Archive for the ‘Nutrition Therapy’ Category
Monday, April 8th, 2013
Here we go again.
The “what to eat and why” plot thickens. So do our artery walls if we’re not careful.
According to the CDC (Centers for Disease Control), heart disease is the leading cause of death in the US for both men and women. Back in my exercise physiology days, I had a fascination with heart disease. I wrote my thesis paper on the effects of exercise on coronary collateralization, worked in cardiac rehab, helped develop an outpatient exercise program, watched up-close-and-personal heart procedures, and was convinced I’d make an awesomely fantastic cardiac surgeon (some of the docs back then were alpha males and not the best listeners). If not for that sternal saw thing, I might have given it more thought.
What I did learn from that experience, though, is that heart disease is a complex condition and doesn’t always follow a direct line to diagnosis or treatment. Researchers are now questioning some of the basic assumptions about causes, lab biomarkers (blood chemistry), nutrition protocols, drug therapies, and invasive surgeries. Some in the medical community are even rethinking our obsession with low cholesterol and statin drugs. I’ll resist picking up that rope, but suffice to say, there’s no easy answer. Throw in genetics and lifestyle choices and there’s a lot to consider.
And now, like there’s not enough to think about regarding heart health and that all-too-common side effect known as sudden death, researchers have discovered those pesky gut bacteria are also playing a role. It appears there’s a type of meat- and egg-loving microbe that produces a substance, which in turn, increases the risk for heart disease. It’s a convoluted pathway, but these microbes convert carnitine (in meat) and choline (in eggs) into a chemical the liver quickly converts to TMAO (trimethylamine N-oxide). TMAO ends up in circulation and is associated with an increased risk for atherosclerosis. That’s not good.
For a variety of reasons, I’ve never been much of a meat fan. I’ve always felt we’re better off sticking to a diverse, plant-based diet. If I eat red meat at all, it’s on very rare occasions and in condiment-sized portions. Plants high in beneficial fiber encourage the proliferation of good gut bacteria. Those are the microbes I want on my disease-fighting team, not the carnitine-fueled, gas-belching, TMAO-producing critters. There’s also growing evidence that carnitine and choline supplements promote higher TMAO levels. Beware.
The conclusion from the scientific and medical community might be (is) to develop antibiotics to eliminate these microbes. If we wipe out the bacteria that play a part in TMAO production, we solve the problem, right?
Hmmm? I wonder what the unintended consequences of that will be? How about we support the magic of our own innate healing power and skip the drugs?
Bottom line (in my humble opinion)? Eat more plants and rethink the use of supplements and energy drinks.
If you’re on a meat-laden Paleo diet, you might want to read the research.
For more information about plants, fiber, and gut bacteria, check my last post.
Plants, peels, fiber, and gut bugs
If you’re still with me, thank you. I’ll post some recipes that promote good bacteria later this week. No science talk, I promise. Just good food.
We’re all in this together. Peace, love, and plant power.
Husten, L “Researchers Find New Path Linking Heart Disease to Carnitine.” Forbes, online. http://www.forbes.com/sites/larryhusten/2013/04/07/researchers-find-new-pathway-linking-heart-disease-to-carnitine/ (accessed April 7, 2013)
Kolata, G “Culprit in Heart Disease Goes Beyond Meat’s Fat.” The New York Times, online. http://www.nytimes.com/pages/health/index.html (accessed April 7, 2013)
Wang Z, et al. “Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease.” Nature 472, 57-63 (April 2011).
Willyard, C “Pathology: At the heart of the problem.” Nature 493, S10-S11 (January 2013).
Tuesday, March 26th, 2013
Do you peel lemons before tossing them into your morning smoothie? How about beets, cucumbers, or kiwis?
The peelings provide added nutrition; no reason to toss them out. I’m also a big fan of fiber, so I don’t peel most fruits or veggies. Plus, my personal entourage of microbial critters, the hundreds of thousands of bacterial species (gut flora, AKA microbiome) that call me home, thrive on this diet as well. Yes, my body is a temple, complete with a bazillion little symbiotic worshipers.
At least that’s the idea. We need a healthy, diverse, and thriving microbiome as part of our internal ecology. That helps keep the immune system strong, autoimmunity in check, and may reduce the risk of some forms of cancer, especially those associated with the GI tract. We’re bombarded today with chemicals our grandparents weren’t exposed to. Many of these toxic substances (pro-carcinogens) become genotoxic (mess up our DNA) upon metabolic activation by our gut bacteria.
Our world is toxic. We eat, drink, breath, and expose ourselves to harmful substances on a daily basis, many of which are in our food supply. Research indicates that a large percentage of known carcinogens require enzymatic activity to trigger malignancy. The bacterial composition of the gut microbiome (good bugs vs bad bugs) and the metabolic byproducts from all those critters can either protect us or do us in.
The idea is to encourage the good bugs to flourish. It’s also important to keep things moving along, if you know what I mean. A plant-based, high-fiber diet not only provides nourishment for our friendly bacteria, it also helps fight disease and prevents us from being full of poo.
The role of the gut microbiome is a hot research topic these days, and although the findings are intriguing, they can also be confusing. Or weird, especially when you throw cootie genomics into the mix. It’s not just our DNA floating around in the gene pool, it’s also the genetic elements of our personal collection of microbes. We’re one big complex ecosystem. Hopefully our microbiome is living in harmony with the rest of us. Food choices, pre- and pro-biotics, and how much fiber we consume can shift the bacterial composition to either enhance our well-being or encourage disease. Here are a few details.
Microbiome: the interaction of all the microscopic organisms, including their genomes, in one specific environment.
* In this post, I’m focused on the human gut microbiome. If you’re interested in the skin microbiome and you’re not germaphobic, check out this article on women’s flat track roller derby in which the skin microbiome of individual contestants was analyzed and matched to team membership. Each team had its own specific microbe community. Not only did they have team colors and team mascots, they had team cooties. Very cool. And weird.
Prebiotics: Nondigestible food ingredients (fiber) that encourage the growth of beneficial bacteria. Prebiotics are food for microbes. Feed your microbes well.
* Gluten-free sources of foods containing prebiotic fiber include Jerusalem artichoke, jicama, asparagus, banana, dandelion greens, onions, leeks, garlic, raw oats (make sure they’re certified gluten-free), chicory root, and yacon. Unrefined wheat and barley are also good sources, but those foods are off limits for those of us with gluten intolerance.
Probiotics: live microbes that provide health benefits to the host (you) by augmenting beneficial intestinal bacteria.
* Probiotics can be found in supplement form. I don’t take supplements, so I try to get my dose of probiotics from fermented foods like miso, sauerkraut, yogurt, and kefir.
Fiber: The nonstarch polysaccharides found in plant foods that are not broken down by human digestive enzymes, although some (prebiotics) are digested by GI tract bacteria. Fiber is often categorized as soluble or insoluble.
Insoluble fibers are called “bulking agents.” They help keep us regular (poo-wise). This is the fiber most people refer to when they talk about constipation. It literally sweeps out the GI tract, which is a good thing. Remember the Elvis story?
Soluble fiber helps that process, but it also has therapeutic effects. Soluble fiber delays the absorption of glucose (insulin response), helps us feel full, and decreases cholesterol levels. There’s even research suggesting soluble fiber may help reduce blood pressure and improve the absorption of minerals.
That last part is especially interesting. Some people avoid grains and legumes because of the phytic acid (phytate) content. Phytic acid isn’t classified as fiber, but is common in fiber-rich foods. It’s a non-nutrient, found in the husk of grains, legumes, and seeds. It can bind with certain minerals (zinc, iron, calcium, magnesium) and decrease their absorption.
But — researchers have also demonstrated that rats absorb more calcium, iron, and magnesium when fed a diet rich in soluble fiber, which is found in those same plants. We’re not rats, but these are interesting findings. Another article suggested that when soluble fiber ferments in the colon, it enhances the absorption of minerals. We eat the plants that contain both phytic acid and soluble fiber and what happens? Beats me, I’m not a biochemist, but the type of fiber appears to be important when it comes to mineral absorption. Soluble fiber that promotes intestinal fermentation and an increase in beneficial bacteria has a positive effect on mineral bioavailability. It’s a convoluted puzzle with lots of variables and depending on what you want to prove, you could cherry-pick data from either side to make your case. Having said that, I’m not convinced phytic acid is anything to worry about, especially if your diet is based on whole foods (lots of plants) rich in micronutrients and fiber.
Soluble fiber in the form of prebiotics is the stuff our gut microbes call dinner. The names don’t really matter, but if you’re interested — inulin, fructooligosaccharides (FOS), arabinooligosaccharides (AOS), and to some degree, pectin, are soluble fibers with prebiotic properties. As mentioned above, they help increase good bacteria at the expense of bad bacteria.
Here’s where it gets even more interesting. You’re fascinated by all this, right?
You’ve probably heard of leaky gut (intestinal permeability), especially if you have celiac disease, gluten sensitivity, Crohn’s disease, IBS, or any other autoimmune or GI related condition. We don’t know all the causes of leaky gut, but one thing is clear. The “Standard American Diet” (processed food, low fiber, high animal product diet) compromises food transit and waste elimination.
In other words, if stuff doesn’t move along at the right speed, you end with a bumper-to-bumper traffic jam.
When that happens, it alters nutrient availability to good gut bacteria and stimulates an overgrowth of bad gut bacteria. The bad bugs start partying, produce icky byproducts, and our intestinal cells take a beating. That abnormal balance alters gut permeability and allows funky stuff to slip through the cracks and be absorbed into the bloodstream. Security is breached, alarms go off, and every system in the body becomes a potential target for invaders (antigens). Antigens are substances that invoke an antibody response, but sometimes our antibodies, which are produced to protect us, get confused and target our own tissues (autoimmunity).
Does that sound familiar? Who’s had antibody testing for this or that?
Is this making sense?
Here’s how it all ties together.
See the smoothie ingredients pictured above? They include a mixture of fiber types, along with a rich assortment of nutrients, including vitamins, minerals, antioxidants, and phytochemicals. The American Dietetic Association’s daily recommendation for fiber is 25 grams for women and 38 grams for men. After age 50, the ADA recommendations drop to 21 grams for women and 30 grams for men.
YIKES, in my opinion, that’s way short of what we should be consuming. I’m over 50 and that smoothie of mine alone contains close to 17 grams of fiber. I’m almost at my daily recommendation before 6 AM. Twenty-one grams is not enough to encourage and support a healthy gut microbiome. Not even close.
Recent archeological findings suggest that at least a few of our hunter-forager ancestors consumed up to 135 grams of prebiotic fiber per day. Whoa, I’d call that high-carb, optimal foraging. Not exactly most modern day versions of the Paleo diet. Although 135 grams of fiber per day is a bit much (don’t try that at home, you’ll explode), American’s are definitely short-changing themselves when it comes to fiber — and overall health.
In a nutshell. Eat more plants.
Prebiotic, plant powered smoothie
* Use organic vegetables and fruit, especially if you’re eating the peels. Scrub the peels well before using (see my little veggie scrubber shown above).
2 cups raw greens (add some dandelion greens)
1 medium pear, seeded and chopped
1 medium celery stalk, chopped
1/2 cup chopped cucumber
2 dates, pitted and chopped
1 lemon (with peel), cut into wedges (pick out the obvious seeds) *
2 tablespoons raw oats, finely ground in a coffee grinder *
4 walnut halves, chopped
2 to 4 cups filtered water
Options: I also use raw beets, jicama, burdock root, broccoli stalks, asparagus, bananas, berries, and whatever else I can think of in my smoothies.
Place all ingredients in a high-powered blender (VitaMix, Blendtec, etc.) and blend until smooth.
Nutrition and health bonus
* Retaining the lemon peel doubles the fiber and significantly increases the vitamin C. The peel also contains a phytochemical called d-limonene, a component of the essential oil in citrus. Studies show this substance is chemopreventive and chemotherapeutic, meaning it helps fight against cancer.
* I always add a source of protein to smoothies. Hemp, chia, various nuts and seeds, or raw oats are favorites of mine. Raw oats provide carbohydrate, but the kind I use are also high in protein, iron, and soluble fiber, which in turn provides prebiotic fuel for beneficial microorganisms like bifidobacteria. If you’re worried about phytic acid, some oats have no hull, lessening the content. At least that’s my assumption, although I couldn’t find any research to back this up. My Understanding Normal and Clinical Nutrition book defines phytic acid as: a non-nutrient component of plant seeds; also called phytate. Phytic acid occurs in the husks of grains, legumes, and seeds and is capable of binding minerals such as zinc, iron, calcium, magnesium, and cooper in insoluble complexes in the intestine, which the body excretes. If phytic acid is found in the husk and there is no husk, it makes sense that there’s less (none?) phytic acid in hull-less oats.
I get my certified gluten-free, high protein, hull-less oats from Montana Gluten-Free Processors or Gluten-Free Prairie.
Some people with celiac disease don’t do well with oats, even gluten-free oats, so ask your healthcare provider if oats are a good choice for you.
For a little background and a list of what good bacteria do for human health, check out this past post of mine (How much of you is really you?). Check this post for some plant magic, (Talking bacteria and disease-fighting veggies).
I signed up for the American Gut Project to determine my gut microbial makeup. It will be interesting to see how those of us with celiac disease compare to the rest of the participants. I’ll keep you posted. If you want to know what you’re made of, check out the open source, community driven effort to characterize the microbial diversity of the American (and global) gut. Let’s compare bugs!
Peace, love and gut checks!
Chadwich RW, George SE, Claxton ID (1992) “Role of the gastrointestinal mucosa and microflora in the bioactivation of dietary and environmental mutagens or carinogens.” Drug Metabolism Reviews. Vol 24, Issue 4, 425-492.
Crowell P. (1999) “Prevention and Therapy of Cancer by Dietary Monoterpenes.” Journal of Nutrition. Vol 129, No 3, 775-778.
Jenkins et al. (1999) “Nutritional and Health Benefits of Inulin and Oligofructose: Inulin, Oligofructose and Intestinal Function.” Journal of Nutrition. Vol 129, No 7, 1431-1433. http://jn.nutrition.org/content/129/7/1431S.full.pdf+html
Kolida S, Gibson G (2007) “Prebiotic Capacity of Inulin-Type Fructans.” Journal of Nutrition. Vol 137, No 11, 250-256. http://jn.nutrition.org/content/137/11/2503S.full
Leach JD, Sobolik KD. (2010) “High dietary intake of prebiotic-type fructans in the prehistoric Chihuahuan Desert.” British Journal of Nutrition. 103(11):1558-61. http://www.ncbi.nlm.nih.gov/pubmed/20416127
Lopez HW, et al. (1998) “Intestinal Fermentation Lessens the Inhibitory Effects of Phytic Acid on Mineral Absorption in Rats.” Journal of Nutrition. Vol 128, No 7, 1192-1198. http://jn.nutrition.org/content/128/7/1192.full
Meadow JF, et al. (2013) “Significant changes in the skin microbiome mediated by the sport of roller derby.” Peer J 1:e53. http://dx.doi.org/10.7717/peerj.53
Vigsnaes LK, et al. (2011) “In Vitro Fermentation of Sugar Beet Arabinooligosaccharides by Fecal Microbiota Obtained from Patients with Ulcerative Colitis to Selectively Stimulate the Growth of Bifidobacterium spp. and Lactobacillus spp. Applied and Environmental Microbiology. Vol 77, No 23, 8336-8344. http://aem.asm.org/content/77/23/8336.full
Whitney EN, Cataldo CB, Rolfes SR. Understanding Normal and Clinical Nutrition. Wadsworth/Thomson Learning. Belmont, CA. 2002.
Wong et al. (2007) “Carbohydrate digestibility and metabolic effects.” Journal of Nutrition. Vol. 137, no. 11, 2539-2546. http://jn.nutrition.org/content/137/11/2539S.full
Tags: American Gut Project
, gut health
, insoluble fiber
, soluble fiber
Posted in Artful Aging
, Celiac & Gluten Intolerance
, Nutrition Therapy
| 14 Comments »
Friday, February 8th, 2013
File this one under, get well soon.
I never get sick. I can’t even remember the last time I had a cold. In fact, I can hang out with the sickest of the sick and it doesn’t faze me. My immune system scoffs at cooties.
At least until last weekend’s all-day, convoluted flight aboard a Delta 757 hack-a-thon.
There was no where to run. No where to hide. I couldn’t escape the recirculating, germ-infested, potently disgusting, cough cloud.
Drats, I’m down for the count.
Here’s my answer — shiitake mushroom, vegetable, and chicken soup.
Take that, you cold cooties.
I’ve been making different versions of this soup for years. I don’t have a recipe. I made it up and it varies depending on what I have on hand. One thing that doesn’t change is the base, which I make out of chicken broth, mushrooms (usually shiitake, but others will do), and a potato. That’s my medicinal launching pad.
Here’s how it goes, but remember, this is an outline, not an exact formula. Be creative.
Melissa’s medicinal soup
What you need
1 small to medium-sized potato, peeled and chopped *
handful of shiitake mushrooms (about 1/2 cup), cleaned and chopped
8 cups chicken broth, divided (if not homemade, I use Imagine GF Organic Chicken Broth)
2 tablespoons oil (I use coconut oil, but any will do)
1/2 cup chopped onions
6 cloves garlic, minced
4 stalks celery with leaves, chopped
4 carrots, chopped
1 sweet potato or yam, peeled and chopped
8-ounce can organic tomato sauce (not tomato paste, I use this version)
1 cup cooked, diced chicken
beans (one 15-ounce can, or dried cooked beans) *
2 cups spinach
herbs, sea salt, black pepper
What you do
1. Place chopped potato in a medium sauce pan. Cover with about 2 or 3 cups chicken broth and bring to a light boil. Use enough chicken broth to simmer potatoes until fully cooked. After about 10 minutes, add the chopped shiitake mushrooms to the potato/chicken broth mix. Cook for another 5 to 7 minutes, until potatoes are fully cooked and mushrooms are cooked, but not mushy. Turn heat off, set aside to cool.
2. In a large soup pot, heat oil over low-medium heat. Add onions and garlic and cook for 5 minutes, stirring often. Add 2 cups chicken broth, celery, carrots, sweet potato, tomato sauce, and cooked chicken. Turn heat to low.
3. Place cooled chicken broth-potato-mushroom mixture into a VitaMix or other blender. Make sure the mixture has cooled somewhat. Add another cup or two of room-temperature chicken broth and blend until all ingredients are incorporated. Mixture should be a gravy-like consistency, but not too thick. Add more broth during blending as needed. Pour the blend into soup pot, along with any remaining chicken broth. At this point, all the chicken broth (approximately 8 cups), the cooked chicken, and the vegetables, with the exception of the beans and the spinach, are in the pot simmering on low.
4. Cook on low for 2 hours or more. This can simmer on low all afternoon. Add rinsed beans (any kind is fine), herbs, seasonings, and spinach about a half hour before you’re ready to serve the soup. Canned beans get mushy if you cook them too long, add them add the end.
5. Serve and get well soon.
Cook’s notes (important):
* I normally use a small-medium Red potato for this base, because it has less starch than a Russet or Yukon Gold. I use potatoes as a thickener in lots of my recipes, rather than using a processed gluten-free flour or starch, but I choose my potato variety according to how much thickening I want in the recipe.
* I often use cooked, dried beans, but when I’m pressed for time, I use a can of beans (any kind) from Eden Organics. Canned beans retain their fiber and Eden Organics uses BPA-free cans. Canned beans are a healthy choice in a meal like this.
* Simply Organic All Purpose Seasoning is my favorite “go-to” seasoning. I use about 2 tablespoons in this recipe.
* Rather than adding the spinach to the soup, a half a cup of raw baby spinach can be placed in the bottom of a soup bowl or mug. Ladle the hot soup directly over the spinach and gently stir. That way the spinach is warm, but also fresh and just lightly wilted. That’s my favorite way to add spinach to soups.
Peace, love, and cootie-busting soup.
Monday, January 21st, 2013
Have you noticed the deluge of Paleo books flooding the market today? Do you know what Paleo nutrition is? Did our hunter/gatherer ancestors do more hunting than gathering? Were they hyper-carnivores? Did a large percent of their daily energy needs come from meat? Should we eat like that today?
Holy mastodon, what are modern humans to do? It’s confusing.
Channel your inner-caveman, grab a drumstick, and let’s unleash the past. On second thought, grab a bowl of baked beans or some goat yogurt, because I’m going to propose we’ve overestimated Paleolithic meat consumption and that, long term, the Paleo diet isn’t the best choice.
But first, a disclaimer and a friendship flag. I’m no evolutionary biologist. I can’t tell you the historical time-lines of different populations, or even who the populations were. Neanderthals, sapiens, upper-lower-middle Paleolithic, pre-Neolithic?
Or who was where? Northern Europe, west Asia, the Mediterranean, sub-Saharan Africa, the Bronx?
In order to propose a specific behavior (archeologically speaking), you need to know what you’re talking about. You also need to have a sound understanding of historical perspective and some scientific evidence. Like cave drawings of ancient BBQs, stone-age meat cleavers, or a well-preserved Neanderthal clutching a mastodon femur. I don’t have any of the above. No artifacts, no fossils, very little knowledge of the time period.
I’m also of the notion that one-sized diet doesn’t fit all. Now or 200,000 years ago, so each to their own.
But, if we’re honest, our fragmented knowledge of the Paleolithic era doesn’t clearly indicate who ate what when. There’s a wide range of possibilities with a zillion variables. If we sift through the research, there’s evidence of fossilized plant particles and starch grains embedded in Neanderthal dental plaque, meaning they ate a variety of plants, including legumes and tubers. Ancient encampments are often littered with animal remains (bones), which gives the impression that early humans ate a lot of meat. But if you think about it, there’s not much evidence to leave behind if you’re a plant. Bones survive thousands of years, plants don’t — they decompose. It’s like searching for an ice cube after it melts. How do we know the Paleo diet wasn’t predominately plant-based, with a little meat thrown in on rare occasions? Recent research is suggesting that theory might be closer to fact than all the hoopla about the caveman diet.
My ancestors ate a plant-based diet, with a little meat when they happened upon fresh road kill, a slow rabbit, or whatever else was around during that time period. I doubt meat was a major source of energy. Since I can’t text my ancestors and ask, this is obviously speculation. For an older post I wrote on this and my thoughts on Paleo and how HLA DQ2 genes add to the mix, please read “Confessions of an HLA DQ2 Cave Woman.”
To make this information easier to “digest,” I’m simply going to compare the modern Paleo diet to what people who currently live the longest eat (Blue Zone communities, see below for details and references). Yes, you could say this is simplistic, misleading, and doesn’t do justice to the Paleo diet. I agree to some extent, but there are too many variables (individual biochemistry, unique gut ecology, genetics, lifestyle, outlook on life, activity levels, food quality, etc.) and not enough accurate historical information to give the Paleo diet a science-based thumbs up or thumbs down. Having said that, I’m not a fan.
Sample 1-day 2200 kcal Paleo menu (“The Nutritional Characteristics of a Contemporary Diet Based Upon Paleolithic Food Groups.” Loren Cordain, PhD, Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado)
Cantaloupe, broiled Atlantic salmon
Vegetable salad with walnuts (shredded Romaine lettuce, sliced carrot, sliced cucumber, quartered tomatoes, lemon juice dressing, walnuts), broiled lean pork loin
Vegetable avocado/almond salad (shredded mixed greens, tomato, avocado, slivered almonds, sliced red onion, lemon juice dressing), steamed broccoli, lean beef sirloin tip roast
Orange, carrot sticks, celery sticks
According to Loren Cordain, macronutrient percentages for a contemporary (2200 kcal) diet based on Paleo food groups (meats, seafood, nuts/seeds, fruits, vegetables) should be:
38 % Protein
23 % Carbohydrate
Food groups not included in Cordain’s version of the Paleo diet are: grains, dairy, dried beans, legumes
Sample 1 day 1900 kcal Blue Zone menu (this is an estimated compilation of several global Blue Zone diets, which are all similar in content)
Herbal tea with honey, corn bread, fruit, goat milk or yogurt
Rice and beans, garlic, onions, large green salad
Stir fried vegetables, sweet potatoes, spicy curries, red wine
Vegetables, orange, nuts/seeds
According to Dan Buettner, longevity researcher and author of The Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest, the typical food groups of Blue Zone inhabitants include: grains, legumes, vegetables, fruit, nuts/seeds, limited dairy (from local goats, for example), small amounts of meat or fish on rare occasions, red wine.
Although neither way of eating includes processed foods, junk food, or fast food, they are quite different in macronutrient composition. One is animal protein heavy (Paleo) and one is unrefined carbohydrate heavy (Blue Zone). Paleo doesn’t include grains or legumes, Blue Zone meals regularly include beans, corn, rice, lentils.
There’s a lot more to the longevity story than diet alone. I’ll focus on that another time, this post is about food alone.
So, what do you think? Paleo or plant-based?
Peace, love, and each to their own.
References (aside from my own way of intuitive eating)
Blaser, Martin, et al. “What are the consequences of the disappearing human microbiota?” Nature: Reviews Microbiology, December, 2009.
Buettner, Dan. The Blue Zones: 9 Lessons for Living Longer from the People Who’ve Lived the Longest. National Geographic Society, Washington DC, 2012.
Cordain, Loren. “The Nutritional Characteristics of a Contemporary Diet Based on Paleolithic Food Groups.” JANA, Vol. 5, No. 3.
Diamond, Jared. Guns, Germs, and Steel: The Fates of Human Societies. W.W. Norton & Company, New York. 2005.
Hardy, Karen, et al. “Neanderthal medics? Evidence for food, cooking, and medicinal plants entrapped in dental calculus.” Naturwissenschaften Journal, Vol. 99, Issue 8.
Henry, Amanda, et al. “Microfossils in calculus demonstrate consumption of plants and cooked foods in Neanderthal diets.” PNAS, November 12, 2010. http://www.pnas.org/content/108/2/486.
Image credit: WikiMedia Commons
Wednesday, January 16th, 2013
I’ve been contemplating a post on the highlights and lowlights of 2012 and what I think the hot trends in health, nutrition, and food will be for 2013, but I’ve had trouble putting it all together. It’s not easy to take internal chit-chat and make it into a concise list. Plus, I don’t like conflict and many of my lowlights are “in vogue” and my predicted trends aren’t all that trendy. I probably can’t call them “trends” if I’m alone on the bandwagon.
What to do?
We made it through another presidential election and we survived the Mayan Apocalypse, so I’m guessing you (my loyal readers) can endure my non-objective, totally biased, opinionated views of what’s going on in the world of food and health.
Here’s what I consider the highlights and lowlights of 2012 and my trends for 2013. This is the abridged version. If there’s anything you’d like me to expand on, please let me know in the comment section and if there’s enough interest, I’ll do a whole post on it.
Highlights of 2012 in no particular order
1. Gluten-free becomes mainstream
2. Increased awareness of non-celiac, gluten sensitivity
3. Pressure to label genetically modified foods
4. Research indicating the importance of a diverse and healthy microbiome (check here for details)
5. The Gluten-Free Edge: A Nutrition & Training Guide for Peak Athletic Performance & and Active Gluten Free Life is released (obviously a highlight for me)
6. An appreciation and focus on farmers, sustainability, and local food
7. Increased awareness of unhealthy food industry practices and factory farming
8. Perceptions are changing regarding cholesterol levels and the importance of healthy fats
9. Lots of choices when it comes to food and nutrition philosophies, one size doesn’t fit all
10. Hearty greens take center stage
Low-lights of 2012 in no particular order
1. Gluten-free becomes mainstream (the good, the bad, and the ugly)
2. Dr. Oz and his over-the-top, magic, fat-busting claims
3. Dr. Mercola and his scary, hyped-up marketing tactics
4. Dr. Davis (Wheat Belly) goes too far with his “wheat equals crack” campaign and becomes joke fodder for Stephen Colbert
5. American’s consumed 1 billion pounds of beef at McDonald’s in 2012
6. Hospital food — my mom was served white bread, this sherbet, and Ensure upon admission (she had diabetes)
7. Dunkin’ Donuts test markets gluten-free donuts
8. Lance Armstrong
9. Too many supplement choices, drug options, ridiculous diets, and “super foods”
10. Low-quality, fast food on every corner, marketing to kids
Food and nutrition trends for 2013
1. Increase in personal genetic testing: epigenetics, nutrigenomics, and a focus on how genetics influence individual health traits, disease risk, carrier status, reactions to medications, ancestry, food likes and dislikes, etc. (I had this done, very interesting)
2. Consumers seek organic, non-GMO, local food
3. Less meat, more plant-based eating
4. The “bacon in everything” trend is over
5. The US has plenty of its own super foods, no need to resort to exotic Himalayan or Rainforest plants
6. Old fashioned oats (certified gluten-free) and dried heirloom/heritage beans make a high-protein comeback
7. Made-from-scratch food is in, processed food is out
8. Chefs take charge of their own health, lead by example
9. Gardening, walking, nature, exercise, quality sleep, whole foods, and a good attitude are in, whining about what you can’t eat is out
10. Basic “recipes” for longevity are in, exaggerated health claims are out
Next up, a recipe and the winner of a big bag of gluten-free oat bran from my farmer friends in Montana. If you haven’t entered to win, check out my “oat bran power bar and giveaway” post and leave me a comment.
Wishing you peace, love, and good joo-joo in 2013!
Image of Evgenia Antipova still life painting from WikiMedia Commons
Wednesday, December 12th, 2012
My last post was about iron-deficiency anemia, celiac disease, and iron-rich foods. It came with a heavy dose of red blood cell biology and those of you willing to wade through it, not unsubscribe, and leave a comment at the end were rewarded with an opportunity to win a copy of The Gluten-Free Edge, my sports nutrition book co-written with Peter Bronski.
And the winner is (drum roll, please)—Jennifer R! Thank you all for participating and congratulations to Jennifer.
Since it’s the season for giving, I’m going to keep the giveaway streak going (see details below).
I thought I’d follow up my anemia post with a gluten-free, iron-packed, power-bar recipe that I developed as a homemade alternative to store-bought energy bars. This one is a take-off on an almond meal version featured in the recipe section of The Gluten-Free Edge and is proof that vegetarians (even vegans) can get the iron and protein they need if they do it right.
Gluten-free oat bran power bar (makes 16 servings)
What you need
1/2 cup oat bran (I used Montana Gluten-Free Oat Bran, see details below)
1 teaspoon ground cinnamon
1/4 teaspoon sea salt
1 cup walnuts
1 cup almonds
1 cup dried, unsulphured apricots, chopped
1/3 cup certified gluten-free oats (I get mine from MT GF Processors or GF Prairie)
1/2 cup chocolate chips (make sure they’re gluten-free)
1/3 cup honey
1 large egg
2 tablespoons coconut oil, melted, plus some to grease the pan
1-1/2 teaspoon vanilla
What you do
1. Preheat oven to 350 degrees. Grease a 9-inch square baking pan (I used a dark-colored metal baking pan).
2. Place the oat bran, the cinnamon, and the sea salt in a food processor and pulse until well mixed.
3. Add the walnuts, almonds, apricots, and oats and pulse several times, until the nuts and apricots are in small chunks but not completely ground. Add the chocolate chips and pulse a few times, leaving larger chunks.
4. In a bowl big enough to hold all the ingredients, whisk together the honey, egg, melted coconut oil, and vanilla. Whisk for 1 minute to ensure the ingredients are well mixed.
5. Add the dry (pulsed) ingredients to the wet ingredients and mash together with a fork. Use your hands if you have to and make sure everything is mixed together.
6. Spread the mixture in the prepared pan. Cover with parchment paper and, using your hands, press and flatten evenly. You can also use a flat spatula to even out the mixture. Remove the parchment paper.
7. Place pan on center rack of the oven and bake for 22 to 24 minutes, until golden brown. Remove from oven and let cool. Place the pan in the refrigerator to chill before cutting into bars. Store bars in an airtight container in the fridge, or wrap individually and freeze.
These bars are power-packed with nutrition and great for athletes. They’re high in carbohydrates (great workout fuel), high in protein (for recovery), and super high in iron (building blocks for RBCs, see prior post). The iron is mainly from the oat bran. The bars are also high in fat (another source of workout fuel), but the fat is from healthy sources, so don’t fret. Because of the high fat content, they aren’t low calorie, but if you need a boost while out hiking, biking, or during a mid-afternoon work slump, these power bars will serve you well.
PER SERVING (1 bar): 225 calories; 14 g fat; 22 g carbohydrate; 6 g protein; 3 g fiber
NUTRITION BONUS: 1 bar provides 30% of the RDA of iron
Would you like a 3-pound bag of this nourishing Montana Gluten-Free Oat Bran? It’s grown out west by awesome big sky farmers and is minimally “processed” in a dedicated, state-of-the-art, gluten-free facility. The oat bran is dry milled, with no heat applied during preparation or packaging. It’s good stuff, non-GMO, is tested and certified gluten-free, and is a great way to boost the nutritional value of GF baked goods. Most GF baked goods are low in iron and other nutrients. Tossing in some oat bran solves that problem.
To enter the giveaway, leave a comment on how you’d use the oat bran. Be creative—I’m curious. Make sure you include your email address where prompted. I’ll pick the winner via random.org. Good luck and happy baking!
Peace, love, and oat bran!
PS I’m not employed in any way by MT GF Processors or GF Prairie. No one asked me to blog about the products or do giveaways. I’m not paid to do it. I buy my own products and endorse the farmers and product developers whom I believe are doing it right. There’s been an explosion in the GF market and a lot of the stuff has the nutritional value of ground styrofoam. It’s junk food. I want the good guys to be successful. We need to support this “grass roots” movement. Our health and the health of the environment depend on it.
Go hug a farmer!
Thursday, December 6th, 2012
Ladies, do you ever feel like this (minus the bodice drama)? Guys, do you ever nod off mid-sentence? Do you spend half your life asleep on the couch?
There are lots of reasons for feeling tired, run-down, and chronically exhausted, but the one I’m going to focus on is iron-deficiency anemia. Anemia is one of the most common adult presentations of celiac disease and the prevailing symptom of that type of anemia is overall fatigue—as in reduced physical work capacity, impaired athletic performance, and a funky attitude.
Who wants to shuffle through life bleary-eyed and drained of energy (not to mention unaware of potential wardrobe malfunctions)?
In order to have the energy you need to enjoy life and thrive, you need healthy, functioning red blood cells (RBCs). RBCs contain an oxygen-carrying protein called hemoglobin, which is the pigment that gives blood its red color. Heme is the iron-containing component, globin is the protein. Unlike most cells, mature RBCs have no nucleus. That way there’s more room to cart around the oxygen you need to work, chase your kids, climb mountains, play tennis, and walk the dog. RBCs only last about 120 days because of the wear and tear they take zipping around the body, squeezing through capillaries, exchanging oxygen for carbon dioxide, and supplying all our cells with nutrients.
Capillaries are the microscopic blood vessels between arteries and veins. They’re called exchange vessels and are found near almost every cell in the body, but their number varies depending on the oxygen and nutrient needs of the tissue. Muscle tissue has lots of capillaries because of the high metabolic demand, especially if you’re an athlete. The same goes for your hard-working liver. If all the capillaries in the human body were placed end to end, the collective length would be about 25,000 to 30,000 miles. Now, imagine how busy your little RBCs are and how many miles they put in each day keeping you upright and functioning. Incredible, isn’t it?
As I mentioned before, RBCs wear out after about 120 days. In order to maintain healthy numbers, we need to be cranking out new mature RBCs at the rate of at least 2 million per second. Yes, you read that right. TWO MILLION PER SECOND. And each RBC contains about 280 million hemoglobin molecules (no typo, 280 million). Each hemoglobin molecule can carry up to 4 oxygen molecules.
Seriously, tell me you’re not totally impressed with yourself. Aren’t we amazing?
Here’s the deal, though. We need to provide our bodies with stellar building blocks to make all this magical stuff happen as planned. Plus, we need to make sure we don’t have something sabotaging our good intentions. Something like celiac disease, which when undiagnosed or unmanaged, can cause nutrient malabsorption so we don’t get the proper building blocks (like iron and animo acids) we need to make all these red blood cells.
Bottom line (short-story version)? If you’re not absorbing your iron, you can’t replace your lost RBCs. If you can’t replace the high rate of RBC loss, you’ll end up with a reduced number of RBCs, a decreased amount of hemoglobin, and less oxygen-carrying capacity. In other words, you’ll be chronically fatigued, have a bad attitude, and simply getting through your day will be a monumental effort. That’s no fun.
First off, find out if you have iron-deficiency anemia. Poor absorption of iron (could be celiac disease), excessive loss of iron, increased iron requirements, or insufficient dietary intake can cause the condition. Celiac disease fits into that scenario, so make sure to consult a medical professional and get tested before taking supplements. Too much iron is toxic and can accumulate in body tissues and organs after normal needs are met.
Getting your nutrients from food should be your priority unless you have a verifiable deficiency. Here’s a list of iron-rich foods. If you’re an athlete, especially one with celiac disease, your iron-related concerns may be compounded. Add foods from this list to your diet and if you want to know more about athletically-induced, iron-deficient anemia, leave me a comment at the end of this post. Your reward for sticking with me to the end of this post is a chance to win a copy of my book, The Gluten-Free Edge: A Nutrition and Training Guide for Peak Athletic Performance and an Active Gluten-Free Life, co-written with endurance athlete, cookbook author, and good friend Peter Bronski of the blog No Gluten No Problem. We go into great detail about nutrient absorption, iron loss, and the critical role deficiencies play in overall health and athletic performance. I’ll choose one winner in a random drawing. This book is a great guide for anyone who wants to “gain an edge” in life and in sports by going gluten-free. Plus, it makes a great Christmas present.
A Sampling of Iron Rich Foods (courtesy of The Gluten-Free Edge)
organ meats (liver, giblets)
bison and beef
pumpkin and squash seeds
oats (make sure they’re certified gluten-free*)
* My favorite sources for uncontaminated, certified gluten-free oats are Montana Gluten-Free Processors and Gluten-Free Prairie (same oats). These oats are rich in iron and protein, making them good building blocks for RBCs.
Are you curious if you get iron from using a cast-iron skillet. Check this post of mine for the geeky details: Heavy Metal Skillet Breakfast.
Peace, love, and the Gluten-Free Edge.
PS Leave a comment for a chance to win and make sure to add your email address (it won’t be seen), so I can contact you if you win. You can also check in with Pete and me on Facebook and/or Twitter. We share lots of good information.
Melissa: Facebook, Twitter
Pete: Facebook, Twitter
Photo Credit: Wikimedia Commons
Monday, October 15th, 2012
Even though I have a blog category called Super Foods, I don’t believe the astonishing claims of “super food” products (powders, pulps, supplements, etc.). The açaí trend is an example. There’s no science behind the claim that açaí powder can reverse diabetes, defeat cancer, help you lose weight, or increase boy-part prowess in older men. Those over-the-top claims have all been made, but there’s no evidence to back them up.
Geez, like life isn’t tricky enough. Now we have to vet our food for false health claims. If it’s not açaí, it’s Tahitian noni juice, or Himalayan goji berries. Each one of these plants have “medicinal” health benefits, but they aren’t going to cure Alzheimer’s or stop the aging process. There are no magic potions. No silver bullets.
Having said that, I’m a big believer in plant power to help resolve biological imbalances, rejuvenate our inner space, and boost overall health. Processed food, environmental toxins, stress, and poor lifestyle choices increase the risk of disease. The more we understand what’s going on inside (up close and personal, on a cellular level) and the more we focus on the foods that promote vitality and mental clarity, the better we feel. The more radiant we become. Who doesn’t want that?
Did you read my last post? How much of you is really you? If not, check it out as that post, this one, and my next one will all be connected. Last week’s was about bacteria and the importance of keeping our inner bacterial garden healthy and balanced. This post will touch on foods that inhibit disease-causing bacteria and help the “knights in shining armor” keep the cooties in check.
Okay, ready? Put on your geek hat.
Quorum sensing is cell-to-cell texting between bacteria. It’s their version of using a “cell” phone (pun intended) to communicate. But rather than an expensive iPhone, they use chemical signaling molecules to pass information around and gather the troops to do good things or to wreak havoc. Bacteria have an amazing ability to engineer their environment and to impact human health. They’re innately smart, very communicative, and quite creative, so it’s important to have the good guys calling the shots. According to a study in the June 2009 issue of PLoS One, a peer reviewed science journal, the human gut is home to about 9 million unique bacterial genes and once we lose control of proper balance, the s**t hits the fan, so to speak.
Probably the most famous example of quorum sensing is the bioluminescence of fireflies. Did you play with fireflies when you were little? I did, although I had no idea how they turned their little tail lights off and on. Fireflies individually regulate their light, but they receive feedback from the other light flashes around them. Peer pressure encourages them to flash in unison. Photinus pyralis is the firefly bacteria that produces light via chemical signaling (quorum sensing). How cool is that? They definitely glow from the inside out and they do it as a community.
That’s quorum sensing and it’s also how super bugs join forces and discuss how to outsmart antibiotics. It’s how your inner garden becomes overrun by weeds. We don’t want that.
Smart plant guys and gals have discovered that vegetables like broccoli, Brussels sprouts, cauliflower, horseradish, garlic, and cabbage (among others) inhibit the growth of disease-causing bacteria. Pseudomonas aeruginosa, to be exact. MRSA (nasty staph germ) and pseudomonas aeruginosa are smart little critters. They’re becoming antibiotic resistant, which is not good.
Here’s the deal, though. If we eat right, avoid the over-use of antibiotics, and focus on health-promoting plant foods, we’ll at least be tending our internal garden in a positive way. We’re setting ourselves up to have an army of good bacteria working (quorum sensing) on our behalf. Go, good bacteria, go!
So, skip the expensive and exotic “super food” powders, supplements, and elixirs and go eat some broccoli. Plants can be potent therapeutic agents, but you don’t have to go to some far-off rain forest or spend a fortune to boost your internal fire power. Ride your bike down to the local farmer’s market and get yourself some green quorum sensing inhibitors.
Peace, love, and plant power.
PS Stay tuned for a simple test to see how well you know yourself.
Thursday, October 11th, 2012
And how well do you know the you that’s not really you? Or even the you that is you?
For the most part, we’re a highly developed species, but our interoceptive skills aren’t all that great. We’re fairly clueless when it comes to our own bodies.
First things first – the basics.
All living things are made up of cells. Some things, like bacteria, are made up of only one cell. Humans are made up of bazillions of cells and almost every one of those cells contains a complete recipe for making you the unique and quirky person you are. That cellular recipe card is encoded in your DNA, which is that long twisty, twirly, ladder-like molecule you learned about in high school biology. The ingredients for your DNA recipe are organized into 23 pairs of chromosomes, which are organized into genes. We each have about 20,000 genes. I have the gene that codes for green eyes and the one that codes for slightly wavy hair. I also have two genes that code for an increased risk for celiac disease and one that makes me a super taster. You may have the gene that codes for sparkling blue eyes and one that’s the marker for straight hair. Or, you may have hit the jackpot with ACTN3, the “I can run really fast” gene.
That’s us in a genetic nutshell.
Now, on to those one-celled, one-piece-of-DNA bacteria. Bacteria consume stuff (nutrients) from the environment and in some cases, that environmental banquet is us. We have WAY more bacterial cells in our bodies than our own cells – something like 10 times more bacteria cells. Simply put, we have (give or take a few) 100,000 bacteria cells (and genes) in and on us at all times.
Take that one step further and we can conclude that 90% of our cells are from bacteria. Yikes! There’s not much of me that’s really me. I’m just a green-eyed, over-grown petri-dish wearing a cute outfit.
So, we’re just one big tour bus for bacteria. We have some nice passengers and some not-so-nice passengers and it’s important for over-all health to keep this ratio in optimal balance. Our unique buggy environment is called a microbiome and includes all the microbes (and their genetic elements) that have become a part of our internal and external environment. These bacterial genes can profoundly impact the progression of disease – in good ways (protecting us from pathogens), or bad ways (causing infection, inflammation, and disease).
What do good bacteria do?
• Produce enzymes that help us digest, absorb, and assimilate food
• Synthesize vitamin K and other vitamins we can’t make on our own
• Break down carcinogens
• May help metabolize drugs
• Rev up the rate in which intestinal cells regenerate
• Boost immune function and metabolism
• Infants get protective bacteria during birth that help “educate” their immune systems
• Antibiotic use can kill off good bacteria, opening the door to disease
A healthy gut microbiome is akin to a functioning organ, carrying out all kinds of important immune system activities. People with digestive diseases and autoimmune conditions (i.e., celiac, colitis, Crohn’s, IBS, food allergies, environmental sensitivities, etc.) often have funky microbiomes, which can impact energy levels, overall vibrance, immune function, and aging. Researchers are even linking obesity and diabetes to bacterial imbalances.
Scientists at the National Institutes of Health are sequencing the genomes of almost every strain of bacteria we have and are connecting them to the organs they inhabit (nasal-oral-lungs, skin, gastrointestinal, urogenital). This new approach to wellness is called medical ecology. Think of your microbiome as a soil system. Without the proper balance of nutrients and microbes in the soil, your garden won’t grow. The more good bacteria we have, the harder it is for bad cooties to take hold and cause problems.
How do we tend the microbial garden?
• Don’t use broad spectrum antibiotics unless absolutely necessary
• Choose organic produce and hormone/antibiotic-free animal products
• Eat fermented foods (yogurt, kefir, sauerkraut, etc.)
• Reduce stress, which can impact intestinal health
• Prebiotics (fibers in whole foods) stimulate the growth of good bacteria
• Avoid processed food, junk food, and sugary drinks
• Talk to your health-care practitioner about taking a probiotic supplement
• Eat cruciferous veggies *
* Next up: quorum sensing, broccoli, horseradish, and a test to measure your interoceptive skills. (I know, I apologize. I just can’t help it.)
I promise you a gluten-free donut if you stick with me. =)
Peace, love, and good bacteria.
Photo credit: WikiMedia Commons
Monday, September 24th, 2012
I’m sure you’ve all heard the famous Hippocrates quote, Let food be thy medicine and medicine be thy food. He uttered those words in 400-something BC. Back in the day when food was actually—surprise—real food. That meant lots of plants and an occasional animal snack, but certainly not double-deep-fried, nacho-flavored, cheese-like chips; high-fat “Sunday” bacon; or 2-pound cinnamon rolls. When Hippocrates was talking about food as medicine, he was talking about plants. Whole foods.
See those scrawny little scallions in the above photo? Nothing all that special. They’re just onions, right? Well, those onions pack a powerful punch when it comes to health-promoting goodness.
I’ve been doing some research on foods that fight cancer, sometimes referred to as chemopreventive (or chemoprotective) foods and ran across an interesting, recently released (last week) study.
But first, a little background. The term chemopreventive was coined in the late 1970s and refers to the phytochemicals (plant chemicals) in natural products (fruits, vegetables, herbs, spices) that reduce the risk of disease. I mentioned Hippocrates because I figured most of you have probably heard the food as medicine quote. Here’s another similar, although more wordy, quote from a March 2010 Pharmaceutical Research Journal abstract on cancer chemoprevention.
Moreover, it has been recognized that single agents may not always be sufficient to provide chemopreventive efficacy, and, therefore, the new concept of combination chemoprevention by multiple agents or by the consumption of “whole foods” has become an increasingly attractive area of study.
Hmmm? Wow, the “new” concept of consuming whole foods as medicine? An “increasingly attractive area of study.” Very interesting (I say with a touch of sarcasm). Wasn’t Hippocrates the father of modern medicine? Back in 400-something BC?
Okay, so we’ve gone astray on many fronts when it comes to health and what we eat. I’ll save that rant for another day and get on with the exciting news about scallions, one of my favorite foods.
There’s an increased risk of intestinal cancers associated with celiac disease. The risk is small and if you’re on a seriously committed and healthy gluten-free diet (think whole foods), the increased risk is minimal. I’m not losing any sleep over it. But colon cancer is one of the most common forms of cancers in the general population, so it’s nothing to sneeze at.
What do scallions have to do with intestinal diseases and colon cancer? Well, according to a new study, scallion extract (scallions soaked in hot or cold water) suppressed key inflammatory markers and reduced the size of cancer tumors. Yes, in rats, but in some ways, we’re not all that different.
In summary, directly from the study: “We therefore suggest that scallion plant materials and their extracts may have the potential to be systematically developed as a chemopreventive agent(s) or medicinal food against specific colon cancers.”
Psst—you don’t have to wait until they’re “systematically developed.”
I say, load up on fresh, organic scallions right now. Chop them and add them to soups, stews, chili, whatever you can think of. Both the hot and cold extracts provided protection, but the hot (cooked) version topped the list. Sauté them and add them to raw salads. I do that all the time and they taste spectacular! Roast them in a medley of vegetables. Slice them length-wise and put them on pizza (check out this recipe: my new favorite pizza topping to see what I mean).
Here’s the good news about this study. It didn’t take much, just one scallion a day to provide the extra boost in protection. If that’s not enough, scallions impair genes that store fat. Yes! Okay, in obese rats, but still. Good news, don’t you think? Onions also help lower blood pressure and are anti-inflammatory.
What’s not to like about the scallion?!
Go, buy some now! Let food be thy medicine!
PS Stay tuned for a roasted scallion pesto recipe. Oh my gosh! Delicious.
* P Arulselvan et al., “Dietary Administration of Scallion Extract Effectively Inhibits Colorectal Tumor Growth: Cellular and Molecular Mechanisms in Mice,” PLoS ONE 7(9), e44658. doi:10.1371/journal.pone.0044658, September 14, 2012.
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should not be used for diagnostic purposes. Consult with your physician regarding any health or medical concerns you may have.