What is Personalized Nutrition and Functional Medicine?

The Masters program of study I am working on at the moment is Personalized Nutrition and it is grounded in Functional medicine.  I'm often asked what Functional medicine is, so thought I'd take a moment to explain it here.

In functional medicine, we look at the underlying causes of disease, engaging the patient with the practitioner in a therapeutic partnership.  There is a shift from traditional medicine being disease focused to functional medicine which is patient focused, and addresses the whole person, not a set of symptoms.


Functional medicine involves understanding the origins, prevention and treatment of complex and chronic diseases.  So for example, if someone is obese and diabetic, the approach isn't to look at their symptoms and prescribe a diabetic medicine, but rather to go back into their health history and look at what imbalance may have caused this shift.  It could be that a situation years ago affected their microbiota in the gut, which led to obesity; or it could be that they have leaky gut and food sensitivities, and that was the trigger; or there could be a polymorphism; or they could be deficient in certain co-factors (micronutrients or macronutrients) that are needed for chemical reactions in the body.

Another example would be someone who has GERD - or reflux disease and has been given Nexium by their doctor.  For one person, the cause of the GERD could be their diet and eliminating the foods that caused the program can solve it. For another, giving probiotics to adjust the microbiota and nutrients to heal the lining of the gut solved the program.  For a third person, they were actually low on HCl - the acid in the stomach and this was because of a deficiency in zinc, which is involved in forming HCl, so restoring zinc sufficiency, solved the problem.

So personalized nutrition then comes into play in trying to correct the imbalances that are at the root of the cause.   It is personalized because what causes one person to present with symptoms can be very different to what causes those same symptoms in another person. The pathway by which they got there can be completely different.

As you can see from the Institute of Functional Medicine tree, we look at all aspects of a person's life, their stress, relationships, sleep, spirituality etc, as all these can create imbalances in the body. Its not about diagnosing disease, it is about looking at root causes, some of which may have started many years ago.  The approach is evidence based.

It is grounded in nutrition and in fact, their annual conference this year is all about nutrition. Its in San Francisco in May - and nearly sold out, so if you want to know more, take a look.

IFM conference
For me personally, I am not a doctor, but after my program is completed, I can work with clients within my scope of practice to help people nutritionally restore balance and also through my health psychology background.

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Roasted leek and hemp hummus

I led a class about essential fatty acids today. One of the recipes was for an oil free hummus which incorporated hemp seeds as a great source of omega 3 fatty acids.  It was very well received - definitely yummy and healthy.


In addition to the hemp, there were leeks in there too. How many of you cook with leeks?  They seem such an under-utilized member of the allium (onion) family.  Leeks are such a good alternative to onions or shallots, especially as they are much easier to prepare and don't cause tears. Why don't we use them more? We should try to eat something from the allium family every day, so swap things around.  Leeks have that great oniony taste and all the health benefits of onions. Buy some this week and give them a go.  Instead of peeling them, you just slit them in half, lengthways and wash out any dirt that may be between the layers. Then just slice them up and use as you would onions or shallots.  No more crying. :-D


Since we got back from the UK, we've been surrounded by leeks. We had leaks in our water filter with water gushing out everywhere, we've had leaks in our fire sprinkler system, we've had leaks in our community well.  Hopefully, as things come in threes, that will be it...but I got the message and decided it was time for some leek recipes!!



In this recipe, I roasted the leeks in the oven for a while and then added them to the hummus which gave it a great flavor.

Sadly, I forgot to take photos of the finished product and it was eaten up quickly! Anyhow, I'm sure you know what hummus looks like! Here's the recipe:


Ingredients:

1 cup leeks, sliced
Spray Can of coconut oil
1 can/carton of cooked organic chickpeas, drained and rinsed
1 cup hemp seeds
4 tablespoons lemon juice
1 garlic clove
Pinch black pepper
4 tablespoons water


Directions:
  1. Preheat the oven to 400F/200C
  2. Line a baking sheet/tray and place the chopped leeks on the tray. Spray with a little coconut oil and roast for 20 minutes, checking along the way to make sure they don't burn.  Remove from the oven and let them cool
  3. Meanwhile, combine the chickpeas, hemp seeds, lemon juice, garlic clove, pepper and water in a blender.  Puree until smooth, scraping down the sides of the bowl as necessary
  4. Add the roasted leeks and puree again.  Depending on how you like your hummus consistency, you may want to add another tablespoon of water. 
  5. Cool in the fridge and serve
As well as using this as a dip or on bread or crackers, you can dilute it with non-dairy milk and use it as a sauce for roasted veggies or as a salad dressing.  Once you've tasted it, you'll come up with ways to use it - maybe even eating it straight out of the bowl!


Hope the green and white leeks are the only leeks you get :-D
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2013 International Conference on Human Nutrition and Functional Medicine

I'm attending the 2013 ICHNFM this week.  It started on Wednesday and I'm loving it.


It is organized by Dr Alex Vasquez - and I tell you - it is really well organized.  I am very impressed.

There have been some great speakers already and more to come.

Wednesday was focusing on Functional Medicine and a Functional Inflammology Protocol, plus integrative pharmacology.  Today it was all about the brain and how to nourish the brain  - including gluten sensitivity and the brain, and Type 3 Diabetes aka Alzheimers disease.  Fascinating stuff.

Tomorrow brings a day on mitchondrial function and what nutrition makes our mitochondria work better.

They are long intense days - so I'm glad to have nothing to do afterwards but go back to my little house that I'm renting and relax.

Roll on the next 3 days :-D  I'm a happy student.
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Food as Medicine class - beans, legumes and lentils


We had a great class this morning, focusing on beans, legumes and lentils.  All wonderful sources of fiber - not to mention also great source of protein, molybdenum, B vitamins, calcium, anti-oxidants, folic acid...the list goes on.


Beans have many health benefits eg in heart disease for reducing homocysteine levels, stabilizing blood sugar levels, anti-inflammatory effects, and from the high fiber content, assisting elimination of excess hormones, cholesterol, toxins and carcinogens.

Coriander and coconut dahl with chickpea pancakes


We also discussed ways of cooking, soaking and how to reduce the gas-producing effect of beans by combining with certain spices and herbs or through the cooking and soaking techniques.

We cooked some yummy food too, including:

  • cannellini bean and basil dip
  • lentil and caper pate
  • coconut and coriander dahl served with chickpea pancakes
  • Moroccan bean stew
What a filling lunch that was! I don't think any went home hungry and we got our 35+g of fiber today, just in one meal!

Moroccan Bean Stew with black beans, garbanzo beans and lentils

And we restrained from the black bean brownies and not-so-dumb blondies this time!


Next time we will be focussing on fats, oils, essential fatty acids and the effects they have on our health.

Let me know if you are interested in attending a class.
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Kitchen tools - four way timer

When I teach my cooking and nutrition classes,  a frequent question asked is "what is my favorite gadget or kitchen tool?"

I don't hesitate in my reply.  However, my response isn't what they expect - some cool, unusual tool that does something fancy and clever.  No, my favorite tool has to be my kitchen timer.


It is definitely my favorite because without it, I'd hardly cook anything successfully!  I'm one of those people who becomes very focussed on what she is doing.  So if I've put something in the oven for 20 minutes or so, I then move onto doing something else and my attention has a new focus.  Then suddenly a bell rings and I'm reminded that something else is going on!

I can't tell you how many meals or dishes I'd have ruined without a kitchen timer. Every time something goes in the oven I know I have to use the timer. That's just the way I am!

But in a way, my timer isn't just a basic timer.  It is a four way timer, meaning that I can time 4 different things at 4 different times.  This is really useful in classes when 8 people are cooking different things.  I assign them a number and when the timer buzzes, I just read out the number on the timer and they know who its ringing for.

Surprisingly, I also use all four timers just when I'm cooking alone too.  I love multi-tasking and if I'm cooking, I can be doing lots of cooking.  So then the only tricky bit is my trying to remember which dish is timer 1 and which is 2 and 3, 4!!!  My mum bought me this timer a few years ago in England.  Good choice mum!

I do actually have another timer  - but he just sits in the drawer.  Here he is:

This duck timer was bought for me for Xmas by my hubby.  When the time is ready, he quacks. The only problem is, he quacks randomly also.  He sits happily in the drawer and all of the sudden, nothing has happened, but we hear this quacking noise!  He does 3 or 4 quacks and then shuts up for a couple of days, and then starts again!

He's not a great timer and my husband has suggested throwing him away - but I feel there is this sort of life to him and it seems too mean to throw him!  Also, it brings a smile to your face when you suddenly hear this quack, out of the blue!

What's your favorite kitchen gadget? Is it fancy or is it just a life saver?  Do tell.
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Whole Grains Nutrition and Cooking Class

I'm back from vacation.  Had a lovely time.  Quite different - no roads or cars, only burros and boats - so that meant for lots of walking!


Tomorrow and Thursday I'm back at my Food as Medicine groups, with this week focusing on the health benefits of Whole Grains.  We are going to be cooking up some yummy food including:


  • my prize winning marmalade granola 
  • goji berry oatcakes
  • popped amaranth bread
  • supergreen quinoa salad
  • middle eastern oat groats, and
  • birdseed burgers (aka millet burgers!)


I am then taking the groups on a tour of Whole Foods to learn about reading food labels and the best food brands to buy.

Sounds like a busy and fun time!  I'll let you know how it goes and try to remember to take my camera!
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A pocketful of pecans

Harvesting continues....since October we've gone from grapes, to figs, to persimmons.....sort of missed the guavas when we were away....to olives and today, to a pocketful of pecans.


Yes, our pecan tree is still small so we both picked a pocketful. There were 17 in all!

Yeah. 17 pecans!  They now "cure" - i.e. dry - for 2 weeks before we open them up and see the goodies inside.


And did you know...pecans are the most nutritious nut with amazing antioxidant content.  I always thought walnuts were healthier than pecans...hmmm....our little tree better get growing! 

Check out this little video from nutritionfacts.org and see if you know how to rank nuts.



"What's next to harvest?", I hear you ask.... Citrus. Our citrus harvest is in mid flow...more on that another day.
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National Prostate Cancer Awareness Month

September is National Prostate Cancer Awareness Month. Prostate cancer is the fourth most common malignancy among men worldwide, with an estimated 400,000 new cases diagnosed annually, accounting for 3.9% of all new cancers.



This summer I read a great book about prostate cancer that I'd like to recommend to you. The title is quite unexpected. It is:

Invasion of the prostate snatchers: An essential guide to managing prostate cancer for patients and their families, by Mark Scholz MD and Ralph Blum.


The book discusses the latest thinking on prostate cancer management, from two perspectives, a doctor and a patient.  Ralph Blum writes in an entertaining style about his twenty year journey with prostate cancer and his decisions along the way, while Dr Mark Scholz presents new scientific advances, with a focus on non invasive approaches.

Chapters alternate between the two authors - with comments at the end by the other.  It's a nice style and makes for easy reading.  It provides a lot of information for patients and families to help them make decisions on what approach to take.  I highly recommend it.


Prostate Cancer Incidence Rates by State, 2008



Epidemiologic evidence strongly suggests that dietary factors play a major role in prostate cancer progression and mortality, with protective effects associated with consumption of fruit (esp. tomatoes),  and increased risk linked to dairy. My recommendation for prostate cancer patients, or those at risk, is to avoid milk and dairy consumption (actually, this is my recommendation for everyone!) .    The evidence is mounting.  Major studies suggesting a link between milk and prostate cancer have appeared in medical journals since the 70's.

In international and interregional correlational studies, dairy product consumption has been consistently associated with prostate cancer mortality.


Researchers are looking at not only whether milk increases cancer risk, but also how.  There are several possible mechanisms: that milk with its high calcium levels adversely affect vitamin D metabolism; that dairy consumption leads to an increase in concentration of insulin like growth factor (IGF-1) which promotes cell cancer growth; and that most dairy products contain substantial amounts of fat and no fiber which is a combination that leads to increased testosterone concentration and activity which can have a cell replicating effect on prostate tissue. .

For further information on the research regarding prostate cancer and dairy, see the summaries supplied by Dr Neal Barnard of PCRM.

References
1. Chan JM, Stampfer MJ, Ma J, Ajani U, Gaziano JM, Giovannucci E. Dairy products, calcium, and prostate cancer risk in the Physicians’ Health Study. Presentation, American Association for Cancer Research, San Francisco, April 2000.
2. Cohen P. Serum insulin-like growth factor-I levels and prostate cancer risk—interpreting the evidence. J Natl Cancer Inst. 1998;90:876-879.
3. Chan JM, Stampfer MJ, Giovannucci EL. What causes prostate cancer? A brief summary of the epidemiology. Sem Canc Biol. 1998a;8:263-73. 
4. Giovannucci E. Dietary influences of 1,25(OH)2 vitamin D in relation to prostate cancer: a hypothesis. Cancer Causes and Control. 1998b;9:567-82. 
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Recipe for healthy gluten free granola

I hope you'll enjoy the following recipe. It is to create a healthy low fat, low sugar, gluten free granola. The recipe shows you how to create a plain granola and then each morning you can add additional fresh ingredients such as fruit, nuts, seeds, etc to create the taste you desire at that time.

Ingredients:
1 cup GF rolled oats
1 cup GF puffed brown rice - I use Erewhon, unsweetened
1 small carton (4oz) unsweetened organic apple sauce

1. Preheat the oven to 375F
2. Mix the oats and rice together and stir in the apple sauce, to thoroughly combine.
3. Spread on a baking sheet and bake for 10 minutes.
4. Remove from the oven and stir well, bringing the edges into the center
5. Return to the oven for another 10 minutes.  If it is dry and crispy, remove. If still a bit soft, stir and put back in for a couple more minutes.  Watch it carefully as the edges may burn.
6. Cool and store in a jar for a month.

It isn't sweet but the addition of fruit sweetens it enough for me.  If you prefer, you could add some stevia as sweetener.  My favorite way to eat this is with raspberries and blackberries and a little unsweetened almond milk.

It has a much lower fat and sugar content than granolas you buy - check the labels.

Let me know what you think.
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Make the switch to non-dairy

I was interested - and excited, to read Mark Bittman's article in Sunday's New York Times, entitled "Got Milk? You don't need it!"

You should read it. Please, take a couple of minutes and click on the link above.


We have been fooled by the Dairy industry for long enough.   Milk is not good for us - even skimmed milk - for the reasons Bittman mentions, but also because it is considered to be a cancer promoter in more than just prostate cancer, as highlighted in the China Study, by T. Colin Campbell.



And we won't all get osteoporosis because we don't drink it.  Levels of osteoporosis are highest in those countries where milk is drunk!

So let's stop drinking milk and using dairy products, and stop encouraging our children to drink it.  You may well feel better for it. Drink water instead, or delicious nut or non-dairy milks.  And yes, you can find soya and non-dairy cheeses too, and yoghurts and ice creams and......Here's my current favorite non-dairy milk:


Or make your own! It's easy :-D

Switching from dairy to non-dairy products is a huge step forward in taking care of your health.
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Dirty Money

Here is a video describing the results of a study that looked at fecal bacterial contamination of banknotes obtained from different food outlets in different countries!


Sadly, the USA had the highest contamination of E. coli.  May you want to check next time you buy food to see if money and food are being handled by the same person!

Thanks to nutritionfacts.org for the news!


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Fooducate

I just downloaded a new food app to my iPhone today called  "Fooducate" .  It looks really good. It is basically an app that, through reading the barcode on food packaging, analyzes the ingredients and nutrition information and simplifies it to show you which foods are healthy and which are not so healthy.  Each food gets a grade, A - D, and then: the product's highlights are listed - both good and bad; other products are compared; and healthier alternatives are suggested.  The scoring system takes into account processing, fat content, nutrients, plus lots of other factors, thus whole foods or minimally processed foods score higher than processed foods.


Highlights they report to you include:

  • excessive sugar
  • too much salt
  • high fructose corn syrup
  • controversial food colorings
  • high fiber
  • additives and preservatives etc, etc

It utilizes the iPhone's camera to scan barcodes of food items.  If a particular food item isn't listed, it then asks you to take three photos of the item and they will then update their list.  Currently more than 200,000 unique foods are in the database.  They are also keen to get feedback from people if they think a product isn't analyzed correctly.


Screen shot of the phone scanning the barcode

The system was created by dietitians and concerned parents with the idea that people will check on items as they are doing their shopping and choose the healthiest version.

I got the free version but there is a $3.99 version too, but I'm not sure what the difference is...maybe just no ads. Fooducate won AppStore 2011 best app in Health and Fitness category. They also have a blog where they educate you even more about food. It seems a good quick guide for people to use.



Have you tried it?  Let me know if you give it a go.  I'm going to try scanning my cupboard now and see what I'll have for dinner tonight.  Eat something healthy tonight.
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What's in a name?

"Tickety-boo Health Coaching".

You may be wondering what 'tickety-boo health coaching' means....what is this blog is all about?   Well, allow me to elaborate.

Tickety-boo is a British word - now also commonly used in Canada.  It means things is going along just fine.....things are all tickety-boo. I think it has a nice ring to it and a sense of fun and ease.  It's a happy little word that makes you want to smile.  It doesn't mean everything is perfect, just that you have found a way to enjoy the positives in life.

So what about the "Health coaching" part? What is that all about? Health coaching is a way of guiding others to find the motivation to make changes that will improve their health.  The relationship between a health coach and their client is a supportive partnership where we can discuss topics such as:what is troubling most about a certain health condition; what would the person most want to change; what support do they have; what obstacles are there, etc, etc.  Health coaching focuses on the special issues and concerns unique to the individual person that are preventing them from leading a healthier life.

The simple goal of Tickety-boo health coaching therefore is to help you feel tickety-boo!


In my area of health coaching, I specialize in helping people with cancer and helping people improve their lifestyle to prevent cancer.  This includes diet (e.g. what should you eat during chemo or radiation therapy), what foods help with side effects of cancer and therapy, what exercise is good, ways of relaxing, guided imagery, biofeedback, spirituality, etc etc.

As my blog progresses, I'll tell you more about how we can work together and how tickety-boo health coaching can help you.  I'll be coaching people one on one and also running a variety of educational community programs.  I will also implement an e-coaching program too, for people who don't live local to me in Northern California.  All this to come soon.

But for now, take two minutes and watch this little video to help you understand just what feeling tickety-boo is all about. I bet you'll be singing along by the end of it!   It features Danny Kaye singing a song entitled "Everything is tickety-goo" from a movie called "Merry Andrew". 

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