular degeneration.

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.

12 The Wellspring | January 2018

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

ARE WE GETTING THE MESSAGE?

THE TORAH APPROACH TO DEALING WITH PAIN

In this life, we humans are bound to experience pain. While we may not understand the precise reason for it, there’s one indisputable element in every challenge Hashem sends our way— every bit of it has a purpose. However, here’s the kicker: When a person denies feeling that pain, he’s defeating the purpose of Hashem’s mission. This includes escaping the pain or doing whatever we can to numb it. The Gemara in Eiruchin (16b) asks, “What is considered yissurim?” What is the most minor form of suffering we can experience? One of the Gemara’s answers is that even if a person puts his hand in his pocket with the intention of extracting three coins and only manages to remove two, he experienced suffering on some level. While the pain seems utterly petty in this scenario, the Ba’al Shem Tov explains why it’s enough to be considered yissurim. The point of suffering, he explains, is to deliver a message that we’re supposed to absorb. If this minor nuisance makes us stop and think about why Hashem may have done this, it’ll be enough for us to get the message that He’s running the world and that everything has a purpose. I recently heard story about the revered Rav Steinman, zt”l, who was once feeling ill but refused to see a doctor. When his grandchildren questioned him about his decision, he explained that in that particular situation, the only solution the doctor would offer would be some painkillers or Tylenol. “But Hashem sent this illness so I can feel something,” he countered. “This is my avodah now.” I’m not advocating not seeking medical care when necessary, but the message of this anecdote is that we must realize that every iota of pain we feel is for a reason. I believe this concept is simple to grasp. However, somehow, the way most people deal with emotional pain, such as anxiety, hurt, disappointment, and rejection, reveals that this under-

14 The Wellspring | January 2018

standing is lacking—we do whatever we can to escape it. While denying the pain may offer a momentary reprieve, as long as we won’t face it, it’ll only fester—because it’s here for a purpose. In Parashas Vayigash, the Ohr HaChaim makes a brilliant statement regarding pain. “Sama deyissura kabila,” he notes. The way to get rid of suffering is through accepting it. As the world says: “Take a little, so you won’t have to get a lot.” If a person is not willing to accept the pain Hashem sends his way and does whatever he can not to feel what he’s really feeling, he’s inadvertently causing himself more anguish. My Rebbe, Rebbe Nachman Biederman, shlit’a, recently shared a profound Bnei Yissaschar on this topic. “Vayar menuchah ki tov,” the Torah tells of Yaakov Avinu. Yaakov saw that peace, menuchas hanefesh, is good. And what did he do as a result? What was his vision of true menuchah? “Vayeit shichmo lisbol,” he extended himself to accept the pain. Our patriarch understood that true menuchah comes from surrendering to the pain. That’s the only one right way to deal with it. If we open our eyes, we see this concept in reality. When people make peace with their situation, which is a result of genuine emunah, the pain dissipates. Ironically, however, the terms emunah and bitachon can be used as a means of denying pain, as well. The Chazon Ish says that bitachon does not mean that Hashem doesn’t send pain. It’s not, “This doesn’t hurt.” Rather, genuine bitachon is living with an understanding that Hashem only does things that are good for us. Sometimes, pain is what’s good for us. If we’re denying that it’s painful, the yissurim aren’t fulfilling their purpose. Last month, the entire Jewish world ecstatically rejoiced with the neis Chanukah of 5778. We witnessed an open

miracle when Reb Sholom Mordechai Rubashkin was liberated from a draconian incarceration. The one question everyone had throughout the years that he was living through this nightmarish ordeal was how the experience hadn’t shackled his spirits. Externally, of course, everyone observed his emunah and bitachon. Personally, I got my answer from a letter he sent to his children after a Pesach he had spent in prison. I believe his powerful words give us a peek into the essence of a man who understood how to face his suffering, which gave him the ability to forge forward with true joy despite the incredibly painful circumstances. In the letter, Rubashkin shared that when he and his fellow prisoners reached the siman of maror at the Seder, one of the prisoners asked, “Is bitterness the essence of life?” Why are the bitter herbs given center stage in the ka’arah setup? It seems that the Jew had a hard time understanding why the Torah seems to emphasize bitterness. Perhaps he felt that putting the maror out of sight would be more appropriate. But Rubashkin explained that although bitterness isn’t the main focus of our lives, we can’t deny that we do encounter bitterness throughout. And only if we face the fact that we’re experiencing it can we survive it. In order to be able to face joy, we must be able to face pain. Not in spite of his emunah and bitachon—but particularly due to it, Rubashkin never denied the fact that his ordeal was incredibly painful. Rav Noach Weinberg zt”l used to say that pain is not the opposite of pleasure. Rather, pain is the price of pleasure. In order to experience true pleasure in life, we must face the pain, we must see the message Hashem is sending us. May we be blessed with the wisdom and clarity to accept our pain— to deal with it in a way that more of it won’t be necessary. Rabbi Ezra Friedman can be reached through The Wellspring.

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Well Informed

Health Updates in the News By Liba Solomon, CNWC

GET MOVING The perils of excessive sitting

Sitting for extended periods of time could be hurting your heart, according to a surprising new study. It finds that the more people sit, the greater the likelihood that they will show signs of injury to their heart muscles. We’re all aware that sitting for hours on end is unhealthy, even if we also occasionally exercise. People who sit for more than about nine or 10 hours each day—a group that includes those who work in offices—are prone to developing diabetes, heart disease, and other problems, and most of these risks remain relatively high, even if we exercise. Excessive sitting has also been associated with heart failure, a condition in which the heart becomes progressively weaker and unable to pump enough blood to keep the body oxygenated and well. But how sitting, which seems to demand so little from the heart, could be linked to heart failure, a condition in which the heart cannot respond adequately to exertion, has until now been unclear. Recently, a group of cardiologists from around the world focused their research on troponins, proteins produced by cardiac-muscle cells when they are hurt or dying. A heart attack releases a sudden tsunami of troponins into the bloodstream. Even slightly elevated troponin levels, lower than those involved in heart attacks, are worrisome if they persist, most cardiologists believe. Chronically high troponin levels indicate that something is going wrong inside the heart muscle and that damage is

occurring there. If the damage is not halted or slowed, it could eventually result in heart failure. For the new study, published in Circulation, the researchers turned to existing data from the Dallas Heart Study, a large, ongoing examination of cardiac health among a group of ethnically diverse men and women, overseen by the University of Texas Southwestern Medical Center. The study’s participants completed cardiac testing, gave blood samples and health information, and wore activity trackers for a week. The researchers pulled information about more than 1,700 of these participants, excluding any who had heart disease or symptoms of heart failure, such as chest pain or shortness of breath. They checked the subjects’ blood samples for troponins and the readouts from their activity trackers to see how much or little they had moved most days. Upon comparison, the researchers found that many of the study participants turned out to be sitters, remaining sedentary for as much as 10 hours or more on most days. Not surprisingly, those men and women rarely exercised. Some of the men and women did work out, though, usually by walking. They were not exercising a lot, but the more exercise they undertook, the fewer hours they sat, on average. Incredibly, this physical activity, limited as it was, was associated with relatively normal levels of troponin. The people who moved the most tended to have lower amounts of troponin in their blood, although the benefits statistically were slight. On the other hand, the people who sat for 10 hours or more tended to have above-average troponin levels in their blood. These levels were well below those indicative of a heart attack, but high enough to constitute “subclinical cardiac injury,” according to the study’s authors. Time to get moving!

MISCONCEPTION: Rainy weather causes aching bones. TRUTH: It happens on dry days too. If you’ve been conditioned to believe that a change of weather causes aching bones, you may be surprised with the results of a recent study: It’s an old wives’ tale. Other studies have looked at whether an increase in humidity, rainfall, or barometric pressure can bring on pain, but never with as much data as in this study, published in BMJ. Researchers looked at medical records of 11,673,392 Medicare outpatient visits. Matching the dates of the visits to local weather reports, they found that 2,095,761 occurred on rainy days. Using probability estimates, they predicted how many of those visits were for a condition related to joint or back pain. Surprisingly, the researchers found that more visits for bone and joint pain happened on dry days than wet ones—6.39 percent for dry and 6.35 percent for wet days,

16 The Wellspring | January 2018

a difference so small as to have no clinical significance. “The weather is not causing joint pain,” said the lead author, Anupam B. Jena, an associate professor of health care policy at Harvard. “But when it’s raining and you have joint pain, you attribute it to the weather. When it’s sunny and you have joint pain, you don’t. People get upset when you say this.” You might not want to share this with Bubby.

Stress is never re c o m m e n d e d , but the lifethreatening impact it may have on women’s heart health makes it especially important for us ladies to take it easy. According to a new study published in Arteriosclerosis, Thrombosis, and Vascular Biology, mental stress can take a toll on blood vessels—and women with heart disease may be especially vulnerable. Here’s the reason the researchers found for this phenomenon: When under psychological stress, women are more prone than men to having their blood vessels constrict. The study involved 678 people with coronary artery disease. This is characterized by plaques building up in larger arteries, sometimes causing symptoms like chest pain and breathlessness. It can also lead to a heart attack if a plaque ruptures and completely blocks an artery. Each patient went through a mental stress test—public speaking, and researchers used heart imaging to see whether it triggered myocardial ischemia. Overall, approximately 15

percent of all study patients had stress-induced ischemia—

with men and women affected at a similar But the Stress takes a greater toll on rate. females underlying causes differed between the genders. In women,

it was mainly caused by constriction in small blood vessels, said senior researcher Dr. Viola Vaccarino, a professor at Emory University’s Rollins School of Public Health in Atlanta. When men developed ischemia, it was mainly because mental stress triggered a rise in blood pressure and heart rate—which boosted the heart’s workload. What are we women to do to avoid stress? “Stress is universal,” notes Vaccarino. “It’s the way we deal with it that matters.” She agreed that simple techniques like guided relaxation can be a good place to start. Regular exercise, like a daily walk, is another—and not only because it can help a stressed-out person feel better. “Physical exercise actually makes the blood vessels dilate. It’s the opposite effect of what we see with mental stress,” she says. “The main message is that we need to find healthy ways to cope with stress,” Vaccarino said. And that may be particularly important for women, she added. “Typically, women often don’t put themselves first, but they need to take breaks every day, and find ways to relax.” We hear you on that.

MINT MAY BE THE ONLY SOLUTION Little is known about the causes of chronic bad breath, or examined the gene Bad breath may be a result of a metabolism error halitosis, a condition affecting “up to half” of the population in five human of the United States. Generally, halitosis is thought to be triggered by bacteria that are broken down into sulfur compounds. In many cases, however, the cause is unknown. To this end, a few years ago, researcher Dr. Albert Tangerman, in collaboration with Ron Wevers, a professor of inborn errors of metabolism, both from Radboud University in the Netherlands, got to work. The scientists discovered the sulfur compound methanethiol, which emanates a foul odor. As Prof. Wevers states, “Methanethiol is produced in large amounts in the intestines, and can originate from food. We believed that the protein responsible for getting rid of methanethiol was defective in these patients.” However, they couldn’t find a lead for this in the patient’s metabolism. The process by which the body counteracts this compound was unknown, so they were stuck. Knowing that some bacteria can help to metabolize sulfur compounds, the researchers examined bacteria and found a human protein that is responsible for converting methanethiol into other compounds. Incredibly, they

patients with chronic extraoral halitosis and found that they all had a mutation of it. Additionally, the patients had increased levels of methanethiol in their blood. To further validate their findings, the researchers used genetically engineered mice. They knocked out the SELENBP1 gene in the rodents, which resulted in increased blood levels of methanethiol and other foul-smelling sulfur compounds. “While we didn’t put our noses up to the mice’s mouths, we did measure high amounts of some of these odorforming chemicals in their blood, matching precisely what was found in the patients,” the researchers concluded. Who would’ve thought there’s a gene for that too!

Teves 5778 | The Wellspring 17

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

WOMEN, WATCH YOUR HEART

Well Informed

Figures By Miriam Katz

The Year in Review

1 3 in

adults didn’t get enough sleep

Breast cancer is the

nearly

2017 Health Stats

50�

of the U.S. population has at least one chronic health condition, such as asthma, heart disease, obesity, cancer, or diabetes

15 in

adults have a mental health condition

form of cancer

highest-cost conditions: cancer and congenital anomalies

18 The Wellspring | January 2018

$73.1 billion Overweight employees cost their employers

a year and file twice the number of workers’ compensation claims

21� billion $344 of total healthcare costs:

annually

62�

of employers gave wellness tips or information at least quarterly in the form of a newsletter, email, column, etc.

34�

of Americans are affected by metabolic syndrome

25 in

(42%)

Projections estimate that by 2018, obesity will cost the U.S.

of Americans are aware of the target heart rate they should be achieving in aerobic exercise for their age

25�

of employees now own an activity tracker

Among employees without an activity tracker,

62�

said they would be interested in using a wearable fitness tracker as part of a workplace wellness program

Teves 5777 | The Wellspring 19

Well Informed

Wealth of Health By Sarah Weinberger

conference with: SHALOM NADOFF

FOUNDER & CEO OF FREEDOM BAR™ LOCATION:

Toronto, Ontario

SINCE: 2017

For Shalom Nadoff, a Toronto-based insurance broker living with Crohn’s disease, the Freedom Bar™ brand is a culmination of a personal quest for a healthy treat that not only tastes great but also feels great. Made from minimal, all-natural ingredients, the Freedom Bar™ has become wildly popular in the relatively short span since its introduction to the public market.

WHAT LED YOU TO CREATE THE FREEDOM BAR™?

Thirteen years ago, at age 16, I was diagnosed with Crohn’s disease. Since then, with the exception of some periods of time, I've followed the SCD diet, which is very restrictive, for which I had to prepare most of my own food. I would stay up late, trying to figure out different combinations that would bring the fun back into food. While I had my regular meals down pat, snacks were a big challenge for me. As an insurance broker, husband, and father, I’m always on the run. Not having any Crohn’s-suitable options to snack on made life very difficult for me.

so I came up with my own that’s comprised of fruits and nuts only. Once I decided to make it into a business, I spent many nights reformulating it. I would make small bite sized pieces, put them in little jewelry-sized Ziploc® bags, label them, and ask people in the community to taste and judge. Although these people weren’t as restricted as I was with their diet—they simply appreciated eating healthfully— they actually liked the product and wanted more of it.

AT THE TIME OF YOUR DIAGNOSIS, WERE YOU ENCOURAGED BY YOUR DOCTORS TO INSTITUTE CHANGES IN YOUR DIET?

Back then, when I started out, the doctors actually made fun of me. They made me feel stupid, and second-guessed everything. Fast forward ten years and today, the GI bulletin boards in the hospital, in Toronto, at least, are featuring bulletin boards filled with diet-related information. The medical world is acknowledging that changes in diet may be a possible route for AREN’T NUTS ALLOWED ON THE SCD DIET? They are, but how many nuts can a person eat? Although managing the symptoms. there are certain foods that we can snack on, we want to have variety. And you can’t always have a fresh cut-up ap- SO WERE YOU ON ple either. At Kosherfest, for example, where I spent two full MEDICATION AT ALL? I didn’t want go on medication days showcasing my product this year, there was nothing for me to eat, despite the abundance of food products on because the ones the doctors were display. The inability to just throw a snack into a bag and prescribing at the time were all autoimmune suppressants that have a run takes a toll. host of negative side effects. My parents were scared too. A cousin who was WEREN’T THERE ANY SNACK BARS ON THE MARKET on the SCD diet at the time introduced me PRIOR TO YOUR DEVELOPMENT OF FREEDOM to it. I was on it for seven years, and overall it BAR™? kept me under control There are one or two bars out there, but I didn’t like them,

20 The Wellspring | January 2018

WOULD YOU SAY THAT GOING ON A SPECIAL DIET HAS BEEN HELPFUL FOR YOU?

be helpful for some, the reality is that most people, including myself, do not have time for that. A lot of us tend to live our busy lives on auto pilot, not giving much conscious thought to what may make us feel the way we do. In reality, our subconscious mind never rests and has constant running thoughts for the positive or negative without us even realizing it. We need to take small steps to focus a bit on what is constantly running through our minds. Once we starts with that, we find our way to stress management.

No one can deny the fact that what we eat affects how the body operates, whether it’s SCD or any other diet. Even just limiting processed foods is a great first step for anyone. The entire world is realizing it now more than ever before, especially since we’re getting sick in so many different ways. In Chicago, where my parents live, the government has actually instituted a tax on soda, which is fabulous. Just because something is officially healthy doesn’t mean it is, especially HAVE YOU ALWAYS STUCK TO YOUR RESTRICTIVE if you’re suffering from an illness.

HOW ELSE HAS YOUR LIFE CHANGED AS A RESULT OF YOUR CROHN’S DISEASE?

We don’t realize the impact stress has on our lives. I’m able to see it directly affect my Crohn’s, so the evidence is pretty clear. Thankfully, there is much greater awareness regarding emotional health today. People are starting to be more in touch with themselves and pay greater attention to what’s causing them to feel certain ways. Dealing with stress is a huge factor in a Crohn’s patient’s life. Even doctors agree that stress aggravates Crohn’s. Personally, stress management has changed my life dramatically.

DIET, OR HAVE YOU EVER “CHEATED” WITH A PIECE OF PIZZA, FOR EXAMPLE?

As long as I followed the diet, I never cheated. I’m an all or none personality type.

WHAT’S YOUR TAKE ON MEDICATION FOR CROHN’S?

There’s no medication that’s 100% guaranteed. I have met many people with Crohn's, who have had multiple surgeries and had been on more medication than I was. Even the surgery is not an end-all. There’s no one perfect solution. A restrictive diet can be especially hard on kids and teens as it takes a toll on social life and can cause extra stress. Plus, WHAT DO YOU MEAN BY STRESS MANAGEMENT? only a very devoted parent can do it properly. But, for an People think stress management means doing yoga or al- older person, it’s absolutely necessary. Even if he’s on medilocating few hours a day for meditation. Although this may cation, he must be conscious about what he eats if he wants

Teves 5778 | The Wellspring 21

Well Informed

Wealth of Health

to stay healthy in the long term

nut butter, raisins, cinnamon, or cocoa powder.

HOW WAS IT TO BE ON SUCH AS RESTRICTIVE DIET AS A TEENAGER?

ARE THERE ANY OTHER FLAVORS IN THE MAKING?

Hard! As an adolescent, I had the added social challenge. My friends knew about my condition, since there was no way I could hide it. I had to bring my own homemade food to yeshiva every day. I also worked hard at home to create gluten-free, soy-free, sugar-free foods. Even now, as the health food industry keeps growing, the options for storebought food are still very limited. It helps that I enjoy playing around in the kitchen, which was how the Freedom Bar™ was born.

WHAT ARE THE BASIC INGREDIENTS OF THE BAR?

As soon as we get more feedback on the ones we already put out, we’ll be rolling out our chocolate peanut butter and chocolate coconut flavors.

No one can deny the fact that what we eat affects how the body operates, whether it’s SCD or any other diet.

Each bar is comprised of about four to five ingredients, not more. They’re simple ingredients that we all know and whose names anyone can pronounce. The base for all four flavors is dates and nuts, and depending on the flavor, we add other ingredients, such as dried apples, pea-

HOW HAS THE RESPONSE BEEN?

When we launched, we were shocked to see how excited not only people with conditions are about it, but also of the interest expressed by healthy people who simply appreciate clean food. During the trial period, when we distributed samples, even young kids were begging me for samples. They would literally knock on our door and ask, “Can we have more bars?” Especially because our packaging is very appealing, we see that all kids, unless they’re very picky eaters, have no problem enjoying it as a snack.

DOES THE BAR TASTE “HEALTHY”?

At Kosherfest, where we first rolled out our full line, I told people, “I’m not telling you what’s in there until you taste it.” After they had their first bite and I told them what it contains, they couldn’t believe it. These were people who would never stand near something healthy. The apple cinnamon is a big hit. It does have a very wholesome taste.

HOW LONG CAN SUCH A BAR STAY FRESH WITHOUT THE USE OF PRESERVATIVES?

Our lab established that it has an 8-month shelf life. It’s a raw bar made of ingredients that have a long shelf life.

WHERE DO YOU PRODUCE THE BARS?

Originally, when we started, we used a co-packer in upstate New York to do the formulating and packaging. Now we are in the final stages of setting up our own facility here in Toronto with our own machines and equipment.

AT WHAT RANGE ARE THE BARS PRICED?

We’re trying to keep them low cost. I know what it’s like to live on a restrictive diet—and it’s not cheap. If I know someone in the community must be on the diet, I’ll sell the box at a discounted price. Our goal is to give people the freedom they deserve, not to be so restricted, at least when it comes to having their snack bar and eating it too.

22 The Wellspring | January 2018

SUGAR FREE

(real farmer cheese premium taste)

find the sugar free version in the freezer section of your grocery

Well Informed

Dedicated to Health by Chana Dunner

10 QUESTIONS

FOR SHLOIME JACOBS OF FRUMSUPPORT

FRUMSUPPORT IN A NUTSHELL: FrumSupport.com is an online support forum where frum people suffering in silence from illness, especially mental health issues, can find chizuk and support anonymously from other frum people in similar situations.

WHAT MOTIVATED YOU TO LAUNCH YOUR ORGANIZATION?

After my wife gave birth to a son with Down Syndrome, I felt that there was a need for a place to get chizuk from other people who have been down the same road. A web developer by profession, I had the necessary knowledge and resources to create this online forum.

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

Getting financial support to keep the site up and help pay for advertising.

24 The Wellspring | January 2018

WHAT IS YOUR CURRENT ROLE AT FRUMSUPPORT. COM?

I basically run Frumsupport on my own so I’m in charge of everything from the technical stuff to monitoring the posts to make sure they are fit for a frum site.

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

I don’t know if I can point to a specific request but from time to time we will get a request from a family dealing with a rare disease asking if we can add a subcategory on FrumSupport for that disease so that they can hopefully meet someone frum who might be dealing with it.

5 6

CAN YOU SHARE A POSITIVE STORY THAT YOU’VE RECENTLY EXPERIENCED? We once had a person who was suicidal and was threatening to take his own life when another FrumSupport member in a similar situation made a deal with him that they would not do anything silly before they reach out to each other on FrumSupport and this way they were able to keep each other alive until the situation stabilized.

WHAT DO YOU WISH PEOPLE WOULD KNOW ABOUT (THE ISSUES YOU DEAL WITH)?

I wish that more people who are in a tight spot would be aware that FrumSupport.com exists.

8 9

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

The most interesting thing that I have seen time and time again is where people who are suffering terribly to the point where I’m even sometimes concerned for their safety or survival and suddenly when they meet another person online who is also struggling they suddenly switch roles from the person in need to the source of unbelievable chizuk for the other anonymous person.

WHAT’S THE BEST PART OF YOUR WORK? THE TOUGHEST? The toughest part of my job is reading the all the posts and seeing the unbelievable suffering that some people are experiencing, sometimes for very long periods of times. The worst part is that most of the time there is not much I can do to alleviate their pain. The best part is to watch and see how people care for each other even if they don’t even know who they are.

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

Sometimes it is pretty tough but when I get home and I see my wonderful family where B”H everyone is healthy I thank Hashem and that relieves a bit of the stress.

WHAT WAS THE BEST COMPLIMENT YOU’VE EVER RECEIVED? The best compliment for me is when people email me to tell me that FrumSupport helped them and in some cases literally kept them alive.

Teves 5778 | The Wellspring 25

Living Well

Ask the Nutritioniust By Shani Taub, CDC

Calorie Counting

Q A

Is the practice eating itself up?

While calorie counting is generally discouraged in the nutrition world, I’m wondering why it isn’t an effective means for weight loss. To me, it seems like a calculation that simply works: consuming less than we expend generates results. Is the practice as bad as it’s made out to be? —Keeping count

You’re asking about the effects of calorie counting on weight loss in particular, so I will address this question first. However, as a nutritionist, I will also offer my take on the nutritional drawbacks of calorie counting, which is where the main issue lies. From a purely weight loss perspective, calorie

counting appears to be a sound practice. As you posit, if we expend more calories than we consume, the only logical outcome is weight loss. So, theoretically speaking, if my daily caloric intake is 1,400 and my expenditure is 1,600, there’s a 200-calorie loss. While this calculation may seem simple, however,

26 The Wellspring | January 2018

there’s more at stake than the weight you lose. The factor that will determine how sustainable your weight loss will be is the source of the calories you’re consuming. Yes, you can probably slash off a considerable number of pounds through traditional calorie counting, but what will be fueling your body as you do so? Getting your calories from real foods—foods that contain fiber and other nutrients, will leave you feeling satiated and content and fuel your body to function optimally, while consuming the same amount of empty calories will impact your body in an entirely different way. When I explain the importance of proper nourishment above calorie counting, I like to use the following analogy. In order for a structure to be solid, a heavy layer of bricks at the bottom and another heavy layer of bricks at the top, with cement all the way through, is required. If you want to build a solid weight loss plan, you must feed your body fueling foods in the morning, fueling foods in the evening, and nourishing snacks throughout the day. Your body needs vitamins and nutrients throughout the day to stay healthy. These are the bricks that hold your structure together. If your sole focus is the calorie count, you can choose to acquire the full amount in chocolate—and you may

even lose weight, but this lifestyle won’t be sustainable. It’s the nutritional content of your food, and its fiber content, that will determine your level of satiation, blood sugar, and energy, which will in turn dictate your food choices for the following meal. My work as a nutritionist is to give my clients the least for their buck—to create a plan that requires the least amount of calories in the most filling way. I believe that sustainable weight loss cannot be merely for cosmetic purposes; proper health must not be overlooked. The ideal daily caloric intake plan is a nourishing breakfast, lunch, and dinner, with 2-3 snacks in between. Staggering the calories you consume is a crucial element in sustainable weight loss. On the other hand, cramming your daily caloric allowance into one meal or party generally leads to a caloric overload. A person should eat when hunger is starting to settle in,

Not Created Equal Notice the glaring differences in nutritious content in the following equal-calorie foods. All of these contain approximately 50 calories, yet you don’t have to be a nutritionist to know how distinctly dissimilar they are in terms of the vitamins, minerals, fiber, and protein, among other nutrients, they contain.

not when it’s already at its peak. Thus, I tell my clients that if they skip a meal, they miss it. In addition to taking the focus off nutrition, calorie counting has other drawbacks. First, it’s practically impossible to know precisely how many calories you need, how many you’re consuming, and how many your body is absorbing from the food. Even the calorie counts on packaged foods are not necessarily accurate. The Food and Drug Administration allows up to 20 percent margin of error in the numbers that you’re likely relying on, so a 250-calorie food may actually contain 200 or 300. While calorie counting may seem like a sensible approach to weight loss, its benefits are glaringly overshadowed by its drawbacks. If you want a sustainable way of life that leaves you feeling satisfied and energized, stick to a healthy plan instead.

Time for a Treat The one exception I make in regards to avoiding calorie counting is that I do recommend this practice for treats. If the majority of the calories you consume are coming from nutritionally-sound foods, 150 calories of the daily intake can be leeway. For example, I will tell a client that she can have 150 calories of any food that she likes, and that’s counted in the caloric index of the day.

1 medium-sized apple 1 cup of broccoli 1 small egg 1 small slice of multigrain bread 2 rice cakes 1 stick of licorice 1 Oreo cookie 1/5 slice pizza ¼ ounce dark chocolate

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.

Teves 5778 | The Wellspring 27

Living Well

In Good Shape By Fraidy Friedman NASM-CPT

The Negative Effects of Poor Posture If you’re like most people, you were probably told: “Stand straight” or “Don’t slouch” while growing up. Having a straight back may seem like just another way to look proper and put together, but how we carry ourselves can impact the rest of the body, both physically and mentally. According to the American Journal of Pain Management, posture affects every physiological function, from breathing to hormonal production. The body is comprised of bones, joints, and tissues that are connected. Thus, each part of the human movement system affects the other parts. The kinetic chain is the combination and interrelation of the actions of the nervous, muscular, and skeletal systems to create movement. Correct posture is the alignment of the kinetic chain, with the purpose of countering the constant forces placed on the body by maintaining alignment and balance in relation to its center of gravity. Poor posture is one of the leading causes of headaches. These days, many people sit at a desk job for numerous

28 The Wellspring | January 2018

hours of the day and use their mobile devices excessively. Over the past seven years, mobile device usage has grown from 0.3 hours a day to 2.8 hours a day. In a recent article by Kenneth Hansraj, MD, the chief of spine surgery at New York Spine Surgery and Rehabilitation, he describes that as the head tilts forward, its weight effectively increases from 10- 12 pounds in the neutral position to as much as 60 pounds at 60 degrees of flexion, which is the typical position that we have while using a mobile device or computer. Over time, this forward position leads to ligament deformation that has lasting neurophysiological effects. Most people associate upper back and neck pain with bad posture. When we slouch, the shoulders roll forward and the lower back is flattened out, eventually leading to pain. The lower back is the prime area afflicted with pain. Joints are protected by connective tissues that create a supportive cushion. If the spine is misaligned, weight or stress needs to be redistributed to compensate for the slouching.

How we sit or stand also impacts our level of selfconfidence. In a recent study conducted at a written interview, one group of people was told to sit up straight while another was allowed to slouch. The applicants were required to fill out a questionnaire on whether they believed they were the right fit for the job. The members of the group that sat straight, with good posture, had considerably more self-confidence than the members of the other group, and believed that they should get the job. So not only does sitting straight make us appear more confident, it seems that it actually makes us more confident, too. As the alignment of the spine changes, it alters the way the internal organs function. When we slouch, our organs have less room than when we stand tall. Blood vessels can be cut off, which hinders the nutrient and oxygen supply to the muscles. Slouching also constricts the intestines, causing digestion to slow down. Acid reflux, constipation, and some hernias have been connected to poor posture. The lungs function optimally when the diaphragm and rib cage can properly expand. Slouching restricts

this, impacting breathing and the oxygen flow in the body. Proper posture becomes even more important when engaging in physical activity, as the body requires a higher oxygen intake to meet the physical demands being placed on it. Poor posture causes the body to work harder to keep us upright, which leads to fatigue. Chiropractor Dr. Mike Okouchi asserts that the nervous system wants to maintain a posture that is upright and demands the least amount of muscle activation as possible. The greater the deviation from the center, the harder the system has to work, and the more energy we expend and require. If the muscular system is not aligned properly, it is more difficult to fully relax as well as affecting sleep. Sitting and standing with proper postural alignment allows us to work more efficiently and with less fatigue and strain on the bodyâ&#x20AC;&#x2122;s ligaments and muscles. Being aware of good posture is the first step to breaking old poor postural habits and reducing stress and strain on the spine.

HERE ARE FOUR QUICK EXERCISES TO CORRECT YOUR POSTURE: Shoulder Retraction Begin standing with good posture. Shoulders should be back and head up. Bend elbows to 90 degrees and keep them flexed near sides. Draw shoulders back, squeezing the shoulder blades together. Do not allow the shoulders to rise upward. Hold for 5-10 seconds. Beginners should start with 3 sets of 5 repetitions.

Active Latissimus Dorsi Stretch Start by kneeling near a stability ball or chair. Place one arm on the chair and support the upper body by placing the other arm under the shoulder. Reach forward with the arm and shift the hips back. Hold the stretch for 1-2 seconds. Repeat for 5-10 repetitions.

Floor Cobra Start by lying face down on the floor with arms at sides and palms upward. Engage the glutes, squeeze shoulder blades together, and lift shoulders off the floor. The head should stay in line with the spine. Hold the position and slowly lower the shoulders back to the ground. Repeat for 5 repetitions.

Glute Hip Bridge Begin lying on the floor, facing up. Bend the knees so that your feet are firmly on the floor and extend the arms. Activate core muscles. Lift hips off the floor to attain a bridge position with knee, hips, and shoulders in alignment. Slowly return to start position. Beginners should aim for 3 sets of 10 repetitions.

Fraidy Friedman, NASM-CPT, is a Brooklyn based certified personal trainer and certified nutritionist. Fraidyâ&#x20AC;&#x2122;s mission is to raise awareness about the importance of physical activity and its link to mental health and weight loss. She specializes in Pilates and proper posture and can be reached via The Wellspring.

Teves 5778 | The Wellspring 29

Living Well

Cover Feature

30 The Wellspring | January 2018

The Top 17 Health Trends of 2017

Tzipora Winter & The Wellspring contributors A last glance back at the health trends that topped the charts in 2017â&#x20AC;&#x201D;and what our experts think of them

Teves 5778 | The Wellspring 31

Living Well

Cover Feature

Tamar Feldman, RDN CDE is a Registered Dietitian/ Nutritionist and a Certified Diabetes Educator with over ten years of experience. She maintains a busy nutrition practice in Lakewood and Edison, NJ and via phone/ skype to numerous international clients, specializing in balanced and sustainable weight loss and nutrition therapy for autoimmune and gastrointestinal issues. Syma Kranz, PFC, is a certified aerobics, Pilates, and Barre instructor, as well as the fitness director at Fusion Fitness in Lakewood, New Jersey. 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. Tanya Rosen, M.S CAI CPT is a nutritionist, personal trainer, and owner of Nutrition by Tanya with locations in Flatbush, Boro Park, Williamsburg, Monsey, Crown Heights, Staten Island, and Lakewood. Tanya is the creator of the TAP (Tanya approved products) line available on her website, offices, and select supermarkets, offering all natural low-calorie delicious snacks and food. Rachael E. Schindler, PhD. is a triple degree psychologist, founder of The Five Towns Diet meals home delivery, Smart N’ Lite takeout meals at Seasons of Lawrence, noted lecturer and author, certified pediatric and adult nutrition counselor, certified personal trainer and celebrated group fitness instructor and Pilates master for over 20 years, practicing in Cedarhurst, Lawrence, and Manhattan. Liba Solomon, CNWC, is a Jerusalem-based nutritionist who specializes in guiding teens toward leading a healthier lifestyle. 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 owns the Shani Taub food line, which carries healthy, approved, pre-measured foods and delicacies sold at supermarkets and restaurants. Beth Warren, R.D.N., is the founder of Beth Warren Nutrition in Brooklyn, NYC and virtual, and author of Living a Real Life with Real Food and the upcoming book Secrets of a Kosher Girl (March 2018). Rorie Weisberg is a certified health coach and the founder and CEO of Full ’N Free, LLC. She is a recipe developer, inventor of Rorie’s dough mixes, and prolific writer on topics related to health.

32 The Wellspring | January 2018

Sugar Detox Is the New Carb Quit In 2017, Google showed a spike in sugar detox searches. While we’ve all been warned of the negative health effects of sugar, it’s only now that people are making serious changes and detoxing from it completely. In recent years, sugar has been linked with cancer, mental health issues, diabetes, weight gain, and a host of other health-related problems. Ever since it was revealed last year in JAMA Internal Medicine that the sugar industry paid off scientists in the 1960s to play down the link between sugar and heart disease, and to instead pin the blame on fat and saturated fat, people have started to realize that excessive sugar consumption increases inflammation in the body and is a major risk factor for cardiovascular disease. Shani Taub: If someone wants to lose weight or lead a healthy lifestyle, I would recommend avoiding added sugar completely. However, it’s important to stabilize the blood sugar levels with sugar from fruits and carbs. When sweeteners are necessary, I highly recommend organic stevia from Wholesome, but an even better alternative is to get used to less sweet food. For a healthy person, cutting out all sugars completely, including natural sugar in fruits, is detrimental to blood sugar levels. Because long-term sugar detox is hard to maintain, it may lead to sugar bingeing in the long run.

Swap Animal Proteins for Veggiepacked Meals Not only vegetarians are avoiding animal proteins. In 2017, a federal panel recommended that Americans eat less meat and take on a diet lower in animal-based foods. They explained that a vegan diet can not only improve our health but has less of a negative environmental impact. Thus, the trend of choosing lentils, beans, and plantbased meals over meat has exploded. Tanya Rosen: This lifestyle is suitable for people with high cholesterol or gout, since animal proteins generally contain a higher fat content. It’s also cheaper and more accessible, and will be less likely to leave you feeling lethargic. People who subsist on plant-based meals risk overeating because they assume these foods are unlimited and do not contain calories. It’s also hard to give the body enough protein on a vegan diet, and cutting out an entire food group completely may leave the person feeling deprived.

Power up on Protein Powder There was once a time when bodybuilders and personal trainers were the only ones privy to the power of protein powder. But in recent years, an increasing number of ordinary people have been incorporating protein powders into their diets—and not just in their smoothies. Arguably the most popular powders are the organic kind made without artificial colors or sweeteners. Liba Solomon: By delivering an isolated form of a nutrient, protein powder has plenty of potential advantages. If you don’t have time to cook, adding a spoonful of protein powder to a drink or a bowl of oatmeal will provide a healthy instant protein boost—as long as you buy a healthy powder. It’s a great power booster if you’re on the run or would otherwise grab a non-nutritious food. In addition to being convenient and shelf-stable, whey protein powders such as Maxi Health’s Naturemax Energize™ offer a combination of proteins that contain all amino acids, which is not always the case with all protein-based foods. Supplementing with protein isn’t as healthful as getting the nutrient from whole foods, such as an egg or a slice of salmon. Plus, exceeding recommended amounts can have serious health consequences.

One-bowl Meals Despite the fact that people have been eating food out of bowls for centuries, the bowl-meal trend took off this year. Smoothie bowls, acai bowls—you name it, they all provided some truly photo-worthy meals, all in one bowl. Shani Taub: One-meal bowls, which offer condensed calories, are good for people who just want to satisfy themselves and move on. Especially if the bowls contain healthful ingredients, they can ensure satiation for a long period of time. Without realizing, a person may be consuming more than a meal’s worth in that one bowl, especially if the foods are blended. Would you eat four fruits, one cup of milk, and a yogurt in one sitting had the foods been separate? I, for one, love to eat, and I think most people do too. But I like to stretch my food, not shrink it. When we chew our food properly we send a message to the brain that we’re eating, which leads to the secretion of appetite-suppressing hormones.

Teves 5778 | The Wellspring 33

Living Well

Cover Feature

The Fading Fear of Fat For people looking to cut fat and lean out, it seems like eating fat would be a problem, right? In fact, in the 1990s, low-fat or fatfree foods were all the rage for people looking to drop fat fast. But now, more and more people are extolling the benefits of fat. While fat does contain more calories per gram than protein or carbohydrates—nine per gram, compared to four for protein and carbs—people are gradually losing their fear of this food group. Rorie Weisberg: When it comes to obesity, the real culprits are sugar and refined carbohydrates. When consumed in excess, these elements are converted into body fat and cause weight gain, as well as many other health risks. Healthy fat can actually aid weight loss, and is essential to our well-being. Fat allows for absorption of vitamins A, D, and K, enables hormones to work properly, helps burn body fat, protects organs, and insulates the body to regulate temperature. Healthy fats also provide the eater with a sensation of fullness, which helps to curb cravings. Saturated fats, such as coconut oil, help provide stiffness and structure to our cell membranes and tissues. Monounsaturated fats, found in avocados, olives, nuts, and some fish, are rich in vitamin E, reduce belly fat, and have cardiovascular benefits. They have been proven to raise good cholesterol (HDL) levels as well. Unrefined avocado oil is a great source for monounsaturated fats and can be used to replace canola and vegetable oils in baking. Polyunsaturated fats include both omega-6 and omega-3 fats. These play a key role in cellular, immune, and hormonal function. Great sources of omega-3 fats are fatty fish and grass-fed meats. There is one form of fat that should absolutely be avoided: trans fat, known as “partially hydrogenated oil.” Trans fats are commonly found in processed foods, shortenings, and margarine, as well as in fried foods, commercially baked foods, and many store-bought foods. Check labels for partially hydrogenated oil, and leave those products on the grocery shelves!

34 The Wellspring | January 2018

Gut Health Awareness The emergence of scientific evidence on the role of the human microbiome and the importance of a healthy gut are appealing to people who are interested not only in weight management but also a bloat-free, healthier life. As a result, gut health has become a new lifestyle approach that affects food, beverage, and supplement sales. In addition to gluten-free, which boomed in the last 5 years, and lactose/dairy-free, glucose-free is starting to gain popularity due to the rising interest in FODMAP (fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols), especially in people who experience gastro-intestinal symptoms after consuming FODMAPs. A June 2017 Google Trends analysis demonstrates that “gut health” and “bloating” are among the most frequent search terms when it comes to managing health through food. Search terms that indicate consumers’ rising awareness to gut health, such as “leaky gut,” are growing too. Tamar Feldman: It is obviously a challenge for me to judge the validity of rising popularity in this health trend, as this is how I spend a significant chunk of my day. Perhaps to me it seems like “everyone” is self-diagnosing themselves with leaky gut, whereas in reality I am just viewing the world through the prism of my profession’s glasses. To give a fair response: Leaky gut is a term that most individuals contacting me are already aware of, which would indicate that there is a lot of publicity and interest in the subject. According to the functional medicine model in which I currently treat clients, the prevalence of leaky gut (believed to be the cause of autoimmunity) is on the rise. Although I have not found any official statistics on the subject, there is no doubt that more individuals experiencing autoimmunity are seeking alternative answers to their medical issues aside from immuno-suppressant “Band-Aid” drugs, and are finding answers in the functional medicine world. The rise in autoimmunity and subsequent interest in leaky gut has in turn raised general awareness of the subject amongst wellness-minded individuals. Now many people are diagnosing themselves (right or wrong) with leaky gut even without any overt manifestations, such as an autoimmune disease. Sometimes this concern is valid and their gastro-intestinal symptoms are the early stages of what may eventually manifest itself as a full-blown autoimmune condition. Often, people have another underlying condition such as SIBO causing gassiness and bloating, in which case a leaky gut healing diet protocol will do little to help them. That is the reason why it is vital to consult with a qualified dietitian or physician who is well versed in functional medicine before self-diagnosing with leaky gut.

The Ketogenic Diet A few years ago, new research into metabolism revealed that consuming too many carbohydrates may be what’s preventing so many Americans from dropping their excess weight. In turn, high-fat diets took over the health scene. This year, the ketogenic diet, one particularly extreme low-carb/high-fat plan, made headlines when various big names gave it a try. It dramatically reduces carb intake to just 5% of a dieter’s daily calories. (This means someone consuming 1,500 calories would only be allocated 19 grams, which is what you’d find in one potato.) Fats occupy a whopping 80%, and proteins, the other 15%. The idea is that your body will use up those 19 grams of carbs so quickly that it will then start to break down stored fat for energy, which can spark weight loss. Liba Solomon: More and more people are going keto because it’s a diet that actually doesn’t leave them feeling hungry. Many of the foods it includes—like dairy and meat, avocado, eggs, and peanut butter—are particularly filling as a result of their high fat content. What’s more, being in a state of ketosis (when your body is burning fat instead of carbs) can diminish hunger. Because the diet’s tight restrictions force out many of the fruits and veggies we know to be healthy, it may not be something you’d want to follow long-term.

Avocado Toast Diet Is Going Strong Data from the health-tracking app MyFitnessPal, including 100 million breakfast entries from August 2016 to August 2017, showed which health trends were most notable. Not only did avocado toast’s popularity increase by nearly 50 percent this year, but the meal also popped up in more than 533,900 social media posts. And millennials aren’t the only fans: Those aged 36 to 52 are getting in on the smashed fun with a 70 percent increase in the Generation X demographic. Dr. Rachael Schindler: Don’t let the name fool you. This new diet touted by Dr. Oz promises to transform the way you eat by eating plantbased proteins and whole foods without counting calories and drinking shakes or powders, and, you don’t only eat avocado toast. In theory there is minimal sugar, and the diet allows whole foods only. The breakfast: toast with a half avocado with any toppings, such as spices or strawberries, is easy to make and includes fiber. You can also have another toast for a snack. Lunch and dinner are mostly nonstarchy veggies, more healthy fats, and plant-based or whole-grain dishes like bean chili or quinoa, which essentially are great for heart health. For someone who is eating junk food and has a lot of weight to lose, this 21-day program may be a jumpstart to weight loss and an introduction to healthy eating. If you are sugar sensitive or have diabetes or thyroid issues in your family’s genes, you would need a whole lot of grains and beans to fill up. There are no amounts or specific order in which to eat these foods. Additionally, if you are consuming even small amounts of sugar, all these “healthy fats” will be stored as well. Also, this diet does not account for any sweet tooth, only fruit or nuts being allowed for a snack (can you eat the whole bag?), and what happens after 21 days? Hmmm, sounds more like a healthful and maintenance diet to me.

Monk Fruit Is the New Superfood Consumption of this natural alternative to artificial sweeteners rose dramatically this year. Beth Warren: Monk fruit tastes much sweeter than sugar and may leave less of a bitter aftertaste than stevia. This natural sweetener provides no calories, is low-glycemic, and can be used in beverages and baked goods. Always remember that just because a healthier sweetener is used in a food or drink, it doesn’t automatically make the entire product healthy. Keep reading all ingredients to ensure that what you’re consuming is in fact healthy, regardless of its monk fruit content. Also, because it’s hundreds of times sweeter than sugar, monk fruit does enhance your sweet tooth. In other words, it doesn’t trick your brain that you aren’t having something sweet. As a result, stick to using 1 packet at most of monk fruit extract to sweeten, in order to keep sugar cravings at bay.

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Living Well

Cover Feature

Nuts Over Soy While alternative milks from sources like nuts and hemp (and even flax seed) continue to soar, there’s one that’s showing a decline in popularity: soy milk. Unlike other trends of the 1990s, soy milk is not enjoying a resurgence. Health-conscious consumers in 2017 are consuming far more cashew milk, almond milk, and hemp milk. People in 2017 have concerns over consuming GMOs, and 93% of soybeans grown in the U.S. are genetically modified. One of the other knocks against soy is that it contains phytoestrogens, a group of natural compounds that resemble estrogen organically and can be endocrine disruptors. Is almond milk the way to go? Rorie Weisberg: Although soy milk is higher in protein than nut milks, this single benefit does not outweigh the health risks. Soy can interfere with hormonal balance, contribute to thyroid problems, and has been scientifically linked to male infertility. I generally do not recommend soy products of any kind to my clients. When it comes to finding a great alternative for dairy milk, I recommend almond milk. As with all nut milks, almond milk is low in protein but high in monounsaturated fat, which has been shown to reduce cancer and heart disease. Almond milk also contains vitamin D, which is important for strong teeth and bones, and vitamin E, an antioxidant. Unsweetened almond milk contains almost no sugar, and no cholesterol or saturated fat. Although it does not naturally contain much calcium, many brands are fortified with added calcium. You can use almond milk to replace ordinary milk in almost any capacity, including ice creams, shakes, and baking. I recommend the Califia Farms® line of dairy-free milks and creamers. If the taste of nut milk does not appeal to you, don’t give up until you’ve tried these products! Califia Toasted Coconut Almondmilk has a delicious, creamy texture, is very lightly sweetened with monk fruit, and is popular with both kids and adults. Make sure you are buying an unsweetened product; I highly recommend Califia’s Almondmilk Creamer and Almondmilk Iced Coffee as well. The Califia products are all carrageen free, with added calcium, so there’s even more calcium in your nut milk than you’d find in a glass of cow’s milk. For those of you who like to froth your milk, try Kirkland™ almond milk, available from Costco; it’s the only frothable almond milk on the market. Although the virtues of almond milk are many, people with nut allergies must avoid it, obviously. In addition, it does not contain a significant amount of protein.

36 The Wellspring | January 2018

Whole30 Topping the list of 2017’s biggest health crazes is Whole30. People couldn’t get enough of the Paleo-esque diet this year—and for good reason. Whole30 is an elimination diet of impressive proportions, cutting out processed foods, dairy, grains, beans, legumes, refined sugar, and alcohol for a whopping 30 (long) days. The idea is that by sticking to the other stuff—like meats and fish, greens, nuts, and seeds—you’ll reduce gut irritation and inflammation, and most noticeably, lose weight. Tamar Feldman: Whole30 differs from paleo slightly, as paleo diets by definition exclude seeds. The diet can be nutritionally sound for most individuals if it is planned well. However, if the goal is primarily weight loss, there are many better ways to do it that are less restrictive and “painful.” Most of my clients are able to successfully lose weight and keep it off once they learn how to mindfully eat a balanced plan that includes whole foods and enough calories, protein, and fat to keep them full. While no one would venture to suggest that refined sugar is needed in a diet, I will sometimes allow it in very controlled quantities for certain individuals on weight loss regimens, and they can still be successful without feeling deprived. While grain/dairy/soy-free is sometimes indicated with the GI/ autoimmune population I work with, restricting healthful foods such as legumes is rarely necessary. My opinion in a nutshell: For weight loss, I view this plan as trying to kill a fly with a machine gun, which can be problematic if it causes long term burnout. For a GI issue, you will have better end results working with a professional.

Strength Training Is Making a Comeback Gone are the days when the biggest fitness buffs out there stick to cardio. Today, they know they can’t miss the weights workout either. Syma Kranz: Strength training offers scientifically-backed benefits, such as boosting longevity, building muscle mass, and protecting against diabetes, back pain, and more. Plus, a growing number of women, in particular, have come to realize that lifting weights won’t necessarily make them bulky, and in fact will help them burn more fat and boost metabolism. A couple days of resistance training per week can lead to big changes in your body. It will strengthen your muscles and bones, give your posture a lift, and boost your mood. Strength training also stokes your metabolism, so you’ll burn more calories even when you rest. And it slashes your odds of getting injured. It’s easy to get comfortable and fall into the habit of doing the same exercises and movements. Mixing things up challenges different body parts and keeps boredom at bay. Vary the equipment—try dumbbells, resistance bands, cables, stability balls, or exercises that use your body weight. Change your intensity—switch between tough and easy days. And alternate your grip, meaning change from palms down to palms up, or vice versa.

Wearable Technology Fitness trackers and smartwatches have become great gifts for the last few years, and the ACSM says that trend was only getting stronger in 2017. Recent updates from brands like Garmin, Apple, and Fitbit revealed the trend as number one for last year. Today’s wearables track distance and also provide heart rate readings, GPS route tracking, move reminders, and so much more, and are thus highly popular with fitness fans across the globe. Syma Kranz: A popular nutritionist once said that the average lazy American takes around 4,000 steps a day. Most people are not aware how inactive they are until they put a tracker on. One woman who recently bought a tracker saw that she was taking 2,000 steps a day! An active person will take around 10,000 a day. A friend of mine who wears a tracker told me that in the summer she can track 20,000 a day. When you wear a tracker, you become more aware of your movements and are thus more motivated to move. You will go up and down the steps to get the milk from the second fridge in the basement, to change the load of laundry—instead of asking your kids to do it for you. People think that once they wear a tracker, they are good to go and don’t need to exercise. Trackers do not replace exercise. Simply by tracking your steps, you won’t get all the benefits of exercise, including core, endurance, stamina, muscle strength, relaxation, and stress release.

Spices for Healing Gourmet seasonings popped up everywhere, and you can find turmeric-flavored everything nowadays. People have turned to spices like turmeric, cumin, and fenugreek to boost their antioxidant levels and to acquire other health benefits. Beth Warren: Although more research needs to be done, it hass been suggested that many spices contain healing properties. Caraway, for example, is great for relaxing the nervous system as well as in aiding in digestion and reducing inflammation. Consuming fenugreek is a fantastic way to remove toxins and impurities from the digestive tract. Of all other healing spices, cumin has a unique function in that it is known to reduce heat in the lungs while at the same time increasing the metabolism and ability to digest food. This makes it a great choice for people who do strong cardiovascular exercise who want to use spice up their food to increase their metabolism. Likewise, if you have tight lungs, congestion and indigestion you can make a tea with cumin before breakfast. Herbal remedies have been used for centuries and can be safe and effective, if used the right way, to help treat a variety of conditions and symptoms. Seasoning your chicken with turmeric or cumin is perfectly okay, but it’s hard to believe that the sprinkling of spice can do much. If you’re taking them in quantities, always discuss taking herbal remedies with your doctor, because they interact with medications such as blood thinners and some medical conditions like high blood pressure. You also have to use a good quality brand to ensure you are getting the purest form of the ingredient.

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Living Well

Cover Feature

Intermittent Fasting Intermittent fasting, or majorly reducing calorie intake during an extended period to achieve weight loss, was a popular diet in both 2016 and 2017. Followers of one particular fasting strategy called “time-restricted feeding” forgo food for a 12-hour period (say, 7 p.m. to 7 a.m.) and are permitted to eat whatever their heart desires the remaining hours of the day. The other popular rendition of the diet, 5:2 fasting, involves a bit more adjusting, as followers choose two non-consecutive days per week to eat 500 calories or fewer, and maintain their normal diet on the other five days. In either case, the bigtime appeal of intermittent fasting lies in its requirement to change how and not what you’re eating—so you can lose weight without feeling restricted around the clock. Tanya Rosen: Intermittent fasting teaches the person to be okay with not eating every few hours. It may be a good practice for nighttime binge/emotional eaters. It is not likely to lead to long term weight loss, as most people overdo the calories they do eat in the permissible hours. Also, too many hours without food can slow down the metabolism and put the body into starvation mode. And, of course, 500 calories is way too low for anyone, and can even be dangerous.

38 The Wellspring | January 2018

Sleep-inducing Foods When 30% of Americans report short- or long-term insomnia, it’s no wonder a flood of sleep-inducing foods are hitting the market. Foods that contain melatonin, such as cherries, have even been marketed with this purpose in mind. Liba Solomon: Carbohydrates allow your brain to produce serotonin. Although not always the healthiest choices, simple carbohydrates provide the greatest impact on your serotonin levels. Found in sweets, refined grains, and fruit, simple carbs enter your bloodstream quickly, giving a serotonin boost that will last up to two hours. If you want to feel sleepier shortly before bedtime, have a small snack containing a simple carb source, such as honey or fruit, along with some protein. Have a glass of low-fat milk with a touch of honey, for example, or fresh cherries, which contain melatonin, topped with a little yogurt. Eating too many simple carbohydrates from unhealthy sources, such as sweets, can disrupt blood sugar control and potentially keep you awake. Also, there are way more effective sleep-inducing means than relying on food to do the work. Maintaining a steady bedtime, avoiding caffeine, or a dose of melatonin will probably help you access your dreams faster.

Raw Foods Diet The raw foods diet centers around the premise that cooking destroys nutrients and enzymes that are needed for digestion and disease prevention. For optimal health, all (or mostly all) foods should be consumed raw or below 115 degrees. Some raw food diet followers are vegans, eating only plant-based foods such as fruits, vegetables, nuts, seeds, grains, and legumes, while others add in a few animal-based products such as unpasteurized milk and cheese, raw fish, and some raw meat. Anything cooked, processed, pasteurized, irradiated, or in other words, not in its “natural state” is off-limits. Dr. Rachael Schindler: People on this diet consume foods that are higher in vitamins and minerals, and it’s suitable for vegetarians/vegans. This diet may also lead to weight loss. You must roll up your sleeves for this one! The raw foods diet requires lots of fresh food shopping, prep time for making shakes and fruit and vegetable washing, and is expensive to maintain. Also, cooking food may help with killing some bacteria, which can help you avoid food poisoning, and supplementation is almost always required. Many nutrient-dense foods such as beans, and proteins cannot be eaten raw. This diet may work for the shortterm. However, it is highly restrictive (think yom tov and Shabbos) and hard to stay on for the long-term.

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ISSUE 24 JANUARY 2018 TEVES 5778

bowl for the soul Keep warm with nourishing soups

new column! thyme for dinner

EAT WELL THERE'S A REASON KALE IS THE GREEN SUPERFOOD

Ingredients (2 Servings) 3/4 cup espresso coffee 1/4 cup sugar 1/2 cup Golden Flow Milk 1/2 cup Golden Flow Half and Half 1/4 cup chocolate syrup 1/4 to taste whipped cream, for topping 1/4 to taste chocolate syrup, for topping Directions Make an espresso using your favorite roast brand. While still hot, mix the coffee and sugar in a mixer until sugar is dissolved. Add milk, half and half, and chocolate syrup, continue mixing for another minute. Combine equal parts coffee mixture and ice in a blender, and blend on high until smooth. Pour into glasses. Top with whipped cream and drizzle with chocolate syrup Ready to serve!

‫חלב ישראל‬

Eat Well

Recipes

Dear Cooks, I was recently speaking to Hindy, a friend whom I haven’t seen since she made a cross-country move. “You won’t recognize me,” she confessed. And before she even had a chance to share the details, I knew she was referring to her weight. What else do we ladies speak about? As a high school kid, Hindy was the friend who had us turn green in the face when she innocently downed packages of Twizzlers and then complained that her skirts were getting looser. “I finally got an adult appetite,” Hindy shared. “I know I always ate a lot of junk food, but I never ate a normal meal. Now, it’s meals plus the treats.” After I commiserated with Hindy over her having joined the human club, we had an exciting discussion about the various grown-up foods we’ve come to appreciate over time. Of course, soup topped the list. While it’s rare to find the child or teenager who gets excited over a bowl of floating vegetables, which adult doesn’t appreciate a hearty bowl of goodness on a blustery winter eve? Which is why I’m sure you’ll love the fabulous soup recipes we have for you in this issue’s Seasoned. In this issue, I’m also excited to introduce you to our new column, by our very own editor-in-chief, Shiffy Friedman. You’ve seen Shiffy’s written work in these pages and you hold in your hands the culmination of her meticulous planning and coordination, but this is your chance to actually visit her kitchen and see what the editor of a health magazine cooks for herself and her family, in keeping to the Seasoned mantra of wholesome and delicious. Keep warm in the kitchen, Esther

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Eat Well

Recipes, Styling & Photography By Yossi & Malky Levine

Mushroom-Barley-Beef Stew We all have our go-to mushroom-barley soup recipe, but the addition of beef in this one ups the ante. It’s practically a one-bowl balanced meal, too. 1 Tbsp olive oil 2 rib eye steaks (about 1 pound each), trimmed of excess fat and cubed salt and ground black pepper, for sprinkling 2 onions, diced

16 oz (1 pound) fresh mushrooms, sliced 4 cloves garlic, minced 8 cups water 1 cup barley 1½ tsp salt Heat olive oil in a large saucepan.

Sprinkle steak cubes generously with salt and pepper. Add them to the saucepan and sear for 3-4 minutes on each side until browned. Remove the steaks, leaving the remaining oil in the pot, and set aside. Add onions and mushrooms, and sauté for 10 minutes over medium heat until soft. Add garlic, water, barley, salt, and steak cubes. Bring to a boil and cook on medium heat for 1 hour and 15 minutes. Yield: 8 servings

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For those with higher standards.â&#x201E;

ned e t e e Sw sun e h t y b

c to s e gh f ru p i h o N yru corn s

Eat Well

Recipes

Spinach-Broccoli Soup If you’re used to seeing spinach as a side dish only, let me tell you that it pays to be daring with this one. The combination of greens in this soup not only pack in the antioxidants but create an incredible blend of deep flavor as well. 1 Tbsp olive oil 1 large onion, diced 16 oz frozen broccoli florets 16 oz frozen spinach 5 garlic cloves, crushed 1 large zucchini, cubed

1 potato, cubed 8 cups water 1 bay leaf 2½ tsp salt freshly ground black pepper to taste

Heat olive oil in a large saucepan. Add onions and sauté for 5 minutes over medium heat, until soft. Add broccoli, spinach, and garlic and sauté for an additional 10 minutes. Add the rest of the ingredients. Bring to a boil, reduce the heat to medium and cook for 40 minutes. Remove the bay leaf and blend with an immersion blender until smooth. Yield: 8 servings

Teves 5778 | The Wellspring 47

For those with higher standards.â&#x201E;

Fre Prov sh egg en R s ecip , e.

Eat Well

Recipes

Jerusalem ArtichokeChestnut Soup This is for when youâ&#x20AC;&#x2122;ve had enough of the regulars. A fabulous combo of good stuff that will excite every one of your taste buds. 12 oz frozen artichokes, defrosted 5 oz roasted chestnuts 2 celery sticks, chopped 1 apple, cubed 1 onion, diced

8 cups water 3 garlic cloves 1Â˝ tsp salt pepper to taste

Add all ingredients to a large saucepan. Bring to a boil. Reduce the heat to medium and cook for 45 minutes. Use an immersion blender to blend until smooth.

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Eat Well

Recipes and Styling by Shiffy Friedman, Photography by Minky Fischer

thyme for dinner 50 The Wellspring | January 2018

Dear Cooks, Hello from Seasoned! I’m stepping into unchartered territory, addressing you not from my writer’s desk but from my kitchen counter (only a few feet apart, by the way). And I’m doing this to answer the question I get all the time, “So what do you eat?” Yes, we’re a health-conscious family, but we’re not a health-obsessed family (at least to my mind). And no, I don’t cook with flour, sugar—or any sweeteners, for that matter—but I do focus on creating not only wholesome but also tasty, beautiful dishes for myself and my family; the kind of dishes we’re glad to enjoy again and again. So, I figured, why not share my simple, classic recipes with all of you? As the frum community’s health magazine, we strive toward creating a balance, offering content not only to those who are fully committed to leading a healthy lifestyle, but also to readers who would like to pick and choose. When it comes to nutrition, keeping this balance is especially challenging because my personal perspective toward healthy living is very rigid—extreme, if you will. I like to believe that because my decision to lead a healthier lifestyle emanated from a place of choice, not resignation, I’m not a “have your pizza/donut and eat it too” fan. My belief, which has brought me to a deep appreciation for the natural gifts Hashem sends our way, is that wholesome food is not wannabe food. It stands on its own merit, not only in terms of nutritional content, which is obvious, but also in terms of its incredible flavor, versatility, and variety. Based on an informal survey I conducted, the hesitation home chefs have when contemplating healthy cooking boils down to two main reasons. The barbeque-sauce-ketchupbrown-sugar-chefs have been happily using ready-made, processed taste enhancers to dress anything from a chicken wing to a rack of ribs. Then there are those who do eat healthfully but admit that they’re sick and tired of having steamed broccoli and dry chicken every night. Still, they have no time (or money—a friend recently shared that most ingredients that healthy recipes call for are beyond her financial means) to experiment with different ingredients—

let alone visit the health food store on a weekly basis, so they’ve resigned to subsisting on tasteless basics. Call me traditional, call me conservative, call me extreme, but my dinner pots rarely come into contact with anything but real stuff. Before you assume that I replace honey with date syrup, granulated sugar with maple syrup or its organic alternative, and wheat flour with almond flour or some other gluten-free alternative, I will tell you that I don’t. Honestly, I rarely step into the food aisle at my local health food store. So, you may be wondering, what is real stuff if not for silan and coconut milk? While these readily available health foods have their merit, I’m one traditional cook. And if you’re wondering what I can whip up with my limited ingredients, simply check out this new column to see how I use very, very (very!) basic stuff—all of which you can not only pronounce but also trace back to their origin, as well as afford, to create wholesome, appealing, nourishing dishes. None of the recipes I’ll be sharing with you are genius inventions; they’re recipes you could have or may have thought of yourself. But, in our harried life, who has time to experiment with anything other than brown sugar and ketchup? I’m here to do the work for you. If you want to eat clean, good stuff on a nightly basis, here’s where you’ll find the inspiration. And as the column title suggests, you’re in on my secret to genuine flavor enhancement: nothing like fresh herbs to add a kick to any dish. With the debut of Thyme for Dinner, I lay forth the Real Deal: 1. Real food 2. Real good 3. Real quick Let me know if I’ve come through on my promise! Happy cooking, Shiffy

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Eat Well

Recipes

real Good

real quick real Food

Pesto Chicken with OvenRoasted Tomatoes

Prep Time: 20 minutes Bake Time: 1 hour Yield: 4 servings

When you prepare this dish, take a moment to inhale the fragrant aroma of fresh basil. It’s thanks to a whiff I caught of this herb while doing my vegetable shopping that I was inspired to create this recipe. 3 oz. pine nuts 4 chicken cutlets 1.5 oz. fresh basil leaves, stems removed (1 packed cup) 12 cherry or plum tomatoes ¼ cup extra-virgin olive oil olive oil, to drizzle salt and pepper, to taste salt, pepper, garlic powder to taste Preheat oven to 400˚. Toast pine nuts for five minutes, and then lower the heat to 350˚. In a food processor fitted with the S-blade, pulse cooled pine nuts for about 1 minute until finely chopped. Add the basil and pulse until fully crushed. Add the olive oil, salt, and pepper and blend just until combined. Pat cutlets dry and spread on baking sheet. Pour pesto sauce over cutlets. Slice the tomatoes. In a small bowl, mix olive oil, salt, pepper, and garlic powder and toss tomatoes in the mixture. Scatter throughout the pan. Bake covered for 45 minutes and uncovered for another 15 minutes. Start to Finish Here’s what I served the last time pesto chicken was on the menu: Broccoli soup (check out the one in this issue’s Seasoned) Pesto chicken on a bed of mashed potatoes (sweet potatoes or cauliflower works great too) Sugar snap peas (lightly sautéed with lots of garlic) Sliced apples (we always conclude our meal with a fruit) Pesto Everything! Double the pesto recipe and keep it pareve to enjoy an array of fabulous pesto-based meals. I’ve used this base as a dressing for salad, with melted cheese on peppers and mushrooms, and even as a dip at the Shabbos table. Add olive oil as needed to achieve a more liquid consistency. Herbs like basil contain essential oil compounds that help the plant defend itself from predators like bugs, rodents and strains of bacteria in the soil. When we ingest these protective oils, we experience similar benefits: a boost in immunity and protection from disease (among other incredible benefits).

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Eat Well

Nutrition Tidbits in the News By Liba Solomon, CNWC

A TEA A DAY A daily cup may reduce glaucoma risk Here’s another reason for you to enjoy your cup of tea in the evening. According to a study published in Ophthalmology, a daily cup of hot tea reduces the risk for glaucoma, a disease in which a buildup of fluid in the eye can damage the optic nerve and lead to gradual vision loss. For this British National Health Service survey of 1,678 participants, the researchers used photographs of the optic disc and other diagnostic techniques to record instances of glaucoma in 2005 and 2006 and correlated them with reports of beverage consumption over the previous year. After adjusting for age, body mass index, gender, ethnicity, smoking, and diabetes, they found that people who drank at least one cup of hot tea a day were 74 percent less likely to have glaucoma. They found no association with soft drinks, iced tea, decaffeinated tea, or with coffee, decaffeinated or not. This observational study does not prove causality, but the researchers assert that tea contains phytochemicals and flavonoids with anti-inflammatory properties that may protect the optic nerve. “If you drink hot tea, keep on doing it,” says the senior author, Dr. Anne L. Coleman, a professor of ophthalmology at the University of California, Los Angeles. “But I wouldn’t switch to it if you prefer something else.”

FISH FOR AN A Myth or truth?

Myth has it that fish is brain food, but it just might be more than myth, a new study suggests. In a study done among Chinese children, those who ate fish at least once a week had intelligence quotients, or IQs, that were nearly 5 points higher than the IQs for kids who ate less fish or none at all, the study found. Fish eaters also slept better.

The t e a m To find out if fish was linked to benefits in children’s health, lead researcher Jianghong Liu, an associate professor of found that children nursing at the University of Pennsylvania School of Nursing who ate fish at least once in Philadelphia, and her colleagues studied the eating habits a week scored 4.8 points of more than 500 boys and girls in China, 9 to 11 years old. higher on the IQ tests The children completed a questionnaire about how often than those who seldom or they had eaten fish in the past month, with options that never ate fish. Those whose ranged from never to at least once a week. The children also meals sometimes included fish took the Chinese version of an IQ test that rates verbal and scored slightly more than 3 points nonverbal skills, called the Wechsler Intelligence Scale for higher. According to the researchers, the benefit in IQ can be pinned to the better sleep afforded by omega-3 fatty Children-Revised. acids found in many types of fish. In addition, the children’s parents answered questions “If parents want their children to be healthy and higherabout their child’s sleep quality. The information included how long kids slept, how often they woke during the night, performing, they should put fish on the table once a week,” and whether they were sleepy during the day. says Liu. If gefilte fish counts, we’re good to go.

54 The Wellspring | January 2018

SALAD FOR BUBBY—AND YOU If you’re seeking a really good reason to get your daily fix of leafy greens, read this. New research shows that eating a salad a day may help keep your brain healthy. The study, published in Neurology, the journal of the American Academy of Neurology, found that people who ate at least one serving of green leafy vegetables per day had a slower rate of decline on tests involving memory and thinking skills than people who never or rarely ate these vegetables. “Older adults who consumed leafy greens in their diet, the equivalent of about a cup and a half a day, have a lower risk of developing memory deficits associated with dementia,” says study author Sarah Booth, PhD, of the Nutrition

Those greens may boost brain health

Research Center on Aging at Tufts University. The study followed 960 people who did not have dementia, with an average age of 81, for about 5 years. The participants completed a questionnaire about how often they ate certain foods, including green leafy vegetables, such as cooked spinach, kale, collard greens, and raw lettuce salad. They also had their thinking and memory skills tested yearly during that time. The research found those who ate the most leafy greens tested the equivalent of 11 years younger on measures of mental function, compared to those who ate the least. Researchers say it’s best to choose greens with dark leaves, because the darker the leaves the more nutrients they have.

Booth says while the new study doesn’t prove that leafy vegetables slow brain aging, incorporating them in your diet is a good idea since they delay the onset and progression of many diseases due to their high nutrient content. Salad, please.

POWER UP! 3 immune-boosting fruits for winter Citrus fruit is now in season and is one of nature’s best sources of vitamin C, a key nutrient for supporting your immune system. Get inspired to juice up your meals and your body’s winter defenses.

1. Pink grapefruit Pink grapefruit gets its deep hue from lycopene, an antioxidant that fights cellular damage and may play a role in reducing cancer risk. Its high water and fiber content also helps you stay hydrated and full, fending off dry skin and weight gain.

2. Orange At just 62 calories, a medium orange provides up to 116 percent of your daily vitamin C. The fruit is also rich in flavonoids, a class of antioxidants that may reduce risk for heart disease, as well as potassium, a key nutrient for regulating blood pressure.

3. Lemon Make fresh lemon juice a kitchen staple for its ability to brighten and balance flavors in dishes. The acidity lightens up earthy or bitter flavors, making vegetables taste better, and it can tone down an overly sweet dessert or too-salty entrée.

Teves 5778 | The Wellspring 55

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:

KALE

Principle

Nutrition Value

Percentage of RDA

Energy

49 Kcal

2.5%

Carbohydrates

8.75 g

Protein

4.28 g

Total Fat

0.93 g

3.5%

Cholesterol

0 mg

Dietary Fiber

3.6 g

Folates

141 µg

35%

Niacin

1.000 mg

Pantothetic Acid

0.091 mg

1.5%

Pyridoxine

0.271 mg

21%

Riboflavin

0.130 mg

10%

Thiamin

0.110 mg

Vitamin A

9990 IU

333%

Vitamin C

120 mg

200%

Vitamin K

704.8 µg

587%

Sodium

38 mg

2.5%

Potassium

491 mg

10.5%

Calcium

150 mg

15%

Copper

1.499 mg

1266%

Iron

1.47 mg

18%

Magnesium

47 mg

12%

Manganese

0.659 mg

28%

Phosphorus

92 mg

12%

Selenium

0.9 µg

1.5%

Zinc

0.56 mg

Vitamins

Electrolytes

Minerals

56 The Wellspring | January 2018

Everyone seems to be talking about green smoothies, superfood shakes, and vegetable juices nowadays, and no wonder—people are discovering all over the world that they help curb unhealthy cravings, boost immunity, and are even fantastic meal replacements for busy people on the go. One of the most common ingredients in these green superfood concoctions is kale. Considering kale’s abundant health benefits, it’s no wonder. A member of the illustrious group of cancer-fighting cruciferous vegetables, kale is quickly becoming one of the most popular health foods today. The health benefits of kale have been enjoyed since ancient Rome, and history tells us that it was one of the most popular green leafy vegetables of the Middle Ages. Kale comes from the Acephala group of the Brassica oleracea (oleracea var) species that includes collard greens. There are two main varieties of kale: one that has green leaves and one that has purple. Interestingly, the central leaves do not form a head, which is one reason why kale is considered to be more closely-related to wild cabbage than most domesticated forms of vegetables.

Arguably the greatest benefit of kale is its powerful anti-inflammatory properties. When you consider the ideal omega-3 to omega-6 ratio, kale is the perfect antiinflammatory food. Being “pro-inflammatory,” the omega6-rich processed foods that many people live off today cause a chronic inflammatory state on a widespread scale, which has been linked to nearly every disease, such as rheumatoid arthritis, Crohn’s, and cancer. Kale, on the other hand, naturally promotes the balance between proinflammatory omega-6 and anti-inflammatory omega-3. Nearly at a 1:1 ratio, kale contains slightly more omega3s, which can help reduce the negative effects that people experience when they eat omega-6 rich processed foods loaded with vegetable and canola oil. Hand-in-hand with its anti-inflammatory potency is the antioxidant power of this food. Of the three main antioxidant vitamins in the world, kale is particularly rich in vitamin C and beta-carotene (the precursor to vitamin A). This is important because antioxidants are known to counteract the damage caused by free radicals. Your body is exposed to highly unstable free radical molecules every day through the polluted air you breathe, toxins in your food, and chemicals in your water. These cause “oxidative stress,” a process that triggers cell damage and has been linked to everything from cardiovascular disease to cancer

In Your Plate

to cataracts. Oxidative stress is also known to be one of the main contributing factors to neurocognitive disorders, such as Parkinson’s and Alzheimer’s diseases. Another top health benefit of kale is that it’s a natural detoxifier. It not only helps destroy toxins, but also helps eliminate them from your body. This is due to compounds called isothiocyanates (ITCs, made from glucosinolates) that help detox your body at the cellular level. These ITCs give a powerful “one-two punch” against toxins and free radicals. Toxins in our environment, such as processed foods, pollutants, pesticides, and pharmaceuticals, increase the toxic level of the body and increase the chance of disease. Toxins are destroyed first by antioxidants and then removed (detoxified) with glucosinolates, so make sure you’ve got your kale to help out with the process. The next health benefit of kale is for women in the childbearing years. Kale is a valuable source of folate. Eating kale regularly can help prevent various birth defects and promotes adequate birth weight, healthy neural tube formation, and proper development of the infant brain, face, and heart. This is extremely important for all women of childbearing age because lack of folate has been linked to vitamin B12 deficiency, epilepsy, lack of focus, trouble sleeping, and emotional instability.

• Steam kale for a few minutes, making sure not to overcook and denature the proteins, for a nutrition-packed side dish. • Shred into thin slices and eat raw in salads or as a garnish. • Sauté kale lightly with coconut oil, fresh garlic cloves, and some onions. •Blend kale with frozen pineapple, frozen strawberries, diced peaches, and coconut milk for a morning power smoothie.

Beware!

The health benefits of kale greatly depend on its source. Make sure to buy organic kale, as it is one of the most heavily pesticide-sprayed crops. Twothirds of produce sampled in recent evaluations were poisoned with pesticides, and non-organic kale ranks among the world’s most heavily polluted crops.

Fun in the Kitchen!

Kale Chips A great recipe for an on-thego, super-healthy snack. 1 bunch kale, chopped 1 Tbsp lemon juice 2 Tbsp coconut oil ¼ tsp sea salt

Preheat oven to 350 degrees. Chop kale into ½-inch pieces. Place all ingredients in a large bowl and massage the oil, lemon juice, and sea salt into the kale using your hands. Place on parchment-lined baking sheets and bake for 12 minutes.

Teves 5778 | The Wellspring 57

Living Well

Health Profile By Esther Steinmetz

RUCHAMA

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 Shaindy Dahan, nutritional counselor at the popular Nutrition by Tanya, offers for improved quality of life.

Age: 67 Location: Midwood, Brooklyn Weight: 186 lbs Height: 5’5” Marital Status: Married Kids: 7; over 30 grandchildren, ka”h

To be in the healthy range, you should aim toward weighing between 125-148 pounds.

Occupation: Full-time bubby; I help my daughter in her hosiery store

Favorite health food: Israeli salad

That’s great! To make this nutritious, use only pure spices, a squirt of lemon, and a little olive oil if needed.

Favorite junk food: Cinnamon babka

Favorite exercise: Swimming

Swimming is one of the best exercises as it works your entire body and burns calories too. You work your arms, legs, and even your core. My usual bedtime: 11:30

My usual wake-up time: 6:30

That’s great! You’re getting 7 hours of sleep.

My biggest meal on a usual day: Lunch. For years, dinner was my biggest meal, but now that we’re getting older, my husband prefers to go to sleep on a lighter stomach and he’s home during lunchtime so we eat our main meal then.

Very smart. Some people believe that breakfast should be the biggest but I like your way better. Breakfast is when we’re “warming up the engine,” so to speak, so too heavy isn’t good then.

58 The Wellspring | January 2018

The soups I usually make: vegetable split pea. Even the young grandchildren love it!

Recipe: Soak 1 lb. green split peas for one hour. Sauté onions, carrots, and celery. Add split peas, water, and spices and cook for about 2 hours.

Make sure you count that as either half or a whole starch as split peas have a higher starch content.

My usual dinner menu: Because lunch is our main meal, dinner is usually toast with salad and eggs or tuna. Very often, we have cheese blintzes too. Yes, I’m Hungarian! My weight loss saga: I was relatively thin all my years, but the pounds have really been sticking to me since we married off our youngest about 8 years ago. I’m watching my clothes get tighter and tighter and I’m feeling more uncomfortable over time. My daughters suggested that I have myself interviewed for this column as a good start. Greatest weight loss challenge: How do I lose weight in my age? I have swimming classes at the gym twice a week, but I’m so used to eating the foods that I’m eating. And how can I resist a slice of hot babka when it’s calling my name?

Where are you getting this babka? Are you baking or buying it? Can it be limited?

The time of year when I find it hardest to watch my weight: Yamim tovim. That’s when I whip up all the goodies I’m famous for!

The extent I’ve gone to implement a healthy lifestyle in my home: I’m from the old school. Only recently have we started eating whole wheat bread, but my husband still prefers his slice of rye.

One slice of rye is still better than 4 slices of whole wheat. Focus on portion size first before focusing on switching everything over.

What I do in my downtime: help my daughter in her store; say Tehillim.

One place I would love to visit: I have a friend in Australia whom I’d love to go see one day.

My weight/lifestyle goals: I think I’ll be happy with just 10 pounds down. I’m okay with not being thin; I just want to be more physically comfortable.

How I would treat myself if I get there: I can’t say a slice of babka, right?

You actually could! Earn it first and you'll enjoy it more then.

Shaindy Dahan 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.

Teves 5778 | The Wellspring 59

Living Well

At the Dietitian By Tamar Feldman, RDN, CDE

CROHN'S DISEASE:

CASE STUDY OF A NUTRITIONAL INTERVENTION FROM THE FILES OF THE GUT DIETITIAN PROFILE: Name: Aviva Age: 21 Aviva is a self-assured young woman, who was diagnosed with Crohn’s disease six months ago. She was started on a course of steroid treatment during her initial flare and had been weaned off the steroids two months prior. At our initial phone consult, she was on Pentasa, a relatively benign anti-inflammatory medication used on occasion for mild to moderate Crohn’s cases. Her symptoms were still not fully controlled, and her main complaints were abdominal pain and/or discomfort and loose stools with occasional urgency. Her doctors didn’t give her much guidance regarding diet,

and being a mature and thought-out individual, Aviva felt strongly that, contrary to the information she had been provided, diet had to have a causal effect in her Crohn’s disease. Her main concern was to reduce her current symptoms and to prevent a flare up of her condition, which would likely lead to pressure from her medical team to advance to stronger immunosuppressant medications. When she voiced the commonly-verbalized desire to “get off all the medications,” I explained, as I typically do at an initial visit, that this goal may not be attainable for all individuals. While I did not completely rule this out as an eventual option, we set an initial achievable goal of improved quality of life and reduced symptoms on her current regimen, and avoiding a progression to more advanced medications.

SESSION 1: Lifestyle: High achiever, studying for a health profession, involved in shidduchim. (Her mother, participating in our consult, voiced this as another motive in getting her Crohn’s under control.) Mom verified that while Aviva overall managed her stress well, she definitely placed a lot of internal pressure on herself in the process of achieving her goals. Stress can exacerbate most health conditions, including Crohn’s disease. In fact, I find that the majority of my GI clients are either “type A” personality, prone to anxiety, or are experiencing or have experienced severe or chronic stress due to outside circumstances. I discussed with Aviva the importance of learning and adopting healthy stress management and relaxation techniques. Food intolerances she was aware of: Raw fruits and vegetables, dairy foods, greasy foods, possibly wheat. Most individuals suffering from Crohn’s cannot tolerate the above mentioned foods well. Other commonly problematic foods for many individuals are nuts/seeds, fatty foods, acidic or spicy foods, alcohol, coffee, and high-fiber whole grains. Overall rating of her GI symptoms (on a scale of 1-10, 1 = perfect, 10 = awful): 6 Typical Diet: Breakfast: skipped, or a bag of dry cereal Snacks: white pretzels, crackers, applesauce

60 The Wellspring | January 2018

Lunch: sushi, rice cakes with tuna or egg, salad with avocado (problematic in large quantities but seemed to be ok in a smaller portion) Dinner: chicken, turkey, fish with rice or potatoes, veggie soup or cooked veggie Aviva appeared to be limiting her diet due to a fear of many foods and the desire to lead a functional life without exacerbating her Crohn’s. Aviva, her mom, and I discussed what dietary restrictions and/or testing she would be agreeable to try. Aviva was quite nervous about any intense intervention such as SCD or GAPS and wanted to start on a milder dietary regimen with supplements and see if she could still achieve success. Because she had already identified gluten and dairy to be triggers, we decided on a gluten-free and dairy-free diet, along with a supplement regimen and some functional medicine testing of her stool and blood to uncover any gut imbalances and nutritional issues. Session 1 recommendations: • Gluten-free and dairy-free diet. I provided Aviva with a customized meal plan and some helpful recipes. • Temporary elimination of raw fruits and vegetables, instead choosing cooked forms such as soups, compote, and applesauce. I permitted blended smoothies. • 3 day stool test conducted through a functional medicine lab I utilize, to evaluate all aspects of her digestion and

gut bacterial balance. • List of bloodwork request for her local doctor to run: Vitamin D, genetic methylation test and homocysteine levels, inflammatory markers, gluten antibody panel. Supplements: Aloe vera juice or capsules, L-Glutamine, Maxi Health’s Maxi Anti-Flame™ (containing curcumin), three types of probiotics containing a large variety of well-studied strains, Citrucel® fiber, zinc carnosine. Nutritional foods to include: Sauerkraut 1-2 Tbsp/day, bone broth 1 cup daily.

SESSION 2

(ONE MONTH LATER): Aviva had been following the diet religiously for one month. She had already seen an improvement in her symptoms, giving herself a 4 on the self assessment scale. Blood test results showed low Vitamin D, negative gluten antibodies, a genetic inability to methylate B vitamins with a borderline homocysteine level (linked to increased risk of many diseases,) and slightly elevated inflammatory markers. Stool tests showed a mild growth of a potentially pathogenic strain of bacteria, mild fat malabsorption, and elevated stool inflammatory markers. New Interventions: • Herbal antibiotic supplement morning and night for eight weeks to reduce levels of the harmful bacteria. I advised Aviva to take her probiotics separately midday. • Vitamin D 5000 IU/day, with monitoring of levels every three months. • Methylated B vitamins

SESSIONS 3-4 Aviva reported progressive and significant improvement, with session 3 spent mainly thinking up new food ideas. By session 4, she scaled her Crohn’s symptoms at a 2, and she had cut her medication dosage in half on her own. (I advised her to notify her doctor, which she was reluctant to do. Fortunately, he was agreeable as long as her condition was controlled.) She requested my approval to reintroduce salad and raw fruits, which I allowed in small quantities, increasing as tolerated. I requested that she re-test blood inflammatory markers and Vitamin D.

SESSION 5

(SIX MONTHS LATER): Aviva was including most raw fruits and vegetables, maintaining a 2 on her Crohn’s self-assessment scale, and was happy with her diet. We were thrilled that her inflammatory markers were in the normal range! Vitamin D supplementation to maintain her sufficient levels was advised indefinitely. Working with Aviva was a wonderful experience, demonstrating to me the effectiveness of functional medicine combined with a positive attitude and a strong will. While not all Crohn’s cases are fortunate to see complete improvement, most can see some degree of positive change from an integrative medicine approach.

Tamar Feldman, RDN, CDE is a Registered Dietitian/Nutritionist and a Certified Diabetes Educator with over ten years of experience. She maintains a busy nutrition practice in Lakewood and via phone/skype to numerous international clients, specializing in balanced and sustainable weight loss and nutrition therapy for autoimmune and gastrointestinal issues. She can be reached at 732-364-0064 or through her website: www.thegutdietitian.com

Teves 5778 | The Wellspring 61

Living Well

Monthly Dose By Yaakov Goodman, CN

TIME FOR DETOX

ONE OF THE MOST IMPORTANT SUPPLEMENTS YOU'VE LIKELY NEVER HEARD OF When it comes to a healthy liver and lungs, a robust immune system, and achieving optimal cholesterol levels, nothing quite compares to N-acetylcysteine (NAC). An important antioxidant that helps reduce free radical damage and plays a role in the detoxification of heavy metals and other harmful substances, NAC belongs to the same family as the sulfur-containing amino acid cysteine. Due to its unique properties and numerous benefits, NAC is used in

both conventional and alternative medicine. It can be found in every hospital emergency room as an antidote for acetaminophen (e.g., Tylenol) poisoning. Large doses of acetaminophen, or chronic use at lower dosages, can destroy the liver's ability to function, resulting in liver failure and fatality. NAC restores normal liver levels of glutathione and helps to heal the liver damage caused by acetaminophen. It is also used in conventional medicine to break down large amounts of mucus, a common symptom of conditions such as emphysema, bronchitis, pneumonia, and chronic obstructive pulmonary disease (COPD). Just as NAC protects the liver, it also

62 The Wellspring | January 2018

protects the kidneys, which play a key role in detoxification and blood pressure regulation. Doctors use a chemical called a “contrast agent” to make the kidneys more visible when taking medical images of patients. However, this chemical is hard on the kidneys and can result in “contrast-induced nephropathy,” which can sometimes lead to kidney failure. NAC has been found to reduce kidney-related toxicity from contrast agent, and it is also used to prevent kidney failure in some patients with chronic kidney impairment. However, the unfortunate truth is that most individuals have never heard of this highly-effective compound. Even many doctors remain unaware of its potential role as a frontline defense against some of today’s most deadly public health threats. Fortunately, renewed clinical interest in its broad-spectrum benefits is yielding fresh data on promising interventions for this safe, effective compound. In this article we will attempt to highlight some of its many benefits in achieving optimal health.

Healthy Glucose Levels Virtually all Americans consume too many calories and are at risk for at least some degree of insulin resistance. Studies show how daily supplementation with NAC helps to turn the tide.

Oxidative stress and inflammation are closely linked to insulin resistance and rising blood sugar levels. These effects are not limited to those with diabetes, but also non-diabetic people and those with metabolic syndrome. There are multiple steps in the sequence of events leading from oxidation to damaged insulin receptors and insulin resistance, so it makes sense to seek a supplement that can target many of those steps independently. NAC has emerged as a powerful defense. Over time, chronic high blood sugar initiates a downward spiral by helping generate advanced glycation end-products (AGEs) that then impair normal responses to insulin, perpetuating elevated sugar levels. NAC reverses those effects in laboratory models, increasing blood sugar levels in laboratory subjects. In an experiment that recreates a common human dietary trend, subjects were given a diet high in the sweetener fructose, which produced increased blood pressure, plasma insulin levels, and triglyceride levels. Yet all of these dangerous physiological alterations were inhibited by NAC. Human studies of NAC to improve insulin sensitivity have recently appeared, especially in a group of people typically very difficult to treat. Profound insulin resistance is seen in women with polycystic ovary syndrome (PCOS), along with a variety of other metabolic disturbances. One study showed that NAC encouraged normal ovulatory cycles and substantially improved insulin sensitivity in subjects. Another study showed that supplementing with NAC daily helped improve insulin sensitivity in women with PCOS.

Animal studies strengthen the case for NAC as a vital anti-cancer agent. NAC protects mice from cigarette smoke-induced lung cancers and other lung changes, a finding with enormous implications not only for current smokers but for ex-smokers and people exposed to second-hand smoke. NAC protects rats from chemically-induced liver cancers immediately following tumor initiation. This early interference with cancer development bodes well for NAC as a chemopreventive agent in the many human toxin-related cancers. Human studies are just as encouraging, even in the most challenging patient groups such as smokers. A randomized, double-blind chemoprevention trial of NAC 600 mg twice daily for 6 months vs. placebo in otherwise healthy smokers showed a significant reduction in formation of damaged or oxidized DNA segments, telltale early markers of cancer development in lung fluid. The same study also demonstrated reductions in abnormal, precancerous cell changes in the mouths of supplemented smokers. These effects support the scientists’ conclusion that NAC can reduce tobacco smoke carcinogenicity in humans. Colon cancer is another malignancy with strong links to oxidative stress and inflammation. Preliminary studies in humans show a 40% reduction in colorectal polyps in patients given 600 mg per day of NAC, compared with controls. In a group of people with a previous history of pre-cancerous colonic polyps, a daily supplement of NAC for 12 weeks significantly reduced the proliferative index, indicating a decreased risk of colon cancer. Supplementing with NAC appears to be an entirely appropriate means of adding to your general cancer-prevention strategy.

Lung Disease Chronic obstructive pulmonary disease, which includes chronic bronchitis and chronic emphysema, is a rapidly growing global issue. COPD is the result of oxidative damage to delicate lung tissue, resulting in chronic inflammatory changes. The disease is worsened by air pollution and cigarette smoking, but is by no means limited to people with those exposures. Over time, victims’ damaged airways may become colonized with dangerous bacteria, leading to chronic infection and still more inflammation, in a vicious cycle. Current treatment consists mainly of anti-inflammatory steroids and lung-opening medications used in asthma, with the addition of antibiotics when infection threatens. With its ability to reduce oxidative stress and simultaneously quash chronic inflammatory changes, NAC is emerging as a game-changing therapy in COPD. A randomized pilot study of adults with acute exacerbation of chronic bronchitis and positive bacterial culture in the sputum demonstrated that 600 mg of NAC twice daily led to a near doubling of the rate of bacterial eradication compared with standard therapy, while reducing the number and duration of acute exacerbations and improving quality of life. NAC treatment of patients with moderate-to-severe COPD improved their physical performance on lung function tests, especially after exercise. Patients with advanced COPD frequently require low-dose oxygen therapy because of their lung damage. In many cases, however, oxidative stress induced by the disease has already rendered them glutathione deficient, so they have diminished protection against ongoing oxidation. Supplementing with NAC daily powerfully counteracts this oxidative stress. In one study, it was shown to completely prevent further protein damage. In

another study, utilizing a dose of just 600 mg per day for 10 weeks aided in healing damaged lung tissue. Another devastating chronic lung condition called idiopathic pulmonary fibrosis (IPF) also involves increased oxidative burden and a deficiency of glutathione in lung tissue and fluids. This progressive disease has a poor prognosis, even when treated with standard corticosteroids and powerful prescription anti-inflammatory drugs. The median survival is only approximately three years, regardless of therapy. Oral NAC supplements now offer a ray of hope for IPF sufferers. NAC significantly increases lung glutathione levels in both animal and human studies of IPF. Given as an aerosol treatment, NAC may delay disease progression, and at doses of 600 mg three times daily preserves lung vital capacity and gas exchange better than standard therapy alone. In summary, evidence suggests that supplementing with a quality NAC formula offers benefits at doses for people who have, or are at risk for, chronic lung conditions such as COPD and IPF.

Maxi NAC Complex™ The formulators at Maxi Health realized it was imperative to create a NAC supplement to match the mountains of research behind this wonder nutrient. They have taken it to the next level with Maxi NAC Complex™. This supplement contains a 600 mg dose (the amount used in most of the clinical trials) of NAC, as well as the trace mineral selenium, with its powerful anti-cancer and longevity boosting properties; molybdenum, a nutrient essential for breaking down amino acids; and of course the all-important L-glutathione.

DUE TO ITS NUMEROUS BENEFITS, NAC IS USED IN BOTH CONVENTIONAL AND ALTERNATIVE MEDICINE. Teves 5778 | The Wellspring 63

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

Cancer Protection

Wellbeing

From the Ground Up By Goldy Guttman, MS. ED.

Taking Shape Understanding your child’s personality

From when your child is as young as 6-9 months old, you may begin to notice the emergence of his personality. Whether he is shy, outgoing, chilled, or more intense, your child will give you small clues as to who he will become as he grows older. What you do with this information does not change your child’s temperament; rather, it can assist your child to flourish and use his personality in a positive way. The following scenario offers a glimpse into the range of personalities present in children as young as two years old. It’s the first day at school at a daycare center. Chaim, the first child to enter, immediately grips Mommy’s leg and will not let go. He won’t remove his coat or hat and remains suspicious of his surroundings for quite a while. Meanwhile, Donni has entered the room with his Mommy, and without further ado, yells out “Truuuucks!!”, forgets his mother exists, and happily immerses himself in play. Suddenly, Moishy arrives, sees Donni playing with the trucks, barrels over, and grabs a truck, possibly knocking poor Donni over in the process. This scenario, which mothers the world over will certainly agree is typical, can present itself daily. The reason each child reacts differently to the same scenario is directly linked to his personality, or temperament. Here are some characteristics to take note of and ways to deal with them. As always, it’s important to note that many children fall in the range of “in between.”

64 The Wellspring | January 2018

Intensity of Reaction

Some kids are more intense, while others are what you can describe as mellow. Think about how your child reacts to situations—with a squeal, or with a shrug and smirk. For the Intense Child: • Have soft music and lighting. • Remove your child before it comes to an explosive situation— know his limits and signals. • Make sure he gets enough sleep. For the Low Key Child: • Play dynamic music, and use different voices while reading stories together. • Play games that involve taking turns, to keep the child engaged.

Tolerance for Frustration

Children with a high level of tolerance for frustration will keep on trying, even when unsuccessful. The child on the opposite end of the spectrum is more likely to give up. For the Persistent Child: • Be firm. He will have a hard time taking no as an answer, so redirect him to something he can do. • Play with your child. You can then teach him new skills, which he can greatly benefit from—since he will persist at them once taught! For the I-Give-Up Child: • An activity that seems impossible at one time can be left and revisited later—after a meal or a nap, when the child is content. • Help your child think on his own without doing the work for him, and give specific compliments on his progress. • Validate frustration through the process: “I know building the ___ is hard; it really makes you mad when it all topples over before you’re done.”

Response to Change and New People

Some children respond to change in an extremely strong, negative way. They can’t handle a change in a chicken recipe, much less a new school or new people. Other children take change in stride and revel in making new friends. For the No-Change Child: • Use familiar objects during a transition, even if that familiar object is you. Hold your child’s hand to show you are there for him. • Prepare your child in advance by talking about the upcoming change. • Give advance notice before a change: “In two minutes, we need to leave to Bubby’s house.” • Don’t label your child as shy. Labels can work against you, when a child uses that label as an excuse and just sticks with it. For the I’ll-Try-Anything Child: • Don’t think all change is automatically okay, since your child is so easygoing. Always be sensitive to any signals your child may be sending. • Spend one-on-one time together. Nothing is more precious to a child than having quality time with Mommy or Totty, even for the most outgoing child. • Give your child enough time to play on his own. Playing with others is great, but it is equally important for your child to be content in his own company. • Hopefully this article has helped you put the puzzle pieces together and understand your child’s characteristics. Each one of our children is wonderfully unique; temperament is neither chosen by the child nor something you can change. • Characteristics are not right or wrong, or better or worse. It is important for us as parents and educators to accept each child, and work to bring their best selves to the fore.

Goldy Guttman, Ms. Ed., is an ABA/SEIT therapist who holds a Master’s in Education and has been involved in early childhood intervention for almost a decade.

Teves 5778 | The Wellspring 65

Wellbeing

Health Personality By Yocheved Grossman

a cup of tea with: BETH WARREN, MS, RDN, CDN TITLE:

Registered Dietitian-Nutritionist

LOCATION:

New York City, Brooklyn, New Jersey, Virtual

SINCE: 2010 AGE: 33 PASSION:

Nutrition, health, and wellness

WISHES PEOPLE WOULD KNOW THAT:

nutrition is not about a short term quick fix. It’s a lifestyle-based approach that is meant to help all areas of your health, including mood, energy levels, and quality of life, not only weight.

WHAT MOTIVATED YOU TO ENTER THE FIELD OF NUTRITION? I became a dietitian for two main reasons. The first is that I love food, and the second is that I love helping people. When I was able to combine both passions, harnessing the power of food to enhance a person’s quality of life and improve their health, I knew it was the perfect fit. I also love dabbling in a lot of different creative areas: writing; physical activities, such as dance, boxing, and yoga; cooking; and public speaking, which are all areas I work into my profession.

cravings and cause you to overeat, and why focusing on whole-foods is essential. The second “F” is Food Rotation. A balanced eater must learn how to balance the various food groups to create cohesive meals and snacks. The third “F” is for Fitness. It’s important to learn how to incorporate exercise into your daily life so that it helps, and does not hurt, your weight loss efforts. Fun is the fourth “F.” Learn how to mindfully treat yourself and enjoy life more. And, of course, it’s also important to focus on time: to modify your eating schedule, regulating your times of eating so that they boost your metabolism.

IN A NUTSHELL, WHAT’S YOUR APPROACH TO NUTRITION?

WHAT DO YOU CONSIDER A NUTRITIONALLY-BALANCED MEAL?

I figured out how to incorporate the discipline and intuitive-eating techniques I was brought up with as a girl keeping kosher with a nutritionally-balanced whole-foods plan that curbed cravings and kept me full and satisfied while living my busy life. I use the same principles in my nutrition practice, BWN, with my clients of various backgrounds and ethnicities. I see how successful these principles are not only with weight loss, but with overall well-being: improved energy levels, mood, and quality of life.

WHAT DO YOU BELIEVE IS THE KEY COMPONENT IN WEIGHT LOSS?

My approach to weight loss can be summarized into our four “F’s”: The first is Food Choices. Learn which foods trigger

66 The Wellspring | January 2018

A nutritionally-balanced meal provides a load of fiber in the form of non-starchy vegetables and high quality carbohydrates, such as legumes, starchy vegetables, or whole grains, plus a source of lean protein, like fish, and a dollop of healthy fat, like a portion of avocado.

WHAT’S YOUR TAKE ON EXERCISE? HOW IMPORTANT IS IT?

Exercise is a proven way to maintain weight loss. The extent it helps with weight loss depends on the type and duration of the exercise, and when or what you are eating in order to both fuel and recover. People trying to lose weight need to be cautious of exercises that cause them to compensate by consuming added calories. For

example, shocking the body by prolonged cardio exercise over an hour or so may not be the best option if it is causing you to be hungrier later in the day. One method of exercise that is proven to burn fat is high intensity interval training (HIIT), or short bursts of activity followed by short active rests. I’m also a big fan of exercising in order to keep your mind at ease, due to the release of endorphins. Plus you will feel and look fitter, which in turn boosts your motivation to stick with a program.

WHICH SWEETENER DO YOU RECOMMEND?

There’s no easy answer when it comes to choosing an ideal sweetener. Ultimately, each type of sugar gets processed in the body in the same way. For example, glucose in candy and natural glucose undergo the same digestion process, as do fructose in fruit and fructose in high fructose corn syrup. When choosing a sweetener, I ultimately go for a natural variety, while taking into consideration the consistency of the recipe. I will use the sweetener that achieves these goals with the smallest amount. Ultimately, it is smart to limit or avoid any added sweeteners, as opposed to natural sugars like whole fruits, which also have the benefits of fiber and antioxidants. If you have to add a sweetener to foods, I would pick pure Stevia or Monk Fruit Extract. However, I train my clients not to rely on sweeteners for taste and instead enhance flavoring through herbs and spices, such as fresh mint and lemon. Not only does limiting sweeteners sensitize the palette when it comes to eating sweetened foods, it also curbs cravings and paves the way for bitter foods, such as vegetables, to taste better.

WHO WAS YOUR MOST MEMORABLE CLIENT?

It’s hard for me to pick only one memorable client, because each patient is memorable in some way. But one thing I love about BWN is how it works with families. I had the pleasure of working with three girls and their older sister, who accompanied them, and got to know them over three years. The youngest had Downs Syndrome and was eight years old, the second was in elementary school, and the oldest was in high school. They were the sweetest kids, who truly transformed their entire lifestyle, developed amazing habits, and succeeded in reaching a healthy weight. I keep in touch with them over the years, and I’m amazed at how healthy they are in both mind and body. These experiences show me how important it is to work

with the pediatric population, as well as the importance of developing a plan that accounts for both emotional and physical well-being.

HOW DOES YOUR WORK WITH CHILDREN DIFFER FROM YOUR WORK WITH ADULTS?

There are similarities and differences. I work in behavioral modification when it comes to both populations, which include learning hunger/fullness cues and nutrition education, which includes portion sizes and which foods fall into the various food groups. Whereas adults will follow a technical meal plan (with suggestions for substitutions), I typically guide my pediatric clients with a more flexible approach, based on maturity level and medical needs.

DO YOU BELIEVE THERE ARE WAYS FOR PEOPLE TO SPEED UP THEIR METABOLISM?

There are ways to boost the metabolism through diet and fitness.

WHAT ARE THEY?

Eating consistently throughout the day, about every three hours, is important. You can also incorporate fat-burning foods into the diet, such as healthy oils, in the form of avocado and nuts, albeit portion-controlled. You can work on boosting muscle mass and burning fat through specific exercise regimens that accelerate metabolism, such as HIIT (high intensity interval training). Keeping hydrated boosts the metabolism by 30% in and of itself.

WHAT’S YOUR TAKE ON EATING LATE AT NIGHT?

Although it’s the last thing people want to hear, there’s no way to respond to this affirmatively. Our bodies run on circadian rhythm. Whether you’re awake at night or not, you still should not eat late at night, because your body is processing food as if you’re sleeping (to put it simply). It’s a hard habit to break, but one of my first goals with clients who are having difficulty with late-night eating.

WOULD YOU LIKE TO TELL US ABOUT YOUR UPCOMING BOOK?

Secrets of a Kosher Girl integrates the principles of a kosher diet and lifestyle with proven weight-loss strategies emphasizing whole foods, or “clean eating.” This easy-tofollow 21-day diet and exercise plan results in an average loss of 6 to 11 pounds as well as improvements in mood, muscle mass, energy, and more, including cholesterol and blood sugar levels. I’m really proud of the book and put a lot of heart and soul into it.

WHAT ADVICE CAN YOU GIVE TO THE WELLSPRING READERS WHO WANT TO START LEADING A HEALTHY LIFESTYLE?

Start by setting a goal, not only a numbers one but with other factors, such as increasing your energy levels. Next, hold yourself accountable, by writing a food and mood diary for example, or creating a support group with friends. Finally, focus on consistency. It’s better to make small sustainable changes long term than taking on extreme measures that are short-lived and burn through muscle and water primarily. Beth can be contacted via The Wellspring.

Teves 5778 | The Wellspring 67

Wellbeing

Emotional Wellness By David H. Rosmarin, Ph.D., ABPP & Malky Berger, LMSW

When to End Our Daughterâ&#x20AC;&#x2122;s Therapy Our 12-year-old daughter has been in therapy for about one year. She began treatment at the recommendation of the school principal, who thought she was very angry and resentful. It was not an easy decision for us to follow, but we deferred to the principalâ&#x20AC;&#x2122;s judgment. At this point, our daughter is even more angry and resentful towards us. To make matters more complicated, she enjoys going to therapy, and her therapist has become the most important person in her life. We are concerned that her therapist might have a grip on her, and we are thinking about pulling her out of treatment. How should we handle this? What are our rights as parents? Can you help us navigate this situation? Sincerely, Concerned Parents

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First, it’s great that you put your daughter’s needs first and did what (seemed to be) best for her. You were willing to seek treatment for her even though it was hard for you, and that shows you are caring parents. You should be proud of the fact that you reached out for assistance; if only more parents would do the same, our community would be much stronger. At the same time, your situation seems complicated. Regretfully, the majority of therapists within our community are not adequately trained. Many are not even licensed, and some don’t have any formal education or experience in mental health service delivery. Each year, countless cases come through our doors after spending months, even years, involved in ineffective and sometimes improper treatments. So, in general, it’s not a bad thing to be skeptical about therapy and highly discerning when picking a provider. With that said, it’s possible that your daughter’s therapist is doing a good job. You simply have not provided enough information for us to determine what is going on regarding your daughter’s care. For example, it’s possible that your daughter loves going to therapy because she feels validated and emotionally cared for, and that she is not getting those needs met outside of therapy. It’s perfectly understandable that you feel uneasy that her therapist has become “the most important

person in her life,” but how and why did that happen? Furthermore, the therapeutic relationship is an important element to make any therapy work, so this could very well indicate that your daughter’s therapist is doing a good job. There are a few more things to consider. Is your daughter better off in any way than she was a year ago? Does she express herself better? Is she more open with you about how she feels? Does her principal see any difference? Has the stress level at home increased, such that the negativity you’re seeing is a function of environmental factors? Again, it could be that you are in good hands and things are moving along better than you think. With that said, it is concerning that your daughter seems more angry and resentful towards you than when she started therapy a full year ago. It’s not uncommon for negative emotions (including anger) to surface and become stronger during the first parts of therapy, but one of the main goals of treatment is to learn how to manage and deal with those emotions. So we would expect that over the course of weeks and months (not years) the intensity of your daughter’s anger would subside as she learns how to cope with it better. Given your daughter’s relatively young age, we would also expect that your therapist directly involve you in the process in any of the following ways: by bringing you into sessions from time-to-time, by

consulting with you on occasion to provide you with updates, or by recommending that you engage in therapy to learn how to better interact with your daughter. If one or more of these components is missing, then it’s time to have a frank discussion with your daughter’s therapist about the clinical approach being taken. One additional point to consider is that the most important person in your daughter’s life is not her therapist. Parents play a much more central role in the lives of their children than any therapist ever could. For this very reason, in our office, it is our practice to always involve parents in the therapy process of their kids. This is because the parent-child relationship plays a much more central role in the mental health of a child than the individual psychological life of the child. There is so much to do to help parents (with children of any age) forge closer connections with their children, engage in positive and meaningful parenting strategies, decrease negativity and invalidation in the home, and increase compliance and collaboration. A rich literature in clinical science is available for all who want to improve their relationships with their children— it’s only a matter of accessing that information and implementing it systematically and over time. Thank you for writing, All our best, Center for Anxiety

David H. Rosmarin, Ph.D., ABPP, is an Assistant Professor in the Department of Psychiatry at Harvard Medical School, part-time, and a board certified clinical psychologist. He also directs the Center for Anxiety, which has offices in Manhattan, Brooklyn, Monsey, and Boston. Malky Berger, LMSW, is a staff clinician at the Center for Anxiety’s Monsey office. She specializes in working with children, adolescents, and adults presenting with anxiety, depression, ADHD, and other mental health problems. She is also fluent in Yiddish. Readers may submit their questions on anxiety or any mental-health related topic to be answered by the columnists in the next Anxious to Know column. All identifying details will be changed. Questions can be submitted to info@wellspringmagazine.com. Subject line should be “Anxious to Know.”

Teves 5778 | The Wellspring 69

Wellbeing

Clean Slate By Shiffy Friedman, MSW, CNWC

EMOTIONS:

THE ULTIMATE CRAVING INDUCER

Every time I entertain the thought of terminating this column, thinking that we’ve covered all the ground, I’m sent what I see as a sign to keep this going. Once, it came in the form of my own emotional eating relapse. Another time, it was a letter from a reader who courageously shared her life saga and how the articles on emotional eating opened up her eyes to the subconscious impact her emotions were having on every aspect of her life. After the last column, it was the overwhelming response I received regarding the codependent factor. I’ve been inundated with questions, “How do you know what’s going on in my life?” comments, and requests for assistance from readers who’ve been stuck in the rut for way too long, those who’ve seen so many nutritionists that they’ve stopped keeping count, even those who’ve seen therapists only to find themselves enmeshed in a cycle that’s sapping every bit of strength out of them. And all emotional eaters want to know is how to finally leave it all behind, once and for all. I’m not here to refute the claim that cravings can be induced by food. As research reveals, certain foods have the ability to activate the secretion of the appetite-stimulating enzyme ghrelin. However, from my personal experience and the experience of my clients, I believe there’s no greater craving stimulator than emotions. Take those date chews my client, whom we’ll call Itta, snacked on this past Friday night as a case in point. There was absolutely no added sugar in those healthful balls made of nuts and dates only, and from a purely nutritional point of view, she was doing everything else right. As nutritionists

70 The Wellspring | January 2018

recommend, one of the ways to reduce the stimulation of ghrelin is to consume enough protein. Itta had just finished a meal that consisted of a full serving of protein, as well as vegetables and some grain. She wasn’t tired, another ghrelin-stimulating factor, and she’d done her regular exercise that morning. Oh, and she’s not ex-

The way codependence plays out in an emotional eater’s life is that food becomes an object the person is dependent upon in order to establish her sense of self. pecting. So why couldn’t she get her hand out of the date chew jar? Furthermore, why was her mind on the next one even before she’d finished the one in her mouth? From a theoretical perspective, the way codependence plays out in an emotional eater’s life is that food becomes an object the person is dependent upon in order to establish her sense of self. In the same way a codependent person who relies on other people to gauge his self-esteem desperately craves their positive feedback, the emotional eater is desperate for a fill of pleasure in order to escape uncomfortable emotions, usually triggered by the self-critic within. In Itta’s case, the meal had been particularly stressful not because the children didn’t stop fighting, but because of

what she kept telling herself as they did so—what an awful mother she was. According to Pia Mellody, the first step toward healing codependent behavior, which is often correlated to emotional eating, is to establish boundaries. I will take the liberty to emphasize that this is only a first step toward recovery if subsequent steps are taken, because if we stop at the boundaries we’re bound to fall back into the trap all too easily. How does establishing boundaries translate into the emotional eating arena? For starters, emotional eaters don’t do well with intuitive eating, at least until their self-regulating abilities are restored. After too many years of not listening to your body, it’s practically impossible to hear the real physical signals. Recovering emotional eaters, therefore, must stick to a healthful, balanced plan that provides them with the nutrients their body needs in order to function optimally. Boundaries also include only eating at meals and eliminating nutritionally-empty foods from the diet. But, as I mentioned earlier, boundaries are only effective if they’re step one. And if you’ve been following this column for a while, you know what comes next. If there would be another way to say, “Now comes the hard part,” dear reader, I’d use it. Inner work—to access the pain that you’re trying to escape through food, is hard, but it’s where true joy lies. 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.

AGE WELL ISSUE 24 JANUARY 2018 TEVES 5778

The Big Idea:

Battling Obesity in Seniors GOLDEN PAGE TREATING ARTHRITIS NATURALLY

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Golden Page By Yaakov Goodman, CN

OIL THOSE JOINTS Arthritis prevention

For the 52 million Americans suffering from arthritis, everyday tasks can be an uphill struggle. Many conventional doctors now consider this debilitating condition to be progressive and incurable. Research, however, points to promising answers in the form of natural treatments and lifestyle changes. Human joints are perfectly designed to allow for smooth movement of the bones on both sides of the joint space. To do that, the joints are lined with a smooth, glistening substance called cartilage, which acts as both a lubricant and a shock-absorber. Cartilage is composed of a variety of biomolecules and proteins, water, and small molecules that help reduce friction and keep joints healthy. The protein called collagen makes up the bulk of the cartilage in your joints. Osteoarthritis and rheumatoid arthritis both involve destruction and loss of integrity of invaluable cartilage in your joint surfaces. Osteoarthritis was long thought to be a consequence of simple “wear and tear” on joints, and largely inevitable. Rheumatoid arthritis, on the other hand, was recognized as an inflammatory autoimmune disease that arises when the body mistakenly attacks its own tissues, in this case the joint linings and cartilage. For those suffering with joint aches, the winter weather brings more flare-ups. Young, healthy joints bear up well under that punishment, but with ad-

vancing age we gradually lose function. Tiny traumas, unnoticeable to a young person, gradually wear away at the smooth cartilage surface, eventually exposing collagen to immune system cells. Despite the fact that over half of all prescriptions for non-steroidal anti-inflammatory drugs, such as ibuprofen are written for arthritis, these drugs do nothing more than transiently blunt the pain; they have no long-term impact on the disease itself. In addition to this, alarming studies documenting the potentially deadly side effects of prescription anti-arthritis drugs have forced many to relinquish these medications. The result has been a frantic scramble among scientists and arthritis sufferers alike to find safe, effective agents that reduce inflammation and relieve arthritis pain. Researchers at Harvard Beth Israel Hospital in Boston have studied collagen supplementation extensively in patients with arthritis. In one study of 60 patients with active rheumatoid arthritis, a major decrease in the number of swollen and tender joints was found in subjects who supplemented with collagen for 3 months, but not in placebo recipients. Still more remarkably, 19% of those patients supplementing achieved complete remission of the disease, an unusual finding for any form of treatment. Similar results were obtained in a much larger trial of 274 patients with active rheumatoid arthritis. Collagen works like a shock absorbing agent for the joints. When collagen levels are compromised, the shock absorbing factor disappears and pain follows. One of the most essential tasks in the support of failing joints is rebuilding the essential lost collagen that cushions them. Maxi Health’s Maxi Collagen H.A.™ has been created to do just that. It is the first kosher collagen on the market, formulated together with hyaluronic acid, an essential joint lubricant. Not only helpful for the joints, Maxi Collagen H.A.™ assists in maintaining good skin elasticity and a youthful complexion. This supplement is not intended to replace drugs when necessary. If you have concerns about supplementing please check with your health care practitioner.

Teves 5778 | The Wellspring 73

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.

Obesity: What's the Big Idea? Obesity, especially among children, remains among the hottest health topics nowadays. The Obama administration went so far as to deem it an epidemic. But as you age, your metabolism slows—meaning that some people who have never had to watch their weight and eating habits before, now have to do so.

much body fat, not mass or weight, you have. In other words, you could be imposing, burly, or otherwise sizable— but not be carrying too much excess, unhealthy, and unneeded body fat. On the other hand, you could be relatively small but be carrying a proportion of body fat that is well beyond healthy: obese.

In other words, obesity can be a health issue for seniors, too. So let’s talk a bit about it.

So the problem is not size. The problem is what too much body fat can cause. Symptoms and side effects of obesity can include asthma, cancer, and depression—never mind high cholesterol and heart disease.

What is obesity? Obesity is defined as excess body fat. Because body fat is difficult to measure directly, obesity is often measured by Body Mass Index (BMI). This is a common scientific way to screen whether a person is underweight, normal weight, overweight, or obese. For adults, here’s how BMI works: Underweight is 18.4 and lower. Normal is between 18.5 and 24.9. Overweight is 25.0 to 29.9. Obese is 30.0 and up. If you have too much body fat, as determined by your BMI number, you are “obese.” There is a critical difference between being overweight and obese. “Overweight” just means weighing too much—which could mean having too much muscle, bone, fat and/or body water. “Obese” specifically means having too much body fat.

What's wrong with being obese? Physical size does not necessarily mean you’re obese. The primary symptom here is how

74 The Wellspring | January 2018

The bottom line is that obesity lowers

The problem is not size. The problem is what too much body fat can cause. your overall quality of life, hindering or preventing you from participating in family activities. Why suffer? See your doctor instead, and get started on the road towards a healthy level of body fat.

How do I treat obesity? Obesity is the result of eating too much and not getting enough physical activity. The true cause of that is, in turn, whatever is causing you to eat too much and not get enough physical activity.

So, what that means is that to treat the symptom called obesity, you’ve got to treat and reverse the cause(s) behind obesity. You may think it’s obvious that the primary treatment for obesity is “losing weight” or “dieting,” but it’s not that simple. You didn’t get obese overnight, and treatment won’t take place overnight, either. To treat obesity, you’ve got to look at the big picture: The person’s eating and exercise habits, family situation, health in the community, and peer pressure. You have to change your lifestyle—your whole way of thinking, behaving, and living. Discouraged? Don’t be! You can do this! It may seem difficult to tackle obesity, since people have emotional and underlying issues when it comes to weight, especially in today’s society where expectations are so high and unrealistic. However, even if you feel that the end result seems so distant and difficult to achieve, every healthy step you take should be applauded. This starts with your own self-praise. One step at a time, one healthy decision at a time,

one day at a time, reversing obesity is possible.

Make exercise fun! Don’t just adopt a daily exercise routine—adopt a daily exercise routine that’s fun! Take a daily walk with a friend or grandchild. As you get better at it, make it longer and/or add more exercises to it. Your doctor will advise you on what to start with.

Weight loss Weight loss isn’t just about what you eat—it’s when you eat it. Quit noshing and stick to eating three solid, healthy meals a day. Besides being better for you, you’ll reinstate the family meal,

too. Slow and steady weight loss each week over the long term is considered the safest way to lose weight and the best way to keep it off permanently. Avoid drastic and unrealistic diet changes. Fruits, vegetables, and whole grains Eating more of these foods give you more “munching satisfaction,” so you can feel full and satisfied on larger portion sizes with less calories.

Summary By and large (no pun intended), obesity is a symptom of an increasingly ailing and dysfunctional society in which material affluence and

abundance—at least according to one study—actually increases unhappiness, not cures it. And while many of us have eaten ourselves into a corner, the good news is that we can adopt healthy lifestyle habits to get out of that corner. Here’s what works: • Drastically reduce (or better yet, eliminate) usage of home electronics and media • Eat daily family meals (and healthy ones) together, not at fast-food restaurants. • Turn daily exercise or physical activity into bonding time with friends and family. By taking positive steps to counteract obesity, you will get to where you should be.

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.

Teves 5778 | The Wellspring 75

Age Well

Sage Advice by Aliza Simon

OUNCE OF PREVENTION Vital tests for seniors

A wide range of screening and preventive measures are available and recommended for people over the age of 65. These guidelines follow the recommendations by the U.S. Preventive Services Task Force (USPSTF) and the Centers for Disease Control and Prevention (CDC) and are based on extensive clinical data.

The following are some of the important preventive and screening measures for seniors: • Influenza vaccination • Pneumonia vaccination • Vaccination against shingles (60 and older; some doctors recommend starting at age 50) • Colon cancer screening for adults between ages 50 and 75 (younger starting age in high risk groups) • Breast cancer screening, with yearly mammogram for females between 40 and 75 (younger starting age for high risk groups) • Prostate cancer screening, with annual rectal exam and PSA (prostate-sensitive antigen) in males above age 50 • Osteoporosis screening, with bone density scan in women above age of 65 • Lipid disorder screening yearly for men above 35 and women above 45 • Diabetes screening in people with high blood pressure, high cholesterol, obesity, or previous high blood sugar levels, with or without symptoms of diabetes • Blood pressure screening at least once a year

Although these are general health maintenance guidelines, primary care doctors may draft an individualized plan for each person based on their personal history. Many of these tests are recommended to be performed periodically. As people get older, the benefits of detecting certain diseases may diminish, obviating the need for further screening. Accordingly, the patient’s primary physician may help guide patients with their decisions regarding recommended health screening tests. Sometimes the possible risks associated with certain tests may outweigh the potential benefits. Therefore, there are times when the right decision for an individual is to not have further testing for certain conditions.

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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.

METHYL FOLATE LOZENGES™ Related to Nutrition Facts pg. 56 Kale is a great source of folic acid, but you’d have to consume a hefty amount of it to ensure that you’re getting the recommended daily value. Especially for women in their childbearing years, this nutrient is crucial for baby’s neural tube development. To ensure that you’re getting your daily fill, invest in a bottle of Methyl Folate Lozenges™, which is made of the most bio-available form of folic acid. Research has shown that no other folic acid is absorbed by the body as effectively.

MAXI OMEGA-3 CONCENTRATE™ Related to Updates pg. 18 You know stress isn’t good for the heart, and in this issue’s “Updates,” you’ve read that sitting excessively isn’t good either. In addition to improving your lifestyle for a healthier heart, why not take a daily dose of Maxi Omega-3 Concentrate™, which has been proven to improve and maintain heart health.

MAXI TURMERIC BCM-95™ Related to Cover Feature pg. 34 One of 2017’s health fads was using spices for healing, but you don’t have to season your chicken with turmeric to get the host of health benefits this spice offers. Plus, you can’t possibly sprinkle enough to get the mega-dose that Maxi Turmeric BCM-95™ contains. Curcumin, turmeric’s active ingredient, is a natural anti-inflammatory and supports a healthy heart, brain, and immune function.

MAXI G-C COMPLEX™ (GARCINIA CAMBOGIA) Related to Ask the Nutritionist pg. 30 When you get your calories from nutritious foods, you’re not only enabling weight loss but also ensuring satiation. But if you still find that you’re hungry despite consuming a recommended diet, Maxi G-C Complex™ can help with curbing your cravings and keeping you feeling full. Made with ChromeMate® brand chromium, it’ll give you the results you’re looking for.

MAXI NAC COMPLEX™ Related to Monthly Dose pg. 64 As you’ve read in this issue’s “Monthly Dose,” Maxi NAC Complex™ does more than support liver health. When it comes to a healthy liver and lungs, a robust immune system, and achieving optimal cholesterol levels, nothing quite compares to N-Acetyl Cysteine (NAC). This supplement contains a 600 mg dose (the amount used in most of the clinical trials) of NAC, as well as the trace mineral selenium, with its powerful anti-cancer and longevity boosting properties; molybdenum, a nutrient essential for breaking down amino acids; and of course the all-important L-glutathione.

MAXI OMEGA-3™ JOINT FORMULA Related to Health Platform pg. 14 As recommended by Rabbi Hirsch Meisels, Maxi Omega-3™ Joint Formula contains just the right combination of nutrients to oil your joints and aid in mobility, especially for those suffering from arthritis.

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

Diary By Riva G.

Good as New

Skin conditions run in our family. I don’t know how many generations have been suffering (the black and white pictures in the albums don't show any skin imperfections), but my siblings and their children have been visiting dermatologists on a regular basis. The specialists differ in opinion if the diagnosis is psoriasis, eczema, or dermatitis, but it all boils down to the same symptoms of itching and scratching, and skin that seems to be attracted to infection. Of course, we’ve tried every trick in the book. You name it, and I bet we did it. During the time that I nursed my baby, my diet consisted of ground chicken and rice cakes. Citrus was not allowed, nightshades were terrible, as were chocolate, cake, and sugar, which caused yeast and fungus. Because the doctor was unsure about milk and eggs, he first advised me to stay off them. The one silver lining of this ridiculous situation was that I was thinner than I was at my wedding. Still, I was nervous, angry, and above all my baby’s skin looked just as bad as it did when I was still enjoying a meal. Blistery, peeling dry, and bleeding, it bothered him to the core. I could not stand to watch him writhe in pain, and Benadryl® became his daily consolation. In my phone conversations with friends and family, my baby’s skin condition was always in the opening statements. What else could be on my mind? In one of those

many conversations, a friend recommended that I contact a kinesiologist who she said might be able to help. I was wary and disinterested. But then my baby got MRSA as a result of the constant scratching of open wounds. I was so frightened of what would happen next that I reached out to this natural therapist. In our initial conversation, I told the kinesiologist every detail of my baby’s history. After she listened to me list all my diet failures, she explained that my baby’s digestive system was probably not up to par. Her first move was to start him on Maxi Health’s KiddieMax Liquid B-Complex™ and Digest to the Max™ (she advised that I empty the capsule and use a small part of the powder). As for myself, I was to take Maxi Health’s Liquid B-50 Complex™, which supports healthy digestion, and Digest Support™. I was also to follow a diet of spelt and some other gluten-free foods, as well as some dairy and selected fruits and vegetables. The miracle did not happen overnight. Over a period of three months, though, my baby’s skin was brand new. Perhaps the greatest gift of all, though, is that he doesn’t have the tense mother he had just a short while ago. With my new diet and his beautiful skin, our home is now a calm and peaceful place.

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.

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

Inkwell

Farewell

Health Ed By Judy Lieber, CNC

Probiotics 101

Here’s a fact you may find appalling: the bacteria in your body outnumber your body’s cells 10 to 1. But, there’s no need to panic. The good news is that most bacteria are harmless. Filling your gut with the right bacteria is key to solid health, including weight loss, improved digestion, enhanced immune function, better skin, and a reduced risk of many diseases. That’s where probiotics come into the picture.

True or false: Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Answer: True. These friendly bacteria are hard at work to keep you healthy from inside out. Studies have shown that when the bacteria level in your gut is balanced, not only is your physical health improved, but your mental and emotional wellbeing is, as well. One 2013 study in Gastroenterology found that when healthy women ate 125 grams of yogurt, which contains mega-doses of probiotics, twice daily for four weeks, their brain scans showed a less intense response when exposed to negative images.

The three general types of microorganisms in your body are: A. Bacteria, yeast, and viruses B. Bacteria, yeast, and flora C. Yeast, viruses, and flora D. Viruses, flora, and bacteria

Answer: A. While the gut contains hundreds of different microorganisms, with some numbers as high as 1,000, the great majority is bacteria. Flora is the type of bacteria in the gut that helps neutralize some of the toxic by-products of digestion, reduce harmful substances, and combat harmful bacteria and yeasts.

True or false: All probiotics operate in the same way.

Answer: False. Different species of probiotics target different health conditions. Therefore, choosing the right type of probiotic is essential. Thankfully, most probiotic supplements combine different species in order to target various conditions simultaneously. It may be helpful to take an iron supplement.

Which of these is an effective means to reset your gut bacteria?

A. Consume food-based probiotics like yogurt, kefir, and fermented foods B. Take a multi-probiotic supplement C. Avoid fatty foods D. Control your stress E. All of the above

Answer: E. The good bacteria found in fermented foods and supplements bolster the number of friendly bacteria in the gut. According to studies on mice, dietary fats can damage the gut lining, allowing undesirable chemicals released by bacteria to leak into the bloodstream and inflame the tissues surrounding it. And some fats raise the population of unfriendly bacteria in the gut. Stress, too, may change the makeup of your gut flora. A 2011 Brain, Behavior, and Immunity study reported that stressedout mice experienced a plunge in beneficial bacteria and an increase in inflammatory chemicals in the blood serum. For the good of your gut, and your health, make sure to incorporate all four means into your life.

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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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