Natural Solutions for Cleaning Your Produce

Whether you buy organic or not, taking some time to properly clean your produce is an important part of any wellness plan that shouldn’t be overlooked.

Eating a rainbow of colors is one of the best ways to ensure you’re getting the necessary vitamins and nutrients to nurture your immune system. But remember, you’re not the first person to handle that apple you’re about to take a bite out of! Because it travels through many hands and has passed through many environments, all produce is a host for bacteria, and unless you’re buying organic, pesticides too.

Take for example the E.coli outbreak in the United States in 2018, caused by infected romaine lettuce and responsible for causing illnesses across multiple states. This may be an extreme, but it illustrates the point — just because you don’t see it, doesn’t mean it’s not there.

Additionally, tomatoes, cucumbers, apples, bell peppers, and many other fruits and vegetables are covered with wax to protect from spoilage and to maintain hydration. But given a choice, is it something you want to eat? Likely not…

The good news is that you DO have a choice! Bypassing a good wash leaves you susceptible to a wide range of bacteria and unwanted substances. “Removing pesticides and de-waxing your fruits and vegetables is a fairly simple process and always recommended. It’s is particularly important for berries and lettuces, even if they are organic, as they are a good host for powerful super bacteria,” explains Kaplan’s Clinical Integrative Nutritionist, Nour Amri.

Nour recommends the following two methods that use natural solutions to properly remove wax, pesticides and harmful microbes before use (best to do this as soon as you unpack your groceries).

To de-wax & clean most fruits and vegetables:
Place the produce in a container filled with baking soda and water, approx. 1 tsp per 2 cups of water, covering them completely and letting it soak for at least 20 minutes. The baking soda will remove the wax on the outer skin and, more importantly, has been shown to be effective in removing pesticides. You can follow this up with a solution of ¼ cup of 3% hydrogen peroxide and water (again, just covering the produce) to remove bacteria. The hydrogen peroxide is a power anti-microbial that will help remove bacteria from the surface of the produce and also helps in removing pesticides.

For produce such as leafy greens and berries*:
Cover the produce in a solution of  ½ cup of 3% hydrogen peroxide and water for 20 minutes & rinse with filtered or spring water.

*Berries typically spoil faster after washing, so this process is best done right before eating.

Although this may seem like a time-consuming process the benefits are far-reaching. Once the habit is created it will become second nature and you’ll feel great about being proactive in your health.

Out of the Fog

Out of the Fog: Strategies to Prevent Brain Fog and Sharpen Cognitive Function

It’s easy to take your mental health for granted until one day you realize that you haven’t been feeling as mentally sharp as you once were. Maybe you’re having more frequent slips in memory or you feel like you’re walking around with your head in a cloud. When these moments occur, you may be quick to dismiss them, but brain fog, in a sense, is the body’s way of indicating that the brain is not working the way it’s supposed to be. So, what is brain fog and why does it happen?

Brain fog is not an actual clinical condition, but rather a term for a subjective set of symptoms that people experience. Some may be affected by poor concentration or a decrease in intellectual productivity, while others may experience memory problems (difficulty with recalling words, details, etc.). Other symptoms can include feelings of confusion, depression, and headaches. People of any age and gender can experience any one or all of these symptoms at any given time.

These changes in cognitive function are not only mentally exhausting, but they can also have a very real effect on a person’s emotional wellbeing. Operating in a reduced state of mental acuity can knock down a person’s self-confidence, cause workplace productivity to suffer, and may even be a reason to withdraw from social outings. But it’s important to understand that brain fog is not a normal part of the aging process.

There are many factors that can initiate symptoms of brain fog; some that you may not think are related. Unlike dementia, which can be permanent, and in some cases, progressive, brain fog symptoms are likely to improve when contributing factors are addressed.

Here are 6 common contributors with tips on what you can do to improve or even eliminate your symptoms altogether.


1. Poor nutrition.

The connection between the brain and the gut is also known as the “gut-brain axis.” It’s a bi-directional connection, which means that the gut and the brain essentially speak to each other. This means that when the integrity of one component is compromised, the other is directly affected. Therefore, poor nutritional choices will have a direct effect on brain function.

Highly processed meals and drinks that are loaded with simple sugars and other artificial ingredients can cause a disruption in the gut flora and lead to a condition called intestinal permeability, or leaky gut. When the gut lining is weakened unwanted substances are able to break through the protective filter between the intestines and our bloodstream. The are several issues that then become a problem. The first is that the body will start to make antibodies to foods, causing allergies to foods we would not have been sensitive to when the intestine was healthy. The other issue is that when the intestinal barrier is impaired, the barrier around the brain that helps protect our brains from immune substances floating in the blood now can enter the brain and incite an inflammatory reaction. This can show up as fatigue, sleep disturbances and alterations in mood, anxiety, and depression, and brain fog.

In addition, common food additives like aspartame, Monosodium Glutamate (MSG), and nitrates/nitrites promote widespread inflammation and oxidative stress by producing free radicals that cause damage to brain cells and DNA when they overwhelm antioxidant levels in the body.

Solution: We should never take our food choices for granted! There are things that can be done nutritionally to help clear brain fog, boost energy, and increase productivity. Start by cutting down on processed foods and eating whole, organic, and non-GMO foods whenever possible. Next, eat probiotic-rich foods to help balance your gut flora and get rid of harmful bacteria. Probiotic-rich foods include sauerkraut, kimchi, Kombucha (watch out for sugar content), and kefir. If you have trouble getting these foods onto your plate, another great way to get good bacteria into your diet is supplementing with a daily probiotic.

2. Biotoxicity and Neurotoxicity

Biotoxins and neurotoxins are environmental toxins that can poison our physical and mental health. As toxins penetrate the blood-brain barrier, they are free to circulate throughout the body – including the brain! Once there, the glial cells that work to defend the nerves and brain cells from damage are compromised and unable to do their job. Although the symptoms vary, a common complaint of someone diagnosed with some form of toxicity is brain fog.

Solution: Eliminating biotoxins and neurotoxins from your home is the first step in any detoxification process. This may mean professional removal of mold-infested areas, air purification, and a change to buying “green” products that do not contain harmful ingredients like pesticides and other toxic ingredients. You’ll also need to make changes to your diet to exclude food items that may contribute to leaky gut. A compromised gut lining will allow more toxic substances to circulate through your body instead of being eliminated. If you have symptoms of brain fog talk to your physician about whether getting tested for the presence of biotoxins or neurotoxins make sense for you.

3. Sleep Disorders

In the United States, as many as one-third of adults do not get the quality of sleep the body requires. It’s during sleep when the body is able to repair itself by calming inflammation and maintaining hormone production. When these two processes – both important elements in brain health – are compromised it can negatively impact your memory, decision-making, the capacity to focus one’s attention, and the ability to complete complex creative activities, among other things.

Solution: There are a lot of things you can do to improve your sleep pattern. Breathing techniques, meditation, dietary adjustments, starting an exercise routine (or adjusting your current one), and establishing a bedtime routine are just a few examples.
If you think you may have an actual sleep disorder, a first step in further evaluation is to answer the eight questions on the Epworth Sleepiness Scale. If your score is equal to, or higher, than 10 the results should be discussed with your doctor.

4. Celiac Disease

People with Celiac Disease (CD) are no strangers to brain fog. Just like poor nutritional choices can lead to leaky gut, so can an allergy or sensitivity to gluten. The difference is, with Celiac Disease your immune system mistakes gluten, a normally benign food ingredient for most, as a foreign and deadly invader. When it’s detected in the body, the immune system begins to attack and destroy the gut lining and causes leaky gut. Once the villi are damaged the body is unable to absorb the nutrients it needs to keep the brain and body healthy and allows harmful substances to enter. Brain fog is a common symptom of people who are ultimately diagnosed with Celiac Disease or gluten intolerance.

Solution: Patients who have been diagnosed with Celiac disease and/or gluten intolerance report a noticeable and significant improvement in cognitive impairment after eliminating gluten from their diet.

5. Estrogen

In women, the onset of menopause can trigger a myriad of symptoms including fatigue, weight gain, mood swings, hot flashes, joint pain, and brain fog. Research suggests that when it comes to changes in memory and other mild cognitive impairments that accompany menopause, the decline of estrogen levels may be partly to blame. We know that the brain is full of estrogen receptors that have neuroprotective and antioxidant benefits. The decline of estrogen during menopause compromises neuronal function and increases the risk of developing age-related neurodegenerative disorders.

Solution: Although there is no single solution that works for every woman, bioidentical hormone replacement therapy can relieve many of the unpleasant symptoms that most women experience during menopause, including brain fog. Talk to your doctor about a screening that will help identify hormonal imbalances so they can be effectively treated.

6. Side-Effects from Medication

Statistics show that over 20% of US adults report using 3 or more prescription drugs in the past 30 days and nearly 12% use 5 or more. Additionally, it’s not unusual that patients receive prescriptions from specialists in addition to their primary care physician, and supplement use is not always reported accurately. This leaves a lot of room for unwanted side effects, including brain fog.

Solution: Make sure to review your medications with your primary physician annually, and more often if necessary, particularly if you feel like you haven’t been yourself.

In sum, the good news about brain fog is that there are ways to help clear it up, boost your energy, and improve your productivity and memory. The key is keeping your brain well-fed, your body well-rested, and keeping your physician in the know about any changes in your mental acuity.

For individuals who would like to work directly with our providers, we offer comprehensive services that utilize the best alternative and conventional medicine solutions to keep your brain young, healthy, and vital. For more information, visit To make an appointment with one of our physicians please call 703-532-4892.


Carabotti M, Scirocco A, Maselli MA, Severi C. The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Annals of Gastroenterology. 2015;28(2):203-209.

Jedrychowski, Et al. Cognitive function of 6-year old children exposed to mold-contaminated homes in early postnatal period. Prospective birth cohort study in Poland. Physiology & Behavior. Volume 104, Issue 5, 24 October 2011.

Lichtwark , Et al. Cognitive impairment in coeliac disease improves on a gluten‐free diet and correlates with histological and serological indices of disease severity. Alimentary Pharmacology & Therapeutics. Volume 40, Issue 2, July 2014.

Yelland GW, Gluten-induced cognitive impairment (“brain fog”) in coeliac disease. Journal of Gastroenterology and Hepatology. 2017 Mar; 32 Suppl 1:90-93. doi: 10.1111/jgh.13706.

Zárate S, Stevnsner T, Gredilla R. Role of Estrogen and Other Sex Hormones in Brain Aging. Neuroprotection and DNA Repair. Frontiers in Aging Neuroscience. 2017;9:430. Published 2017 Dec 22. doi:10

Glutathione: Master Antioxidant, Detoxifier, and Immune Booster

In recent years, there has been increasing interest in glutathione (GSH) and the role it plays in the progression and treatment of a wide variety of illnesses and conditions.

Glutathione is the most abundant and arguably the most important antioxidant in the body. Several biological processes rely on it to perform optimally, but levels diminish as we age, opening the door to premature cell death, aging, and age-associated diseases and conditions.

Glutathione is critical for the detoxification process. Low glutathione compromises liver function, which works to flush the body of damaging free radicals. Free radicals, like reactive oxygen species (ROS) and reactive nitrogen species (RNS), are naturally occurring, toxic compounds that are formed when the body converts food to energy. They roam freely, targeting and altering different types of molecules in the body through an exchange of electrons. In ideal circumstances, free radicals are kept in check by antioxidants that prevent them from causing damage.

However, when the scales tip in their favor free radicals can cause significant damage to our cells and our DNA. The result is oxidative stress (OS) which is linked to numerous disease processes including cognitive decline (Alzheimer’s disease) and other age-related conditions like cancer, cardiovascular disease, and diabetes.

Studies confirm the link between low GSH and cognitive impairment:
Oxidative stress predicts cognitive decline with aging in healthy adults: an observational study
Glutathione relates to neuropsychological functioning in mild cognitive impairment

Closely tied to this is glutathione’s role in mitochondrial survival. Mitochondria are responsible for creating cellular energy and they are directly linked to the pathways of cellular death. Without adequate levels of glutathione cellular health and longevity are compromised.

Over time, toxins, poor diet, medications, infections, and stress all contribute to depleting levels of glutathione. Without enough of it in our cells we become “unbalanced” in terms of inflammation and anti-inflammation. When the body’s normal cycle of destruction and repair tips more towards destruction and moves away from repair we see disruptions in the proper functioning of the immune system, we see an increase in inflammation, and we see an increase in neuropsychiatric and neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, depression, ME/CFS, and fibromyalgia.

Optimizing Glutathione Levels

Vitamin and mineral IVs are a wonderful way to deliver and replenish vital nutrients to the body. By bypassing the digestive system, you get maximum absorption into the bloodstream and maximum bioavailability. Glutathione has shown it can cross the blood-brain barrier (BBB) and can, therefore, be an important tool in preventing and treating neurodegenerative conditions.

Some of the benefits of glutathione IV supplementation include:

  • Encourages cellular health
  • Lowers inflammation
  • Boosts immune system function
  • Helps maintain the body’s detoxification process
  • Improves cognitive function (clarity, focus, executive function)
  • Improves muscle repair and muscle development
  • Improves muscle endurance and energy

Bottom line: Increasing glutathione is one more way to slow down the aging process, encourage recovery, prevent disease, and maintain optimal health.


Ballatori N, Krance SM, Notenboom S, Shi S, Tieu K, Hammond CL. Glutathione dysregulation and the etiology and progression of human diseases. Biol Chem. 2009;390(3):191–214. doi:10.1515/BC.2009.033

Mol Neurobiol. 2014 Dec;50(3):1059-84. doi: 10.1007/s12035-014-8705-x.

Forman HJ1, Zhang H, Rinna A. Glutathione: overview of its protective roles, measurement, and biosynthesis. Mol Aspects Med. 2009 Feb-Apr;30(1-2):1-12. doi: 10.1016/j.mam.2008.08.006.

Ribas V, García-Ruiz C, Fernández-Checa JC. Glutathione and mitochondria. Front Pharmacol. 2014;5:151. Published 2014 Jul 1. doi:10.3389/fphar.2014.00151

Mytilineou C1, Kramer BC, Yabut JA. Glutathione depletion and oxidative stress. Parkinsonism Relat Disord. 2002 Sep;8(6):385-7.

Aoyama K1, Nakaki T. Impaired glutathione synthesis in neurodegeneration. Int J Mol Sci. 2013 Oct 18;14(10):21021-44. doi: 10.3390/ijms141021021.

Hirrlinger J1, Gutterer JM, Kussmaul L, Hamprecht B, Dringen R. Microglial cells in culture express a prominent glutathione system for the defense against reactive oxygen species. Dev Neurosci. 2000 Sep-Dec;22(5-6):384-92.

Kannan R, Kuhlenkamp JF, Jeandidier E, Trinh H, Ookhtens M, Kaplowitz N. Evidence for carrier-mediated transport of glutathione across the blood-brain barrier in the rat. J Clin Invest. 1990;85(6):2009–2013. doi:10.1172/JCI114666

Purslane: A Super "Weed" Worth Trying

If you haven’t heard of purslane it’s not very surprising. What is surprising is that despite it being so darn good for you most mainstream grocers fail to keep it on the shelf.

It is estimated that human cultivation of the plant goes back 4000 years. It has long been used as a medicinal herb in Chinese medicine and is still a commonly used vegetable in Asia, Europe, Africa, and the Middle East. It grows abundantly across the globe and can be found in crop fields, gardens, orchards, and vineyards.

Here, purslane is often mistaken as a nuisance weed, but in truth, it is a nutritional powerhouse on par with many of the vegetables we find at the grocery store. Its vast nutritional benefits include:

  • Omega 3 fatty acids – We know that Omega 3 fatty acids offer protection against neurodegenerative diseases, cancers, cardiovascular disease, and other chronic illnesses. When tested, purslane was found to contain as much as 400 grams of alpha-linolenic acid, or ALA, a type of omega 3 fatty acid per serving (100 grams), making it one of the richest vegetable sources of ALA that you can find. Purslane is a great source of Omega 3s for vegans and vegetarians.
  • Glutathione – Glutathione is the most abundant of the endogenous anti-oxidants in the Central Nervous System, and perhaps the most important. Our bodies need glutathione to keep our bodies in balance. What does this mean? Without enough glutathione in our bodies, we become “unbalanced” in terms of inflammation and anti-inflammation, and in terms of destruction and repair. The depletion of this important antioxidant plays a role in the onset and progression of neurodegenerative and neuropsychiatric diseases. Unfortunately, glutathione levels naturally deplete as one ages, so maintaining adequate levels is important. Purslane contains approximately 8 mg of glutathione per 100 grams, that’s more than spinach, broccoli, carrots, and many other more common store-bought vegetables.
  • Vitamins & minerals – Purslane contains the highest vitamin A content among the green leafy vegetables, which fulfills 44% of the daily needs. Research has shown that eating higher amounts of foods that contain vitamin A may help with vision and protect from certain types of cancer.[i] It’s also rich in vitamin C with 21mg/100g and other B-complex vitamins. Purslane also boasts high mineral content, with potassium (494mg/100g), magnesium (68/100g), calcium (65mg/100g), phosphorus (44mg/100g) and iron (1.99mg/100g) all well represented.[ii]

Note: Like parsley, spinach and other leafy greens, purslane contains oxalic acid, a naturally occurring acid found in vegetables. Oxalic acid binds with calcium, reducing its absorption and also forms compounds called calcium oxalate and iron oxalate. These compounds can be naturally eliminated by the body by most people; however, for some, they can produce kidney stones and possibly other health issues. Therefore people who are prone to kidney stones should limit the consumption of foods that contain oxalic acid, particularly in its raw form. Cooking or steaming vegetables with oxalic acid can reduce the amount present.

In order to prevent oxalate from binding to calcium is to eat foods known to contain oxalic acid 2 hours apart from dietary calcium sources. Doing this will allow enough time for the body to absorb it.

How to use it

Grab a stem, take a bite and enjoy the tangy crunch! Fresh purslane’s texture and flavor make it a great addition to any salad. It also holds up well when sautéed and can be used in soups and stews. Or, try substituting purslane in your favorite pesto recipe! Many recipes call for removing the leaves from the stems, but there is no harm in keeping them in.

Farmers’ markets or farm stands are your best bet in finding purslane. It can also be found at some Whole Foods Markets.

[i] Vitamin A Fact Sheet for Health Professionals, National Institutes of Health, Office of Dietary Supplements
[ii]National Nutrient Database for Standard Reference Legacy Release, United States Department of Agriculture Agricultural Research Service

Q&A: Maximizing Calcium Intake From Leafy Greens

“I love green, leafy vegetables, but need calcium. How long should I wait between eating foods with calcium and green, leafy vegetables to prevent oxalate binding of the calcium. I usually eat spinach and kale with some kind of fat, like eggs, salad dressing or other oils. Thank you!”
Adequate calcium intake is important for maintaining healthy bones. Dietary calcium can be found in a number of dairy foods, sardines, certain legumes, even oranges! But when you eat calcium-rich foods along with foods that contain oxalate, a type of antinutrient found in certain vegetables, legumes and grains, calcium bioavailability and absorption is compromised. Examples of foods high in oxalates (also called oxalic acid) are spinach, parsley, beet greens, kale, chard, peas, fava beans, navy beans, rice bran, soy flour, and wheat berries. Other common antinutrients found in greens, legumes and grains are: phytate, tannin, saponins, lectins and isoflavaones.
In order to prevent oxalate from binding to calcium is to eat foods known to contain oxalic acid 2 hours apart from dietary calcium sources. Doing this will allow enough time for the body to absorb it.
Research show that soaking green, leafy vegetables in water for at least 30 minutes, or boiling them, can significantly reduce their antinutrient content. Other methods include sprouting, and fermenting.
by Nour Amri, MS, CNS, LDN

Meal Kits: A Tool Towards Healthier Eating?

Many of our patients struggle when it comes to starting a new diet. In fact, the word diet alone can provoke feelings of anxiety, self-doubt, and even depression about one’s current state of health, hindering efforts to make real lifestyle changes. While most of us know what we should and shouldn’t be eating, impulsive decisions can cause major mental setbacks.
Meal kit services, like Hello Fresh and Blue Apron, debuted in the United States in 2012 and have steadily gained popularity. With over 150 companies delivering all the components of a home cooked meal tucked inside a box it is estimated that nearly one third of Americans have now tried one! While the most obvious reason for signing up may be convenience, from our perspective meal kits can be a wonderful way to kick-start and maintain a healthy eating routine.
If you’ve ever considered giving one a try but remain undecided, here are some pros and cons to help determine if it’s a good fit for you:

  1. Convenience. Let’s face it, meal planning night after night can be exhausting! Despite our best intentions, more people are dining out just to avoid the drudgery of grocery shopping. Meal kit services offer meal plans that send you up to 3 or 4 meals per week with no planning necessary whether you’re cooking for yourself or for a family. While many of the services are subscription based, there are some that are not, a perfect option for a trial run.
  2. Variation. “Eat this, not that! Make it colorful! Be creative!” This is all wonderful advice, but hard to adhere to day after day. A meal kit service can do a better job of introducing a variety of fresh and nutritious foods to your plate that you may otherwise never try.
  3. Portion control. It’s no secret that portion sizes in the United States are far larger than those in other countries, so it’s no wonder that our waist sizes are too. Meal kits come pre-portioned and ready to assemble and cook leaving no room for overindulgence. Over time, our bodies adjust to smaller, healthier meal sizes.
  4. Options galore! Fortunately, with so many online services available, it won’t take long to find one that caters to your food preferences. Whether you have no food restrictions or are following a vegan, vegetarian, gluten-free, or paleo diet, there is a service (and app!) for that. Some of the more well-known meal kit services include: Blue Apron, Hello Fresh, Sun Basket, Plated, and Green Chef.


  1. Cost. While some of services claim affordability, some can get downright expensive, especially if they offer irresistible add-ons and require minimum order amounts.
  2. Customization. While you are able to choose the type of meal plan you are on, many companies are designed to not allow substitutions. That means, you get what you get and you don’t get upset! However, with a little researching you’ll find that there are a few that do allow small changes for those who need to maintain a little more control over their selections.
  3. Not environmentally friendly. With some notable exceptions, most services have each of their ingredients wrapped individually in plastic or cardboard so make sure to have a plan for reusing or recycling those contents whenever possible.

At a time when we know so much about nutrition and how it can either facilitate illness or improve overall wellness, a meal kit service can be one more tool in the arsenal when it comes to better managing our health.
*The Kaplan Center for Integrative Medicine does not endorse any one service mentioned above. We encourage due diligence by our readers before making any purchase and, if necessary, a discussion with your physician or nutritionist about the options that may work best for you!

ketogenic diet foods

A High Fat Diet for Health? Understanding The Ketogenic Diet

The ketogenic (“keto”) diet is a high fat, moderate protein, and low to very low carb diet. Its composition challenges what the nutrition industry has promoted as healthy eating over the last century, but despite this, it has become one of the most popular diets of the moment. But the Ketogenic diet should not be considered just a fad diet – it has been prescribed by physicians and nutritionists for nearly a century. So, why the popularity now? One could say in part that it’s a social phenomenon; thanks to a few celebrity endorsements and tweets, social media has thrust this diet in the spotlight. But more importantly, recent revelations about how Big Sugar has influenced our models of proper nutrition, along with the steady increase in chronic illness rates in the United States, have prompted us to rethink the hierarchy of the foods we choose to put on our plates.

Sugar consumption in the U.S.

The World Health Organization (WHO) and the American Heart Association (AHA) recommend that adults should ideally consume 25 grams of sugar/day, and no more than 50 grams to avoid sugar toxicity. This translates to approximately 5-10% of daily caloric intake. But CDC statistics show that on average men and women in the United States consume approximately 13% of their daily calories from added sugars, and unfortunately that percentage increases to 16% for children.

Soft drinks are the leading source of added sugar in the American diet and can deliver a whopping 30+ grams in just one 12 ounce can. Pastries like cakes, cookies, and donuts have become “staples” in the American diet and sit at top of that list as well, but much of the sugars we consume are hidden away in the carbs we love to eat, like breads (even the “healthy” ones), granola bars, flavored yogurts, condiments, and dressings.

Carbs vs fat

When you eat a meal high in carbohydrates, the body burns glucose, a form of sugar, as the main source of energy for both muscle and brain activity. It is the simplest molecule to convert and is immediately available and metabolized when needed. Excess glucose gets stored in the liver and muscles as glycogen. But the human body was not designed to process large amounts of sugar so when those stores are filled, excess glycogen then gets stored as unhealthy fat around the body’s tissues and organs.

But unwanted body fat is not the only consequence of a high carb diet. There is an increasing body of evidence that confirms excessive sugar consumption is tantamount to poison and is directly related to the increasing prevalence of metabolic disorders like diabetes, obesity, and cardiovascular disease.

When your body burns glucose for energy it creates toxic byproducts called reactive oxygen species (ROS). ROS are harmful free radicals that can damage brain cells and DNA when they overwhelm antioxidant levels in the body. The result is oxidative stress (OS). OS is a major contributing factor to widespread inflammation present in metabolic disorders as well as cancer, arthritis, chronic pain, and cognitive decline.

In comparison, minimizing carbohydrate intake forces the body to rely on dietary and stored fat, not glucose, as a primary fuel source, and this is the basic premise of the ketogenic diet. By severely restricting the daily intake of carbohydrates to approximately 20-50 grams, glucose levels are kept in short supply and the body is forced to find an alternative energy source. The ketogenic diet essentially puts the body into “starvation mode” and forces the body into a state of ketosis. In this state, fat molecules are broken down by the liver and are converted into what are called ketone bodies, made up of acetone, acetoacetate (AcAc), and betahydroxybutyrate (BHB). Ketone bodies travel through the bloodstream and are utilized by all the healthy cells in the body and brain.

How the ketogenic diet benefits the brain

The ketogenic diet was originally developed in the 1920s as a treatment to help control epileptic seizures in children and is still used as such by some physicians. Since then, and particularly over the last 20 years scientists have looked into the diet as a possible intervention for other neurological conditions. Studies show that the ketone bodies created during ketosis have neuroprotective benefits, which include:

  • Ketone bodies burn more efficiently than glucose and have the ability to deliver more energy to brain cells per unit of oxygen consumed compared to glucose. As the brain uses more energy than any other organ in our body, this is particularly important, especially for the aging brain.
  • Ketone bodies lower the production of free radicals which in turn will help keep inflammation levels down in the body.
  • Ketone bodies help keep the ratio of GABA/Glutamate in balance. Glutamate is a neurotransmitter that helps with brain function. When glutamate levels are elevated it can cause cell damage. GABA (gamma-aminobutyric acid) is responsible for “quieting down” heightened neuronal activity.

What about fasting?

Food availability, prolonged exposure to screens, and artificial light are a few of the modern-day amenities that have contributed to the disruption of our internal clocks resulting in extended awake time and feeding times. In the body, this can translate to an imbalance in hormone secretion, cellular repair, and digestion. Insulin is the perfect illustration; every time we eat we produce the hormone insulin to control the glucose surge from the foods we consume, and the more we eat, the more insulin is pumped into the bloodstream leading to an avalanche of chemical reactions that contribute to insulin resistance and other metabolic diseases we are seeing today.

A recommendation many ketogenic diet proponents give their patients is intermittent fasting (IF). Alternating normal daily caloric intake with a period of fasting promotes health by:

  • Stabilizing insulin secretion – When we abstain from food for several hours, insulin levels go back to normal;
  • Promoting autophagy – Autophagy is an important cell recycling process that helps clean our body of damaged or dysfunctional protein components and mitochondrial waste. This process is crucial for the regeneration of cells – including brain cells;
  • Fasting also drains the liver of its glycogen stores for use as energy. Remember, glycogen is the stored form of glucose. This means accessing the glycogen that the body has been accumulating. Once you use all the stored glycogen, the body is already in fat-burning mode; and,
  • Promoting ketosis – Fasting and the ketogenic diet work hand in hand in activating in the ketosis process. When you fast, your body will use whatever is available as a source of fuel, and because you’re already restricting carbohydrate intake, the body instantly shifts to using ketones.

Conditions that benefit from a ketogenic diet

Patients who have tried the ketogenic diet have reported improvements in overall health including weight loss, increased energy levels, heightened mental clarity, and success in stabilizing insulin levels. Clinicians have also seen great results with modified keto diets as an adjunct treatment for the following conditions:

  1. Most inflammatory conditions: By adopting a high-fat ketogenic diet and limiting carbohydrate intake, you will reduce the overload of reactive oxygen species produced while burning glucose which exacerbates inflammation.
  1. Insulin Resistance: Inflammation resulting from sugar toxicity is most of the time accompanied by insulin resistance. Insulin resistance is among the leading causes of type 2 diabetes and cognitive decline and is a serious problem in the U.S. and around the world. By adopting a ketogenic approach, the body relies on ketones for energy production, which improves glycemic control and has shown to reduce the dependency on diabetes medications and may even completely reverse it. 
  1. Weight Loss: Several research studies are proving the benefits of a high-fat ketogenic diet for weight loss, especially for obese people, as it accesses the body fat for energy production.
  1. Lowering the risk of cancer: All body cells can use both glucose and ketones for energy production and optimal functioning, except cancer cells. They only rely on glucose for survival and do not have the flexibility to adapt to ketones, which cause them to starve and die when the person adopts a ketogenic diet. 
  1. Preventing and Reversing Cognitive Decline: Adopting one specific variation of the ketogenic diet known as “RECODE” protocol or “Ketoflex 12/3”, developed by Dr. Dale Bredesen, an internationally recognized expert in the study of neurodegenerative diseases such as Alzheimer’s disease, together with close monitoring and lifestyle changes, the body can restore proper brain growth and reduce neuroinflammation, increases insulin sensitivity, and excretes toxins. These benefits will improve mild cognitive decline and early Alzheimer’s.

The ratio of carbohydrates to fats change depending on the condition you are adopting the ketogenic diet for.  In most cases, carbohydrate intake varies between 5% and 10% of total caloric intake, and fats represent 70%-80%. However, protein intake should be in a moderate amount as excessive protein intake promotes gluconeogenesis, converting protein to glucose for energy. Ideal protein intake on a ketogenic diet is approximately 0.8 – 1 gram per kilogram of body weight, representing 20%-25% of total caloric intake.

It may not be for everyone…

Starting a new diet plan can be difficult under any circumstances, and particularly when drastic changes are made. Although researchers and clinicians have demonstrated that a ketogenic diet can benefit multiple health conditions and can have a positive influence on overall health, we don’t advise undertaking a ketogenic diet without the guidance of a Dietitian Nutritionist or physician. Under proper supervision, the initial transition can be closely monitored in order to catch any changes or symptoms that may arise.

A ketogenic diet may not be a good choice under the following conditions:

  • Pregnant women
  • Breastfeeding women
  • Naturally thin physique
  • Pancreatic Insufficiency (needs monitoring)
  • Gallbladder removed (needs monitoring)
  • History of kidney stones
  • Have an eating disorder, especially Anorexia
  • Children and adolescents still growing

What to eat and avoid on a ketogenic diet

There are plenty of food options for someone on a ketogenic diet. Here are some “yes” and “no” foods to keep in mind. This is not a complete list so talk to your physician for more detailed information on foods that should be included or should be avoided before you start!

YES: fish and Seafood (fatty fish like salmon, mackerel, sardines – wild-caught is best), meat (grass-fed is best), poultry (grass-fed is best), all non-starchy vegetables, “good for you” oils (olive oil, coconut oil), some dairy (cottage cheese, unsweetened yogurt, butter), eggs, nuts in moderation, coffee & tea (unsweetened of course!).

NO: All grains, all types of sweeteners (agave, maple syrup, sugar, honey, etc…), candies/pastries, pasta, alcoholic beverages, sodas, fruits, starchy vegetables (like potatoes or corn), and most legumes.

In sum, excessive sugar consumption and sedentary lifestyles have had an enormous influence on the health decline in the United States. The ketogenic diet, which focuses on unprocessed foods that naturally lower inflammation, combined with lifestyle modifications and monitoring, can reverse and improve a number of inflammatory illnesses like diabetes, obesity, cardiovascular problems, cancer, arthritis, chronic pain, and depression.

If you would like to meet with a Kaplan Center physician or dietitian to learn more about the ketogenic diet – or to find the ideal diet for your optimal health – please call 703-532-4892 for an appointment or use this contact form to send us a message.

Research Confirms Benefits of Curcumin on Memory & Mood 

The daily consumption of curcumin, the active compound in turmeric, can have significant benefits on memory and mood, according to a study published in the American Journal of Geriatric Psychiatry.
According to the National Institutes of Health (NIH), one in five Americans over the age of 65 will be diagnosed with a neurodegenerative disease by 2030. The progression of neurodegeneration has been associated with the imbalance between the level of antioxidants and the increased oxidative damage by free radicals to proteins, DNA and lipids.
Curcumin is a chemical compound found in plants, with anti-bacterial, anti-inflammatory, anti-proliferative, and antioxidant properties. Research has seen an astounding success proving the benefits of curcumin as an antioxidant and anti-inflammatory, with over 7000 articles published in the last two decades. Curcumin helps prevent free radical damage and calms the inflammatory process at the root of many chronic diseases. Studies have shown it to be effective against many gastrointestinal diseases and metabolic diseases such as diabetes and obesity, certain cancers, cardiovascular disease, and neurodegenerative diseases such as Alzheimer’s. In fact, curcumin has long been suspected to be the reason behind the low rates of Alzheimer’s disease in India, where turmeric spice is widely and frequently used in curry meal preparation.
However, curcumin is unique in that it is not easily absorbed by the body on its own. In order to increase its bioavailability, it must be paired with other compounds, one such example is piperine, a compound found in black pepper.
But for those who don’t have a taste for this beautiful golden spice, supplementation can be key. Research on the supplement Theracurmin®* a bioavailable (more easily absorbed by the body) form of curcumin, has shown it contains significantly higher plasma concentration of curcumin than other leading brands of supplements. Clinical studies have also shown it to have benefits in osteoarthritis, muscle fatigue after exercise, and clearing alcohol metabolites. There are on-going clinical trials investigating the effects of Theracurmin® on other inflammatory diseases.
The study on curcumin, led by Dr. Gary Small, director of geriatric psychiatry at UCLA’s Longevity Center, was conducted over an 18 month period and included 40 adults that ranged in age from 51 to 84. Twenty-one randomly selected participants were given twice daily doses of Theracurmin®, and the remaining 19 participants were given a placebo. Cognitive assessments were taken every 6 months and curcumin levels were measured at both the start and end of the study. In addition, 30 participants (15 placebo & 15 curcumin) underwent PET scans to measure levels of the proteins amyloid and tau in their brains both at the start of the study and after 18 months. These two proteins are targeted because of their association with neurodegenerative disorders; when accumulated in the brain, they are thought to contribute to the breakdown of neurons which can potentially lead to symptoms of Alzheimer’s disease.
At the end of the study, researchers concluded that the daily intake of Theracurmin® resulted in “improved memory performance and attention in non-demented adults.” Based on the PET findings, the study further concluded that “behavioral and cognitive benefits are associated with decreases in plaque and tangle accumulation in brain regions modulating mood and memory.”
While this study was quite small, the results are indeed promising and warrant continued research. Supplementation with a bioavailable form of curcumin, like Theracurmin®, shows tremendous potential as a preventative measure against age-related cognitive decline. Furthermore, the effect curcumin has on decreasing existing amyloid plaque and tau accumulation in the brain shows that it may play a significant role in delaying the onset of other neurodegenerative diseases such as Alzheimer’s dementia.
As research continues to reveal turmeric’s bounty of health benefits, including its ability to limit and possibly reverse the damage of inflammation in the brain, it is becoming more and more evident why it is widely referred to as a miracle spice!
Before taking any supplement consult with your physician to discuss any potential side effects.
*Patients of the Kaplan Center can purchase Theracurmin® HP from the Kaplan Medical Center Store.

For more on the benefits of Turmeric:

When Going Gluten-free Makes Sense

Gluten is a general name for the family of proteins found in the grains wheat, barley, and rye. Glutenin and gliadin, the 2 main proteins in gluten, are responsible for giving dough its characteristic elasticity and glue-like structure before the baking process and its wonderful texture and rise when baked.

Most people can eat gluten without any problem. However, for some, even the smallest amount of gluten can trigger a wide array of inflammatory reactions in the body when consumed, with symptoms sometimes lasting for months. Sensitivity to gluten presents across a spectrum, sometimes being the primary factor that is making a patient ill, but more often it exacerbates an existing pain condition.

Gluten is directly correlated with 3 major gastrointestinal disorders: autoimmune celiac disease (CD), non-celiac gluten sensitivity (NCGS) and wheat allergy.

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Celiac disease is characterized by the damage and atrophy of the villi of the intestinal cell lining. The villi are finger-like extensions that extend from the wall of the small intestine into the lumen. The primary role of these villi is to absorb nutrients from the foods we consume. This damage leads to an increase in the space between cells, allowing food particles to enter the bloodstream (also referred to as intestinal permeability or “leaky gut”), and triggers an inflammatory immune response.  Celiac disease can directly cause atopic problems, nutritional deficiencies, and anemias. Research also confirms that individuals with CD have a higher risk of developing other autoimmune disorders, such as Type 1 Diabetes, Sjögren’s Syndrome, Rheumatoid Arthritis, and Hashimoto’s thyroiditis.

Celiac disease is also genetically linked, thus, anyone with a relative who has CD is at higher risk to develop CD themselves. You can be tested for celiac disease just as you can be tested for food allergies and food sensitivities. Usually, after following a gluten-free diet for just one month the health of patients with celiac disease improves dramatically.

People with non-celiac gluten sensitivity share many of the symptoms common to celiac disease but do not test positive for CD. Once gluten is eliminated from one’s diet, patients with NCGS will quickly see an improvement of symptoms.

The most common symptoms of celiac disease and gluten sensitivity are listed below. Individuals with these conditions can experience a combination of any number of symptoms and some people with CD report having no symptoms at all.


  • Chronic diarrhea and/ or constipation
  • Chronic indigestion
  • Dehydration
  • Irritable Bowel Syndrome
  • Flatulence
  • Sores or ulcers inside the mouth
  • Poor appetite and lactose intolerance
  • Recurring abdominal bloating, cramping, distention or pain and vomiting


  • Anxiety and Depression
  • Extremely itchy skin rash called dermatitis herpetiformis (DH)
  • Fatigue
  • Fluid retention
  • Hair loss
  • Joint pain, muscle weakness or cramping
  • Migraine headaches
  • Peripheral Neuropathy (tingling and numbness in hands and feet)
  • Vitamin deficiencies, especially Vitamin D
  • Weight loss
  • Cognitive impairment

The following foods usually or often contain gluten:

  • Breading, coating, Panko (Japanese bread crumbs) (wheat)
  • Cakes, pastries, cookies, pies, etc. (wheat)
  • Broth, soup bases (barley)
  • Brown rice syrup (barley)
  • Candy, for example, licorice (wheat) and some chocolates (barley)
  • Croutons (wheat)
  • Breakfast cereals (wheat, barley)
  • Imitation bacon (wheat)
  • Imitation seafood (wheat)
  • Processed lunchmeat, sausages, frankfurters (wheat)
  • Marinades (wheat, barley)
  • Pastas (wheat)
  • Sauces, gravies (wheat)
  • Self-basting poultry (wheat)
  • Soy sauce or soy sauce solids (wheat, barley)
  • Stuffing, dressing (wheat)
  • Thickeners (roux) (wheat)
  • Communion wafers (wheat)
  • Herbal supplements (wheat)
  • Drugs and over-the-counter medications (wheat)
  • Nutritional supplements, Vitamins, and mineral supplements (wheat)
  • Play-Doh (wheat)
  • Beer, ale, porter, stout, malt liquor (wheat)

Do oats contain gluten? Strictly speaking, no; but oats have been found to be at risk of contamination with gluten during its production process. Gluten-free oats are available and should be labeled as such. Many people with CD can eat a small amount of gluten-free oats without a problem. A percentage of people with CD react the same way to the protein in oats as they do to gluten.

Every celiac or NCGS patient differ in their sensitivity level to gluten. In 2014, the FDA required that food manufacturers who wished to use a “gluten-free” label on their products had to limit its gluten content to 20 parts per million or less. The FDA chose this standard based on evidence that suggests that most individuals with celiac disease can tolerate “variable trace amounts and concentrations of gluten in foods (including levels that are less than 20 ppm gluten) without causing adverse health effects.”

What can you eat on a gluten-free diet? Plenty! In the last 5 years, we have seen tremendous growth in gluten-free products available in grocery stores and a growing number of gluten-free cookbooks.  But going gluten-free can be tricky; federal law requires wheat and the other top 7 food allergens to be clearly identified on food labels, but there are no regulations regarding barley, rye, and oats. For example, if you see a label that lists malt extract, malt vinegar, malt flavoring, or brewer’s yeast, that product will contain some barley. Learning what to look for on a food label is essential!

Fruits, vegetables, meat and poultry, fish and seafood, dairy, beans, legumes, and nuts are all part of a healthy, gluten-free diet. The following grains do NOT contain gluten: rice, corn (maize), millet, quinoa, sorghum, buckwheat, amaranth, teff, flax, chia, and nut flours.

Important to note is that implementing a gluten-free diet without a celiac diagnosis or without any symptoms of sensitivity does not come without some risk. A review published in Clinical Nutrition in 2016 found people who follow a gluten-free diet are at higher risk of developing nutritional deficiencies. The reason? Many processed gluten-free foods on the market are lower in vitamins and minerals, such as Vitamin B12, Vitamin D, folate, magnesium, iron, and calcium, than their non-gluten-free counterparts.

In sum, a gluten-free diet is necessary for all patients with celiac disease and highly recommended for patients with a commonly associated autoimmune disorder (Sjögren’s disease, Hashimoto’s thyroiditis). Our experience at the Kaplan Center has also shown that patients with non-celiac, inflammatory conditions, such as arthritis, chronic muscle pain, chronic fatigue, and fibromyalgia, also see great improvements in their health when implementing a gluten-free diet.

Learning how to dissect food labels and understanding what ingredients indicate the presence of gluten is the key to staying gluten-free! By eliminating your exposure, a GFD can provide a clean slate to curb the cycle of inflammation.

tonic herbs

I’ll Drink to That! The Benefits of Tonic Herbs

When consumed daily, tonic herbs can balance and tone most body systems. They often strengthen immunity, reduce inflammation and restore overall wellness. While used for centuries in Eastern and Western herbalism traditions, recent research has elucidated that many of their active chemical constituents reduce inflammation, oxidative stress and promote health(1,2,3).

Some of these tonic herbs are also called adaptogens, meaning they help the body adapt to stress, reducing cortisol levels and restoring vitality (5). Some common tonic herbs are commonly used in our cooking- sweet basil, sage, coriander, parsley, oregano, rosemary, mint, thyme, marjoram, dill, cinnamon, cardamom, cumin, licorice, ginger, etc. Others like holy basil (tulsi), dandelion root, red clover, skullcap, rhodiola, marshmallow root, burdock root, and alfala are thought to be restorative tonics. Many of these herbs may support the liver’s detoxifixation pathways, likely due to their nutritive qualities and bioactive compounds.

An excellent way to reduce inflammation, increase nutrition and promote overall health is to drink a variety of tonic herbs as infusions on a regular basis. Below is a chart of different forms of herbs and their optimal ratios for steeping. There are some exceptions to this chart, so you can always look up the individual herb’s recommendations (Rosemary Gladstar’s books are a great resource). With longer infusions (4+ hrs), you can get more vitamins, minerals, phytochemicals and other active plant chemicals from these herbs. For herbal teas, a minimum of 10 minutes is recommended to allow the medicinal properties to infuse in water. Depending on the herb, longer times may be recommended to maximize nutrition and active constituents. For example, some barks require a 30 min low boil, or decoction, while other leafy herbs like oatstraw and nettles are most nutritious when steeped overnight (6-12 hrs). Use the chart below as a general guide.



  • 4-6 tbsp dried herbs
  • 1 quart filtered water


  1. Add dried herbs into a glass quart jar.
  2. Pour boiling, or near boiling, water over the herbs and let it steep 30-45 min. Most herbs require at least 10 min for enough of the medicinal properties to infuse in the water. (Depending on the tea, different steeping times are recommended)
  3. Strain and drink right away or refrigerate. Keeps for 1-2 days

• Good herbs for infusions: nettles, rosehip, oatstraw, red clover, reishi, mint, fennel, turmeric etc

Caution: Please consult a medical practitioner before you begin consuming herbs, especially if you are taking any medications. Many herbs can interact with drugs or other herbs.
– Vanessa Berenstein, M.A., R.D.