Back to Nature

total wellness

a ucla student wellness commission publication

boosting your health with mindfulness

what “all natural� really means

maximizing your workout: indoor vs. outdoor exercise

back to nature

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paving the way for improved wellbeing summer 14 | vol 14 | issue 5

a message from the director This issue of Total Wellness marks a milestone for many of us. For our spring interns, this is their first Total Wellness publication. For our graduating seniors, this is their final issue.

For me, this issue is particularly special because it marks the end of an amazing 4 years with Total Wellness.

It has been a great privilege to have had the opportunity to serve as both the director and editor-in-chief of this publication and work with such a talented and dedicated group of writers, designers, and leadership. Every issue of Total Wellness requires an immense amount of work. Just ask any Total Wellness member and you’ll learn that each issue takes months of preparation, starting with brainstorming article ideas to submitting the issue for publication. However, Total Wellness is always looking for ways to better serve our readers and go beyond our traditional role as the Student Wellness Commission’s health publication at UCLA.

total wellness ▪ summer 2014

Some highlights from this volume include our Volume 14 Launch Party, Music for Your Health Conference, and No-Bake Dessert & Snack Making Event. Missed these events? Be sure to like our Facebook page (@Total WellnessMagazine@UCLA), follow us on Twitter (@total wellnessLA) or Instagram (@totalwellness magazine), or email totalwellnessatucla@gmail.com to sign up for our mailing list to receive notifications about our future events and magazine releases.

For our last issue of Volume 14, we’ve gone Back to Nature to explore the impact of nature on wellbeing (page 30).

In our modern world, we’re often surrounded by urban environments that can make it easy to lose touch with nature. Nevertheless, staying connected with nature can help us overcome some of the challenges associated with our fast-paced lifestyles. Check out what nature has to offer for overcoming problems like stress, frustration, aggression, and decreased attention spans on page 12.

Additionally, be sure to learn about mindfulness meditation and it’s health benefits on page 25.

In this issue, you’ll also find articles on air pollution and how indoor and outdoor air pollution may be impacting your health (page 45). You can also explore the pros and cons of indoor and outdoor exercise to determine the best exercise environment for your workouts (page 16). We’ve also explored numerous topics related to nature and nutrition, ranging from the Paleo (page 8), raw (page 7), and gluten-free diets (page 40) to fruit spreads (page 49) and artificial flavors (page 53). Curious about what “all natural” and “organic” really mean? Check out page 34 for the truth behind “natural” and “organic” labeling.

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We hope you enjoy this issue of Total Wellness and will share what you learn from the publication with your family and friends. Interested in reading more of Total Wellness? Visit us at http://issuu.com/ totalwellnessmagazine to browse our publications.

For the past 4 years, Total Wellness has been an integral part of my life and it has shaped my dedication to lifelong wellness. In fact, having the opportunity to lead this organization and interact with healthcare professionals through Total Wellness has been extremely influential in inspiring me to pursue my passion of service through medicine. As I depart to join the MD/PhD Program at Johns Hopkins University School of Medicine, I am excited to pass on this publication to the new leadership team, welcome Annie Theriault as the new director and Pavan Mann and Julia Feygelman as co-editors-in-chief, and see where they take Total Wellness in this upcoming volume, which will be launched in the fall. So, stay tuned for Volume 15!

Before my final farewell, I would first like to thank everyone who’s made this publication possible. From our readers and sponsors to our staff, leadership, and professional reviewers, without everyone’s support and devotion to Total Wellness, this magazine could not have continued to grow. I hope you have enjoyed Total Wellness as much as I have and that the publication has motivated you to lead a lifestyle shaped by wellness.

Cheers to your health and lifelong wellness,

Shannon Wongvibulsin Director and Editor-in-Chief

Total Wellness is a division of the Student Wellness Commission that is dedicated to spreading awareness of and sharing knowledge on issues of student health and health care. By providing an understanding of health and lifestyle issues, elucidating health concepts, providing recommendations for physical, mental, and social wellbeing, and making visible and accessible various health resources, programs, and events occurring at UCLA, Total Wellness seeks to empower students with up-to-date and accurate knowledge on the appropriate management of their health.

editor’s note

leadership

You may be asking, what does nature have to do with health?

Perhaps surprisingly, a lot. Yes, greenery may have a calming effect, and yes, the “healthiest” foods are often associated with the most “natural” ones but the interconnection between nature and wellbeing is both multi-faceted and complicated.

As we’ll see in this issue, our relationship with the world around us really might matter after all. For example, who would’ve thought that exposure to green spaces might improve self-esteem? We don’t really have the whys yet, but we do have some of the whats. These are summed up briefly in our cover story, Health in Urban Nature: Link Between Nature and Wellbeing on page 30. We went a little more in-depth than that, though. Find out exactly how nature can affect mental health on page 12, and learn about the pros and cons of exercising outside versus indoors on page 16.

Sadly, with all the potential good of nature comes some caveats, such as sun and outside air exposure. With exposure to nature inevitably comes sun and outside air exposure and the accompanying risks. Learn how to protect yourself and practice sun safety on page 20, and find out how much of a risk air pollution really is on page 45.

There’s also the caveat that “natural” is irreversibly associated with mental images of beauty and wholesomeness, and this can lead to a lot of assumptions about the health effects of various trends. Make sure you’ve got all the facts by checking out the real deal behind the raw food diet in our Q&A section on page 7 and seeing whether the recent fad of going back to our roots and “eating like a caveman” is actually legitimate in our Paleo diet article on page 8. Also, read about the truth behind the words “natural” and “organic” on food labels on page 34 and find out whether a gluten-free diet is right for you on page 40.

JULIE ESCOBAR Co-Copy Editor

TIFFANY LIN Co-Copy Editor

BARBARA WONG Co-Art Director

KARIN YUEN Co-Art Director

LESLIE CHANG Managing Editor

ANNIE THERIAULT Outreach Director

HARINI KOMPELLA Finance Director

KEVIN SUNG Webmaster

total wellness ▪ summer 2014

All of this just goes back to the idea that health and nature are circular concepts that support and build upon each other.

A healthier Earth may mean a healthier environment for us, which may contribute to better wellbeing in a number of ways. And it may just work the other way around too. If we’re in better health, then maybe we’ll have the energy and the motivation to try to make our world a healthier place for us and our children in the future too.

Wishing you all the goodness of this wonderful world we inhabit, Chalisa Prarasri Editor-in-Chief

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total wellness Director and Editor-In-Chief Editor-In-Chief Co-Art Director Co-Art Director Managing Editor Co-Copy Editor Co-Copy Editor Finance Director Outreach Director Webmaster

Shannon Wongvibulsin Chalisa Prarasri Barbara Wong Karin Yuen Leslie Chang Julie Escobar Tiffany Lin Harini Kompella Annie Theriault Kevin Sung

Staff Writers Sydnie Bui, Sarah Chang, Peter Chu, Julia Diana Feygelman, Catherine Hu, Grace Lee, Sofia Levy, Tiffany Lin, Alyssa Lok, Pavan Mann, Zoë Merrill, Halee Michel, Omid Mirfendereski, Payam Mirfendereski, Jennifer Miskabi, Monica Morucci, Allison Newell, Brian Khoa Nguyen, Lillie Luu Nguyen, Sepideh Parhami, Vesta Partovi, Niyati Patel, Christopher Phan, Jasmine Sidhu, Elsbeth Sites, Rebecca Tang, Nancy Vu, Catherine Wang, Emily White, Pauline Yang, Danielle Zola Design Shana Bird, Nicole Chang, Natalie Chong , Emily Hsu, Allison Newell, Jackie Nguyen (intern), Catrina Pang, Mary Sau, Danielle Swenson (intern), Jessica Sun, Annie Theriault, Maxine Tsang, Alexandria Villanueva, Barbara Wong, Helena Wong, Shannon Wongvibulsin, Karin Yuen Web Erik Jue, Catrina Pang, Sepideh Parhami, Mary Sau, Kevin Sung, Maxine Tsang, Barbara Wong Outreach Shana Bird, Sydnie Bui, Nicole Chang, Sarah Chang, Peter Chu, Michelle Do, Catherine Hu, Alyssa Lok, Pavan Mann, Zoë Merrill, Omid Mirfendereski, Payam Mirfendereski, Monica Morucci, Allison Newell, Brian Khoa Nguyen, Niyati Patel, Christopher Phan, Jasmine Sidhu, Rebecca Tang, Nancy Vu, Emily White, Danielle Zola Advisory & Review Talin Babikian, PhD

Assistant Clinical Professor, UCLA School of Medicine

Susan Bowerman, MS, RD, CSSD

Assistant Director, UCLA Center for Human Nutrition

Jenny Hu, MD, MPH

Dermatologist, UCLA Division of Dermatology

David S Black, PhD, MPH Keck School of Medicine

Eve Lahijani, MS, RD

Nutrition Health Educator, UCLA Bruin Resource Center

Anastasia Loukaitou-Sideris

Associate Dean, UCLA Luskin School of Public Affairs

Edward K Hui, MD

Assistant Clinical Professor of Medicine, UCLA School of Medicine

Nancee Jaffe, MS, RD

Registered Dietitian, UCLA Digestive Health and Nutrition Clinic

Helen Lavretsky, MD

Associate Professor, UCLA School of Medicine

Dolores Hernandez, MA, RD

Nutrition Education Coordinator, UCLA Dining Services

Raffi Tachdjian, MD, MPH

Assistant Clinical Professor, UCLA School of Medicine

Zhaoping Li, MD

Associate Professor, UCLA School of Medicine

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Total Wellness is a free, student-run, publication and is supported by advertisers, the Student Wellness Commission (SWC), the Undergraduate Students Association (USAC), the Arthur Ashe Student Health and Wellness Center, UCLA Healthy Campus Initiative (HCI), UCLA Recreation, and UCLA Health System: Center for East-West Medicine.

Contact 308 Westwood Blvd., Kerckhoff Hall 308 Los Angeles, CA 90024 Phone 310.825.7586, Fax 310.267.4732 totalwellnessatucla@gmail.com www.totalwellnessmagazine.org Subscription, back issues, and advertising rates available on request Volume 14, Issue 5

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© 2014 by Total Wellness Magazine. All rights reserved. Parts of this magazine may be reproduced only with written permission from the editor. Although every precaution has been taken to ensure the accuracy of the published material, Total Wellness cannot be held responsible for the opinions expressed or facts supplied by authors. We do not necessarily endorse products and services advertised. The information in Total Wellness is not intended as medical advice and should not replace the advice of your physician.

Always consult a health care provider for clarification.

contents IN EVERY ISSUE 02 03 06 07 55

A Message from the Director Editor’s Note & Leadership In the News Q&A Credits

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DEPARTMENTS 08 eat well Ancient Eats: A Guide to the Paleo Diet 12 mind well How Nature Can Help Your Mind 16 move well Choosing the Best Exercise Environment 20 body in focus Sun Safety: Protecting the Skin You’re In 25 self care Mindfulness Meditation: The Importance of Conscious Living 53 decoding the nutrition label Tricking Your Taste Buds: Artificial Flavors

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FEATURES 30 cover story Health In Urban Nature: Link Between Nature and Wellbeing 34 The Truth Behind “Natural” and “Organic” Labeling 38 Nutrition In a Pill: Too Good to Be True?

40 Is the Gluten-Free Diet Right for You? 45 Our Home and City: How Both Could Be Affecting Us 49 Spread Some Nature: A Guide to Fruit Spreads

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25 30 34 45

Mindfulness and Your Health Nature and Wellbeing “All Natural” Food Labeling Indoor vs. Outdoor Exercise

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left: moncherie /istockphoto; cover: moncherie /istockphoto

ON THE COVER

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in the news

what’s happening in health? by shannon wongvibulsin| design by barbara wong

PROTEIN-RICH DIETS MAY CONFER PROTECTION AGAINST STROKES

A recent review published in Neurology suggests that diets rich in protein, especially lean animal protein such as fish, may reduce the risk for stroke. Specifically, the authors reported that individuals with the highest amount of animal protein in their diets were 20% less likely to suffer from a stroke compared to those with the lowest protein consumption. Additionally, with every 20 g increase in daily protein intake, there was a 26% decrease in stroke risk. However, these findings do not apply to red meat, which was not studied in this analysis since red meat has been previously shown to increase stroke risk.1,2

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PORTABLE ARTIFICIAL PANCREAS MAY BENEFIT INDIVIDUALS WITH TYPE I DIABETES

A recently developed artificial pancreas may help individuals with type I diabetes maintain their blood sugar levels in a healthy range.

According to an article in The New England Journal of Medicine, the device dispenses both insulin and glucagon, hormones that regulate blood sugar levels. This device consists of an iPhone 4S, a glucose sensor, 2 pumps, and reservoirs for the 2 hormones. Overall, the artificial pancreas operates with little intervention from the patient since the sensor, which is implanted under the skin of the patient’s abdomen, measures glucose levels and sends the reading to the smartphone.

Every 5 minutes, the phone’s software performs a calculation to determine the dose of insulin and glucagon necessary for the patient. Nevertheless, to ensure accuracy, finger-stick blood glucose readings (which are inputted manually into the phone) are required twice a day from the patient.

Despite the advancements that this device provides, further research is still necessary before this artificial pancreas can be marketed as a product.3

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AT UCLA UCLA STUDENT-DEVELOPED CAL ECOMAPS WEBSITE PROVIDES FACTORY EMISSION INFORMATION

Cal EcoMaps, a website launched by a team of UCLA environmental science students as part of UCLA Institute of the Environmental and Sustainability (IoES) senior practicum course, provides an interactive map with emission information on local Los Angeles factories involved in petroleum, primary metals, fabricated metals, or chemical production. One student involved in the website’s development explained that the team focused on these 4 industries because “they account for 89 percent of the total toxic release in L.A. County.” To assign each facility an environmental impact score, the students graded the factories on a wide variety of factors, such as “the total amount of toxic releases, releases per $1,000 of revenue, the percentage of waste treated through preferred management practices, and the cancer risks.”

The director of the Environmental Protection Agency’s toxic release inventory program commented that Cal EcoMaps can potentially be of value to both LA residents and industries since it consolidates important information into 1 location and presents the details in a userfriendly manner.4

NUMBERS

6.2 million

number of adults in California without health insurance

401 number of national parks in the US

MEMORY PROBLEMS MAY BE RELATED TO POOR HEALTH AND LIFESTYLE FACTORS

A recent UCLA study published in PLOS ONE indicates that factors like depression, insufficient exercise, and high blood pressure can contribute to memory problems even in young adults. Additionally, the researchers found that 14% of the young adults (ages 18 to 39) examined in the study had memory complaints.

However, the authors of the study noted that the memory problems that these younger adults suffer from may be different from the ones that influence the older population. The authors plan to use the findings from this study to design further experiments to examine how decreasing these risk factors can help reduce the frequency of memory complaints.5 t w References 1.

“Diets Rich in Protein May Help Protect Against Stroke.” nlm.nih.gov. (2014).

2.

“More Protein in Diet May Lower Stroke Risk.” nytimes.com. (2014).

3.

“Artificial Pancreas Shows Promise in Diabetes Test.” nytimes.com. (2014).

4.

“Is that factory near you spewing toxins? UCLA students create website to tell you.” newsroom.ucla.edu. (2014).

5.

“Poor health, lifestyle factors linked to memory complaints, even among younger adults.” newsroom.ucla.edu. (2014).

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million number of US adults with sleep or wakefulness disorder chis; national park foundation; cdc

left: floortje/istockphoto right: irochka_t/istockphoto

RESEARCH AND NEW FINDINGS

q&a

Q: A:

what is the raw food diet?

by alyssa lok| design by barbara wong

As the name suggests, the raw food diet is a dietary practice consisting of uncooked food. It is based on the idea that cooking methods destroy nutritional content.

Known as raw foodists, its adherents claim that the absence of cooking and processing preserves natural enzymes that aid digestion and the absorption of nutrients that protect against disease.1 Resembling the vegan and vegetarian diets because of its emphasis on the consumption of fruits and vegetables, the raw food diet is yet another means by which people attempt to lose weight or engage in healthier lifestyles.

what do raw foodists eat? what do they avoid?

Food consumed under the raw food diet cannot, at any point in its preparation, exceed a temperature threshold of 118° F. As a result, the diet typically consists of whole fruits, raw vegetables, and uncooked nuts and seeds. Dried fruit prepared by a food dehydrator is also an option. Some raw foodists choose to consume raw eggs, fish, and meat, as well as unpasteurized dairy products, such as raw milk, yogurt, and cheese.1 They avoid cooked and processed foods, such as steamed vegetables, bread, and tofu.2

what are the benefits?

Because the raw diet contains very little saturated and trans fats, adherence to it could decrease the risk of cardiovascular diseases. In a 2005 study published in The Journal of Nutrition, 46% of 201 participants exhibited improved cholesterol levels after following the raw food diet for at least 2 years.3 High intake of carotenoids (plant pigments) and antioxidants found in fruits and vegetables can fight off cancer-causing substances and are associated with lowered cancer risk.4 Naturally low in calories, fruits and vegetables help maintain a healthy body weight.5

what are the risks?

got a question? We love curious readers. Send

your question over to totalwellnessatucla@gmail.com and the answer may appear in a future issue.

The overall impact of cooking methods on nutrient content remains unclear. Some researchers have found there to be a loss of nutrients in some foods. For example, a 1991 study published in Plant Foods for Human Nutrition associated methods of processing, preservation, and storage with losses of protein, fats, and vitamins in cassava and pumpkin leaves.

The cassava and pumpkin leaves were cooked for 90 and 50 minutes, respectively, which resulted approximately 36% and 38% loss in vitamin A. Storage in pots for 6 weeks resulted in similar losses in vitamin C.8 Likewise, a 2006 study in Journal of Food Composition and Analysis observed a loss of folate and thiamin in carrots, spinach, and green beans after cooking.9 However, other numerous studies suggest that cooking poses no negative effects on nutrition. According to a 2005 study published in Food Chemistry and a 2008 study published in Journal of Agricultural and Food Chemistry, there was either an increase or no observed change in antioxidant content and activity after cooking. The results indicated that antioxidants were retained and could thereby continue fighting against cell damage.10,11

who should avoid the raw food diet?

Due to potential deficiencies in vitamins and minerals crucial for growth and overall health, the raw food diet is not recommended for children, pregnant women, or the elderly. The raw food diet is especially not recommended for individuals with impaired immune systems, such as those who have immune disorders or are undergoing chemotherapy.6

bottom line: The research conducted thus far on the

nutritional content of raw foods remains inconclusive. At best, the raw food diet encourages individuals to consume more fruits and vegetables, although this can be done without becoming a raw foodist. At worst, it can result in nutrient deficiencies, so consult your doctor before starting a new diet.

As with any dietary regimen, it is crucial that you receive all of the nutrients necessary to maintain a healthy lifestyle. t w

References 1.

“The Raw Foods Diet.” wedmd.com. (2014).

2.

“The Raw Deal.” Gastronomica. (2002).

3.

“Long-Term Consumption of a Raw Food Diet Is Associated with Favorable Serum LDL Cholesterol and Triglycerides but Also with Elevated Plasma Homocysteine and Low Serum HDL Cholesterol in Humans.” J of Nutr.

(2005).

4.

“Carotenoid Analyses of Selected Raw and Cooked Foods Associated With a Lower Risk for Cancer.” J Natl Cancer Inst. (1989).

5.

“Effects of a Raw Food Diet on Hypertension and Obesity.” Southern Med Journal. (1985).

6.

“What is a raw foods diet and are there any risks or benefits associated with it?” J Amer Dietetic Assoc. (2004).

7.

“Orthorexia — When eating healthy goes awry.” webmd.com. (2011).

8.

“Investigations on the effect of traditional food processing, preservation and storage methods on vegetable nutrients: A case study in Tanzania.” Plant Foods Human Nutr. (1991).

9.

“Vitamin losses: Retention during heat treatment and continual changes expressed by mathematical models.” J Food Comp and Anal. (2006).

10.

“The effect of cooking methods on total phenolics and antioxidant activity of selected green vegetables.” Food Chem. (2005).

11.

“Effects of Different Cooking Methods on Nutritional and Physicochemical Characteristics of Selected Vegetables.” J of Agric Food Chem. (2008).

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total wellness ▪ summer 2014

Deficiencies in essential nutrients, such as protein, calcium, iron, and vitamin B12, may result from a low intake of meat and animal products.1 Because the high temperatures of cooking kill harmful bacteria, the absence of such methods can subject food to contamination and lead to food poisoning.6 The diet’s severe restrictions also pose psychological risks, such as orthorexia (an unhealthy obsession with healthy eating) or food preoccupation (constant thoughts concerning food).7 In today’s fast-paced society, the lack of practicality may cause some to compromise food quality in order to remain within the diet’s guidelines.

does cooking affect nutritional value?

eat well

ancient eats: a guide to the paleo diet by monica morucci | design by nicole chang

In an era of fast food, meals are available in minutes – not just from drive-thrus, but straight from the microwave or in the form of a quick energy bar. This contrasts greatly with the lifestyle of our huntergatherer ancestors, who spent a large portion of their energy and many of their waking hours in search of food. Despite our progress in making food accessible, some people think we have strayed too far from our hunter-gatherer roots. Some advocates of the Paleo diet believe that our bodies are best suited to the diet of our pre-agricultural ancestors. Read on to learn about the claim of the Paleo diet, which foods are included and which are excluded, as well as what science has to say about following the diet of a caveman.

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the claim

the aim

Proponents of the Paleo diet argue that the human genome has not changed much since the Paleolithic Era, 2.6 million to 10,000 years ago. They claim that the advent of agriculture 10,000 years ago greatly changed our environment and diet, and our bodies haven’t caught up.1 Thus, they believe that our bodies are genetically adapted to the diet of our Paleolithic ancestors.

Some believe that hunter-gatherers lacked the chronic diseases (obesity, type II diabetes, heart disease, common forms of cancer) that developed with the advent of the Western diet in the 1800s.1 Followers with these chronic diseases aim to use the Paleo diet to reduce the incidence of chronic diseases, which accounted for 7 of the top 10 causes of death in the US in 2010.2

left: lizleyden/istockphoto right:okanmetin/istockphoto; mehmet hilmi barcin/istockphoto

total wellness â–Ş summer 2014

a diet for our genes

the paleo diet3

paleo vs. western: the 7 diet differences4,5

inclusions - lean meats (10% fat or less)

- fish/seafood - eggs

- vegetables and fruits

- nuts and seeds - unrefined vegetable oils (olive, walnut, flaxseed)

exclusions - cereal grains (wheat, oat, rice, etc.)

- refined sugar, salt

1. higher protein diet details In the Paleo diet, protein makes up 19 to 35% of intake compared to 15% in the Western diet. Common sources of protein are meat, seafood, and other animal products, such as eggs. Ideally, animals should be fed a diet of grass to best match ancient growing conditions, which result in animals with a healthier fatty acid composition.6 how this impacts health A 2005 study in the American Journal of Clinical Nutrition placed 19 volunteers on a 12 week diet in which dietary protein doubled from 15% to 30%, the amount of carbohydrates stayed constant at 50%, and the amount of fat decreased from 35% to 20%. Participants were instructed to eat when they were hungry and to stop when they were full. The researchers found that these experimental conditions resulted in significant weight and body fat loss, an increase in satiety (or fullness), and a decrease in calorie consumption. This suggests that any diet, including the Paleo diet, in which high levels of protein replace fat, may increase fullness and thus decrease calorie consumption.7

- dairy - potatoes - legumes (peas, beans, lentils, peanuts) - refined vegetable oils (canola) - processed foods - alcohol

2. lower carbohydrates diet details Carbohydrates (sugars, fibers, and starches) make up 35% to 45% of intake in the Paleo diet compared to 50% in the Western diet. The Paleo diet emphasizes fresh vegetables and fruits as the main carbohydrate sources, instead of the highly processed grains that are typical of the Western diet.

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total wellness ▪ summer 2014

how this impacts health Carbohydrates can be broken down into “good” carbs and “bad” carbs.

“Good” carbs include slowly digested foods like vegetables and whole grains that are rich in fiber, vitamins, and minerals. “Bad” carbs are quickly digested foods like refined grains and sugary pastries that rapidly raise blood glucose levels. Over time, high blood sugar levels may decrease the effectiveness of insulin, a hormone that signals cells to remove glucose from the blood after a meal. A condition called insulin resistance may develop, in which the body’s cells become unresponsive or less sensitive to signals from insulin. Insulin resistance is associated with chronic diseases like type II diabetes, obesity, and hypertension.8 A 2009 study in the European Journal of Clinical Nutrition found that participants with the least sensitivity to insulin on their usual diet saw an increase in insulin sensitivity when put on a Paleolithic-type diet.9

3. higher fiber diet details The main sources of dietary nutrients in the Paleo diet are vegetables and fruits, which make up 35 to 45% of intake.

Vegetables and fruits contain higher amounts of fiber than most refined carbohydrates, like wheat bread and pasta, which make up the majority of the Western diet.10 how this impacts health Soluble fiber, found in apples, citrus fruits, and carrots, may lower levels of low density lipoprotein (LDL, or “bad”) cholesterol. High levels of LDL cholesterol are associated with increased risk of a heart attack.11 The aforementioned study in the European Journal of Clinical Nutrition placed participants on a Paleolithic-type diet for 10 days and found that in 8 of 9 participants, total cholesterol and LDL cholesterol levels decreased by 16% and 22%, respectively.9 Insoluble fiber, found in nuts, seeds, and broccoli, helps maintain digestive health by regulating bowel movements.12

5. higher potassium and lower sodium diet details The Western diet’s preference for processed foods over fruits and vegetables results in excess sodium and deficient potassium levels. The average American consumes 3,400 mg of sodium daily, more than twice the 1,500 mg recommended by the American Heart Association. The Paleo diet does not allow for added dietary salt and emphasizes potassium-rich fruits and vegetables, thus significantly decreasing sodium and increasing potassium intake.5,14 how this impacts health A diet with a higher amount of sodium than potassium may increase one’s risk for chronic diseases. A 2011 study in JAMA Internal Medicine on a sample of 12,267 US adults found that a higher sodium-potassium ratio was associated with an increase in mortality from many causes, including cardiovascular and heart disease.15

6. acid-base balance

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4. higher unsaturated fats diet details Unsaturated fats are mostly plant-based, liquid at room temperature, and consist of 2 types: monounsaturated and polyunsaturated fats. These healthy fats are found in the nuts, vegetable oils, and seafood of the Paleo diet and replace the unhealthy trans and saturated fats found in processed foods and fatty meats common to the Western diet.13 how this impacts health Unsaturated fats decrease levels of LDL and VLDL (very low density lipoprotein or “very bad”) cholesterol. High levels of LDL and VLDL can increase the risk of heart disease. The 2009 study mentioned above found that all 9 participants placed on a Paleolithic-type diet showed an average 35% decrease in VLDL cholesterol levels. This is a promising but rather weak association due to the small size of the study.9

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diet details During the process of metabolism, the body breaks down complex foods into simple compounds. For example, proteins are broken down into simple amino acids, and vegetables are broken down into simple sugars and amino acids. Diets high in fruits and vegetables are net base-producing, while diets high in animal products and grains are net acid-producing. The standard Western diet is net acid-producing, while the absence of grains and high intake of fruits and vegetables in the Paleo diet result in basic conditions.5,16 how this impacts health Currently, there is not enough research to support the claim that the acid-base balance of the Paleo diet is healthpromoting. However, some proponents of the Paleo diet claim that a net base-producing diet high in vegetables and fruits is better for the body. Their explanation is that when the body is in an acidic state due to excess consumption of acid-producing foods, the body uses its alkaline, or basic, stores (calcium salts in bones) to bring the body back to neutral, resulting in increased urinary calcium excretion. They claim that this may result in decreased bone density and increased fracture risk.5,16

7. higher essential nutrients diet details The Paleo diet includes nutrient-dense foods like vegetables, fruits, nuts, and meats, and it eliminates heavily processed foods, which can be lacking in vitamins and minerals. how this impacts health Vitamins and minerals have many different roles in the body ranging from processing nutrients (B vitamins) to aiding muscle function (potassium). They are a necessary part of any diet and are required for maintaining normal body functions.17

potential risks lack of legumes The Paleo diet doesn’t allow legumes, which include beans, peas, lentils, soybeans, and peanuts. Legumes are an important source of fiber as well as folate, potassium, iron, and magnesium. Potassium and magnesium aid in nerve and muscle function while folate and iron are important for red blood cell function. Legumes are also a source of plantbased protein utilized by many vegetarians. The Paleo diet’s emphasis on protein and exclusion of legumes and soy products does not make it very vegetarian-friendly.17,18 increased meat consumption The Paleo diet is characterized by an increase in protein consumption from mostly animal sources, which comes with its own risks. Protein makes up 19 to 35% of intake in the Paleo diet compared to 15% in the Western diet. The exclusion of significant plant-based protein like soy and beans means that most protein must come from animal sources.

Some problems with increased meat consumption are listed in the next paragraph. However, these can be avoided if you choose to eat mostly seafood, which is low in saturated fat and high in heart-healthy omega-3 fats.19

The Paleo diet’s emphasis on vegetable and fruit consumption has many potential benefits, especially in contrast to the Western diet. These include increased amounts of fiber, potassium, healthy fats, and micronutrients. The diet’s elimination of processed foods and resulting reduction in sodium and trans fats may decrease the risk of cardiovascular disease. While increased protein consumption may result in increased fullness and weight loss, there are also risks of increased meat consumption, especially in the modern era. However, these risks can be reduced if care is taken to select high quality meat and to minimize the consumption of red meat by eating seafood instead. With a little meal planning and strategic pantry stocking, the Paleo diet can be a good way to increase the amount of fresh, unprocessed food in your diet. t w

grain-fed meat Ideally, meat in the Paleo diet should come from animals that are allowed to roam freely and raised on a diet of grass to mimic ancient conditions. Grass-fed beef has been shown to have lower levels of saturated fats and higher levels of heart-healthy omega-3 fats than grain-fed beef. However, most animals raised for meat in America are not grass-fed but fed a diet of grains. Grass-fed meat is available, but it tends to be expensive and hard to find. Thus, the consumption of a high amount of meat for most people in the present day will likely not be exactly similar to the meat consumption in the Paleolithic era.6

References 1.

“Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21st-century hunter-gatherer.” Mayo Clin Proc. (2004).

2.

“Chronic Diseases and Health Promotion.” cdc.gov. (2012).

3.

“What to Eat on the Paleo Diet.” thePaleodiet.com. (2014).

4.

“Origins and evolution of the Western diet: health implications for the 21st century.” Am J Clin Nutr (2005).

5.

“The Paleo Diet Premise.” thePaleodiet.com. (2014).

6.

“A review of fatty acid profiles and antioxidant content in grass-fed and grain-fed beef.” Nutr. J (2010).

7.

“A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations.” Am J Cln Nutr. (2005).

8.

“Glycemic index diet: What’s behind the claims.” mayoclinic.org. (2011).

9.

“Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet.” Am J Clin Nutr. (2009).

10.

“Fiber Content of Foods in Common Portions.” huhs.harvard.edu. (2004).

11.

“Dietary fiber: Essential for a healthy diet.” mayoclinic.org. (2012).

12.

“Dietary Fiber: Insoluble vs. Soluble.” webmd.com. (2010).

13.

“Types of Fats - Topic Overview.” webmd.com. (2013).

14.

“Sodium and Salt.” heart.org. (2014).

15.

“Sodium and potassium intake and mortality among US adults prospective data from the third national health and nutrition examination survey.” JAMA Intern Med. (2011).

16.

“Diet-induced acidosis: is it real and clinically relevant?” Br J Nutr. (2009).

17.

“Vitamin and Mineral Sources.” webmd.com. (2012).

18.

“Beans and other legumes: Types and cooking tips.” mayoclinic.org. (2011).

19.

“Fish and Omega-3 Fatty Acids.” heart.org. (2014).

20.

“Meat consumption and colorectal cancer risk: Dose-response meta-analysis of epidemiological studies.”

Int. J Cancer. (2001).

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total wellness ▪ summer 2014

left: alexraths/istockphoto; krummelmonster/istockphoto right: creativeye99/istockphoto

bottom line

red meat Consumption of lean, grass-fed meat is recommended for the Paleo diet, but there are no restrictions on the amount of red meat allowed. A 2001 review in the International Journal of Cancer found that the increased consumption of red meat is associated with a moderate but significant increase in colorectal cancer risk.20

mind well

how nature can help your mind

total wellness â–Ş summer 2014

It is no secret that hectic urban environments and fast-paced technological lifestyles can lead to mental fatigue. Media, traffic, and social and emotional stressors can all bombard us with engaging stimuli that unintentionally wear out our minds. Although at times we may certainly continue to thrive with technology and the dazzling city surroundings, at other times we may get so exhausted that we must simply escape the hustle and bustle and retreat into the natural world. Research suggests that exposure to nature may have numerous advantages for mental health, so if we are indeed feeling a little bit out of tune, we may truly benefit from the great call of the wild. Here are just some of the key mental health troubles that Mother Nature may have the solution for.

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left: stockphoto4u/istockphoto right: tanatat/istockphoto

by omid mirfendereski | design by mary sau

attention

improving concentration and sustained attention

what is the problem?

Findings suggest that exposure to nature may improve performance on concentration tasks. A 2008 study published in Psychological Science found that walking in nature for 50 to 55 minutes improved performance on a task which involved recalling sequences of numbers in reverse order. The study also found that walking in nature improved mood, but interestingly, it did not find a correlation between mood change and task performance. In a second experiment involving relatively fewer participants, the study found that viewing pictures of nature improved performance on a task that involved determining the direction of a specific arrow.3,4

Certain features of modern technological lifestyles – such as television – are said to weaken attention capacity. A 2007 study published in Pediatrics obtained the number of weekday hours that children watched television from 5 to 15 years of age, then assessed attention problems like short attention span and poor concentration through checklists and interviews. The study discovered that a greater number of television-watching hours during childhood was correlated with a greater frequency of attention problems during adolescence, possibly due to the attention-grabbing techniques used in television. The study’s findings suggest that the overwhelming stimulation of digital life may take a toll on our ability to focus.1

how can nature help?

Nature has been shown to improve directed-attention abilities, which involve focusing on certain stimuli while suppressing irrelevant or competing stimuli.2 According to the Attention Restoration Theory, nature strengthens these abilities since it involves effortless rather than effortful attention.3 In other words, a walk in a park or a look at a landscape photograph could engage our focus without draining the perceptual processing capacity that would be needed for difficult attentional tasks.

Other research supports the notion that photographs of nature may enhance sustained attention. A set of experiments from a 2005 study published in the Journal of Environmental Psychology discovered that performance on a sustained attention test improved after viewing photographs of restorative natural environments, regardless of the time conditions involved.5 Other findings demonstrate that habitual views of nature, like walks in nature and glances at photographs of nature, can improve mental focus. A 1995 study published in the Journal of Environmental Psychology found that university dormitory residents with more natural views from their windows performed better on attentional tasks, such as substituting numbers for symbols, than their counterparts with more artificial views from their windows.6

total wellness ▪ summer 2014

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stress what is the problem?

increasing immunity to future stress

Research suggests that urban lifestyles are associated with greater stress. A 1993 article published in the American Journal of Human Biology indicated that levels of norepinephrine and epinephrine, 2 hormones released during stress reactions, were lower in rural villagers than in urban sedentary workers and students in Western Samoa.

The article also indicated that levels of norepinephrine (but not epinephrine) were lower in villagers of rural Western Samoa than in residents of modernized American Samoa or urbanized Hawaii. Both sets of findings reveal that urban and modern lifestyles may correlate with higher stress levels.7

Immunity to subsequent stressors may also improve with exposure to nature. In a 1998 study published in the Journal of Environmental Psychology, college-age participants watched a videotape of either an artifact-dominated or a nature-dominated simulated drive, immediately before and after mildly stressful events. It was discovered that participants who viewed nature-dominated drives experienced quicker stress recovery and also greater immunity to subsequent stress, based on perceived autonomic responses to later stressors.10

how can nature help?

frustration and aggression

Nature has been shown to encourage and speed up stress recovery. Exposure to real-life or videotaped natural environments may decrease physical arousal (high heart rate and high blood pressure) brought about by the largely subconscious autonomic nervous system in times of stress.

This outcome may facilitate both immediate stress relief and future stress immunity.

what is the problem?

total wellness â–Ş summer 2014

Findings indicate that nature may relieve responses to daily stressors. A 2003 study published in the Journal of Environmental Psychology found that after either driving or completing attention-demanding tasks, sitting in a room with views of trees promoted a quicker decline in participant blood pressure than sitting in a viewless room. The study also found that subsequently walking in a nature reserve promoted greater stress reduction in participants than walking in an urban environment.8 Other research suggests that videotapes of natural environments may also counteract stress responses. In a 1991 study published in the Journal of Environmental Psychology, subjects first viewed a stressful movie and then watched a videotape of either a natural or an urban setting. It was discovered that recovery from stress was faster and more complete when subjects were exposed to videotapes of natural environments, based on perceived changes in heart activity and muscle tension.9

14

how can nature help?

It has been suggested that nature decreases irritation, frustration, and aggression. Exposure to vegetation may boost frustration tolerance and discourage violent tendencies, possibly because it decreases mental fatigue and improves attention.12

left: davidf/istockphoto

reducing stressful arousal and nervous activity

Study results suggest that contemporary urban environments increase frustration and aggression, possibly due to the particularly high presence of traffic. A 1999 study published in Aggressive Behavior indicated that driver aggression was greater in high-congestion conditions than in low-congestion conditions, as revealed through participant responses to the State Driving Behavior Checklist, which asks about behaviors used to cope with stress. Urban areas, which are more likely to have high-congestion conditions, are also more likely to breed aggression.11

reducing aggression

increasing frustration tolerance

It is possible that exposure to nature also decreases the likelihood of aggressive actions and behavior. According to a 2001 study published in Environment and Behavior, urban public housing residents living in relatively barren buildings reported more aggression and violence than urban public housing residents living in buildings with nearby trees and grass. The study indicated that the mechanism that lowered aggression in the latter group of residents was attentional restoration, an advantageous process discussed earlier in this article.12

It has been shown that nature may reduce feelings of irritation and frustration. In a 2003 study published in Environment and Behavior, participants viewed videotapes of specific highway drives, each of which differed in its amount of roadside vegetation and man-made material. It was discovered that participants who were exposed to videotapes with more vegetation had greater frustration tolerance with more vegetation had greater frustration tolerance, as they spent more time on a difficult word activity.13

bottom line Research suggests that nature can be restorative and therapeutic for the mind. While urban environments and lifestyles may impair concentration, increase stress, and promote aggression, natural environments may strengthen directed-attention capacity, improve stress recovery, increase frustration tolerance, and reduce aggressive behavior. So the next time you are feeling overwhelmed by the hectic pace of city life, simply take a walk in the park or watch a video of nature to restore your focus and regain your mental vigor. t w

THE ASHE CENTER Student Health and Wellness

Contact

Academic Year Hours Mon-Thurs Friday Saturday

8:00am–5:30pm 9:00am–4:30pm 9:00am–12:00pm*

*Walk-ins only, limited services available

UC SHIP is a comprehensive health care package including medical, behavioral health, vision and dental benefits with 24/7 Nurseline assistance.

+ + + +

NEW: Delta Dental coverage now included for undergraduates NEW: UC “family” discount when students visit UC medical centers Full compliance with benefit standards of the Affordable Care Act Free healthy check-ups right on campus at your student health center

total wellness ▪ summer 2014

Main Line: (310) 825-4073 24/7 Nurseline: (877) 351-3457 Address: 221 Westwood Plaza (Bruin Plaza), Los Angeles, CA 90095

References 1.

“Does Childhood Television Viewing Lead to Attention Problems in Adolescence? Results From a Prospective Longitudinal Study.” Pediatrics. (2007).

2.

“Mechanisms of Directed Attention in the Human Extrastriate Cortex as Revealed by Functional MRI.” Science. (1998).

3.

“The Cognitive Benefits of Interacting With Nature.” Psych Sci. (2008).

4.

“Testing the Efficiency and Independence of Attentional Networks.” sacklerinstitute.org. (2008).

5.

“Exposure to restorative environments helps restore attentional capacity.” J Environ Psychol. (2005).

6.

“Views to nature: Effects on attention.” J Environ Psychol. (1995).

7.

“Stress and Changing Lifestyles in the Pacific: Physiological Stress Responses of Samoans in Rural and Urban Settings.” Am J Hum Biol. (1993).

8.

“Tracking restoration in natural and urban field settings.” J Environ Psychol. (2003).

9.

“Stress recovery during exposure to natural and urban environments.” J Environ Psychol. (1991).

10.

“The View From the Road: Implications for Stress Recovery and Immunization.” J Environ Psychol. (1998).

11.

“Traffic congestion, driver stress, and driver aggression.” Aggressive Behav. (1999).

12.

“Aggression and Violence in the Inner City: Effects of Environment via Mental Fatigue.” Environ Behav.

(2001).

13.

“The Restorative Effects of Roadside Vegetation: Implications for Automobile Driver Anger and Frustration.” Environ Behav. (2003).

THE ASHE CENTER SERVICES Primary Care • Women’s Health • Walk-in Urgent Care • Specialty Clinics Immunizations • Lab Services • Pharmacy • Optometry • Radiology Acupuncture • Chair Massage • Travel Clinic • Physical Therapy

www.studenthealth.ucla.edu 15

move well

choosing the best exercise environment by danielle zola | design by alexandria villanueva

left: geber86/istockphoto right:deklofenak/istockphoto

total wellness â–Ş summer 2014

What if where you exercised could make you want to work out more? Daily life gets busy — and we all know that it is easy to let the recommended amount of daily physical activity fall by the wayside.1 While exercise is beneficial for psychological, physical, and social health, enjoying your surroundings while exercising is important if you want to make your routine a habit.2 Read on to find out if exercising indoors or outdoors is right for your workout routines.

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outdoor vs. indoor environments Whether you are running outdoors or hitting the gym, it turns out that your exercise environment may influence the likelihood that you stick to your exercise schedule. Exercise locations can be divided into outdoor and indoor settings.

Outdoor, or natural environments, include public parks, “green” university campuses, gardens, and woodlands — essentially anywhere that contains components of nature as opposed to purely man-made environments.3 A 1998 study published in Environmental Science & Technology states that the typical amount of time spent in natural environments is 8.3% of the average person’s day (only about 2 hours!).4 On the other hand, indoor environments, or synthetic environments, are composed of man-made surroundings that are primarily in the context of gyms or training facilities. These can also be outdoor urban settings that contain little to no natural elements.

benefits of physical activity indoor

A 2011 review published in Environmental Science and Technology analyzed 11 studies that each had adults (average age 25) walk or run indoors and outdoors at the same intensity.

Results revealed that participants reported decreased feelings of calmness with the outdoor walk compared to the same activity indoors.5 Additionally, expectations of social interaction influence how individuals perceive their exercise environment. People are drawn to exercise environments that allow them to meet new people, and the expectation of social benefits draw people to indoor exercise facilities instead of outdoor environments.

In many indoor facilities, simple factors such as the setup of weight machines and treadmills as well as group exercise opportunities are designed to increase social interaction.2 While outdoor exercise can be a social activity, indoor facilities make this socialization easier.

outdoor

indoor vs. outdoor: influence on exercise frequency Many of us put off exercising because we don’t necessarily like working out. However, certain elements of where you perform physical activity could help you enjoy it a little better. A 2009 study published in Health & Place examined members of a fitness club and their responses to a weekly training regimen involving exercising 1 to 3 times indoors and 1 time outdoors weekly for 30 days. Participants reported social interaction as a reason to attend indoor exercise facilities, and aesthetic quality was most frequently reported as a reason to maintain physical activity outdoors. In this way, the restorative quality of physical activity could act as a predictor of exercise frequency.2

Compared to indoor exercise, outdoor physical activity may:5,7* > Allow for the body to produce vitamin D through sun exposure > Decrease feelings of tension, confusion, anger, and depression > Increase feelings of energy and revitalization > Reveal a greater amount of reported enjoyment and satisfaction > Ultimately result in a larger reported intent to engage in the Wactivity again at a later date *More research is needed to confirm that outdoor activities really produce these effects.

There are other factors aside from these findings that may influence our decision to keep up with an exercise routine or not. Other determinants of exercise frequency, besides preferred environment, include accessibility to facilities, season, weather restrictions, and personal safety. These factors can truly sway how motivated we are to exercise.2

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total wellness ▪ summer 2014

While both indoor and outdoor exercise environments have their draws, a 2011 study published in Environmental Science and Technology reveals more reported feelings of satisfaction from those who exercised outdoors rather than indoors. This translated into a greater intent to perform the physical activity in the future if it was performed outdoors rather than indoors.5

It turns out there may be additional benefits to exercising outside that aren’t commonly thought of. A 2010 study in BMC Public Health reveals that exercise in natural environments provides meaningful benefits to wellbeing, based on self-reported levels of anxiety, anger, fatigue, and sadness.4 Additionally, a 2008 article in Psychology Science noted that individuals participating in exercise in natural environments experienced significant improvements in mood compared to those exercising in an urban setting.6 Natural environments likely provide added physiological benefits, but more research is needed to see if the effects are significant.5

psychological impacts The Journal of Environmental Psychology published a multistudy analysis in 2011 about the link between nature, exercise, and mental health. Participants exercising in natural environments revealed diminished feelings of frustration after engaging in activity in distraction-free natural exercise environments. The study also demonstrated that conscious mental engagement with the natural environment, such as thinking about natural surroundings while performing exercise, increases the above benefits for psychological wellbeing.8 Environments near natural water sources have also shown to have an impact on mental health. An article published in Environmental Science and Technology (2010) reported that environments adjacent to water sources produced the greatest increase in mental health benefits, though participants in all natural environments showed improved self-esteem and mood.9

environment and vitality Vitality is the state of being strong and active, which can be both a feeling and a lifestyle.10 Vitality can be measured by a 7-item subjective vitality scale that includes feelings of being alive, energetic, alert, and optimistic about the future. In studies on vitality, participants rate each of these feelings on a scale from 1 to 7 based on their present state of mind.11 Such methods were used in a 2010 study in the Journal of Environmental Psychology that examined effects of indoor and outdoor walks on individuals’ vitality. The study focused on a group of undergraduate students aged 18 to 22, measuring vitality ratings before and after each walk in both indoor and outdoor environments. It suggested that indoor physical activity allows for the vitalizing effect of social interaction.

However, when walks were conducted with individuals walking alone without social interaction, overall vitality improved more in natural outdoor exercise environments versus indoor synthetic environments.11

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chemical exposure indoor

A study published in Environmental Science and Technology (1998) reported that a chemical in many indoor coolant systems can have negative effects on health. The study also found that newer buildings had less exposure to the chemical, but still more than as compared to outdoor environments. It also may be difficult to gauge the age (and chemical content) of a building, especially if it has been renovated to create a state of the art gym facility. Try to alternate between indoor and outdoor environments in order to minimize chemical exposure.3

outdoor

It is no secret that outdoor air pollution from cars and industrial facilities is harmful. A 2014 article published in Sports Medicine explains that airborne pollutants, such as gases or particles, can often be in higher concentrations in outdoor than indoor environments. Exercise can create as much as a 10-fold increase in airborne particles deposited in airways, which would otherwise be exhaled. Physically active people should be aware that both indoor and outdoor environments may increase exposure to potentially harmful airborne chemicals.12 To learn more, take a look at the air pollution article on pages 45 to 48.

perception of workout intensity Where you excercise could influence how hard your workout feels. A 2004 study in Psychology of Sport and Exercise suggests a strong correlation between exercise environment and perceived exertion of physical activity. The study involved 60 individuals running 15 miles per week, with participants reporting how hard their workouts felt using the Rating of Perceived Exertion Scale (RPE).

In comparing responses from participants running on an outdoor running route versus a treadmill, the study showed that those participating in the outdoor running route reported the lowest amount of perceived exertion. By contrast, the treadmill runners reported the least satisfying, highest level of perceived exertion, and the slowest performance times in the study.Ultimately, this study suggests that individual perception of how hard a workout feels may be based on exercise environment and that outdoor exercise may make a workout seem less difficult.13

bottom line Sticking with an exercise routine can be difficult, especially when environmental factors come into play. Some people may have very limited interaction with the natural environment on a daily basis. However, the desire to avoid air pollution and preference for social interaction may encourage people to choose indoor gyms over outdoor workouts.

Studies suggest that exercising in outdoor environments could have a higher number of positive health effects and may increase your likelihood of future activity when compared to the same activity in synthetic or indoor environments. The need to balance both indoor and outdoor exercise may also be necessary in order to balance personal and environmental conditions. So the next time you exercise, try swimming, cycling, hiking, or running outdoors to engage your mind and body in nature, and maybe enjoy your workout a little more. t w

SUMMER 2014

Wellness Skills Groups The Wellness Skills Program offers a series of brief groups designed to help students enhance wellness and develop personal, academic, and social skills.

Call or visit to sign up for a group, or for more information.

Art of Public Speaking

Mindful Pathways to Wellness

If you dread speaking in public, you are not alone.

Many Americans rate speaking in public as one of their top fears. Yet, being a successful student requires speaking in public, whether it is in social situations or in academic settings, such as seminars. Join this supportive group if you would like to learn effective tools for managing public speaking anxiety and speaking publicly with greater comfort.

Mindfulness-based psychological techniques are effective for coping with difficulties in life and in improving the overall quality of life. Learn basic principles of mindfulness and practice a variety of ways of being in the present moment.

Thursdays, 1:00-2:00pm, Three Sessions Section One: August 21 – September 4

Biofeedback Training Biofeedback combines modern technology and ancient wisdom to increase awareness of subtle physiological indicators of stress. Learn how to recognize early signs of distress and utilize feedback from electronic devices to restore inner calm.

Tuesdays, 1:00 – 2:00pm, Two Sessions Section One: July 1 – July 8

Tuesdays, 1:00-2:00pm, Three Sessions Section One: August 26 – September 9

Overcoming Procrastination If your procrastination has become problematic or embarrassing, this group can offer some help. Explore reasons behind excessive procrastination and discuss the costs involved through this hands-on, structured and supportive group.

Wednesdays, 3:00-4:00pm, Three Sessions Section One: August 6 – August 20 Wednesdays, 3:00-4:00pm Section Two: August 27 – September 10

Progress (Not Perfection)

Tuesdays, 2:00 – 3:00, Two Sessions Section Two: August 12 – August 19

Break the Cycle of Anxiety Are you feeling overwhelmed by academic pressures and other stressful circumstances? This group is for students who want to learn about anxiety and how to manage it.

Wednesdays, 11:00am-12:00pm, Three Sessions Section One: July 9 – July 23 Thursdays, 1:00 – 2:00pm Three Sessions Section Two: August 21 – September 4

Getting What You Want: Interpersonal Effectiveness

Tuesdays 1 – 2pm Section One: July 15 – July 29

Tuesdays, 1:00-2:00pm, Three Sessions Section One: July 8 – July 22 Section Two: August 19 – September

Taming Your Inner Critic This 3-session wellness skills group is designed for individuals that have developed the habit of being hard on themselves (e.g., related to academic, social or emotional difficulties) and have realized it is not working the way they hoped. This group aims to help students identify their inner critic, understand the function and outcome of self-criticism, and practice non-judgmental stance and self-compassion as an alternative method of self-talk.

Mondays, 2:00-3:30pm, Three Sessions Section One: July 21 – August 4

right: thebroker/istockphoto

Make Peace with Food Do you find yourself stuck in a pattern of chronic dieting or trying to gain control over eating? This group focuses on challenging what you think you know about what you should eat and reconnecting you with your body’s natural ability to guide food choices and portion sizes.

Thursdays, 3:30 – 5:00pm, Three Sessions Section One: August 14 – August 28

Drop-in Groups This group offers support and skills whether you are waiting for your first therapy session or in-between sessions. Students must obtain a referral into the group from a CAPS counselor Wednesdays and Fridays, 2:00-3:00pm

CARE: Campus Assault Resources & Education www.counseling.ucla.edu/care ucempoweru.ucla.edu CARE is a safe place for survivors of sexual assault, dating violence, and stalking to get support, consultation, and have a safe place to talk. We offer several response and prevention services.

CARE is located in The Counseling Center at Wooden Center West.

To access a CARE Counselor: Call (310) 825-0768 or visit The Counseling Center To access a Student Care Manager: Call (310) 825-0628, (310) 825-7291, (310) 825-7299, or visit www.studentsincrisis.ucla.edu Advocacy and support are available for UCLA students to understand their rights and options. A Student Care Manager can assist students in finding resources and can serve as an advocate for students who arte attempting to navigate legal, criminal, and university judicial stystems, and connect students to other campus resources.

CAPS Connect Trainings for Graduate Students & UCLA Staff These trainings will teach key bystander intervention principles to prevent violence, and how to respond and support students who are distressed.

Trainings are co-sponsored by GSRC.

total wellness ▪ summer 2014

Do you struggle with asserting yourself in relationships, interpersonal problem-solving, or feeling good about yourself after interactions with others? This 3-session skills-based group is for students who want to learn how to get their needs met in their interactions and relationships with others.

Do you set very high standards for yourself and feel badly when you fall short? Does your desire to be the best prevent you from trying new things or taking risks?

Learn how perfectionism can get in your way and how to be a high achiever without being a perfectionist.

References 1.

“How much physical activity do adults need?” cdc.gov. (2014).

2.

“Restorative qualities of indoor and outdoor exercise settings as predictors of exercise frequency.” Health & Place. (2009).

3.

“A systematic review of evidence for the added benefits to health of exposure to natural environments.” BMC Public Health. (2010).

4.

“Comparison of Polychlorinated Biphenyl Concentrations in Indoor and Outdoor Air and the Potential Significance of Inhalation as a Human Exposure Pathway.”

Environ Sci Technol. (1998).

5.

“Does Participating in Physical Activity in Outdoor Natural Environments Have a Greater Effect on Physical and Mental Wellbeing than Physical Activity Indoors? A Systematic Review.” Environ Sci Technol. (2011).

6.

“The Cognitive Benefits of Interacting with Nature.” Psychol Sci. (2008).

7.

“Diet, sun, and lifestyle as determinants of vitamin D status.” Ann NY Acad Sci. (2014) 8.

“Enhancing the benefits of outdoor walking with cognitive engagement strategies.” J Environ Psychol. (2011).

9.

“What is the Best Dose of Nature and Green Exercise for Improving Mental Health? A Multi-Study Analysis.” Environ Sci Technol. (2010).

10.

“Vitality.” crcresearch.org. (2014).

11.

“Vitalizing effects of being outdoors and in nature.” J Environ Psychol. (2010).

12.

“The Health Effects of Exercising in Air Pollution.” Sports Med. (2014).

13.

“Effects of cognitive strategy and exercise setting on running performance, perceived exertion, affect, and satisfaction.” Psychol Sport Exer. (2004).

How to Identify and Refer a Distressed Student Wednesday, July 16 SAC Conference Room 5

QPR Gatekeeper Training for Suicide Prevention Wednesday, July 30 - 5pm SAC Conference Room 5

E-mail rsvp@caps.ucla.edu to enroll.

The Counseling Center • John Wooden Center West • (310) 825-0768 • www.counseling.ucla.edu Confidential Individual Counseling • Group Counseling • Urgent Walk-In • Psychiatric Care • Sexual Assault Services • 24 Hour Access

19

body in focus

sun safety:

protecting the skin you’re in

total wellness ▪ summer 2014

It’s a beautiful day, and you’re ready to race out the door and enjoy the sunshine.

But wait a second — you may have forgotten about something very important: sun protection. Although you might moan and groan while slathering yourself with sunscreen or trying to find your hat and sunglasses, it will be worth your time.

By following sun safety guidelines, you reduce your risk of many dangers — some of which are even deadly.

Read on to learn about the hazards of sun overexposure, tips and tricks for protecting yourself, and helpful (and maybe even surprising) facts to keep in mind while having fun in the sun.

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left: creativemarc/istockphoto right:topalov/istockphoto

by nancy vu | design by annie theriault

eye damage3

the consequences of too much sun exposure skin blemishes1 Overexposure to the sun’s ultraviolet (UV) radiation can harm the appearance of the skin.

It can result in premature aging, causing the skin to become dry, thick, wrinkled, and leathery.

Also, the skin can begin to look blotchy and discolored. When the skin is exposed to UV rays, a natural substance called melanin is produced to provide protection and give the skin its color.

Too much sun exposure causes excess melanin.

Overproduction of melanin can result in hyperpigmentation, or uneven darkening of the skin. This can include brown to black sun spots (also known as age spots or liver spots).

sunburn2 As many people have learned from experience, too much exposure to the sun’s UV rays can cause mild to severe sunburns, or redness and irritation of the skin. Especially during the warmer seasons when UV rays are stronger, the skin may produce too little melanin for adequate protection.

Consequently, the UV light causes the skin to burn, resulting in tenderness, sensitivity to touch, and sometimes swelling and blistering.

Severe sunburn, also called sun poisoning, can lead to fever, chills, and nausea.

Excessive sunlight exposure over time can also lead to eye damage. Even though the eyelids are able to limit the amount of light that enters the eye, they are thin and vulnerable to the chronic effects of sun exposure. Similarly, parts of the eye such as the lens and cornea play an important role in filtering UV rays but can become damaged after overexposure. This can result in irritation or serious eye diseases. Some of these conditions include eye cancers, abnormal growths on the eye, or cataracts (the yellowing or clouding of the eye lens).

skin cancer4,5 Too much exposure to UV radiation is the leading cause of skin cancer, accounting for almost half of all cancer cases in the United States. Skin cancer develops when damage from UV rays mutates the DNA in genes that control skin cell growth, causing abnormal skin cells to start growing uncontrollably and malignant tumors to form. The most deadly form of skin cancer, melanoma, begins in melanocytes, or cells that produce the skin pigment melanin. Like many other skin cancers, this cancer can be cured if found and treated early but can lead to serious consequences if not addressed. (Check out “Patrol Those Moles” in Issue 4, Volume 13 to learn more about melanoma and how to detect it.)

total wellness ▪ summer 2014 21

the bright side of sun exposure Although overindulging in sunlight can indeed be hazardous, getting some sun exposure can be beneficial to health. One of the powers of the sun’s energy is its ability to trigger chemical reactions in the skin, causing the production of vitamin D and many vital hormones. Below are some of the gifts sunshine can provide as long as overexposure is avoided. Be sure to keep up with sun safety and try to stay under the upper limit of 4,000 IU/day of vitamin D, which is equivalent to about 20 minutes of sun exposure.6 If it’s difficult to get a daily dose of sunshine, there are also other ways to receive the same benefits.

potential benefits of sun exposure:

alternatives:

a better night’s sleep Exposure to sunlight can help you get better zzz’s by helping to regulate the circadian rhythm. This rhythm is a 24-hour cycle that acts as an internal biological clock that determines sleep patterns. The pineal gland, located in the middle of the brain, secretes melatonin, which plays an important role in regulating the sleep-wake cycle.7 Exposure to sunlight during the day causes melatonin production to occur earlier. This increase of melatonin induces sleepiness, leading to a sounder slumber.8

Use indoor lighting during the day. This can also regulate the circadian rhythm.

Increased exposure to indoor lighting during the day can affect melatonin levels and improve sleep quality.

improved immune system Sun exposure can also boost the immune system. The vitamin D synthesis stimulated by the sun can help defend against bacteria and viruses in the body because vitamin D is a major contributor in regulating immune responses. After being processed by the body, the vitamin is able to act on immune cells, which help protect the body from diseases.9

stronger teeth and bones

Eat foods (like seafood) that are rich in vitamin D, or get vitamin D from taking oral supplements.

total wellness ▪ summer 2014

a sunnier outlook Sunlight exposure can enhance mood and energy.

When skin cells are exposed to UV radiation from the sun, endorphins, also known as “happy hormones,” get released into the bloodstream, stimulating a feel-good effect.10 Additionally, vitamin D production triggered by the sun can boost levels of serotonin, a mood-elevating neurotransmitter (a chemical that transmits signals in the brain).8

lower blood pressure Another potential benefit of sun exposure is lower blood pressure. UV radiation activates nitric oxide production in the skin. This compound then gets released into the bloodstream, causing blood vessels to dilate, thus reducing blood pressure.11

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Exercise can also increase the levels of endorphins in the blood. (Read more about this in “The Science behind Happiness and Exercise” in Issue 3, Volume 14).

Maintaining a healthy diet and exercising regularly can also reduce blood pressure.

left: aluxum/istockphoto; slyudmila/istockphoto; bluestocking/istockphoto right:fotohunter/istockphoto

Vitamin D is a key player in maintaining bone health.

By helping the body break down and absorb calcium and phosphorus, vitamin D regulates the levels of these minerals, helping build strong teeth and bones.8

soak up these sun safety tips

use sunscreen Apply sunscreen at least half an hour before going into the sun, allowing the skin to absorb it.

Be sure to reapply sunscreen every 2 hours (more frequently after swimming or sweating).

how does sunscreen work?

Sunscreen contains several ingredients that help prevent the sun’s UV rays from penetrating the skin. The combination of chemicals that make up sunscreen acts as a filter, reducing the amount of light from the sun reaching the skin. Sunscreens can protect against ultraviolet B (UVB) rays, which are the main cause for sunburn, and ultraviolet A (UVA) rays, which penetrate the skin more deeply and can cause premature aging and cancer.12

what is spf?

The Sun Protection Factor (SPF) is the measure of the sunscreen’s ability to protect UV rays from damaging the skin. This number tells you how long you can stay in the sun before getting a sunburn.

For example, if your skin starts turning red in 20 minutes while unprotected, SPF 30 sunscreen will theoretically prevent the reddening 30 times longer, or for about 10 hours.12

what type of sunscreen is recommended?

Check the labels! Sunscreen that protects against both UVA and UVB rays should be used. Also be sure to grab sunscreen with the recommended SPF rating of 30 or higher. Some cosmetics, including moisturizer, foundation, and lip balm, can also offer some sun protection. However, these products usually have a low SPF, so they should be used as supplements instead of by themselves.13

cover up clothes

Wearing a wide-brimmed hat can help protect the neck, ears, scalp, and face from sun exposure. Choose a hat with a 3 to 4 inch brim all around for optimal shade instead of other hats like baseball caps or visors, which leave the lower face, ears, and neck exposed.

sunglasses

Sunglasses can help prevent eye damage from the sun. Try to use sunglasses with full protection against UV light.

Choose sunglasses with a label or sticker indicating that the lenses block 99% or 100% of UVB and UVA rays.

UV-blocking contact lenses are also available to help reduce the amount of UV rays that strike the eyes.

seek shade (or make it)

Avoid direct sunlight by staying in the shade. In many cases, shade can be easy to spot, such as from trees or roofed areas.

However, when shade isn’t available, create your own by using a large umbrella to laze under.

avoid tanning Stay away from both indoor and outdoor tanning! Lamps on tanning beds give off large amounts of UVA and usually UVB rays which can cause long-term skin damage and skin cancer. Indoor tanners are 74% more likely to develop melanoma than those who have never experienced indoor tanning.14 Tanning outside by deliberately exposing yourself to sunlight can be just as

dangerous. Using tanning oils to speed up the tanning process outside is even worse. These oils enhance the effects of UV rays and increase the production of melanin to darken the skin, overexposing the skin to the harmful radiation.15 A safer way to tan is by using sunless tanning lotions, like bronzers, but remember that these often provide little to no UV protection.16

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When possible, wear long-sleeved shirts and long pants. Fabrics that are thick, tightly woven, or dark- or bright-colored are especially effective in blocking out sunlight.13 Additionally, many athletic and outdoor clothing brands carry sun protective clothing and swimwear that are designed to provide UV protection. This type of clothing usually has an ultraviolet protection factor (UPF), similar to SPF, which indicates what fraction of the sun’s UV rays can pass through the fabric.

hats

other important things to know ouch! i’m sunburned…

now what?

Here are some ways to treat a sunburn:

stay cool

Create a cool compress by soaking a washcloth in cool water and let it sit directly on sunburned areas.

Taking frequent cool showers or baths can also provide relief by cooling the skin.

stay hydrated

Any burn brings fluid to the skin surface from the rest of the body, so be sure to stay hydrated by drinking plenty of water.

UV light is strongest between 10 a.m. and 4 p.m.

This is the peak time period in which the sun is highest in the sky.

Try staying out of direct sunlight as much as possible during these hours.

Taking sun protection measures is especially important during this time period.16

Sunburn doesn’t only happen when it’s sunny.

It’s possible to get a sunburn on a cloudy or overcast day since the sun’s UV rays can pass through clouds.17 Don’t neglect to put on sunscreen even if it’s not sunny outside!

a significant portion of UVA to pass through. According to a 2006 study in the Journal of the American Academy of Dermatology, standard side and rear windows allow 48% of UV radiation to transmit. However, tinted window glass greatly reduces transmission, with 3.8 times less UV transmission than untinted cars.18

UV rays bounce off water, concrete, sand, and snow.

Water, concrete, sand, and snow are all reflective surfaces that UV rays can bounce off of. This is why sunburn can still happen while in the shade and in the snow. UV rays that bounce off of these surfaces can be just as severe as direct sunlight.19

moisturize

Apply moisturizing lotions to soothe sunburned skin and alleviate pain and inflammation caused by sunburn.

take pain relievers

total wellness ▪ summer 2014

Medications can help treat fever or pain caused by sunburn. Take acetaminophen or nonsteroidal anti-inflammatory drugs, such as aspirin or ibuprofen, as soon as signs of sunburn appear. Avoid using topical “-caine” products, such as benzocaine, as they may lead to dangerous health effects.

Some UV rays can also pass through windows.

Being in a car or in a building does not guarantee protection from the sun’s rays! Windows usually block most UVB rays but not all UVA rays, so skin can still become damaged even if sunburn isn’t felt.16 > sun hazards in the car In most cars, windshields are made from laminated glass, which filters out most UVA rays. Conversely, side and rear windows usually have non-laminated glass, which allows

References 1.

“Sun Damage.” mayoclinic.org. (2014).

2.

“Sunburn.” nih.gov. (2013).

3.

“How Sunlight Damages the Eyes.” skincancer.org. (2014).

4.

“Skin Cancer Facts.” cancer.org. (2014).

5.

“Melanoma.” skincancer.org. (2014).

6.

“Vitamin D: Fact Sheet for Consumers.” nih.gov. (2011).

7.

“Role of Melatonin in the Regulation of Human Circadian Rhythms and Sleep.” J Neuroendocrinol. (2003).

8.

“Benefits of Sunlight: A Bright Spot for Human Health.” Environ Health Persp. (2008).

9.

“Vitamin D: modulator of the immune system.” Curr Opin Pharm. (2010).

10.

“Beneficial effects of UV radiation other than via vitamin D production.” Dermato-Endocrinology. (2012).

11.

“Is sunlight good for our heart?” Eur Heart J. (2010).

12.

“Sunscreens Explained.” skincancer.org. (2014).

13.

“Year-Round Sun Protection.” skincancer.org. (2014).

14.

“Tanning.” skincancer.org. (2014).

15.

“How Tanning Oil Works.” livestrong.com. (2013).

16.

“How do I protect myself from UV rays?” cancer.org. (2014).

17.

“Sunburn - Topic Overview.” webmd.com. (2013).

18.

“Photoprotection by window glass, automobile glass, and sunglasses.” J Am Acad Dermatol. (2006).

19.

“Guideline for Outdoor Workers.” skincancer.org. (2014).

20.

“Who, what, where and when — influences on cutaneous vitamin D synthesis.” Prog Biophys Mol Bio. (2006).

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Sunlight doesn’t affect everyone in the same way.

Those with light skin, living in high altitudes, and who are younger are more sensitive to the sun’s UV rays and have a higher risk for developing skin damage and skin cancer.20 These people should be especially careful in the sun by using sunscreen with extra SPF, seeking shade whenever possible, checking their skin regularly for any suspicious growths, and scheduling annual professional skin check-ups.

in a nutshell Although Mr. Sun may be calling your name, taking sun protection measures before heading out (and during your time outside) is worthwhile. Leaving your skin unprotected and overexposed to the sun increases your risk of skin and eye damage as well as skin cancer, and there are quick and easy ways to prevent this. It is crucial that you put in the time and effort to keep yourself safe from the sun — your skin will thank you for it! t w

self care

mindfulness meditation: the importance of conscious living by payam mirfendereski | design by maxine tsang

Despite originating in Eastern contemplative traditions, meditation has today gained a foothold in both American popular culture and scientific research.1 In the US, many meditative practices have expanded beyond their reputation as stress-relieving exercises, and have been increasingly introduced by researchers as interventions for various psychological and behavioral disorders. Mindfulness meditation, in particular, has promised a myriad of health benefits for children and adults alike.2 Whether pursued as a clinical intervention or as a systematic method toward self-development and personal insight, mindfulness meditation may be able to address a wide range of health issues. Here, we take a look at some of these benefits. what is mindfulness meditation?

right: valentynvolkov/istockphoto

Contrary to popular belief, mindfulness meditation does not consist of any special ideologies or belief systems. In fact, it does not need to be a time-consuming ritual that is performed at the same time every day. Rather, it harnesses the innate human capacity for self-awareness and attentiveness. Even stopping what you are doing for a couple of minutes to bring attention to your bodily sensations, breathing, and thought patterns qualifies as a valuable act of mindfulness.3

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Mindfulness meditation is a form of meditation that prioritizes conscious living, summarized in the quality of mind-body awareness called mindfulness. The basis of mindfulness is surprisingly simple: avoiding unconscious or mechanical activity, tuning in to the present moment, and becoming fully aware of your inner sensations and the world around you.3

Mindfulness meditation is far from being a passive practice, and it demands mental discipline, intention, and wakefulness on the part of the meditator.3 Part of this discipline involves adopting a non-judgmental attitude toward thoughts and emotions, which means observing them objectively and without becoming absorbed in or unconsciously reactive to their content. It is also important to observe internal sensations without trying to change whatever is present, including potentially difficult thoughts and feelings.4

As a form of integrative and complementary medicine, mindfulness meditation has the potential to support routine medical practices.5 Various therapeutic programs, indeed, now contain elements of mindfulness training. Two of the most publicly recognized of these are Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT).4 MBSR, originally developed for the management of chronic pain and stressrelated disorders, is the most frequently cited systematic training program for mindfulness meditation.6 As an 8 to 10 week intervention, MBSR trains participants in stress coping mechanisms as well as in meditation skills such as hatha yoga postures.4 MBCT, which involves a combination of MBSR and traditional cognitive therapy techniques, aims to prevent depression relapse. MBCT promotes a non-judgmental approach to emotions and bodily sensations, facilitating detachment through statements such as “I am not my thoughts.”4

what can mindfulness meditation do for your brain? > enhance cognition

total wellness ▪ summer 2014

Mindfulness meditation may be able to improve brain function due to brain plasticity, or the brain’s ability to be changed over time. A 2003 study published in Psychosomatic Medicine evaluated the effects of an 8-week mindfulness meditation program on brain function. Results demonstrated for the first time that meditation can increase activity in the left anterior, or the front left, side of the brain. This region of the brain is associated with greater resilience toward negative or stressful events, suggesting that mindfulness training may be able to mitigate the cognitive effects of stress.7 Additionally, a 2005 study published in Neuroreport found that meditation practice also increases activity in the cerebral cortex, located in the front of the brain. Regular meditation practice may lead to increased thickness in the regions of the cortex that process visual

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and auditory information.8 The cortex also plays an important role in maintaining present-moment awareness and regulating emotions, so meditation training may be able to enhance attention and self-control.9 Although evidence for a causal relationship between meditation and changes in brain structure remains tenuous, studies have consistently linked MBSR training to increases in the concentration of gray matter in the brain. A 2014 meta-analytic review published in the Neuroscience & Biobehavioral Reviews found that such neuroplastic changes can be induced even after just a few hours of meditation practice.10

> reduce depression relapse Regarded as a combination of MBSR and cognitive therapy techniques, MBCT may be a powerful tool in reducing relapse for patients with recurrent depression.6 Studies published in the Journal of Counseling and Clinical Psychology in the years 2000 and 2004 discovered that MBCT reduced relapse rates for patients with 3 or more previous episodes of depression by almost 50%.11,12 In addition to reducing depression relapse, mindfulness meditation techniques may counter depression by decreasing negative ruminative thought, which involves repetitive reflections on one’s assumed faults or shortcomings.9

what can mindfulness meditation do for your body? > boost immune system activity In addition to improving cognitive function, mindfulness meditation may be able to enhance the vitality of the immune system, specifically by increasing antibody production. Antibodies are proteins produced by the immune system in order to destroy viruses and other harmful foreign substances, and stressful events can disturb antibody production. A 2003 study published in Psychosomatic Medicine found that participants who completed an 8-week mindfulness meditation program experienced a greater increase in antibodies to influenza vaccine than a control group, suggesting that mindful meditators may be less vulnerable to the effects of stress on the immune system.7

left: esolla/istockphoto right: dblight/istockphoto

applications of mindfulness meditation

body in focus

Mindfulness may be able to elicit certain changes in brain function due to brain plasticity, that is, the brain’s ability to be changed over time by external forces.

> prevent cellular aging

Due to its emphasis on greater self-awareness and self-control, mindfulness meditation may be effective in treating eating disorders marked by binging. Evaluating a 6-week mindfulness intervention on obese women, a 1999 study published in the Journal of Health Psychology noted a significant drop in the number of binges reported by participants after mindfulness training.

The study revealed that mindfulness meditation may increase the ability to recognize and respond to normal satiety cues, thereby decreasing the tendency to binge.13

Telomerase is an enzyme that hinders the age-related loss of genetic material, thus contributing to greater cell longevity. Its activity decreases with age and age-related diseases, but may actually increase with meditation practice. A 2010 study published in Psychoneuroendocrinology investigated the effects of a 3-month meditation retreat on participants’ telomerase activity. According to the results, the retreat contributed to a significant increase in the activity of the enzyme, suggesting that meditation training can reduce the likelihood of cell death and agerelated diseases.9,15

Mindfulness-based interventions may also be able to improve emotional eating and reduce external eating frequency. By mitigating maladaptive eating behaviors, mindfulness practice can constitute an effective means toward weight loss and weight maintenance.14

when and where should you engage in mindfulness meditation?

Mindfulness meditation can be pursued independently, as part of a course, or as part of a clinical intervention. There is no magical formula for cultivating mindfulness, and meditation techniques can be modified to individual needs and goals. Since mindfulness involves consciousness of internal and external stimuli, a quiet environment might be considered ideal. Nonetheless, mindfulness meditation does not need to be practiced in a secluded environment. MBSR and MBCT participants, for example, are trained in mindfulness meditation techniques as a group, and they are encouraged to practice mindfulness during ordinary activities such as walking, standing, and eating. Mini-meditations are also possible, allowing individuals to take a few moments to stop where they are to stop and tune in to their thoughts and feelings.4,13

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> treat binge eating

what is the future of mindfulness meditation?

The pool of research on mindfulness meditation has been increasing rapidly throughout the past few decades. During the past decade alone, there was a tenfold increase in the number of academic articles published on the subject of

mindfulness. The number of articles published on the topic reached a peak of 477 in 2012, revealing a significant and continued interest in mindfulness meditation within the scientific community.16 More methodological research may be needed to assess the extent to which mindfulness meditation can improve various aspects of

mindfulness meditation at ucla

References 1.

“The Mindful Revolution.” time.com. (2014).

2.

Sitting-Meditation Interventions Among Youth: A Review of Treatment.” Pediatrics. (2009).

3.

“Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life.” Hyperion Books. (1994).

4.

“Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review.” Clin Psychol-Sci Pr. (2003).

5.

“Meditation: An Introduction.” nccam.nih.gov. (2010).

6.

“Mindfulness Meditation for Substance Use Disorders: A Systematic Review.” Subst Abus. (2009).

7.

“Alterations in Brain and Immune Function Produced by Mindfulness Meditation.” Psychosom Med. (2003).

8.

“Meditation Experience Is Correlated with Increased Cortical Thickness.” Neuroreport. (2005).

9.

“Can Meditation Slow Rate of Cellular Aging? Cognitive Stress, Mindfulness, and Telomeres.” Ann NY Acad Sci. (2009).

10.

“Is Meditation Associated with Altered Brain Structure? A Systematic Review and Meta-Analysis of Morphometric Neuroimaging in Meditation Practitioners.” Neurosci Biobehav Rev. (2014).

11.

“Prevention of Relapse/Recurrence in Major Depression by Mindfulness-Based Cognitive Therapy.” J Consult Clin Psych. (2000).

12.

“Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects.” J Consult Clin Psych. (2004).

13.

“An Exploratory Study of a Meditation-Based Intervention for Binge Eating Disorder.” J Health Psychol. (1999).

14.

“Mindfulness-Based Interventions for Obesity-Related Eating Behaviours: A Literature Review.” Obes Rev. (2014).

15.

“Intensive Meditation Training, Immune Cell Telomerase Activity, and Psychological Mediators.”

Psychoneuroendocrino. (2010).

16.

“Mindfulness-Based Interventions: An Antidote to Suffering in the Context of Substance Use, Misuse, and Addiction.” Subst Use Misuse. (2014).

the self-care column is sponsored by UCLA Health System: UCLA Center for East-West Medicine

left: deinfo/istockphoto right:dblight/istockphoto

total wellness ▪ summer 2014

The UCLA Mindful Awareness Research Center (MARC) offers a myriad of resources on mindfulness meditation for students and non-students alike. The center offers lectures, experiential workshops, retreats, and classes for those interested in practicing or simply learning more about mindfulness meditation, and many programs are specialized for different age groups and degrees of commitment. Most programs are open to the public, including the free drop-in meditations and the weekly community practice for novice and continuing meditators. More information at marc.ucla.edu. tw

biological functioning, but the research conducted so far has been very promising.4 Mindfulness meditation is today considered to be effective in addressing a wide range of health issues, including stress, depression, and binge eating. In order to better address other psychological and behavioral disorders, scientists and health organizations are sure to further examine mindfulness meditation and its goal of conscious living.

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totalwellness ›› on the cover

total wellness ▪ summer 2014

“There is health and happiness for him in the study of nature; and the impressions made will not fade out of his mind, for they will be associated with objects that are continuously before his eyes.”

– E.G. WHITE

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cover story

health in urban nature: link between nature and wellbeing by julie escobar | design by natalie chong

left: antares71/istockphoto

total wellness â–Ş summer 2014

It has long been recognized that natural ecosystems provide many basic necessities for human survival, including but not limited to: clean air, water, food, and shelter. However, as more than half of the world’s population now lives in urban settlements, regular contact with the natural environment has heavily decreased.1 Urbanization, along with an increasingly sedentary lifestyle, have become the new norm. Nature’s potential contributions to human health, however, may help address modern-day problems associated with inactivity, obesity, mental illnesses, and other chronic illnesses.2 Read on to discover how contact with nature relates to health in urbanized societies, ways this contact can take place, and the potential benefits.

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what defines nature?3 What is it?

Nature encompasses all the phenomena of the physical world and the physical features. Nature also includes the processes of nonhuman origin in which plants and animals thrive, including features of water, weather, and varying geographic landscapes. As such, these forms of nature overlap with the term “natural environment” an environment with little or no apparent evidence of human presence or intervention.

How do we experience it?

In contrast to traditional notions of “nature,” many individuals living in an urbanized society experience aspects of a more “natural environment” in combination with artificial manifestations. Natural settings like urban parks and community gardens are often situated within man-built environments. Popular examples of urban parks in Los Angeles include Angels Knoll (made famous by the film 500 Days of Summer), LA State Historic Park (near Chinatown), and Echo Park Lake, which re-opened to the public last summer after a 2-year rehabilitation project.4,5 In the city of Santa Monica, for example, the Community and Cultural Services Department oversees multiple community gardens where residents can purchase individual plots of land to grow their own plants.6 Such community spaces are designed and constructed to reflect natural features and allow for opportunities to engage with natural processes, like the plant lifecycle via gardening. This type of “urban nature” environment acts as a hybrid space that brings together the presence of nature within a partial or entirely man-made setting.

expansions in research According to the Annual Review of Public Health (2014), there has been a significant increase in the number of available research publications studying the relationship between nature and health over the last 2 decades. Major concerns about the loss of human contact with nature as a result of increased urbanization, resource exploitation, and changes in lifestyle have helped motivate the expansion of research on the possible health benefits of contact with nature.3

why should we care? nature as a pathway to health Urban nature, while smaller and less diverse than “the great outdoors,” provides convenient recreational opportunities for city dwellers who may otherwise have limited or no access to nature-based activities.

Furthermore, green spaces in urban areas have the potential to contribute to overall health and wellbeing. The following section describes findings that illustrate the positive benefits of nature on health in an urban environment. improve social cohesion Social cohesion, as promoted by green space, illustrates multiple characteristics of a healthy community, including shared norms and values, the existence of positive and friendly relationships, and the feeling of acceptance and belonging.3 Some of the negative impacts of urbanization, in contrast, include individual isolation, lack of social support, interracial conflict7, and an increase in crime and violence.7 In the American Journal of Epidemiology (2011), the greening of 4,436 vacant urban lots across Philadelphia from 1999 to 2008 was positively associated with a decrease in gun assaults, vandalism, and other criminal mischief. It is theorized that the maintenance and attractiveness of local green spaces suggest strong social ties in the community that discourage local crime, which in turn may increase feelings of safety and security among residents.8 improve air quality According to the Environmental Protection Agency (EPA), air pollution can have toxic effects on health. Breathing polluted air, for example, can burn your eyes and nose, make breathing difficult, or aggravate respiratory problems like asthma. Other highly toxic chemicals, like benzene, can lead to cancer, birth defects, or brain and nerve damage in extreme cases.9

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Trees, shrubs, and other vegetation found in green spaces may change air quality, in turn affecting human health and wellbeing. In a 2006 study from Urban Forestry and Urban Greening, computer models using meteorological and pollution data across the US illustrated that trees and shrubs in urban areas can help improve environmental air quality and human health through removal of air pollutants like carbon monoxide, nitrogen dioxide, and sulfur dioxide via uptake by leaf stomata-pores on the surface of the leaf through which gaseous molecules pass. The study also indicated that urban trees may be able to help reduce urban ozone (highly reactive gas made of 3 oxygen atoms) levels through natural processes like transpiration, the evaporation of water from plants to the atmosphere. Transpiration can reduce air temperatures, remove air pollutants, and can decrease building energy and power plant emissions (through temperature reductions and through tree shade).10

promote physical and emotional health The outdoor environment provided by green spaces may influence how physically active an individual is by providing the appropriate space for certain types of transportation and recreational activities, like cycling or walking.3 In the Journal of Preventive Medicine (2010) for example, researchers found that the availability of neighborhood parks was associated with higher participation in active sports among adolescents.11 Furthermore, in a study published by the International Journal of Environmental Health Research (2005), researchers compared groups of people who were exposed to pleasant green landscapes versus barren urban environments while exercising on a treadmill. They found that those who were exposed to pleasant green landscapes displayed significantly greater reductions in blood pressure as well as increases in positive mood after exercise relative to the control group, who exercised with no visual images.12 According to Environmental Science and Technology (2010), acute changes in mood can last 2 to 4 hours after exercising without images, creating positive influences on one’s quality of life through increased social interaction, improved productivity, and better behavioral choices.2

promote mental health Achieving mental health in modern society is no simple task. To attain good mental health means finding a balance between self-satisfaction, independence, capability, achieving one’s full potential, and coping with stress and adversity. Both self-esteem and mood are short and long-term determinants of mental health, and are often examined in greenexercise research.2 In a study by the International Journal of Environmental Research and Public Health (2013), group walks in natural environments were associated with less perceived stress than group walks in urban settings. Additionally, walking alone in a maintained forest had a greater impact on positive mood than walking alone in a wild, unmaintained forest, suggesting that the condition of nature is important for its ability to reduce stress.13

Health disparities, due to socioeconomic inequalities, are in many circumstances an accepted reality among researchers.

However, a new area of interest explores how such inequalities may be affected by exposure to natural environments. In a study in The Lancet in 2008, researchers hypothesized that those with more exposure to green space would exhibit less effects from socioeconomic inequalities in health such as high blood pressure, chronic stress, and poor diet than those with less exposure to green space. From 2001 to 2005, researchers analyzed the associations between various causes of death (i.e. circulatory disease) with income deprivation and exposure to green space among working populations in England. They found that those exposed to the greenest environments also have the lowest levels of health inequalities related to income deprivation. This particular study therefore suggests that green space may be beneficial in reducing health disparities among those with a lower income.14

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left: antares71/istockphoto right: emiliau/istockphoto

total wellness â–Ş summer 2014

improve health inequalities

bottom line how can YOU benefit from nature?

Whether it’s having a picnic with a friend at the park, participating in a community garden sharing program, or going for a jog with your dog at a nearby hiking trail, anything counts!

> DowntownLA.com: http://www.downtownla.com/parks.asp#1

> City of Los Angeles Department of Recreation and Parks: http://www.laparks.org/

References 1.

“State of the World Population 2007: Unleashing the Potential of Urban Growth.” unfpa.org. (2007).

2.

“What is the Best Dose of Nature and Green Exercise for Improving Mental Health? A Multi-Study Analysis.”

Environ Sci Technol. (2010).

3.

“Nature and Health.” Annu Rev Public Health. (2014).

4.

“Parks and Green Spaces.” downtownla.com. (2014).

5.

“Echo Park Lake Rehabilitation.” echoparklake.org.

6.

“Community Gardens.” smgov.net. (2014).

7.

“What are the benefits of interacting with nature?” Int J Environ Res Public Health. (2013).

8.

“A Difference-in-Differences Analysis of Health, Safety, and Greening Vacant Urban Space.” Amer J Epidemiol.

(2011).

9.

“Why should you be concerned about air pollution?” epa.gov. (2012).

10.

“Air pollution removal by urban trees and shrubs in the United States.” Urban For Urban Gree. (2006).

11.

“Where can they play? Outdoor spaces and physical activity among adolescents in U.S. urbanized areas.” Prev Med. (2010).

12.

“The mental and physical health outcomes of green exercise.” Int J Environ Health Res. (2005).

13.

“Walking for well-being: are group walks in certain types of natural environments better for well-being than group walks in urban environments?” Int J Environ Res Public Health. (2013).

14.

“Effect of exposure to natural environment on health inequalities: an observational population study.” The Lancet. (2008).

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total wellness ▪ summer 2014

Still need ideas? Visit the following sites for information on some of Los Angeles’ most popular parks and green spaces.

Research has shown that exposure to the natural environment has a positive effect on health and health-related behaviors.

Nature, however, does not have to equate to wilderness. The benefits of nature can also be gained in our local community parks and urban green spaces. From improvements in individual mood to community social cohesion, access to green spaces in urban areas can help boost both physical and mental health. t w

feature

the truth behind “natural”

& “organic”

labeling

by catherine hu | design by jessica sun

left: ferhatmatt/istockphoto right: Pingebat /istockphoto; arcady_31/istockphoto

total wellness ▪ summer 2014

The word “natural” conjures up images of nature and plants grown from the earth, untouched by humans.

However, “natural” has a different meaning in the food industry world. In fact, the US Food and Drug Administration (FDA) does not have an absolute definition for this term, which may lead to many misconceptions about the “natural” label for consumers.1 In addition, labeling requirements can be subjective for various food products. Find out what the label “natural” really means and how it differs from “organic” items.

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natural labeling and the consumer market

what does “natural” really mean?

FDA definition The FDA does not have a definition for this term. It states that many foods have been modified, such as with man-made machinery, and cannot be considered as products originating from Earth’s natural processes.

Since so many food products have been processed in some way, the FDA instead only allows the label to be used if the food is devoid of added color, artificial flavorings, or synthetic substances.1 USDA food safety and inspection service definition For meat and poultry products, the United States Department of Agriculture (USDA) Food Safety and Inspection Service allows the “natural” label if there is minimal processing, no artificial ingredients, and no added colors. These conditions must also be stated explicitly on the label.2 According to the FDA, the processed foods category applies to foods that have been subjected to processing, such as canning, cooking, and freezing. Minimal processing means the product was processed in a way that did not fundamentally alter it.3 The term “fundamentally altered” is not defined by the USDA, which may make the labeling more subjective.

However, some foods that fall under “minimally processed” may include cut vegetables, roasted nuts, and frozen fruit. On the other hand, crackers and deli meat may be considered fundamentally altered since they are more processed.4

The “natural” label may seem more appealing to consumers than other food labels, and can affect their judgment when shopping for groceries. Consumers tend to think of “all natural” products as being good and wholesome.5 For example, in a 2009 study published in Agriculture and Human Values, a poll of consumer opinions found that most people believed that there were not many chemicals, hormones, or antibiotics in “natural” pork, despite their skepticism concerning the regulation of the term “natural.” In addition, the consumers thought that the term “organic” signified that the product was healthier, more expensive, or grown in a garden.6 A majority of the comments made were not necessarily true, showing just how misleading food labeling can be. Multiple assumptions seem to be made in regards to food labels, when in reality the “natural” label only assures that the product does not contain added color, artificial flavorings, or synthetic substances.

how do food items get a “natural” label? regulations of “natural”8

The FDA evaluates whether a product’s beneficial factors to health will outweigh its risks. If it has a higher beneficial factor, the FDA may overlook the risk. In addition, the FDA reviews lab results of clinical tests and does not do testing itself. This may make the approval process more lenient and variable.

There are also some products, such as dietary supplements, that may be marketed before going through this process. Thus, not everything on the market is necessarily FDA approved or considered completely safe.

The USDA Food Safety and Inspection Service has been working towards more defined guidelines. In particular, the USDA has more specific regulations for the natural flavoring of meat and poultry products than the FDA. Any dried meat content, including meat stocks, extracts, and dried broth, cannot be listed as “natural flavorings” and must be displayed on the label.

Hydrolyzed animal and vegetable proteins, or broken down proteins, must also be displayed, and cannot be considered “natural flavorings.”

Natural flavorings can only include spices, essential oils, spice extracts, and oleoresins, which are mixtures of oil and resin from plants.

The FDA requires that all ingredients be listed on the label if the product is to be considered “all natural.”

total wellness ▪ summer 2014

how items become FDA approved7

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biochemistry of

“not-so-natural” products According to a 2007 editorial published in Nature Chemical Biology, synthesized products can be categorized as natural if their chemical structure is exactly the same as that of a natural source.9 A 2007 review from the same journal examined terpenes, which come from both synthetic and natural sources and make up many essential oils.

These are used as natural food flavorings and have been found to have anti-cancer and antimalarial functions.5,10 Thus, terpenes are an example of how synthesized products can be “natural,” and the incorporation of these molecules into food products could provide health benefits.

what does “organic” really mean?

Unlike the FDA’s vague definition for “natural,” food products labeled “organic” must comply with stricter USDA certifications and labeling standards.11 According to the USDA, “organic” refers to foods produced without antibiotics, hormones, pesticides, or ionizing radiation.12 Organic ingredients must also be marked on each label.11

what does a USDA organic seal mean? if the food product has a USDA seal, that means:13 > The food product has been produced organically, and contains raw agricultural substances that have been certified as organic. > The product must have 95% to 100% organic content. if the food product does not have a USDA organic seal, that could mean:13

total wellness ▪ summer 2014

> The food product may be processed, or may contain multi-ingredient products with less than 95% organic material. > The product may still contain at least 70% organic content, in which case it may be labeled as containing organic ingredients (up to 3 can be listed), but it cannot have a seal.

Thus, the presence of a seal guarantees that the food is certified organic and may potentially have less harmful ingredients than a product without a seal.

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are “natural” products safer to consume?

Although the word “natural” may make a product seem safer, that is not necessarily true.

The ambiguous definitions for the label “natural” allow food companies to incorporate various ingredients into products, which may ultimately lead to negative consequences. For example, the addition of salt in chicken, as described below, could present health risks depending on the amount incorporated. Extra ingredients like this can also confuse consumers because they alter the “natural” product.

example: 100% “natural chicken” Poultry companies can label their products as “natural” even if their chickens are injected with salt and spices.2 These “enhancements” can increase the sodium content by 3 to 5 times the average sodium levels per 100 g of food.14 This is more than 25% of the American Heart Association’s recommendation of 1,500 mg of sodium per day.15 Next time, when shopping for poultry products, make sure to check the nutrition label for added salt, as this can indicate that salt solution was injected.

the bottom line Research suggests that the “natural” label on food products can cause confusion among consumers. The term is ambiguous and does not mean that a product is safer. Since the “organic” label is regulated more strictly, foods that are certified organic guarantee that they were grown without the use of pesticides. The ambiguity of some of these labels leaves room for interpretation, but it is important to know, as far as we can, what these labels really mean. When shopping for food products or fresh produce, check the label and ingredients list to see how “natural” or “organic” they really are. tw

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References “What is the meaning of ‘natural’ on the label of food?” fda.gov. (2012).

“Meat and Poultry Labeling Terms.” usda.gov. (2013).

“Regulatory Information.” fda.gov. (2012).

4.

“Avoiding Processed Foods? Surprise! This is Processed Too!” eatright.org. (2014).

5.

“Modern synthetic efforts toward biologically active terpenes.” Nat Chem Biol. (2007).

6.

“Naturally confused: consumers’ perceptions of all-natural and organic pork products.” Agric Human Values. (2010).

7.

“About FDA Product Approval.” fda.gov. (2009).

8.

“Natural Flavorings on Meat and Poultry Labels.” usda.gov. (2013).

9.

“All Natural.” Nat Chem Biol. (2007).

10.

“Fragrances, vitamins and hormones - the ABC of terpenes.” dermaviduals.de. (2010).

11.

“If a food is labeled “organic” according to the USDA, is it still subject to the laws and regulations enforced by FDA?” fda.gov. (2012).

12.

“Going Organic.” ams.usda.gov. (2010).

13.

“Organic certification.” ams.usda.gov. (2012).

14.

“USDA monitors levels of added sodium in commercial packaged and restaurant foods.” Procedia Food Sci. (2013).

15.

“Frequently Asked Questions (FAQs) About Sodium.” heart.org. (2014).

left: sage78/istockphoto; creativeye99/istockphoto

1.

2.

3.

37

feature

nutrition in a pill: too good to be true? a guide to dietary and herbal supplements by niyati patel| design by catrina pang

what are dietary supplements?

From daily vitamins to herbal remedies, many people turn to dietary supplements in an effort to boost their health.

Although following a well-balanced diet plan is the best way to ensure nutritional needs are met, some supplements may subtly increase overall nutritional intake for those who do not follow such a diet or have an allergy or medical deficiency. However, most claims made by manufacturing companies are over-exaggerated and not stringently regulated by the US Food and Drug Administration (FDA). Read on to find out about the guidelines governing dietary and herbal supplements and how to take caution before proceeding.

In 1994, Congress defined dietary supplements in the Dietary Supplement Health and Education Act (DSHEA). The product must:1 > be intended to supplement the diet by mouth, in forms such as: tablet, capsule, powder, softgel, gelcap, or liquid. > contain one or more dietary ingredients (including vitamins, minerals, herbs or other botanicals, amino acids, and certain other substances). > be labeled as being a dietary supplement on the bottle.

what are herbal supplements?

Herbal supplements are 1 type of dietary supplement. They consist of a single or mixture of herb plants or plant parts (leaves, flowers, or seeds) used for flavor, scent, or potential health-related properties.2

how are they regulated?

Under DSHEA, all herbs or ingredients must be listed on the product label.3 Except in the case of a new dietary ingredient, dietary supplements do not need approval from the FDA before they are marketed. A new dietary ingredient is a dietary ingredient that was not sold in the United States in a dietary supplement before October 15, 1994. The FDA requires specific safety information from a manufacturer intending to market a dietary supplement containing a new dietary ingredient. This information is not required for older dietary supplement ingredients.4

> evaluating the safety and labeling of the products it manufactures or distributes. > ensuring that any claims made about the products are not false or misleading. > complying with the Federal Food, Drug, and Cosmetic Act (a list of laws passed by Congress in 1938, requiring the FDA to oversee the safety of food, drugs, and cosmetics).

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The manufacturer of the supplement is responsible for:2,5

should I take dietary supplements?

safety considerations: what should I watch out for?

Supplements should not take the place of the variety of foods that are important to a healthy diet. However, scientific evidence shows that some dietary supplements are beneficial for overall health and for managing some health conditions, especially if essential nutrients are not consumed in the diet, as is common with vegetarians or pregnant or breast feeding women.6,7

No determinate conclusions have been made about the safety of dietary supplements as it is up to the discretion of each individual manufacturing firm, but the FDA will investigate and test the product if any adverse effects are reported by consumers.7,8,15,16

In particular, some studies show a positive correlation between vitamin D and calcium supplementation with an increase in muscle strength and balance, along with a reduced risks of bone loss and cancer.8-10 However, most studies are not conclusive because new data is constantly being gathered, and studies on vitamin D and other supplements need more support to determine their value. Hence, it is more efficient to correct an unbalanced diet with food to avoid common vitamin and mineral deficiencies such as vitamins D and B12, calcium, iron, magnesium, and zinc. Refer to the article “Getting the Daily Dose” in Issue 4, Volume 13 for more information on common food sources that are rich in these nutrients.

what about herbal supplements?

A 2007 National Health Interview Survey specifically examined the use of herbal supplements amongst adults and children in the United States.11 The most popular of these products used by adults were omega-3 [in the form of fish oil or docosahexaenoic acid (DHA)], glucosamine, and echinacea.2 > omega-3: Several studies have indicated that the health benefits of omega-3 supplements are unclear, especially in the realm of brain, heart, and eye diseases. However, moderate evidence has emerged about the health benefits of eating seafood to obtain the same benefits of omega-3 fatty acids.12 > glucosamine: A 2003 study by British Journal of Sports Medicine suggests that glucosamine supplementation can provide some degree of pain relief and improved function in persons who experience regular knee pain from cartilage injury and/or osteoarthritis. At a dosage of 2,000 mg per day, the majority of improvements are present after 8 weeks.13

> Watch out for any claims listed on the bottles and made by the manufacturing firms. They are not FDA approved since they are not drugs and therefore, are not intended to treat, diagnose, mitigate, prevent, or cure diseases. > The term “natural” doesn’t always mean safe, though it is a common connotation of herbal supplements. > Follow label instructions for recommended use as vitamin overdose can lead to potential dangers and toxicities, especially for vitamins that are fat-soluble: vitamins A, D, E, and K. These vitamins dissolve in fat and are stored in body tissues, rather than being excreted through the urine.

bottom line Using dietary and herbal supplements may be beneficial to those with inadequate nutritional intake, but these supplements should not replace proper diets. While there have been noted benefits to both herbal and conventional supplements, research is not conclusive and potential toxicities still exist. Because manufacturing firms of supplements do not need FDA approval before placing their product on the market, watch out for the above safety precautions and consult a doctor before proceeding. tw References 1.

“Dietary and Herbal Supplements.” nccam.nih.gov. (2013).

2.

“Using Dietary Supplements Wisely.” nccam.nih.gov. (2013).

3.

“Dietary Supplement Labeling Act.” fda.gov. (2014).

4.

“New Dietary Ingredients in Dietary Supplements.” fda.gov. (2014).

5.

“Q&A on Dietary Supplements.” fda.gov. (2014).

6.

“Dietary Supplements: What you need to know.” nccam.nih.gov. (2011).

7.

“Tips for Dietary Supplement Users.” fda.gov. (2014).

8.

“Effect of supplementation of calcium and vitamin D.” Pharmacol Res. (2004).

9.

“Vitamin D and calcium supplementation.” Am J Clin Nutr. (2007).

10.

“Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis.” J Am Geriatr Soc. (2011).

11.

“Statistics on Complementary and Alternative Medicine: National Health Interview Survey.” nccam.nih.gov.

(2013).

12.

“Omega-3 Supplements: An Introduction.” nccam.nih.gov. (2013).

13.

“The effect of glucosamine supplementation on people experiencing regular knee pain.” Br J Sports Med. (2003).

14.

“Common colds: Does echinacea work?” ncbi.nlm.nih.gov. (2010).

15.

“Dietary Supplements.” nia.nih.gov. (2014).

16.

“Herbal Medications and Plastic Surgery: A Hidden Danger.” Aesthetic Plast Surg. (2014).

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> echinacea: It is unclear yet whether echinacea can help prevent colds, especially due to the wide variety of sizes and types of echinacea products available. More research is needed but some echinacea products, if taken at first sign of a cold, might help reduce the length and severity of a cold.14

> Consult your healthcare provider when starting a supplement, especially if scheduled to have a surgical procedure, as potential dangers have been noted.

feature

is the

gluten-free diet right for you?

total wellness ▪ summer 2014

Browsing through the aisles of the local supermarket, you might notice the label “gluten-free” or “GF” on the packaging of some expensive pasta. Or maybe you glanced at the magazines at checkout, wondering why Lady Gaga and Drew Brees cut gluten out of their diets. Because of all this publicity, gluten may seem harmful to our bodies. However, before spending extra money on GF products, you should know what gluten is, why people go on such diets, and how following it can impact your health and wellbeing.

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by sarah chang | design by allison newell

what is gluten?

Gluten describes the storage proteins gliadin and glutenin, which are commonly found in wheat, rye, barley, and other grains. In plants, storage proteins provide energy for seeds before they grow leaves to absorb sunlight.1 Because these grains are ubiquitous in the American diet, following a GF diet can be difficult. Since the 1970’s, the percentage of people who have experienced harmful reactions to gluten have increased from 0.5% to 1.26% in Europe and the US. These reactions include digestive problems such as diarrhea and constipation, along with dizziness, headaches, emotional instability, infertility, iron deficiency anemia, hair loss, and osteoporosis. However, these reactions can be attributed to other conditions, which is why gluten intolerance is difficult to diagnose.2

who should go on a gluten-free diet? celiac disease (CD) patients

individuals with non-celiac gluten sensitivity (NCGS)

what are the symptoms of CD?

what are the symptoms of NCGS?

CD is an autoimmune condition, which is when the body produces an immune response against its own tissue constituents.3,4 People living with CD cannot consume gluten because the proteins in gluten cause damage to the small intestines. In addition, they may experience vomiting, abdominal pain, and diarrhea upon ingestion of gluten. These symptoms may vary greatly depending on age.2

how common is CD?

The disease affects approximately 0.5% to 1% of the world’s population, but the percentage can vary between regions; in the US, the prevalence is roughly 1 in every 133 people, or approximately 1%.5

what causes CD?

how common is NCGS?

Some researchers estimate that more than 6% of the world is affected by NCGS.5 However, other studies offer differing statistics.

what causes NCGS?

Scientists have not officially established a biological marker for NCGS but some researchers have noted that people with NCGS have a presence of anti-gliadin antibodies (proteins produced in reaction to gluten) in their blood.5,7

the take away on NCGS

Because NCGS is newly recognized by the scientific community, there are many uncertainties about its causes and treatments. Despite their unanswered questions, scientists cannot deny the existence of the syndrome because of the overwhelming evidence found.6

think you may have CD?

Consult a doctor immediately if CD is suspected in order to make the necessary dietary changes as soon as possible.

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Almost all people diagnosed with CD carry 1 of 2 specific genes for the condition. Hence, when they consume gluten proteins, it triggers the detrimental reaction.2 Since researchers discovered that 30% to 40% of the world’s population carries the CD gene, they now believe that exposure to gluten proteins plays a larger role than initially anticipated.3 Scientists once thought that CD could develop only in childhood, but now they believe that CD can manifest itself at any time due to environmental triggers.5

Upon gluten consumption, those with NCGS suffer from digestive symptoms, headaches, and fatigue. Removing gluten from their diets results in significant symptom improvement. NCGS is similar to CD, but those with NCGS do not suffer small intestinal damage.6

those with pre-existing digestive problems > Human Immunodeficiency Virus (HIV) patients what is HIV?

HIV inhibits the body from fighting infection because it attacks the white blood cells, which naturally help the body fight disease. Because HIV attacks these cells, HIV patients are more susceptible to illness. Although the human body can combat and remove other viruses from circulation, HIV never disappears. So once people contract HIV, they remain HIV positive for the rest of their lives.8

how common is HIV?

At the end of 2010, over 870,000 people in the US were affected

by HIV.9

what causes HIV?

HIV is caused when an infected person’s fluids (blood, semen, etc.) enter an uninfected person’s bloodstream. Common ways of contracting HIV include sharing a contaminated needle when taking drugs or receiving tattoos or having unprotected sex with an infected person.

why does following the GF diet help HIV patients?

Many HIV patients experience unexplained chronic diarrhea and endure intestinal injury, but following the GF diet reduced the mean number of bowel movements from 48 to 18 per week, and increased average weight from 117 lbs to 123 lbs in a week.10

> Irritable Bowel Syndrome (IBS) patients what is IBS?

IBS is a long-term disease that can cause diarrhea, constipation, bloating, and cramps. People with IBS often have difficulty digesting certain foods.11

how common is IBS?

eat:

> corn > rice > millet > buckwheat > quinoa > oat*

avoid:

> wheat >rye > barley > malt

*should only be allowed with a doctor’s permission

potential benefits of living gluten-free: improving psoriasis A 2000 study published in the British Journal of Dermatology evaluated the effect of a GF diet on patients with psoriasis (a skin condition in which skin cells grow too rapidly). The authors of the study found that psoriasis patients who are sensitive to gliadin (a protein found in gluten) could benefit from a GF diet and experience a decrease in psoriasis severity while following a GF diet.14

what causes IBS?

The causes of IBS can vary from person to person. Common causes include stress, anxiety, and problems with signals between the brain and digestive tract. However, all symptoms can be traced to intestinal problems.11,12

why does following GS help IBS Patients?

A 2013 study published in Gastroenerology found that the mean number of bowel movements per day of IBS patients who experienced abnormal stool decreased from 2.6 to 1.9.13

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Most studies estimate that 10% to 15% of the adult population is affected by IBS.11

common grains to eat and avoid on the GF diet:2

potential consequences of living gluten-free 1 certain demographics general population

One 2005 study reviewed in Gastoenterology suggested that people following a GF diet lacked enough fiber, minerals (iron), and vitamins (folate, B6, B12, and riboflavin) for a healthy diet, even while taking nutrient supplements. This trend is due to the lack of such nutrients in GF products.2,15 Furthermore, very few GF products are enriched with additional vitamins in the US, adding to the increased possibility of prolonged nutrient deficiencies for long-term adherence to the diet. A 2010 study reviewed in Nutrients found that following a GF diet often results in an excessive consumption of animal proteins and fats, which can lead to weight gain.2

in women:

The bone densities of women diagnosed with CD as adults were significantly lower than that of others. This trend is a result of consuming more calories from fat and less from carbohydrates. Lower bone density can result in osteoporosis, in which bones fracture easily.15

in children:

A 2005 review in Gastoenterology reported that children following a strict GF diet had higher levels of lipids and lower levels of calcium, fiber, and iron than children loosely following a strict GF diet. And while 72% of children following the GF diet were obese, only 51% of children loosely following the diet were obese, and only 47% of healthy age-matched controls were obese.15

2 lower availability & higher costs

A 2011 study in The Journal of Human Nutrition and Dietetics suggests that GF diets may be difficult to follow because of the lower availability of GF products and higher cost.

> higher cost: In the study, all 10 GF versions of normal wheat products were more expensive.16 The cost of GF products depended more on the type of market rather than geographic location.17

> availability:

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Regular grocery stores carried GF products 90% of the time, while budget supermarkets only did 9% of the time. Furthermore, out of the supermarkets in the study, only 41% of wheat products had gluten-free counterparts.17

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3 specific nutrient deficiencies

alternative solutions for living with CD and GS

fiber

consume other grains

Those with CD and GS should have an intake of 20 to 35 g per day. Some studies have reported that low fiber intake is associated with the GF diet, so patients should be especially attentive to their fiber consumption.2

Buckwheat, millet, and quinoa are grains that do not contain gluten, making them viable alternatives.2 In general, these minor and pseudo-cereals are cheaper than GF products.

unsaturated fats

a future alternative: reduced-gliadin wheat

GF products have a higher percentage of trans fats and saturated fats than most non-GF products. However, fats should only represent a maximum of 25% to 30% of the GF diet. Additionally, unsaturated fats (in vegetable oils, nuts, salmon, and trout) should be emphasized, while fatty acids found in animal foods (meat, poultry, whole milk) should be minimized. Trans fats should only be 1%, and ideally 0%, of total calories.2

fruits and vegetables

Researchers recommend at least 5 servings of fruits and vegetables a day to reduce the risk of heart disease and cancer and raise the intake of vitamins and minerals.2

A study published in PLOS ONE in 2014 suggests that eating very small doses of gluten can actually help those with CD or NCGS due to an increased amino acid content. Researchers developed reduced-gliadin wheat, which has a low content of gluten and allows people with CD to safely consume wheat products.

Reduced-gliadin wheat is not currently commercially grown, but could potentially become very beneficial to improve the nutrient deficient diets of CD patients.21

vitamins

References 1.

“Storage Proteins.” biologie.uni-hamburg.de. (2004).

2.

“The Gluten Free Diet: Safety and Quality.” Nutrients. (2010).

3.

“Spectrum of Gluten-related Disorders: Consensus of New Nomenclature and Classification.” BMG Med. (2012).

4.

“Autoimmunity.” merriam-webster.com. (2014).

5.

“The Diagnosis and Treatment of Celiac Disease.” Dtsch Arztebl Int. (2013).

6.

“Effect of the Gluten-free diet on Immune Response to Gliadin in Patients with Non-celiac Gluten Sensitivity.”

BMC Gastroenterology. (2014).

7.

“Diagnosis of Non-celiac Gluten Sensitivity.” celiaccentral.org. (2014).

8.

“About AIDS/HIV.” cdc.gov. (2014).

9.

“HIV Surveillance Report.” cdc.gov. (2011).

10.

“Treatment of Human Immunodeficiency Virus Enteropathy With a Gluten-Free Diet.” Arch Intern Med. (2000).

11.

“Irritable Bowel Syndrome.” webmd.com. (2012).

12.

“Irritable Bowel Syndrome.” digestive.niddk.nih.gov. (2013).

13.

“A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea: effects on bowel frequency and intestinal function.” Gastroenterology. (2013).

14.

“Psoriasis patients with antibodies to gliadin can be improved by a gluten-free diet”. Brit J Dermatol. (2000).

15.

“Dietary Guidelines and Implementation for Celiac Disease.” Gastroenterology. (2005).

16.

“Limited Availability and Higher Cost of Gluten-Free Foods.” J Hum Nutr Diet. (2011).

17.

“Economic Burden of a Gluten-Free Diet.” J Hum Nutr Diet. (2007).

18.

“Folic Acid in Diet.” nlm.nih.gov. (2014).

19.

“Vitamin B12.” ods.od.nih.gov. (2011).

20.

“Vitamin D.”ods.od.nih.gov. (2011).

21.

“Reduced-gliadin wheat bread: an alternative to the gluten-free diet for consumers suffering from gluten related pathologies.” PLOS One. (2014).

conclusion People considering the GF diet should be cautious because scientific studies suggest that those who don’t consume gluten may experience nutritional deficiencies and economic setback. And because the availability of food products vary with location and culture, managing a GF diet can be difficult without professional consultation. Furthermore, researchers have not fully investigated the long-term effects of the diet. On the other hand, following a GF diet may help patients with psoriasis. Those who suspect that they are suffering from any of the previously addressed conditions should consult a doctor before going on a restrictive diet regimen. tw

right: alptraum/istockphoto

total wellness ▪ summer 2014

Followers of the GF diet are often deficient in vitamin intake (B9, B12, D), so it is especially important to follow these guidelines. Leafy greens, dried beans and peas, citrus fruits, and fortified cereal all contain folic acid (also known as vitamin B9), a commonly lacking vitamin for celiac patients.2,18 Chicken, turkey, clams, and fish (such as trout, salmon, and tuna) are good sources of B12.19 Milk and orange juice fortified with vitamin D also help maintain a balanced diet. 20

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feature

our home and city: how both could be affecting us

by jasmine sidhu | design by jackie nguyen & danielle swenson

45

total wellness ▪ summer 2014

When’s the last time you looked outside your window and counted the number of stars in the sky? If you’re living in a crowded city like Los Angeles, then you’ve probably never had that opportunity. With a booming population, a massive international automobile industry, and factories in the thousands, it’s no surprise that America is becoming more polluted. According to a recent report published by the World Health Organization in March 2014, it is estimated that 7 million people die from air pollution every year worldwide.1 It is currently the single biggest environmental risk in the world. Air pollution is the presence of chemicals, gases, particulate matter, and fumes that are inserted into the air in amounts that are sometimes harmful to living organisms.

Although indoor and outdoor air pollution have many differences, they both have serious effects on our health.

Read on to discover what may be in the air you breathe!

indoor and outdoor air pollution:

what’s the difference?

indoor

vs

outdoor

what is it?

Indoor air pollution is the chemical, biological, and physical contamination of air in closed areas.2

Outdoor air pollution is the severe contamination of air that stems from chemicals that have natural and human causes.3

where is it found?

In general, pollutants are found in closed buildings, schools, houses, and offices. More specifically, chemical and biological pollutants are found in objects like carpets, unfinished floors, central heating and cooling systems, humidifiers, cleaning products, and even candles!4

Pollutants are found primarily in urban cities that have a lot of motor vehicles and factories, or in third world countries where practices like extensive coal-burning produce mass pollution. In America, outdoor air pollution is most prominent in large cities such as Los Angeles and New York.2

where does it natural sources5 > Mold from old carpets come from? > Biological irritants (pollutants from living organisms like fungi, viruses, mold, pollen from plants) from outdoors carried inside via humans

natural sources6 > Dust from wind storms > Pollutants from wildfires and volcanic eruptions

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human source6 human source5 > Nitrogen oxide and ozone from burning fossil fuels > Particulate matter (tiny liquid and solid (in power plants and factories) particles that pollute the air) from pesticides > Carbon monoxide and ozone from motor vehicles > Asbestos from floor tiles > Carbon dioxide from burning forests and clearing > Tobacco smoke from cigarettes grasslands > Formaldehyde from furniture and carpeting > Tricholoroethane from aerosol sprays > Volatile organic compounds (VOCs are a combination of chemicals that can have shortterm or long-term adverse health issues like nausea and lung cancer) from paints, cosmetics, and cleaning products > Carbon monoxide from unvented stoves For more information on the background of some of these chemicals, please refer to “What’s in the Wind” from Issue 1, Volume 14. what are the primary chemicals?

Radon, carbon monoxide (CO), and particulates.5,6

Sulfur dioxide (SO2), carbon monoxide (CO), carbon dioxide (CO2), nitrous dioxide (NO2), ozone (O3), and VOCs.6

how do they affect each other?

Urban outdoor air pollution can significantly affect indoor air pollution, especially in highly ventilated homes or homes near pollution sources. For instance, a 2000 study published in Atmospheric Environment determined that the indoor particle concentrations were mainly of outdoor origin. This suggested that a ventilation system may have contributed to the indoor air pollution by bringing in particles from outdoors like pollen, radon, and carbon monoxide.7,8

Because outdoor air is not concentrated into a small amount of space, it is less affected by indoor air pollutants since there is more room for the pollutants to disperse outside. Indoor air pollution is affected more by outdoor air pollution rather than the other way around, because outdoor air pollutants can seep into indoor buildings through windows and cracks. A 1972 study published in Atmospheric Environment revealed that there was a noticeably higher concentration of sulfur dioxide and particulate matter inside a room that was observed than in the outdoor air surrounding the building. This may have been due to absorption of outside air pollutants through room surfaces and fixtures.8

46

indoor

outdoor

which affects us more?

Indoor air pollution is much more concentrated than outdoor air pollution, because the pollutants are trapped in a small amount of space. Studies of human exposure to air pollutants by the Environmental Protection Agency (EPA) indicate that indoor pollutant levels may be 2 to 5 times – and occasionally more than 100 times – higher than outdoor pollutant levels.9

Outdoor air pollution affects us less strongly than indoor air pollution. Since Americans spend 90% of their time indoors, on average, they are more likely to be affected by indoor air pollution.

However, some substances like pollen are more prominent outdoors than indoors and have negative effects on people’s breathing patterns. Thus, it is important to be aware of both types of pollutants.9

who does it hurt us or the Earth?

Indoor air pollution mostly affects us and not the Earth. It is ranked amongst the top 5 environmental risks to public health. Because we spend the majority of our time indoors, we are more likely to be affected by indoor air pollutants.9

Although outdoor pollution influences everyone’s health, it also hurts planet Earth. Outdoor air pollution creates 2 primary environmental issues: photochemical smog and temperature inversions. > Photochemical smog is a mixture of air pollutants under the influence of sunlight. It makes the air appear dense and brown. This smog is prominent in cities with dry climates and many motor vehicles.

As a result of photochemical smog, many plants die due to a lack of sunlight, and many forests and crops are affected. Smog can also cause serious respiratory and cardiovascular problems as well as aggravate asthma. > A temperature inversion is a condition in which the temperature of the atmosphere increases with altitude, in contrast to a normal decrease. It causes the air to become murkier and prevents sunlight from reaching the ground. Thus, ecosystems, especially plants, suffer as a consequence. Because planet Earth functions as a set of interconnected ecosystems, humans, in turn, are affected as well.

Major temperature inversions can create serious respiratory issues. This environmental phenomenon affects Los Angeles at least half of the year, particularly in the summer and fall.2

Breathing in higher levels of carbon monoxide causes flu-like symptoms such as: headaches, dizziness, weakness, sleepiness, nausea, vomiting, confusion, and disorientation. Carbon monoxide is the most common type of fatal air poisoning, so it is important to be aware of it. Other chemicals also have negative effects on our health. Tricholoroethane can cause severe liver and kidney damage, while mold can aggravate asthma. In addition, radon exposure is estimated to be the cause of 16% of lung cancer cases. If a person smokes and lives in a home with a high level of radon, then he or she is at an even higher risk for lung cancer.

Asbestos, formaldehyde, and tobacco smoke can all encourage the development of lung cancer as well. In addition, they can cause nausea and irritation of the eyes and nose.4

The chemical pollutants released from motor vehicles have the potential to create substantial health issues. A 2008 study published in the Journal of Epidemiology found an association between black smoke from traffic and lung cancer in people who had never smoked before. This suggests that pollutants released from motor vehicles have the ability to encourage the development of lung cancer and other respiratory problems.10 Furthermore, chemical pollutants can cause cardiovascular diseases. A 2013 study published in the Journal of Epidemiology found a connection between prolonged exposure to NO2 and particulate matter and the development of heart failure.11

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left: geber86/istockphoto right:deklofenak/istockphoto

how is it affecting us?

indoor whose health does it affect the most?

> Pregnant women because their unborn babies risk suffering developmental problems from the teratogens (agents that cause malformation in the embryo) they are exposed to through indoor air pollution > Children under 5 because their immune systems are weaker > Smokers because they expose their lungs to tobacco smoke > People with allergies because they are more susceptible to biological irritants > People with weak immune systems or lung disease because they can easily catch viruses > The elderly because their immune systems become weak as their bodies ages > Factory workers because they are constantly exposed to chemical pollutants4

outdoor > People in industrial cities because there is more pollution from factories > People in locations where motor vehicles are highly used due to the released chemical pollutants2

what can be done for safer air in homes and cities? > Avoid smoking > Clean carpets > Clean surfaces with water > Install a home carbon monoxide detector > Control dust > Garden without pesticides > Use natural cleaning products > Burn less wood4

> Use motor vehicles less often and opt for alternative modes of transportation like biking, walking, and public transportation > Have a professional annually evaluate the home to check for cracks, leakages, mold, etc. > Reuse, recycle, and repurpose (think of a creative way to find a new function for used manufactured products) > Drive slower to reduce emissions6

the bottom line

References 1.

“7 million deaths annually linked to air pollution.” who. int. (2014).

2.

Miller, G. Tyler. "Air Pollution." Living in the Environment: Concepts, Problems, and Alternatives. (2007).

3.

“The Adverse Effects of Air Pollution on the Nervous System.” J Toxicol. (2012).

4.

“Pollution and Air Quality.” lung.ca. (2014).

5.

“Factors Affecting Indoor Air Quality.” epa.gov (2013).

6.

“Outdoor Air Quality.” lung.ca. (2014).

7.

“Indoor air measurement campaign in Helsinki, Finland 1999 – the effect of outdoor air pollution on indoor air.” Atmos Environ. (2000).

8.

“Relationships between outdoor and indoor air pollution.” Atmos.Environ. (1972.)

9.

“Questions About Your Community: Indoor Air.” epa.gov. (2014).

10.

“Long-term exposure to traffic-related air pollution and lung cancer risk.” Epidemiology. (2008).

11.

“Long-term exposure to outdoor air pollution and incidence of cardiovascular diseases.” Epidemiology. (2013).

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left: amphotora/istockphoto right:viafilms/istockphoto

total wellness ▪ summer 2014

Air pollution, both indoor and outdoor, is one of the biggest threats to living organisms and the environment. Common pollutants like nitrogen dioxide, radon, and sulfur dioxide can create respiratory issues and environmental abnormalities like photochemical smog. This is why it is necessary that we learn more about our environment and how it functions so we can take the necessary precautions.

Activities like cleaning our homes and offices weekly, recycling paper and plastic, and driving less will help reduce our exposure to air pollution. If we take appropriate measures, then we may be able to reduce our risk of contracting diseases like lung cancer and side effects like nausea. By being aware, we can protect the environment and ourselves! t w

feature

spread some nature a guide to fruit spreads by sydnie bui| design by shana bird

In ancient times, jams and jellies were served as sweet desserts, and their production was considered an art form.1 Today, they are eaten in many ways, such as with teas or in stir fries. There are other fruit spreads available, including compotes, marmalades, fruit butters, and curds — all of which cover a wide variety of tastes and consistencies. In this guide, you’ll learn about the ingredients, health effects, and uses for these flavorful spreads.

total wellness ▪ summer 2014 49

what’s in a spread?

Although there are no set recipes, fruit spreads contain some common ingredients such as fruit, pectin, sugar, and acid.

> fruit

health effects Fruits, in their natural state, are good sources of vitamins, minerals, and dietary fiber.2 Many fresh fruits are good sources of vitamin C, which is an antioxidant needed for growth and tissue repair, support of the immune system, protection against eye disease, and reduction of inflammation.3 The dietary fiber in fresh fruits plays a role in lowering cholesterol, helps regulate digestion, and relieves constipation.4 However, spreads may contain added sugar, and may not boost the full nutritional value of the fruits they are made of.5

> pectin

total wellness ▪ summer 2014

purpose Pectin is a soluble fiber, meaning that it can dissolve in water. Found in fruits, it is used as a natural gelling agent that helps the spread thicken. The amount of pectin found in fruits varies with the type and ripeness. Some fruits naturally have enough pectin to gel, while others need added pectin, either from high-pectin fruits or commercial pectin. Just-ripe sour apples and lemons, for example, can gel sufficiently if only sugar is added, while apricots always require additional pectin.6 health effects As a soluble fiber, pectin can make you feel full longer by slowing digestion. Soluble fiber may also lower blood sugar levels and can lower low-density lipoprotein (LDL) cholesterol levels by hindering cholesterol absorption.7 LDL is considered “bad” cholesterol because at high levels, it can increase the risks of coronary heart disease and atherosclerosis by blocking the arteries.8 A 2011 study in the European Journal of Clinical Nutrition reported that adults with high cholesterol who had 15 g of orange or apple pectin daily with food for 4 weeks reduced their LDL cholesterol levels by 7% to 10% as compared to the control group who had the indigestible plant fiber cellulose with their food. The researchers proposed that the amount and source of pectin could affect LDL cholesterol reduction.9

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> sugar purpose Sugar is added not only for enhancing sweetness, but also for gel formation and preservation. Sugar detracts water molecules away from pectin, allowing the pectin molecules to interact more closely to form a more stable, gel-like substance.10 This also prevents the spread from spoiling.

In high concentrations, sugar can also prevent bacteria from growing by essentially drawing the water out of the bacteria.11 health effects US diets are typically high in sugar. A 2014 study published in The Journal of the American Medical Association reported a positive correlation between added sugar consumption and risk of death from cardiovascular disease.12 Added sugars can come in the form of high fructose corn syrup, corn syrup, fruit juice concentrates, and any sugar ending in “-ose.” Sugar can indirectly cause cavities by prompting bacteria in your mouth to produce acid that eats into your tooth, which lets the bacteria live in the hole and continue to produce more acid.13

> acid purpose Acid, in the form of added citric acid or lemon juice, helps in gel formation.6 The firmness of the gel depends on the proportion and type of pectin to acidity of the fruit mixture.

Acidity also affects the setting temperature of the gel.14 health effects The amount of acid from citric acid or lemon juice added to a fruit spread is small. Tooth enamel erosion associated with high levels of acid, such as from excessive consumption of soft drinks or fruit juices, is highly unlikely to occur when consuming fruit spreads in moderation.15

left: pixitive/istockphoto; oliverchilds/istockphoto right: peJo29/istockphoto; oliverchilds/istockphoto

purpose Naturally, fruits — in the form of whole pieces, chunks, pulp, or juice — are an important part of fruit spreads. They give the spread its characteristic flavor and are natural sources of pectin, sugar, and acid. Fruits commonly used in spreads include berries and citrus fruits such as raspberries, strawberries, and oranges.

types of fruit spreads > jams14 Jam is crushed fruit cooked in sugar. It contains no large chunks, has an even consistency, and is not watery. what’s in it? pureed fruits: typically berries and small fruits pectin and acid: added to aid in gelling, depending on their content in fruit sugar: added to enhance sweetness or to help in gel formation and preservation what’s it used for?

Jams can be found in tea, pastries, on toast, or even as a yogurt topping.

> jellies16 Jellies are soft solids made of cooked fruit juice. what’s in it? fruit juice: boiled juice, such as from blackberries or cherries pectin and acid: added for gelling sugar: added for sweetness, gelling, and preservation what’s it used for?

Jellies can be used as dessert fillings and in meat glazes or sandwiches.

> compotes17 Compote is a dessert spread made of fruits stewed in a syrup of sugar. what’s in it? fruit: fresh or dried fruit, whole or in small pieces; includes rhubarb, fig, pear, apple, or berries sugar: added for sweetness and preservation flavorings: complements the fruit; includes cloves, cinnamon, pepper, orange or lemon zest, vanilla, brandy what’s it used for?

Compotes can be enjoyed as a dessert alone, served over ice cream, or as a spread.

> marmalades14

Marmalade is a jelly with suspended fruit chunks or rind.

what’s it used for?

Marmalades can be baked in scones, put on pastries, or used in marinades or salad dressings.

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total wellness ▪ summer 2014

what’s in it? citrus fruits: extracted and boiled fruit juice for flavor fruit rind: gives the marmalade a slight bitterness fruit chunks: added for flavor and texture sugar: added for sweetness, gelling, and preservation pectin: added to help in gel formation flavorings: complementing flavors of orange cognac liqueur or ginger

> fruit butters16 Fruit butter is pulp cooked to a smooth, thickened paste with a consistency like regular butter. what’s in it? fruit: particularly apple, boiled and pureed or mashed sugar: added for sweetness and preservation acid: added for flavor seasonings: can contain seasonings like cinnamon and cloves what’s it used for?

Fruit butters can be found in some sauces and meat glazes.

They can also be used as spreads.

> curds18,22 Curd is a traditional English spread that is rich and smooth. what’s in it? fruit juice: usually lemon; other flavors like lime, orange, and banana butter and eggs: traditionally used; can be substituted or left out sugar: added for sweetness and preservation zest: citrus fruit skin included for aroma and intensifying flavor what’s it used for?

Curds can be used as a spread, topping, or filling.

jams: a closer look

Pectin could help retain antioxidant capacity.

In a 2013 study published in the Chemistry Central Journal, researchers measured the antioxidant capacity of blackberry jams with different pectins of various concentrations. Certain types of pectins and higher doses of pectin in general helped stabilize and retain anthocyanins, which are plant pigments that act as antioxidants.19,20 Refrigeration and heat processing have opposite effects.

A study in the Journal of Agriculture and Food Chemistry (2010) evaluated the antioxidant capacity of sugar and sugar-free blueberry jams after processing and 6 months of storage at 25°C (room temperature) and 4°C. After 6 months, jams stored at 4°C contained more anthocyanins. The results suggest that jams should be refrigerated in order to retain higher antioxidant content.21 Another study, published in a 2012 issue of the Chemistry Central Journal, found that thermal processing in low-sugar bilberry jam production and storage at room temperature for 7 months appeared to decrease vitamin C and antioxidant capacity content. Nonetheless the jams could potentially be good sources of antioxidants and vitamin C. The researchers stated that exploring the best processing and storage techniques could maximize nutritional value in jam products.22

References “Fruit Preserves and Jellies.” Encyclopedia of Chemical Technology. (2007).

“Nutrition Facts.” nutriondata.self.com. (2014).

3.

“The Benefits of Vitamin C.” webmd.com. (2010).

4.

“Dietary Fiber.” nlm.nih.gov. (2014).

5.

“Added Sugars.” heart.org. (2014).

6.

“Jams, Jellies, and Other Fruit Spreads.” ohioline.osu.edu. (2009).

7.

“The Benefits of Fiber: For Your Heart, Weight, and Energy.” webmd.com. (2010).

8.

“LDL (Low-density lipoprotein) Cholesterol.” webmd.com. (2012).

9.

“Cholesterol-lowering properties of different pectin types in mildly hyper-cholesterolemic men and women.” EJCN. (2011).

10.

“Pectin.” Royal Society of Chemistry. (2014).

11.

“How Salts and Sugars Work to Preserve Foods.” livestrong.com. (2011).

12.

“Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults.” JAMA. (2014).

13.

“15 Myths and Facts About Cavities.” webmd.com. (2012).

14.

“Fruit Jellies: Food Processing for Entrepreneurs Series.” ianrpubs.unl.edu. (2006).

15.

“Tooth Enamel Erosion and Restoration.” webmd.com. (2012).

16.

“Making Jams and Jellies.” nchfp.uga.edu. (2009).

17.

“Compote.” merriam-webster.com. (2014).

18.

“Preparing and Preserving Lemon Curd.” nchfp.uga.edu. (2004).

19.

“Assessing the effects of different pectins addition on color quality and antioxidant properties of blackberry jam.”

Chem Cent J. (2013).

20.

“Anthocyanins and Human Health: An In Vitro Investigative Approach.” J Biomed Biotechnol. (2004).

21.

“Jam Processing and Storage Effects on Blueberry Polyphenolics and Antioxidant Capacity.” J Agric Food Chem. (2010).

22.

“Tracking antioxidant properties and color changes in low-sugar bilberry jam as effect of processing, storage, and pectin concentration.” Chem Cent J. (2012).

1.

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2.

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Fruit spreads are not always 100% fruit, and studies have found implications of decreased nutritional value after processing and storage. Moreover, recommended serving sizes are small. Thus, nutritional benefits are not as great as fruit alone. Despite this, it is still a good idea to read the nutrition labels in order to make health-conscious choices. Scientists continue to investigate ways to maximize the nutritional content of fruit spreads. In the meantime though, you can continue to enjoy fruit spreads in moderation. There are countless varieties and uses, but if the grocery store’s options don’t satisfy your taste buds, it is possible to make a brand new, customized spread! tw

left: noderog/istockphoto right: scantynebula/istockphoto

the bottom line

decoding the nutrition label

tricking your taste buds: artificial flavors by zoë merrill | design by helena wong

what are artificial flavors?

An artificial flavor is a synthetic flavor made to taste like a natural flavor, though it is not actually derived from natural sources.1 Artificial flavors are generally made up of complex chemical compounds, varying from product to product. For example, a chemical compound called borneol is used in nut or spice flavors, while another, fenchone, is used in everything from berry-flavored sports drinks to liquors.2 Artificial flavors are useful because they are cost effective and are easily produced in large quantities.

where are artificial flavors found?

Products such as the following may contain artificial flavors:

potential health risks of artifical flavors As of now, there has not been much research conducted on the direct consequences of artificial flavor consumption, though health risks have arisen from other additives, such as artificial sweeteners.

the not-so-sweet side of artificial sweetener A sweetener is an artificial flavor that replaces the taste of real sucrose and can be 100 times as sweet as sucrose.13 Sweeteners can be found in many “sugar-free” sweet products, such as diet sodas. In a 2002 study published in The American Journal of Clinical Nutrition, overweight men and women who consumed real sucrose over a 10-week period not only had heightened blood pressure, but also gained body weight (1.6 kg) and fat mass (1.3 kg), while those who only consumed artificial sweeteners actually lost body weight (a decrease of 1.0 kg) and fat (a loss of 0.3 kg).14 On the other hand, a 2013 study in Nutrition Reviews suggests that in both men and women, a high consumption of artificially sweetened beverages may be associated with greater weight gain and an increased risk for type II diabetes.13 Therefore, the findings on the health risks of artificial sweeteners are controversial and more evidence is needed.

Cereals3 Chips4 Jell-O5 Ice cream6 Pre-made baked goods7 Sugary beverages8 Mouthwashes2,9 Cough syrups2,10

how are artificial flavors labeled?

The US Food and Drug Administration (FDA) requires companies to indicate on labels whether or not their products contain artificial flavors, but it does not require all artificial additives to be listed. Though the FDA cannot force a company to inform its consumers of all the additives in processed foods (e.g. yellow dye in a butter product does not necessarily have to be listed), it does mandate that the company must mention any artificial flavoring on the label in a visible place.1,11

exceptions to the rule

are artificial flavors safe?

As far as we know, artificial flavors are safe to consume. Using a classification system called “GRAS” (Generally Recognized As Safe), the FDA either allows or forbids the production of specific artificial flavors. The FDA determines how safe an additive is, making sure it is not carcinogenic (cancer-causing), in even the smallest dosage.11,12

Artificial flavors are chemical compounds that imitate their natural counterparts and exist in many processed foods. The more you observe labels, the more you will notice the prevalence of artificial flavors. Though no significant health risks have been found to arise from consuming artificial flavors, there has not been enough conclusive research done to determine whether or not they are safe to consume.tw References 1.

“CFR - Code of Federal Regulations Title 21: Specific Food Labeling Requirements.” fda.gov. (2013).

2.

“Flavor Enhancing and Medicinal Taste Masking Agent.” US Patent. (1991).

3.

“General Mills Lucky Charms Ingredients.” generalmills.com. (2014).

4.

“Frito Lay Doritos Ingredients.” fritolay.com. (2014).

5.

“Jell-O Ingredients.” labelwatch.com (2014).

6.

Goff, H. Douglas and Richard W. Hartel. Ice cream. Springer. (2013).

7.

“Pillsbury Cinnamon Roll Ingredients.” generalmills.com. (2014).

8.

“Dr: Pepper Ingredients.” walmart.com. (2014).

9.

“Listerine Ingredients.” ingredientpal.com. (2014).

10.

“Robitussin Ingredients.” robitussin.com. (2014).

11.

“Secret Ingredients: Who Knows What’s In Your Food?” Environ Health Perspect. (2013).

12. ”U.S. GAO - Food Safety: FDA Should Strengthen Its Oversight of Food Ingredients Determined to Be Generally Recognized as Safe.” gao.gov. (2010).

13. ”Diet beverages and the risk of obesity, diabetes, and cardiovascular disease: a review of the evidence.” Nutr Rev. (2013).

14. ”Sucrose compared with artificial sweeteners: different effects on ad libitum food intake and body weight after 10 wk of supplementation in overweight subjects.” Am J Clin Nutr. (2002).

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total wellness ▪ summer 2014

A food is exempt from the ruling of the FDA if it is not packaged, if it is packaged in bulk form without individual labeling, or if there are barely detectable quantities of additives.1

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credits

We would like to acknowledge the following people for their contributions to this edition. We would also like to make special mention of the following UCLA physicians, professors, and faculty members who donated their time and expertise to ensuring the accuracy of content published in the following articles:

q&a

Raffi Tachdjian, MD, MPH, Assistant Clinical Professor of Medicine and Pediatrics, Division of Allergy and Clinical Medicine, UCLA David Geffen School of Medicine Eve Lahijani, MS, RD, Nutrition Health Educator, UCLA Bruin Resource Center

ancient eats: a guide to the paleo diet

Susan Bowerman, MS, RD, CSSD, Assistant Director, UCLA Center for Human Nutrition

how nature can help your mind

choosing the best exercise environment

Helen Lavretsky, MD, Associate Professor, Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine

Jenny Hu, MD, MPH, Dermatology, Mohs Micrographic Surgery, UCLA Division of Dermatology

mindfulness meditation: the importance of conscious living David S Black, PhD, MPH, Department of Preventive Medicine, Keck School of Medicine, University of Southern California

health in urban nature: link between nature and wellbeing

Anastasia Loukaitou-Sideris, Associate Dean, Luskin School of Public Affairs, Professor, Department of Urban Planning, UCLA

the truth behind “natural” & “organic” labeling

Eve Lahijani, MS, RD, Nutrition Health Educator, UCLA Bruin Resource Center

nutrition in a pill: too good to be true? a guide to dietary and herbal supplements

Edward K Hui, MD, Assistant Clinical Professor of Medicine, Center for EastWest Medicine, Division of General Internal Medicine and Health Services Research, UCLA David Geffen School of Medicine

our home and city: how both

coud be affecting us

Raffi Tachdjian, MD, MPH, Assistant Clinical Professor of Medicine and Pediatrics, Division of Allergy and Clinical Medicine, UCLA David Geffen School of Medicine

spread some nature: a guide to fruit spreads Dolores Hernandez, MA, RD, Nutrition Education Coordinator, UCLA Dining Services

decoding the nutrition label

Zhaoping Li, MD, Associate Professor, Department of Medicine, Member, Nutritional Medicine and Obesity, UCLA Center for Human Nutrition

copy-edits and review

Julie Escobar, Julia Feygelman, Tiffany Lin, Pavan Mann, Chalisa Prarasri, Rebecca Tang, Annie Theriault, and Shannon Wongvibulsin

layout revisions

Natalie Chong, Barbara Wong, Shannon Wongvibulsin, and Karin Yuen

cover & table of contents

Designed by Natalie Chong, Barbara Wong, and Karin Yuen

is the gluten-free diet right for you?

Nancee Jaffe, MS, RD, Registered Dietitian, UCLA Celiac Program, UCLA Digestive Health and Nutrition Clinic, Division of Digestive Diseases, UCLA

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total wellness ▪ summer 2014

Talin Babikian, PhD, Assistant Clinical Professor, Clinical Neuropsychologist, Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine

sun safety: protecting the skin you’re in

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