Wellspring Issue #35 by The Wellspring

CONFERENCE WITH ZEV JURAVEL OF EXERTIQUE EXERCISE BOUTIQUE IN MONSEY, NEW YORK

UNTANGLING THE TRUTH ABOUT TONGUE-TIE This may be the reason your child can't suck, eat, or speak properly. Misconceptions that even medical practitioners have of this common but often overlooked condition

CUP OF TEA with nutritherapist Gitta Bixenspanner

RAISING EMOTIONALLY HEALTHY CHILDREN The one thing parents should know

10 QUESTIONS for Shevy Kahan & Pessie Schlafrig of Chaim Medical Resource

TAMAR FELDMAN'S TOP 10 Weight Loss Tips

ISSUE 35 JANUARY 2019 TEVES 5779

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WINTER COMFORT FOODS WARM UP WITH ROOT VEGETABLE POT PIE, WILD RICE SOUP, AND OTHER GOOD STUFF

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By: Reizy Itzkowitz

Dietary restrictions are a thing of the past with Mehadrin’s new PARVE line! Whether you’re lactose intolerant or just ate chicken, you can still savor the joys of milchig foods. Now, if your kids are allergic to milk, they can still get the same treats as their siblings. Chalk one up for fairness! Packaged in a family-pack of four 4-oz cups, this 100-calorie treat is a perfect snack for on-the-go or as an addition to your kids’ lunchboxes. The great thing is that the dairy-free chocolate pudding comes in real handy for a late-night craving as well. It really tastes awesome. Rich and flavorful and oh-so-smooth! The butterscotch and vanilla are a light, warm option that you can feel good about serving your kiddies and are the ideal comfort food at any age! I say that as the samples on my desk are slowly diminishing, one little 4-oz container at a time. The most amazing thing about this line is that they are completely soy-free, so I am really enjoying the taste. The butter beans and oats seem to be a better tasting combination that is really similar to a milk-based pudding that I can clearly taste my ‘Mehadrin chocolate pudding’ and it’s not a tease at all! It has the same thickness I love, which is really not common with any non-dairy product I’ve ever tasted before, and definitely better than any I can stir up for my lactose-intolerant kids. A closer look at the ingredients of coconut oil makes me feel validated as close readers may remember that I love everything coconut and I guess although I can’t really taste the coconut, it somehow helps me really enjoy the flavoring of this unique product. I can’t wait to check out Mehadrin’s full line of PARVE products that are the perfect accompaniment to a filling sandwich and are completely dairy-free. The butter and cream cheese spreads all are great options. You can serve milchigs with your lactose intolerant child getting the same butter or cream cheese sandwich as everyone else albeit in parve! You can now offer a late afternoon sandwich worry-free on the fleishig tablecloth since ‘supper is almost ready’!

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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 Find our products in Health Food Stores near you. Or Call: 718-709-6525 Email: releafhealing@gmail.com

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From the Editor

Dear Readers, Over a year has elapsed from when The Wellspring first made contact with Shevy Kahan until her interview in our pages has finally seen the light of day. In our quest to make this article happen, we learned that Shevy is the kind of woman who’s almost impossible to reach—unless you’re in a medical crisis. When I finally got to speak with Shevy, I detected a tiredness in her voice that exposed her secret even before she shared it with me: this woman barely sleeps. “It’s been a rough night,” she confided. “Even if we have someone covering the nighttime emergencies, when cases get very complex, I end up getting involved.” Shevy Kahan is the unassuming powerhouse behind Chaim Medical Resource, a medical referral organization that she founded in memory of her dear son Chaim, who succumbed to cancer approximately a decade ago. Shevy emerged from her painful five-year plunge into the medical arena as a bereaved parent, but also as an empowered Jew. From her experiences as a mother who was prepared to traverse the length and breadth of the globe to save her child, Shevy understands what it means not to leave a stone unturned in finding a cure for a loved one. Her example of spending endless hours on research and contacting professionals in all corners of the globe in her quest for hope became the model for Chaim Medical Resource. In addition to taking a range of 400 calls per day, Shevy and her team spend hours upon hours poring over clinical trials and dealing with medical teams to bring together the puzzle pieces so that another desperate Yid can grasp a thread of hope. In their commitment to help, Shevy and her team exhaust every possibility and weigh the best options to guide each patient toward a healthy future. As patient advocates, they effectively cut through the bureaucracy of the medical community, reaching the field’s most respected physicians and gaining sought-after appointments. There’s a reason people turn to Shevy, her co-director Pessie Schlafrig, and her dedicated medical research team, and that is the reason they keep doing what they’re doing. As a health magazine, The Wellspring often cites studies in varied areas of health. In this issue alone, we bring you trials that tested the presence of bacteria in stethoscopes, the antioxidant content in tomatoes, and the potency of ginger’s anti-inflammatory properties, just to name a few. But in these pages we also find studies of a different kind, that take a good look at way more valued specimens, zooming in on members of our community who essentially represent all of us, who reflect the goodness of our hearts and our deep desire to help one another. We find Shevy and Pessie, two women whose demarcation between night and day completely disintegrates in their quest to help another Jew. We find Racheli, a young mother who reached out to us, begging us to feature her children’s tongue-tie saga so she could help fellow mothers who are still in the dark regarding this condition. We find Mr. Zev Juravel, who understood the need for an exercise studio in Monsey, New York, that would finally cater to the discerning frum exercisers who refuse to give up on their standards to lead a healthy lifestyle. Each in their own way, these individuals are prototypes of a nation of givers. Providing them a platform at The Wellspring is the least we can do in return. May we always be on the giving end, to be there for our fellow Jews in any way we can, and may the day soon arrive when every member of Am Yisrael will be cured forever.

Shiffy Friedman

shiffy@wellspringmagazine.com

Well-Put!

“Not only do cells need carbohydrates, but the brain is entirely dependent on carbs for energy. Carbs help maintain blood glucose during exercise and restore muscle glycogen during rest and recovery from exercise,” says nutritherapist Gitta Bixenspanner. Read more about her take on nutrition in this issue’s Cup of Tea on page 68.

Teves 5779 | The Wellspring 7

Contents

JANUARY 2019 - TEVES 5779 WELL INFORMED TORAH WELLSPRING By Rabbi Ezra Friedman WELLNESS PLATFORM By Rabbi Hirsch Meisels SECRETS OF A KOSHER DIETITIAN By Beth Warren, RDN HEALTH UPDATES IN THE NEWS By Rikki Samson

12 14 16 18

FIGURES By Miriam Katz

HEALTH ED Hydration is Key By Laurah Shammah, MS, RDN

DEDICATED TO HEALTH Chaim Medical Resource By Shiffy Friedman

WEALTH OF HEALTH Conference with Zev Juravel By Sarah Weinberger

LIVING WELL ASK THE NUTRITIONIST Does Sequence Matter? By Shani Taub, CDC IN GOOD SHAPE Fitness for Seniors By Syma Kranz, PFC COVER FEATURE The Truth about Tongue-Tie By Shiffy Friedman AT THE DIETITIAN Top 10 Weight Loss Tips By Tamar Feldman, RDN, CDE MONTHLY DOSE Black Cumin Seed By Yaakov Goodman HEALTH PROFILE Client: Yael By Rachel Esses 8 The Wellspring | January 2019

30 32 34 62 64 66

ISSUE #35 EAT WELL

43 53

SEASONED By Yossi & Malky Levine FRESH. By Rivki Rabinowitz

TIDBITS IN THE NEWS By Liba Solomon, CNWC

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

WELLBEING

67 68 70 73 74

EMOTIONAL WELLNESS Functional Anger By Esther Moskovitz, LCSW HEALTH PERSONALITY Gitta Bixenspanner By Shiffy Friedman CHILD DEVELOPMENT The Socially Awkward Child Friedy Singer & Roizy Guttman, OTR/L CLEAN SLATE Taking Responsibility By Shiffy Friedman SERIAL DIARY Entry #4 By Zahava List

AGE WELL

GOLDEN PAGE Magnesium By Yaakov Goodman

INKWELL FROM A KINESIOLOGIST 78 MEMOS By Miriam Schweid The next issue of The Wellspring will appear iy”H on January 23rd.

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Springboard

Letters

Trans Fat in Meat? [Issue #33: Figures]

I think some of the information in the past issue’s Figures was wrong. The article stated that a rib-eye steak contains 1.5 grams of trans fat, but trans fat can’t be found naturally in food. According to the USDA, it’s a type of fat that is found only in hydrogenated oil, which is found only in commercially-produced foods, not even when one fries in their own home. Miriam Katz responds: You’re right that trans fats are usually not found naturally in foods, but meat is the one exception—according to the USDA.

Suri’s Saga

[Issue #32: Springboard] I am writing this letter so others can benefit from my story and to thank Miriam Schweid for her concern and great advice. When the number of my daughter’s school flashed on the caller ID, I rushed to answer the phone. I didn’t remember seeing a snack or homework lying around the house which would warrant one of my children calling an hour after they boarded the bus. It was, however, the school secretary on the line, saying that the principal wanted to speak with me about my third-grade daughter Suri. All my girls attend the same school. I’m a part-time substitute, my husband is on the board of directors, and the principal is an old school friend. With such a long-standing relationship, I was apprehensive, to put it mildly. The principal forthrightly told me that Suri was unable to learn, sit, or participate in class. She had been handling the situation herself since September, but now she felt it was for the child’s benefit

10 The Wellspring | January 2019

that I become involved. To my great surprise, the teacher wanted Suri out of the classroom, the principal told me, since she was disturbing the other students. She recommended Suri and I see a psychologist, as well as Suri’s pediatrician, and she suggested I strongly consider giving Suri Ritalin. I felt this was all too harsh for a nineyear-old. My other girls were good students, assets to the school. Suri had her own unique traits. Did all siblings have to fit the same mold? The principal listened kindly as I vented my feelings, but I went home confused and upset. Where had I gone wrong? What was the right step to take? My husband listened patiently, as we assessed the situation together. He told me he had read something about brain exercise in The Wellspring and advised me to get in touch with Miriam Schweid, saying he would get her number from the editor. Miriam listened to the story and made it sound like she hears similar scenarios frequently. She advised me to start my daughter on Maxi Health’s Maxi ITC™, a supplement that promotes focus and relaxation, as well as to engage in brain gym exercises. She reassured me the supplement is not addictive and that I would soon see improvement, and meanwhile we could decide which further action to take. Baruch Hashem, no further action is necessary. Thank you, M. L. Lakewood, New Jersey

Thanking Was My Lifeline

[Issue #34: Cover Feature]

As an avid reader of your magazine, I look forward to your monthly take on health and wellbeing as it pertains to our community. There are plenty of resources in the secular world, but you fill an important niche in discussions about health issues from the Torah perspective. This was especially clear in last issue’s feature, where you wrote about

medical miracles from such an inspirational, thought-provoking perspective. I understand that this is a health magazine, which is why you didn’t launch into a general conversation about how thanking Hashem generates miracles in all areas, not only health, but I would like to add how instituting this practice has helped me in my personal life. At a time when I was experiencing excruciating challenges related to chinuch, a mentor suggested I spend a few minutes a day focusing on what I was grateful for in my life. The journals I filled during those months were literally my lifeline. I look back at them today, when things have Baruch Hashem settled in ways I could have never imagined, and I marvel how the perspective of gratitude saved me during those trying times. It gave me the strength to wake up every morning, to continue taking care of the rest of my family, and to smile. It allowed me to be a positive presence to myself and others, even when external circumstances appeared so bleak. I highly recommend this practice. In the merit of providing guidance not only related to physical health, but also in the area of mental, emotional, and spiritual health, may you have much continued success! With appreciation, Batsheva M.

What I Learned from My Children [Issue #34: Cover Feature]

I would like to commend you on a publication that is well written, highly informative, and covers all areas of health in every single issue. I’m amazed every time how you do this again and again, always providing content that is so applicable to my life. Honestly, when I read about teaching children how to thank Hashem, I thought it was a bit cumbersome. I liked the idea of making them aware that people are only the messengers, but why make kids thank twice for everything they get? But, to my good fortune, my husband ended up reading the Cha-

invites readers to submit letters and comments via regular mail or email to info@wellspringmagazine.com. 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.

nukah issue, and he was intrigued by the idea. We discussed it, and he said, “Why not? What can we lose by trying?” Our kids loved the idea. Their eyes are literally shining when they keep reminding each other to thank both Hashem and the messenger for everything they get. Looking at these innocent children goes to show how much all of us need that Divine connection, and how much joy it brings. Children are simply more open to expressing it. Thanks so much for bringing this to my attention! With gratitude to you, Hashem’s messengers, L. Hasenfeld

Paying Attention

[Issue #34: Child Development] As the mother of six children who are Baruch Hashem developing as they should, I generally read The Wellspring

cover to cover, skipping over the child development section. For some reason, I was under the impression that the column is geared toward parents whose children exhibit developmental issues. In this past issue, however, the pullquote in the column caught my attention: “Many of a child’s actions that seem like a nuisance, such as when he throws things off the high chair again and again, are valuable learning moments.” Wow! I had never thought of these annoying behaviors as valuable. Intrigued, I read the article in its entirety—and it didn’t disappoint. The column gave me an entirely new perspective on aspects of development I had never thought about before. Now, every time I see my baby unpacking the cabinets again, I pat myself on the back for giving him the opportunity to develop the systems that I hadn’t realized are so related to movement. Thank you, Freidy and Roizy, for sharing such valuable information with us. I

look forward to reading your future installments! Yehudis R. Wesley Hills, New York.

Recipe Review [Seasoned]

The Wellspring is getting better by the month. I look forward to reading it every time! I would like to compliment Yossi & Malky Levine for the excellent and healthy recipes they come up with in every issue. The photos are gorgeous, and any recipe I ever tried turned out to be delicious, which is quite unusual for foods that call for nutritious ingredients. I also appreciate that the ingredients are easy to obtain and are available in most supermarkets. Their props and dishes make for beautiful serving suggestions. Keep up your artistic work and original designs! Sarala P.

Public Service Announcement Have you or someone you know experienced an episode that resulted in a greater awareness concerning a particular health matter? If you would like us to publish it as a service to The Wellspring readers, please send it our way. Anonymity is guaranteed.

Swallow With Water I recently saw a news report about an 18-month-old baby, who was taken into the hospital after swallowing his pacifier in his sleep. When the child’s caretaker heard his short breaths and snorting, she immediately called for help. Thankfully, the medical team saved the child’s life through a delicate and complex procedure. It turned out that the pacifier had slid down deep into the baby’s throat and esophagus, which could have easily led to suffocation. Although this story sounds very strange, it spurred me to share my own incident as a public service announcement to The Wellspring readers. Two years ago, a similar story happened to my own baby, who was about seven

months old at the time. She had become attached to her newborn-sized pacifier, and I thus hadn’t considered getting her the new size. One day, I heard interesting sounds coming from her bedroom, where she was napping. When I came into the room, I saw that the pacifier had slipped into her mouth and she couldn’t catch her breath. She was literally gasping for air! This is a call to all parents of infants: When your child is above the age the pacifier is geared toward, please make sure to buy the new size. This simple deed can save your child’s life. Rachael G.

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’m wondering if you have ever addressed which supplements can help heal herniated discs, of which I have several. Is there anything I could take to help my back heal? Thank you. Response: If you are familiar with the Sarno method, you know that a herniated disc is generally stress related. In addition to other stress-reducing exercises, daily supplementation with Maxi Health’s Relax to the Max™ may be helpful in healing your issue. Take care, Miriam Schweid, health consultant

Teves 5779 | The Wellspring 11

Well Informed

Torah Wellspring: Emotional Health By Rabbi Ezra Friedman

RAISING EMOTIONALLY HEALTHY CHILDREN WHAT DO YOU SEE WHEN YOU LOOK AT YOUR CHILD?

Hashem created every human being with an incredible instinct to want to feel that he’s good. Whether the individual is cognizant of it or not, this instinct propels him to do good things and to want to accomplish, and draws him away from negative behaviors. This is true even for the person who is considered evil and appears to have been born without this instinct. Every single human being, especially every single Yid, wants to do good and feel good about himself. As an aside, this is one point of evidence that man was created for a purpose. If you want proof for this instinct, the greatest evidence you’ll find is in yourself. Look into your own life to see when you feel your best, and you’ll be the best proof that when we do good, we feel good. If that’s the case, how can it be that we falter? Why is it that we don’t always do our best in order to feel our best? For starters, many people aren’t even aware of this basic reality. Since they don’t know that when they do their best they feel their best, they’re not connected to doing good. In other words, there are people who don’t really and truly believe that they’re good at their core. They live with the assumption that they’re not cut out to do good. And because they don’t live with the belief that their true will is to do good and that they are good, they erroneously stay stuck with this negative self-belief that doesn’t allow them to move forward. The first step for a person to feel good and therefore do good is to understand that everything he did in the past and everything he believed about himself was all just deeds and thoughts. They do not identify him. Every human being is good, was born good, and wants to do good. Knowing this truth is half of his salvation. Then there are people who do recognize that in essence they are good, that they want to be good, and that they want

12 The Wellspring | January 2019

to accomplish good things in order to feel good. Yet, they have a hard time seeing themselves in a positive light. They find it difficult to do the things they know will make them feel good. Why? The sefarim tell us something crucial: If a person would be cognizant of the strengths Hashem gave him, of how much he could accomplish, he would start to use them. What percentage of our kochos do we use? As much as we know that we have, that’s how much we can use. Rav Shlomo Wolbe zt”l writes that people know that cheshbon hanefesh means to make a calculation of what we need to improve in, to ask ourselves how we’re doing in our service of Hashem, but what people don’t know is that cheshbon means doing the calculation both ways. One must ask himself: What do I need to improve in and also what are my strengths? Part of making a cheshbon is seeing how incredible we are. Many people erroneously believe that focusing on their strengths is ga’avah. We will refute this succinctly. Ga’avah is when a person who doesn’t feel good about himself starts imagining that he is what he isn’t. Acknowledging our strengths is not ga’avah. Hashem doesn’t want us to convince ourselves that we don’t have what he gave us. On the contrary, if He chose to give us certain strengths, coupled with the instinct to want to do good, He wants us to accomplish with them. Thus, the first step in using our strengths is knowing what they are. Think of a hungry person who walks into a bakery, begging for food. He approaches the shopkeeper, who tells him that he can only buy bread if he has money. He looks at the food, desperate to take a bite, feeling miserable. Then someone shows the man that he has a few coins in his own pocket. Suddenly, he’s not so hungry anymore. What was missing until now? It wasn’t the man’s ability to buy food, because he had the money

all along. Rather, it was his lack of knowledge that he had the money that left him feeling so miserable and helpless. A person doesn’t give up on doing good because he doesn’t want to feel good. He gives up because he doesn’t know what strengths he has. Because he doesn’t know that he has the “money” to pay for the good feeling, he simply gives up in order not to have to face the pain that he can’t do better. The key to feeling good is being cognizant of our strengths. If we put ourselves down, we will not develop this awareness. Cheshbon, as Rav Wolbe says, is taking everything, including our kishronos, into account. When we do this, we start honing in on these strengths, which will lead us to feel better. Rav Yisrael Salanter zt”l once said to his disciples, “How do you think I became different from the peers of my youth? When we were younger, we would play with a tall ladder. Most of my friends would climb until a certain rung and then quickly come back down. Why? When they looked up to see how many steps they still had left, they gave up.” said Rav Yisrael. “But I would look at how many steps I’d succeeded in climbing. For every step I climbed, I would say, ‘Wow! If I could climb this many, I can surely climb another one.’ And that’s how I would reach the top rung.” These youths were all faced with the same ladder. The one who gave himself the encouragement was the one who rose to the top. Two people could be looking out of the same window; one sees mud and the other sees a clear blue sky with fluffy white clouds. It’s the way we look at ourselves that determines how we feel about ourselves. People erroneously believe that when they put themselves or others down, they’re doing a righteous thing. But I once heard a gadol say that this is called the “frum yetzer hara.” The average yetzer hara, he quipped, is called a “goyish yetzer hara” because this evil inclination persuades us to engage in anti-Torah activity, whereas the “frum yetzer hara” cloaks himself in a cover of supposed Yiddishkeit. How can we know if our estimation of ourself is sourced in good or evil? Look at the results, the sefarim tell us. As a result of my inner examination did I have more enthusiasm to serve Hashem and do His will, or did I lose faith in myself? If my mussar shmooze only caused me to give up, how can I tell myself that this is what Hashem wants from me? It’s obvious that someone other than the yetzer tov is talking to me here. I write all this to adult readers, who have already experienced a past. If you haven’t come out of your childhood with a clear belief in your goodness, in your desire to do good, and in your strengths, the work to fortify this belief may be difficult. But, at the end of the day, if you don’t do this for yourself, no one will. Moving beyond ourselves, though, when we look at our children, who are still pure, whose faith in themselves is yet untainted, we see what an opportunity we have in our hands. Our children build their associations of themselves based on how we treat them. If we want to scare or criticize our children into submission, they may obey us for the short term, and they probably will, but in the long run, we’re causing profound damage. Giving our children the message that their essence isn’t good is faulty chinuch. How different things would be if we would find the good in them! “My dear child, you’re so sweet, you’re so pure. I’m sure you’ll do the right thing, because you’re one piece of

Part of making a cheshbon is seeing how incredible we are. good. I believe in you.” When a parent believes in his children, they grow up to be confident, happy, and self-assured. They will be able to handle direction, because they’re so aware of the good in themselves. If you ever ask an adult who experienced such a blessed childhood, “How are you so okay with yourself? How can you accept constructive criticism so graciously?” He will probably tell you that he had a father or mother or adult in his life who believed in him. This is the only way to grow into an emotionally healthy adult. Every single child needs encouragement and positive reinforcement to grow. We would expect that Rebbe Nachman of Breslov zt”l, who had a profound understanding of the nefesh, would be cognizant of his kochos in his youth. Yet, even he said of himself that in his youth he struggled in avodas Hashem. As an adult, he said that if someone would have come to him, given him a clap on his back and told him, “You’re doing so well! Don’t give up, and you’ll get there,” it would have been so much easier for him. Rebbe Nachman is the one who tells us that only through focusing on the nekudah tovah, the good attributes, can a person grow. The more a person focuses on his strengths, the more he’ll live with those strengths and grow in his service of Hashem. In the recent parshiyos, we read about the great challenges Yosef Hatzaddik experienced in Mitzrayim. At the hardest moments, Yosef overcame his temptations thanks to the d’mus deyokno shel aviv, the image of his father that appeared before his eyes. What did he see, our sefarim ask, and how did it help him? Based on his circumstances, Yosef’s emotional state should have been so deficient that he would have easily succumbed to the challenges he faced. He was alone, abandoned, so far from home. But in his father’s image, Yosef saw the love, the belief his father had in him. The “I believe in you, Yosef!” was what kept him strong. As soon as he saw his father’s image, his self-esteem was fortified, despite the circumstances. If someone believes he can do this, he will do this. When a parent raises his children with this approach, even when the child has a difficult moment, he will rise above the challenge, because the love and esteem will accompany him always, everywhere. Rav Avigdor Miller zt”l, who learned his derech from the greatest baalei mussar of his generation, once told his grandchild, “In my younger years I studied and tried all the various methods of avodah and mussar, and I found that what resonated the most with me was the derech of the Chovos HaLevavos and the Rambam, which show that the path to loving Hashem is by appreciating His wonders and the amazingly kind world he created.” From all darkei mussar that he explored, Rav Miller found that what built him most was not living in fear of Hashem and His retribution, but being cognizant of Hashem’s love of us, His belief in us. When we live with this understanding, that there is Someone out there who sees our greatness, we will work toward bringing that greatness to light. As parents, we can be that someone for our children.

Teves 5779 | The Wellspring 13

Wellness Platform By Rabbi Hirsch Meisels

IS YOUR BODY LACKING THE BASICS?

The first important step in vitamin nutrition is to start off with a solid foundation, namely a quality multivitamin supplement. A potent multivitamin is generally composed of 20 to 30 ingredients. It’s true that the supplement doesn’t provide a large amount of any nutrient, but when ingesting this capsule or tablet, you know that you’re giving your body at least a little bit of what it needs to function at its optimal level. Then, according to the specific needs of your body, you can supplement with other vitamins or nutrients. It’s interesting to note that even a multivitamin supplement, which is fairly general, is not always a onesize-fits-all solution. For instance, Maxi Health produces various multivitamin supplements: one for men; one for women, which contains a higher dose of iron; one for the elderly population; and, of course, one for children. The logic behind starting off with a foundation of a multivitamin is to first ensure that your body isn’t desperately lacking the primary critical nutrients. For this reason, regardless of which vitamin protocol you choose to fol-

low, you should always start off with a quality multivitamin. In this column, I will familiarize you with the various ingredients the multivitamin contains so you’ll be aware of what this wonderful supplement provides for your body. In most columns focusing on vitamin nutrition, the writers delve into a condition and then discuss which vitamin could work to ameliorate or heal it. I feel, however, that by detailing the benefits of every vitamin individually, every reader has the opportunity to cull information that may pertain to him or her currently, or at a later date.

versation, I received a letter from this man. He wanted to share the wonderful news with me that, incredibly, the most recent blood tests revealed that his kidneys were now 100 percent healthy. If I have the opportunity to help other Jews heal from illness, to give them

He told me that his blood tests revealed damage in his kidneys and that the doctors were unable to detect where the issue stemmed from.

Indeed, in a series I ran several years ago on this vital topic, I had the zechus of helping another Jew, when I only vaguely touched upon the idea that certain vitamins may heal damaged kidneys. I hadn’t even specified the vitamin by name, but soon after that lecture I got a phone call from a middle-aged man, who told me that his blood tests revealed damage in his kidneys and that the doctors were unable to detect where the issue stemmed from. Of course, I immediately advised him which vitamin to take, adding that I wasn’t promising any results, and discussed the various studies I’ve researched on this topic. Two months after our phone con-

more energy and clarity of mind, to offer information that they won’t receive at the doctor’s office, how can I withhold it from the klal? Elokim bara es ha’adam yashar, Hashem created each and every human being to perfection, veheima bikshu cheshbonos rabbos, and some people will just continue making cheshbonos. “And you also believe in vitamins? How can you?” When you realize the power that these G-d-given nutrients contain, you’ll understand why they’re so beneficial to your health and wellbeing.

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.

14 The Wellspring | January 2019

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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Research-Based Recommendations By Beth Warren, RDN

SECRETS OF A KOSHER DIETITIAN SECRET #9: JUST EAT LESS... AT ONE TIME One of the most common questions I’m asked is, “What do I eat on Shabbos?” People often feel frantic when they think about the temptation of heavy foods, late night meals, social eating, inactivity, and other potential mindless-eating pitfalls of the weekend. Their concern is understandable, considering the abundance of food and weekly frequency. On the whole, our Jewish cultural existence has a high focus on food. At some point, we have to figure out how to feel comfortable in situations in which we’re faced with all kinds of foods. It’s important to think beyond “being on a diet” and tackle these situations with a more practical approach, in order to create long term success and enjoy these occasions and what we eat at them. Because of the frequency of Shabbos, Yamim Tovim, and simchas, it’s extremely difficult to approach the challenge by saying you won’t eat anything or by being too restrictive. This may work the first few times, but because of the constant temptation, at some point you’ll give in, and excessive self-imposed limitations will lead you into making unhealthy choices. However, if you approach each of these situations as a time when you simply have to “eat less,” without setting an unrealistic standard, you can find success. There’s a lot to say about the effectiveness of portion control, as one study concluded: “Controlling portion size is an effective, simple, reliable, and sustainable tool that can be used to bring about weight loss.” Research has shown that people consistently eat more food when offered larger-sized portions. So portion control is important when you’re trying to lose weight and keep it off. Here are some ways you can begin practicing portion control at home, so that you become a pro when eating out: Start Cooking with Condiments First Try adding whatever extras you plan to use in your dish, like oil, and then put the bottle away before you get cooking so you aren’t tempted to add more.

Don’t Eat “Diet” Foods Fat-free, low-cal, and gluten-free basically mean super-easy to overeat. In a study from the Cornell University Food and Brand Lab, people who thought they were eating low-fat foods automatically ate 28.4 percent more calories than those who knew they were dining on the full-fat version. This is one main reason why I don’t advocate diet muffins etc., as a normal, everyday food. It’s also a way to fuel a potential poor habit, like the need to have a cookie with coffee, instead of working on why that’s the case and how to fix it. Fill Half of Your Plate with Veggies When putting food on your plate, follow one simple rule: fill half of it with vegetables, one-quarter with protein, and one-quarter with starches (or 2 fists for the protein and carb, the rest of the plate is veggies). Vegetables take up space on the plate, leading to psychological satiety, and are full of fiber, leading to physiological satiety. Cut up Your Food Before Sitting at the Table When you chop up a chicken breast or sweet potato, it automatically takes up way more space on your plate. According to research from Arizona State University, this method can help you feel that your portion sizes are more satisfying. Satiety is as much in your head as in your stomach. Sit at the Table Savoring every bite of your food will also help you feel satisfied with less. When we scarf it down while staring at a computer or phone screen, we eat more. One study presented at the European Congress on Obesity found that people who ate mindfully (slowly, not distracted, and taking pleasure in eating) felt satisfied faster, ate less, and lost weight. When there’s a temptation to overeat or eat unhealthy foods, mindful-eating techniques can be helpful. Mindful eating is about developing awareness of your experiences, physical cues, and feelings about food. Anything that increases your awareness of what you are eating is likely to be beneficial. Sometimes it’s less about avoiding a food than the amount and way that we eat it.

To schedule a nutrition appointment with Beth in the Brooklyn, NYC, NJ locations or virtually, or book an appearance, email beth@ bethwarrennutrition.com or call 347-292-1725. Most insurances accepted. You can also follow her Instagram for healthy eating motivation and recipes @beth_warren

16 The Wellspring | January 2019

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Well Informed

Health Updates in the News By Rikki Samson

CAREFUL, DOC!

Is this important tool making you sick? The stethoscope is one of the most important and perhaps the most recognizable of all tools used by health care professionals. But new research finds it is often crawling with bacteria, including some germs that can cause serious infections. The study, published in Infection Control & Hospital Epidemiology, found that Staphylococcus, the bacteria responsible for staph infections, was found in abundance on many stethoscopes, with more than half of the devices having confirmed contamination with the bacteria. For the study, researchers used molecular sequencing to analyze stethoscopes in use in an intensive care unit (ICU), including 20 traditional reusable stethoscopes being carried by physicians, nurses, and respiratory therapists, and 20 single-patient-use disposable stethoscopes used in patient rooms. They compared these to 10 unused single-use disposable stethoscopes as a control. All 40 of the stethoscopes in use in the ICU were significantly contaminated with a rich and diverse community of bacteria, the researchers said. However, it is unknown if the stethoscopes had made patients sick. The researchers also found that cleaning stethoscopes using a hydrogen peroxide wipe, alcohol swabs, or bleach wipes reduced the amount of bacteria but did not totally eliminate it. “This study underscores the importance of adhering to rigorous infection control procedures, including fully adhering to CDCrecommended decontamination procedures between patients, or using single-patient-use stethoscopes kept in each patient’s room,” senior study author Ronald Collman, MD, a professor of medicine, pulmonary, allergy, and critical care at the University of Pennsylvania Perelman School of Medicine, said in a statement. Until my doctor does that, I’ll keep praying that my body has the strength to fight whatever comes its way.

DOES YOUR DIET PROVIDE ADEQUATE NUTRITION? A recent study shows that for most people, it doesn’t Diets all over the world are lacking vitamins and minerals essential for healthy growth, Australia’s peak scientific body found. An analysis of global diets released by the Commonwealth Scientific and Industrial Research Organization (CSIRO) revealed that the worldwide intake of calcium, vitamin D, vitamin E, and folate is likely to remain inadequate through 2050. In poorer countries, the study projected that the intake of zinc, iron, vitamin K, and vitamin A would remain inadequate. According to the World Health Organization (WHO), micronutrient deficiencies can impair intellectual development, stunt growth, and weaken the immune system.

18 The Wellspring | January 2019

They estimate that more than two billion people around the world suffer from micronutrient deficiency. The study did find that nearly every country in the world is achieving adequate carbohydrate and protein intake. Researchers used current diets to create a trajectory of what the average human diet would look like from now through 2050. “Global food security is not just about providing adequate calories,” says Jessica Bogard, CSIRO study author. “A person can consume too many calories but still be malnourished. We must refocus our efforts on dietary quality rather than quantity.”

THE TALC TALE

Why are people suing Johnson & Johnson? Nearly 12,000 women have sued Johnson & Johnson, with most claiming the talc in its well-known product Johnson’s® Baby Powder caused their ovarian cancer. In a recent case, a group of plaintiffs argued that the talc was contaminated with asbestos, a carcinogen considered unsafe at any level of exposure. A jury agreed with them, and awarded them $4.69 billion in damages in July. The carcinogen has been a concern for the company for decades. Talc is a mineral in clay mined from underground deposits. It’s the softest mineral known to man and that makes it useful in a wide range of consumer and industrial products. Asbestos is also found underground, and veins of it can often be found in talc deposits, leading to a risk of crosscontamination, geologists say. Talc is used in many cosmetics: lipstick, mascara, face powder, blush, eye shadow, foundation, and even children’s makeup. In the list of ingredients, it can be listed as talc, talcum or talcum powder, cosmetic talc, or magnesium silicate. Talc is added to cosmetics to create a silky feel and absorb moisture. Some brands make talc-free cosmetics. Talc is also used in food processing and to make some supplements, pharmaceutical pills, chewing gum, and polished rice. Talc was routinely applied to surgical gloves until the 1990s,

when the Food and Drug Administration told manufacturers to stop using it because of health concerns. And it’s typically the primary ingredient in baby powder. Johnson’s® Baby Powder is made of talc, unless the bottle says “pure cornstarch” on the front. If you’re using another brand, check the ingredients. Johnson & Johnson has the largest share of the talcum powder market and has been selling baby powder and other similar products for more than 100 years. The company says that its talc does not contain asbestos, that claims that talc causes cancer are based on bad science, and that it is appealing any jury verdicts against it. With the case still up in the air, pediatricians suggest changing infants’ diapers frequently to prevent rashes and recommend using an oil-based ointment when necessary, rather than using talc. For teenagers or adults, cornstarch is a good alternative to using talc on the skin.

CHAPPED WINTER SKIN?

These are the vitamins to look for in skin creams Creams that contain vitamins can boost the appearance of the skin in a variety of ways, from preventing dryness to stimulating metabolic processes. Our bodies need an adequate daily supply of vitamin-rich nutrition not just to stay healthy but to survive—that’s because vitamins are involved in many essential processes in the body. However, the vitamins contained in many skincare products can also play an important role. For example, they can stimulate rejuvenation, help fight aging, and defend against harmful substances, according to The German Cosmetic, Toiletry, Perfumery and Detergent Association (IKW). The most important vitamins found in skin creams are: • Vitamin A (retinol) can help combat dandruff and dry skin. It also stimulates cell renewal on the skin’s surface. • Vitamin E (tocopherol) and Vitamin C (ascorbic acid) are among the most effective remedies against free radicals. Vitamin C also promotes collagen formation, thus ensuring the formation and maintenance of connective tissue. • Vitamin H (biotin) plays an important role in metabolic processes. It improves the keratin structure of the skin and nails and thus supports the skin’s own regeneration process. • Vitamin B3 (niacin) strengthens the skin’s barrier function and balances dry and rough areas.

Teves 5779 | The Wellspring 19

Well Informed

Figures By Miriam Katz

Tongue Tie Stats

69%

of lactation consultants believe that tongue tie frequently causes feeding difficulties.

Studies have shown that for every day of maternal pain during the initial

Tongue tie in infants is associated with

25% - 60% incidence of difficulties with breastfeeding, failure to thrive, and other lactation issues.

weeks of breastfeeding, there is a

10% - 26% risk of cessation of nursing.

only

of lactating mothers of normal infants have intractable pain or difficulty getting their babies to latch at 6 weeks, but

25%

of mothers of babies with tongue-tie have these problems. 20 The Wellspring | January 2019

According to research reviewed by Dr. Scott Siegel,

Mainstream media reports that tongue-tie affects around

4-11% 20-37% CLASS

This is the most common type, in which the tie is at the very tip of the tongue.

CLASS

The tie is located at the base of the tongue.

main classes of tongue tie:

CLASS

There are

of the population has a form of tongue tie.

The tie is farther back, toward the middle of the tongue.

CLASS

of newborn babies.

Also known as posterior tongue tie, the tie is underneath the mucous membrane and must be felt for a diagnosis.

Well Informed

Health Ed By Laura Shammah, MS, RDN

Hydration is Key—Even in Winter During the summer months, water gets a lot of attention—and rightfully so. Drinking water helps combat dehydration, which often occurs when we spend hours in the hot sun. But this doesn’t detract from the importance of hydration during the winter. Take this quiz to find out how much you know about the benefits of drinking water every single day and the adequate amounts to ensure proper hydration.

True or False: Drinking water helps your body burn fat. Answer: True.

If you don’t drink enough water, your liver will be forced to help your kidneys detoxify your body. When you drink enough water, your kidneys don’t need any extra help, which allows them to focus on metabolizing stored fat more efficiently.

Which of these is a benefit of drinking water? A. Helps maintain the body’s fluid balance, assisting in transporting nutrients, regulating body temperature, and digesting food. B. Helps lose weight, because water helps us feel full, resulting in the consumption of fewer calories. C. Clearer skin. Certain toxins in the body can cause the skin to inflame, resulting in clogged pores and acne. Water helps flush out these toxins and can reduce the risk of pimples.

True or False: Every individual should drink eight cups of water per day. Answer: False. Eight cups is the generic average, but the precise amount for optimal hydration is individual. The best way to know how much water your body needs is to divide your weight in half. That’s the amount of water, in ounces, your body needs every day. However, it’s important to note that this number varies depending on activity level, age, and how much water you are consuming in coffee, tea, or water-rich veggies and fruit.

D. All of the above. Answer: D But there’s more! Water fuels muscle. Sweating at the gym causes muscles to lose water, which causes muscle fatigue. For extra energy, drink water to push through that final set of lunges. Water also helps you concentrate. The human brain is comprised of approximately 85% water. When you are not properly hydrated, the effects can be felt in your brain as symptoms like headaches, poor concentration, and reduced short-term memory. A glass of water can help you focus and stay refreshed and alert.

Water can also serve as a fatigue buster. Better than your cup of coffee, water can help fight those puffy, tired eyes. One of the most common symptoms of dehydration is tiredness. Another benefit of water is pain prevention. Aching joints and muscle cramps and strains can all occur if the body is dehydrated. And last but not least, water keep things flowing in the digestive tract. Drinking enough water adds fluids to the colon, which helps evacuation occur smoothly.

If you have no problem downing cups of plain water at a time, good for you. But for most, plain water can be pretty boring. Which of these is a not healthy way to spruce it up? A. Using flavoring agents.

C. Drinking flavored seltzer.

B. Cutting up fresh fruit to create infused water.

D. Dividing your cups throughout the day.

Answer: A The flavoring powders and flavored water that are sold commercially are full of chemicals, which not only detract from the benefit of these waters but may also harm the body. Instead, go for something more natural—like adding slices of lemon, lime, orange, fresh strawberries, watermel-

on chucks, and/or mint. Let the fruit sit for a few hours in the water in the fridge for optimal flavor. Begin by drinking a glass of water as soon as you wake up, and before eating every meal and snack. Get in the habit of keeping a water bottle on hand at all times. Before you know it, drinking sufficient water will become a habit.

Laura Shammah MS, RDN, has been operating a private practice in New York and New Jersey for over 20 years. Her clientele runs the gamut from people with eating disorders to those dealing with hypertension, high cholesterol, diabetes and cancer. She also helps clients who run in marathons or are looking to lose or gain weight in a healthy way. Her nutritional guidance is published in MaryAnne Cohen’s book Lasagna for Lunch: Declaring Peace With Emotional Eating. Laura can be reached at 718-376-0062 or Laurashammah@aol.com.

22 The Wellspring | January 2019

THE AMI MEDICAL ISSUE

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Well Informed

Dedicated to Health by Shiffy Friedman

10 QUESTIONS

SHEVY KAHAN AND PESSIE SCHLAFRIG

FOUNDERS AND DIRECTORS AT CHAIM MEDICAL RESOURCE

CHAIM MEDICAL RESOURCE IN A NUTSHELL:

Providing medical referrals to individuals and families facing the devastating effects of medical crises and guiding them through the maze of doctors, specialists, hospitals, and available treatment options; to search and find hope in impossible places.

WHAT MOTIVATED YOU TO LAUNCH YOUR ORGANIZATION?

Shevy: I started my medical tenure fifteen years ago, when our eight-year-old son Chaim was diagnosed with glioblastoma, a rare brain cancer. From a medical perspective, I was pretty much on my own during much of his medical journey of five years. Although there were wonderful organizations around to help us out with various aspects of the challenge, the research and treatment arena was largely unexplored. It was a very lonely journey. I would sit online for hours, trying to find a cure for my son. Whenever a lead looked promising, we packed our bags and travelled. Chaim’s illness took us to many corners of the globe and opened my eyes to an entire new realm that I had never been exposed to before. After the doctors had given up on Chaim, I gave it one last try. I was looking into a clinical trial of a device called Novocure™, which transmits radio frequency waves to the brain and is supposed to destroy the DNA structure of tumor cells. Today, this device is used as a treatment, but at that point, it was still in its experimental stage. When I learned of this treatment, I did not let go. I called its inventor, Professor Palti, in Israel, approximately three times a day, begging him to give it to Chaim. When he told me that my son’s cancer was at too advanced a stage for it to help, I tried offering great financial compensation. And when that didn’t work, I even got through to the prime minister, begging him to intervene. Chaim was fully aware of my efforts and of his dire state. In my quest to convince Dr. Palti to administer his treatment to Chaim, I said to him that when I told my son that the device was still being tested on mice, he said, “I wish I were a mouse.” Such was his desire to live, and such were my efforts, the efforts of a mother, to save my child’s life. Shortly after his bar mitzvah, I finally got a phone call that they could offer to try this device on him for $50,000. Sadly, it was not an option at that point. Chaim was niftar two days later. With my experience in medical research and upon the insistence from others, I launched Chaim Medical Research in memory of our dear Chaim, to help patients and their families find the right medical team for their recovery. The organization has grown way beyond I ever envisioned. Unfortunately, we have an average of 198 open cases each day, with around 400 calls coming in on a daily basis. At Chaim Medical Resource, every case gets the attention it deserves. The process begins with a thorough intake that includes every detail of the case and continues with extensive research done by our team. We go the extra thousand miles to find a cure for every Jew who reaches out to us.

24 The Wellspring | January 2019

WHAT IS YOUR CURRENT ROLE AT CHAIM MEDICAL RESOURCE?

Shevy: All our coordinators have their specialty, just as the medical treatment field has specialists for every particular area of medicine, such as cancer, transplants, obstetrics, autoimmune diseases, etc. This was my vision for the organization, because I understood that one person can’t research and be an expert in every field. Each member on our team is handpicked by Hashem. In addition to being passionate to find answers, many of us have been through our own challenges—we know what it means to be a patient or the parent of a patient, and we can thus relate to the struggles. Pessie Schlafrig and I deal with the off-hour crises and complex cases. Pessie is familiar with most clinical trials in the world. As laypeople, not medical professionals, we have a perspective on treatment and healing that professionals appreciate. In fact, doctors reach out to us often to discuss treatment protocols.

CAN YOU SHARE A STORY THAT HIGHLIGHTS THE WORK THAT YOU DO?

Pessie: Confidentiality is one of our core principles, so identifying details in the following case have been changed. A woman called to consult with us about her preteen son’s medical issue. As a by the way, she mentioned her son was anemic. I don’t know what ticked me off, but I asked her to send me his blood work. As soon as I took one look at it, I literally flipped. A hemoglobin level under 7 requires an immediate transfusion, and his was down to 6.2! When I could not get through to the child’s pediatrician, I called the mother and told her to take her son to the hospital immediately. I couldn’t believe the doctor hadn’t sent him right away. At first the mother told me that it’s okay—her kid was a bit pale but she had sent him to school— but I insisted she go pick up her child and take him to the emergency room. By the time they arrived at the hospital, he was bleeding internally. He probably would not have survived the night had he stayed home. He was later diagnosed with Crohn’s colitis and had probably been bleeding from his digestive tract. I like to say that we do lifesaving work even if we’re not turning over the world.

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

For about 15 years, I did this work in a more informal way. Then, I launched the official organization with two coordinators. Today, only a few years later, we’ve just interviewed our 20th coordinator, in addition to the 7 members on our administration staff. We’re constantly expanding in order to help more people. Fortunately, we’re able to help. Unfortunately, the demand keeps growing. The usual way of launching a business is to first draw up some plans and gather a budget that allows for potential growth. In our field, there’s no such thing. It’s inconceivable for us to turn anyone down. Thus, if we need more help, we hire more help, budget notwithstanding. And so, we hope that Klal Yisrael will partner with us in this important endeavor. Our organization is mainly run by the kindness of philanthropists. Also, people who have been helped by us are very forthcoming. But we want to be there for more Yidden in pain. We’re working very hard and struggling to pull it all together.

CAN YOU TELL US A POSITIVE STORY THAT YOU’VE RECENTLY EXPERIENCED?

Pessie: Several years ago, we were working with a patient who had AML, acute myeloid leukemia. She was in her late thirties, a mother of five young children, and was not responding to the initial treatment. The doctors tried one round of chemo, and then another, until they told her family to say goodbye. But we wouldn’t give up. Two years ago, we found a trial in Minnesota that was being run by a doctor who had a good success rate. We got the woman over there, where the medical team managed to get her into remission so she could go ahead with a bone marrow transplant. On the first day of school, I got a phone call from this woman. She was crying so hard I could barely hear her. “I put five kids onto the bus this morning,” she told me. Because she had been away for so long, this was the first day since her return that she was able to do this again. “I can’t believe I’m here to raise them,” she said.

WHAT DO YOU WISH PEOPLE WOULD KNOW ABOUT MAINTAINING GOOD HEALTH?

Shevy: I wish more people would be aware of the importance of a healthy lifestyle. I’m very passionate about it, because we get calls that are often the result of neglect. It’s sad to see how people who didn’t make wise choices struggle with worn and torn bodies. They didn’t pay attention to the signals all along. Many years ago, a doctor spoke to me about the importance of “listening to your body.” Although we must not be hypervigilant or paranoid, the body has a way of letting us know if something is going on. These are the Rambam’s words, not mine. The body is a vessel that Hashem gave us in order to serve Him properly in this world. One doesn’t have to be a health nut, just tuned in to what they’re eating. Eating carbs without thinking, for example, ends up taking a toll on the body, including the immune system. Exercise is also crucial for good health. It’s important to keep it up, at all ages. When people tell me they don’t have time for this, I tell them, “You should know that you’re gaining a lot of time with this—years of healthy life, with Hashem’s help.” A third factor in a healthy lifestyle is keeping stress at bay. If an individual abuses their body and health, there are consequences. They don’t always come immediately, but just like if someone doesn’t take care of their car, it’ll break down at some point, so too will the body, if it isn’t cared for. The highest percentage of calls we get for a particular issue is 50-60-year-olds with type 2 diabetes. This disease, which is all too common in our community—way more prevalent than cancer—has so many repercussions, from heart disease to circulation problems to vision deterioration to kidney issues. With the right hishtadlus, it can be prevented.

Teves 5779 | The Wellspring 25

Well Informed

Dedicated to Health by Shiffy Friedman

WHAT IS ONE INTERESTING AREA OF MEDICINE THAT YOUR TEAM HAS EXPLORED?

We have a metabolic mitochondrial disease department, which is run by Rabbi Krasner, a medical genius. His knowledge in this area is so extensive that he educates doctors regarding the different forms of these metabolic genetic diseases. After we received several calls from parents whose children experienced failure to thrive in addition to other similar symptoms, such as low sugar levels and seizures, we noticed a pattern. We have now identified 10 families who have similar patterns. We’re investing in the research of this disease, helping patients access the best care. We’re currently working with a cohort of doctors to find certain genes that are characteristic of this disease, since a gene has not yet been identified. We’ve assembled a team of doctors—from the Netherlands, CHOP, Yale, Connecticut Children’s Hospital, and more—to help families struggling with glycogen storage disease, a particular type of metabolic disease that seems unique to our community. One of the children with this disease was in and out of the hospital for a long time, until Rabbi Krasner helped figure out what the underlying issue was. Today, the child is a beautiful thriving two-year-old. Sometimes, patients who have complex diseases that the doctors can’t figure out reach out to us. With Hashem’s help, we guide them toward figuring out what’s going on, and many of them bounce back to normal completely.

8 9

WHAT’S THE BEST PART OF YOUR WORK?

There’s no better feeling than knowing that we’re helping save a life. Not a day goes by that we can’t say we didn’t help save a life or a limb of a fellow Jew.

WHAT KEEPS YOU GOING ON ROUGH DAYS?

Certainly the siyata d’Shmaya that we experience motivates us to keep going. Of course we have days that we cry, when the Eibishter says, “Until here.” But when we hear good news, when patients report back with a happy ending, we get the push we need to continue our work. Another source of strength we draw from our work is that we don’t take life for granted. We see how many problems we don’t have. When I wake up in the morning, I notice that my circulation is working fine, my breathing is okay. Because I know of the myriad things that could go wrong, my asher yatzar is a heartfelt expression of gratitude.

WHAT WAS THE BEST FEEDBACK YOU’VE EVER RECEIVED?

Hearing that we were able to alleviate pain, to make a difference, is our best feedback. We get lots of grateful notes, as well as invitations— to brissim of babies that we helped save, to weddings of former patients or patients’ children, etc. On the Shabbos aufruf of his son, a father suffered a massive heart attack. His case required immediate intervention. Despite it happening during a weekend, we got top doctors involved to facilitate his recovery. When this man called us several days later to report that he was able to dance at his child’s wedding, we knew we had made all the difference.

HEALTH ALERT

As the director of research and referrals at Chaim Medical Resource, Pessie knows "a thing or two" about the diseases that are most prevalent in our community “People should take their health seriously,” she beseeches when I ask her for a message to Wellspring readers. “Every man and woman over the age of 50 should make sure to have a colonoscopy done on a consistent basis, and every woman over 50 should keep tabs on her mammograms.” Knowing the family’s medical history, Pessie notes, also makes a big difference. “Ignorance is not bliss,” she stresses. “Finding out something early can make the difference between a small, minor procedure versus a life-threatening situation.” As a case in point, Pessie tells of a woman who called up their office reporting a lump in her upper body. “She told me that a year earlier she had noticed the lump, but she didn’t think it was anything that deserved medical attention. By the time she

went for testing, the disease was all over her body. At the same time,” Pessie continues, “we had a woman who knew she had a strong family history of breast cancer. She went for aggressive testing, and it was found so early that she needed only a small procedure to be cured. Still, despite the importance of being on top of our health, hypervigilance is not healthy either. Being frightened has never helped anyone.” Blood in the stool is another symptom that shouldn’t be ignored, she says. “If you feel or see something that’s not normal, don’t ignore it. It doesn’t hurt to ask a doctor. As the mother, if something doesn’t seem right with your child, especially if you feel the doctor is being dismissive, know that you’re your child’s best advocate.” While doing our hishtadlus to prevent illness is vital, Pessie emphasizes, it’s important to keep in mind that, ultimately, we’re in the hands of Hashem.

mediaotg.com

Well Informed

Wealth of Health By Sarah Weinberger

conference with: ZEV JURAVEL

OWNER AND GENERAL MANAGER OF EXERTIQUE SERVICE: Group fitness classes and private training

LOCATION: Monsey, New York SINCE: October 2018 MOTTO: Our customers deserve the best When he took a look at the fitness options available around Monsey, NY, Zev Juravel saw the need for a smartly-designed fitness studio to service the frum community. He had heard of grueling gym workouts that left exercisers hurt or strained and was determined to create a space for people to exercise safely, where their individual needs would be met even in a group setting. The idea of beautifying the fitness studio experience to transform exercise from a task to an inspiring experience came next, and the concept of Exertique—exercise, boutique-style—was born.

Then there’s the “boutique” aspect of our service. First, Exertique staff tune in to each of our clients’ needs. This individual approach ensures each client feels unique. Also, the space is beautiful and inviting, from the front desk to the locker and changing rooms, the private reformer room to the magnificent, spacious studio. During the design stage, we focused on providing an elegant background for exercise, while creating a warm and welcoming atmosphere. The studio is airy, welllit, and mirrored, and it’s well stocked with equipment for the varied classes and workouts we offer.

WHAT MOTIVATED YOU TO PURSUE THIS VENTURE?

WHAT ARE SOME CHALLENGES YOU FACED IN OPENING THE GYM?

We wanted to provide a beautiful space, where people could feel comfortable attending quality, smart fitness classes that would leave them feeling good in a balanced way.

WHAT MAKES YOUR FITNESS STUDIO UNIQUE? We provide the highest-quality fitness regime to the frum community, while upholding the highest standards, in an elegant and beautiful setting. A frum fitness boutique. Our programming was designed by experts in the fitness world. It’s geared to properly train the body by building it up, rather than breaking it down. Exertique workouts leave clients rejuvenated and strengthened, not depleted and strained. Every modality of fitness we use is designed to build you up, from our foundation and core classes to strength building and yoga. Sessions are spaced to ensure that men and women are never in the facility at the same time. We also adhere to high standards regarding the music played during classes. While we do use secular music, it’s either instrumental or carefully selected so that the lyrics have no foul language and aren’t hostile, provocative, or romance-related. Music with women’s voices is not played in the men’s classes.

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Spreading the word throughout the diverse community. Finding great instructors who are well-trained, on the same page with our fitness philosophy, able to offer individualized attention, and can cater to various levels within the class. Determining the ideal programming and scheduling to meet the needs of as many people as possible.

CAN YOU SHARE SOME NOTABLE FEEDBACK YOU’VE RECEIVED FROM MEMBERS? People feel that working out at Exertique makes a healthy, positive difference in their lives. People often approach me to say how they feel so much better—not just physically, but emotionally, as well. They get results that they weren’t getting in other workouts and feel better in the process. They love the studio, the instructors, and the other people in the classes. After our evening

classes, we’ve had to remind clients that it’s time to go home and that we’re closing!

WHAT TYPES OF CLASSES DO YOU OFFER? Our programming properly trains the body in a focused, balanced way. Our classes provide a systemized approach to developing core strength, balance, and flexibility; optimizing circulation; and enhancing the mind/body connection. Our initial curriculum included Pilates-Based Foundations of Flexibility and Stability, Functional Movement, Cardio-Strength, Cardio-Dance, Yoga Flow, and Yoga Burn. We’ve been adding classes like Body Sculpting and Turbo Kick to the mix. We also offer private one-on-one training sessions in our Pilates Reformer room.

DOES THE GYM ALSO HAVE EQUIPMENT? We have premium equipment that’s used during the group sessions, such as balls, weights, rings, TRX suspended straps, bands, tubing, gliders, mats, blocks, yoga blankets, etc. Other than the Pilates Reformer table and pedal chair in our private training room, we do not have machines.

DO YOU HAVE SEPARATE HOURS FOR MEN? We have separate men’s hours on select evenings throughout the week.

DOES THE GYM HAVE A POOL? No. Although swimming is great exercise, group classes provide the motivating energy that push you further with varied exercise modalities.

DO YOU HAVE ANY PLANS FOR EXPANSION OR IMPROVEMENT? We’re only open since October, so right now, we’re focused on fine-tuning our program and schedule to provide the best mix of classes at the times that best match the community’s preferences and availability. We work hard to take clients’ feedback and needs seriously. Ultimately, we plan to extend programming to teens, children, and the elderly population, as well.

HAVE YOU RECEIVED ANY INTERESTING REQUESTS FROM MEMBERS? We welcome all sorts of requests, no matter how interesting! Obviously, private training sessions are customized to each client. But even in group sessions, our instructors pay attention to the members’ needs, then guide each individual with modifications to help them make the most of their time in the class. Our instructors make it a priority to leverage the group energy while meeting everyone’s particular needs.

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Living Well

Ask the Nutritionist By Shani Taub, CDC

Fruit First, Carb Last Does Sequence Matter?

Q A

I’ve been pondering the following question for a while and hope you can provide some clarity. Does the order in which we eat our food affect digestion? Very often, when I sit down to a meal, I’ll consciously choose to start with what I see as the healthiest food group first. At breakfast, for example, I’ll start with my fruit, then eat the protein, then the starch. At dinner, I’ll finish all my vegetables first, before having my other food groups. For some reason, it feels right to me to eat the most natural, nutrient-dense food first. Is this just an obsession, or is there a nutritional explanation for my assumption? If order does make a difference, in what sequence should we consume our food?

Thank you for your interesting question. I’m glad you took

advantage of this platform to ask what’s been on your mind. From my understanding, based on research, the sequence in which we consume our food has no significant

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impact on digestion. In fact, neither does the way we space our meals and divide our food groups. The body takes whatever it’s given and digests it over a 24hour period. Technically, I can eat just protein at one meal and just vegetables at the other, and the body will get the same amount of nutrients and calories as when the food groups are distributed more evenly. We don’t do this, of course, for other reasons, which include optimizing satiety and leading a balanced lifestyle. The reason I tell people to eat during the day and not lump their calories together in the morning and evening, for example, is to ensure they have energy when they need it. But from a digestion standpoint, distribution of foods makes little difference. One part of your question intrigued me: You wonder whether this is an obsession, or whether your practice has a rational backing. Regarding what you mention as

“feeling right,” I would like to address an important point that pertains to all areas of life, including diet. Even if I would have told you that yes, sequential eating does matter, it’s important for a healthy lifestyle to not only feel right but also to feel good. If you like to have your apple as dessert, not as the first part of the meal, go for it.

Research Review Food combining or sequential eating has been a popular topic in the nutrition realm for years and continues to resurface with claims that these practices can improve digestion, increase metabolism to promote weight loss, and provide more energy for the body.

The Theory behind Sequential Eating The practice of food combining or sequential eating is not backed by any scientific knowledge of physiology and nutrition. The process of food combining or eating in a specific sequence requires a great deal of planning and can be inconvenient for someone leading a busy lifestyle. The human digestive system is a complex series of organs and glands that process the food into smaller molecules. There are specific areas of the gastrointestinal tract that perform different jobs in order to nourish the body. If you analyze the content of foods, you will see most food groups naturally have more than one macronutrient— carbohydrate, protein, and fat. For example, dairy products contain carbohydrates, protein, and fat, with the exception of skim-milk products, since the fat is removed. The nutrients are packaged together and cannot be separated. The gastrointestinal tract is well equipped and sophisticated enough to handle mixed meals. Your body relies on a variety of nutrients to support its many structures, preferably from a plentiful supply in your diet.

Restricting yourself due to feeling dictated to by a desire for health borders on disordered eating. You want to be able to enjoy your healthy meal, to eat it in the order that appeals to you. When a healthy diet doesn’t only feel right but also feels good, it’ll be a pleasant and thus sustainable experience.

The Truth behind Sequential Eating Research has shown that digestion occurs no matter in which order the food is eaten. Digestion begins in the mouth by chewing food to break it down. The stomach acids further break down the food, which passes into the intestines, and the nutrients from the broken up foods are absorbed and used by the body. However, there have been some well-designed nutrition studies that have examined how putting certain types of food first in a meal, or even before a meal, influences appetite and food intake at the meal and at subsequent meals. The end result was that first eating high-fiber, low-calorie, high-satiety foods, such as vegetables and high-fiber fruit or lean protein, would decrease food intake during the rest of the meal. To try this on your own, eat a salad or an apple prior to dinner and see if you eat less at the meal. Protein foods help with feeling satisfied at meals and snacks, and are important in building and repairing muscles. If you are filling up on pasta or bread first, you risk having no room left for lean protein. You have then displaced protein, an essential macronutrient for your body. The key to weight management is calories in versus calories out. Managing your appetite can aid in controlling calorie intake by eating a balance of nutrients—the order in which the food is eaten does not matter. Enjoy healthy foods in different combinations, but also in moderation.

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, pre-measured foods and delicacies sold at supermarkets and restaurants.

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Living Well

In Good Shape By Syma Kranz, PFC

Better Balance and Better Bones for Seniors No matter your age, the best exercise for you is the one you enjoy most. After all, if you don’t like your workout, how long are you going to stick with it? Focus on workouts designed to help you build strength, maintain muscle mass, stay mobile, and improve balance and stability. Stay strong, be safe, and maintain your independence by integrating these top fitness options into your life. As always, it’s smart to check with your doctor before beginning a new fitness program, especially if you have a health condition. The good news: Assuming your doctor hasn’t said a type of exercise is off-limits, choose whatever you like—all of these are terrific.

SWIMMING There’s a reason swimming is called the world’s perfect exercise. Whether you’re performing the breaststroke, taking a water aerobics class, or playing Marco Polo with the grandkids, getting in the pool is a great way to increase your cardiovascular fitness, while also strengthening your muscles. Swimming gives you all these benefits, while putting minimal stress on your bones and joints—a major plus for men and women who have arthritis or osteoporosis.

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YOGA Yoga helps build muscle strength, aerobic fitness, balance, core stability, mobility, and flexibility—all of which are important for older adults. And while yoga is low-impact and gentle on your body’s joints, it’s still weight-bearing, meaning that you have to support your body’s weight with every posture. That’s vital for strengthening not just your muscles, but also your bones.

PILATES Like yoga, Pilates is known for being a lowimpact strength program, but its focus on core strength and stability makes it especially great for older adults. Most gyms offer Pilates classes designed for first-timers, which is particularly important for those exercisers interested in classes that rely on the “reformer,” an exercise machine that uses springs, bars, and straps for resistance.

WALKING Even if you can’t find the time to perform a structured workout, you likely do have time to put one foot in front of the other to get where you need to go. The recommendation for most people is to take 10,000 steps per day, even on days they don’t “work out.” For some older adults or people with a chronic condition, 10,000 may not be the right number. But the fact remains: Walking is a great, free workout that can have a big impact on your health. Easy ways to increase your step count include parking farther from the supermarket door, playing with your grandkids, and taking the long route wherever you need to go.

BODYWEIGHT TRAINING RESISTANCE-BAND TRAINING One out of every three older adults experiences severe muscle loss. Meanwhile, when it comes to fighting age-related abdominal fat—a marker for overall health— Harvard research shows that strength training is more time-efficient compared to cardiovascular exercise. It’s far safer to start small. Simple bodyweight exercises, such as chair squats, single-leg stands, wall pushups, and stair climbing will do a great job at keeping your body strong and ready to tackle everyday activities.

STRENGTH AND AEROBIC CLASSES Exercise isn’t just a fantastic way break a sweat, you’ll also have tons of fun and make new friends along the way, both of which are hugely important when it comes to making exercise a habit.

Bands can help you challenge your muscles in ways you might not be able to with equipment-free training. For instance, when it comes to strengthening your back (important for good, strong posture), rows and other pulling motions are vital—but hard to do if you don’t have any exercise equipment on hand.

PERSONAL TRAINING If you’re looking for more attention and instruction than group classes provide, working with a personal trainer is a great path to fitness and fun. Many offer one-on-one and small-group sessions, the latter in which you and one to three of your friends perform the same workout with the trainer. Make it easier on your wallet by using one-on-one sessions to help you get started with a program you can continue on your own or by going the small-group route. No matter which option you choose, the trainer will help you master proper form and build a solid base of exercise knowledge that you can carry with you for years to come. In addition, your workouts will likely blend elements from all of the above forms of exercise.

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

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Living Well

Cover Feature

34 The Wellspring | January 2019

Untangling the Truth about Tongue-Tie This often overlooked condition may be the reason your baby canâ&#x20AC;&#x2122;t suck, eat, or speak properly. It may even be the culprit for your dental issues.

By Shiffy Friedman

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Living Well

Cover Feature

At 32 years old, Racheli wasn’t a first-time mom when she gave birth to her daughter Adina. Still, when Racheli noticed, soon after her fourth baby’s birth, that the child was exhibiting difficulties with feeding that were similar to some of her siblings and that nursing was an excruciatingly painful experience, she knew this was more than the “it’s normal for things to be difficult in the beginning” claim. “When I had my first baby almost eight years ago,” says Racheli, “I started nursing right away. It was a given. But here I was, this heroic woman who gave birth without pain-relieving intervention, finding every feeding to be a nightmare. The pain was worse than that of childbirth,” she remembers. Not one to take her concerns lightly, Racheli got herself and her baby over to her midwife, and then to the baby’s pediatrician, who all agreed that there must be an issue with the baby’s latch. “I got this diagnosis from multiple people,” Racheli recalls of that fragile time in her life as a first-time mom being overwhelmed with confusion and torrents of advice. “When I finally took my baby to a pediatrician who does only lactation consulting, she diagnosed him with tongue-tie. If I remember correctly, I had a feeling that this was what he had, based on pictures I had seen in a book that resembled his tongue exactly.”

When I finally took my baby to a pediatrician who does only lactation consulting, she diagnosed him with tongue-tie.

Tongue-tie (ankyloglossia) is when a band of tissue tethers the tongue, restricting its range of motion. Typically, this band of skin, the lingual frenulum, separates before birth, allowing the tongue free range of motion. With tongue-tie, it remains attached to the bottom of the tongue. Being the good mother that she was, Racheli took her baby to his next stop: the ENT (ear, nose, and throat) doctor. In all of two seconds, the doctor used what looked like nail clippers to snip the tie, and off Mommy and baby went, hoping for some much-needed rest and happily-ever-after feedings. “I was told that releasing the tie would completely change the nursing experience,” says Racheli. “It totally didn’t. Not at all.” At that point, with her baby already eleven weeks old, Racheli figured it was too late for another intervention, especially since she was told by the ENT doctor that once a baby turns four months old, the procedure must be done under general anesthesia, which she later learned was incorrect. And so, Racheli left matters as they were. “With my next child,” Racheli continues her tongue-tie tale, “I didn’t yet know enough about tongue-tie to determine whether this baby had it as well or not, but with my third child, I was determined not to suffer.” Although Racheli didn’t see much improvement from her eldest’s tongue snipping procedure, when she noticed the tie in her third child, she took him to the ENT doctor within the first few weeks of his life, hoping it would help this time. “The doctor used a pair of scissors to release the tie, and I had no idea at the time that it wasn’t actually helping.

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“Even when my kids had it cut, they still had tie-related issues. When I started my third child on solids, for example, he would gag and vomit any time I would give him anything to eat, even in pureed form.” Only later, did Racheli learn that this was happening because her son couldn’t use his tongue to eat or swallow. “Imagine having do eat with your tongue tied down to the bottom,” she says. “I saw that my child needed feeding therapy, but I didn’t know it was related to his tongue-tie. Even after we did the procedure and it didn’t help, it didn’t dawn on us that this might be the issue.” Because Racheli realized that the procedure hadn’t helped, she decided that with Adina, her fourth child, she wouldn’t have the procedure done. By six months, however, when she started her baby on solids, Adina stopped gaining weight, exhibiting similar feeding issues as her third child. “Around the same time that we were struggling with our baby,” Racheli says, “our sevenyear-old, who’d been in speech therapy for a while, asked me to get his tongue clipped again. He had realized his tongue was tied when I once asked him to lift his tongue to reach his palate, which is something everyone should be able to do, and he wasn’t able to do it. Once he asked for it, I knew it was time to have it done.” This time, Racheli realized it was time for her to be her children’s own advocate, to do her own research on behalf of herself and her children. “In my research,” she says, “I learned that most practitioners don’t know what they’re doing when it comes to tongue-tie. I connected to other mothers whose children have tongue-tie, from whom I learned that there are various types of ties, including lipties, and I was referred to an oral surgeon who specializes in this field.” At the oral surgeon, Racheli learned that tongue-tie was not only her eldest son’s issue, but also her baby’s, attributing to her difficulties with feeding. “At that time, Adina was almost 12 months old, and she wasn’t eating. Every feeding session was a nightmare. My relief wasn’t so much in knowing they have tongue-tie, but in hoping that finally, this new procedure would be the one to actually work. It’s not so much about which tool the doctor uses, but more about how they cut and how deeply they go.” This time, the procedure was done through laser, starting with her eldest child. While Racheli feared that it would be traumatic for her son, she took comfort in knowing that this was what he had asked for. “The procedure

didn’t end up being painful,” she reports. “And they gave him an option for laughing gas. The painful part was the stretches that he was required to do in the days following the procedure, which other practitioners hadn’t even mentioned. For that, we got him chocolate spread and marshmallow fluff to make it fun, which he had to stretch his tongue to reach out toward on his palate and along the walls of his mouth.” While an older child can do the stretches on their own, says Racheli, this part proved to be way more difficult with her baby. “We had to sweep Adina’s tongue with a finger every four hours for two weeks—and that was tough. She would be screaming every time. But two weeks later, she was eating completely normally, which made such a difference to her mood. After having gone through so much heartache until we got to this point, we couldn’t feel more grateful to finally see improvement.” With the treatment for tongue-tie finally figured out in Racheli’s household, it became the in thing for the rest of the family members who were still tied up. “There’s a genetic factor in tongue-tie,” Racheli notes. “With my second child, the symptoms presented in a bit of a lisp, and she has a hard time saying certain sounds. And I have my issues too, which I never thought were associated with tongue-tie. In fact, I never knew I had tongue-tie, until I got into this. My mother used to tell me that I mumbled growing up, but I never thought anything of it. Today, I realize how it caused orthodontic problems for me. There’s a gap between my two top teeth, because the piece of skin went down too far until the end of the gums, causing my teeth to grow in with a space between them. I always used to get comments that I had something big and black between my teeth, but it was just this empty space.” At a recent visit to the oral surgeon, Racheli was brave enough to have the procedure done for herself, as well as for her second child. At the time that this article went to print, she was still in the two-week span of her stretching exercises, and so progress has yet to be reported. “It’s a minimally-invasive procedure that can actually make a difference in our lives,” she says. “There are people who say that tongue-tie isn’t a real problem, but I’ve seen how it affects development. Even as an adult, it’s hard for me to say certain sounds. I can’t roll my r’s when I try to speak Hebrew. Also, when I talk a lot, it’s hard for me, perhaps because it’s tiring to keep moving my tongue. When get tired, I start slurring my speech. Because of my lip-tie, which is often associated with tongue-tie, I’ve had some dental issues, too. With my top lip pulled down, food ends

At that point, with her baby already eleven weeks old, Racheli figured it was too late for another intervention. up getting stuck under the gum, which may cause decay. Although I take great care of my teeth, I have always had issues with my gums.” In her extensive research on the topic, Racheli learned that snipping tongue-tie used to be commonplace in the hospital right after a baby was born. “Tongue tie often causes nursing issues, more so than with bottle feeding, and since everyone used to nurse before the advent of formula, tongue-tie was a known problem back then. Then formula was invented and later became the new fad, so tongue-tie diagnosis and revision became a lost art,” she explains. “Now that nursing is ‘popular’ again, it’s back on people's radar.” For Racheli, discovering a treatment for releasing tongue-tie that actually works was a relief. Finally, she confirmed that not only did she and her children have a condition that was causing the various issues they were struggling with, but also that the procedure to release it requires expertise that not every pediatrician or even ENT doctor has. “Tongue-tie, and being in the dark regarding its treatment, made my post-birth experiences so much more difficult than they had to be. It’s so overwhelming to have a new baby,” Racheli says, “and to have the added issue of such painful nursing when it could be avoided is such a shame. Not enough people know how simple it is for them to solve issues that appear so enormous.” Because of her past difficult experiences with tonguetie treatment, Racheli quips, she has something else to look out for in her new babies post-birth. “I don’t only check for ten fingers and ten toes, but also for tongue-tie. Next time, however, the sight of it won’t scare me as much. With Hashem’s help, I know that there is good treatment available, treatment that can make all the difference to my child’s development and the bonding experience from the very start.”

Signs and symptoms of tongue-tie include: Difficulty lifting the tongue to the upper teeth or moving the tongue from side to side Trouble sticking out the tongue past the lower front teeth A tongue that appears notched or heart shaped when stuck out

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Living Well

Cover Feature

Q&A WITH ORAL AND MAXILLOFACIAL SURGEON DR. SCOTT A. SIEGEL. A fellow of the American College of Surgeons, International College of Surgeons and American Academy of Pediatrics, Dr. Siegel M.D., D.D.S., FACS, FICS, FAAP, is known as a pioneer in tongue-tie surgery utilizing laser. Dr. Siegel is most noted for his research in the area of reflux associated with lip and tongue-ties. He is in private practice in both NYC and Long Island and is the medical director of The Center for Tethered Oral Tissues.

Do you think all cases of tongue-tie should be treated? With tongue-tie, an unusually short, thick or tight frenulum tethers the bottom of the tongue’s tip to the floor of the mouth. When we evaluate patients for tongue-tie (or other ties in mouth such as lip-ties or cheek/buccal ties; collectively known as Tethered Oral Tissues or TOTs) we look for indications to treat or “surgically release.” The number one indication is an associated problem with function. There are numerous tongue-tie related functional problems known and published in the literature, such as difficulty with lactation, bottle feeding, reflux symptoms, solid food feeding issues, speech/articulation difficulties, orthodontic and dental issues, and potential sleep apnea and snoring.

What have you seen as the greatest negative effect of tongue-tie? The greatest negative effect has been infants and children misdiagnosed with having other issues when a tongue-tie was missed. We have had several patients subjected to majorly invasive medical/surgical procedures for failure to thrive, reflux symptoms, and airway issues that either resolved or were reversed very quickly after the tongue-tie was diagnosed and treated. I originated the term Aerophagia Induced Reflux “AIR” which is now used in describing reflux symptoms that are alleviated after tongue- and lip-tie release.

How did you come to specialize in this field? I was first introduced to the field as a medical student in 1995-1997, when I was rotating in pediatric surgery. I had the privilege to be taught about tongue-tie by my professor Elizabeth “Betty” Coryllos, who developed one of the infant tongue-tie classification systems, the Coryllos Classification System, used widely throughout the world. Dr. Coryllos became a mentor and close friend of mine up until her death a few years ago. When I went into private practice in 2000, my office happened to be across the street from hers, and she then

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taught me the intricacies of diagnosis and treatment of tongue-tie in the nursing infant, and asked me to use laser on some of the more difficult patients she was seeing. I then helped conduct ultrasound research with her in treating these babies. Since then, I have pioneered surgical techniques using carbon dioxide (CO2) laser. I publish on the topic, lecture internationally, and conduct ongoing clinical research in conjunction with Columbia University and NYU specifically relating to tongue-ties.

Can you tell us of an interesting case you treated? There are so many varied and interesting cases, and so many have changed families’ lives. I recently treated a five-year-old child with a rare genetic disorder, who had craniofacial and neurologic malformations and was minimally verbal. He had been working closely with a speech language pathologist, who recognized that he had a form of tongue-tie that was not obvious to many practitioners. Upon releasing his tie, he was able to improve very quickly, becoming more verbal and using and exploring with his tongue immediately upon release.

What is the range of age in which tongue-tie can be treated? The optimal age is immediately upon birth, if it is diagnosed. The oldest patient I treated was 79 years old, who had swallowing difficulties and sleep apnea.

Does every type of tongue-tie require the same procedure? No, many of the procedures are dependent on age. As one gets older, many of the ties become either thicker or more intertwined with muscles. The procedures are typically similar, with some variations.

Can the procedure lead to complications? Any surgical procedure can lead to complications. Although very rare, as reported in the literature, tongue-tie

surgery (known specifically as frenotomy, frenectomy, or frenuloplasty) can have resultant bleeding, infection, and damage to adjacent structures such as nerves and muscle. Scarring, further impairing function, is another potential complication. In the over 20,000 procedures I have performed in the past 18 years, I have not had any major complications. Scarring or what many people refer to as “reattachment” is the most common issue we describe. Current rates in my practice are up to 2%.

Why do you believe so many people are in the dark about this condition? There are no uniform classification systems, and there is poor education on the topic in medical and dental schools. There is starting to be more research and publication on the topic, which helps many understand the immediate impacts and long-term impact of untreated tongue-tie. Most recently, studies out of Stanford University School of Medicine have shown tongue-tie to be a marker for the development of forms of sleep apnea, thus thrusting the topic into more mainstream medicine.

We have found that education and understanding about tongue-ties was very common up until the 1950’s-60’s when formula was introduced in the United States. What was once a very routine and common procedure, often taking place in the nursery upon birth, went out of common practice and medical education. As nursing rates started climbing back up in the US over the past 10 years, there has been an increasing awareness about tonguetie. Multiple fields of medical and dental specialties, lactation, speech/feeding, orofacial myofunctional therapy, and physical and occupational therapy are now conducting interdisciplinary research regarding tongue-tie and Tethered Oral Tissues in great hope to shine the light on the subject that has so many people in the dark.

Is there a genetic factor in this condition? There have been genes isolated for the transmission of tongue-ties that we see in the familial types. There are many that just pop up in families. There are some investigators examining how environmental factors and the potential impact of increasing amounts of folic acid in prenatal vitamins may be related to tongue-tie.

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Living Well

Cover Feature

Q&A WITH DR. BOBBY GHAHERI, whose clinical interest is helping babies with lactation difficulties. This desire stems from personal experiences, since both of his daughters had significant problems nursing. He is one of the only ENT surgeons in the US who uses an in-office laser treatment for assisting babies to latch on, in addition to treating older children and adults for certain dental and speech issues.

Do you think every case of tongue tie should be treated? I think there’s a scientific answer and a practical answer, and they don’t always match. If you look at tongue-tie as an isolated issue, just as a medical problem, then if that tie is causing symptoms, then yes, it should be treated. But that’s not how medicine works. Unfortunately, there are practitioners who don’t think about the mother-baby unit and get too focused on the presence of the tie, who barrel in and treat it. That’s a setup for problems. One has to take into account how the family is doing; is mom suffering from PPAD? Does she have a support system? Is the baby medically ready or appropriate for a procedure? Is there a chance that a procedure can actually worsen feedings? All of these are examples of considerations that must be taken into account before releasing a tie.

What do you think are the drawbacks of not treating tongue-tie? There are potential drawbacks, but the hard part in counseling families is that there’s not a guarantee that

something bad will definitely happen because of inaction. In general, I explain that if symptoms related to feeding the baby (either lactation or bottle) are attributed to a tongue-tie, then the first thing to expect logically is lack of improvement of those symptoms. Two papers demonstrate that there is anywhere from a 300% to 500% chance of not nursing if tongue-tie is not treated in the first 10 days of life. There are other future implications as well. There are theoretical issues with how a child can handle solid foods (they can be labeled “picky”), speech delay, sleep apnea, or orthodontic problems. There may be future implications, such as how they lick an ice cream.

How can a parent detect tongue-tie in their child? It’s not always easy for a parent to detect, but if it’s obvious, many parents can do so. Often there is a feeding issue or speech issue, etc. that indicates tongue-tie. However, seeing a tie is less important than grading its function. That’s something that needs to be done by an IBCLC, speech pathologist, or medical professional with specialty understanding in tongue ties.

Why is Nursing So Painful? While tongue-tie and upper-lip tie are the cause for many feeding-related issues, there are many potential causes of lactation problems. Here are some: Technique problems This includes poor latch technique, especially with positioning. Poor positioning can certainly be a problem, often caused by the wrong kind of pillow or how the baby is held. Nursing an acrobatic toddler who may forget that she is feeding when something more interesting comes by can cause pain. Anatomical problems in the baby There are anatomical issues other than tongue-tie or lip-tie that negatively impact lactation. One of the most common is tight oral/neck musculature. Congenital disorders of the baby can affect their oral or facial anatomy, making nursing extremely difficult (cleft lip or palate, for instance). Specific factors affecting the mother While some of these factors can be caused by tongue-tie or lip-tie, problems the mother can suffer from due to nursing might be the cause of problems. Mastitis, plugged ducts, thrush, and blebs can be caused by trauma when the baby bites or chews. Some mothers have allergic reactions to products applied directly to the skin, or to fragrances in toiletries or laundry. There is a small subset of mothers that have pain with letdown, or a painful milk ejection reflex. Others have severe negative emotions associated with letdown, called a dysphoric milk ejection reflex.

40 The Wellspring | January 2019

From Dr. Ghaheri’s Archives If Everything Looks Okay, Is Everything Okay?

There are numerous situations in which a baby who has an oral restriction can seemingly do “well” with nursing. The most common example involves focusing just on infant weight gain. How can a baby with a tongue-tie or liptie successfully gain weight? Early in life, a baby can successfully gain weight by being very tenacious. These are babies who have relatively high muscle tone and can cause significant pain to mom while nursing. They often have enough muscle tone to not become fatigued during the process, but because their oral restrictions make them inefficient feeders, they can feed for very long periods of time. It’s important to recognize that weight gain is not the only marker of successful nursing, and if mom is on the verge of quitting because pain is unbearable, the early successful weight gain becomes irrelevant. Supplementation with bottles may mask the issues that would have been apparent with exclusive nursing. While the normal weight gain may make the primary care provider satisfied, the loss of exclusive nursing is associated with shorter durations of lactation. Additionally, bottle feeding can cause changes to palate architecture that have downstream effects. But here’s why the compensations that the baby employs can cause problems in the long-term. Completely normal lactation is nature’s way of expanding the palate. The process of nursing molds the palate into a broad shelf by putting pressure on the inside of the

infant’s gums. This, in turn, allows the teeth to eventually come in with adequate spacing. Many of the orthodontic problems that we see are a result of a high palate and crowded teeth (maxillary constriction). There is good evidence that nursing promotes better dental occlusion. The nasal septum sits on the palate (anatomically, the roof of the mouth is the floor of the nose). When the palate arches up instead of staying broad, the nasal cavity is narrowed. Furthermore, the septum has to buckle if the floor it sits on comes up, which results in a deviated septum. Both of these consequences predispose the baby to mouth breathing. While the deviated septum happens over years, the high palate can be noticed immediately after birth; some babies are very snorty while nursing. Because babies are obligate nasal breathers, the nasal obstruction can even further complicate the latch. The palate is the hub of facial growth as a child gets older. If the palate is low and broad, the child can breathe out of the nose, and there is less chance of sleep-disordered breathing and sleep apnea. Nursing for as long as possible, even when it’s not primarily for calories as a child enters toddlerhood, is critical for optimizing palate formation. We are starting to see more evidence for the benefits of nursing for reasons previously undescribed. A study done by researcher Guilleminault from Stanford University (International Journal of Pediatric Research, 2015) shows the correlation between tongue-tie and sleep apnea, which has many downstream consequences (fatigue, difficulty concentrating, teeth grinding, bedwetting, behavioral issues, and even symptoms mimicking ADHD).

Psychological or other health factors Postpartum depression can magnify any discomfort or can be interpreted as discomfort. This becomes especially apparent when the baby has other reasons to have lactation problems, specifically with tongue-tie or lip-tie. Primary pain disorders like fibromyalgia can also become very problematic for a mother who is trying to nurse. Some mothers experience increased discomfort during certain times of their cycle. Equipment misuse Improper use of a shield can certainly cause problems with nursing, either leading to inefficiency of transfer, frustration for the baby, or pain for the mother. Additionally, improper use of a pump can cause undue pressure and pain. This list is by no means exhaustive. It is only meant to demonstrate that a mother who is experiencing difficulty with nursing should visit someone who is versed in diagnosing these potential problems.

Teves 5779 | The Wellspring 41

ink h t u ... o s y g n n i e n h r o W about m

ISSUE 35 JANUARY 2019 TEVES 5779

Soup of the Day Get Cozy with Nourishing Comfort Foods

TIDBITS 17 IMMUNE-BOOSTING FOODS TO GET YOU THROUGH THE COLD AND FLU SEASON

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Recipes

Dear Cooks, In this issue’s Seasoned, we bring you exactly what you’d expect to see in a winter issue of a health magazine. There are no surprises in our basic theme—winter comfort food and soups. But wait until you see what our recipe developers came up with. Both the Levines and Rivki Rabinowitz have gone all out, creating genius ways for you to incorporate nutrition and comfort in one dish. Some of the soups you’ll find here are so nourishing that you may want to forget about chicken and potatoes for one night or two. Isn’t it time we realized that a hearty bowl of soup may be enough to give us everything we need in a meal? Many of us are under the impression that dinner must include a “main dish” in order to be called a proper meal. Even if the soup contains more ingredients and food groups than we’re used to eating in three courses, we still feel it doesn’t do justice as a proper dinner. Perhaps it’s time for us to think out of the box; to pat ourselves on the back for putting the protein, carb, and vegetable into one hearty dish; and to savor every spoonful of this only course we’ll be serving. Just my thoughts, before I head to my kitchen and start chopping my vegetables for tonight’s one-pot dinner.

To a cozy, happy winter, Esther

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Recipes, Styling & Photography By Yossi & Malky Levine

Winter Wild Rice Soup Here’s the soup that says, “I’m comfort in a bowl.” 2 Tbsp olive oil 1 small onion, diced 4 cloves garlic, minced 8 ounces portobello mushrooms, sliced 2 medium carrots, cut into small chunks 2 celery stalks, diced 1 large sweet potato, cut into small chunks 1 cup uncooked wild rice

6 cups water 3 cups milk (dairy or alternative) 2 bay leaves 1 Tbsp salt ¼ tsp black pepper (or to taste) 1 cup coconut milk Optional: 2 large handfuls of kale, roughly chopped with thick stems removed

Heat olive oil in a large saucepan over medium heat. Add onions, garlic, mushrooms, carrots, celery, and sweet potatoes, cover the pot, and sauté for 15-20 minutes. Add rice, water, milk, bay leaves, salt and pepper and bring to a boil. Reduce the heat to medium-low, cover the pot, and simmer for 45 minutes, until the rice is tender, stirring occasionally. Add the coconut milk and stir to combine. Remove the bay leaves. Optional: Add chopped kale before serving and gently stir to combine. Serve warm. Yield: 8 servings

FIVE-STAR DINING

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Recipes

Garlic-Parmesan Broccoli and Potatoes The party of flavors in this fabulous dish…well, you’ll have to take one bite to know what we’re talking about. 24 oz. broccoli florets 16 oz. red baby potatoes, halved 4 Tbsp olive oil 3 cloves garlic, minced 1 tsp salt

1 tsp paprika ¼ tsp black pepper ¼ cup freshly grated Parmesan cheese 2 Tbsp fresh parsley leaves, chopped

Preheat oven to 400˚F. Add broccoli and potatoes to a large bowl. Add the oil, garlic, salt, paprika, and pepper and toss until evenly coated. Spread onto a baking sheet in a single layer. Bake for 30-40 minutes, stirring once halfway through. Sprinkle with Parmesan cheese and fresh parsley before serving. Yield: 6 servings

Teves 5779 | The Wellspring 49

Eat Well

Recipes

Root Vegetable Pot Pie The ultimate in a homemade, whole-grain crust filled with winter veggies. This works great as a side dish for your main course on Friday night or anytime. Dough: 1 heaping cup white wholewheat flour ¼ tsp salt ⅓ cup COLD coconut oil (it should be solid), diced 4 Tbsp ice-cold water Filling: 2 Tbsp avocado oil 1 small red onion, diced 2 purple potatoes, diced 1 carrot, sliced

1 celery root, diced 1 cup butternut squash, diced 1 cup water 1 cup milk (dairy or alternative) ¼ cup red wine 1 tsp salt 2 Tbsp honey dash each of black pepper, garlic powder, and paprika ¼ cup water plus 1 Tbsp corn starch, mixed together well (you can use arrowroot powder or tapioca starch)

Dough: Add the flour, salt, and coconut oil to a food processor. Pulse just a few times to lightly mix until pea-sized balls are formed. While the processor is running, add the water and process until the dough is crumbly. Do not let it turn into a big dough ball, or you will have overmixed the dough. Gather dough into a dish, wrap in plastic, and place in fridge until you are ready to roll it out. Filling: Heat the oil in a large skillet on medium-high heat. When the oil is hot, add carrots and sauté for 5 minutes. Add onion and celery root and sauté for 5 minutes. Add squash and potatoes and sauté for 5 minutes. Add the water, milk, wine, salt, honey, black pepper, garlic powder, and paprika and stir to combine. Bring to a boil, then reduce the heat to a simmer. Cook for 20 minutes. Mix the water and corn starch and slowly pour into the pan while stirring constantly. The broth will begin to thicken. Cook for another 10 minutes. Remove dough from the refrigerator and divide into 4 equal parts. Roll them into thin circles, slightly larger than your ramekins. Fill the ramekins with the vegetable mixture and place a circle of dough on top of each. Pinch the sides of the dough down to the sides of the ramekin. Slice a few vents in the dough to allow steam to escape. Optional: brush dough with egg to help it brown. Put the ramekins on a lined baking sheet and bake for 45 minutes, or until the crust is a golden brown. Remove from oven and let them rest for 3 minutes. Yield: 4 ramekins

Teves 5779 | The Wellspring 51

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Dietary restrictions are a thing of the past with Mehadrin's new Parve line!

Whether you're lactose intolerant or just ate chicken, you can now still savor the joys of Milchig foods.

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Recipes

fresh. By Rivki Rabinowitz photos by Zoe Mandelbaum

Mini Meatball Minestrone

(Recipe on next page)

Brought to you by: Savours Fresh Market

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Recipes and styling by Rivki Rabinowitz , photos by Zoe Mandelbaum

It should come as no surprise that soup is foremost on my mind, as temperatures plummet and hibernation begins. In this issue, I present to you the spicy cauliflower soup; homey chicken and rice soup, updated with a current twist; and a nourishing minestrone soup. Regardless of your flavor preferences, you can find me with a soup spoon in one hand, salad fork in the other, and always—wishing you the freshest, coziest of winters!

Mini Meatball Minestrone What I love about this one is that it truly is a complete meal. Using turkey as the meatball keeps fat content down, and the accompanying ingredients work together to up the ante on this warming winter soup. Meatballs: 1 lb. ground dark turkey 3 Tbsp quick-cooking oats 1 Tbsp chopped fresh basil 1 Tbsp oil ½ tsp black pepper ¾ tsp kosher salt 1 large egg, lightly beaten 1 Tbsp oil, for browning Soup: 2 cups diced onion

¾ cup sliced carrot ¾ cup sliced celery ¾ cup cubed parsnip 3 cups chopped kale ½-1 cup dry red wine ¼ tsp kosher salt 1 32 oz. container chicken broth 2 Tbsp dark red miso, optional but recommended 1 14.5 oz. can of tomatoes seasoned with spices (basil, oregano) 1 15 oz. can chickpeas, rinsed and drained ¼ cup chopped fresh basil 2 Tbsp oil

To prepare meatballs: Combine first 7 ingredients in a bowl. Shape by tsp into 30 or so meatballs. Add oil to a large pan and swirl to coat. Add half of the meatballs, cook 2 minutes, turning them to brown. Remove meatballs from pan and repeat with remaining. To prepare soup: Add onion, carrot, celery, and parsnip to a pan and sauté in 2 Tbsp oil for 6 minutes. Add kale and sauté 1 minute. Stir in wine, chicken broth, miso, canned tomatoes, and chickpeas. Add the salt. Bring to a boil, reduce heat, and simmer for 10 minutes. Add meatballs. Cover and cook 12 minutes, or until meatballs are done. Stir in basil.

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Recipes

Cauliflower Soup with Cinnamon Apples and Smoky-Sweet Pecan Topping For me, comfort food can easily be defined as something that evokes nostalgia; a memory-driven taste that warms the soul as it does the palette. Cauliflower soup is a classic; good enough to stay as is, but basic enough to jazz up with some accoutrements. Here I give you that blank canvas, and some fun ideas to garnish. Who says your soup needs to be loaded with starchy vegetables? When prepared thoughtfully, cauliflower yields a rich and creamy texture. Add the textures of nuts and the brightness of apples, and this is comfort and excitement combined. Soup: 4 cups cauliflower, or 1 medium head 2-3 Tbsp oil, plus more for drizzling kosher salt freshly-ground pepper 1 small fennel bulb, chopped 1 small onion, chopped ⅓ cup water 6 cups chicken broth ½-1 cup almond milk creamer 2 bay leaves

To prepare soup: Preheat oven to 400°F. Toss cauliflower and 2 Tbsp oil on a baking sheet. Season with salt and pepper. Roast, tossing once, until cauliflower is golden and tender, 30–35 minutes if using a fresh head, about 17 minutes if using frozen. In a pot, cook fennel and onion in about 1 Tbsp oil until they are very soft, 8–10 minutes. Add water and cook until mostly evaporated, about 5 minutes. Add roasted cauliflower, broth, almond milk creamer, and bay leaves; season again with salt and pepper. Bring to a boil, reduce heat, and simmer until cauliflower is very tender, 20–25 minutes. Pluck out bay leaves; discard. Let mixture cool slightly. Working in batches, purée cauliflower mixture until very smooth. Strain back into pot; season with salt and pepper.

1 Tbsp chopped fresh parsley, or 1 Tbsp chopped fresh thyme, or ½ cup sage

Garnishes: Cinnamon Apple: Slice apples into matchsticks. Season with lemon juice, cinnamon, and coconut sugar.

Cinnamon Apple Garnish: 2 hard Granny Smith apples ½ lemon, juiced ½ Tbsp cinnamon 1 Tbsp coconut sugar Smoky-Sweet Pecan Garnish: 2 Tbsp olive oil ½ cup pecans 1 cup cauliflower rice (either blitz cauliflower in your food processor or chop very finely) 1 tsp smoked paprika pinch of cayenne pepper 1 Tbsp maple syrup salt and pepper to taste

Smoky-Sweet Pecan: Heat 2 Tbsp of olive oil in a pan to a medium heat. Add all remaining ingredients, except herbs, and fry for 7 minutes, stirring often. You want the crumb to be crispy and deep in flavor. To serve: ladle soup into bowls; top with apples and smoky-nut mixture, and season with crispy sage, or chopped parsley or thyme.

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Recipes

Sea Salt Fig Focaccia with Rosemary and Lavender What is soup, if not a means with which to dunk something comforting and cozy—something that soaks up all the liquid, leaves you with that perfect sweet and salty bite, and completes the meal? Here I give that to you. 1 medium-size red onion 3 Tbsp olive oil, divided flaky salt plain cornmeal 1 lb. bakery pizza dough 8 fresh figs, sliced down the midline 1 Tbsp fresh rosemary leaves ¼ Tbsp dried lavender drizzle of honey

Preheat grill pan. Slice onion into ¾-inch slices. Brush onion slices with 1 Tbsp olive oil and season with sea salt to taste. Grill onion slices 3 to 4 minutes on each side, or until softened and lightly charred. Preheat oven to 425°F. Lightly dust work surface with cornmeal. Stretch dough into a 10- to 12-inch oval on work surface. Place dough, cornmealside down, on a greased baking sheet; drizzle with remaining 2 Tbsp olive oil. Rub oil into dough. Arrange figs and grilled onion over dough, pressing lightly. Sprinkle with rosemary, lavender, and a fine yet encompassing drizzle of honey, and salt to taste. Bake at 425°F on lowest oven rack 15 to 20 minutes, or until golden.

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Recipes

Chicken and Rice Soup with Lime and Ginger One of my favorite things to do is take a homey classic like chicken and rice and inject a current twist. I know I’m not alone in this. Here, I’ve created a riff on the flavors of the ubiquitous ramen bowl, but with your momma’s foundational chicken and rice. 1 Tbsp olive oil ½ cup chopped onion 1½ Tbsp finely-minced fresh ginger, or ¼ tsp ground ginger 1 Tbsp white miso 1 8 oz. package pre-sliced cremini mushrooms 4½ cups chicken broth 2 cups shredded, skinless, rotisserie chicken breast 3 cups chopped bok choy 1½ cups precooked brown rice 1 Tbsp tamari, soy sauce, or coconut aminos ½ tsp kosher salt 1 tsp lime zest 2 Tbsp fresh lime juice

Heat oil in a large pot over medium-high heat. Add chopped onion, ginger, and miso. Sauté 4 minutes. Add mushrooms, sauté 2 minutes. Add stock, chicken, and bok choy. Reduce heat, and simmer 8 minutes. While soup simmers, prepare rice according to package directions. Stir rice, soy sauce, and salt into the soup. Cook 4 minutes, or until bok choy is tender. Remove from heat and stir in lime zest and juice.

Rivki is an interior-design-trained mom of three girls, who is passionate about cooking—particularly with elevating the vegetable. Showcasing their diversity in modern and innovative preparation is her happy place! Find her cooking and lifestyle shenanigans @rivkirabinowitz

Teves 5779 | The Wellspring 57

Well Informed

Nutrition Tidbits in the News By Liba Solomon, CNWC

FOOD IS MEDICINE

17 immune-boosting foods to get you through the cold and flu season 1. GINGER TEA When it comes to treating a common cold, ginger is one of the best foods for relief. In a review published in the International Journal of Preventative Medicine, researchers summarized that ginger’s potent anti-inflammatory properties are key in the root’s powers to combat a cold or flu. Because inflammation can affect your body’s immune response, anti-inflammatory ginger can play a key role in boosting your immunity.

5. BLUEBERRIES Blueberries are filled with antioxidants that can help treat and prevent coughs and colds. According to research conducted by the University of Auckland, consuming flavonoids—a class of antioxidants found in blueberries—made adults 33 percent less likely to catch a cold than those who did not eat flavonoid-rich foods or supplements daily.

2. ORANGES Oranges are packed with vitamin C, an essential nutrient when you’re feeling under the weather. According to a review conducted by the National Centre for Epidemiology and Population Health, at the Australian National University, vitamin C is helpful in preventing the common cold for people exposed to sickness-inducing environments, such as cold weather, and can help lower the duration and severity of a cold.

6. GINSENG TEA Ginseng tea is popular for more reasons than its delicious taste. Namely, the tea has been used as a treatment for upper respiratory tract infections. A review published in the Canadian Medical Association Journal noted that ginseng has been shown to significantly reduce the symptoms of colds and influenza. However, the researchers noted that more research needs to be conducted to fully support ginseng’s immunity-boosting claims.

7. TOMATOES

3. WATER When you’re feeling sick, good old H2O can be one of the most helpful drinks to sip. Staying hydrated can help loosen trapped mucus. Try drinking at least the recommended eight glasses of water a day to keep yourself fully hydrated, since we tend to lose more fluids when we’re sick.

4. GREEK YOGURT Greek yogurt is filled with sickness-fighting probiotics and packed with more protein than regular yogurt. A meta-analysis published in the Korean Journal of Family Medicine found that probiotics can help prevent and treat the common cold. The researchers discovered that people who ate probiotics daily had a lower risk of catching a cold than those who did not eat any probiotic-rich food.

58 The Wellspring | January 2019

system.

Tomatoes are also a great food to eat when you’re sick, due to their high concentration of vitamin C. Just one medium tomato contains a little over 16 milligrams of vitamin C, which is a proven fuel to your body’s immune

In a study published by Medizinische Monatsschrift fur Pharmazeuten, vitamin C was shown to be a vital component of the strength of the body’s phagocytes and T cells, two major components of the immune system. The researchers also noted that a deficiency in this nutrient can lead to a weaker immune system and a lower resistance to certain pathogens that can lead to illness. Check out this issue’s “Nutrition Facts” for more on this vegetable.

8. WILD SALMON Wild salmon has a high zinc content, the nutrient that has been proven to assist in reducing common cold symptoms. To help your family, and especially your children, avoid a cold this winter season, give them zinc-rich foods. The journal Family Practice published a study examining

the effects of zinc on the common cold in children ages 1 to 10 years old. Researchers found that zinc, in comparison to a placebo, significantly reduced the severity and duration of symptoms when taken within 24 hours of the onset of cold symptoms. The researchers noted another trial involving children ages 6.5 to 10 years old that showed zinc also helps prevent catching a cold. The children who took 15 mg of zinc daily for seven months were found to be significantly less likely to catch a cold during flu season in comparison to those in the control group.

9. DARK CHOCOLATE Believe it or not, dark chocolate is more than a comfort food when you’re struck with a cold. Dark chocolate contains a heavy concentration of theobromine, an antioxidant that has been proven to alleviate coughing. A study published in Frontiers in Pharmacology found that theobromine is helpful in suppressing cough symptoms for people with bronchitis, but notes that more research needs to be done to fully confirm their findings.

10. BROCCOLI Researchers at the University of California, Los Angeles, have reported that broccoli can be a great addition to your diet if you’re trying to prevent a cold. Broccoli and other cruciferous vegetables were proven to help boost immunity, according to the study. Researchers claim that sulforaphane, a chemical in the vegetable, switches on antioxidant genes and enzymes in specific immune cells that combat free radicals in your body and prevent you from getting sick.

13. SPINACH Spinach is a major superfood that is great for your overall health. Not only is it packed with digestion-regulating fiber, but it also contains vitamin C. Vitamin C is a powerful nutrient that can assist in preventing the common cold and help reduce symptoms of sickness.

14. WHOLE-GRAIN BREAD Whole grains contain anti-inflammatory properties, which allows for an increase of production of healthy bacteria, according to a study published by The American Journal of Clinical Nutrition. Seventy percent of your immune system lives in your gut. So it’s important to keep your gut healthy if you want to fend off any cold-causing germs.

15. EGGS Eggs, especially the yolks, are packed with immunity-boosting nutrients. Eggs contain a high amount of vitamin D, a vitamin that’s vital in regulating and strengthening immunity. According to a study published in the journal JAMA, participants who took a daily serving of vitamin D in the wintertime were less likely to catch a cold or any other upper respiratory tract infection in comparison to those who did not.

11. EXTRA VIRGIN OLIVE OIL This oil has been shown to help rebuild and boost the body’s immunity. A study published in the British Journal of Nutrition found olive oil’s high content of polyunsaturated fatty acids act as an anti-inflammatory agent in the body, assisting in boosting the immune system and guarding the body against infection.

12. GREEN TEA Green tea is not only recommended for weight loss, but it’s also one of the best sources for fighting off a cold. It contains flavonoids, antioxidants that boost immunity, and has antiinflammatory properties, according to a study published in t h e Journal of Indian Society of Periodontology. The study states that the antioxidant catechin, which is heavily prevalent in green tea, is known to be a powerful antibacterial and antiviral and can kill off cold-starting bacteria and the influenza virus.

16. GARLIC Garlic has a reputation for being one of the best cold-curing foods, and for good reason. A review published in the Cochrane Database of Systematic Reviews showed that a group of participants in a study who ate garlic over a three-month period had only 24 cases of the common cold, significantly less than the 65 cases reported by the control group. However, the researchers noted more studies need to be conducted in order to validate garlic’s true impact on the common cold.

17. APPLES “An apple a day keeps the doctor away” isn’t just a saying—apples can help prevent illnesses such as the common cold. This fruit contains phytochemical antioxidants, according to a study published in Nutrition Journal. These antioxidants help boost immunity and reduce the risk of chronic diseases.

Teves 5779 | The Wellspring 59

Eat Well

Nutrition Facts in a Shell By Devorah Isaacson

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

THIS MONTH:

TOMATOES

Principle

Nutrition Value

Percentage of RDA

Energy

18 Kcal

Carbohydrates

3.9 g

Protein

0.9 g

1.6%

Total Fat

0.2 g

0.7%

Cholesterol

0 mg

Dietary Fiber

1.2 g

Folates

15 µg

Niacin

0.594 mg

Pyridoxine

0.080 mg

Thiamin

0.037 mg

Vitamin A

833 IU

28%

Vitamin C

53 mg

21.5%

Vitamin E

0.54 mg

Vitamin K

7.9 µg

6.5%

Sodium

5 mg

>1%

Potassium

237 mg

Calcium

10 mg

Iron

0.3 mg

Magnesium

11 mg

Magnesium

0.15 mg

6.5%

Phosphorus

24 mg

Zinc

0.17 mg

1.5%

Vitamins

Electrolytes

Minerals

Whenever I had a classic Caesar or Greek salad as a teen, the tomatoes were the last vegetable to go—on good days. Most of the time, they ended up staying in the bowl, marinating in the dressing until I found a garbage can. As my taste buds matured, tomatoes have become one of my favorite vegetables. In fact, when I’m in a rush and left with no time to cut up a proper salad, I’ll have my fill of vegetables in the form of cherry tomatoes, which I often refer

60 The Wellspring | January 2019

to as nature’s candy. They could be so sweet that I almost feel I’m eating a fruit! Actually, from a botanical perspective, they are. But tomatoes have more to offer than their great taste. According to the Department of Food Science at North Carolina State University, in regard to a study on tomato nutrition: “Tomatoes are the second most produced and consumed vegetable nationwide and are a rich source of lycopene, beta-carotene, folate, potassium, vitamin C, flavonoids, and vitamin E.” Tomatoes, a member of the nightshade family, which also includes vegetables like peppers, eggplant, and potatoes, are one of the most common vegetables (or fruits) grown in people’s gardens around the world.

High Antioxidant Content Why are tomatoes good for you? Not only are tomatoes low in calories and a good source of vitamins C and K, but they are also high-antioxidant and one of the best sources of the phytonutrient lycopene in the world. Lycopene is closely tied to enhanced immunity and cancer risk reduction. Although most people correlate lycopene with deeply-colored red tomatoes, it’s believed to be present in equally high quantities in organic yellow, green, and orange tomatoes. Studies over the past several decades have found that people who eat more tomatoes are less likely to suffer from prostate cancer, the most common form of cancer in American men. Cooked tomatoes are especially beneficial for fighting cancer, because once cooked (especially with a source of fat, like olive oil), the lycopene they contain becomes more available. As a natural cancer treatment, researchers have known about the immune-enhancing effects of foods containing lycopene for decades. Studies dating back to the 1990s conducted by Harvard University Medical School found that men who ate the most tomatoes had a much lower risk of developing prostate cancer than non-tomato eaters. Some were eating as many as 10 servings a week (or more) of tomatoes—including tomato juice, tomato sauce, and raw toma-

toes. At least five studies support a 30-40 percent reduction in prostate cancer risk associated with high tomato or lycopene consumption. A large report published by the Royal Victoria Hospital and McGill University of Montreal investigated 11 case-control studies and 10 cohort studies on the use of tomato, tomato products, and lycopene for cancer prevention. Researchers found that tomatoes, especially when eaten in high amounts, offer significant protection. Besides lycopene, tomatoes contain a variety of other powerful phytochemicals that help fight widespread chronic diseases. For example, research shows that phenolic acids found in tomatoes have the potential to fight lung cancer because of their ability to inhibit the formation of nitrosamine compounds in the body. A Natural Anti-Inflammatory Tomatoes’ deep color is a good indication of their high supply of inflammation-fighting antioxidants. This is exactly why many nutrition experts tell you to “eat the rainbow.” Tomatoes are especially known for a trio of antioxidants: zeta-carotene, phytoene, and phytofluene that are found together in many brightly-colored fruits and vegetables. These phytonutrients are effective in helping lower disease-causing inflammation and thus slow age-related diseases, like heart disease, cancer, diabetes, arthritis, and cognitive decline. The processing of tomatoes may significantly affect the bioavailability of these anti-inflammatory nutrients. Homogenization, high-heat treatment/cooking, and the incorporation of oil in processed tomato products lead to increased lycopene bioavailability. Unfortunately, at the same time, these processes can cause significant losses of other delicate nutrients. This is why it’s a good idea to eat both raw and cooked tomatoes regularly.

Heart Health Tomatoes are good for you, if you’re at risk for heart-related problems. Tomatoes’ antioxidants, especially lycopene, fight free radical damage and thus protect the heart against oxidative stress, lowering the risk of heart attack or stroke. This is a big deal, since heart disease is the No. 1 cause of death in the U.S. and many other nations Some studies have found that treatment with antioxidant-rich tomato extract can also reduce high blood pressure, lower cholesterol naturally, and improve blood vessel health. In a 2002 study, healthy adults ingesting lycopene in the form of tomato juice, tomato sauce, and soft gel capsules for one week were found to have significantly lower levels of LDL oxidized cholesterol compared with control groups. Vision and Eye Health The compound lutein is present in tomatoes, and it’s very healthy for your eyes. Lutein is often studied in regards to eye health because it protects the eye’s retina. The retina is especially vulnerable during old age, due to long-term damage by UV light radiation and oxidative stress from other factors. Among the many carotenoids present in the body, only lutein and zeaxanthin are found in that portion of the eye where light is focused by the lens, called the macula lutea. Skin Health Tomatoes are an excellent source of vitamin C, which is crucial for keeping skin’s immunity, elasticity, appearance, and complexion strong into older age. This vitamin is most concentrated in the gel-like substance surrounding the tomato seeds. So be careful not to let this valuable juice “leak out” too much and go to waste when cutting tomatoes.

Are Tomatoes Bad for You? Although tomatoes are loaded with benefits, keep in mind that they are a nightshade vegetable that can aggravate health conditions in some people. Green tomatoes contain a substance called solarnine, which may aggravate conditions like arthritis or other autoimmune-related diseases. Nightshade vegetables are also somewhat of a common allergy, at least when it comes to fruits and vegetables. Many health professionals counsel people with painful arthritis symptoms to avoid nightshades altogether, although some say the benefits vary depending on the individual’s tolerance, so avoidance is not always necessary. Tomatoes are also usually avoided by people with GERD or other reflux disorders like heartburn because of their high acidity. If you frequently have acid reflux symptoms or stomach, joint, or muscle pain, staying off tomatoes might be smart to test your reaction. If you experience unexplained digestive issues that might suggest a possible food sensitivity, you can try an elimination diet cutting out all nightshade vegetables, including tomatoes. These diets are usually most helpful when followed strictly for at least six weeks. Although this might sound a little daunting, it’s worth a try to help reduce further inflammation and swelling. In Your Plate! *You can use all types of tomatoes—whether beefsteak, cherry, or grape—in diverse ways, including eating them raw, adding them to sauces, juicing, or adding to a smoothie. Tomatoes go great with ingredients that bring out their flavor, like garlic, oil, fresh herbs of all kinds (especially basil and parsley), onions, avocado, peppers, beans, and leafy greens. *The protective properties of lycopene, especially regarding cancer prevention, are most beneficial and absorbable when tomatoes are consumed with a fat-rich food. This is why it’s a great idea to eat tomatoes along with healthy fats like avocado, olive or coconut oil, nuts and seeds, or fatty fish, like salmon. Why? Carotenoids are fat-soluble nutrients. This means they get maximum absorption only when you eat them with a source of natural fat.

Teves 5779 | The Wellspring 61

Living Well

At the Dietitian By Tamar Feldman, RDN, CDE

TOP TEN WEIGHT LOSS TIPS I am often asked the question: What is the secret to successful weight loss? While I hate to burst bubbles, the reality is that there are no grand “secrets,” just good old-fashioned, tried and true tricks that work for most of us really well. Here are a number of my favorite simple weight loss tips:

1. DON'T SKIP MEALS I started with the most basic tip for a reason. In my opinion, this is the most vital trick to success. To jump-start weight loss, and maintain it, get your hunger in check by choosing satiating meals and snacks every three to four hours. For optimal hunger control, aim to have meals and snacks that contain both protein and fiber—two nutrients that have serious staying power.

2. MAKE YOUR FOOD LOOK PRETTY We eat with our eyes as much as with our mouths. Instead of throwing veggies into a bowl, plate them with care, cut them in new ways, and pick lots of colors. Take that extra step to enjoy the process of eating healthy options. As a time-saving trick, roast veggies twice weekly on a cookie sheet, leave in a container in the refrigerator, and throw onto salads at mealtimes for color and flavor.

3. EAT PROTEIN AND FIBER-RICH MEALS AND SNACKS Crowding out your plate with as many veggies as you can will keep you fuller, and you’ll be practicing portion control without even thinking about it. Adding protein to every meal and snack, such as an ounce of cheese, an egg, some chickpeas or beans on a salad, nut butter, or a fish/chicken/lean beef entrée will give the meal staying power and will prevent post-meal hunger crashes.

62 The Wellspring | January 2019

4. DRINK MORE WATER Our bodies need lots of water to keep our energy levels up, undergo regular digestion, etc. Drinking water before meals may also help curb hunger and keep you satisfied before, after, or during a meal.

5. MEAL PREP IN ADVANCE Being organized is key. I usually suggest clients decide on weekly menus for dinners and lunches in advance, on a pre-arranged day of the week, or at our weekly weigh in session. Once you have your menu in place, shop accordingly, so there are no last minute shortages to derail you. Pre-slice vegetables and fruits, and keep in air-tight containers at eye level in the front of your fridge. They should be the first items you see when you need a quick snack. Having pre-sliced veggies makes it easier to whip up omelets, salads, casseroles, and soups. If you are pressed for time to slice your own fruits and veggies, train in your cleaning lady, or buy presliced produce from the grocery. The extra cost is worth it, if it means you’re more likely to eat more fruits and vegetables.

6. DON'T DEPRIVE YOURSELF Allow yourself to have a treat from time to time. If you deprive yourself, chances are that over time you’ll give in and binge. Instead, set a time each week when you can treat yourself to a pre-determined caloric allotment of a treat without feeling guilty.

7. EAT MINDFULLY AND INTUITIVELY Slow down and use your senses as you eat. Enjoy the smell, visual appearance, textures, and flavors of the food. Eating mindfully in this manner has been shown to decrease total calories consumed, likely by increasing the satisfaction derived from the meal and thus preventing mindless overeating. In addition, I have seen great success with many clients who choose balanced meals following an intuitive eating approach rather than a traditional weight loss plan. With this “non-dieting” approach, a specified allotment of food portions isn’t provided; rather clients are instructed to follow internal hunger cues and satisfaction guilt free, trusting their body’s instincts. When using this approach with a client, I usually encourage proteins and veggies to be eaten first, if desirable to the client. Participants in intuitive-eating programs were shown at one year follow-up to have experienced decreased cholesterol levels and blood pressure. They enjoyed increased physical activity, improved eating behaviors, increased self-esteem, and increased weight loss, as well as decreased body dissatisfaction. Participants also reported maintaining a non-diet approach one year after the intervention. Few studies followed participants for longer than one year, but those that did reported similar sustained improvements. While this approach is not for everyone, particularly chronic dieters who have lost touch with their hunger cues and need some time and training to better get in touch with them, it may be a good fit for many individuals.

8. KEEP A FOOD JOURNAL Our minds are always busy, so it’s easy to underestimate the amount of food we consume. Tracking food consumption with a journal or mobile app can make you more aware. Be as specific as possible, tracking the type of food, amount, time, place, hunger level and emotions surrounding eating. Not only can developing a food-tracking habit make you more aware of portion sizes and eating patterns (e.g., overeating at night, skipping breakfast), it can also help detect mindless or emotional eating.

9. GET A GOOD NIGHT'S SLEEP While you may think the road to weight loss begins at the gym or in the kitchen, research has shown that it might start with your sleep habits. Getting a good night’s sleep (ideally eight hours) helps guide your food choices by controlling your hunger and fullness hormones, ghrelin and leptin. Ghrelin tells your brain it’s time to eat, but when you lack sleep, your body makes more ghrelin. The reverse is true for leptin, the hormone that cues fullness; sleep deprivation slows down leptin production. These hormonal changes cause you to overeat, resulting in unwanted pounds. So plan for seven to eight hours of shut-eye.

Aim to have meals and snacks that contain both protein and fiber. 10. DO WEEKLY WEIGHT CHECKS One of the common factors amongst participants in the National Weight Control Registry, a registry of individuals who have successfully lost weight and kept it off for more than five years, was a weekly weight check. Apparently, knowing what you weigh instead of burying your head in the sand seems to keep most individuals better on top of their eating and weight. Once you start making changes, you are probably agitated to see the numbers go down quick, but obsessing with the scale on a daily basis won’t help. Instead, it’s better to give it a week. The rule of thumb is to weigh yourself every week using the same scale, preferably in the morning. Even so, keep in mind that day to day fluctuation in weight occurs—so be patient and give it a full two weeks to determine if you are at a plateau or not. Did these tricks work for you? Let me know about your success at tamar@thegutdietitian.com.

Tamar Feldman, RDN CDE is a Registered Dietitian/Nutritionist and a Certified Diabetes Educator with over twelve years of experience. She maintains a busy nutrition practice with offices in Lakewood and Edison, 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 5779 | The Wellspring 63

Living Well

Monthly Dose By Yaakov Goodman

TINY IN SIZE, GREAT IN NUTRITIONAL VALUE

GET TO KNOW THE BLACK CUMIN SEED

Among the wealth of health-promoting and disease-fighting vitamins, minerals, and herbs that nature has to offer, one in particular has gained great popularity in recent years. Black cumin seed (not to be confused with the common spice cumin) is one of the most ancient herbal remedies native to Southern Europe, North Africa, and Southwest Asia. This seed has been

scope of clinical trials, black cumin is emerging as nothing short of a miracle herb.

used to cure diseases for many centuries in different indigenous systems of medicine as well as folk medicines, which has earned it the traditional names of “seeds of blessing” and “panacea.” Nigella sativa is a small flowering shrub with purple or white-tinged flowers that grows in Eastern Europe, the Middle East, and Western Asia. The fruits have tiny black seeds that have been used in remedies for thousands of years, and under the micro-

disorders, and rheumatoid arthritis. It also supports the immune system, reduces inflammation, and fights infections. The oil is used topically for skin and hair concerns, such as acne, dry hair, psoriasis, hair growth, and dry skin.

64 The Wellspring | January 2019

Black cumin seed oil has been demonstrated to be a powerful agent in ameliorating virtually all health disorders, from allergies to asthma, fertility issues, diabetes, headaches, sinusitis, high blood pressure, fungus, digestive

Many active compounds of black cumin seed oil have been isolated and identified, but the primary active ingredients that contain the majority of ben-

eficial compounds are thymoquinone and thymohydroquinone. As mentioned above, the health benefits of black cumin seed oil are plentiful. In order to do it justice, we will focus on two primary health conditions where black cumin seed oil has shown promising salvation. Asthma More than 23 million Americans suffer from asthma, a potentially debilitating condition causing the airways of the lungs to swell and narrow, leading to wheezing, shortness of breath, chest tightness, and coughing. It is distinguished by bronchial hyper-responsiveness, which is an exaggerated response of the airway characterized by swelling and infiltration of inflammation. Allergens and inflammatory tissue are the typical culprits involved in triggering asthmatic attacks. The disease affects people of all ages, but often begins during childhood. Asthma therapies aim to reduce inflammation and improve airway function. Conventional treatment modalities can effectively treat asthma in many cases, but for those with chronic, severe asthma, long-term use of glucocorticoids is linked to detrimental side effects, such as bone fractures and adrenal dysfunction. Incidentally, observational studies have shown that pregnant women with higher intakes of vitamin D had children with significantly lower risks of wheezing and asthma compared to women with lower intakes of this vitamin in the prenatal stage.

which causes mutations leading to malignant changes. A certain degree of healthy inflammation is needed, however, to protect us when the body encounters infectious agents, trauma, and malignant cells. The trouble is, however, that when our health is at a less than optimal state, inflammation can spread like wildfire. This not only promotes pain but also destroys tissues, while our ability to mount a strong immune response to pathologic killers is diminished. This imbalance underlies virtually all diseases of aging and early death. Scientists have found that black cumin seed oil can reverse this. New discoveries reveal that black cumin seed oil contains potent and safe compounds that suppress excessive inflammatory molecules, while at the same time stimulating the normal, acute inflammation we need. A staggering 52 million Americans suffer from arthritis, one of the most common inflammatory conditions. In fact, the first recorded use of black cumin seed oil was for this condition. Research supports the use of black cumin seed oil in both the prevention and treatment of arthritis, for both rheumatoid arthritis and osteoarthritis.

Black cumin seed oil stimulates the immune system in both directions. It suppresses dangerous chronic inflammation, while boosting appropriate immune function. ma symptom score, asthma severity, frequency of symptoms per week, and severity of wheezing were recorded in the beginning and end of the study. All asthma symptoms, frequency of asthma symptoms/week, chest wheezing, and PFT values in the study group significantly improved. In addition, further improvement of chest wheezing and in the severity of disease was noted. However, in the placebo group, there were no reported improvements. Inflammation Most people think of inflammation as just a nuisance, or as pain in the back or joints. However, chronic inflammation is the underlying culprit behind virtually all age-related diseases. In addition, those who suffer from chronic inflammatory diseases encounter impairment of the immune system’s strength in combatting foreign invaders. Chronic inflammation damages cells throughout the body, including the delicate linings of the arteries and brain cells. About 25% of all cancers are associated with chronic inflammation,

Immune System Black cumin seed oil stimulates the immune system in both directions. It suppresses dangerous chronic inflammation, while boosting appropriate immune function. The result is enhanced protection against both infections and inflammation. In other words, black cumin seed oil offers true immune system balancing, promoting healthy immune function when it’s needed, while suppressing excessive immune activity (inflamma-

tion). Black cumin seed oil achieves this immunological balancing act by means of several distinct but interrelated mechanisms. First, black cumin seed oil stimulates actions of patrolling immune system cells on the lookout for invading organisms or abnormal cancer cells. The oil triggers an increase in the activity of macrophages (cells that engulf and destroy abnormal cells) and helper T cells (cells that marshal natural killer cells and direct them to their targets). Mice injected with the oil were dramatically protected against cytomegalovirus, a version of the herpes virus that can infect humans and cause birth defects and other consequences. While control animals still had detectable virus in their systems at 10 days, treated mice were virus-free, the result of enhanced macrophage and T-helper-cell activity. These effects appear in humans treated with black cumin seed oil as well, according to a study presented at a recent international conference. That study reported a 55% increase in the activity of immune-helper cells, and a 30% increase in natural killer-cell function following black cumin seed oil supplementation. Far from being an irrelevant, old folk remedy, black cumin seed oil has been demonstrated to assist significantly in fighting virtually all areas of disease and in promoting maximal health. Additionally, various clinical trials have shown it to be virtually free of harmful side effects. Maxi Health is proud to present our newest formula, the Maxi Black Cumin Seed™, meticulously-sourced, cold-pressed, organic black cumin seed oil, the only kosher certified black cumin seed oil on the market. We encourage those seeking greater everyday health to take full advantage of this supplement. Always consult your healthcare practitioner with any concerns. To order Maxi Health products by phone, call 718-645-2266. Mention The Wellspring for an additional discount.

Teves 5779 | The Wellspring 65

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

Black cumin seed has a multi-healing ability in regards to asthma. It reduces respiratory inflammation, and, as one of the most powerful antioxidants, it has a remarkable ability to aid in healthy breathing. In a study on the black cumin seed oil’s ability at respiratory clearance, a large group of asthmatic adults were randomly divided and studied for three months. While one group supplemented with black cumin seed oil, the second group was given a placebo. Asth-

YAEL

Living Well

Health Profile By Rachel Esses

Age: 28 Gender: Female Location: Brooklyn Weight: 158 lbs. Height: 5'6” Marital Status: Single Occupation: Secretary Favorite health food: Apples and peanut butter. Soooo good!

That’s amazing! Apples provide lots of nutrients and their fiber helps you stay full throughout the day, plus peanut butter is high in healthy monounsaturated fats and nutrient-rich, which is why it’s one of our favorite foods for weight loss. Favorite junk food: Ice cream, chocolate, and French fries. Favorite exercise: StairMaster mat at the gym. Favorite nutritious dish: Grilled chicken salad with loads of veggies, with a tablespoon of my own light garlic-mayo dressing. That’s a great favorite nutritious dish to have. Consuming lots of free vegetables also helps keep you full. My usual bedtime: 12:00 a.m. My usual wake-up time: 6:00 a.m.

It’s recommended to get at least seven hours of sleep. Studies have shown that sleep deprivation is associated with increased feelings of hunger and body weight, as well as depression, diabetes, and heart disease. My weight loss saga: I find it so hard to stick to my meals. I’m always so busy and never “remember” to eat at the right time. I totally understand how much of a challenge it is, especially since I’m a workaholic myself, but set alarms so you don’t forget. Timing meals is really important to keep your metabolism going. My weight/lifestyle goals: To be able to maintain my weight but still enjoy my food.

How I would treat myself if I get to my maintenance plan: Bagels. Greatest weight loss challenge: I want to lose weight, but one of the hardest things for me is to prepare my meals. I’m always in a rush to get to work and tend to grab random things to take with me because I didn’t prepare ahead of time. Yes, prepping your food can be challenging, but there are so many grab-and-go options that can be used without steering off your diet. Visit a one-stop shop and get all your grocery needs, and try preparing the next day’s food the night before, so you’re prepared. Then what you take with you to work is what you eat. Rachel Esses is a nutrition counselor at Nutrition by Tanya, a nutrition practice run by Tanya Rosen, which has locations in Boro Park, Flatbush, Lakewood, Monsey, Monroe, Williamsburg, Queens, Five Towns, and Israel. Tanya is the creator of the TAP (Tanya approved products) line available on her website, offices, and at select supermarkets, offering all-natural low-calorie delicious snacks and food. Tanya can be reached through The Wellspring.

66 The Wellspring | January 2019

Wellbeing

Emotional Wellness By Esther Moskovitz, LCSW

I Can’t Wait to Meet You on the Other Side of Anger Not all anger is bad. Keeping it in may be worse. Anger is a very misunderstood emotion. Although the negative aspects of anger are well-known to us all, we may be unaware of how anger can be used in a positive way. Let’s examine two types of anger, known in therapy circles as “functional” and “unmoderated.” When someone oversteps one of my boundaries, if I am a healthy person, I will first be alerted by my functional anger; I will be bothered. Functional anger serves as an alarm; something here is not right, someone has overstepped a boundary. Boundary violations can be physical—someone went through my stuff without permission, someone handled my property with disrespect. Boundary violations can also be internal or emotional—someone embarrassed me, someone manipulated or tried to control me, someone tricked me into doubting myself so I wouldn’t hold them accountable. However, if I’m angry, it doesn’t give me the right to violate your boundaries because of it. It doesn’t give me license to subject you to my rage; it doesn’t give me license to touch your stuff without permission, or to shame or embarrass you. Whatever I wouldn’t be allowed to do in a normal situation still stands true even if you’ve crossed one of my boundaries. Two wrongs don’t make a right. And definitely, losing control of myself fits into that rule. This form of anger is “unmoderated anger.” When we’re operating from unmoderated anger, we think we have a different set of rules. But this may turn us into boundary violators, based on the false belief that I have a right to do what I want because I’m hurting. On the other hand, functional anger presents itself very differently. Suppose you overstep a boundary, e.g., you borrow my things, are careless with them, and they break. Functional anger, that internal alarm, goes off inside my head to let me know something wrong just happened. What’s

my job now? First, I need to protect myself. If you embarrassed me, I need to maintain an internal boundary to your words and not allow my self-esteem to plummet. If you took something that belongs to me without permission, I need to take action to get it back, or at least ensure I don’t allow you to do that to me again. After I’ve protected myself from being further damaged by your boundary violations, I must engage in some internal work. I have now become free to accept the real, whole, flawed, human, imperfect you. This is a big deal. Our culture projects the message that we shouldn’t feel anger. Good girls don’t get angry. But then the following scenario plays out: We don’t allow ourselves to notice when we’ve been hurt or taken advantage of. So we don’t protect ourselves from the damage the other person causes, and we become a victim. This causes resentment. We can’t relax or feel good around the person who hurt us, and we can’t accept that person for who they are. Since we feel we’re not allowed to feel angry, we end up being resentful, insecure people. But consider what happens when we allow ourselves to notice our anger but not stay stuck in it. Suppose I hurt you. You notice that you’ve been hurt or taken advantage of and take steps to protect yourself from the damage I’ve caused. You also take steps to prevent yourself from being damaged in such a way in the future. You can now relax and feel good, because you have protected yourself against future victimhood. And now you can know me, flaws and all, and love what is good about me. You have retained and protected your peaceful, accepting, loving stance. Wow! I can’t wait to meet you on the other side of anger, where I'll get to see the self-respecting, wise, loving individual that you are.

Esther Moskovitz, LCSW, specializes in challenges faced by adults raised by narcissistic or emotionally undeveloped parents using EMDR and the work of Pia Mellody. Her practice is in Monsey, NY and she has an active telephone practice, as well.

Teves 5779 | The Wellspring 67

Wellbeing

Health Personality By Shiffy Friedman

a cup of tea with: GITTA BIXENSPANNER OCCUPATION: Nutritherapist, teacher of limudei kodesh and nutrition workshops, artist, inspiring public speaker

SINCE: Teaching since 1970, graduated

nutrition school in 2008, painting since 2010

LOCATION: Montreal PASSION: I love all aspects of life. I’m not

afraid to experiment with new things. Right now, sourdough and fermenting vegetables are on the agenda.

WISHES PEOPLE WOULD KNOW THAT:

Hashem gave us an incredible body that has the capability of curing and regenerating itself, if we use it properly. There is no need for major cleanses, just to eat sensibly and not abuse the body with harmful food choices.

Gitta Bixenspanner’s foray into the field of health began over twenty years ago, when her mother-in-law was diagnosed with the machalah. “Instead of taking the usual trajectory, at the advice of the Tosher Rebbe zt”l, we did not administer chemotherapy,” recalls Gitta. “We took her to the Hippocrates Institute in West Palm Beach, where we learned to eat mostly raw foods and follow a vegetarian diet, along with juicing and other healthy practices.” With her newfound appreciation for healthy living, Gitta started instituting changes in her own lifestyle. “At the institute, I realized how food was impacting my life in more ways than I had ever imagined, and I was committed to doing it right. For the past 21 years, we have been vegetarian. We do eat fish and eggs a couple times a week, cheese and milk products very sparingly.” For years, Gitta has been studying nutrition and expanding her knowledge to remain in the know of the latest trends in nutrition. Finally, in 2008, she graduated nutrition school, which gave her the ability to take her appreciation of life to the next level. However, in addition to her knowledge in nutrition, Gitta is familiar with various other practices in natural healing, as well. “I use kinesiology extensively to ascertain what foods my clients should or should not eat, which vitamins are helpful and which are not. Being familiar with homeopathy and aromatherapy has allowed me to treat myself and family members with these two models, with much success, Baruch Hashem. I haven’t taken an aspirin or antibiotics in years.”

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On this point, Gitta notes the importance of not only leading a healthy lifestyle but also in knowing which nutritional supplements are good for the body and which aren’t. “I call myself a nutritherapist,” she explains, “healing people with the proper nutrition for their own body and personality. One of my main mottos is ‘Listen to your body.’ Every person is different and will thrive in a variety of ways when they eat what is right for them. This is a topic I focus on often in my talks, accompanied by visual presentations to illustrate the point.” What does Gitta think is the most important element of a healthy lifestyle? “I believe that a positive attitude and thinking of Hashem daily—asking for His help in every endeavor large or small, plays a promi-

nent role in all areas of health, in addition to a healthy and nutritious diet and exercise. I recommend going for any form of exercise, as long as you keep moving.” To Gitta, a healthy diet is not about cutting out food groups, not even carbs. “I find it especially disconcerting when parents try to limit their children’s healthy carb intake. Healthy carbs are vital for children’s growth. Avoiding carbs altogether can have negative effects on brain health and muscle tone. Carbohydrates are found in fruits, vegetables, whole grains, beans, and dairy. Not only do cells need carbohydrates, but the brain is entirely dependent on carbs for energy. Carbs help maintain blood glucose during exercise and restore muscle glycogen during rest and recovery from exercise. Eating the right carbs in moderation is advisable. There are numerous diet books expounding a variety of diets, but not everything is for everyone.”

less fat.” In her own kitchen, Gitta whips up dishes that are not only good for the taste buds, but kind to the body. “For Shabbos,” she says, “I bake challos with kamut or spelt flour, which is easier on the digestion. I recently started experimenting with sourdough, too. When I eat bread during the week, a rare occurrence, I use Ezekiel bread, which is produced from sprouted grains. We juice fresh vegetables daily, and we recently upgraded to fermented vegetables, such as beets and other vegetables. I make my own fermented pickles. Potato kugel is made with fermented potatoes, which eliminates the gluten and is easier on the digestive system.”

In her own kitchen, Gitta whips up dishes that are not only good for the taste buds, but kind to the body.

Since Gitta finds exercise to be very important, she engages in physical activity five times a week in a variety of workouts, including yoga, aqua fitness, lap swimming, dancing, and walking. Gitta shares her vast knowledge and passion regarding a healthy lifestyle with her clients in her practice, as well as with her audiences in lectures that she’s held in her hometown of Montreal, and in other places like Toronto, New York, and England. As a certified nutritionist and a seasoned home chef, she also authored Kosher Classics (Israel Bookshop), a recipe book that goes through the year, starting with Shabbos and then tackling every month, so that frum consumers, especially young marrieds, can ease into very familiar recipes for every month of the year. “The recipes in my book aren’t all salads and vegetables soups. Rather, my point was to take traditional recipes, especially those for Shabbos and Yom Tov, and recreate them in a healthier version—with less sugar, less salt, and From Gitta's art collection

Perhaps what makes Gitta’s interest in nutrition trends so unique is how it all comes together at her stage in life. As the mother of four, grandmother of numerous grandchildren, and a great-grandmother, Gitta’s fascination with a healthy lifestyle hasn’t waned. “I was born in Germany,” she shares. “I grew up in Sao Paulo, Brazil, where I attended the local fledgling Bais Yaakov. At age 16, I travelled to Gateshead Seminary, where I solidified my love for kodesh subjects. It was there that I learned the English language.” In Brazil in 1971, Gitta married her Canadian husband, who had been raised in France. For decades after, she delighted in teaching. Then, when she officially retired from her position, she discovered her love for painting. “Under the guidance of able teachers, I filled my home with beautiful pieces that I am now ready to sell, but I am still on call for substituting in various schools.” Today, besides her busy schedule, Gitta helps out the local Bikur Cholim by animating groups of senior citizens who look forward to the social experience, as well as delivering meals on wheels. In a recent article on a subject that is close to her heart, Gitta laments about how the abundance of today’s ready-made food has led many to abandon the stove and opt for boxed or processed alternatives. “Besides the fact that we don’t really know what’s in those ready-boxed foods, we’re also diminishing the memories that our children have from their home and hearth,” she says. “We have become very commercialized, spending too much on ready dips and other simple condiments that can be easily made at home. I strongly feel that parents should involve children in helping in the kitchen, so that they will be able to pass on the traditional foods eaten in their home. What they see at home, including food preparation practices and healthy choices, is what children will later perpetuate in their own home.”

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Wellbeing

Child Development by Friedy Singer & Roizy Guttmann, OTR/L

The Socially Awkward Child Why isn’t she getting the skills she’s being taught? When a parent notices that their child isn’t interacting properly in social settings, or that the child’s social skills warrant improvement, they often turn to social skills groups, behavioral therapy, or books to facilitate their child’s social development. A mother may spend hours reading to her child about sharing and caring and not interrupting, and the child may offer appropriate responses and exhibit comprehension. The same may be true for a child who’s part of a social skills group or in therapy. Yet, for some reason, this understanding does not translate into action. Why? Sometimes, when children present with social issues, we think their challenge lies in not knowing the social norms; they don’t know what do or how do it. For many, this is indeed part of the problem. In today’s day and age, many parents assume that teachers and/or entertainment, such as books and CD’s, will teach their child social norms. However, even when parents do teach social norms, they often don’t realize the importance of focusing on the nuances, as well. A parent should engage in dialogue with their child and ask questions like, “Did you see how that person was looking at you?” It’s also important to know the child’s own thought process in terms of how they view the social situation the parent is discussing, and then discuss if and how the child picked up the cues, and what they could have meant. While for many children, simply teaching the nuances and discussing them is enough to help facilitate social development, for others—especially those on the autistic spectrum— the problem may emanate from underdevelopment in other areas. When such a child is taught a social skill, such as to say “please” when asking for something or not to push in line, they may demonstrate it once or twice, because all children want to please. But a week or two later, the child’s interactions will reveal that he hasn’t retained it. This leaves a parent feeling frustrated. “How many times do I have tell you not to push?” The child is frustrated, too. He knows he’s supposed to learn

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something and apply it every day, but feels he can’t hold it down. It’s not about knowing the cues, but about being developed enough in other areas to retain the skill. The child probably knows he did something off but he doesn’t know what it is. Even after the parent explains what he did wrong, he may pretend he understands, but that may not be the case. It’s important for parents to know that just because their child is doing something inappropriate, he is still sensitive toward his own treatment. Even if the child didn’t pick up on a social component of interaction, he may still be highly affected by the tone around him. In other words, if the parent yells or looks at him disapprovingly after he’s done something inappropriate, the child will pick up on the cues, which will lower his self-esteem. Why is it that a child doesn’t get the social skills he’s being taught? The Feeding Connection In most cases, the foundation of social development begins with the relationship between a mother and her child, in particular with feeding. When a mother feeds her child, the baby picks up on social cues by looking at his mother. In a good feeding session, if the baby feels comfortable and the mother is smiling or looking relaxed, the infant is able to receive a positive response, which becomes an imprint for what happiness feels like. He now perceives that “Happiness is when I feel good and the person I’m with is smiling.” If an infant is feeling content during the feeding but the mother is not expressive, he will know what it means to feel happy within himself, but he won’t know how to express it. Such a child will probably be okay in the long run, picking up the cues for happiness later on. However, if a baby feels uncomfortable during the feeding, even if Mommy is smiling, it won’t help him feel happy. Hence, it’s more about how the baby is feeling than about the mother, which makes feeding an important component of subsequent

social and emotional development. If a baby has difficulties with feeding, it may often play a role in his grasp of social nuances later on. Because early feeding experiences have such an impact on a child’s social development later on, in our neurodevelopmental courses, we advise behavioral therapists to ask parents about their child’s feeding experience as an infant. Often, a physiological issue may have prevented the child from acquiring a brain map of a proper social relationship. Because

Many children are overwhelmed by visual stimuli, to the extent that they can’t focus on social nuances. the child wasn’t feeling well physically during feedings, the emotional cues connected with positive feeding experiences are not mapped during this critical time of social interaction. Indeed, one of our clients with social difficulties had a history of never having asked her parents for something to eat or drink. After we started working with this family, helping to develop his regulation and healthy experience with food, he began attaining an appreciation for social skills. Underdeveloped Proprioception If a child doesn’t know where he is in space, and he doesn’t have good awareness of where his body is, he will have a hard time being aware of things, in particular people, around him. Children with an underdeveloped proprioceptive system find it difficult to differentiate the boundaries between themselves and other people. These children usually have a hard time with pronouns. When they want to say “you,” for example, they’ll say “I.” These are the kids who constantly move around.

Since they lack awareness of personal space, they may stand too close to other people or ask intrusive questions. The more a child knows where he is in space, the better he is able to know who he is as a person. Once he identifies and establishes who he is, he can relate to people in a more appropriate manner. From this perspective, the child’s lack of social skills is not related to a psychological problem. It’s fascinating that, cognitively, such a child could understand the concepts perfectly. If a parent later explains an awkward situation, saying things like, “Did you see that person rolled their eye when you said that?” The child may say, “Yes,” but he didn’t really pick up on what was going on. Perhaps, during the actual interaction, he was so busy with his own body that he couldn’t focus on anything else, just as when any person is very focused on a particular task. Underdeveloped Visual System An underdeveloped visual system may also affect a child’s ability to pick up on social skills. Many children are overwhelmed by visual stimuli, to the extent that they can’t focus on social nuances. When the teacher or therapist says, “Look at me,” in an attempt to have them practice eye contact, concentration only becomes more difficult. They may find the teacher’s clothes too bright, the pupils of her eye too large. Their teachers may be lovely, but the posters or flashing colors in the classroom may be overwhelming, making it difficult for them to stay engaged and focused. While eye contact is a valuable asset to normative social interaction, for some children, this could trigger their lack of focus. These children need the visual stimulation to be minimized. They should not to be told to look at a certain spot or direction. For some children, when they’re not looking is when they’re actually listening. Incredibly, after giving this advice to many parents in the 20 years we have been practicing, most have reported what a difference it made in their understanding of their child’s social interactions.

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Wellbeing

Child Development

Fight or Flight What about the child who does well in every area of development except the social/emotional arena? The child is not on the spectrum, is keeping up well academically, yet seems to lack social smarts. She may be talking too much, asking inappropriate questions, seem overbearing and controlling, not pick up on social cues, or exhibit a complete lack of tact. Conversely, the child may shut down completely in social settings. In such cases, the child may be in a fight or flight response. This is especially true for children with selective mutism, which may result from internal anxiety. For this reason, playing in a relaxed way with them, in a relaxed environment, helps them speak. We will expound on this topic in a future installment.

pened to your child, if your child has difficulty remaining still, don’t focus on eye contact and listening alone, but rather allow for them to move freely while you are conversing. Positive Feeding Experiences Children pick up on social cues while eating. For children who are getting feeding therapy, or for parents who want to help their child associate feeding with positive social interaction, it’s important that the behavioral approaches should be very positive. In order to facilitate social and emotional development, parents should feel positive before doing a feeding session. Whether you’re about to nurse your infant or feed your toddler a banana, make sure you’re in a positive place before you start. If you’re not, take a moment to walk away and disconnect.

Tips for Facilitating Social Development Movement If your child is having a hard time with expressive language, such as explaining how she feels, she may find it easier to engage in this behavior while she’s in motion. Have her sit on a bouncing ball, rolling back and forth, or take her on a walk. Through movement, children develop an awareness of themselves, which facilitates language. It’s interesting to observe that children in a playground are more verbal than usual. Often, parents ask us why their babies are more verbal at occupational therapy than at speech therapy, and this may be the reason. Movement facilitates expressive language. When you want to talk about an important topic, such as personal safety, or if you want to find out if something hap-

Ensure there are minimal distractions during dinnertime, so your children are able to pick up on the social interactions that are going on and listen to the conversations around them, in order to construct their own brain map. This can be done even when the child is nonverbal. Mindfulness Being aware of how your child feels and identifying what is making him feel uncomfortable will help your child with social interactions. By identifying and working on acknowledging his emotions during social situations, he will be able to take the break he needs, or change his mindset, to take in the information that is actually happening, rather than being overwhelmed by the emotion. Exercises using role playing and modeling can help. Make sure to change the parameters during the play so the child can learn to cope with “unexpected” feelings that may come up. Mirroring Be foolish, silly and inappropriate yourself to “test” your child or show him how his inappropriate behavior makes others feel. This is a powerful tool in making progress in social/ emotional challenges. Activities An effective way to facilitate improved social skills between peers is to involve your child in a preferred sport or craft activity that they and other children can enjoy together. The side benefit is improved self-esteem. For children who are active and socially inappropriate, before attending a social event, let them engage in activities that provide proprioceptive input, so they can develop better awareness of themselves and their physical space. This will allow all parties involved to enjoy the event.

Friedy Singer and Roizy Guttmann are neurodevelopmental therapists and the directors of Hands on OT Rehab Services, Hands on Approaches, and the H.O.P.E. (Hands on Parent Empowerment) Foundation. They are focused on educating and empowering the community to help children with anxiety, processing and learning issues. They can be reached at info@handsonapproaches.com

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Wellbeing

Clean Slate By Shiffy Friedman, MSW

IT'S MY RESPONSIBILITY VS. IT'S MY FAULT

TAKING RESPONSIBILITY FOR EMOTIONAL HEALTH IS A CHOICE

Whether an individual is engaging in compulsive overeating or any other behavior detrimental to physical, spiritual, or emotional health, the process toward healing starts with the same first step: taking responsibility. Without doing so, she could remain stuck in a self-harming cycle for years. She will always find a logical reason to explain her behavior. A woman who’s in a difficult marriage may choose to blame her marital discord for her unhealthy eating patterns. A parent of a challenging child may do the same. Another individual may attribute her behavior to childhood pain or an overwhelming schedule, to hormones or holidays. Most common of all, the overeater may just lift her hands in the air, saying, “This is me. I’m an emotional eater. This is how I come.” All of these scenarios have one common denominator: the individual finds it difficult to take responsibility for her actions. Taking responsibility isn’t easy. To someone who isn’t used to doing so, it may appear as a declaration of self-blame: “Everything I’ve done until now was my own fault. I ruined my health/body/self-image with my own hands.” But the reason why this isn’t true is the reason why taking responsibility is the first step in all healing: Everything that happened in the past is exactly the way it was meant to be. The excess weight, the skin condition, the diabetes—if it already happened, says the Chovos HaLevavos, we are obligated to believe with firm faith that this was exactly what Hashem wanted for us. How is this belief in line with taking responsibility? After all, it seems to convey that “if I’m not in control, nothing is a result of my doing.” But there are two components to this attitude. The first is acknowledging that this was Hashem’s will. But second, and perhaps equally important, is realizing that from now onward, this is my bechirah. The Chazon Ish explains bechirah not as a decision between two choices, but as either going along with nature or making a choice to rise above it. Going

along with nature would mean to do what comes naturally—when I feel something unpleasant, I do what I can not to feel it. Rising above nature would mean choosing to recognize that I’m feeling something unpleasant and instead of fighting it or drowning it out, acknowledging it for what it is (which we will discuss in later installments, iy”H). Thus, an individual who takes responsibility for her choices realizes that it isn’t the stress or the hectic schedule or the difficult child that is propelling her to finish the package of cookies. It is her choice to distract herself from difficult feelings through food. An individual who takes responsibility realizes that her deeds are never dictated by external factors, only by the choice she made to avoid feeling pain. This acknowledgement is huge. It’s about stopping to point fingers and starting to notice that external factors are never responsible for my choices. They may appear as if they are, and I may spend the rest of my life deceiving myself into believing that they are, turning myself into a person who is consistently reliant on others for my happiness, but that’s only until I’m willing to take responsibility. Even if an individual still hasn’t disconnected completely from compulsive overeating or other self-harming behavior, acknowledging that the behavior is a result of her own bechirah is a monumental step toward healing. It’s facing the truth, which shifts the entire perspective from “I can’t help it,” to “It’s up to me to stop doing this.” It follows that a person who comes to the realization that her deeds are the result of her own bechirah will approach future choices from a different perspective. She understands that whatever happened happened, but she also understands that from this moment on, when she is faced with a choice, it is up to her—and only her—to decide whether she will take

the high road or allow herself to do what comes naturally. With every challenge that arises, the choice is hers again. I’ve had women say to me, “I need help. I know I’m eating because I’m stressed, and I want you to help me deal with the stress.” Fine words, indeed. But then, once

Only once we take responsibility for our own choices can we begin to truly heal. we scratched a bit beneath the surface, the process became too painful. They were frightened to take responsibility, to give space to the pain that’s been badgering them for years or even decades, and they opted instead to keep engaging in self-harming behaviors as a means to distract themselves from their pain. I understand these women completely, because we human beings abhor feeling pain. We’ll do anything not to feel alone, unloved, unappreciated, afraid, or anything unpleasant. But we fail to realize that drowning out unpleasant emotions actually gives the pain a place to fester. It leaves us entrenched in constant battle. Only once we take responsibility for our own choices can we begin to truly heal. In her practice as an MSW, Shiffy Friedman realized that her knowledge in psychology was not helpful in healing the infinitely profound nefesh. An intensive search led her to discover the Torah’s direction toward a more connected life. To sign up to receive Shiffy's weekly message on this subject, write to emotionalwellnessthroughTorah@gmail.com.

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Wellbeing

Serial Diary by Zahava List

Unveiled

Life with mental illness #4 In my manic state following the birth of my first child, I thought I could read people’s minds. I would walk on the street and start a conversation with random people. To one seminary girl I met, I told her I had a shidduch for her and invited her to my house to come see a picture. During the day, I would see myself as the best person in the entire universe, but at night I’d feel I wasn’t needed in this world, that I was done with my tafkid, and there was nothing left for me to accomplish in the painful world from which I was desperate to escape. When my husband had come to learn in Eretz Yisrael as a bachur, he got to know some families in the neighborhood, spending time in their homes. Later, when we came back as a couple, although I had lost interest in social connection in my mild depressive state during pregnancy, he persuaded me to build a connection with the women of these homes. I was particularly impressed with one woman he introduced me to. The mother of a large family, Batya* exuded the kind of warmth and understanding that made me feel so comfortable in her presence. She always prepared delicious food, and I was drawn to the friendly and peaceful atmosphere in her home. Batya was the wife and mother I wanted to be. I hardly went to her because I was so shy in public, but when I did, I enjoyed her company very much. After my baby was born, my condition was brought to Batya’s attention. She called up my husband and asked him if everything was okay. When he said it was, she was persistent. “Is everything okay?” She pressed. When he didn’t answer, she said, “I’m coming over.” A few minutes later, Batya was in our apartment. “Zahava,” she said, “I think you’re having a postpartum reaction. You need to go to a psychiatrist and get medication.” And then, she said the words that made all the difference: “I know what it’s like to go through this. I went through this too.” At that point I was already out of touch with reality. Of course, I didn’t want to hear of going to a doctor and getting medication. It meant I wouldn’t be able to nurse anymore, and I wasn’t going to let that happen. “You’ll be a healthy mother for your child,” Batya reassured me. I remember Batya telling me, “Zahava, think of it as if you have strep. Wouldn’t you go to the doctor to get medication and feel better?” My reaction changed from being so excited at seeing her to intense crying. It’s normal for postpartum women to have mood swings, but this was

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extreme. Upon Batya’s behest, my husband reached out to Nitza, a postpartum network in Yerushalayim. They referred me to a therapist, as well as to the psychiatrist Dr. Michael Bunzel of Bnei Brak. In an interesting chain of events that exhibits his concern for every patient, we went all the way to Bnei Brak to meet him, thinking that our appointment was in his regular office, but at the same time he had come all the way to Yerushalayim to see us there. When we finally met, our conversation was centered on my resistance to medication. I was so convinced that I was okay, that it was everyone else who had a problem. I remember going behind my husband’s chair and silently pointing to him so the doctor would realize we were really in his office to heal my husband. Both Dr. Bunzel and Ahava Winston, the head of Nitza, tried persuading me to do this for my own wellbeing and the good of my family, but I wouldn’t hear of it. What ultimately convinced me was my delusional view of Dr. Bunzel and Ahava as my spiritual parents. In my delusional state, I told myself that if I took medication I’d save the world. And so, I finally acquiesced. In Hindsight I ended up having 7 manic episodes, including after the birth of my second and third children, and each one presented differently. My very first episode reached its peak 10 days after giving birth and some of the other relapses escalated in record speed. Some people are hypomanic for a significant amount of time before they reach the point of severe psychosis that I did. Every case is individual and deserves its own support toward healing. It meant so much to me that my husband believed me when I shared my story with him, even in my manic state. At the same time, when people distanced themselves from me, it hurt me to the core. If only people would have shown more acceptance, my experience would have been so different. Mental illness is in no way a reflection of the individual. It is often a biochemical reaction to painful triggers from the past that robs the person of their free will. No one should feel judged or stigmatized when that happens. A friend of mine once told me that when I was in my manic state people had cautioned her, “Don’t hang around with Zahava. Her condition might be contagious.” To be continued... *Name changed to protect anonymity. Zahava List is the founder and director of Chazkeinu, a peer-led support organization for Jewish women who struggle with mental illness and their female family members.

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.

MAXI ANTIOX SUPREME™ Related to Nutrition Facts pg. 68

DIGEST TO THE MAX™ Related to Inkwell pg. 26

Tomatoes are a great source of antioxidants, but you’d have to consume a hefty amount to ensure you’re getting a fair dose of these disease-fighting agents. Maxi Antiox Supreme™ is unique in that it contains 22 of the finest, most potent antioxidants, giving you the maximum benefits.

As kinesiologist Miriam Schweid notes, acid reflux puts a strain on the digestive system, which in turns saps energy from the body. If you’re a nursing mother, a daily dose of Digest to the Max™ may be all you need to help your child and yourself. This unique formula provides the body with the enzymes necessary for the proper breakdown of foods.

MAXI MAGNESIUM LYSYL GLYCINATE™ Related to Golden Page pg. 83 While magnesium is crucial for the body’s optimal functioning, most people are lacking in this vital mineral that supports heart health, healthy blood sugar levels, and strong bones, among other benefits. Thus, a daily dose of Maxi Magnesium Lysyl Glycinate™ is highly recommended, especially for those in the senior population.

BLACK CUMIN SEED™ Related to Monthly Dose pg. 84 Black cumin seed oil stimulates the immune system in both directions. In addition to suppressing dangerous chronic inflammation, black cumin seed oil has been shown to boost appropriate immune function. The result is enhanced protection against both infections and inflammation.

MAXI HEALTH TWO COMPLETE™ Related to Health Platform pg. 14 As Rabbi Meisels writes, supplementing with a multivitamin is always a good idea as a starting base for proper nutrition. You certainly can’t go wrong with taking a daily dose of Maxi Health Two Complete™, the multivitamin that contains essential vitamins, minerals, and even a superfood blend of antioxidants and amino acids, to support your health and help you get through the day.

Ask for these products at your local health food store.

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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.

Selection Guide

Golden Page By Yaakov Goodman

THE VIRTUES OF MAGNESIUM

AND WHY YOUR BODY DOESN’T HAVE ENOUGH OF THIS MINERAL

Magnesium, the fourth most abundant mineral in the body, is essential for optimal health. Over half of the body’s magnesium is found in bones. The other half is found predominantly inside the body’s cells. Needed for more than 300 duties in our body, magnesium helps maintain normal muscle and nerve function, keeps heart rhythm steady, supports a healthy immune system, and keeps bones strong. Magnesium also helps regulate blood sugar levels, promotes normal blood pressure, and is known to be involved in energy metabolism and protein synthesis. There is an increased interest in the role of magnesium in preventing and managing disorders such as hypertension, cardiovascular disease, and diabetes. Dietary magnesium is absorbed in the small intestines and excreted through the kidneys. However, research shows that we’re falling far short of the amount we need for our bodies to function optimally, so much so that many experts believe this is one of the most common nutrient deficiencies today. And this deficiency only acceler-

come larger and more brittle. In two separate studies published in The American Journal of Clinical Nutrition, researchers found that inadequate magnesium intake lowered bone mineral density, whereas sufficient magnesium intake increased bone mineral density, thus potentially reducing the risk of osteoporosis and related bone fractures. Magnesium is essential for the proper utilization of calcium, by directing it to the bones and preventing calcification in the arteries, which helps prevent conditions such as kidney stones. In part, magnesium’s salutary effect on bones appears to be in slowing the speed of bone turnover, which is the rate at which new bone replaces old. Increased levels of bone resorption are the primary cause of age-related bone loss, often resulting in osteopenia or osteoporosis. A human study found that magnesium is so crucial to proper bone growth and development that a 50% reduction in dietary magnesium significantly disrupted bone and mineral metabolism. Interestingly, while serum magnesium levels remained constant, there was a significant reduction in bone mineral content.

Research shows that we’re falling far short of the amount of magnesium we need for our bodies to function optimally, so much so that many experts believe this is one of the most common nutrient deficiencies today. ates with age. In past generations, when we drew water from natural springs and wells, minerals such as magnesium were easily accessible. Now, however, our municipal water supplies and bottled, purified water has left us woefully deficient of this essential mineral. Strong Bones and Teeth Magnesium is a dominant mineral that comprises the bone matrix, helping keep bones strong and healthy. In fact, magnesium is a critical element needed to guard against osteoporosis, the decrease in bone mass and bone density that increases the risk and/or incidence of fracture. As the magnesium content of bone mineral decreases, bone crystals be-

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A study published in The Journal of Clinical Endocrinology and Metabolism found that dietary supplements of magnesium given to young men, slowed bone turnover. The researchers concluded, “Because bone turnover has been implicated as a significant etiological factor for bone loss, these findings raise the interesting possibility that oral magnesium supplementation may have beneficial effects associated with high bone turnover, such as age-related osteoporosis.” Together these findings highlight the essential role of magnesium in building and maintaining strong bones at all stages of life. Similar to bones, teeth also have high magnesium content and rely on its presence for their structure. Because of this connection, magnesium supplementation has been found to improve tooth attachment and help subjects retain more teeth. Lowers Stroke Risk There are numerous factors that can lead to a stroke. For

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

Age Well

example, a stroke can occur when blood pressure is too high, weakening cerebral arteries in a way that can induce bleeding in the brain. More commonly, strokes occur when artery linings are damaged, setting up conditions for an artery-blocking clot. They also commonly occur when a heart arrhythmia or artificial heart valve creates a blood clot that travels into a cerebral artery and blocks vital blood flow. Maintaining consistent magnesium levels helps to prevent all of these processes. In one study, men with the highest magnesium intake had significantly lower blood pressure and total cholesterol, and were 61% less likely to have a stroke than those with the lowest magnesium intake. And according to a 24-year-long study of nearly 43,000 men, subjects with the highest supplemental magnesium intake had a 26% lower stroke risk than those with the lowest intake. Studies in women have also demonstrated the dangers of low blood levels of this mineral. In one of these studies, women with the lowest blood levels of magnesium were found to be 34% more likely to have an ischemic stroke than those with higher levels. In another study, low blood magnesium levels were associated with an approximately 50% greater likelihood of developing atrial fibrillation, a type of irregular heartbeat that can cause a blood clot that might lead to a stroke, compared to those with higher levels. Magnesium is so critical for helping maintain a regular heartbeat that hospitals use intravenous magnesium to pre-

vent atrial fibrillation following heart bypass surgery. Blood Sugar Aging and obesity induce insulin resistance, which elevates blood sugar levels. High, or even “borderline high,” blood sugar inflicts glycation damage to proteins throughout the body, preventing their optimal function. Controlling blood sugar, both for diabetics and nondiabetics, is a crucial approach to preventing age-related diseases. Magnesium supplementation improves the body’s response to insulin, which removes sugar from the bloodstream. It is apparently clear that magnesium holds a central place in human health and is at the very core of combatting age-related and other diseases. This highlights the importance of choosing the correct supplement form. For this reason, we recommend Maxi Health’s Maxi Magnesium Glycinate Capsules™ as the best way to get your daily magnesium. This form of magnesium is bound to an amino-acid known as glycine, which transports the magnesium to the cells, maximizing absorption and preventing any laxative effect or stomach pain. To order this and any other health-promoting supplement, call the vitamin hotline at 718-645-2266. Mention The Wellspring for a special discount and to receive free shipping.

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Memos from a Kinesiologist By Miriam Schweid

Acid Reflux in Infants Dairy isn’t always at fault

One early winter afternoon, I was sitting with two of my children at the pediatrician’s office, awaiting my turn in the long queue. It was during the after-school rush, when the office was full of school-aged children brought in to catch up on their belated immunizations. In the seat near mine, a young mother waited too. From her sighs and gestures, it was obvious she was not enjoying her wait. She kept my son busy, asking him to get her napkins to clean up her baby and the floor around his stroller. Over the twenty minutes of our wait, the baby threw up twice. He was crying incessantly, and this young mother looked like she was at her wits’ end. “It’s my first child,” she whispered to me, when I expressed my sympathies. The little boy was six weeks old, and this was her fourth visit to the pediatrician. At her last visit, she confided, the doctor diagnosed the baby with acid reflux. For the uninitiated, reflux is a burning sensation in the esophagus accompanied by gas, bloating, and occasional shortness of breath. Stomach acid serves to break down the food so our body can digest it properly. A small sphincter at the base of the esophagus keeps the stomach acid from flowing upward as the food goes down. When this sphincter doesn’t work properly, as is often the case in infants with an underdeveloped digestive system, acid from the stomach backs up into the esophagus and produces heartburn and gastric reflux. At this baby’s last visit, the doctor prescribed Zantac®, but the mother reported she hadn’t seen any improvement in the baby’s behavior or eating patterns, and that he had become constipated. The waiting room provided an unusual yet perfect place for

us to talk. Against the noisy backdrop of boys playing marbles and girls trading stickers, Henny poured out her tale of woe. When I told Henny that acid reflux was one of the conditions I often work with in my capacity as a health consultant, she asked me to explain what was happening to her baby and how she could help him. She told me that her older sister had advised her to go off dairy for as long as she was nursing the baby, which was especially difficult for her. Not only did Henny deprive herself of her basic breakfast choices of yogurt or cereal and milk, but she hadn’t seen any improvement as a result of this dietary change. I explained to Henny that it might rather be the foods she was eating that were aggravating her baby’s esophagus. Upon my questioning, I learned that she didn’t know that citrus, orange juice, mango, pineapple, and kiwi were highly acidic. I told her that fried food and chips weren’t very helpful in managing acid reflux either, as was the chocolate she was having with her dairy-free coffee every morning. I encouraged Henny to change her diet and to take the a dose of digestive enzymes contained in Maxi Health’s Digest to the Max™, which would be passed on to her baby through her milk. This formula, I explained, would improve her baby’s digestive system and help prevent bloating and gas pain. When the doctor called Henny into his office, she threw me a smile of thanks. She followed the nurse into the room, but instead of entering as an exasperated mother, Henny was more at peace. Her long wait had helped give her the hope she was desperate for, which turned out to be just what her baby’s underdeveloped digestive system needed. *Names and identifying details have been changed.

Miriam Schweid is a Brooklyn-based kinesiologist. She can be reached through The Wellspring.

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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

Dictionary

Frenulum Definition: noun

a small fold or ridge of tissue that supports or checks the motion of the part to which it is attached, in particular a fold of skin beneath the tongue, or between the lip and the gum.

“ ”

WITH TONGUE-TIE, AN UNUSUALLY SHORT, THICK OR TIGHT FRENULUM TETHERS THE BOTTOM OF THE TONGUE'S TIP TO THE FLOOR OF THE MOUTH. - DR. SCOTT SIEGEL COVER FEATURE

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