vitamin D

I can think of worse places to soak up that vitamin D.

One of the trendiest things in medicine today, if the medical world can have a ‘trendy’ thing, is vitamin D. Its totally the new(ish) buzz. Vitamin D has a whole list of functions throughout our bodies, but mostly is responsible for calcium absorption in our intestines and kidneys. The reason why this vitamin has become so exciting recently is that research is showing that it might have the ability to lower your cancer risk and reduce the chance of complications or death from cancer.

Lets look at what happens when we are vitamin D deficient: First, your intestines have a hard time absorbing calcium and phosphorous –> this forces your body to suck the calcium out of your skeleton –> this causes small areas of bone weakness and generally decreases the bone mineral density (weaker bones) –> this leads to osteoporosis in adults and muscle weakness in children. 

How does this relate to cancer? Cancer will often spread from its point of origin to the bone. If your bones are stronger then the cancer has a harder time spreading there.  

The major source of vitamin D has always been exposure of skin to sunlight. When it is produced in the skin, vitamin D can last at least twice as long in the blood compared to when you eat your D. Therefor, the main cause of vitamin D deficiency is not getting enough sun. Here are a few factors that can reduce your skins production of D: 

1. darker skin (you’ll need 3-5 times more sun exposure than lighter skin),
2. aging,
3. topical sunscreen (SPF 30 reduces vitamin D synthesis by more than 95%),
4. obesity (the fat holds the vitamin hostage).

In the absence of sun exposure it is difficult, if not impossible, to obtain an adequate amount of vitamin D from dietary sources without supplementation. But we also have to be careful about the risk of skin cancer from too much sun. The current recommendation is to spend 10-15 minutes in the sun, without sunscreen, three times a week. But its not a bad idea to eat some vitamin D or take a vitamin D supplement. 

Here are some dietary sources of vitamin D:

• cod liver oil (400-1,000 IU/tsp)
• salmon, fresh (600-1,000 IU/ 3.5oz)
• salmon, other (100-600 IU/ 3.5oz)
• shitake mushrooms, dried (1,600 IU/ 3.5 oz)
• fortified milk, OJ, infant formula, yogurt (100 IU/ 8oz)

Here is the recommended daily intake of vitamin D, from all sources (food, sun, supplements):

• age 0-1 year:        400-1,000 IU
• age 1-18 years:    600-1,000 IU
• age 19  on:            1,500-2,000 IU

Numerous studies have suggested that adequate blood vitamin D levels (above 30) may have additional health benefits in reducing autoimmune diseases, type 2 diabetes, cardiovascular disease, and infectious diseases. This doesn’t mean that the more vitamin D you eat, the healthier you will be. You can, for example, overdose on vitamin D and end up with calcium deposits in your blood. And some people might actually have an increased chance of some types of cancer when they have too much vitamin D. 

In summary: vitamin D is made when your skin is exposed to sunlight and, less efficiently, can also be eaten or taken as a supplement. Vitamin D is used by the body to help keep your bones healthy; so a deficiency can lead to osteoporosis. Vitamin D is also proving to be an important factor in preventing or limiting cancer. Personally, I am now taking vitamin D supplements and sitting in the sun for a few extra minutes each week, arms and legs exposed. But I’m not going to stop putting sunscreen on my face and neck because I’m vain and want to look young for as long as possible.

Gheymeh Lapeh

I forgot to take a picture as soon as I finished the recipe. This picture is when it was already half eaten.

Persian food, or the Persian food that I know, is all peasant food. These recipes were created out of desperation by mothers who needed to feed ten people and only had enough meat for two. Persian mothers had to learn to stretch that food and make tough cuts of meat delicious. Khoresht is one such type of food; it is a stew that takes cuts of tough meat, adds spices and veggies, and cooks the hell out of it until that meat is soft and delicious, then is served over rice so that you only need a small amount of stew for each person. And these recipes easily adapt to enormous portions. So if you have your family coming for dinner one night, and your family numbers around 40 adults and even more children, then you could set a pot of khoresht earlier in the day and let it simmer while you got everything else together. Easy peasy.

A few weeks ago I had some friend over for dinner, the most people I have ever hosted, all by my lonesome, and I decided it was as good a time as any to make Gheymeh Lapeh (aka Khoresht-eh Gheymeh) for the first time. And, despite making a few mistakes like adding too much salt, cinnamon and water, it turned out pretty damn good (if I don’t say so myself). The best part was that I could make it the day before while I was working on other things and just heat it up an hour before people came over.

I recommend this recipe if its your first attempt at Persian food. And then make it a few more times until you have made the recipe your own. As I have said previously, measurements are an approximation, dried lime (aka limou omani) is essential but lemon juice is a half-decent substitute, and this is a Jewish recipe so it might be different from non-Jewish recipes.

10k

My goal, when I first signed up for the 10k, was just to finish without being kicked off the route for going too slow. Two weeks of training later, when I knew that I was capable of running for 5 miles straight, the goal became to not be the last person to finish.

Have you ever been last place in something? I have. When I was a little kid I was ranked dead last in my tennis camp (I am devastatingly un-athletic). Why they felt it necessary to rank the last twenty of us is beyond me, but they sure did. I was not a competitive kid, but that moment still burns a little and has motivated me. 

By race morning I was so nervous that my palms were clammy. Thousands of us lined up at the start line, numbers pinned to our chests, ready to run the streets of downtown San Francisco. The first mile was slow until the crowd thinned out and gave us room to move at our own pace. Roy stuck by my side the whole time, even though I could tell he was itching to go faster. In the last mile I got a burst of energy and decided to take advantage; my legs weren’t tired and my lungs were so relaxed I could have almost held a conversation. But just a few yards into my sprint my lungs tightened up so much that I actually got scared. (Note to self: don’t get fancy on a 10k.) If it wasn’t for Roy I’m pretty sure I would have given up. By that point he had pushed past me by a block and I knew I couldn’t let that distance get much greater. Then he stopped a few blocks before the finish line so that we could cross it together (I mean, come on, what a guy). 

We definitely didn’t finish last. And I am really proud of our 1 hour 9 minutes finish, although that still landed us in the bottom third. But this is just the start. We will definitely be doing more runs and we’ll be working on our times. I can’t believe I’m saying this (Vikki, you were right), but I can even see myself doing a half marathon one day. 

I think the moral of this story, if you’re trying to find one, is that if I can get off my butt and run a 10k then, truly, anyone can. I encourage you to try it!

And now I leave you with this adorable picture from the race taken a few yards before the finish line:

carrots and chlorine

By now I’m sure you have heard that baby carrots are rinsed in chlorinated water before they are packaged and sent off to grocery stores where you then buy them and eat them and THEY WILL POISON YOU!!!

For the love of god, if you ever read anything on the internet that claims that some random food that you eat all the time will either kill you or cure you, it’s probably a lie. Not always, but most of the time it’s just a load of malarkey.

Baby carrots are, in fact, rinsed in chlorinated water. If that bothers you then you can soak them in tap water for a few minutes and rinse them off. But that probably wont help because there is chlorine in your tap water. Time to start freaking out? Please, no. Trace amount of chlorine in your water will not hurt you.

The most annoying part of the chlorinated carrots controversy (see what I did there? it’s called alliteration. boom.) is the assertion that the white coating that forms on carrots is chlorine. No, actually, its just dried carrot. I was lucky enough to grow up in a house with a father who loved to grow fruits and veggies so I know what home-grown carrots look like. When they get dry, they get white. Stick them in a bowl of water and the white goes away. 

Still not convinced that your baby carrots aren’t killing you? Do yourself a favor and look around at all the other things you are eating. Chances are that your alternative to carrots isn’t much healthier. So relax and enjoy- its still a healthy snack.

are you a runner?

A few years ago my yoga instructor came over to help me stretch my hamstrings. “Whoa! Are you a runner?” Now, I have always been quite inflexible, but no one had ever suggested that I might be a runner. I hate running. I mean, I do it, but I have to beg myself to lace up my shoes and I am bargaining with myself the entire run. Lets be honest, its more of a jog.

But ever since that day I have struggled with the existential question: am I a runner? I don’t enjoy every run, but I have found a runners high a few times. And, at this point, I’ve been running about 3 miles a day a few days a week for a decade. Does that make me a runner? 

A few weeks ago our friends Tanya and Andrew, both marathon runners, encouraged Roy and I to sign up for a full marathon. We laughed. They suggested a half marathon. We kept laughing. But they kept pushing until we were actually inspired enough to sign up for a 10k (6.2 miles). They promised us that having the run looming in the distance would push us to train harder than we ever had before.

They were right.

The run is this Sunday and we only started training a week ago (most trainers recommend 6-8 weeks of training). So on the first day I had to force myself, after 2 weeks of not running at all, to go 3 miles straight, without walking. I couldn’t bargain my way out of it because the fear of being kicked off the route (you have to finish the 10k in 2 hours) was more powerful than any muscle pain or heavy sweating. And I knew that each time I ran, I would have to run a little further and a little faster. A few days ago I ran 4 miles in 50 minutes and today I did my first outdoor run: 5 miles in 65 minutes. My legs hurt, my abs hurt, even my shoulders a bit sore. But I am getting stronger and I am improving faster than I thought I was capable of. I know that for most people, running 5 miles straight is nothing to be excited about – Roy could do that at his most unhealthy. But for me, it’s a life-altering accomplishment. I ran 5 miles straight, people! 

While I’m still not sure if I can call myself a runner, I feel like I’m getting closer. So who’s going to join me on my next 10k?

My mom and her running mate, Pete Carroll, at the LA 5k in 2009

ghondi berenji (Persian meatballs with rice)

On the night that Roy would finally kiss me for the first time, he came over to help me cook dinner for a few friends. While the night was a great success (best. kiss. EVER.), the food was a disaster. It was the first time I attempted to make any sort of Persian food, and I chose Ghondi Berenji. This is one of my favorite dishes and, really, whats not to love? Dense giant balls of ground meat, rice and spices are stuffed with dates and dried limes and boiled until they create a sweet, sour, savory broth.

I have recently decided to learn and perfect as many Persian dishes as possible. Being so far from my community, I feel like I’m losing my connection to my Persian roots and, aside from reading books like Daughter of Persia, food is my only connection. I hadn’t attempted ghondi berenji since that night, eleven and a half years ago in Berkeley and I assumed that this time, after years of perfecting my cooking techniques, I would succeed in creating a beautiful and delicious pot of ghondi berenji. Jokes on me! It didn’t taste bad, but it didn’t taste like my mom’s. And, just like the first time, the balls disintegrated into a pot of mushy nastiness. So when I went home this weekend, my mom and I went to my grandmother’s house so that they could both show me, exactly, how its done. 

Note 1: This is a Jewish version of the dish. If you find other recipes they will call for different spices, eggs, and yellow lentils. I’m not sure why the Jewish version is different (if you know, please share!). Note 2: Use very finely ground meat. The one sold at my Trader Joe’s doesn’t seem to work so I’ll be going to my butcher and asking them to grind it for me. Note 3: Dried limes are essential for cooking persian food, are fairly inexpensive, and can be found at ethnic food stores. Note 4: The measurements are estimations; once you have made this a few times, just eyeball the proportions.

organic contraversy

Why do you eat organic foods? Or, do you eat organic foods at all? A few months ago an article was published that tried to compare the nutritional value of organic foods versus conventionally grown foods (a similar article was published in 2011). Let me spare you the suspense, they didn’t find much of a difference in the vitamin and nutrient content of produce; nor did they find a difference in the protein or fat content of organic and conventional milk. But is this why we eat organic foods? I thought we were supposed to eat organic foods in order to avoid eating pesticides and because it might be nicer to the earth, not because they had more vitamins.

Organic food is big business, and is growing. Between 1997 and 2010, U.S. sales of organic foods increased from $3.6 to $26.7 billion. A food is organic when it is grown without synthetic pesticides or fertilizers or routine antibiotics or growth hormones. Organic livestock are fed organic feed and have access to the outdoors, direct sunlight, fresh air and freedom of movement. Organic foods are also usually processed without irradiation or chemical food additives and not grown from genetically modified organisms (GMOs).

So we don’t find a nutritional difference between organic and conventional foods. What about pesticides? The study reported that pesticides were found in 7% of organic produce and 38% of conventional produce. Great! So here is at least one reason to eat organic foods: fewer pesticides.

One would assume that, with fewer pesticides, we would have more bacteria and pests. Aside from E coli, which carries a higher risk in organic foods, the research found no difference in bacterial contamination of organic versus conventional foods. (Here is another source that confirms that  the pesticides aren’t even killing what they are supposed to be killing.)

Actually, pesticide use appears to increase the risk of antibiotic-resistant bacteria by 33-35%. Although this might not matter much because the over-use of antibiotics in humans is the major cause of antibiotic resistant infections in humans.

It’s important to know that this research, which was a review of many other articles, had some flaws. The samples of certain foods could not be standardized. For example, sampling milk that was pasteurized versus raw or collected in winter versus summer can have a significant impact on the results – and this was not standardized. Or, for example, some studies tested whole apples while others removed the peel. What we need is a long-term study of health outcomes of populations consuming mostly organic versus conventionally produced food, which would be very expensive.

Looks to me like eating organic foods might still be more beneficial than conventionally produced foods. But if you can’t afford, or don’t have access to organic foods then don’t worry too much. It’s still much healthier to eat conventionally produced food that you prepare yourself than it is to eat processed foods. Here is a downloadable list of the top foods that you should try to buy organic and top foods with the lowest pesticide count (not as important to buy the organic versions).

the antioxidant myth

Do you remember James Watson, of Watson and Crick DNA fame? Well, aside from turning into a racist homophobe, he has also dedicated the later part of his life to cancer research. Just last week he published a ‘cancer manifesto‘  railing against the future of cancer research and calling in to question the therapeutic benefits of anti-oxidants, suggesting that some forms of anti-oxidants (beta-carotene, vitamin A, vitamin C, vitamin E and selenium) might even cause some types of cancer.

And Watson is not alone. Dr. David Agus, an oncologist who wrote a great book called The End of Illness, has been arguing against the over-use of anti-oxidants for more than a year. And here is another great resource that espouses the same message. 

We are urged to eat anti-oxidant rich foods because they neutralize free radicals that can damage DNA. But is this really true? Can we prevent cancer by eating more blueberries and broccoli? Watson and Agus argue that, in fact, instead of preventing or curing cancer, anti-oxidants might raise the risk of disease or early death. That, if we overload our bodies with antioxidants, it can prevent free radicals from doing what they are supposed to do, which is to kill damaged cells and invaders like bacteria.

But, when you think about it, its not surprising that anti-oxidants don’t cure or prevent disease. Look at who is sending us this message. Its usually coming from someone trying to sell you something. “Take this pill. Eat this product. Drink this elixir.” and you, too, can live forever. Did you really think that a martini could be made healthy by adding pomegranate juice?

Living longer and healthier is only achieved with equal parts effort and luck. You have to exercise, eat healthy, don’t smoke or do drugs or drink too much alcohol. These are all difficult habits, until you relent and just start doing them until they become your normal. You should still enjoy anti-oxidant rich foods, just eat them because they taste good, not because you think they will prevent cancer.

fertility, an interview with Dr. Shahin Ghadir

You know how sometimes you hear about women who, in their mid thirties, finally start trying to get pregnant and then are shocked that they don’t conceive naturally and are devastated that they might need medical intervention to make a baby? I was never one of those women. I don’t, at all, understand these women. Maybe its because I have studied the body for so long, or maybe its just my personality, but I never assumed that my body would just be waiting for me until I was ready to get pregnant.

Still, it didn’t occur to me that I could be, or should be, proactive about my fertility, until recently. So many women I know are using fertility treatments to assist in becoming pregnant- women that are much younger than I expected. So I decided to ask Dr. Shahin Ghadir about fertility. Dr. Ghadir, a friend of mine for more than 15 years, is a reproductive endocrinologist, double board-certified in Obstetrics and Gynecology and Reproductive Endocrinology and Infertility, and assistant clinical professor at both UCLA and USC Keck Schools of Medicine. He is the perfect combination of kind, patient, and straight forward. I sat down with Dr. Ghadir to learn more.

Dr. Lustig’s Crusade

Dr. Lustig’s Crusade – is he fighting a losing battle?

Apropos Nina’s recent review of sugar and sugar substitutes – a leader in the fight against table sugar and high-fructose corn syrup additives recently publised his first book. “Fat Chance” may seem like pop-science but trust me folks, the data is also published and widely available. Fructose is not metabolized like glucose. It takes a toll on the liver and increases the lipids in our bloodstream further predisposing to heart disease. Dr. Lustig, is a Professor of Pediatrics in the Division of Endocrinology at UCSF and the Director of the Weight Assessment for Teen and Child Health (WATCH) Program. If you’d like to learn more about his work, I highly recommend you watch his lecture which is available on YouTube. There are two versions: scientific (which I suggest for all) and less-scientific. This is not some boring video about nutrition. This thing has 3 million views! But if you really want the “skinny” (drum-beat) – just watch this short 60 minutes video from last year – although you will have to tolerate the Emmy®-award winning douche, Sanjay Gupta.