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Frequently Asked (Medical) Questions

For my inquisitive friends and former patients: Answers to the most common questions I’ve had recently, for your entertainment and conversation. Please email if you have counterpoints, questions, or comments!

Should I take Vitamin D? Depends- Deficiency symptoms may also be due to hormonal changes, digestive difficulty, as well as not enough pineal gland stimulation by sunlight which will throw off the circadian rhythm and confuse other bodily processes. It seems not harmful to take up to 2000 daily, but, especially since it’s a hormone, I’d pay attention to finding out why someone is deficient in the first place, getting natural light at appropriate times, and fixing any digestive difficulty, as well as intaking adequate nutrition.
* and if you do take it as a supplement, remember it is fat-soluble (like A, E, and K), so you need to take it along with food with fat in it, or your body won’t absorb it!

Should I try the raw food diet? While not inherently harmful, it’s not a long-term healthy plan for most people. Keep in mind that we humans grew large brains because we started cooking our food (and getting more nutrients out of it, leaving our bodies’ digestion energy to be used in other ways), so the argument that raw is healthier is completely wrong. Nutrition content of different vegetables and foods depends on each food (check out the book “eat wild” if you’re intrigued), and different people have different digestive strengths. Keep in mind also that your body has to ‘cook’ everything you put in it to be able to use the nutrition from it, so eating only raw is a huge energy requirement for your body as well. Many people feel amazing when they start a raw food diet, likely because they’ve stopped eating processed food and things that may not be very healthy for them. But the worst diet-induced digestive and immune dysfunctions I’ve ever seen have actually been in raw-foodists that have been eating that way for 3-7+ years. It seems that, like everything else, the best idea is to eat a variety- in this case a variety of raw and cooked food, depending on your personal digestive strength and nutrition needs. For most people, I suggest between 10-40% raw (most of it vegetables). The higher percentage is if you are trying to lose weight, have a particular health concern, or are doing it for religious/meditative reasons. The lower percentage is for those with weak digestion who are building a better gut flora profile which may need to be done gently.

Should I eat more vegetable oils and spreads instead of animal fats? No, there is not enough evidence in my opinion that ‘vegetable oils’ are better for us (except olive oil). The issue may have more to do with whether the fat is oxidized or not. To decrease your free-radical intake (to help decrease artery damage), cook with liquids more often (add water to steam-stirfry, braise, poach, and boil when practical and tasty), use oils with lower smoke points like olive oil for water-cooking and raw preparation, and use oils with higher smoke points (pasture-grazed ghee or fair trade/organic coconut oil) when you absolutely must cook at a higher temperature (roasting and pan frying should be rare).

Should I eat fewer animal products if I am trying to be healthy, lose weight, or prevent heart disease? Not unless you consume an inordinate amount (= two or more meals daily). Eating animal products isn’t inherently harmful. Instead, pay attention to the quality of what you eat. Consume only animal fats from animals that have been only pastured (happily and sustainably raised chickens, pigs, sheep, and goats, or wild sustainably hunted animals if you’re into that), and especially only grass fed cow products like beef and dairy and butter. Several studies now show the improved nutrition profiles of these and their anti-inflammatory properties, just like many studies show the harmful effects of corn fed and feedlot-raised cow products. Some fish consumption seems to be beneficial as well, but not shrimp, and others only from sustainably managed fisheries, and not from farms (especially farmed salmon which can be as unhealthy as corn-fed beef; the exception may be oyster farms). Mostly, decrease your risk of all of those things and improve your heath by meditation, exercise, and moderate eating.
* the caveat here is cured (processed with salt, smoke, etc) meat products (such as hot dogs, sausages, bacon, ham, kebab meat, etc)– these have been proven to cause the most cancer of any food and cause earlier death in those who eat them most days, so eat these sparingly if at all!

Should I eat more soy or whey products to get adequate protein? First of all, most people who eat balanced diets get more protein than is absolutely necessary. But if you’re vegetarian or really excited about exercise, you may need to be more conscious of how much you need and what combinations will get you the amino acids your body can’t make on its own. Old-recipe soy products are likely very healthy for you, like non-gmo organic tempeh, tofu, miso, and soy sauce. Newer highly processed formulations (like those ‘fake meat’ concoctions) are where the problems likely lie. Heating protein isolates to high temperatures for use in protein powders or processed food likely changes the structure of the proteins and may be the cause of some of the hormonal, oxidative, and digestive disturbances seen in studies of people who eat these types of foods. I suggest if you can’t buy the ingredients listed on the package of protein you’re looking at in the store it came from, leave it alone and eat something you can identify.

What diet is best for general health and which is best for weight loss? Easy answer. None of the popular diets are better than any other except this one: whole foods, plant-heavy (80% is a good start), no heavily processed foods at all, no sugary or artificially sweetened beverages, only whole-ground flours but otherwise eat entire whole grains that are high in fiber, and little to no alcohol. Exercise an hour every day or more, and make sure do something that makes you sweat seriously at least 3 times per week. Relatively simple, but not quick or easy if you’ve been doing the opposite for a long time—but this is the only way that works.
* p.s. high-protein diets have been harmful for females in some studies, leading to higher cardiovascular risk, and don’t have a better weight-loss advantage over moderate whole food diets… and also– eating whole high fiber grains decreases the risk of diabetes and intestinal cancer across the board!

Should I eat organic? I think at this time it’s a good option when your choices are only ‘regular’ vs ‘organic.’ If you have more choice, there are better options- buying from local farms and buying in-season may have more immediate environmental impact, with the added benefit that if your local farmer is nearly organic or sustainable, you can encourage them to keep going in that direction. Buying from farmers markets improves the local economy and also puts more money in the farmers’ pockets- and if they have more flexibility financially they may be able to invest in more sustainable practices and get out of the traditional hamster wheel of gmo and big-ag suppliers of petroleum fertilizers and pesticides. Permaculture is I think the only way to go at this point for the long term, but my advice is to do what you can when you can. Spend the extra to eat organic thin-skinned produce (strawberries, stone fruit, potatoes, apples, grapes, spinach, tomatoes) as much as possible, and invest in quality animal products.

What type of bottled water, juices, and sports drinks are best? None. Get a reusable bottle and a water filter you like the taste of and stick to that. Juices are highly processed, generally not fresh, and high in quickly-absorbed sugar you don’t need- eat a piece of whole fruit. Sports drinks are a huge marketing ploy and have artificial flavors and sweeteners that your body doesn’t need at all. Unless you’re running a marathon or doing something equally strenuous so you desperately need the electrolytes, don’t bother– ditch the plastic bottles, save oodles of money, stay hydrated with water when you’re thirsty, and drink tea and coffee you make yourself out of a reusable container.

How much sleep do I need? Depends on you, and depends when you sleep, but likely somewhere between 7.5-8.5 hours. If you go to sleep nightly at 10pm and allow yourself to sleep as long as necessary for a week or two, you’ll eventually catch up and know when you feel best. The body rests in approximately 90 minute cycles, so whatever iteration leaves you feeling most energetic is your best bet– some people feel genuinely great with 6 hours, some need 9. The most important thing here is keeping your circadian rhythm steady- get enough UV light in the mornings, go to bed at the same time nightly, eat regularly, and get exercise daily. This helps your body set its clock and thus its hormonal cycles. If your daily cycle is off, so will your monthly, seasonal, and yearly cycles, which will take health and years off your life. Sleeping well is the most comprehensive way to keep your brain, body, and emotional health in good shape :)


and of course... view more castles :)

and of course… view more castles :)

Top 5 Food Tips Ever

In honor of Dave Letterman retiring… I thought I’d do a list of the top 5 food priorities for optimal health:

1. Eat fewer oxidized fats– using low heat cooking for oils/fats of all kinds (boiling, braising, poaching) most of the time keeps free radical load down and saves your arteries from damage from outside sources (the two main sources are internal: infection and stress- so minimize those two too!)

2. Eat top quality fats (which means top quality proteins along with them)– small amounts of grass fed beef and dairy, antibiotic free and grass/bug fed chicken and eggs, wild sustainable fish, free range animal meat in general, and pesticide-free organic vegetable and whole grain fats are best to keep your nervous system, hormone processes (=metabolism), and immune system healthy and stable.

3. Eat mostly plants– make sure they are pesticide free for bee health and overall ecosystem health, and fertilized mostly by animals if possible for soil and water health… permaculture, sustainable and organic farming are top priorities!

4. Keep your food miles low– know your local sustainable farmers and buy local as much as you possibly can… keep your community, your soil, your water, and yourself healthy with a smaller carbon footprint.

5. Enjoy your food– eat slowly and chew well, learn to choose and cook delicious healthy food, and eat with people you feel nourished by as well… avoid screens and intense conversation and always make time to sit (not driving) to eat.

fresh tomatoes from the market (last fall actually…) :)

Simple Food Rules and the “Pillars of Health”

Sustainable Health Nutshell: Enjoy life, take care of yourself, your community, and your planet, and when something is out of balance, try and find the root of it rather than blaming it on something outside!

“It’s not the food!” was the most obvious thing I learned from my 10 day silent meditation sit a year ago. I was sick every single day, and couldn’t figure out why my body was rejecting everything I put in it- simple vegetarian healthy food, cooked with love, that was tasty and eaten in a calm (and quiet!) environment… but a voice in my head kept saying it wasn’t the food, and sometime around day 8, during a group silent hour-long meditation session, I noticed an anxious fluttering in my chest, followed instantly by an anxious cramping in my gut… and a pinball-like exchange that went between my head and heart and gut regarding whether I’d have to get up and leave the meditation room and be embarrassed and all the other things that had been coming up that week…. and it clicked. Somehow I was creating and amplifying my body’s reaction by my thoughts and emotions. Now, if I’d been eating junk food or lots of GMO/non-organic processed stuff, maybe then the food choice would’ve had something to do with it… but nope. This was all ‘in my head’ as they say. But it was brilliant, because it gave me a very clear understanding of how our consciousness either allows our natural state of health and balance, or creates resistance to teach us something… Apparently I still want to learn a lot! :)

Anyway, today’s post is to help you understand the basic framework of the 3 Ayurvedic “Food Rules,” and a brief explanation of the 4 Pillars of Health that we focus on when you come in for consultation… Understanding the basics here can help you pinpoint where the health issue you have may be coming from, and once you find the source, you can then dig down and find the root and pull it up to “eat” (meaning process/transform) it!

The 3 food rules! 

1. Eat delicious food. Enjoy each bite, sit down, eat it in a calm environment, eat only until 75% full, but 100% full of gratitude!

2. Eat food prepared with love. When you can, choose food grown by an organic and sustainable farmer that loves their land, as close to where you live as possible. Cook the food with love and the intention to nourish and help create health.

3. Eat according to your imbalance and constitution. You can ask someone like me for help, but you really know your body better than anyone- eat intuitively- imagine what the food choice you’re making will taste like, will feel like in your mouth and stomach, and how you will feel after eating it. If it isn’t nourishing and energizing, then perhaps make a choice that is!

The 4 pillars of health! {If even one of these is off, we feel terrible… your body is asking for attention!}

1. Sleep (rejuvenation includes rest and meditation): Humans’ natural hormone cycle would like you to turn lights down at 8, be asleep by 10, and sleep straight through until 530 or so- anything else causes the body to have to compensate and burn reserves. If you have trouble sleeping there might be a simple reason, but it might point to something else that could use a little attention! See my sleep post and please ask questions!

2. Digestion (transforming and processing of food and experience): If you aren’t digesting what you take in and it rushes through too fast, if the body is creating toxins or storing too much, or it isn’t absorbing nutrients and energy efficiently, you’re probably not feeling as energetic or healthy as possible. Eating according to the food rules above will help- but again, it might not be the food! Timing, emotions, sleep, and nervous system overload all affect digestion (and thus the immune system), so sometimes changing one of those things ‘fixes’ a perceived problem with digestion!

3. Elimination (cleansing and releasing toxins both physical and mental/emotional): This is the loosening, cleaning, and pushing out of toxins. You eliminate through stool, urine, and sweat. If there are issues with these, again, it might not be the food, though food choices of course may be an issue. Using stool as an example- if you don’t eliminate efficiently (‘normal’ is once a day, between 5-7 am, easily and completely- sometimes with a second in the afternoon also during ‘colon time’ between 5 and 7), toxins build up and can cause illness. If each elimination process is not too slow, not too fast, and without pain or difficulty, then you can assume the process is going well- if not, your body is asking for help!

4. Purification (menstruation, exercise, and panchakarma = flushing the channels or srotas in Sanskrit): This is a periodic ‘reset’ of the entire body system. For part of their lives, women get the chance to cleanse monthly without having to do anything at all (which may be why we live longer!), but ayurvedic panchakarma treatments can mimic the same process for anyone. Exercise is also helpful to create heat and movement to eliminate toxins. The body’s channels all need to be open and flowing to allow toxins to leave and for health to exist. Periodic flushing is recommended, but is best done very gently and with the body’s own mechanisms in order to not deplete the system or cause more imbalance. Please ask me for individual recommendations!

Learning a little about the most important ways your body wants to work can help point out a problem, can help you translate your own body’s messages, and can then allow you to see that you can choose to remove obstacles to your own best health!

Happy learning!

Strawberry-Flavored Strawberries :)

Sustainable Health Nutshell: If you adore strawberries but don’t grow your own yet, purchase local organic strawberries from a farmer you actually spoke with to confirm that they are organic- and return and reuse the little pint baskets and cardboard boxes! The farmers will thank you. No market? Buy organic, during the season, from as close to you as you can. Here’s why it’s important for you and for the planet.

Strawberries are delicate little fruits. They are perennial plants, in the rose family, and are the only fruits with seeds on the outside. They are delicious, not just to us but to birds and bugs too. Strawberry farming (and most of it is done in central California) has become a pretty streamlined and chemically-dependent industry. Driving the 101 or the 1 gives you plenty of opportunity to see some of the big commercial producers next to the highway (check out the conventional farming practices loosely described in that link if you’re interested). The problem is, commercial strawberry farming (like most large scale agriculture) isn’t so great for people or the planet. Fumigants are used to sterilize soil before planting as a monoculture crop, and ones like methyl bromide were banned internationally because of ozone layer depletion. Unfortunately the brominated version was replaced by methyl iodide, which is sufficiently controversial (causing cancer, miscarriages, pollution, etc) to still be banned in California. There are other reasons to choose organic over conventional, like pesticides and fungicides and petroleum-based fertilizers, but to simplify, the Environmental Working Group has this list of the foods it’s most important to buy organic (strawberries are number 3!) to help lower your pesticide consumption.

Hydroponic strawberries (and other hydroponic produce) are touted as better for you since there are no pesticides needed with no soil or open fields, no herbicides are needed with no weeds, no birds or insects can eat the fruits, and much less water is used than for soil irrigation since it’s all self-contained and recycled. A local hydroponic strawberry farmer actually told me it’s impossible to grow strawberries organically and that is why he chose hydroponics. The thing is, a huge amount of energy is used for hydroponic farming, for lighting, temperature control, and water circulation, and the most common fertilizers I’ve found for it are petroleum-based. And it’s in a building. And salmonella loves wet fertilized conditions, as does legionella. I have a theory about food that I learned from my stint in the wine industry. Soil matters. Call it terroir if you like, but it’s real. And makes a gigantic difference in flavor of food, not to mention environmental concerns and our health. Not that there isn’t an application for some hydroponics, but for me, farmers who are stewards of the land and raise food that is good for us and the planet have my dollar and doctor vote for sure.

On to organic or sustainable local farming. This is a neat time chart about berry availability from a huge producer you’ve probably seen in stores that gets a small part of their product from organic farmers. If you can’t get to a farmers market and you need a berry fix, you can support the organic branches of the big distributors (they usually source from independent growers), and try to buy during the season in your part of the country to cut down on food miles. Here are two sites, one from Maine’s Organic Farmers and Gardeners Association, and one from Swanton Berry Farm in California, that explain organic farming practices very thoroughly. And this is a very fun article about ‘how broccoli will save strawberries.’ It is a great story about crop rotation serving multiple purposes, and has a lovely list of available varietals across the country! Reading these articles, you get a sense of the serious work that goes into organic farming, and of the care that is taken to ensure the health of the entire system, the soil, the plants, the surrounding area, the people working on the farm, and the people that eat the food produced.

Armed with this good information, you can ask your farmers at the markets not just if they are organic, but what they mean by “no sprays” or “no pesticides.” I’ve heard this commonly from non-organic farmers- some of whom are using above and beyond organic practices but just didn’t pay for certification and are using this common second-best advertisement. Others may not use pesticides but do use fungicides, herbicides, and soil sterilizers or fumigants (like the methyl iodide-style above), which I avoid if at all possible- but I wouldn’t know this from just a ‘no sprays’ sign.

This also brings up the point of asking the person selling the fruit if they actually grew it. It’s pretty common out here to have stands set up (at markets or on roadsides) by people who bought flats of fruit from a farmer and are selling them on their own as a middleman/woman. If they don’t know where the actual farm is, or aren’t sure of the farming practices, try to find a farmer you are more certain of that can be the source of fruit for yourself, especially in the case of strawberries!

Now, what prompted this very opinionated post? Strawberry-flavored strawberries. A couple days ago I wandered over to the little Wednesday version of the SB farmers’ market while I was biking around town. I picked up some rainbow chard and tricolor carrots from a farm I’d not bought from before [Ellwood Canyon Farms, Goleta!], and noticed two little pints of strawberries alone in the sun on a smaller table next to the big veggie spread. The berries were smaller than the ones on the big berry table near the entrance to the market, but looked inviting and cheerful. I asked if they were organic and the guy looked at me like I was possibly insane (or just illiterate I guess) since the sign said the farm was organic, and said “yep, all our stuff’s organic.” I smiled and added a pint to my saddle bag. I pedaled them home up my giant hill, washed them, and stuck them in a bowl next to my computer on my desk.


I absentmindedly stuck one in my mouth while reading a news article… and lost my mind for a minute. It tasted as if someone had injected the strawberry with STRAWBERRY FLAVOR!! I paused in flavor heaven. Then I laughed at myself. Apparently that is what seriously incredible strawberries taste like! I had just found out exactly how rare it is to find strawberries grown perfectly, the right varietal, the right time of year, in chemical-free soil, watered the perfect amount, resulting in what seems to be what we all expect but may seldom have the pleasure of tasting in our long strawberry-eating lives. Maybe I had berries this perfect around age 6 or 8 when my best friend’s dad let us pick strawberries he’d planted in their backyard. Maybe that’s where I got the imprint of what I know ‘strawberry flavor’ to really be. I ate the entire bowl with slow joyful abandon. I was very happy for the other person that bought the other pint who was hopefully sharing my strawberry heaven that evening!

Since I ate all the strawberries all in one go, I didn’t take a picture and totally should have since they were delicious but also really adorable. Fortunately, I just had a similar experience with some heirloom black cherries I picked up at the Montecito FM today. They are incredible. I’m pacing myself this time. But clearly half are gone before I remembered to take a picture… I’ll do better next food post, promise! These also turn your mouth dark purple. Very entertaining. :)

Which came first?

Who cares?! Eggs are yummy! :) But seriously…

First, the Sustainable Health Nutshell: If you don’t have chickens of your own, find a neighbor or farmer close by who does. Make sure they pasture-raise them, and use organic feed if they purchase it elsewhere! Eat them fresh and not cooked at hotter temperatures than 220 degrees. {And if you’re willing to take some Ayurvedic advice, try not to mix them with milk, potatoes, or fruit- this may help your symptoms if you have food sensitivities, problems losing weight, or skin issues…**}

So, are eggs good for you or not? It depends, but in moderation, yes! Eggs have a lovely balance of concentrated nutrition that would end up being an entire baby chick if it was allowed- which means lots of perfectly balanced protein, fats (including cholesterol for brain development), minerals, and vitamins like B12 (necessary for those who don’t eat meat). The fats include Omega-3s (higher percentages in chickens allowed to pasture graze), but also 70% of the RDA of cholesterol… which means it has only 70% of what you need to eat in a day to be healthy- so if you eat a very healthy diet otherwise with little cholesterol, that’s fantastic and you can have two! :) But if your diet includes many other sources of fats, eating many eggs in addition certainly gives you an excess. [My cholesterol post debunks a few myths about cholesterol, which by itself isn’t really the problem, and egg cooking tips are in the last paragraph here- the point is moderation is the key regardless of what you do!]

The other issue many people don’t always connect with animal raising is antibiotic resistance. Overuse of antibiotics in people creates some resistance, but the continual use in animal feed has escalated the problem exponentially. The first resistant bacteria in our valley seen by the other doctor I work with was around 10 years ago. He noticed the patient’s resistance profile happened to be exactly the same as the list of antibiotics in the widely-used brand of non-organic chicken feed he was forced to buy that week when the small local feed store ran out of the organic version that only he and one other valley resident requested… The CDC has a great summary here of why one particular bacteria has become resistant, and the same applies to hemorrhagic e. coli, MRSA, and VRE… And thank goodness, a recent bill proposed would make the FDA ban the use of antibiotics in animals that are not sick (yikes that that’s necessary)! Organic feed and pasture for your chickens ensures no antibiotics are snuck in so the animals don’t develop resistant bacteria and pass it onto you, through themselves or in and on their eggs!

Now, how do you find great eggs? Supermarket eggs may be a bit confusing with all the green-washing, so look for the words “pasture-raised,” organic or sustainable, and go to the websites of the companies to see how they treat their chickens. Roaming chickens that get to eat bugs and grass in addition to grain-based feed have a much better nutrition profile, brighter yolks, and thicker stronger shells, which gives you a nice solid physical idea of how much better they are for you. Farmers markets usually have someone who is selling their eggs, so that’s even better because you can ask them in person! If you’d like to try your hand, check out Dare 2 Dream Farms (and buy their eggs if you live near the co-op in Isla Vista or near New Frontiers market in Solvang)! They have a great website that explains several different breeds of chickens if you’re wondering what type to keep for yourself, or if you wonder what types lay what colors and sizes of eggs! Personally I think I’d try the Russian Orloffs if I lived in a cold place (plus they’re endangered so breeding them is cool :) ), and Brahmas for this part of Cali… friendly and happy to be in a little yard sounds good for a first go at keeping chickens. Check that same site for tips on what exactly you need and how to do it (‘care guide’). Oh, and you don’t need a rooster to get your hens to lay (good news since those guys can be feisty and loud… think Kauai)- you only need one if you would like to breed or need your hens protected.

Eggs are a high-energy food, and should be treated as such. Eating just a few, only when you need the nourishment, and cooking them properly are key. My favorite way is to make a quick 20 second tarka of a little warmed olive oil and spices (including turmeric to help digest the cholesterol), add the egg, then put a little water around the edge of the egg, and cover the frying pan with a lid to lightly poach it. I cook them until the white is done and the water just steams off so the eggs don’t get too hot and oxidize the cholesterol, and I generally serve them over veggies I cooked in the same pan (not a dishes fan!). The temperature issue means that using egg substitutes (heated and processed), buying packaged foods with egg proteins added (usually heated to very high temperatures to make a powder that is added for texture or protein), and eating lots of baked goods with eggs in them isn’t such a great idea. Mindfulness + moderation= healthier you and healthier planet. :)


**Ayurvedic tip: Improper food combining can contribute to poor digestion and buildup of ama or toxins that can lead to health problems. Some of the most common symptoms of poor digestion in the US are experienced as food sensitivities and skin problems… eggs are very rich and full of prana/energy, so they are particularly prone to making things difficult for a stressed digestive system if not eaten mindfully, hence the advice above :) Questions? Add a comment or send an email! ;)