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Are You Dying For A Good Night’s Sleep?

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It is estimated that over 70 million people suffer from a chronic sleep disorder in the United States, impacting not only the individual struggling to get a good night’s sleep but potentially all of us. It is conservatively estimated that more than 91,000 car accidents resulting in 800 deaths and 51,000 injuries each year are the result of driver fatigue.

And here’s another thought that might keep you up at night

One of the most common medical responses to helping you sleep may actually be putting your health at risk. About 4% of U.S. adults use a prescription sleeping aid in any given month. Yet taking as few as 18 sleeping pills a year increases your risk of dying 3.6 fold compared to people not using them. Those who take a prescription sleeping medication more than 132 nights a year have a 6.6-fold increase of death and a 35% increased risk of developing cancer.

A better response?

Individualized treatment to discern the underlying cause of sleep loss.

Sleep deprivation is the most common sleep disorder.

Newborns need as much as 18 hours a day, while teenagers — the most notoriously sleep-deprived group — require nine to 10 hours. Adults should have between seven and eight hours a night of restful sleep, yet a 2013 Gallup poll found that as many as 40% of Americans get only six hours or less of sleep a night.

Sleep deprivation can exhibit as insomnia, taking longer than 20 minutes to fall asleep, multiple awakenings during the night with difficulty returning to sleep, early wakening, and shortened sleep due to demands of work or school. Whatever the cause, its long-term consequences on your health and well-being are the same.

In the short term, your mental performance and reaction time when chronically sleep-deprived are the equivalent of being drunk. And like the inebriated, the chronically sleep-deprived do not recognize the extent of their impairment. Lack of sleep compromises the normal functioning of your immune system, and long-term sleep deprivation causes your body and brain to be in a chronic state of inflammation, potentially leading to an increase in heart disease, stroke, obesity, chronic pain, ADD, depression, and anxiety. The problem is also bidirectional; conditions such as chronic pain, depression, and heart disease can cause sleep disturbance, which then worsens the underlying condition.

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So how sleepy are you?

If you think you may be suffering from sleep apnea or another type of sleep disorder, don’t put off seeking help. Being this tired is a potential danger to your own health as well as the health of others. One way to quickly assess your level of daytime sleepiness is the Epworth Sleepiness Scale. It takes about a minute to complete the test and should be part of any medical exam when someone is complaining of fatigue. A score of 10 or higher is suggestive of a significant sleep issue.  At the Kaplan Center, we also utilize WatchPAT ONE, a recyclable Home Sleep Apnea Test (HSAT) to help us detect sleep apnea as well as providing markers for quality of sleep.

Here are some steps you can take right now to improve the length and quality of your sleep:

  1. Go to your room! Try to tuck in and rise around the same time each day.
  2. Move it! Regular exercise improves sleep and regular sleep improves exercise performance. The regular practice of yoga, especially in older adults, has been shown to improve the duration and quality of sleep.
  3. Cut caffeine. If you have a sleep problem, minimize or eliminate your caffeine consumption. Caffeine in all forms — tea, chocolate, energy drink or pill — disrupts sleep.
  4. Eat more fish. Eating fatty fish, salmon, and tuna appears to not only lower your risk of heart disease but also betters your sleep.
  5. Eat at regular intervals. When and how much we eat, as well as the types of foods we eat, impact our internal clock, called our circadian rhythm. While we are just beginning to understand the relationship between food and internal clocks, it is clear that the two are related and the consequences of eating at irregular intervals are obesity and increased risk for disease, in addition to disruption of your sleep.
  6. Cooldown to sleep sound. People may have trouble falling asleep because they have trouble cooling down their core temperature, which reaches its maximum typically around 3 pm. A warm room will exacerbate the problem. Temperatures above 75 degrees and below 54 degrees Fahrenheit can disrupt sleep. So what is ideal for sleep? The consensus is that a room temperature between 65 and 68 degrees is probably ideal; this will vary among individuals.
  7. Go dark. Light is a major factor that regulates our sleep-wake cycle. Light exposure at night not only disrupts our sleep but also increases our risk for obesity, high blood pressure, and possibly breast cancer in women.
  8. Keep it quiet. Any amount of noise starting at 30 to 40 decibels, a level between a whisper and a quiet conversation, begins to impact sleep quality. That said, people generally find the sounds of their usual environment relaxing. Sound can also be used to help with sleep. One study looking at patients suffering from a generalized pain syndrome called fibromyalgia found that music embedded with a specific sound frequency called Delta wave that pulsated between .25 to 4 Hertz improved the quality of patients’ sleep and decreased their pain symptoms.
  9. Meditate. Numerous studies demonstrate that the regular practice of meditation can improve the quality of sleep, as well as help in the treatment of anxiety disorders, depression, and chronic pain.
  10. Sample supplements. Some supplements that might help in getting a good night’s sleep include 5-HTP and melatonin. The FDA does not regulate supplements, so be careful that the supplement you purchase actually contains the substance and the amount of the substance stated on the label. Also, supplements are drugs and can have side effects and interactions with other medications. If you are taking medications on a regular basis, please check with your physician before taking any supplements.

For more information on identifying & treating sleep disorders click here.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Note: This post was originally published in August 2014 and has been reviewed and updated for accuracy. 

Minimizing Exposure to Pesticides on Produce

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Several of our favorite fruits and vegetables made an unwanted appearance on Environmental Working Group’s (EWG) Dirty Dozen™ list yet again this year. Strawberries, spinach, apples, kale, and nectarines top the list, but you’ll find many more summertime favorites and lunchbox staples on it as well. If you’ve been trying to eat a rainbow of colors to improve your nutrition these fruits and veggies should be a welcome addition but finding them on EWG’s Dirty Dozen™ may have some of you saying, “no thanks”.

EWG’s Dirty Dozen™ is a shopper’s guide that ranks pesticide contamination of some of the most popular fruits and vegetables sold in the United States. According to EWG’s website, “the guide is based on test results by the Department of Agriculture and the Food and Drug Administration of around 45,000 samples of produce.” Their analysis finds that approximately 70% of non-organic produce carry pesticide residue even after they have been prepared to eat (i.e., peeling, scrubbing, rinsing).

Much like a produce PSA, the intent behind EWG’s list is simple: to provide you, the consumer, an educational tool that empowers you to make the most informed decisions for your health. EWG recommends that consumers choose to buy the organic versions of the Dirty Dozen™ whenever possible to the conventionally grown counterparts with the goal of lowering exposure to pesticides – and we agree.

Pesticides are toxins that over time can accumulate and have a poisonous effect on our physical and mental health. As toxins penetrate the blood-brain barrier they are free to circulate throughout the body, including the brain and other organs. Health risks from an accumulation of toxins are wide-ranging but can lead to very serious health issues, including brain fog, cognitive decline, cardiovascular disease, hormone disruption, and some forms of cancer.

We understand that for a variety of reasons, especially now as food prices are rising, buying organic is not always possible, but there are ways to limit your exposure. When weighing options, a diet of plentiful fruits and vegetables outweigh the risk of pesticide exposure.

Tips to limit pesticide exposure in produce:

  1. Buy organic products that do not use harmful pesticides whenever possible. Local farmers’ markets and CSAs (Community Supported Agriculture) are also a great source of organic produce. To lower the cost of a CSA consider splitting the membership with a friend. When fresh produce is not necessary (i.e., for cooking) frozen organic produce is a great and more affordable alternative
  2. Refer to EWG’s Clean Fifteen™ for an alternative selection of fruits and vegetables with the lowest concentration of pesticides (even when they are grown conventionally).
  3. Before eating, wash your produce with this two-step method that uses natural solutions to properly remove pesticides as well as wax and harmful microbes.
  4. Grow your own! If you have the time and space, pick a few of your favorites and start a container garden or raised bed. Not only will you reap the benefits of harvesting your own organic produce, but you may find it helps with managing stress and overall mental health.

 

Looking for a new recipe? Download and browse some of our staff’s favorites in our Recipe eBook: https://kaplanclinic.com/resources/recipe-ebook/

Hypothyroidism Article

Hypothyroidism: Causes, Symptoms, Diagnosis and Management Options

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Hypothyroidism is a medical condition that is characterized by the body’s inability to produce enough thyroid hormone. The thyroid gland (located in the neck area) produces thyroid hormone. This hormone is particularly important as it is responsible for a wide range of bodily functions. Thyroid hormone plays a role in our metabolism, it helps regulate our energy levels, weight and even has a hand in regulating our sex-drive. When levels of the thyroid hormone start to decline, individuals may experience a wide range of symptoms.

The symptoms of hypothyroidism can appear unconnected and vague. They usually develop slowly and mimic many other medical conditions. For these reasons, it can take years for people to realize that they are suffering from hypothyroidism.

Causes

Hypothyroidism can affect people of all ages and genders but it is especially common among women over age 60. Causes of hypothyroidism include:

  • Autoimmune hypothyroidism (Hashimoto’s Thyroiditis)
    Most cases of hypothyroidism are caused by the immune system mistakenly attacking the body’s own thyroid gland. This damages the gland and stops it from producing normal levels of thyroid hormone. Like other autoimmune conditions, autoimmune hypothyroidism has its own causes, triggers and mediators that keep the disease active. Factors such as extreme stress, trauma or gut inflammation can also play a role in worsening symptoms.

Less common causes of hypothyroidism include:

  • Postpartum hypothyroidism -following the birth of a child, the normal function of the thyroid gets disrupted.
  • Damage to the thyroid gland -i.e., damage that occurs as a result of treatments for thyroid cancer or radiation.
  • Thyroiditis -inflammation of the thyroid gland.
  • Hereditary conditions -a medical condition passed down through your family.

Symptoms

Many symptoms of hypothyroidism reflect changes that are caused by a lack of thyroid hormone in the body. Symptoms of hypothyroidism include:

  • Tiredness
  • Being sensitive to cold
  • Weight gain
  • Constipation
  • Indigestion
  • Depression
  • Muscle aches and weakness
  • Dry and scaly skin
  • Loss of libido (sex drive)
  • Irregular periods or heavy periods
  • Seeing physical changes in your face (including drooping eyelids, as well as puffiness in the eyes and face)

On the face of it, these symptoms may appear random with little relation to each other. But the overall effect of low thyroid hormone in the body is a reduced metabolism. This slows down many of our normal functions and results in some of the symptoms listed above.

If you experience one or more of these symptoms, be sure to make an appointment to speak to one of our doctors. Our physicians are skilled in identifying hormonal problems, including thyroid disorders.

Diagnosis

For some patients, finally receiving the diagnosis of hypothyroidism can be a huge source of relief. Many have experienced symptoms that have gone undiagnosed for years, as the symptoms of hypothyroidism can be vague and may be mistaken for other conditions. That’s why our doctors will spend time with you to make sure that we have a good understanding of your situation and your symptoms.

At your first visit, your Kaplan physician will take time exploring the onset of your condition, the specific nature of your symptoms and the overall status of your health.

The diagnosis of hypothyroidism is made based on a combination of medical history, physical examination and diagnostic tests. Tests may include:

  • Blood tests – a full thyroid panel that measures thyroid levels and thyroid antibody levels
  • An evaluation of minerals and vitamins to look for low levels of these nutrients that support the thyroid
  • Digestive tests
  • Tests that measure functioning of the adrenal gland and cortisol levels

Other testing may be carried out to exclude different causes for your symptoms.

Management

The functional medicine approach to treating hypothyroidism is much more thorough than the traditional medicine approach. Our approach involves a more holistic view and may include a recommendation of the following:

  • Dietary changes to improve your gut function
  • Appropriate vitamin and mineral supplementation
  • Improvement of the adrenal-cortisol function by introducing activities to reduce stress such as therapy, meditation, yoga or exercise.
  • Thyroid replacement tablets to replace the thyroid hormone that you are no longer making.

Management will also take into account a number of factors such as the exact cause of the hypothyroidism, the symptoms you have been experiencing and the impact that it is having on your quality of life. Our goal is to find the best possible treatment options that work for your condition and your lifestyle.

If you suspect that you have a thyroid disorder or feel that you aren’t being treated well for a thyroid disorder that you do have, make an appointment to speak to one of our providers.

References

 

improving_brain_fog

3 Steps to Improve Brain Fog

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Doctors across the globe are seeing a noticeable uptick of patients concerned with memory problems, forgetfulness, and brain fog since the start of the coronavirus pandemic. If you are experiencing more frequent slips in memory, if you are more easily distracted, making more frequent mistakes at work, or feel like you are walking around with your head in a cloud, you’re certainly not alone.

For many people experiencing brain fog for the first time right now, the overload of pandemic-related stress and trauma from a very difficult year is more than likely to blame. Chronic stress and chronically disturbed sleep alone can cause inflammation in the brain which, over time, can damage neurons and affect cognitive functioning and memory.

But there is good news! Our brains are resilient, and when given the opportunity, the degenerative effects of chronic inflammation can be reduced – or even reversed – with certain lifestyle changes. There is light at the end of the tunnel, so, while we emerge from this pandemic let’s consider just a few basic strategies that will help improve your symptoms today.

3 ways to improve symptoms:

1) Get regular aerobic exercise:

Simply put, aerobic exercise increases blood flow to the brain, which helps your brain create new neurons and improve neural connections. A study by the University of Maryland School of Public Health, published in July 2013, showed that people who increased their heart rate with daily moderate exercise “improved their memory performance and showed enhanced neural efficiency while engaged in memory retrieval tasks.”

Regular exercise also down-regulates microglia in the brain. Try to incorporate just 30 minutes a day of moderate physical exercise – such as walking – for a significant impact on your brain health.

2) Eat smarter:

Not surprisingly, nutrition also plays an important role in brain health and there is an impressive amount of research confirming that essential fatty acids, like Omega-3’s, are very beneficial. If DHA levels are low (DHA is a form of Omega-3) the brain is more susceptible to degeneration. Omega-3 fatty acids also help scavenge free radicals (atoms, molecules, or ions with unpaired electrons) that attach inappropriately to tissue and damage it.

Since our bodies are unable to produce these fatty acids on their own, foods rich in Omega-3’s like salmon, shrimp, sardines, eggs, walnuts, and almonds, should make a regular appearance on our plates.

Fruits and vegetables, high in a type of antioxidant called flavonoid, also play a major role in brain health. Foods rich in flavonoids offer a number of neuroprotective properties, and can decrease rates of cognitive decline and potentially slow the progression of many neurodegenerative diseases, such as Alzheimer’s Disease. Foods rich in flavonoids include tea (black, green, oolong), bananas, blueberries, and other colorful berries, onions, apples, citrus, Ginkgo biloba, parsley, red wine, and chocolate!

3) Don’t take your sleep for granted

Sleep deprivation, sleeping less than the amount of time your body needs for growth and repair, is the most common sleep disorder. Adults should have between seven and eight hours a night of restful sleep, yet CDC statistics show that as many as 35% of American adults are not sleeping enough, and this figure is likely to have increased since then.

During sleep, the body repairs 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.

Breathing techniques, meditation, and establishing a bedtime routine are 3 great ways to help you settle down and improve the length and quality of your sleep.

Supplements May Be Helpful for COVID-19

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Those of us in the integrative medicine field have long seen the benefits of supplements and herbal medicine in healthcare.

COVID-19 is a novel virus, meaning it has never been seen before in nature. There is a lot that we don’t know about this virus, but there is a lot that we are learning as well. There have been studies done with supplements for other types of coronaviruses like SARS CoV. We also have research about the effects of supplements on the immune system suggesting that they may be helpful for upper respiratory infections in general.

Below is a list of several supplements along with a short discussion on research and clinical experience and references where you can read more on each topic. Please note: None of these have been proven as treatments for COVID-19, and none of the information should be taken as medical advice.

Dietary supplements are generally considered safe, but it’s important to review your medical history and current medications with a practitioner before starting. Please call (703) 532-4892 to make an appointment with your provider, nutritionist, or acupuncturist/herbalist. If you suspect you have any kind of infection, please make a telemedicine/ cloud appointment with your doctor.

Please remember that supplements are not regulated by the FDA and sometimes do not contain ingredients that they claim. At The Kaplan Center, we do extensive research to find the best companies with 3rd party testing to make sure you get the highest quality products. You can order your supplements directly through our online store at: https://store.kaplanclinic.com/

It is important to continue following guidelines from health departments and governments including frequently washing hands for 20 seconds, staying physically distant and socially innovative. When in public places like grocery stores, be sure to wear a mask.

ANTIOXIDANTS

Vitamin C

Vitamin C is long known for helping the immune system prevent colds and flu. It is important for the function of white blood cells to fight infections and the overall immune system.  High dose Vitamin C is being used by IV in several hospitals around the world including in New York. There is a small study that showed critically ill patients with COVID-19 who were given 1-6 g of Vitamin C either intravenous (IV) or oral decreased ventilation time by 25%.  There are other trials in progress to see if high dose Vitamin C can improve outcomes. Doses range in 12-24g administered by IV. At this time there is no evidence that taking Vitamin C orally will prevent or cure COVID-19. As a supplement, it is suggested to take 3g of Vitamin C per day. Talk to your doctor about if IVs would be right for you.

Glutathione/NAC

Glutathione is a powerful antioxidant in the body. It scavenges damaging free radicals and is involved in tissue repair and builds chemicals and proteins that are used for the immune system. N-Acetyl cysteine, or NAC, promotes the production of glutathione and is also used as a supplement. Studies in animal models of other viral infections have shown that NAC reduced the severity and duration of symptoms by increasing cellular defense and repair. NAC is taken in doses of 500-600mg. Glutathione can be taken orally 500mg or by IV 400-2400 mg with a doctor’s order.

Quercetin

Quercetin is a bioflavonoid found in a variety of fruits and vegetables. Laboratory and animal studies have shown that quercetin may inhibit a wide variety of viruses, including a coronavirus SARS CoV which is related to COVID-19. Quercetin supports antioxidant capacity and protects lung tissue. As a supplement is combined with Vitamin C, bromelain or sold as a single supplement. Recommendation is between 500mg-1000mg daily.

Food Sources: Leafy green vegetables, dill, peppers, apples, grapes, fennel leaf, red onion, oregano, chili pepper, green tea, and black tea.

ANTI-VIRAL PROPERTIES

Chinese Medicine

Computer analysis done in February of this year showed which drugs and natural compounds have the potential to inhibit COVID-19. Several Chinese herbs were shown to have the potential to interact with specific targets of SARS-CoV-2. These included Andrographis paniculate and Scutellaria baicalensis, two herbs that are commonly used in formulas for upper respiratory infections. This data is preliminary and does not meet the standards of evidence-based medicine.

Chinese herbal medicine is a complex system of medicine that is based on sequential diagnoses of signs and symptoms that change throughout the illness. It is personalized and a formula should be prescribed by an NCCAOM certified herbalist.

Monolaurin

Generally considered anti-viral, coconut oil contains lauric acid and the derivative monolaurin. It prevents the adherence of viruses to tissues by fluidizing the lipids and phospholipids in the envelope surrounding the virus that leads to the disintegration of viral particles and symptom improvement. Studies have not been conducted in humans on coronaviruses. Unrefined coconut oil contains the most lauric acid. Refined coconut oils and MCT oils contain very little. Supplementation of monolaurin is 1,200 -1,800 mg 2-3 times per day.

Biofilm Disruptors

Biofilm disruptors are enzymes that have the ability to weaken the virus by inactivating or fluidizing its outer layer, then exposing its viral content to the immune system. Biofilm disruptors are extensively studied for the treatment of bacterial infections, as most bacteria protect themselves within biofilms to hide away from antibacterial therapies. They slowly multiply until they form important colonies that then attack the body’s immune defense. An example of a biofilm disruptor is Lumbrokinase found in Buluoke, made from earthworms.

Probiotics

Are friendly bacteria that reside in the intestinal tract, they actively participate in the modulation of the immune system, synthesize vitamins, and aid digestion. Studies have shown that probiotic use can decrease the number of respiratory infections, particularly in children. Food sources include fermented foods like sauerkraut, kefir, yogurt, kombucha, kimchi, natto, and tempeh.  We can’t overstate the importance of gut health and nutrition on the immune system. For that reason, look for an entire article on this subject in a future newsletter.

IMMUNE BOOSTERS

Zinc/Copper

Zinc may improve the chance of avoiding respiratory tract infections in the elderly and those who are zinc deficient and is shown to have strong anti-viral properties.  It is found in beef, crab, lobster, and smaller amounts in chicken, cheese, kidney beans, garbanzo beans, cashews, and almonds. Supplementation can be taken in a pill or lozenge, daily recommendation is between 30-60mg.

Copper is a trace mineral that is needed in small amounts. It also has immune-boosting properties. The problem with supplementation of trace minerals is that they compete for absorption, so it’s necessary to take about 8 mg of copper along with Zinc. Typically a multivitamin supplement contains a small amount of copper for this reason. Be sure to eat food sources like two squares of 80% dark chocolate!

Food Sources of Immune-Boosting Nutrients

Food sources of immune boosting Nutrients

DOWNLOAD THE INFOGRAPHIC

 

Vitamin D

Vitamin D is created in the body in response to sunlight. While vitamin D has not been studied for coronavirus, low Vitamin D levels have been linked to a higher risk of upper respiratory infections in general. Most people do not have optimal levels of Vitamin D, especially in the winter. Since it is not found in foods at doses needed, supplementation is recommended at 2,000-5,000 IU per day.

Melatonin

Melatonin is used as a sleep aid that also has antioxidant and anti-inflammatory properties. Melatonin also has been shown to have an inhibitory effect on NLRP3 inflammasomes, which COVID-19 stimulates to create a cytokine storm in the late stage of the disease. This compelling research suggests the potential for melatonin as adjuvant treatment for COVID-19 but more research is needed. Dosage is typically 5-20 mg at bedtime.

 

Sources/ Additional reading:

Vitamin C:
https://jintensivecare.biomedcentral.com/articles/10.1186/s40560-020-0432-y

NAC/Glutathione:
https://www.sciencedirect.com/science/article/pii/S0033062020300372?via%3Dihub

Quercetin:
https://www.tandfonline.com/doi/abs/10.1080/019021490927088?journalCode=ielu20&fbclid=IwAR1ZQN3xo9wHbqsp_53Fq57o4AEO19y0ChJWcph9QND9Fp8F8elkgysp11g&

Chinese herbs:
https://www.sciencedirect.com/science/article/pii/S2211383520302999

Monolaurin:
Seleem, D., Freitas-Blanco, V.S., Noguti, J., Zancope, B.R., Pardi, V., & Murata, R.M. (2018). In Vivo Antifungal Activity of Monolaurin against Candida albicans Biofilms. Biological & pharmaceutical bulletin., 41(8), 1299-1302. doi:10.1248/bpb.b18-00256
https://www.liebertpub.com/doi/abs/10.1089/act.2006.12.310?journalCode=act

Melatonin:
https://www.sciencedirect.com/science/article/pii/S0024320520303313?via%3Dihub
http://www.melatonin-research.net/index.php/MR/article/view/71

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

tonic herbs

Teas to Help You Sleep

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Herbal teas are a very gentle way to reduce stress and anxiety that also promotes sleep. They have been used across the globe for centuries, and are very accessible to all of us.

If you’re experiencing sleepless nights and looking for natural ways to get some z’s, here are a few to try:

  • Rose tea: loaded with antioxidants known as polyphenols that have anti-inflammatory properties, and one study showed that it also has antimicrobial properties. Roses are also a great immune booster as they are a source of vitamin C. In addition to its great taste, it is also effective for stress and anxiety and premenstrual symptoms.
  • Passionflower tea: used for insomnia, anxiety, adjustment disorder with anxious mood, in addition to menopausal symptoms, premenstrual symptoms, muscle cramps, and asthma.
  • Chamomile tea: in addition to its benefits for the gastrointestinal system in relieving colic, flatulence, and diarrhea, chamomile is also used for anxiety, restlessness, insomnia, and ADHD.
  • Peppermint tea: used for respiratory infections, including the common cold, pharyngitis, sinusitis, and others. Peppermint is also used to relieve IBS symptoms, SIBO, spasms, and flatulence. It could be a good preventative delicious herbal tea that can replace caffeinated beverages and keep you hydrated.
  • Lemon balm: Several studies have shown that lemon balm may be effective insomnia, relieving stress and anxiety. It also has immune-boosting properties.
  • Lavender tea: Lavender oil supplement has been studied and proven effective for the treatment of depression and anxiety. For its use as an herbal tea, it has calming and soothing properties. Spraying lavender mist on your pillow is a great sleep inducer and helps with insomnia.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

large amounts of supplements

Supplements Offer Value, But Come With Caveats

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A recent article in the Washington Post rightly expressed outrage on the massive amount of money Americans are spending on dietary supplements each year. In this country alone, $35 billion dollars of our hard-earned money is being pumped into in an industry that has little oversight and is selling products that for the most part have no known benefits whatsoever.

I completely agree with the fact that the overwhelming number of supplements taken by Americans are pretty much worthless if not outright dangerous. The majority of the supplements sold and discussed in this study are for weight loss, muscle building, and sexual enhancement. Studies have repeatedly shown that these products are frequently not what they claim to be. Many are adulterated with medications that can potentially harm the people who are taking the supplement. Many have other potentially harmful contaminants. Most of them have little if any scientific support for efficacy.

Is there a time and place for supplements?

Absolutely. Caveats abound, however. The FDA does not regulate over-the-counter nutritional supplements. One study showed that many over-the-counter melatonin supplements did not contain the dose advertised on the label with ranges from 0% of the advertised supplement to over 200 x the dose. This can be an especially serious problem in taking a supplement like vitamin D where overdoses can have serious health consequences. So, the first caveat is that you need to know if you can trust the manufacturer.

The second caveat is – why are you taking the supplement? For people on a healthy diet, a general multivitamin is not necessary. Supplements should address specific issues and be monitored appropriately. Is there any research that the supplement is helpful? At what dose for which patients? The research is ongoing, conflicting, and ever-changing so you really need to be talking with someone who is knowledgeable about supplements if you are going to be serious about improving your health.

The third caveat is – are you on the right diet for you? The definition of a healthy diet is changing and as we get better with genetic and other testing methods, we are learning that one diet fits all is not true. It turns out that foods that might be excellent for one person, such as a paleo diet, may be a disaster for another, resulting in gout and heart disease. Also, the diet that is appropriate for you today might not be appropriate when you are sick or after a major illness. This gets complicated and you need a good coach who can help tailor a proper diet for YOU.

The supplement issue is complicated. If we are going to take supplements, we are going to need to be smart consumers and treat them as seriously as we would anything else that we put in our bodies.

Gary Kaplan, D.O., DABFM, DABPM, FAAMA
Medical Director Kaplan Center for Integrative Medicine

The Kaplan Medical Center Store offers a variety of supplements from trusted suppliers. Click here to visit the store. 

Purslane: A Super "Weed" Worth Trying

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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, which is 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]

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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.

References:
[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

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Understanding The Ketogenic Diet

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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. Despite this, it has become one of the most popular diets of the moment.

However, the Ketogenic diet should not be considered just a fad diet – it has been prescribed by physicians and nutritionists for nearly a century.

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 causes them to starve and die when the person adopts a ketogenic diet. 
  1. PREVENTING & REVERSING COGNITIVE DECLINE. Adopting one specific variation of the ketogenic diet known as “RECODE” protocol or “Ketoflex 12/3”, the body can restore proper brain growth and reduce neuroinflammation, increase insulin sensitivity, and excrete toxins. With close monitoring and lifestyle changes, these benefits will improve mild cognitive decline and early Alzheimer’s. This variation was developed by Dr. Dale Bredesen, an internationally recognized expert in the study of neurodegenerative diseases such as Alzheimer’s disease. (More about how the ketogenic diet benefits the brain below.)

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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 the top of that list as well, but much of the sugars we consume are hidden away in the carbs we love to eat, like bread (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 beta-hydroxybutyrate (BHB). Ketone bodies travel through the bloodstream and are utilized by all the healthy cells in the body and brain.

The ratio of carbohydrates to fats changes 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.

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 bodies 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 to activate 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.

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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” FOODS
  • Fish/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 (examples: avocado, asparagus, Brussels sprouts, broccoli, cabbage, celery, eggplant, cucumber, bell pepper, kale, okra, summer squash, spaghetti squash, tomatoes)
  • “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” FOODS
  • All grains
  • All types of sweeteners (agave, maple syrup, sugar, honey, etc…)
  • Candies/pasteries
  • Starchy vegetables (like potatoes, parsnips, or corn)
  • Alcoholic beverages
  • Fruits
  • Pasta
  • Most legumes
  • Sodas

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

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.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2