Calcium Without Dairy

If you follow any part of my real food approach, then you already know that I do not do dairy.  While I really like a warm, stringy, cheesy stuffed pepper as much as the next person, I do not like the zits it causes.  Other people do not like the gas and bloating it causes, and still others do not like the ache of their inflamed joints or the constant drip of their runny nose after consuming dairy.

The good news, there is hope for the masses who choose to live dairy free.  If we make educated food and beverage choices, then we can get much of the calcium we need from foods and beverages.  Short pause for a mini-disclaimer.  I am not a doctor and cannot diagnose or treat illnesses or diseases.  This information is for informational purposes only.  It is your responsibility to see your healthcare provider to determine the status of your bone health and create a plan to prevent or treat your own ailments.  Okay, let’s move on…
We already know that calcium is super important.  It is a mineral important for maintaining strong bones and teeth.  What many do not know though, is the small fraction of calcium in the blood is kept in a very narrow range, and is important for blood clotting and regulating muscle contractions such as your heart.  
Dietary Reference Intakes (aka DRI) from the Institute of Medicine is 1000 mg for adults 19-50 years old and 1200 mg for adults 51-70 years old.  Women who are pregnant or breastfeeding need 1000-1300 mg. 
One of the main reasons dairy is recommended as the primary source of calcium is due its bioavailability, which simply means how much of the calcium in the food or beverage is available to be absorbed by the body.  Dairy provides the highest percentage of bioavailable calcium when compared to vegetables, grains, nuts, seeds and legumes.  This is because plant-based sources of calcium also contain nutrients that inhibit absorption of calcium.  These are known as anti-nutrients, and include oxalates and phytates.  
On the other hand there are other nutrients, such as magnesium, potassium, vitamin C, vitamin D and boron that work along with calcium to enhance absorption. So, all of that to say…it is still possible to get calcium from plant-based sources by eating an abundance of different kinds of plants.  I eat over a pound of vegetables every day.  It does my body good.

The Diary Nutrition website has an awesome chart that puts the concept of bioavailability into perspective.  For example, it takes 3.2 cups of kale to provide the equivalent amount of calcium available in 1 cup of milk.  So, the point here is for those of us who do not or cannot consume dairy we must mindfully select foods, beverages and possibly even supplements to ensure we are getting enough calcium for optimal health…and you know how I feel about optimal health…it feels good and looks good, so it must be good.
I’m starting to sound like a broken record, but that is intentional.  Please understand that if we do not include food group that has  a significant source of nutrients,  then we must replace those nutrients in other forms.  That requires planning and expanding our culinary horizons.  Bacon and eggs taste great, but are not necessarily going to save the world unless we combine them with a  heaping pile of vegetables to add color, goodness and, of course calcium.
Here are my top 5 tips for getting calcium if you don’t do dairy
  1. Eat at least 1 serving of vegetables at every meal.  This is equivalent to 1/2 cup of cooked vegetables, 1 cup of raw vegetables or 2 cups of leafy greens.  Work up to eating a pound of vegetables daily. Check the references at the bottom of this post for lists of foods that contain calcium.
  2. Try selecting seafood options with tiny little bones that are safe for consumption.  Those bones are filled with calcium and minerals and all the goodness we need.  The other great news is that these foods are more bioavailable then plant-based sources.  For an added bonus they also contain protein and omega 3 fatty acids, which help reduce inflammation, protect our heart and do other great things for us.
    • 3 ounces of canned salmon with bones contains 170-210 mg of calcium
    • 3 ounces of sardines contains 370 mg of calcium
    • 3 ounces of canned mackerel contains 250 mg of calcium
  3. Drink homemade bone broth.  Oh the goodness coming from bone broth is infinite.  It is filled with minerals and collagen.  It even has properties for healing and maintaining joint and gut health.  Stay tuned for a future blog post on this topic.  For now you can check out the Wellness Mama for her take on this good stuff and to get her recipe.  I prefer to make my bone broth in the slow cooker and love this post from Team Nutrition Genius.
  4. Add plenty of nuts and seeds to your diet if you can tolerate them.  A great snack might include 2 ounces of tahini (sesame paste) blended with 1 cup of sprouted garbanzo beans and garlic, salt, pepper to taste.  This is also know as humus and pairs really well with carrots and celery…yum!
  5. Check with your healthcare provider to determine if you need to supplement.  We can only absorb 500-600 mg of calcium at one time.  If you need a higher dosage, then split it up throughout the day.  You may also want to check out why Chris Kresser recommends eating your calcium rather than popping a pill for it.
And now for one last consideration.  There are products fortified with calcium, such as orange juice,  non-dairy milks, breads, cereals and crackers.  None of these are a part of my real food pantry for several reasons.  First, these items require a lot of processing that removes their natural goodness and adds in nutrients that did not exist before.  Second, all of these items include additives, preservatives, added sugars and other ingredients that most of us cannot pronounce.  Some of these ingredients can be difficult to digest, cause irritation and can lead to a leaky gut.  The added sugars also increase blood glucose.  If your body is anything like mine, then this sends me on a blood sugar roller coaster and inevitably I am hangry later.  Lastly, many of these products have shelf lives longer than my natural life. I do not trust food that does not go bad. 

So, once agin have no fear.  We can have strong bones and meet our calcium needs by eating real foods, even if we do not eat dairy.  Choose wisely and contact me at for your own nutrient assessment.

That’s it for now.  Hope this helps.
A Guide to Calcium-Rich Foods, National Osteoporosis Foundation.  Accessed at
Calcium and Bioavailability, Dairy Nutrition.  Accessed at 
Calcium Content of Foods – UCSF Medical Center.  Accessed at
Dietary Reference Intakes for Calcium and Vitamin D, Institute of Medicine of the National Academies, November 2010.  Accessed at 

Vitamins & Minerals Health Centre, WebMD.  Accessed at 

How I Got Rid of Adult Acne

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Even thinking about adult acne makes me cringe.  I mean really, anyone who has had big, fat, red zits as an adult can relate to the pain and even embarrassment of the unsightly blobs.  My story is unique to me, because the last time I checked every physical body is different from another.  There may still be parts of my experience to which you can relate.  For those of you with acne who cannot relate to my story, keep reading! There are some strategies for acne-management that are still effective for you.
So, my zits were cystic and red and painful.  They were hard round bumps that wouldn’t just go away either.  Zits as a teenager came and went for me in like 2 or 3 days.  As an adult they lingered, sometimes for months.  I’m not kidding.  It was awful.  The discoloration of my skin was a reminder that haha, puberty might be over, but your hormones are still all jacked up.  I just wanted to flip off mother nature while sarcastically saying, “Thanks for the experience.”
The first round of adult acne came in my mid to late 20s, perfectly timed right before I got married.  At the time I was not fully integrated into the nutrition and functional medicine world as I am now, though I was resistant to taking oral medications for it.  So, I decided to see a dermatologist, who quickly prescribed multiple creams that most teenagers use.  Guest what, they didn’t work.  Why? Because hello…I was not a teenager and, although I didn’t realize it at the time my acne was not a dermatological problem!  The retinol A was so harsh on my skin that it made other areas breakout in red, itchy splotches. Round 2 of treatment came in the form of blue light therapy to which I did not respond well.  On top of the treatment itself, I had to take steroids to control the inflammation and ran a low grade fever for several days.  People were also scared to look at me for a good 2 weeks, during which time I got more zits.  That was so frustrating, and I was mortified at what I had done to myself.  The dermatologist office said it was just a bad reaction, but it was still “normal” and recommended that I come back in for another treatment.  Um no thanks.  Like any polite, skeptical patient, I just ignored their recommendation and never went back.  So, after that I tried Proactive, which also didn’t work…duh…read the ingredients.
As I continued to seek solutions for my acne I also started noticing other signs of dysfunction.  My blood sugar would drop too low after workouts and big meals, so my level of hangry was off the charts.  I was stressed out all the time, worked too much and studied too much. I also had a bad habit of working out like a crazy person.  And to bring it all together my menstrual cycle was unpleasantly unpredictable.  For some one who wants to be the epitome of healthy, there was a lot of shit going wrong.  Excuse my language, but I don’t feel hormone imbalances and adult acne are polite, so I don’t want to be polite when discussing it.
I finally found an osteopathic physician with a functional medicine approach.  After changing my diet and taking a ton of supplements I finally had better control of most of my ailments and happily discovered my skin was clearing up.  The good news is this lasted for several years.  The bad news is I did not maintain all of those lifestyle changes and I got a fresh round of zits 8 years later.
Fast forward to now, when I have a master’s in dietetics, an obsession with functional medicine and access to quality food and supplements, and I am cured!  Well, maybe cured is a strong word.  I now have an understanding of what causes my zits and how to manage it.  I have also gone through cycles of being willing to make necessary changes and seeing good results, then getting lax and living with more zits.
So, what’s my deal?  I have poly cystic ovarian syndrome (PCOS).  Approximately 5-10% of women of childbearing age have PCOS.  There is not one singular test that diagnoses PCOS, rather it is a cluster of symptoms that may include weight gain, hormonal imbalances such as insulin resistance and excess androgens (fancy way of saying higher than normal testosterone levels), excess hair growth in unsightly areas (chin, upper lip, areolas), acne and multiple cysts on ovaries or enlarged ovaries.  I’ve experienced all of these symptoms at one point or another. What’s even more exciting is that the hormone imbalances also cause mood swings and some of the more notable signs (excess hair and acne) really took a toll on my body image.
So, what did I do about it?
  1. Work with qualified health professionals to get the support I need for determining which changes are most important and what supplements may be most helpful FOR ME!
  2. Eat more fresh vegetables than any other type of food.  I use the Environmental Working Group’s list of the Dirty Dozen and Clean 15 to guide me through the world of organics.  I eat a minimum of 1 serving of vegetables with every meal.  Most days I consume over 1 pound of vegetables.
  3. Limit fruit, avoid all fruit juices and shun all sugar sweetened beverages.  Fruit is not bad because it contains a lot of great vitamins and minerals and it has fiber…yay fiber!  Fruit does have a lot of naturally occurring sugar though.  Because I have had insulin resistance and fluctuating blood sugar levels I do not need to add to the problem by dumping more sugar into it and making my body work harder.  I typically eat 2 servings or less of fruit each day.
  4. Consume grass fed, free range animal products and wild caught fish.  Conventionally raised animal products contain added hormones to increase the rate of growth and size of the animal.  Clearly I do not need extra hormones, since as I mentioned earlier mine are all out of whack.  Grass fed, free range or pasture-raised animals have some other health benefits, such as higher amounts of essential nutrients such as omega-3 fatty acids that fight inflammation and vitamin K2, among several others. (Explaining all the goodness of vitamins and minerals will have to be saved for another blog post.)
  5. Drink more water and less alcohol, in fact, avoid alcohol most of the time.  I do not drink heavily, but I do enjoy wine and hard cider.  I love dark beer, but don’t drink it anymore because it contains gluten.  Alcohol itself is an endocrine disruptor, which is another fancy term with a simple meaning and basically sends your blood sugar on a roller coaster ride which is hard to control for several days after consumption.  The beauty of drinking more water is that it helps us get rid of a variety of toxins.
  6. Avoid dairy, gluten, soy, nuts and seeds. 


·      Dairy is one of the most common food sensitivities.  Dr. Sara Gottfried provides a great overview of dairy’s effect on hormones and health in The Hormone Reset Diet.  Approximately 75% of people cannot make the enzyme, lactase, needed to breakdown lactose, which is the naturally occurring sugar found in milk.  It is a major cause of inflammation for many people who are sensitive to a specific milk protein known as casein. Conventional dairy has also been linked to rises in growth hormone and insulin, both of which trigger fat deposition (increased weight gain) and blood sugar dysregulation.  For me the bottom line is I get zits.  No amount of scientific evidence is as strong as my own personal experience.
·      Gluten is found in barley, wheat and rye.  It is a food glue used in a gazillion different processed foods, most of which we are completely oblivious to because the food label does not say gluten, barley, wheat or rye.  Gluten itself is a protein that provides structure to many baked goods.  Unfortunately, it too is on the list of the top 8 most allergic foods.  The problem is our guts really do not know what to do with gluten.  When our guts are not working perfectly, which let’s face it most of our guts are not, gluten damages the tight junctions that maintain the integrity of our gut lining.  When the gut lining is damaged the large gluten molecules can leak out of the gut and into the blood stream and cause a variety of reactions, such as skin rashes and acne, dry coughs and brain fog just to name a few.
·      Soy, nuts and seeds are all plant-based food sources that may be very healthy for other people.  For me though, these foods contain an excess of phytoestrogens.  This plant-based version of the hormone estrogen found in the human body exacerbates hormonal imbalances.  In my case it further increased estrogen dominance and made PMS symptoms even worse.  I’ll spare you the details of my monthly discomforts, but suffice it to say I can control them through mindful eating and managing my hormones.
Let me also be super honest and say that despite knowing this information and understanding all of the science (which I did not include in the blog post…waiting on my future book deal for that…kidding), I still stopped and started dairy like 14 times.  I am also well-aware that I have been “glutened” while dining out and on very rare occasions have knowingly consumed it.  It also took me the longest to even recognize that I am not able to tolerate nuts and seeds.  The bottom line is that this is a lifestyle change.  It comes with the traditional learning curves of any change and has led me through a number of successes and failures along the way.  All in all, I have learned a great deal about myself and how food affects my health.
Since I am still alive and well I cannot say “the end” to this story.  The journey continues, but for now I am done sharing.  Go forth and prosper, and I will do so gluten-free, dairy-free and nut-free.  Be well.

Smoothie is Not King

I came to a disappointing realization this week. Smoothies do not make a good breakfast for me…again, so disappointing. My husband drinks one every morning, and has been for several months. I decided to join in the morning smoothie goodness out of convenience, because our microwave is on the fritz and I cannot heat up my usual egg and greens scramble. 
This week my husband and I are having the exact same smoothie. They fill him up and leave him satiated for hours.  (Satiated being a fancy nutrition word for feeling full and satisfied.) He does not need a snack between breakfast and lunch. On the other hand I drink the same smoothie and still feel hungry afterwards. I also get hangry (hungry and angry as a result of low blood sugar) and shaky 2-3 hours later and MUST have a snack before lunch. This does not happen with my usual breakfast of eggs and greens.
I did a quick nutrient analysis on this week’s recipe just to make sure it was Grateful Guts balanced, meaning it had adequate protein, plenty of fat and was high fiber.  The analysis met my criteria.  It was very nutrient dense, with 50% of calories coming from healthy fat, 20% coming from protein and 30% coming from carbohydrates, with more than 9 grams of fiber.  
The nutrient breakdown is ideal, so the question of the week…what is my problem?  The answer…nothing, I have no problem. This is one of the best examples that demonstrates how individualized nutrition is for each person. What works for my husband does not work for me. 
You see foods that are blended or juiced are already partially broken down/partially digested before they even get to your stomach, which makes the rest of the digestion easier for your gut and faster. I simply digest, absorb and metabolize the nutrients in smoothies faster than my husband does. My body functions a lot better when I have to chew my food rather than just drink it.
To recap, the moral of this story is that everyone’s nutrient needs are different in form and function.
Just because smoothies do not work for me as a complete meal, does not mean that they will not work for others, my husband is a prime example. Most importantly, when testing smoothies for yourself, remember to ensure that it is nutrient dense and balanced.  Create a real meal in a glass rather than a sugar bomb that will send you on a blood sugar roller coaster and leave you hangry within 2 hours.   
Follow these tips for making balanced smoothie creations:

  1.  Use water as the main liquid source.
  2. Add healthy fat using sources such as full fat coconut milk from the can, coconut oil, avocados or MCT oil.
  3. Stuff in at least 2 handfuls of greens. I like spinach the best, but kale works well too.
  4. Find a quality protein powder and avoid junky ingredients and additives.  My best recommendations are high quality gelatin, like that found from Great Lakes; an unflavored grass fed whey protein powder; or a vegan protein powder that has at least 2 sources of plant-based protein. We use Sun Warrior. Regardless of the protein powder you use select a brand that has 5 ingredients or less.
  5. Add ½-1 cup of high fiber fruits.  Berries are my favorite. Right now we are using fresh blueberries because they are in season. During the winter we buy frozen organic berries.
  6. Use ½ of a banana if you need a little extra sweetness.
  7. When assembling your smoothie, put all of the liquids and greens in first and blend until the greens are liquefied.  Add the remaining ingredients and blend until you reach your desired texture.
  8. Follow the Grateful Guts recipe for making a big batch of smoothies in advance. This recipe makes 5 servings that are 2 cups each.
·         32 ounces water
·         1 can full fat coconut milk
·         1 avocado
·         5 handfuls of greens from the farmer’s market or a 5 ounce package
·         1 ½ cups fresh berries or 10 ounce package of frozen berries (buy organic)
·         1 banana
·         5 scoops Sun Warrior protein powder

Good Carb, Bad Carb, Real Carb

Confession, I have been working on this post for a few weeks, anytime we have been on a road trip. I mean really, who doesn’t write blog posts in the car? Besides the fact that I have not worked on this post unless I have been traveling, you must also understand that I get motion sick really easily. It has been some kind of mini-miracle that my sentences are coherent (at least I hope they are). And please excuse any typos. My thumbs got quite a workout putting this together.
Anyway, a long long time ago (sung to the tune of American Pie by Don McLean … much of my internal dialogue is in musical form to tunes that most often I cannot name the title, song or artist, just random verses), I indirectly received a question/comment inquiring about my take on carbs found in fruits. My response comes in the form of this post, because that is a complex discussion.
So, the quick answer to the question about my opinion of sugar found in fruit – if it is coming from a real food source and is chewed, not drank, then it is acceptable and fits into my lifestyle. HOWEVER it is a simple sugar, and when over consumed elevates blood glucose (blood sugar) and increases triglycerides…among several other things.
I do not believe in “good” food, “bad” food. All real food is good. To me real food is defined as recognizable and coming from as close to its natural source as possible with minimal, if any, processing before it gets to my mouth. Think apples, roasted potatoes, bone-in pork chops, all fresh vegetables. Anything that is pre-processed, packaged in plastic, contains ingredients I cannot pronounce or recognize as a food source, has a shelf life longer than my natural life or requires excessive temperature changes to modify its molecular structure for product sustainability is not a real food and is not something worth my money, time, possible gut disturbance, acne or foul mood.
I do not follow a low carb diet per se, but since I take a real food approach and eat a lot of high quality fat my carb intake is much lower than someone who follows a standard American diet (SAD).
I think one of the reasons carbs get such a bad wrap (opportunity for food pun here) is that most people do not actually understand what a carb is or its various functions. Carbs are actually one of three macronutrients, the other two being protein and fat. Macronutrients contain calories and are important for fueling our bodies (carbs), providing the building blocks of our tissues and support optimal immune function (protein) and are important for nerve conduction, hormone regulation and protecting our organs (fat).
Carbohydrates are derived from plant sources and contains carbon, hydrogen and oxygen. The simple form of a carbohydrate is glucose, and the more complex form is either starch or fiber (also known as cellulose).
Simple carbohydrates are sweet tasting and are easily broken down to glucose. Forms of simple carbs, called monosaccharides are glucose, fructose and galactose. Glucose is the building block of simple carbs. Fructose is found in fruits. Galactose is found in dairy products. Disaccharides are formed from two monosaccharides, which we know more commonly as sucrose, or table sugar (fructose and glucose), lactose found in dairy products (galactose and glucose) and maltose found in barley, which is then fermented to make beer (glucose and glucose).
The complex carbohydrates, starch and fiber, are known as polysaccharides, which are much longer chains of carbohydrates that cannot be broken down as easily as simple sugars. Complex carbs are also slightly bitter tasting and tend to have rougher, grainy textures. Starch is the storage form of energy in the plant world. It can be broken down to glucose after many biochemical processes, therefore it can become a source of energy for the body…or in excess it gets stored for later use.
Fiber, or cellulose, on the other hand is a ribbon-like molecule that provides structure to the cell walls of plants. Fibers cannot be broken down by human digestion, which means they are not a source of energy. They serve important purposes though. Soluble fiber can become a gloppy-like substance (gloppy being the unscientific term for gelatinized) that slows down the rate at which contents leave your stomach, therefore helping you stay full longer. It also helps create bulky stool for people with diarrhea, and helps lower LDL cholesterol. Soluble fiber is found in oatmeal, the fleshy part of an apple, oranges, lentils, berries, nuts, carrots and cucumbers, just to name a few sources. Insoluble fiber cannot be digested and does not react with water. It is like a scrub brush for your intestines. It can increase gut motility, which is a fancy way of saying it can speed up digestion and have a laxative effect that helps prevent constipation. Insoluble fiber is found in whole grains and many different vegetables. It is also in the skin of foods like apples and potatoes.
Just knowing carb basics does not explain why all carbs are not created equal. Sometimes their may be inflammation, an imbalance of gut bacteria or even a gastrointestinal condition that makes digestion, absorption and metabolism of carbs difficult for some people. Simply put when certain forms of mono and polysaccharides are consumed they can be fermented in the gut rather digested and absorbed. Fermenting produces gas and bloating and general discomfort. This is why some people may not be able to tolerate an apple, but may be able to tolerate strawberries. The biochemical explanation for this is quite complex, but suffice it to say that restoring gut health can help you increase the variety of carbs you can to tolerate.
Another important point is that any carb consumed in excess will be converted to fat for storage. In fact any macronutrient consumed in excess is turned to fat for storage. Excess carbs can increase blood glucose, throw off insulin regulation, increase triglycerides, increase inflammation and contribute to many chronic diseases including heart disease, diabetes, certain cancers and dementia.
Knowing how many carbs to consume and in what forms is not something that most people think about beyond the “good carb/bad carb” mentality that has been drilled into the brains of those in mainstream society in recent years, so I’ve compiled my top five tips that may be helpful for the average person who does not have autoimmune issues or existing chronic diseases (we’ll save those recommendations for private client who need very specific, individualized plans…contact me for more info). Also these tips are functional for those taking a real food approach or just making the transition.
1. Chew more nutrition than you drink. This means drink more water, unsweetened tea or coffee and avoid juice. That’s right. Juice is not a health food. It is more closely related to sugar water, aka soda. You will get far more nutrition from eating the entire fruit because the food version contains all of the vitamins, minerals, FIBER and phytochemicals that get left behind when you just drink the juice. Smoothies should be consumed in moderation, if at all. Check out @gratefulguts on Instagram for #gratefulgutsmadehusbandapproved recipes made with appropriate amounts of protein, fat and carbs for a mini-meal.
2. Get simple sugars, starch and fiber from whole fruits and an abundance of vegetables. Aim for at least 1, ideally 2, servings of vegetables at each meal, including breakfast. Select 2-3 servings of fruit per day.
3. Avoid most, if not all grains, especially in the form of breakfast cereals, pastries, snack foods, bread/toast and pasta. These are not real foods anyway, so this recommendation should not come as a surprise. These foods are highly processed and contribute to excessive intake of carbs, deteriorating health problems, expanding waistlines, gut issues etcetera, etcetera, etcetera. Most of these foods also contain gluten, which is a topic for another blog post…or podcast (hint, hint).
4. Limit, or avoid, alcohol if trying to reduce carb intake. All alcohol is carbohydrate-based. The carbs in barley (beer), starch in potatoes (vodka), fructose in grapes (wine) are fermented to create the beloved beverages. Alcohol can also serve as an endocrine disruptor that sends us on a blood sugar roller coaster.
5. Ditch the soda. No good comes from these, even if you have an upset stomach. If you like carbonation, then try getting seltzer water and infusing it with your own combination of fresh fruit or veggies (berries, citrus, cucumber).
This topic is huge and brings up many other opportunities for discussion and future posts. Stay tuned for other topics including gluten, blood sugar regulation, real food snacks, real food sweeteners and much more. Be sure to to like the Grateful Guts Facebook page and follow @gratefulguts on Instagram.

A Week of Real Food Meals and Tips for Eating Away from Home

I am so excited for this week I can barely contain myself.  First it is a short work week. We are taking a few days off to extend this long holiday week, and trust me we NEED it. With our extra time we will get to visit a few of our besties, including FoodRN. We will also get to cuddle with their babies, catch up with family and eat some seriously good food. There really is no other way I want to spend this time.
A notable menu moment for this weeks is that there are two recipes I did not make from last week’s menus. They made their way onto this menu though. One thing I think is crucial for real food budgets and time savings is to be flexible with menu planning and meal prep. We are NOT afraid of eating leftovers. I repurpose our food regularly.  It saves so much money and so much time. Last week we had leftover flat iron steak from Father’s Day, so we ate it one night in a huge entrée salad alongside hefty slices of grain free foccaccia bread, and another night in stuffed potatoes. Both meals took less than 30 minutes to prepare and saved us from having to buy a new meat bundle for one more week…win-win for me!
So here is what we are planning for this week:

Erin – egg bake and Great Lakes gelatin latte with Swiss water pressed decaf

    1. Heat oven to 350 degrees.
    2. Saute 1 pound mushrooms, half large onion diced, 2 small cloves minced garlic and 5 ounces arugula, then dish vegetables into 4 glass, oven-safe dishes.
    3. Beat 8 eggs and pour equally over vegetable dishes. Season liberally with salt and pepper.
    4. Put glass dishes into baking pan and fill with water about halfway up glass dish.
    5. Bake for 40ish minutes or until eggs are completely cooked through
     Nathan – high protein, green smoothie

      • Beef stew over zucchini noodles, recipe courtesy of Inspiralized
      • Salad
      • Freshly sliced bell peppers or carrots
      • Fresh fruit 
      • Organic whole milk yogurt for Nathan
      • Dark chocolate for Erin. This week I am trying Theo, and I am loving its rich, bitter flavor


      • Larabars for Nathan
      • Sunflower seeds for Nathan
      • Frozen berries for Erin
      • Bone broth for Erin
      • Hard boiled egg


      • Sunday – grilled polish sausage with grilled asparagus
      • Monday – grilled pork steak, roasted smashed potatoes, broccoli salad (I have not selected a recipe for this yet, but know that it will not contain traditional mayo. I will likely make it myself or use a bacon grease and rice vinegar dressing instead.)
      • Tuesday – leftover grilled pork stead, roasted plantain (current food obsession) and leftover broccoli salad
      • Wednesday – grilled wild caught salmon with cauliflower rice tabbouleh
      Even though we are not cooking meals at home beyond Wednesday, we will still honor our real food preferences.  While not all of my family makes the same real food choices as I do, they are accepting. There is always a grocery store close to our destinations, which means I have the ability to bring my own dishes for sharing.  Here are my top 5 tips for keeping it real away from home:
      1.  Take a real food dish as a contribution to the party.
      2. Build a plate that has more fresh vegetables than processed foods. This means raiding the relish tray before grabbing a handful of potato chips.
      3. Select protein carefully. I like to make bunless burgers wrapped in lettuce, and I prefer to eat chicken off the bone rather than gnawing on an overcooked boneless, skinless chicken breast.
      4. Avoid ewwwy-gooey side dishes with lots of creamy sauces – think potato salad, coleslaw, macaroni and cheese, and baked beans. These items are typically made with condiments that contain vegetable oils (read Confessions of a Real Food Dietitian post for my thoughts on those), added sugars (in about 14 different varieties) and other fake food (powdered cheese, preservatives and food dyes). Consider taking these as a way to follow tip #1 and ensure there is something real to eat.
      5. Have snacks stashed away in case there is not enough real food from which to choose. A few foods that travel well, oranges, beef jerky (I am loving Epic products right now), kale chips and bars (2 Moms in the Raw, Larabars, Kind bars.
      BONUS TIP: When determining if a prepared food or condiment is Grateful Guts worthy I always read the food label.  If it contains enriched flour, whole wheat flour, high fructose corn syrup, maltodextrin, modified food starch, soy sauce, food dyes or alternative sweeteners (acesulfame potassium or acesulfame K, aspartame, saccharin), then I put it back.  
      With all that in mind have a safe, delicious holiday weekend!

      Feel the (Not So Good) Burn

      Oh so many people have heart burn. It is also known as GERD, which stands for gastroesopohageal reflux disease. That is simply a more clinical name for chronic acid from the stomach that backs up into the esophagus. It technically does not have any relation to the function of your heart, but for some people the pain is situated in the center of your chest and can easily be confused with chest pain associated with cardiac complications. Other symptoms of heart burn can include a dry cough, problems swallowing or feeling that there is something stuck in your throat, hoarseness, sore throat and juicy burps that contain regurgitated food in liquid form that is very sour.

      At some point everyone experiences acid reflux, but most people do not truly understand its cause. Acid reflux actually occurs when the band at the bottom of your esophagus (known as the lower esophageal sphincter or LES) cannot stay closed. When the LES is open highly acidic content from the stomach can move back up into the esophagus where it does not belong. So how do we manage acid reflux without using medications that have unwanted side effects and lead to other digestive disturbances?
      Grateful Guts top 10 tips for lifestyle changes to manage acid reflux:
      1.  Work with a registered dietitian nutritionist, like yours truly, to complete a short elimination program to determine which foods may be considered triggers. Often we become de-sensitized to signs of dis-ease because these symptoms have become so common. Know that a common symptom does not mean it is normal function. The best example of this was a client who went through an elimination and re-introduction program with me in order to identify the cause of gas, bloating and abdominal pain. Interestingly though the first thing she noticed was that her persistent dry cough disappeared when she eliminated gluten. It returned when she tried to reintroduce gluten-containing foods. She had not even considered her persistent dry cough as a sign of dis-ease because she was so used to having it. Not until it was gone did she notice how it affected her quality of life.
      2. Eat real food! Shocking that I would say such a thing. Most real food, consumed in a form that is as close to its natural source as possible, is going to be lower in acidity and therefore will not be trigger foods. These real foods include whole muscle meat products from grass-fed, free-range, sustainably raised animals, as well as fruits and vegetables and wonderfully gelatinous bone broth. I also recommend avoiding all dairy products (milk, yogurt and cheeses), along with gluten containing foods (barley, wheat, rye, soy sauce, processed lunch meats, most convenience foods and products containing modified food starch and maltodextrins). This is where #1 is important. People like me can really help with this part.

      3.  Get exercise that strengthens your muscles. Try yoga, Pilates and functional movement training.  Cardio exercise like walking, swimming or riding your bike are helpful in maintaining good heart health, but these forms of exercise are not as effective for maintaining muscle tone (think diaphragm) as strength training.
      4. Eat slowly. Put down your eating utensil between bites and do not pick it up again you have swallowed the first one. It takes approximately 20 minutes for your body to recognize that you are full. If you are still eating when you start to feel full, then you have over eaten. You will continue to feel full for at least another 20-30 minutes. Remember that overeating creates excess pressure in the stomach, which can prevent the LES from closing thereby causing the acid to back up into the esophagus…ouch! If you slow down the speed at which you eat, then your brain can keep up with your body and you will be able to recognize when the physical sensation of hunger is gone. That is when you should stop eating.
      5. CHEW your food. Do not just chomp and swallow. Help your stomach work more efficiently by actually chewing. Chewing breaks down your food into tiny particles. The acid in your stomach continues breaking down those tiny particles into their most basic forms. If the particles are still too big when they hit your stomach, then the chemical breakdown from the acid can create gas, in your stomach, increases the pressure in your stomach and can prevent your LES from closing.  Gas in your stomach escapes as a burp. Have you ever noticed that the faster you eat the more you burp?
      6. Eat more frequently throughout the day, but consume smaller quantities in one sitting. This is important so that you do not overeat. I feel like a broken record now. Eating smaller portions will prevent you from overeating. And once again overeating creates excessive pressure in your stomach and prevents the LES from closing…sigh.
      7. Avoid ALL sodas and any carbonated beverages. Carbonation is a gas. Gas inside your stomach can create pressure…you get my point. Also sodas and chemically created beverages made in a lab or factory contain a lot of sugar and A LOT of acid. Don’t put extra acid in if you do not want to feel it come back up.
      8. Stop drinking alcohol and stop smoking. These damage your health, including your GI tract. Enough said.

      9.  Consume your last meal at least three (3) hours before lying down. Myth, eating too close to bedtime makes you gain weight. Fact, eating too close to bed can cause acid reflux.

      10.  Sleep with the head of your bed at a 30 degree angle. OK not every person needs to actually measure the incline of the head of their bed, but know that sleeping at an incline can help keep the stomach acid from moving up into the esophagus.
      To understand why these are my top 10 tips, let’s do a quick anatomy/physiology review. The gastrointestinal tract (GI tract) is technically a one-way street. It starts when you put solid and liquid items in your mouth. Mechanical digestion occurs through the act of chewing and your tongue in needed to move the food back to your throat so that it can be swallowed. Once swallowed it moves down a tube called the esophagus, hence the E in GERD. At the bottom of the esophagus is the stomach. The LES is the band where the esophagus and stomach join. In this same general vicinity is a sheet of muscle that runs horizontally across our upper abdomen known as the diaphragm. This muscle is important for breathing and it helps maintain closure of the LES, thereby preventing stomach acid from sloshing upward into the esophagus. Now let’s understand part of the physiology of the GI tracts. The environment inside the stomach is very acidic. It contains hydrochloric acid (HCL), which is important for chemically digesting nutrients, especially protein. HCL can also activate other digestive enzymes in the small intestines needed for absorbing nutrient. There are cells inside the stomach that create a protective lining in the stomach that prevents acid from causing damage. There are no such cells in the esophagus, which is why we often feel a burning sensation when stomach contents back up.

      So, the burning question is what prevents the LES from closing all the way? Unfortunately there could be many explanations for this. For example obesity, pregnancy and overeating can cause excess pressure in the stomach that prevents the LES from closing. Occasionally older adults can develop a hiatal hernia, that occurs when the top of the stomach protrudes into your chest. When this happens the LES is above the diaphragm and therefore no longer has the musculature support that helps keep it closed. Lifestyle factors such as smoking, alcohol and caffeine consumption can cause damage throughout the GI tract, including weakening the LES and causing heartburn. There are also some medications that can weaken the LES. Anecdotally I have had clients with food intolerances experience heartburn after eating an offending food, and I attribute this experience to inflammation occurring within the GI tract that temporarily prevents LES closure.
      Regardless of the cause, the pain associated GERD is exacerbated by highly acidic foods like alcohol, caffeine, soda (regular and diet…don’t even get me started…there will be an entire blog post dedicated to the syrupy, bubbly poison), tomato and citrus based products and even chocolate. Other triggers can be foods that create acid when they are digested, such as dairy products and simple sugars, especially those that are refined and added to processed foods. And of course there are those pesky food intolerances which can be both a cause the LES dysfunction and can be a trigger that can create excess acid.
      Treating heartburn is often multi-factorial, and being the crunchy-not quite hippie-let’s try a natural approach-kind of girl, I prefer to start with lifestyle changes rather than medication…and here is why. More often than not, too much acid is not the actual problem; rather the problem is that the acid from the stomach is simply in the wrong spot. We want acid so that we can actually digest our food, especially protein. We also need acid to activate other digestive enzymes in the small intestines to aid in nutrient absorption, especially calcium, magnesium and vitamin B12. Problems associated with not digesting or absorbing nutrients properly cause many of the side effects listed in the fine print of these medications, which interestingly enough are also symptoms of irritable bowel syndrome (IBS) – bloating, gas, abdominal pain and diarrhea.

      There are a number of natural remedies such as DGL (licorice) and slippery elm, along with other supplements that complimentary healthcare practitioners recommend for symptom management.  While I truly believe these can be very helpful when used appropriately, it is important to work with a qualified practitioner to ensure the appropriate use of such remedies.

      I could probably write an entire dissertation on this topic, but I think we have covered enough for now. If you have questions, then please leave them in the comments. And once again cheers from my cup of gelatinous bone broth to yours.

      Welcoming Summer and Previewing a Week of Real Food

      It is officially summer. Today is the summer solstice, which is also the longest day of the year. Of course there is science and a solar system that explains the positions of the sun and earth and why the amount of sunlight is longest on this day, but I really prefer to focus on its symbolic representation. Om Times posted an article that really resonated with me this year, and within it stated, “Sun represents the soul and when it is at its northernmost elevation, the light within the consciousness is also shines brilliantly, opening possibilities of tremendous growth and evolution.” I find so much inspiration and optimism in this line; especially as I embarking on new personal and professional endeavors that will allow me to align passion with profession. 
      There are innumerable rituals surrounding both the winter and summer solstices. Today I completed my own version of a yoga mala during which I performed 108 sun salutations. One hundred eight is evenly divided by three, which is representative of mind, body and spirit. In addition to connecting movement with breath, I also focused on affirmations. The first 36 sun salutations included mind affirmations. The next 36 were body affirmations, and the last 36 were spiritual affirmations. I also took advantage of technology and used the laps on my stopwatch app to keep count. In all it took me about an hour and a half to ease into practice, then finish with restorative yoga poses. It was a powerful practice that serves as my personal reminder of how important it is to stay balanced and connected with my passion and purpose.    
      Turning the tables now…Happy Father’s Day to all of men out there. This weekend turned out to be a mostly sunny change of pace from the previous week’s daily deluge. We were grateful that the weather reports from earlier in the week were wrong. Of course more sunshine means more grilling. I can certainly appreciate a perfectly grilled morsel of goodness. In fact we planned our Father’s Day celebrations around our grill. It was so simple, and had so much flavor. Grilled flat iron steak from our local butcher, avocado tomato salad, grilled corn, spinach and berry salad, and roasted smashed red potatoes. It was 80% locally sourced, real food, made with love.

      I would like to address, and effectively debunk, the myth that quality, real food is unaffordable. Let it be known that I live on a budget. I eat really well, and my husband never goes hungry. My most important budgeting strategy is planning. On Fridays I create a menu for the week. We tend to have the same breakfast and lunches all week because we make them in bulk on Sunday evenings. This saves us so much time during the week. On Saturdays we shop, first at the farmers’ market for 90% of our produce. Anything that I cannot get locally, like quality fish or coconut milk, I typically buy at Whole Foods. My grocery bill for this past week amounted to $105, and that included the extra items needed for hosting Father’s Day. Another very important money and time saving strategy is sourcing quality animal products locally. I am so grateful for a local butcher shop that sells meat bundles. Our bundle has beef, pork and chicken and provides around 40 pounds, which averages approximately $4.25 per pound. I can stretch this bundle out for three months with careful planning. 
      Our meals for the next week are detailed below. I linked recipes when I plan to use them, otherwise recipes include the ingredients listed and eyeballing quantities and cook times.
      Breakfast this week:

      • Erin: spring mix salad with two over-easy eggs, homemade oil/vinegar dressing and high protein Swiss water pressed decaf coffee
      • Nathan: green protein smoothie

      Lunch this week:

      • spaghetti squash with bacon, ground cube steak, mushrooms and roasted broccoli
      • spring mix salad with tomatoes and homemade oil/vinegar dressing
      • carrot sticks
      • full-fat, organic yogurt for Nathan
      • fruit for both of us
      • dark chocolate for Erin

      Snacks this week:

      • fresh fruit
      • homemade pickles
      • homemade roasted plantain chips
      • sunflower seeds for Nathan
      • a cup of bone broth for Erin

      Dinner this week:

      • Tuesday:
        • sweet potatoes stuffed with leftover flat iron steak and coconut oil
        • roasted asparagus
      • Wednesday:
        • Grilled sausages served over zucchini noodles
        • leftover grain free focaccia bread
      • Thursday – eating out at Chipotle for work fundraiser

      Hope you have a great week, and cheers from my cup of gelatinous bone broth to yours!

      Food Shaming – Stop It! Entering a Judgment Free Zone

      Stop food shaming.  Seriously, stop it now! I am talking to myself and the catrillion other people who have looked at some one’s lunch and either thought or said, “I can’t believe she’s eating that.” I am talking to myself and the catrillion other people who have deprived themselves of nourishment because it had too many calories, too much fat or too many carbs. I am talking to myself and the catrillion other people who have felt guilty about eating something. I am talking to myself and the catrillion other people who have been labeled as picky, high maintenance, difficult or too good because we asked for no cheese, we wanted to know how the sauce was made or we decided not to indulge in the delicacies brought to some celebration.

      In an article from the Huffington Post, Michelle May, M.D was quoted as saying, “When we judge food as being ‘good’ or ‘bad,’ we also judge ourselves and other people as ‘good’ or ‘bad,’ depending on what we ate.” It is my belief that these judgments are cultivated through social norms and misguided perceptions of the perfect body, clearest skin, roundest ass, perkiest boobs, flattest abs, longest legs or whichever body part has been assigned highest value for the moment. Somehow these physical traits have been assigned moral values, while the purpose and intent of the food itself has been disconnected from the act of eating. As if not eating to be skinny means we are nice or having an extra piece of cake to keep our curves and have big boobs means we are fun.
      The purpose of food is to fuel our bodies and maintain optimal health. It is not inherently good or bad.  It does not make us more enlightened, and it certainly does not make us better or worse than the next person. As a dietitian I know how different types of foods affect our bodies and minds.  I have strong opinions about foods I choose as fuel and why, because I understand the science and can explain digestion. I will serve as a guide to making food choices that support the highest quality of life and optimal health, not the food choices that achieve a specific physical shape.
      Since health is individualized it should not be measured by the size of our pants, the numbers on the scale or how our assets compare to Kim Kardishian’s. While there are some markers of health that can guide us towards making appropriate lifestyle changes, we get to determine what feels best and how we want to live, and there is no shame in that. Consider this a judgment free zone.


      Confessions of a Real Food Dietitian

      All of the reasons I LOVE nutrition are the same reasons why I make specific food choices.

      I eat a lot of fat. It is the nutrient that I consume in the largest quantity, but guess what…I am HEALTHY. I am not obese and I am not at any increased risk for having a heart attack on my next run or stroking out as I climb the stairs at work. Mainstream medical professionals and functional medicine practitioners alike would look at my cholesterol panel (total cholesterol, HDL, LDL, HDL:LDL ratio and triglycerides) and give me a double thumbs up.
      I choose fat from high quality sources. My favorites are avocados, whole olives, cold-pressed coconut oil, cold-pressed olive oil, real butter and fat that is found naturally in grass-fed, pasture-raised animal products. The major difference between my favorite fats and those found in the standard American diet (SAD) is that my list of fats are either real food or easily identifiable from their real food source.  Vegetable oils, that supposedly promote heart health, go through extensive processing, bleaching and deodorizing. Just watch this short video from Discovery Channel on how canola oil is made. It is gross, and certainly does not fit within my perception of a quality sourced product. 
      My favorite fats have an optimal ratio of omega-6 to omega-3 fatty acids. Omega-6 fatty acids are readily available in the standard American diet (SAD) with an over abundance found in vegetable oils. Excess omega-6s can increase inflammation and oxidative stress. On the other hand omega-3s are more abundant in grass-fed, pasture-rasied animal products, fatty fish (wild caught of course) and in nuts. These fatty acids can reduce inflammation and among other fabulous benefits have a positive effect on heart health. 
      Not only am I eating a lot of fat, much of it is coming from saturated sources. These fats are solid at room temperature and are more stable. They better withstand heat and do not go rancid as quickly as unsaturated fats. By the time an unsaturated fat is processed and makes it to your kitchen it has been exposed to heat, air and light, all of which further contribute to its breakdown and produce off flavors. When consumed, unsaturated fats are oxidized in the body which creates free radicals that cause cell damage and once again…inflammation. 
      Besides all of the health benefits associated with my favorite fats I also have to admit that I am most grateful for their flavor. Seriously…why eat something that does not taste good? Try this for a quick meal and a burst of flavor.

      Sauteed Greens 
      2 strips of bacon
      1/2 cup chopped onion
      1 minced garlic clove
      4 handfuls greens of choice (I prefer kale)
      salt/pepper to taste
      Chop the bacon and pan fry.  Remove bacon from pan, keeping bacon grease over heat.
      Sautee chopped onion and minced garlic in gacon grease until translucent
      Add greens and wilt to desired consistency
      Season with salt and pepper to taste
      Roasted Plantain
      1 plantain
      1-2 tablespoons coconut oil
      salt to taste
      Preheat oven to 375-425 degrees
      Slice plantain into thin discs
      Melt coconut oil
      Toss plantain with coconut oil
      Season with salt
      Roast in oven until it smells good and looks done.  I like mine crispy, so a little brown is best.