Health is lifelong- chapter 2 from “Start Healthy, Stay healthy”

                   Health is lifelong- chapter  2

I decided on the specialty of pediatrics because it is a happy field. Kids get better! Most of the time. You get to know families . Watch children grow and develop into good people. Pediatricians primarily focus on a child’s health while they are under our care.  Our goal is to get them through childhood healthy . We specialize in preventive guidance including vaccines, acute and chronic childhood illness, childhood behavior, and childhood safety.

To us childhood health outcomes refer to diseases that we document which begin in childhood.

The diseases which occur after they grow up are a whole other story in a much larger internal medicine textbook . Which generally speaking is not on a pediatrician’s bookshelf. The saying “little kids little problems big kids big problems”, assumes the big problems of heart disease, diabetes, cancer, by in large are part of adult medicine and not the venue of pediatricians.

We pay very little attention to a long term healthy lifestyle approach that focuses primarily on life long nutritional excellence. Nutritional health has a very narrow perspective in Pediatrics. We help introduce food, guide parents to the best nutrients for their children to help grow healthy, and avoid obesity. But very few physician’s have the type of concentrated lifestyle training in nutritional medicine to have a significant impact on a child’s lifelong health .

Like many other pediatricians, over the years of practicing I had noticed a tremendous increase in the number of overweight children even before childhood obesity and diabetes became a recognized concern. With these observations was a realization that the parenting focus had not been keeping up with the changes in family dynamics namely poor diet, video games, screen time, and parental busy-ness.  I have tried to change this by working with families to make substantial improvements in weight and exercise of overweight children for years. I’ve instituted many programs and consultations in order to help parents change their children’s eating and exercise habits and lower their weight. I even began a sports and Nutrition Center with a dietitian as well as a psychologist in my office.

But successful nutrition and exercise modification resulting in lower weight and improved fitness parameters were few and far between. Without meaningful and long term family adoption of change there is little hope to improve the child’s weight and health.

      I have had difficulty in getting parents with overweight children to improve their lifestyle and consistently participate in nutrition counseling. It is very challenging to change an unhealthy pattern that has already been established even as young as 2 years of age. Family food habits and cultural tendencies are ingrained early. But as hard as it is for an adult facing health issues to change their habits it is even more complex to change a child’s eating and exercise behavior. Try pleading your case and rationalizing with a five year old who has already developed a taste for sweets, fried foods,  fatty meats, and salty foods. Not to mention eating processed snacks at every chance.

The conclusion that is obvious if you have been a pediatrician for any length of time is that if we don’t start early with a health and nutrition conscious approach the chances of creating the template for a healthy lifestyle later is difficult .It’s important to start from the beginning by developing your child’s taste for nutritious food. Food and health values related to diet and exercise have to become a priority just like vaccines, illness prevention, car seats, seat belts, smoking, and home safety. This is not luck of the genetic lottery but a given. If you and your family do not eat healthy and make good nutrition a priority and move regularly ; illness will be part of your child’s life sooner rather than later. Poor nutrition choices will accelerate disease resulting from childhood obesity and poor lifestyle including diabetes, heart disease , hypertension,and cancer.

It’s never too early to start eating healthy . The markers of disease are forming right below the surface attacking your children from an early age.If you start early there is a better chance to prevent poor health and chronic disease before the damage is done. Raising your children healthy is the mindset I try to  promote . Starting early from the beginning by developing tastes for good food is the surest way to help your child lead a healthy life .

Setting the tone for good nutrition early is as important as anything else you’re going to do for your child. Most of the parents of my patients worry about all sorts of diseases from autism to cancer  . Everyone is very much on alert for anything wrong with their children especially fever , cough, and developmental problems but a healthy diet is the one thing you can control. It is a gift you can give your child for a good life.

Warren Krantz MD

HealthfulMD

Author of “Start healthy, stay healthy”

Spice up your food- spice up your health

Spice up your life- spice up your health

Spice up your food, enjoy the flavors, and improve your health.

Spices are a key component to a healthy diet. Throughout the world spices play a major role in healthy flavorful cooking . My goal is to help parents introduce spices to their children at a young age in order for them to develop a well rounded taste for healthy diverse eating .

There are several parts to good health related to whole healthy nutrition. First is the type of food. Whole natural foods with an abundance of green vegetables and other plant foods like fruits, beans, nuts, seeds, and whole grains. For maximum health the food you eat should be organic ( when available and affordable) unprocessed with no preservatives or chemicals. Developing a taste for truly healthy foods not only includes what you add to the foods  including important healthy spices but just as importantly what you eliminate. Salt, oil, sugar are negative influences on whole healthy food and reduce the health quality of food and hide the true flavor of natural food. With the inclusion of spices to improve the taste of your food you will be able to reduce the amount of unnecessary oil, sugar, fat, and salt.

Spices enhance your food while improving your health.  Spices are essential to both enjoyment of the flavor and health of natural food when you remove the processed ingredients.

I generally carry a mixture of my base of spices with me whenever I go out to a restaurant. I often get asked which spices should I start with when people who want to start on the  road to improving their health and that of their families. Below is my essential spices to begin a healthy meal.

My basic spices include the following health enhancing choices

(Most parents start with a very small amount on their hand allowing their child a taste. Slowly over weeks they increase the amount as the child develops both enjoyment and tolerance for that particular spice)

Turmeric- should be organic. You can buy it fresh and grate it yourself which is preferred. Remember the yellow stains everything it touches or you can buy organic powder. Review the brands some are cleaner than others. Turmeric is establishing a reputation in medical circles for its anti-inflammatory properties which help reduce diseases associated with inflammation. Turmeric is being studied for improving symptoms from everything from viruses to  joint pain and even cancer. – start with a 1/4 teaspoon working to 1-2 teaspoons per day or meal.

Ginger– Also should be fresh when you grate it or you can buy organic ginger powder. Ginger that is already incorporated into other spice mixtures or tea is not the recommended form. This is one of the favorite ingredients in many holistic recipes to fight colds and flus. Ginger is anti inflammatory and Immune enhancing. It is known to help fight viruses and colds, particularly nausea and influenza symptoms.  You can add it to food, teas, or lozenges

-start with a 1/4 teaspoon working to 1-2 teaspoons per day or meal.

Cinnamon – should be organic. Ceylon cinnamon is the purest and healthiest form and is considered the real cinnamon. Cinnamon helps regulate your sugar level. Keeps you from being hungry and has anti inflammatory properties. -start with a 1/4 teaspoon working to 1-2 teaspoons per day or meal.

Garlic- same fresh local organic cut it or grate it yourself. If you buy powder it should be organic from brands you trust. Besides the taste, garlic has immune enhancing properties and anti inflammatory characteristics which helps your body fight colds and viruses.- start with a 1/4 teaspoon working to 1-2 teaspoons per day or meal.

Peppers of all forms – particularly spicy red peppers and cayenne peppers, and bell peppers are anti inflammatory, immune boosting, and even help with fever and viruses. Black pepper is also immune boosting especially in conjunction with turmeric. Start with just a few flakes and sprinkles. Work your way up to a pinch and then quarter teaspoon slowly.

Oregano ( herb or spice) is also key in any healthy diet -is tasty and helps enhance your immune system for fighting colds. -start with a 1/4 teaspoon working to 1-2 teaspoons per day or meal.

There are many more healthy spices for flavor and health benefits but these six are what I consider the basic ones to add to a whole food and you can build from there.  

Try to keep these spices readily available so you can remember to add them to as many meals as possible. They should become a consistent part of your healthy diet. Start slowly with a very small amount then work your way up to your desired taste as you and your child get accustomed to the spicy taste. You can add additional spices depending on the type of meal you are preparing.

So spice up your food, enjoy the flavors, and improve your health

Warren Krantz MD

HealthfulMD

Calcium dairy free and still growing

Calcium dairy free and healthy !

Simply put most parents think that the only way to get sufficient calcium is from dairy products or milk, and if your children do not eat enough dairy they will not grow. Our mass perception equates milk to strong bones and being tall. One of the most difficult tasks of a pediatrician who is concerned with a child’s overall health is dealing with this myth perpetuated by the dairy industry and many pediatricians themselves. But it is not fact. It may be convenient.  It may insure our children and elderly ingest a easy cheap adequate source of calcium . But dairy products are in no way the healthiest nutritional choice for calcium. There are many healthier ways to get calcium. Dark green vegetables for instance are full of calcium, and a much healthier source. Your child will grow just as well and without the health compromising results of dairy ( see milk articles). Much of the world’s population do not eat diary as a primary protein and they seem to grow fine with a lot less health problems.

A diet without dairy can easily provide the daily allowance of calcium without compromising nutrition or your health. Looking at the top calcium plant foods and the sample meals below you realize with very little effort it is not difficult to get the daily allowance of calcium from only one meal. If you pay attention and make healthy plant exchanges for milk and dairy products throughout the day you will achieve your goal of improved health with more than enough calcium and your children will certainly manage to grow “big and strong”.

How much calcium do you need per day at each age                     

Between 1- 3 years of age a child needs 500 mg a day

              4- 8                                            800 mg a day

              9-18                                           1300 mg a day

              Over 19                                    1000 mg – 1200 mg a day

Some high calcium plant foods- compared to a cup of milk which has 300 mg 

Figs   cup                          300 mg

Sesame seeds,ounce 180 mg

Chia seeds, ounce      179 mg

almonds, ounce            80 mg

tofu, 3 oz                         300 mg

broccoli, cup                 180 mg

kale, cup raw                100 mg

spinach, cup cooked 240 mg

beans, cup                      80 mg

Fortified breads and oatmeal. 100 – 250 mg

Scroll below for comparisons of calcium based foods

2 easy meals below and the calcium content

Sample salad for maximum calcium

Arugula/spinach/kale- cup of each                       260 mg

Carrots half cup

Tahini based dressing – half ounce                        70 mg

Add olives

Sesame seeds one ounce                                         140 mg

Tomatoes

Soy cheese ( calcium fortified) one ounce         173 mg

Tofu one ounce                                                              250 mg

Calcium content of salad about 800 mg almost an entire day’s calcium requirement for an adult

 

Sample vegan meal

Non meat protein example tofu 3 oz                    300 mg

(Compared to 3 oz meat protein 40 mg)                                               

Quinoa one cup                                                            100 mg

Beans half cup                                                              40 mg

Broccoli cup                                                                  180 mg

Slice Bread ( fortified)                                               100 mg

Dessert compote with half-cup dried figs,       150 mg

With dessert and a vegan meal total calcium is  870 mg . Well over the child requirement for calcium for an entire day in one meal.

As you can see if you spread out the high calcium healthy foods throughout the day you will not encounter any difficulty in meeting the recommended calcium requirements for you or your growing child.

 

See below for sample comparisons of high calcium dairy vs non dairy foods

Cup of milk                                          300 mg

Cup of breast milk                               79 mg

Cup of formula                                     400 mg

Cup of soy milk ( fortified)                300mg

Cup of almond milk( fortified)         350 mg

Cup of orange juice ( fortified) up to  500 mg

 

Ounce of cheese                                   200mg

Cup of yogurt                                        450 mg

Cup of ice cream                                   200 mg

Ounce of soy cheese                            173 mg

 

Cup Broccoli  ( cooked)                        180 mg

Cup of kale ( raw)                                 100 mg                          

Cup arugula (raw)                                 125 mg

Cup spinach (cooked)                           240 mg

Cup spinach ( raw)                                 30 mg

Cup of figs (dried)                                   300 mg

Cup of dates                                             57 mg

Apple                                                        10 mg

Kiwi                                                            50 mg

Orange                                                      50 mg

 

Cup of Beans                                              75 mg

Tofu  3 oz                                                    200 mg or more

Cup tempeh                                                150 mg

1 oz almonds                                                80 mg

1 oz sesame seeds                                     180 mg

1 oz Chia seeds                                          179 mg

1 oz Sunflower seeds                                    50 mg

1 oz tahini                                                    130 mg

 

Cup fortified cereal                                        250 mg or more

Cup oatmeal instant ( fortified)                 150 mg

 

Cup Brown rice                                               50 mg

Cup quinoa                                                     100 mg

Cup whole wheat pasta                               21 mg

Slice whole wheat bread fortified          200mg

 The list above indicates that there are many plant sources of calcium and the belief that you have to have dairy products to grow or as we age is misleading and not factual. With very little effort you and your children can find healthier sources of calcium than dairy.  

Not having to feed cows to produce milk reduces greenhouse gas. Eliminates the issue of what we do to the calves. and the enormous waste and farmland resources for cows.

Warren Krantz MD, FAAP.

HealthfulMD, KrantzCare.com

Eggtroversy

Eggs: Can’t live with them can you live without them?

Can you live without eggs? Most definitely  yes!

Should you live without eggs? I will cover my views below.

Quick takes :

  1. HealthfulMD egg as a healthy food rating is a minus. It does not contribute to good health and eggs do not promote healing.
  2. Egg industry funded studies have been geared towards convincing you they are healthy but are misleading.
  3. You do not need to introduce eggs earlier to your child as an essential food.
  4. Eggs are in fact high in cholesterol and not necessary cholesterol
  5. While eggs are an easy and fun source of protein for young children they do not contribute to better health. And are not an essential part of a nutritionally excellent diet.
  6. There are many healthier sources of protein other than eggs.

If we are talking about basic scrambled, poached, hard boiled, sunny side up; eggs as the main protein dish, are not all they’re cracked up to be. And certainly not the healthiest way to get the same level of protein. If you never eat a whole egg you get more than enough of the daily recommended amount of egg ( one a day) in all sorts of baked goods and prepared foods. Eggs are the staple of most recipes as a binder and filler and therefore you are getting more than enough of the good things you think you need from eggs without ever trying.

Should you introduce eggs early under a year of age to babies to prevent allergies like we have instituted with nuts?. No I do not believe you should. Eggs are not a food essential to good health and therefore introducing early just helps your child develop a taste for eggs earlier than necessary. Something that potentially is not healthy should not be pushed earlier .

The big controversy surrounding eggs are not whether you should be having any at all  but  whether they contribute to a nutritionally sound diet in an ongoing effort to be healthier , have less disease . and heal.

The egg industry and their funded studies would have you believe that eggs are a healthy source of protein and nutrition and make you healthier. Many respected physicians and dietitians still follow their propaganda .

Nutritional scientists, Cardiologists,cardiac researchers, and those of us promoting optimum health and healing nutrition have a less than flattering take on the value of eggs and the necessity of including then as a mainstay of our diet.

Pros:

They have plenty of protein for your nutritional needs.

They have biotin which is essential for nails, hair, and skin.  .

Eggs provide choline which can help nerve and brain function, muscle movement, and metabolism. .

Eggs are an easy food to prepare and relatively inexpensive meal .

Yolk has some omega 3 and vitamins.

Cons:

Eggs have very high cholesterol 213 mg, which is not directly correlated to high cholesterol but definitely contributes due to its high saturated fat. Recommended daily intake of cholesterol is not more than 300 mg a day.  

The choline in the egg form may actually not be healthy. While they are high in choline this choline is turned into tma by our intestine and then tmao by our liver. Tmao seems to be associated with higher risk up to 9x of heart disease and stroke.

Egg white- the white of the egg has methionine which stimulates igf-1 growth factor which contributes to cell growth and may cause cancer cell stimulation in adults.

Only the yellow has omega 3 but this is the less desirable portion as far as cholesterol and fat.

The biotin is not as useful as alleged because eating too many eggs actually binds the biotin and has the opposite effect. Whites have protein that can interfere with the body’s use of biotin as well.

Eggs have a much higher risk of salmonella than most foods. Which causes gastrointestinal illness.

A substantial portion of the population have egg allergies even if you were to introduce them earlier .

 

Alternatives for the nutritional content that eggs are promoted to provide but in a healthier form.

Choline : Plant source of choline are anti inflammatory. Have better glycemic index, more fiber and are healing.  Most plant sources of protein have good levels of choline. Beans and lentils have a comparable choline content to eggs but in a healthier healing form.

Biotin: Healthier sources of biotin at similar levels to eggs include swiss chard, berries, nuts, carrots, and onion. All have anti inflammatory properties, low fat, high fiber, and healing phytosterols. All of which eggs have minimum amount in comparison.

Protein; There are many healthier sources of protein besides egg. Beans , nuts, tofu, wheat, etc. See protein article. All of the plant sources come without the negative effects of egg protein.

Omega 3: Many plant sources have substantially more and healthier omega 3, flax seed for one.

Egg substitutes: Both for health and for cooking use.  

Chia seeds with water or almond milk protein.

Tofu scramble mixed with turmeric for yellow color .

Egg substitutes like the” Vegg”, Egg beaters and pea protein substitutes . Should be organic.

“Aquafaba”- bean juice. The liquid in the can from chickpeas  ( used most commonly)

Or other legumes – beans. Either from the can or cooking in water for 2 hours.  3 tablespoons of aquafaba liquid is approximately the equivalent of one egg. This liquid is used in the same way as eggs particularly the properties of egg whites for cooking, baking, whipping. Nutritionally has protein and starch but no fat, no cholesterol, and no animal inflammatories.

If it’s too thin or watery drain some of the water out to improve the consistency.

Bottom line : Although eggs are easy and a mainstay of our western diet, they are not necessarily a part of optimal nutritional health. I do not recommend you introduce them to your children earlier in order to develop a taste for them or avoid allergies . At best the egg industry studies supporting eggs as a good food have only shown that if you are already very ill  with high cholesterol or heart disease eating eggs will not make you sicker. But if you are not ill they definitely contribute to poor health.

The process of farming eggs often is not environmentally sound or humane for the chickens. Please buy organic and eggs from free range chickens.

Warren Krantz MD , FAAP

HealthfulMD. KrantzCare.com

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Vitamin C

Vitamin C without supplements

The best source for vitamins is whole natural food and not supplements.

[Please consult your physician before self treating a medical condition with any supplements or alternative therapy including holistic remedies.]

Why is Vitamin C good for you?

The main benefit of vitamin C is it’s an antioxidant and anti inflammatory properties . Whole natural plant foods have both the most vitamin C and the best form to benefit from . These properties of vitamin C rich foods help protect the body from oxidative stress and fight free radicals that cause cell damage which can lead to disease. The value of this is in its disease fighting properties such as helping lessen skin damage from the sun, fighting colds, preventing and improving chronic diseases..

Colds and viruses- these properties of vitamin C in plant form help you protect against the symptoms associated with the cold namely all the inflammatory responses ,congestion, pain, and fever. These are often lessened with an anti inflammatory diet including foods sources containing high levels of vitamin C.. Vitamin C from plant sources can work in conjunction with your body’s immunity to reduce the length of illness of colds and viruses.

Cancer – there is no real proof that vitamin c helps or cures cancer. However, eating foods with high vitamin c content helps with inflammation and antioxidative stress that studies have shown can lead to cancer. Foods high in vitamin C and the vitamin C itself may help prevent and repair the cell damage that can lead to cancer.

Heart disease- higher levels of vitamin C have been linked with lower heart disease, better blood flow to the heart arteries, and better blood pressure.

Skin-vitamin C is involved in protein production and formation of healthy skin and healing such as collagen production, maintenance, and strength.. It helps prevent free radical damage and cancer development on the skin from sun exposure.

Natural whole food is the best way to get the most bioavailable vitamin C. All plant foods contain vitamin C. Below are the top 5 vitamin C rich foods for fruits and vegetables.

You get the most vitamin C by eating the fruits and vegetables raw.

The top 5 fruits for vitamin C content.

1.Papaya

2.Strawberries

3.Pineapple

4.Oranges

5.Kiwi

The top 5 vegetables for level of vitamin C

1.Bell peppers

2.Broccoli/broccoli sprouts

3.Brussel sprouts

4.Cauliflower

5.Kale

It is always better to cut out the middle man when striving for better health- go straight to the food source for the vitamins and nutrients you require . The less processing and the closer you are to the natural unadulterated form of a food the better for your health and well being. The less chemicals and additives that change a food the better for your body and the environment.

Warren Krantz MD, FAAP

HealthfulMD.com

Turmeric

Turmeric – the number one spice for what ails you- best spice award

I often get asked what is the best spice to start with for those individuals who want to make the first move in a healthful direction.  What spice would you say is the most important one if you want to introduce just one ?. I answer turmeric for several reasons. (This is not to be confused with the first spice I recommend to introduce to infant feeding which is cinnamon.)

 Why turmeric

Turmeric with curcumin the main active ingredient thought to have food super powers- mostly from its  anti inflammatory properties . It has been used for thousands of years in cooking. In the Geographic regions where turmeric is a food staple the populations have much less chronic inflammatory associated disease; heart, prostate, intestinal, and cancer. Turmeric acts as an antioxidant helping neutralize free radicals that cause damage  thus slowing aging , keeping your skin elastic, and preventing harm to your cells.

Turmeric helps enhance your immune system. It helps fight disease and the associated inflammation.

Turmeric helps with everyday illnesses

In my line of work it is helpful in keeping the inflammation associated symptoms like pain, fever, coughing and congestion from viruses to a minimum while helping fight the infection.

Taste:

Turmeric  has a mild taste. A little chalky but it blends well and is not overpowering in whatever you put it in. Not real spicy. Main drawback is the yellow color which to me is sign of health but to children and those new to spices when visual cues are sometimes just as important as taste may be a problem. Try to begin its use in foods which have a color that masks the yellow.

Amount

Goal to introduce turmeric (curcumin) slowly to avoid developing an aversion from the child or adult. Start with 1/4 teaspoon slowly over the first week or two going up by 1/4 teaspoon per week for a goal of 2 teaspoons a day and even more when you are not feeling well or having aches pains or for specific conditions

When I feel like I am getting sick I double or triple my daily turmeric dose heaping portions at every opportunity .

How to use it?

I use it as often as possible and carry it with me!

My first recommendation is to add it to your version of chicken soup or vegan non chicken soup, yellow vegetables like squash, hash browns, even sweet potatoes. I also make a point of including them in any vegetable dishes and meats if you are not vegan. A parent recently said she adds it to pancake mix, grains, and eggs.

Turmeric is my  base for all my meals to make sure I get enough throughout the day..

Any chance you get add turmeric to your food.

How much?

I put a quarter to half teaspoon in my morning tea every day along with ginger.

I put one to two teaspoons on my vegetable mixture for lunch

I sprinkle turmeric along with my spice mixture on salad or any dressing I use.

Even put it on pasta or quinoa .

All my soups I add turmeric.

I take a spice mixture in a small container with me whenever I eat out (with a turmeric base), And add it to salads, soups, vegetable and bean dishes, etc. Any where, any time I am ready to add my spices beginning with turmeric,

To improve absorption of turmeric

Add black pepper along with it to food. In tea add a little coconut milk. Adding a small amount of healthy oil or fat to turmeric helps absorption -seeds and nuts have oil in them and can be added to any dish to serve as a vector for turmeric absorption, as well as the overall health benefits from seeds and nuts versus empty oil calories. Also avocado is a good fat to mix with turmeric to enhance its absorption.

Turmeric has been shown to have benefits for all sorts of diseases and illnesses.

Latest studies and those currently under review are indicating very positive results and benefit from large doses of turmeric including inflammatory bowel disease, joint disease, rheumatoid arthritis, heart disease, autoimmune conditions , and even cancer . Please consult your physician or particular specialist before beginning any mega dose trial of turmeric for any one of these conditions .Doses at this level usually comes in a pill form and precise medical information regarding dosing is not widely agreed upon yet.

Brands and form of turmeric

Consumer labs has reviewed a number of brands of turmeric for safety regarding foreign substances, and contamination. In general it is better to have organic turmeric and even better to buy it and grind it yourself. Some of the organic brands for reasons that seem logical have a percentage of bug parts and some non organic brands have chemical residues. It is better to include turmeric in any form. But your physician, grocer, or health food specialist might be helpful in selecting a safe and healthy brand.  

If you are going to add one food supplement in natural form to improve your health make it turmeric

Warren Krantz MD, FAAP

HealthfulMD.com

 

Vitamins -general approach

Vitamins in general (as supplements) not what you were told.

Since the days of Hippocrates physicians have been asked to recommend vitamins to cure what ails people. From poor eating for children to low energy in adults people want a magical vitamin pill to jump-start their health. All form of concerns seem to bring up this magic vitamin pill. But in reality other than the scientifically known disease associated deficiencies ( which by in large do not exist any longer in western society) vitamin supplements are rarely needed and of little true value.

Main points:

Vitamins are not as advertised. They have no magical healing or disease preventing properties in supplement form.

They are not a panacea for what ails you and in no way replace healthy nutritious whole food.

With the exception of b12 for vegans and possibly the new recommendations of vitamin d 3 , receiving the majority of vitamins from supplements are a poor substitute for real food as vitamin source.

Vitamins are not readily bio-available and as useful for what you need when you take them in a supplement form versus from food

Vitamins will not stimulate your appetite. Physician’s treat vitamins like a placebo.  Doctors only give to children when parents request them to supplement a diet in order to encourage the parents stop pushing their kids to eat and relax. It takes the pressure off parents who are worried about adequate nutrition particularly vitamin intake. When parents relax and stop showing anxiety regarding the amount of food a child eats, regardless of the reason,  then the children often actually start to eat better .

The real source of useful bio-active body enhancing vitamins is whole foods.

Enriched foods do offer an alternative to supplements but not nearly as valuable as in whole foods.

Vitamins like all supplements are not regulated for content, amount, value,claims, or quality.

Taking vitamin shots is not any more valuable than supplements. The rare exceptions are for true medical conditions like b12 deficiency anemia , pernicious anemia.

Organic whole fruits , vegetables, nuts , and seeds are the best form to receive your vitamins. Best method is to chew and eat them yourself.

Warren Krantz MD, FAAP

HealthfulMD.com

 

Iron Getting enough naturally

Iron  

I often get asked how do we get enough iron?.

Patients  have been told and read that if they do not have enough variety in their diet or if their children are not eating a balanced (meat centric) diet they will not get enough iron and become anemic..

Is this fact or more marketing and tradition ?

It is confusing that the same physicians who are recommending you diet, eat healthier, exercise to lower your cholesterol and improve your health , also recommend meat as the only source to get your iron.

What is the best way to get your iron ?

“Best” meaning healthiest with foods that add to your health at the same time . Not merely treating with iron but recommending foods that will have a positive impact on your overall health; perhaps even improving your underlying condition which caused the anemia in the first place with optimal nutrition.

MAIN POINTS  :

You can get as much iron from non meat sources as you can from meat.

Iron is in most foods including plant based foods in adequate amount to get your requirements except for the most medically necessary anemia conditions ( please check with your physician if this is the case)

Top plant foods for iron per serving

Fortified cereal  18 mg

pumpkin seeds  4.2 mg

dark chocolate  7 mg

soy beans, 8.8 mg

tofu, tempeh  3 mg

black beans 3.6 mg

lentils   3mg

quinoa  2.8  mg

Compared to a 

hamburger lean- 2.2 mg

See extended iron  list below 

Why do people say meat is the best source for iron?

This comes from the fact that the iron (heme iron)  in meat is more readily absorbed from your gastrointestinal system than plant food iron, which is non heme. But that does not make it better or necessary for meat to be your absolute source of nutrition for iron

Plant foods have plenty of iron in them to maintain and establish iron supply for your blood cells to carry oxygen ( some say not to replenish low iron stores – but with nutritionally sound diet you can)

The non-heme iron in plants is the same quality iron as any other source . There is no difference in quality or types of iron once your body absorbs it from your diet or supplements. It is strictly a quantity issue.

You do need to almost double the amount of iron requirement listed in a plant diet. This means you have to eat twice as much as the number listed of iron for a regular diet in the quantity of food to get the absorption as meat. See the chart below where I already calculated the amount of iron to ingest if you are vegan or from strictly plant food sources.This should in reality be easy since plant foods are usually eaten in bulkier quantities combined with several different types – greens, seed, nuts, soy products, etc.

Healthier source for iron – most people will admit that nutrition derived from a plant source is much healthier than meat. Usually the argument revolves around their contention that meat has a better iron content and protein. But that is not accurate as you can see from the chart below and a previous post on protein sources.  Healthy plant based foods such as seeds , nuts, dark green vegetables, will add to your health with the fiber, anti inflammatory properties. , and anti-oxidants. People who depend in large part on plant based diet generally have larger portions of plants and more balanced whole meals of grains, seeds, beans , and greens. So in reality it should not be a problem. Scroll down below to see some examples of  iron content in various foods and the amount you need to eat to be certain you get and give enough.

Iron absorption from plant sources is enhanced if you eat vitamin c abundant foods along with your meals , which if you are already primarily vegetarian you probably are already eating. Not just citrus foods, but most vegetables and fruits are rich in vitamin c, including dark fruits and dark green veggies.

Vegetarians and vegans do not have more anemia or poor iron intake than people who eat meat.

Milk and dairy products may interfere with iron absorption

As with all other posts regarding healthier non medical nutritional means to improving your health and medical conditions please check with your physician first before undertaking a non medical approach. Also not all conditions are stable enough to solely rely on nutritional methods of therapy. Anemia can be a serious medical condition and be a result from complicated conditions. Please consult medical experts first. Adding plant based healthy means to improving your health is always advisable but make sure you are stable enough to rely on that in lieu of your doctor’s advice.

 

 

 

 

 

The table below lists the daily requirement of iron in foods per age to get the necessary absorbed requirement of iron. The number is higher for plant foods because the non-heme iron is not as easily absorbed as heme iron from meats. For vegans the amount calculated to ingest is almost double so the necessary iron will be absorbed

 

 

    Age

Male Female Vegan Pregnant
Birth to 6 months assuming breastfeeding requires more for formula 0.27 mg* 0.27 mg*              
7–12 months 11 mg 11 mg 19.8 mg
1–3 years 7 mg 7 mg 12.6 mg
4–8 years 10 mg 10 mg 18 mg
9–13 years 8 mg 8 mg 14.4 mg
14–18 years 11 mg 15 mg 19.8mg (m)/27 mg( f) 27 mg/48,6 vegan
19–50 years 8 mg 18 mg 14 mg( m)/32 (f) 27 mg/48,6 vegan
51+ years 8 mg 8 mg 14.4 mg

* Adequate Intake (AI)

 

Food Milligrams

per serving

Percent DV* for regular diet
Breakfast cereals, fortified with 100% of the DV for iron, 1 serving 18 100
Pumpkin seeds 1 oz 4.2 mg 23
White beans, canned, 1 cup 8 44
Chocolate, dark 70% cacao or more, 3 ounces 7 39
Beef lean sirloin or hamburger, 3 ounces 2.2 18
Lentils, boiled and drained, ½ cup 3 17
*Spinach, boiled and drained, ½ cup is not as well absorbed 3 17
Tofu, firm, ½ cup 3 17
Kidney beans, canned, ½ cup 2 11
Quinoa cup 2.8 12
Chickpeas, boiled and drained, ½ cup 2 11
Tomatoes, canned, stewed, ½ cup 2 11
Steak NY strip 3oz 1.6 9
Potato, baked, flesh and skin, 1 medium potato 2 11
Cashew nuts, oil roasted, 1 ounce (18 nuts) 2 11
Green peas, boiled, ½ cup 1 6
Chicken, roasted, meat and skin, 3 ounces 1 6
Rice, white, long grain, enriched, parboiled, drained, ½ cup 1 6
Bread, whole wheat, 1 slice 1 6
Bread, white, 1 slice 1 6
Raisins, seedless, ¼ cup 1 6
Spaghetti, whole wheat, cooked, 1 cup 1 6
Tuna, light, canned in water, 3 ounces 1 6
Turkey, roasted, breast meat and skin, 3 ounces 1 6
almonds, dry roasted, 1 ounce (49 nuts) 1.3 6
Broccoli, boiled and drained, ½ cup 1 6
Egg, hard boiled, 1 large 1 6
Rice, brown, long or medium grain, cooked, 1 cup 1 6
Cheese, cheddar, 1.5 ounces 0 0
Kale  1 cup 1.2 6
Soybeans  1 cup  cooked 8.8 48
Black beans 1 cup 3.6 20
Milk, 1 cup 0 0

* DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration (FDA) to help consumers compare the nutrient contents of products within the context of a total diet. The DV for iron is 18 mg for adults and children age 4 and older. Foods providing 20% or more of the DV are considered to be high sources of a nutrient.

The U.S. Department of Agriculture’s (USDA’s) Nutrient Database W

Several food sources of iron are listed in Table 2. Some plant-based foods that are good sources of iron, such as spinach, have low iron bioavailability because they contain iron-absorption inhibitors, such as polyphenols [15,16].

Sample meal

Salad with spinach , kale , soybeans, pumpkin seeds, tomatoes, tahini dressing , quinoa half cup=3, 2,1,2,4,2.4.4,2.7 for total of iron of almost 19 mg for the average sized salad or almost 70% of the 27 mg vegan requirement of iron in one salad, Add tofu or any other grain or vegetable and you probably have reached your daily requirements

Add any source of meat protein in the suggested minimal amount of 2-3oz 3 x a week them you are getting more than enough iron with a healthier nutritional profile

Add dark chocolate for dessert and you have your daily allowance of iron

Please consult your physician before starting any non medical treatment with nutritional sources. Not all conditions will respond to holistic or dietary or supplement for that matter adjustment.

Iron supplements are not recommended unless you are anemic or have a diet with insufficient in iron.

As with all supplements iron supplements are not regulated and the actual content can vary.

Absorption of iron from supplements can also vary so please check with your physician before taking any supplements.
Environment: The processing of supplements and disposal has a greater environmental impact as does meat based iron sources than natural organic plant food sources. Getting your iron from optimal nutrition both improves your overall health and that of the environment.

Warren Krantz MD. FAAP

HealthfulMD.com

Diarrhea dilemma

Diarrhea the natural treatment

Ask any vegan  how they treat diarrhea and they will offer a difficult response. When your whole life is high fiber plant based diet treating diarrhea and stomach issues is always a dilemma .

Traditionally we have and continue to treat diarrhea as naturally as possible but with low fiber starchy foods and electrolytes. Pediatricians refrain from using any medications particularly those over the counter medications which treat the symptoms and not the condition. Diarrhea is one of the few maladies where we are more patient than not and for the most part let your body heal itself. The symptom of  diarrhea generally speaking is a natural tool to rid the body of toxins from pathogens such as viruses and even bacterial intestinal infections . We try to accomplish this while insuring that the child and adult do not become dehydrated or toxically ill from the infection .Our major emphasis is on fluid replacement with high electrolyte solutions and low sugar foods including a bland carbohydrate diet while eliminating foods that irritate the bowel.

Below is the basic natural approach:

                                         Medical supervision

Medical supervision to insure the diarrhea source is not infectious, doesn’t need a culture, you do not have parasites , or require any medical treatment – always consult your physician before beginning any self treatment of diarrhea.

                                           Hydration

Adequate hydration is the key to making sure you or your child do not get dehydrated and require iv fluids

Electrolyte solutions are our main source of hydration for diarrhea by containing the electrolytes you are losing in watery stool – pedialyte, coconut water, watered down and low sugar gatorade/powerade are the mainstays of re-hydration therapy and should replace other fluids.

                                          Elimination diet

Elimination of foods and drinks that increase intestinal movement . Eliminate fibrous fruits and  vegetables, oily fried foods, dairy ( including formula and milk but do not stop breast feeding), and spices should all be eliminated in the effort to control the diarrhea.

                                                   Tea

Healing Tea for diarrhea- in a cup of peppermint tea mix a teaspoon of ginger and turmeric to help settle bowel inflammation

                                            Binding foods

Foods for control of diarrhea and resting your intestinal system particularly carbs. Binding foods should be low in oil . Breads crackers, low in fiber and low in whole grains. Particularly saltines and cuban crackers, with minimal ingredients, including bagels, plain rice, plain pasta, ( all the low fiber foods not recommended on a regular diet). Applesauce, bananas, mashed carrots. Try adding tumeric or ginger to your bland food to reduce inflammation.

                                            Healthy healing

Healthy healing foods-pumpkin meat, coconut, carob powder, teaspoon of apple cider vinegar 2 -3 x a day.

Nutritional yeast and brewer’s yeast ( live yeast should not be used in crohn’s or patients with immune problems ). These have essential amino acids and protein, especially important for vegans who generally get their protein from high fiber sources like beans.

Probiotics for diarrhea symptoms: below are the most common bacteria reviewed to help restore bowel flora from diarrhea. No one recommended probiotic has everything. May use more than one. For instance start with culturelle, and can add florastar and another type listed below to come close to the full panel of helpful bacteria needed to replace the flora lost during bouts of diarrhea.

Certain bacteria you want for illness associated diarrhea include Lactobacillus GG, L. Acidophilus, bifid lactis, L. reuteri, and saccharomyces boulardii

Children- florastar for antibiotic associated problems, culturelle for general gastro problems,trunature, and natures way are all recommended . Can combine 2 of these once consulting with your physician. culturelle was not reviewed by consumerlab; one of my sources for safety.reviews

Adults- culturelle, nature’s way, align has one strain good for IBS, phillips, garden of life has many of the bacteria you would want.

Yogurt with pre and probiotics can be helpful such as Activa, but always be cautious with the dairy and not for vegans.

Medication for diarrhea should be very limited, and rarely for children. It can cause more problems than you started with. Natural food modified treatment is recommended more than any other condition . We do not use medicine in children it can cause bloating, abdominal pain, and blockage of the intestine. Check with your physician before using any meditation for diarrhea.     

Warren Krantz MD, FAAP

HealfhfulMD.com

Sensitive skin- Eczema-Dermatitis-Psoriasis: a natural approach

Sensitive skin: Eczema -dermatitis-Psoriasis

Healthful natural rx inside and out

What is Atopic skin condition? – or eczema and psoriasis similar skin conditions on an allergic skin continuum .If you have it it means you are more sensitive to changes in weather, things you touch and eat. It is not an illness that we can give a medicine and it does not come back. Think of it like a life long condition. Like being allergic to cats. You have to keep constant maintenance of your skin and vigilance regarding irritants to control the severity. Being aware of your personal  irritants is the best approach to helping maintain healthy skin. Changing your lifestyle, your habits, what you eat, touch, and what touches you are the cornerstones of minimizing long term inflammatory flare ups and progressive eczema and psoriasis. Like anything else we discuss please check with your physician or Pediatrician before making any changes or starting treatments natural or otherwise. This post involves a more natural approach to Atopic skin. There are many useful and successful medical treatments that your physician and Dermatologist can prescribe for successful dermatitis, eczema, and psoriasis care. These modalities including the standard skin maintenance with moisturizers and cortisone creams are very useful and I advocate their use for relief and treatment when the lifestyle I suggest below is less than adequate. . Sticking to a rigorous natural regimen is not practical or possible for everyone. Getting the best and timeliest medical care is more often than not the best choice when you or children are suffering with significant atopic skin.

Like any other condition it is important to find the source of the problems not just treating the symptoms.

These conditions can start at birth. We get a hint of things to come with babies that show signs of  sensitive skin. Namely rashes, bad infant acne. Dry skin. Etc.
With the help of one of my patient’s moms who suffers tremendously from psoriasis and keeps  her daughter as healthy as possible I have developed a go-to outline of natural eczema skin care.  All the below also apply to breastfeeding moms as well.

[Always seek medical advice for any severe reaction or before starting any new treatment whether it is labeled natural or not].

Main points of interest for skin care:

  • Eliminate and limit-anything you touch, eat, or wear could irritate your skin.
  • Foods- eat healthier-cleaner. Natural food changes and anti inflammatory diet are helpful
  • Cream- natural organic aloe products, and healthy oils. Moisturize consistently.
  • Gentle soap-  olive oil soap, oatmeal bar
  • Reduce stress-exercise, yoga, meditate.

Details on each point below. Scroll down to the end for more information on eczema conditions.

1.Eliminate and limit

  • Allergic foods and products and irritants. Review your diet and see what change or new food could be causing a recent skin flare up ( something you might have been eating more of lately)
  • Stay away from all creams and lotions with scents for you or your children ( remember  anything you touch can be an irritant if you don’t wash your hands and then go on to touch yourself or your children) Cleaning solutions, perfumes, soaps, foods, oils. etc. are all are potential irritants).
  • Clothes and sheets should be made of  plain untreated cotton.
  • Stay cool. Inside air conditioning if possible

 

2. Foods changes- improve your diet, include foods herbs and teas that heal

  • Eat healthier- generally processed, fried, sugar dairy, meat, all contribute to atopic skin .
  • Increase fiber to help keep your bowel and toxins flowing through and not absorbed
  • Make sure you and your children are hydrated. When the weather is hot and humid drink more.
  • Refine your anti inflammatory diet-increase organic colorful foods, greens, purples, oranges, yellows.
  • Increase healing, immune enhancing, anti inflammatory spices particularly the main ones turmeric, garlic, ginger, cinnamon,chili peppers, and oregano.
  • Teas are helpful in calming inflammation -green and red teas, chamomile tea,
  • Start a probiotic or adjust the amount of probiotic.to maximize it’s immune support and bowel proctection
  • Oils to take for additional anti inflammatory and immune support- fish oil , flaxseed oil, black currant oil.
  • Vitamin D3- seems like everyone is deficient in vitamin d and may help with eczema.

3.Creams lotions skin soothing support

  • Use California baby aloe cream or other organic aloe products..
  • Calendula cream reduces inflammation of skin, as well as lavender,chamomile, and rosemary based creams.
  • Coconut oil or coconut butter on skin has been shown to help. Also linseed and primrose oil.
  • Bathe in Earth Mama Baby Angel (no fragrance), Other fragrance free bath agents generally made of natural ingredients like oatmeal.
  • Healing Tree natural first aid anti itch cream helps with the scratching.
  • Vitamin E can also have anti inflammatory and soothing effect.

4.Soaps detergents water

  • Use olive oil soap bar or oatmeal bar for bathing
  • Limit bathing and swimming when skin is irritated. Water tends to dry the skin out.
  • Only use gentle natural clothes detergent. Baby detergents, even soap free.

5.Reduce stress

   Well known that stress can exacerbate most illness including eczema and psoriasis

  • Meditate and become mindful of what sets you and your skin off. Big events and life changes as well as illness can be the instigator of a breakdown in immune defenses including skin changes
  • Exercise- always has a positive and mood lifting effect
  • Do something you love. Read, travel, cook, calm your internal and external flames with peaceful activities.
  • Yoga is built around exercising and mindfully paying attention to your body.

 

For more severe cases resistant to the above or medical treatments including steroids, the suggestions below may be helpful in improving your atopic skin condition and boosting your  immune system.

  1. Clean healthy  vegan diet – no oil, no salt, no sugar,( possibly gluten free) – Switch to a soil based vegan probiotic .
  2. Nutritional yeast to help immune protection
  3. Take lauricidin, an immune booster to support good response to illness and challenges to your system.
  4. Gluten free diet.
  5. Eliminate nuts and seeds
  6. Raw Shea butter lotion.

Main causes

Genetic- it’s difficult to get past your family tree. Generally speaking children and individuals with atopic profile , sensitive, allergic skin, have first degree relatives, parents, siblings,uncles , aunts, grandparents with similar symptoms

Atopic allergic – from the foods you eat to the perfume you wear many things can be irritants and elicit a skin reaction . Usually more sensitive to bug bites, and skin contact with scents and creams.

Seasonal weather- many people have dry itchy exacerbations or their eczema during cold season. In climates such as South Florida the dramatic change in temperature in the winter and the heat and humidity in the summer are the two more prevalent times for eczema patients seeking treatment.

Even babies react to change in temperature, over bundling, creams and lotions.

Man made diet- poor inflammatory eating habits especially dairy, processed

foods, eating specific-allergic foods.

Water makes most atopic skin conditions worse by drying it out. Limit the bathing , especially for babies to few times a week. For older children and adults quick shower with room temperature water not very warm .

Summers are a particularly bad time for sensitive skin with sunscreen, swimming , lots of showers, sweating , hot cars, intense sun,and insect repellent

What we touch and what touches us

Chemicals in our clothes, hands, lips, sheets, pillow cases. Even the car seat, couch. Your clothing material on your baby’s face. When you are cooking or eating and then touch your skin or that or your child’s .

Pay attention to all ingredients when applying to yourself or your child. Lotion detergent perfumes . sunscreen , etc.

[Wash all members of the family’s clothes in gentle detergent so whoever rubs up against you or holds the baby will not cause irritation

Always wash your hands before handling your children and baby and your face particularly if they have sensitive atopic skin Anything you or anyone who touches your children touch can be an irritant ( perfumes, cologne, insect repellent). What you touch touches them, when you are cooking – all the foods you touch can be an irritant.

Every towel cloth napkin wipe that you use has ingredients and previous irritants that could be the culprit

Try to stay cool as much a possible when the sensitive skin is acting up, moisturize vigilantly in am, after swimming, immediately after bathing.

Pay attention to the part of the body that is most affected- scalp, arms, shoulders, behind knees.

Think about something that might have been new or has ingredients that are not being tolerated, new shampoo, hot seat in the car.

The more natural the better. The less added chemicals and scents the better. Try to find products free and clear of anything but the essential ingredient .

For instance in sunscreen the two main ingredients in all natural products are titanium and zinc oxide which are considered safe and usually not a source of irritation for dermatitis sufferers

Eating  healthy makes a difference. If you look at eczema ( atopic dermatitis) as the inflammatory process, it is easier to understand how anything you do or eat that would disrupt your body’s health and cause more inflammation would make your eczema worse. As in my other posts, the approach here is to be organic, natural, healthy and limit your sources of inflammation to limit your inflammatory conditions of which eczema is a prime example of one.

Warren Krantz MD, FAAP

HealthfulMD