West meets East…Guest post: Jonathan Black, MD/MPH student
I spend a lot of time on Flashfree writing about complementary or Integrative Medicine. This refers to the meeting of the Western versus Eastern minds, combining the best of both worlds, if you will. Hence, I was excited to read my Twitter friend @jonathanblack’s positive experiences with his integrative medicine courses, so much so, that I asked him to write a guest post. I was curious to learn how and if medical schools were starting to slowly incorporate Eastern/Integrative health into their curriculum and even more so, how students felt about it. It seems that there is a huge divide between doctors who are up and coming in the field today and those who have been practicing for awhile. Although it is possible to encounter a physician who embraces integrative medicine, it is probably easier to find those who characterize it as “quackery,” refusing to give credence to the evidence-based studies that exist or consider that perhaps, the way that studies are conducted in Western medicine do not consider the intricacies of Eastern practice. Regardless, because I feel so strongly about integrative strategies and their role in our healthcare as women, I think that it’s imperative that we understand where the bridges and gaps are. Without that understanding, we can never entirely play an active role in our own healthcare. Or become a strong voice for a broader imcorporation of these practices into Western, or allopathic medicine.
Please welcome Jon and show him some love with some great comments!
The exposure that medical students receive to Integrative Medicine varies between medical institutions. It depends on a number of factors, including whether or not the institution has a center for Integrative Health, how progressive the medical administration is at the medical school, and the relationship between practitioners and physicians within the geographical area. Regardless, most of the time, the degree that medical students are exposed to Integrative Medicine is insufficient.
To that end, my medical school dedicates one afternoon during the second year to Integrative Medicine. For students who opt out of an an additional four-week elective, that one afternoon is the only exposure that they will receive throughout their entire education. Considering that over 40% of patients use some form of Integrative Medicine, whether it is Yoga, vitamins, or something else, this is problematic. If you don’t have a solid understanding about Integrative Medicine, it is difficult to talk to patients about it. Understanding this concept, I chose to take the additional four-week elective.
During these four weeks, I shadowed and worked with massage therapists, herbologists, yogis, reiki masters, music therapists, chiropractors, and qigong instructors. Ultimately, I found this experience to be tremendously useful, as it provided me with a new perspective from which I can discuss Integrative Medicine with my patients and it allowed me the opportunity to connect with practitioners who I otherwise wouldn’t have had access to. As someone going into Obstetrics and Gynecology, it also peaked my interest regarding how these forms of therapies might be integrated into women’s healthcare.
The more I’ve looked into the blossoming relationship between women’s health and Integrative Medicine, the more I have realized that I am like a small fish lost in open water. From conferences to complete guides on the subject, the materials and opportunities available in this field are endless. There is also a lot that is unknown on the matter and an abundance of research continues to evolve. That being said, I have come to the conclusion that while I will always be able to competently care for women from an allopathic standpoint, this won’t always be the case from an Integrative Medicine standpoint, regardless of how much time I put into learning different modalities. So, on a professional level, it will be important for me to develop solid relationships with Integrative practitioners within the community I am working in, and hopefully, integrate them and their work into my own practice. Collaborative medicine is the wave of the future and I want to be on the forefront and I think that this approach will allow me to be there.
About Jonathan…
Jonathan D. Black is a 4th year MD/MPH student at the University of Rochester School of Medicine and Dentistry in Rochester, New York. He is going into the field of Obstetrics and Gynecology.
Read MoreUnchain my lungs…estrogen and asthma
As the evidence continues to accrue against the use of combined hormone replacement therapy (HRT), attention must be turned to estrogen-only hormone replacement therapy. However, is it safer?
In the Women’s Health Initiative, which was halted last decade, taking estrogen alone was associated with an increased risk of blood clots, stroke, impaired cognitive function and dementia. In the latest bit of information to hit the news, estrogen-only therapy may also increase the risk for developing asthma.
Results of a 12-year study among almost 58,000 women who were not suffering from asthma at the start of menopause showed that they were 21% more likely to develop asthma symptoms. This risk was significant among women who had been taking estrogen only compared to women who had never used hormones, had a 54% greater risk of developing asthma. The risk was even greater among women who had never smoked, although a small proportion of study participants had allergies prior to developing asthma.
Once again, Reuters has done an excellent job of reporting on this study and has some great quotes from the researchers as well.
Meanwhile, what should you do if you’ve been taking estrogen to combat the symptoms of menopause? As always, you have a choice and only you and your practitioner can determine if you are at risk for developing any of the conditions that are associated with hormonal therapy. The good news? Breathe easy. Yet another reason to lose the hormones…for good.
Read MoreWednesday Bubble: Just melt that fat away
What if someone told you that you zap that tired around your middle that’s suddenly appeared? Or melt away the flab on your thighs? According to manufacturers of Zerona™, low-level laser can be applied to the areas of fat deposits lying right below the skin to literally reshape and recontour the body. In fact, you can reportedly lose up to two sizes with only two weeks of treatment. What happens to the fat? It seeps into the body’s lymphatic system and then is used as energy.
Why does this sound too good to be true?
According to an in-depth piece in the New York Times, Zerona is readily available nationwide at a pricetag of $1700 to $3800 for six sessions. Experts say that results depend on the individual, including whether or not they are obese, have had prior surgery on the area that they want re-treated, and if they eat healthy and exercise. However, some experts say that it’s unclear how the body rids itself of fat and remain unconvinced that fat can be eliminated in a non-invasive way. On the other hand, data presented at the American Society of Dermatologic Surgery suggest as much as a 22% reduction of the fat layer in some people.
What do you think? Bubble or not? It might be too early to tell. Although the company has reportedly submitted clinical information to the Food & Drug Administration in hopes of approval, so far, it’s just an experimental dermatologic treatment that can put a major dent in your bank account.
Zerona. “Reveal your true self.” Hmmmmm.
Read MoreStirring the pot: a conversation with author/chef Mollie Katzen on food, women and aging
Just about anyone who’s interested in cooking and whose formative years took place in the late 60s and 70s knows these names: Moosewood Cookbook and The Enchanted Broccoli Forest by Mollie Katzen. Personally, both of these volumes occupied prominent places on my bookshelves for years. That is, until worn from overuse and stained with food and memories, I reluctantly let them go.
So, what do cooking and midlife and menopause have to do with each other? And what type of insights can chef and author Mollie Katzen lend to the conversation?
I originally approached Mollie in search of nutrition advice for women going through midlife and menopause. Although I realize that she isn’t a dietician or a nutritionist, as someone who’s immersed herself in food for decades, she seemed quite capable to lend a perspective. But as our conversation took hold and we found our rhythm, I realized that the focus had shifted: what I ended up with was a mini-instruction manual, not only for eating healthy but also for forming and maintaining positive relationships with food and with ourselves.
A champion of “keep it healthy,” Mollie entered the scene when cookbooks were largely geared towards the typical American meat and potato diet. When the Moosewood Cookbook first hit the shelves, “there was barely even a cookbook section in the bookstore, let alone, a ‘healthy eating’ or ‘vegetarian’ section,” explains Mollie. Yet, she is not what many of us classify as “vegetarian,” and although she primarily skews the dinner plate towards greens and veggies, she consistently includes small amounts of animal protein. “My diet in my 30s and 40s could have been classified as practically vegan,” she says, “even if I wasn’t orthodox about it.” (At that time, she was also keen on a low-fat diet, which, coupled with the lack of ample amounts of protein, spelled trouble.) “It was almost ‘remorse cuisine;’ I’d eat this way and by mid-afternoon I’d almost be fainting, depleted, irritable. I had no focus. I found that I wasn’t functioning and would wonder what was wrong with me because I thought I was eating the purest diet on the planet. I felt like I was falling apart.”
If you are familiar with the earlier editions of Mollie’s books, they concentrate heavily on whole grains and legumes. However, age has paved a path for a significant alteration in what she eats. Emphasizing that the amount of bulgar and beans she’d have to eat to obtain the amount of protein that she needs for her blood sugar to stay stable could easily translate into an extra 50 pounds, Mollie says that she has changed her diet to include grass-fed animal protein and raw milk cheese, milk and butter.
What about aging and diet? “I think that women get really frustrated,” she says, pointing out that as we age, even if we change nothing about our lifestyles, e.g., if our lifestyle is reasonable, we are of fairly normal weight, exercise moderately and eat pretty well, we still gain weight. “Our bodies become an inefficient machine and our metabolisms slow,” she says, adding that one of the most consistent things she’s observed amongst her friends is the “oh my god, what happened to my body” moment. The ‘I’m minding my business, doing the same things I’ve always done and all of a sudden, I’ve got this spare tire, I’ve got the fat” epiphany. Sound familiar?!
Although challenging, the answer to this common dilemma is fairly intuitive. And while we’d love to fool ourselves into believing that declining hormones are the primary culprits, they aren’t. Rather a decline in physical activity and lack of dietary restraint are the key players. Mollie agrees that while women can’t do a whole lot about the fat redistribution, the “one thing [they] need in order to keep the [weight gain] at bay is to keep muscles toned as possible with resistance exercise and also, eat less.” New flash! This actually works; Mollie reports that she currently weighs the same as she did in her 20’s!
Of course, what works for one woman might not be exactly what works for another. We all need to forge our dietary paths and strategies that work for both our individual metabolism and our bodies.
“Health is trial and error,” Mollie explains. “So much of it shows up in how you feel a few hours later. For example, do you feel sleepy after you’ve eaten? Do you feel sluggish or irritable later in the day? Do you have trouble sleeping at night? For me, these were all symptoms of what was going on when I was eating almost no fat or protein.” Much in line with health and nutrition experts, Molllie’s strategy has been to reduce her daily caloric intake while at the same time increasing the percent of calories in her diet that are fat. “I get a good 30% of my calories from nuts, olive oil, avocado and fatty fish.” And when she snacks, its the good fats that she reaches for: “avocados and nuts, especially walnuts. When I am hungry, I have a handful of almonds. I just think that for people as they get older, they should lose the pretzels and eat almonds or guacamole or something with good fat in it.”
We also need to slow down. Bet you’ve heard that before! Mollie says that the most radical transformation we can make with food isn’t so much changing what we eat but how we eat it. Her advice? “Don’t even pick up the fork for the first minute that the food is served. Breathe deeply, look at it, admire it, thank the cook, be grateful. Then pick up your fork, take a few bites and put your fork down. Swallow your food. Women simply don’t have the metabolic ability to do a good job with all that food.”
Food heals. As women, our love-hate relationship with food is complex. We not only use food as fuel, but also to feed our emotions. Or on the flipside, we deprive ourselves in ways that are counterintuitive and sometimes, downright unhealthy.
“This sounds so obvious,” says Mollie, “but I really want people to turn towards cooking and not away from it. To me, the more hands-on and proactive we are about food and cooking, the more we heal whatever issues or concepts we have around food. I’ve actually seen people healing their relationship with food by diving into it.” Make food one of your favorite hobbies. She suggests that rather instead of shunning away from the grocery store run, step back and make it a trip to pick up something beautiful to be celebrated. “Diving into a more positive, deliberate relationship with food gives you something nice to do,” she adds.
What are the take-away messages?
- Tailor it uniquely: keep it healthy.. for you.
- Move towards healthier choices and use food in a healing, more positive manner.
- Embrace yourself with beautiful food, whether it’s a perfect tomato from the Farmer’s Market or some kick-ass, green-as-grass guacamole.
- Take it slow, and breathe.
Wise words, from a wise woman who knows her way around a kitchen or two.
p.s. Mollie has shared two of her favorite recipes. Check them out, try them out and please, comment and show some love!
About Mollie:
Mollie Katzen, with over 6 million books in print, is listed by the New York Times as one of the best-selling cookbook authors of all time. A 2007 inductee into the prestigious James Beard Cookbook Hall of Fame, and largely credited with moving healthful vegetarian food from the “fringe” to the center of the American dinner plate, Ms. Katzen has been named by Health Magazine as one of “The Five Women Who Changed the Way We Eat.”
In addition she is a charter member of the Harvard School of Public Health Nutrition Roundtable and an inaugural honoree of the Natural Health Hall of Fame. An award-winning illustrator and designer as well as best-selling cookbook author and popular public speaker, Mollie Katzen is best known as the creator of the groundbreaking classics Moosewood Cookbook, and The Enchanted Broccoli Forest. Her other books include the award-winning children’s cookbook trilogy, Pretend Soup,Honest Pretzels, and Salad People; Vegetable Heaven (winner of the International Cookbook Reveu Best in Category award); Sunlight Café; Eat, Drink, & Weigh Less (with Walter Willett, MD of Harvard), and the best-selling The Vegetable Dishes I Can’t Live Without.
Read MoreStirring the pot, part 2: recipes from author/chef Mollie Katzen
Food is powerful. It can engage, embrace, empower and entertain. It can inspire community, sharing and love. It can make you feel “I am woman (or man)” or stir powerful memories.
Mollie Katzen has shared two of her favorites that respectively represent empowerment and community. The first, from her book Still Life with Menu, is filled with greens and pasta and feta cheese, a powerful combination of flavors, textures and nutritious wonder. The second is a lovely Indian-inspired dish; truly, what’s better than a big, thick dal with split peas and lots of exotic spices?
Enjoy!
Pasta with Greens & Feta
Mollie Katzen (© All rights reserved. Reprinted with permission.)
Here is a painless way to slip some of those ultra-nutritious bitter greens into our diet. You can use any combination of kale, mustard, collard, dandelion, escarole, chard, beet, turnip, or spinach.
The instructions call for “short, substantial pasta,” and I have suggested a few forms. This kind of sauce, with tender pieces of onion and bite-sized flecks of greens, studded with soft crumbles of feta, adheres best to small shapely units of pasta. Each mouthful of this dish delivers a beautiful integration of textures and truly satisfying flavor.
3 to 6 tablespoon olive oil
3 to 4 cups chopped onion (pieces can be on the large side – up to you)
3 or more bunches leafy greens – washed, dried, stemmed (if necessary) and coarsely chopped (8 or more cups chopped)
Salt
3/4 pound penne, fusilli, shells, orechiette, farfalle, or some comparable short, substantial pasta
1 cup crumbled feta cheese
Freshly ground black pepper
Chopped walnuts, lightly toasted (optional)
Put up the pasta water to boil. Place a deep skillet or Dutch oven over medium heat, and wait for about a minute. Add the olive oil and swirl to coat the pan, then wait another 30 seconds or so. Add the onions, and cook for about 10 minutes over medium heat, stirring occasionally. Meanwhile, add the pasta to the water when it boils.
Add as many of the chopped greens as will fit to the skillet, salt lightly, and stir until the greens begin to wilt. The wilting will make room for more of the greens, so add as many more as will fit, salting lightly as you go, and lifting/turning the greens (cooked and uncooked) with tongs. Keep doing this over medium-low heat until all the greens are in and they are all wilted.
When the pasta is done to your liking (keep it on the al dente side) scoop it out with a “spider” or a strainer, bit by bit, hold it over its cooking water briefly to drain, then add it directly to the potful of sauce. (You don’t need to drain the pasta thoroughly – okay if some water adheres…) Mix with tongs until reasonably well blended, sprinkling in the feta as you go. Grind in a generous amount of black pepper.
Cook the complete dish just slightly over low heat for just a few minutes (really just until the feta melts in a little). Serve immediately, topped with walnuts, if desired.
Preparation time: About 40 minutes. Yield: 4 to 6 servings
Yellow Split Pea Dahl
Mollie Katzen (© All rights reserved. Reprinted with permission.)
“Dahl” in Indian cooking refers to porridgelike dishes made from legumes – usually split peas, mung beans, or lentils. Dahl is often served in a thinned state as a soup, but equally often, it well be a thick, hearty side dish. This is a thick one, comprehensive and highly spiced enough to be the focus of a meal. It goes beautifully with basmati rice (I especially like the rice with toasted almonds added), and keeps and reheats very well.
2 cups yellow split peas
2 tablespoons peanut oil or canola oil
1 tablespoon cumin seeds
2 tablespoons ground coriander
2 tablespoons mustard seeds
2 teaspoons turmeric
1 teaspoon cinnamon
10 to 12 medium-sized garlic cloves, minced or crushed
1 1/2 teaspoons salt (or to taste)
3 tablespoons fresh lemon juice (or to taste)
Freshly ground black pepper
Cayenne
Place split peas and 10 cups water in a soup pot or Dutch oven Cover and heat to boiling point, then reduce heat and simmer very slowly, partially covered – stirring intermittently- for about 2 1/2 hours, or until very soft.
About 45 minutes into the simmering, heat the oil in a small skillet (over medium-low heat) and add the cumin and mustard seeds. Cook for 2 to 3 minutes, stirring often, until the seeds smell toasty and make popping noises. Add the remaining spices and the half the garlic, and sauté for another 2 to 3 minutes, or until everything is heated through and well mingled. Add this mixture to the simmering split peas.
About 45 minutes later, add the remaining garlic. Stir and continue to simmer. As the dahl becomes thicker, you can add a heat diffuser under the pot to prevent sticking. You can also add more water – 1/4 cup at a time.
When the split peas are tender, add salt, lemon juice, black pepper, and cayenne to taste. Again, if desired, okay to add small mounts of additional water. Simmer for about 5 to 10 minutes further, and serve hot.
Preparation time: A few minutes of work; 2 1/2 hours of independent simmering Yield: 6 to 8 servings (maybe more, depending on the context)
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