Insect repellent guidelines

Insect repellent guidelines and recommendations

I had published an article evaluating insect repellents about 5 years ago . The main ingredient I have consistently recommended to prevent insect bites has been Picaridin. It is still difficult to find in stores and for the most part has to be ordered online.

In addition since most people travel in the summer months and many to areas now considered high risk for lime ticks it is essential to know which products cover these as well. The high picaridin concentration products also are effective against ticks as well. Permethrin is considered the most effective ingredient for tick avoidance. However, Permethrin is not as safe to place directly on the entire body and should be applied to clothing only.

Tips to avoid mosquitos 

Place a large fan by each doorway, Mosquitoes cannot fly past a strong wind force.

Spray all your plants and areas that are breeding grounds . there are many natural products that several companies are using to spray in our yard.

Empty all containers outside that contain water to avoid the mosquito breeding

Mosquito lights ( zappers) and fans to attract them work in a restricted area . Several brands are popular including dynatrap which I have found to be effective.

My recommendations for products you can easily purchase

Sawyer 20% Picaridin spray or lotion

Repel -15% Picaridin – ( Has a red Label and says Tick defense but is the same for Mosquitoes  ) Available in Target and Walmart.

Natrapel – 20 % Picaridin

Wipes – Natrapel 20% Picaridin

Fan- place a large fan at your entrances angled to keep the mosquitoes from flying into the house. Or around the area where you plan on sitting in the yard.

Lime tick preventionSawyer permethrin

Top products recommended by Consumer Reports

Sawyer Fisherman’s Formula – 20% Picaridin

Natrapel 8 hour- 20 % Picaridin

Off Deepwoods V111- DEET 25 %

Repel Lemon Eucalyptus  Oil of Eucalyptus 30 %

2019 update to insect repellent for mosquito protection. As before, I used Consumer Reports ratings and suggestions as my starting point for recommendations. This time there is added emphasis on the most successful protection with less concern regarding  type of spray- organic or not . Similar to last review “ Picaridin “ ingredient comes in first across the board for both effectiveness and least toxic to you and your children weighed against this effectiveness. Over the years I have tested most products since I am a personal mosquito feast. The organic and natural products do not work for me and their smell was so noxious that family and friends and my dog stayed away from me but the mosquitoes  were hardly deterred .In addition many of these “ natural and organic” products have not been tested by the FDA and really can not be verified for safety, quality, ingredients,  or effectiveness. With the Zika virus making the stakes higher than ever to prevent mosquito bites all individuals involved with caring for children and preventing disease are more strongly than ever recommend products that work effectively rather than are most natural. Fortunately , in this case the one I have found to be most tolerable across the board Picaridin is the most effective and least irritating.

In addition with consideration to the environment Picaridin also rates highly. Many of the organic and natural products would have contaminating effect on the environment in the concentrations necessary to garner any substantial repellent activity. But in this instance they do not offer enough protection against the Zika virus mosquito to warrant serious consideration. DEET has been found in streams and rivers and shown to have some impact on wildlife. Taking effectiveness , toxicity to children, and least possible environmental impact I recommend “ Picaridin” as my first choice in insect repellent.  The only difference , the products that have been previously recommended do not have a high enough percentage of Picardin in their solution. 20 % seems to be the concentration that works the best in the Consumer Reports testing and ratings . The brands which were the most effective were Sawyer Fisherman formula Picaridin, Naturapel; 8 hour with Picaridin, . Deepwoods off with 25 % DEET was as effective against mosquitoes but not ticks, but I do not recommend that strong of a percentage of deet for children. Repel lemon eucalyptus 30% was the only non Picaridin based repellent rating as high but the smell is difficult to tolerate and it’s irritating to the skin and eyes to the point that it is not recommended for anyone under 2.  

Insect protection and repellent guidelines.

  1. The ingredients proven the most effective and with the longest history of safety is Deet. Picaridin has been studied for 15 years and has proven to be safe and is less irritating especially to children with sensitive skin. Oil of Eucalyptus has proven to be moderately effective as well.
  2. Children under 2 months of age should not receive any topical insect repellent. [ Use mosquito netting to prevent any access to babies ]
  3. Oil of Eucalyptus should not be used on any children under 2 years of age due to the concerns regarding possible eye irritation.
  4. Apply it to your hands and then rub them on your child. Do not spray it anywhere near a child to avoid inhalation of fumes. In the case of Permethrin for lime tick prevention do not put it directly on your hands before spraying it on your child’s clothes and shoes.
  5. Do not apply it to a child’s hand, they may put them in their mouth.
  6. Adults should do the applying for young children.
  7. Apply to clothing first and foremost to avoid unnecessary skin irritation. Do not apply it under clothing.
  8. Apply sunscreen first before adding insect repellant.
  9. Sunscreen and insect repellent mixture is absorbed in a higher degree and not recommended.
  10. Be careful applying to cuts wounds, and after shaving. It can be absorbed more readily.
  11. The percentage of each ingredient correlates to the time spent outdoors. 10 % is usually sufficient. However, now we recommend Picaridin 20 %.
  12. There has been no reported serious illness regarding the use of these ingredients in children.
  13. The recommended ingredients are safe for pregnant women, breastfeeding moms, the elderly, and babies older than 2 months of age.
  14. Natural products that have proven moderately successful include Avon “Skin so Soft”, California Baby, and Burt Bees. And some essential oils tend to be helpful including cinnamon oil, eucalyptus oil, citronella oil, peppermint oil,  lemongrass and rosemary. However, in the recent Consumer Reports review none of these natural style products were effective against the Zika carrying mosquitoes .
  15. Remember to reapply according to the instructions on the package .
  16. Pay attention to any skin irritation in areas where you apply the repellant.
  17. Should wear long sleeves and long pants this year. Collared shirts give more protection.
  18. Shoes – be very cautious with open toed sandals and crocs.
  19. Hat- hats offer protection not only from the sun but also keeping mosquitoes off your face and scalp. Can spray the hat before putting it on to offer even more protection.
  20. Try to avoid early morning and dusk through the night time without complete protection described above.
  21. Don’t spray near food and wash your hands before eating.
  22. Do not go to sleep or get in your bed before washing off the insect repellent.

Make your own natural insect repellent ( have not been proven to be as effective as the recommended picaridin products.

Base: Calendula cream – 4 0z -has repellent qualities as well

Cinnamon leaf oil -about 20 drops or 3 ml

Peppermint oil – 20 drops

Rosemary oil 10 drops

Lemongrass oil  20 drops

lavender oil – 20 drops

( I avoid citronella and eucalyptus even though they are he most effective ingredients because of their strong odor and irritating quality on the skin.

Deet  products are the highest rated-for most effective by consumer reports for all concentrations .  I tend to add  smell and feel to the list of important criteria in selecting an insect repellant.

Consumer reports ranked Deep woods Off, Cutter Backwoods, and Off family care the most effective at 98% with Cutter Backwoods unscented and Off Family care smooth and dry much more tolerable for feel and smell to me. They all last up to 8 hours and keep mosquitoes away well. However, due to the higher percentage requirement for DEET for the Zika carrying mosquito , I prefer we avoid DEET at those levels.

Picaridin– the product I use the most has a similar effectiveness. Previously I have recommended the the lower percentage of products by Off and Cutter advanced which contain 5-7 % Picaridin. These two products have worked well for me in Florida as well as while hiking in Mosquito infested areas. Consumer reports ranked Natrapel which has 20% Picaridin very highly at 97 %. And now with the concern with a more vigorous mosquito carrying the Zika virus , based on Consumer Reports findings , the higher percentage is now recommended.

Permethrin – used in treating lice on the hair and body is a good tick repellent. It should be handled carefully and applied to clothing and shoes when going out in areas known for deer ticks.

Avon skin so soft has a smell and feel that I have never been happy with. It is ranked as more effective than organic products at 73% by consumer reports.

Lemon Eucalyptus– ( for instance Repel ) works well but the smell is generally intolerable to others. In my experiment I had to walk and jog by myself by at least 10 feet due to the annoying smell to other people in my party. My dog would not go near me or any room that had the clothes sprayed with Eucalyptus. This is not recommended for children under 2.

Organic products- based on plant oils generally are considerably less effective as a group .Bite Blocker  had a 56 % rating and Burt’s Bees had a 24 % rating compared to the recommended products effectiveness by Consumer reports.

Off ” clip on repellent”– the off “fan” that clips on and distributes a fine mist of repellent by fan is moderately effective if you are still for long periods of time. It is not nearly as effective if you are moving or walking. There is a warning on it to not breathe in the fumes, which is not really possible especially for children. In addition to these findings by Consumer Reports it tends to not last nearly as long as it states on the package. I have used it for sitting in the backyard and it helps keep the mosquitoes away, but I would not recommend it for small children.

Stickers and bracelets – have been successful for many parents. I have tried them on my collar ( one on each side to avoid putting on repellent and they have moderate success in avoiding mosquito bites.

Warren Krantz MD

Your best immunity from the ground up

The purpose of this post is to help you maintain the natural immunity you are born with and limit the habits we as a society have accepted that have compromised our ability to deal with and fight every day common germs

Building a strong immune system is as important today in our modern times as it has ever been. Our modern lifestyle has moved us away from our natural physiological immunity. Our attitudes and fears toward germs have led us to try to control all these perceived threats by sterilizing our life and interaction with our surroundings.

But in our effort to eliminate all these perceived threats from germs we have weakened our collective immunity . We have dampened our immune response to germs by aggressively trying to avoid them in the first place..

We need a strong immune system to fight viruses and colds, to ward off infections in the air, in our food and on our skin. As the world becomes closer and germs travel further it’s never too early to start considering how to maximize our natural immune capabilities.  

Our health and longevity have benefited immensely from modern medicine. Medical discoveries including antibiotics, diagnostic tests, surgeries , and certainly sterilization techniques of surgical equipment and environment to prevent hospital infections .But by taking all these benefits out of context , by sterilizing everything in our everyday lives , we have weakened our native immunity.

When the news and social media cries wolf regularly, common diseases seem like an epidemic breeding fear in parents. We all become overprotective in order that our children avoid all germs and common infections. But there is a real danger in making our environment too sterile. We will not have the individual or community immune resources to fight emerging epidemics.

Until recently our personal habits including hygiene, diet, less exercise, poor sleep, too much screen time,  and the way we raise our children was not recognized as having a negative influence on our immunity . But we now know these are key factors in lowering our immune potential.

Key points to maintaining your natural immunity

  • Too clean– need to go back the old fashioned idea of getting your hands dirty to build a good childhood immune system
  • Getting sick is key to staying healthy- avoiding germs early in life leads to a weaker immune system and you won’t have the immune reserve when you need it the most
  • Go outdoors and bring the outdoors in- our indoor environment has become too sterile and we spend too much time in it.
  • Eat healthy organic unprocessed foods for your immediate and long term health as well as for your intestinal and immune health
  • De-stress – sleep,exercise, mindfulness. Learning how to cope in today’s world are key to a strong and healthy immune system
  • Move– exercise, physical activity, and plain movement is as important as anything else in building a sound immune system

Starting at birth-enhancing the immunity we were meant to develop

Delivery- the rampant rise of c-sections has not helped babies develop as strong of immune systems from the very beginning as they were intended. Natural vaginal deliveries are the way we were intended to be born and present the first opportunity for exposure to good bacteria and an immune enhancing environment vs the sterilized environment of the surgical suite. Studies have shown that children born vaginaly have a beter early immunity and seem to deal with early illness better.

Baby feeding

Breastfeeding is superior in every way as a source of nutrients than formula . When it comes to immune enhancing ability there is even less of a contest.  Breast milk gives direct immune protection with immunoglobulins passing through the milk to the baby. This helps them fight infections as well as protective benefit for intestinal system. In addition the act of breastfeeding is beneficial due to the direct oral contact with mom’s skin by inoculating the baby with mom’s skin flora for a developing immunity.t The warmth and social contact with mom have the benefit of close maternal bonding which is known for stress reducing and immune building.

Bottle feeding – new evidence shows that we are sterilizing the bottles and nipples too much not allowing our baby’s any opportunity to come in contact with any immune building potential from the environment.

Personal hygiene -All our sterilizing has also killed the protective bacteria from our skin, mouth, hair, intestinal system, and nasal passages.

Bathing –

Baby . Parents generally have a tendency to over wash their baby’s. Unless your baby runs a marathon they really do not need a bath every day. They benefit from a strong skin barrier, beneficial bacteria, and protective oils on the skin. These are all reduced with too frequent bathing with soap. Baby’s need this protective skin barrier to guard from rashes, irritations, and infections.

Children and adults – truth be told -we should not be constantly showering and bathing. We are removing valuable protective barriers from our skin including oils,  and bacteria. We are also drying out and breaking down intact skin with constant water, soap ,and scrubbing with abrasive agents and perfumed soaps. Our largest organ is our skin and our most important protective barrier for our body against the dangers of world.

      Compromise- during work and school days particularly sweaty dirty outdoor day’s you can’t get away without bathing . But on weekends and when spending your time primarily indoors every once in awhile it’s ok to forgo a bath.

Hand washing

Too much hand washing and hand sanitizer removes all the good bacteria from our skin. Not to mention the chemicals in the sanitizer. We do not get the opportunity to interact with the good immune enhancing environment we were meant to when we constantly wipe it away with chemicals.

There are a number of times that it is essential to wash your hands. For instance after using the bathroom, especially public restrooms or when you are near others with a cold or flu. Good hygiene habits are not synonymous with constantly sterilizing your hands, it merely means to protect yourself from dangerous germs in a reasonable and sound way. Not all germs are the enemy.

Deodorant

Antiperspirant vs deodorant. Stopping sweat is not the best idea for both health versus deodorant which hides the smell but does not change the body’s response. It is natural for us to  sweat and smell as part of a natural protection.

Too much deodorant prevents natural oil and protection of bacteria that usually forms in most warm areas. ( not to mention the danger of the aluminum in deodorant)

The sanitized house – spotless dirtless house is not always the healthiest.

Clean versus sterile- method of cleaning . Sterilizing with alcohol and bleach bringing toxic chemical to remove all sorts of useful dirt ( natural immune support) vs cleaning and making your house sanitary.

Cleaning all objects and surfaces relentlessly with harsh chemical can be couter productive. Use mild natural detergents and soap and water. Do clean well when necessary but relentless obsession of being spotless and sterile is lowering our immunity and not helping us face the outdoors

Put nature back in our immune system

Bringing the outdoors in-

Taking off your shoes- many homes  are trying to eliminate dirt both for aesthetic reasons and in an effort to keep outside dirt and germs at bay. But is this a good thing. Not according to studies that have indicated that too sterile of an environment has a negative impact for children trying to build a young immune system. Once again you need exposure to the elements and allergens earlier in life in order to build and enhance your system for the long run.

Removing shoes when you come in the house ( other than circumstances where your child was walking in mud or dirt or is allergic to the pollen they might be carrying in) – while keeping the house clean prevents needed environmental allergens and exposure to common environmental germs .

Get a dog

Your immune system is helped by having a dog . Studies have shown that a dog brings the outdoor environment in and improves a child’s immune system by slowly exposing them to all sorts of good bacteria from the outdoors.

Play outside

Going outside in mother nature especially to green places and is immune boosting .

Allow your children to play outside in the green outdoors. Run kick play with balls .

Play in the dirt and sand like children should. Sure there are some germs in dirt but building up your immune system is worth the risk. If you wash their hands appropriately with soap and water you can maintain a good balance between outdoor germs and cleanliness

You are what you eat  

Healthy local organic fruits and vegetable are the best version of food to enhance your immunity. Eat lots of organic fruit and vegetables avoiding preservatives .Washed well but do not sterilize.  Want the good bacteria that comes with it – eating nature in a way in it’s healthiest form . Processed chemically altered foods are harmful to our bodies but especially to our intestines and digestive process. Processed foods with chemicals reduce your body’s immune fighting .

Intestinal flora needs to be maintained with healthy eating and natural- probiotics, high fiber, whole foods. Try to eat a good balance of raw ( but safe not on recalled list) fruits , nuts, seed, and vegetables). We are learning that our intestinal system is integrally involved with our immune system. And a healthy intestinal system is crucial to a good immune system. Eating organic, natural , unprocessed high fiber foods is the best way to maintain intestinal health

Introduction of probiotics may be helpful if you or your children have an altered intestinal flora but you must be careful in the brand and types you introduce. Many physician’s are now recommending probiotics to enhance immune health in people who do not have optimal healthy diets.

Sleep

Having a goods night sleep is essential to maintaining a good immune system. Be sensible with the time you go to sleep. And keep your sleep patterns regular. A change of schedule and sleepless night could be the weak point in getting sick.

Exercise and movement

Stop playing video games and start using your brain while moving . Many studies show that movement improves blood flow and immunity. Exercise helps thin mucus and your ability to fight illness. It also has been shown to reduce stress.

Stress- It is important for children to learn how to deal with adversity . Teach them how to interact, respond, and resolve. Do not just distract with food and screen time. Talk things through don’t just do everything for them guide your children. It’s never too early to introduce your child to mindfulness.

Exposure to childhood illness and vaccines

In our new world, parents do not expose their child to germs and viruses from common childhood illness early enough. Diseases and illness are much worse when you first get them when you are older. Schools are making parents paranoid with all the caution regarding every common everyday virus that passes through during the cold and flu season. Childhood viruses have been around for centuries but only recently demanding unreasonable parents have forced the schools to become neurotic guardians of a germ free environment,quickly sending out a panic notice for every disease and virus . Parents feel it is a bad thing to go to school and catch the latest greatest bug. Even some schools make parents bring a note that the sibling of the ill child is free of illness before allowing them back. This approach is irrational since the viruses are the most contagious at the very beginning with the runny eyes, sneezing, and fever. Not at the end with the congestion and coughing symptoms.

A New study on childhood leukemia has indicated that if your children are not allowed to cultivate the germs and build their immunity at a young age they will not be prepared for the germs when they get older and will overreact to the point that these children have a higher risk of getting seriously ill. This is preliminary but a warning to all the parents and schools trying to eliminate every cold and viral germ from all children.

Fever is our friend ( see fever blog for information ). Not letting our children fight viruses with fever. A fever is a major way we develop our immune system and create immunity for future infections . Like training our system to fight future germs . Most parents generally do not allow their children to fight the gems with the body’s natural response including fever.

Too much anti fever medicine does not let us fight the germ with all our ability.

Vaccines do enhance your child’s immunity –  I have never had a documented legitimate experience after a child gets the vaccine that they have a sudden lowering of their immune system or get colds more frequently. This is one of the arguments from parents who want to delay the vaccines . Vaccines  are protective as well as good exposure and a challenge to the immune system to help it build stronger. When these unvaccinated children finally do get sick it is much more severe and complicated.

Socialization- interacting with others is beneficial in many ways but for the purpose of this article interacting helps develop your immunity directly by sharing germs and inoculating you with community germs.

Close relationships -sharing drinks, hugging, bonding ,and touching are beneficial on many levels to our immune growth as humans.

Homeschooled and isolated children are not exposed to the many good types of bacteria and germs at an early age to slowly build up a strong and resilient immunity. They are more likely to get complicated and severe responses to the common viruses when they are finally exposed to other school children.

Early testing like rapid tests for strep, flu, other infections leads to early treatment and although there are clear benefits to not letting us or our children suffer with a preventable illness we do not get to experience the germ and build up an immune response to fight this infection the next time.

Antibiotic overuse is a topic itself. But generally speaking antibiotics change your intestinal flora killing the good bacteria and have a negative impact on the intestines ability to respond to immune challenges.

It is important that we use common sense in approaching the fears we have in our changing world regarding treatment of illness especially viruses and infections. There is much we can do to improve our individual immunity . We are stronger than our fear tells us we are.

Approach to allergies

Allergy management

Medical care– seek medical care for any of the below symptoms particularly if it is of acute and problematic nature. Allergy symptoms have many similarities to other medical conditions.Before attempting any self treatment or holistic methods below please discuss your or your children’s symptoms with your Physician for a consult and physical exam.Things are not always what they seem and a trained physician is the best place to start when diagnosing and managing allergies.

Description of allergies

General explanation for allergies is your body’s immune overreaction to things in the environment and your diet.

Common allergic symptoms include runny nose, sneezing watery itchy irritated eyes, nasal congestion,sinus problems, skin rashes, hives and itchy skin rashes. Severe reactions could include swelling in the throat, eyes, lips, coughing with trouble breathing.

( For any symptoms call your Medical doctor, and any doubt as to the severity of your or your child’s symptoms go to the emergency room or call 911)

An example of a mild allergic reaction is when you are sensitive to someone’s perfume and start to sneeze, develop a runny nose and itchy eyes.

The sources of these irritants are many and can be from food which can also cause stomach pain, gas,bloating and diarrhea; or allergens that range from pets to the environment which tends to cause runny nose, coughing, and respiratory issues. . Allergic and commonly called atopic symptoms range from merely a little sneezing to sensitive eczema skin and asthma with wheezing.Many allergies run in families .

Managing allergies:

 

  • Elimination of the sources of your allergy in the home, outdoors, diet , and personal care products
  • Medical treatment from over the counter to emergency medical care always consult your physician first
  • Foods, herbs, teas, that help with allergic symptoms
  • Supplements that may improve allergy symptoms
  • Lifestyle change- exercise, meditation , stress reduction can moderate some of the allergy triggers

 

Elimination.

Best method in managing allergic symptoms is to avoid the causes in the first place. Below are things to consider eliminating to lower your exposure to allergens that cause your allergic reactions.

Environmental and Household allergy management and control

Pets bring us unconditional love and joy but allergies to these pets can be problematic . Your friendly family pet can help enhance a child’s immune system by exposing them to healthy bacteria and at the same time help the whole family de-stress, but many people are allergic to dogs and more so cats,( there is really no such thing as a non allergic dog, only some dogs shed less.) All dogs potentially cause allergies in the house and particularly in the child’s room. Also something to consider even if you and your children are not allergic to your dog or cat is that your pet is the perfect vector for bringing all sorts of outdoor irritants and allergens into the house including pollen, ragweed, grass, dirt, mold etc.

House

Bedroom

Mattress- buy a hypoallergenic mattress ,place a plastic cover on mattress, no curtains,no frilly blankets. No carpet. No stuffed animals or toys in the room, keep them away from contact in glass or storage containers. Keep pets out of the babies room until you know the child is not allergic to this pet. Take your shoes off when you come into the house. Any clothing with lotions , plant residue or spray remove and leave in the washroom, by the front door or the bathroom.

Dust and mite collectors-  try to eliminate clutter, curtains,  carpet , stuffed toys, mattresses, and furniture that collects dust,

Cleaning products– detergents, carpet cleaners, floor products including bleach, ammonia, and anything with a scent  are all irritants.

Exterminator and bug spray – have non toxic brands. Stay out of the house for at least 3 hours after you spray for insects or the exterminator does. Keep your child out of the room where you spray for at least an hour when you do it yourself.

Indoor plants– pay attention to any indoor plants that may have mold,bugs, seed, flowers or pollen.

Air conditioning – use an electrostatic filter to lower the dust and allergens in the air, clean vents with non toxic chemicals. Have the whole unit checked for mold and germs in the motor, pipes and fans. Set up an ultraviolet light to keep the filter clean and free of mold.

Mold is a particularly problematic in humid climates such as South Florida. It can get in the air conditioning vents, walls, floorboards, and any closet, bathroom, or moist area inside the house or outside. Be vigilant to keep the house mold free it can be one of the most irritating and toxic sources of allergies and respiratory problems.

Outdoors

including your yard and the neighborhood –

Be aware of the allergy irritation potential of the flowers, plants, trees with pollen surrounding your house or apartment.

Insects are also a common source of allergic reaction ranging from simple itchy mosquito bites to severe redness swelling and respiratory issues with bee,wasp,and red ants. If you find you or your child has a severe reaction to one of these insects you should see an allergist and make sure you have diphenhydramine and an injectable with you whenever you are outdoors or in school.

Seasonal allergies particularly mold during rainy season,pollen during the windy season, and decaying leaves on the ground during fall are things to consider.

Chemicals sprayed on the grass in your yard, the neighborhood or the park travel back in the house on your shoes with allergens from outside are additionally something to be aware of.

Pools and lakes can be a source of problems- pool chlorine tends to bother many children. Lakes can have algae and other plants that are irritants.

Personal

Hygiene – is a new area of discussion. We of course want to be clean but not too clean. Appropriate hygiene is the catchphrase- try to avoid putting allergens on your body and face by touching your face and nose with contaminated hands from touching plants, dust ,and pollen by washing regularly after coming in from the outdoors or when you know you have a substance on your hands. This can initiate an allergic reaction without even realizing you have done it yourself.

But there is much discussion regarding being too sterile with wipes, hand sanitizer, constant washing and cleaning. This leads to eliminating good bacteria from the skin as well as causing children to be more susceptible to allergens from food and the environment since they were not exposed and allowed to develop a tolerance while they were young. They subsequently do not develop a proper proportional response to allergens and overreact to anything new causing worse reactions. So use wipes and hand washing when you know there is particularly dirty little hands or your child touched something obviously irritating. But it is not necessary to constantly clean them for any reason.

Personal and household supplies that you should consider eliminating or changing.

Beauty supplies-perfume,cologne, make up, shaving cream,deodorant, body lotions, soaps. Can all be irritants and should be evaluated for possible allergic reactions. Hair supplies- shampoo and conditioner, straighteners, creams, spray, gels can also cause allergies and rashes around the hairline and neck.

Additional Things you put on your skin, moisturizer, sunscreen, insect repellent are all known to be very irritating to the skin and respiratory system.

Cleaning goods including clothes detergent, household cleaners like floor cleansers, furniture polish, dust sprays .

Other possible sources for allergies in the house. Smoke , candles. Incense, fragrance .

Food elimination when trying to uncover allergies

Keep a food diary or log to try to see if their are any foods which might be responsible for allergic symptoms. Generally food allergies are manifested more internally such as stomach upset, gas, loose stools. But often they can also be part of a wider allergic profile such as congestion, coughing, eczema and atopic skin and rashes.

First monitor your most commonly ingested foods , diary is one of the most common. Then look carefully at the known allergic food group including berries, corn, nuts, tomatoes, citrus, and eggs. Then move on to evaluating you or your child’s diet for additional foods consumed and those you may need to eliminate. Next see if eliminating them makes an improvement in your symptoms.  It can take up to a week or longer to notice improvement but often the difference can be seen in a few day’s.

If elimination and management particularly once you have consulted your physician or child a Pediatrician does not help then it may be time to  take your child to an allergist

[ Early introduction of common healthy allergic foods such as peanuts and fruits such as berries is now recommended to prevent development of these allergens in children  ]

Medical management :Always seek medical advice from your medical doctor and child’s Pediatrician before beginning any medication including over the counter meds. Even the smallest of signs of allergies can turn into big problems quickly so consult your physician for advice and a plan in the event of worsening of your symptoms.

Medications to have in your cabinet and with you when you travel if you have known allergy symptoms in the family

Benadryl or generic name diphenylhydramine, claritin, allegra, and more emergency treatment as prescribed by your physician for known serious allergies. epi-pen, and auviQ

Nasal- washes with sterile saline is often helpful in keeping your nasal passages open and clear of allergens. Cortisone sprays are now available over the counter but should be recommended by your physician prior to beginning any therapy

Non medical options to reduce allergic symptoms to try  

Foods to include  that have been known to help with allergies

Quercetin containing foods – quercetin is a  component of foods that it is known to be anti inflammatory and antioxidant particularly for the over response of our immune system to things that cause allergies

Foods high in quercetin include red apple skin, red onions, capers used in flavoring  ( try to find low salt), lovage leaves, berries including blueberries and elderberries , black plums,and red grapes.

Nettle Leaf is another anti inflammatory plant that has been commonly used to help with allergic symptoms.

Supplements

Quercetin and nettle leaf supplements are also available – please check with your physician before starting as any antioxidant may interfere with other meditation

Teas

Green tea has catechins which helps reduce histamine ( the source of allergic reaction ) production by your body in response to allergens.

Ginger tea is a good  anti inflammatory and helps calm allergies

Rooibos tea helps reduce the histamine response as well

Peppermint tea is known to help with the congestion and allergy symptoms

Nettle, yerba mate, and lemon balm tea can all also help with allergic symptoms.

Spices and herbs

Cinnamon in general helps with it’s anti inflammatory and blood stabilizing properties. Cassia cinnamon in particular helps moderate allergic symptoms with about a teaspoon a day being the recommended amount.  Cassia cinnamon mixed with spanish needles makes a reasonable anti allergy mixture that has been researched to have benefits.

Turmeric once again helps with allergy symptoms with it’s anti inflammatory benefits

Elderberry syrup has been used for centuries to help with allergy symptoms such as congestion and runny nose.

Ginger itself is useful for allergy symptoms by lowering your reaction and helping with cough.

Black pepper also has been shown to be useful to help lower allergy and other atopic symptoms including skin issues.

Probiotics- help your intestinal flora keep your immune system functioning at peak and generally maintain the appropriate response to stimulants in food.

Stress reduction is immune building and allergy reducing

Exercise always helps calm your nerves which contribute to allergies. Blood flow enhances clearance of sinuses and thinning of the mucus

Meditation and mindfulness at the very least helps with the anxiety and frustration associated with chronic allergy sufferers. But in addition there much research regarding the nature of stress and its effect on your immune system even your overreaction to allergens in the environment and the development of allergies particularly eczema .

As with all recommendations please check with your physician before beginning any regimen .

Allergies present a particular dilemma for anyone trying to avoid medications and live healthy .

Allergic symptoms can be miserable and often worth using medications to be comfortable. But if you do your homework with the help of this guide  you can reduce your dependence on some medications and use them more wisely

Warren Krantz MD

The HealthfulMD

Author of “ Start Healthy, Stay Healthy”.

The too active child and natural ways to maintain focus and calm

The active child – natural ways to help maintain focus and calm

Every parent, at some point, thinks  their child is overactive and concerned that they might have ADHD . And who hasn’t blamed sugar or chocolate or sweets for kids acting out of control ? Most parents blame misbehavior on their child being either overtired, hungry, or getting sick . The next question invariably is “what can I to do to prevent my child from being hyper?”

From a medical and psychological professional’s perspective ADHD needs to be treated properly and is considered a true disease with multiple treatment modalities not just magic pills. These methods include psychological family counselling, behavior modification, parenting education, medical and psychological evaluation, and comprehensive testing. The whole family has to participate to change the household dynamics and ingrained patterns of reactive behaviors when interacting with the active child as part of the comprehensive psychological work. Being the Pediatrician, I am fortunate enough to develop a good relationship with my families and have gained unique insight into the personality of each child and the parents sincere efforts to use whatever of the available non medical modalities they could to manage their often disruptive child. When all these efforts have not been successful in improving behavior, self-esteem, or their ability to succeed then the parents and I feel that medication is  the correct treatment option.

It is always recommended to have a Medical exam before beginning any therapy to rule out any treatable sources for changes in behavior like poor sleeping, sleep apnea, allergies, stomach upset , and pain . It is also recommended to include a blood exam for thyroid , anemia, proper organ functioning, and other medical and physical causes .

[Please consult your physician before trying any remedies to alternative therapies for any behavior issues.]

ADD and ADHD evaluation and treatment is well described by many other resources. That is not my goal here. My purpose here is to offer guidance to some of the remedies promoted by many non medicine proponents.

While changing the diet of your child is not the end all for diagnosed ADHD children it can be part of a comprehensive and constructive plan to effectively treat a child with many of the characteristics of an overactive child.

Food and behavior There are many things you can do to modify your child’s diet that might help them not be as reactive. Managing their diet  is something simple that might have an impact on their behavior..

Elimination diet

There are no comprehensive double blind studies to show that particular foods tend to overstimulate children who have a tendency to be overactive or have ADHD, but it has become an accepted anecdotal notion by most Pediatricians and parents that many foods hype their children up. It is worth keeping a log of foods your child eats and correlating their behavior to these foods.

The foods listed below are commonly accepted as foods that make even the average child excitable and should be the first foods you eliminate in their diet management plan.

Chocolate – particularly brands with more processed sugar. Dark chocolate with high percentage of cocoa over 85% and less cocoa butter and sugar is much less likely to cause over activity.

Processed sugar in store bought products and packaged foods is also considered overstimulating in many forms for children.

Candy not just chocolate has a lot of processed sugar and fillers.

          Baked goods like cakes with frosting, cupcakes especially with icing and sprinkles .                  Drinks – soda, juice with sweeteners, fruit drinks, sports drinks.

          Cereals- most of the store bought children’s cereals are packed with artificial                               sweeteners and sugar even the ones deceivingly marketed as healthy.

Food coloring particularly red dyes in candy, drinks, colorful cereals, snow cones, slurpees, colorful icing, colored sprinkles.

Fatty fried and sugary food – fat seems to make the effect of the meal even worse for hyperactivity. Donuts are a perfect example of fried with sugary coating.

Big carb meals generally makes everyone tired but also causes a “hyper” child to have less control over impulsivity and lose their focus.

Foods and natural means to improve behavior

Foods, supplements, and natural products that are popularly accepted to help with focus and calm excitable behavior

Low glycemic foods particularly high fiber healthy whole foods maintain an even sugar level without the resultant highs and lows of high glycemic low quality foods. Keeping their sugar and insulin level stable tends to also maintain an even behavioral response to diet. You don’t get the initial jump in energy from sugar and avoid the follow up drop in energy from the precipitous drop in blood sugar.

High fiber food assist in stabilizing blood sugar in addition to keeping constipation another distracting problem from exacerbating the unwanted behavior.

Zinc has been shown in some studies to help improve attentiveness and calm children with hyperactive behavior

    Zinc rich foods -seeds include pumpkin seeds, watermelon seeds, squash seeds,and sesame seeds. Also dark chocolate, garlic wheat germ chickpeas or hummus have good amounts of zinc.

Magnesium is considered a good mineral for calming nerves and some studies have shown it to be particularly low in ADHD children.

Magnesium rich foods include dark chocolate , seeds particularly pumpkin seeds, nuts especially almonds and cashews, bananas , avocados, deep sea fish, legumes-beans,lentils, chickpeas, peas,  tofu, whole grains – barley, wheat, oats, and of course lots of healthy greens.

Choline is considered important to nerve development and function. Good healthy diet with plants as a main food offers more than enough choline .

    Choline rich foods – Soy products including soy milk and tofu,  quinoa, broccoli, cabbage, kale. Animal products having higher levels of choline include yogurt, fish, liver, and eggs. Egg as a source is controversial for it’s true value versus negative health impact. And liver comes with it’s own heart health cost.

Omega 3 rich foods have been shown to help with attention in children – including fish oil, ground flax seed, deep sea fish – salmon ( limit the amount due to mercury contamination)

Teas- green tea has been shown to help with focus, other teas that might help include white and black teas, all purported to help with focus

Herbs have historically been used to bring calm -lavender , velerian,ginseng and green oats, and lemon balm are the most widely used herbs with some success in calming and helping focus. Also ginkgo biloba, licorice root, brahmi, gotu kola, and pine bark have been used for centuries by many eastern cultures. [AvoId kava due to liver toxicity and other side effects ]

(Once again consult your physician before trying any remedy )

calming teas and other herb teas are more for sleep and slowing down at bedtime, they really are not useful for waking hours, chamamille, passiont flower, lemon balm

Essential oils- lavender, rosemary are most commonly used to help active children with focus. Others include peppermint oil, Ylang ylang, Frankincense, which have been reported to calm, and may help with focus.

[Essential oils are not for oral ingestion and are only to rub on the skin. Be careful with redness, rashes, and allergies. Some anecdotal discussion also include the value of scents of these same oils for calming effect.]

Supplements – zinc, magnesium, green tea supplements are purported to help quiet an overactive child. I am generally not a big believer in supplements instead of the natural plant source for benefit. It can be worth a try with problematic children particularly if they will not eat many of the healthy sources for these supplements.

Activities and other tools to help your child develop a sense of control over their own behavior

Sports– exercise has many benefits for a very active child. It has been proven to have positive effects on self esteem, overall health, learning ,and improves nerve function and helps release their pent up energy. Team sports in particular teaches a sense of camaraderie and teamwork often lacking in a very active child’s life. Teamwork also helps with their self-esteem by working with others to a common goal and form friendships outside of the classroom.

Channeling energy – creative stimuli and focus adaptation on tasks such as – artwork- painting, pottery and sculpture; music- playing an instrument ; puzzles and constructing- building blocks and legos; projects- science, design, and gardening.

Games – board games can help the active child learn to take turns and focus on the tasks without the stress of school work.  Family game time with a set of rules should be fun and an opportunity to learn the structure of cooperating with positive reinforcement of acceptable behavior working with others.

Limit screen time and video games- both these modern day habits have led to what has been called the ” dis-tractable generation” possibly contributing to the rise in ADHD diagnosis.

Shorten Work and activities which require a lot of focus and concentration.They are much more successful with intense brief focused tasks and homework, rather than sitting for hours and not getting anything done while fidgeting and their mind wandering.

Movement – whenever your child takes a break from work try to find ways for them to move. Any form of movement activity helps calm the nervous system and the endorphins that are generated have additional calming benefit. It helps them re-focus their energy .

Meditation and mindfulness – teaching your children the art of breathing to refocus their energy and calm both their active mind and body is a vital part of non medical means to helping then develop staying power and a better focus.

Music particularly classical music calms the brain and can be helpful in bringing focus to a task. I tell parents of newborns to play classical music for a sense of peacefulness for newborns and the family household and they will respond to it for the rest of their lives.

Pets are beloved family members and elicit a lot oxytocin production just by interacting with them. This can makes you happy and also has a calming effect. A sweet dog can be an important asset to manage erratic emotional behavior for any family member but in particular for an energetic  over active child. In addition the bond and satisfaction in caring for a pet is a bonus for self-esteem and character building

A good caring non judgmental family is the best resource for any child. Particularly those children dealing with the difficulties and frustrations of ADHD and Hyperactivity.

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  and hard cheese which has 200 mg, and a cup of yogurt with 450 mg of calcium

Figs   cup                          300 mg

Sesame seeds,1 oz      280 mg

Tahini 1 oz                      135 mg

Chia seeds, ounce      179 mg

almonds, ounce            80 mg

Almond milk cup          450 mg   ( fortified)

tofu calcium set, 3 oz  300 mg

Soy yogurt 1 cup           300mg

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

.

 

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