Facts and Myths Regarding Vitamin A

If you ask the average kid (or even nutritionist!) which foods are high in Vitamin A, they are more than likely going to tell you carrots and other bright orange vegetables. Everyone knows that!

Except they’re not high in Vitamin A…

Vitamin A comes from eggs, whole dairy products, fish liver oils, and beef, calf, and chicken liver (1). Carrots and other bright orange fruits and vegetables are a good source of beta carotene, and beta carotene is NOT Vitamin A (1). Beta carotene must be converted to Vitamin A in the body. Unfortunately, research shows that this conversion process is extremely inefficient (2). Most people absorb only a tiny fraction of the beta carotene they consume, and only a fraction of that ever becomes vitamin A, even if you’re stuffing your face with “pumpkin everything” this time of year.

Why care about this? Well, first of all, Vitamin A is crucial for healthy bones and calcium metabolism, vision, healthy skin, immunity, proper hormone function, making healthy babies, and carrying a healthy full-term pregnancy, so making sure you’re getting enough is important.

Second of all, as a consumer, you should be annoyed. Beta carotene is included as Vitamin A on the Nutrition Facts panel of food and supplements. This is confusing for consumers. This leads people to believe one cup of carrot juice contains a whopping 700 percent of their daily intake.

carrot juice

Not only is that wrong given what we know about absorption, it’s wrong because those Nutrition Facts panels amounts are based on erroneous calculations that are way too high (3).

Food and supplement companies can voluntarily declare the portion of vitamin A derived from beta carotene on a label, but many do not. The FDA has proposed that the labels change to reflect the new unit of vitamin A measurement – mcg RAE (mcg’s of retinol activity equivalents). That will help deal with some of the confusion, but it won’t help with the next issue.

Third, it’s estimated 45 percent of adults don’t convert ANY beta carotene into vitamin A at all (4, 5). That’s a BIG deal!

What are some signs of vitamin A deficiency? Keratosis pilaris (“chicken skin” on the backs of arms), impaired immunity (getting sick all the time), rough/dry skin, acne, and dandruff.

Bottom line? People with restrictive diets excluding certain types of food might be at risk of vitamin A insufficiency, even in developed countries. Sufficient vitamin A intake cannot be reached by consuming only beta carotene alone (6). Your best bet would be to eat foods containing BOTH beta carotene and vitamin A, and focus on practices that are known to improve beta carotene conversion, such as:

  • Eating beta carotene-rich foods along with some fat, such as an olive-oil based dressing on a salad, increases the amount you absorb.
  • Treat your gut nicely. So many of my clients suffer from food allergies, low stomach acid, or other manifestations of compromised gut health, all which can hinder absorption. Contact me for more on this.
  • Iron and zinc are critical in converting beta carotene to vitamin A. If you’re deficient in them, your vitamin A status will probably be impaired (1).
  • Lightly cook your vegetables to break down fiber and improve absorption.

A special note for anyone interested in fertility and lactation: vitamin A needs go up during pregnancy and nearly DOUBLE during lactation (1), yet pregnant women or those considering becoming pregnant are often advised to avoid the intake of liver, based upon unsupported scientific findings (7).

“The American Pediatrics Association (err.) cites vitamin A as one of the most critical vitamins during pregnancy and the breastfeeding period, especially in terms of lung function and maturation. If the vitamin A supply of the mother is inadequate, her supply to the fetus will also be inadequate, as will later be her milk. These inadequacies cannot be compensated by postnatal supplementation. A clinical study in pregnant women with short birth intervals or multiple births showed that almost 1/3 of the women had plasma retinol levels below 1.4 micromol/l corresponding to a borderline deficiency.” (7)

We’ve been somehow conditioned to believe that vitamin A supplements and/or eating liver during pregnancy is associated with birth defects. It’s a myth that won’t die. The World Health Organization (WHO) reviewed the research and concluded that even retinol dosage levels of 20,000 to 30,000 IU daily did not reach the level that could theoretically cause birth defects (8). The WHO recommends  that all pregnant women take vitamin A as retinol (8). They also say vitamin A may REDUCE the risk of birth defects! Oh the irony.

I always bring up liver with my fertility clients.  I estimate about 50 percent are game to try it weekly, especially if they grew up eating it. The other 50 percent recoil in horror. I’m fine with that. I don’t like it either! I can’t seem to acquire the taste for it no matter what I do. I sometimes buy liverwurst from U.S. Wellness Meats, but I mainly get my Vitamin A from a mix of eggs, dairy, and vegetables.

A note on supplementing: many in the nutrition and health community are wild about cod liver oil as a vitamin A supplement. It’s good for the majority of people, but for those with low calcium levels, it could be detrimental. I don’t recommend any supplements anymore without mineral analysis first.

  1. http://lpi.oregonstate.edu/infocenter/vitamins/vitaminA/
  2. http://www.ars.usda.gov/is/pr/2001/010323.htm
  3. http://ajcn.nutrition.org/content/87/4/1067.1.full
  4. http://ajcn.nutrition.org/content/75/5/900.long
  5. http://www.lmreview.com/articles/view/common-genetic-variants-and-other-host-related-factors-greatly-increase-susceptibility-to-vitamin-a-deficiency/#fn-ref-113-3
  6. http://www.ncbi.nlm.nih.gov/pubmed/21957049
  7. http://www.ncbi.nlm.nih.gov/pubmed/17665093
  8. World Health Organization Micronutrient Initiative. Safe vitamin A dosage during pregnancy and lactation. World Health Organization 1998 WHO/Nut/98.4

Killer Calcium?

I’ve been thinking a lot about calcium lately. Our bodies need this mineral to build and maintain bones and teeth. Calcium also helps with blood clotting, muscle function, and regulation of the heart’s rhythm.

We’ve had it hammered home since we were in grade school that increasing calcium intake will prevent osteoporosis, the weakening of bones. We’ve been told to take calcium supplements if we don’t get enough calcium in our diet.

Yet, we have a very high calcium intake in the U.S. and also high osteoporosis rates, plus, calcium supplements are linked to heart disease (1). What gives?

It has to do with calcification, calcium buildup in the body’s tissues. Along with reduced metabolic rate, calcification is a hallmark sign of aging.

Examples of calcification:

  • Atherosclerosis: calcification of blood vessels
  • Osteoarthritis: calcification of joints
  • Tartar: calcification on the teeth
  • Gallstones/kidney stones: caused by calcium deposits
  • Infertility: sometimes caused by endometrial calcification
  • Alzheimer’s: evidence is mounting brain calcification contributes
  • And so many more!

When you consume calcium, regardless of if through food or supplements, you hope it will be deposited in the bones and teeth, right? Well without a critical vitamin in your diet to direct calcium, it often winds up in the body’s tissues instead. So you could conceivably have a high dietary calcium intake or take calcium supplements, and still wind up with osteoporosis and heart disease to boot. Sucks, right?

So what’s this critical vitamin? Vitamin K2, not to be confused with the Vitamin K1 that is found in dark leafy greens. K1’s main role is in blood clotting, while K2’s main role is calcium metabolism. K2 activates certain proteins that guide calcium into bones and teeth where it belongs. And even cooler? K2 will activate other proteins that sweep calcium OUT of other tissues where it is potentially harmful. So you could potentially REVERSE heart disease just by getting enough of this crucial vitamin (2).

Other potential benefits? Better teeth. Weston A. Price (3) was a dentist who embarked on an medical anthropology trip around the world in the 1930’s to study how diet and lifestyle affected dental health. He found cultures with straight, beautiful, healthy teeth and deduced what they had in common. He has been called the “Charles Darwin of Nutrition,” since much of what he discovered looks at how food and food quality affect health in general. If you haven’t read his 1939 book, “Nutrition and Physical Degeneration,” a nutrition classic in my opinion, pick it up for the photos alone! Anyways, Price is credited with discovering Vitamin K2, although at the time, he had no idea what it was. He called it Activator X.

He realized that humans are capable of thriving on very diverse diets. However, he did find one thing in common: they all ate some amount of animal-derived fat-soluble vitamins. Even the near-vegetarian groups ate insects or small animals that were rich in pre-formed Vitamin A, Vitamin D, and what we now know is Vitamin K2. And here’s the kicker for my fertility clients: many of the foods high in these nutrients were fed preferentially to pregnant or reproductive-age women in the groups he studied.

Depending upon your current understanding of fats and the causes of heart disease (see here and here), you either will be pleasantly surprised or horrified by the list of foods high in Vitamin K2:

  • Butter from grass-fed cows
  • Organ meats
  • Shellfish
  • Fish eggs
  • Cheese from grass-fed cows
  • Natto (a fermented soybean popular in Japan)
Butter from grass-fed cows vs butter from the grocery store

Butter from grass-fed cows vs butter from the grocery store

Now, think about the French Diet and the above list of foods. Health experts have been talking about the “French Paradox” for years – the confusion over France’s rich, fatty diet and their low heart disease rates. What if the French Paradox isn’t such a paradox after all? What if it’s not the red wine that’s protecting them, but all the foie gras, quality cheese, and butter?

Now think about the Japanese diet. What if it’s not the green tea that’s protecting them from cancer and heart disease, but all the fish eggs and natto?

Previous thinking on Vitamin K2 was that our gut bacteria can make what we need from Vitamin K1. Does the typical American’s damaged gut do this? Who knows. I’ve seen evidence for and against the claim that we get enough from eating dark leafy greens.

But logically, when I think about the modern American diet, our current rate of disease, and compare it to someplace like France that has loads of K2 in their diet, it makes sense to me to eat more foods with K2.

As a side note, my latest obsession in my nutrition practice is mineral analysis. I find it most useful for determining tissue calcification. I would say that about 80 percent of my clients have high calcium levels in their tissues and would benefit from more K2 in their diet, either from foods or supplements, to help “sweep” it out of tissues. For those few who actually do need more calcium, K2 would also be beneficial in guiding that extra calcium into bones and teeth.

I see lots of potential in Vitamin K2 and I think you’re going to be hearing a lot more about it in the future. Vitamin K2 has potential benefits for nearly every major health concern of our time. K2 might be the ‘missing link’ that explains many of our modern health woes.

So eat your pastured dairy, organs, fish eggs, and shellfish! And if you have arterial calcification, as determined by a heart scan, or tissue calcification as determined by mineral analysis, you may want to consider supplementing with additional K2 (also called menaquinone-4 and menatetrenone).

For more information on Vitamin K2, “Vitamin K2 and the Calcium Paradox,” by Kate Rheaume-Bleue, is a great place to start.

1. http://well.blogs.nytimes.com/2013/04/08/thinking-twice-about-calcium-supplements-2/?_php=true&_type=blogs&_r=0

2. http://wholehealthsource.blogspot.com/2008/11/can-vitamin-k2-reverse-arterial.html

3. Trolls: I am not a lacky for the Weston A. Price Foundation. Stop trying to label me. I’m anti-dogma and support many different types of diets.

Good Food/Bad Food

Note: I wrote this post for pasta company Jovial’s “Win a trip to Italy” competition. That was before I realized nearly every submission dealt with gluten intolerance or Celiac Disease. Oops! In my defense, they do sell non gluten-free pasta and flour! Anyways, I think it’s one of the best things I’ve ever written and I’m very proud of it.

I want to tell you about a common scenario I encounter every day as a registered dietitian. After introductions, when I ask about their typical diet, many of my clients declare that they’ve recently “given up bread and pasta” in their quest to be healthy and lose weight. They obviously feel virtuous. Apparently bread and pasta are the dietary villains du jour? I can’t keep up anymore with what’s considered “good food” and “bad food” these days.

That’s partly because I don’t believe there are good foods and bad foods. I believe in food neutrality. There is no perfect food; each comes with give and take <- Remember this line! It’s life changing when you really let it sink in.ch~

It’s taken me fifteen years to get to this point. Yes, fifteen. When I first started studying nutrition in 1999, my professor would say, “there are no good foods and bad foods,” and talk about the importance of moderation, blah blah blah. I would roll my eyes and think, “of course there are good foods and bad foods!”

I saw all sorts of bad foods in the world around me: fast food, soda, cakes, French fries, sugary cereal…they’re all definitely bad foods, right?

I got older and I became a registered dietitian and a voracious reader. I read every nutrition best-seller and health blog I could find in my spare time. I seemed to get caught up in every dietary theory. I was vegetarian for a year. I gave up gluten for a year. I went low-carb for a few months. While some of these practices may have given me short-term health gains, in the long-run, simple practices like, ahem, moderation and intuitive eating have served me more.

It’s not that I don’t care about food quality. I do. In fact, I own a farm and produce much of my own food because I believe so strongly that eating mostly whole foods grown close to home will better anyone’s health.

However, it’s the constant media attention on dietary villains that’s gets me riled up. The term food neutrality is sometimes used in eating disorder treatment and that’s what I think we have in the U.S. – disordered eating! People hear differing nutrition messages from the media, bloggers, doctors, and alternative health care providers:

  • “Sugar is a toxin!”
  • “Carbs are what’s fueling the obesity epidemic!”
  • “No one can digest gluten or lactose.”
  • “Humans don’t need animal foods.”
  • “Saturated fat will clog your arteries.”
  • “Kale is a super food!”

These ideas change like the the wind! Remember in the 80’s when cholesterol was the bane of human existence? Now we have a whole generation of people who think Egg Beaters and margarine are healthy, when in reality, butter and whole eggs can be incorporated into a healthy diet. Focusing on one food or nutrient as “THE problem” or “THE solution” has a really poor track record when it comes to actually improving nutrition and health.

Another problem with the good food/bad food dichotomy? Where do you draw the line? You can’t. When is bread or pasta a good food and when is it a bad food? Some people may in fact eat too much bread and pasta or have Celiac disease, a condition that warrants complete elimination. But for my average, busy client, bread and pasta can be incorporated into their diet occasionally, just like any other food. People seem incredulous when I give them meal plans that include these foods. They think that in order to improve their health, they have to give up all their favorite foods.

People often talk about Europeans and their appreciation and enjoyment of food. I doubt most French people sit down to a butter croissant and cafe au lait and worry about the saturated fat and sugar content. But Americans? We obsess. We worry. We don’t enjoy. Sit down with a big group of women at a social event with food and you’re likely to hear worry, guilt, and shame, and obsession over calories, fat, carbs, sugar, or whatever other nutrient is trending at the moment. You probably won’t hear appreciation and enjoyment.

Food should never have morality attached to it. Food is fuel. Food is nourishment. Food is joy. Food is never good or bad.

Another note: please don’t use my previous post against me. People should be able to enjoy fried food occasionally (if they want) and not feel guilty, just like pasta. I’m all about educating people and creating awareness, not fear mongering.

The Biggest Dietary Change in American History

Okay, take a stab at it. What do you think is the biggest dietary change in American history over the last 100 years?

Increase in refined sweeteners?

Increase in refined flour?

Increase in soft drinks? Fast food? Saturated fat? Carbs? Calories?

I think the biggest, and arguably most significant change in the American diet over the last century has been the development and mass adoption of seed and vegetable oils.

Think about your current diet. How many foods did you eat today that contained some sort of seed or vegetable oil? Corn, soybean, cottonseed, safflower, sunflower, grapeseed, canola oil…If you ate anything in a package or box, it likely contained one of these oils. If you ate at a restaurant, it’s likely your food was cooked in one of these oils. These oils have worked their way into nearly everything we eat, often even so-called health foods.

Before 1900, these oils were scarcely used. People used fats that could easily be extracted from food, like tallow, lard, butter, olive oil, and coconut oil. Seed and vegetable oils were used in paints and as furniture polish, until the development of chemical extraction methods made them cheaper and easier to obtain.

Seed and vegetable oils contain mostly polyunsaturated fats, like linoleic acid, a type of omega-6 fatty acid. I’m sure you’ve heard of omega-3 fatty acids? The balance of inflammatory omega-6 fatty acids to anti-inflammatory omega-3’s has changed from about 8:1 to about 20:1 in the past 100 years (1). In those years, saturated fat consumption has remained relatively stable, monounsaturated fat consumption increased by 54 percent, and polyunsaturated fat consumption increased a whopping 300 percent (2)!

And it’s not just from packaged, boxed foods either. These oils, in the form of corn and soy-based feed, are fed to pigs, chickens, and cows to fatten them up quickly. This changes the fatty acid composition of the meat, increasing the omega-6 fatty acids. However, grass-fed and pastured meat has fewer omega-6 fatty acids and more omega-3 than feedlot-raised meat.

As opposed to most other fatty acids, linoleic acid accumulates to a large degree in fat tissue, and over the past 50 years, it’s showing up in increasing quantities, including in breast milk (2,3).

Moreover, seed and vegetable oils are in nearly every store-bought beauty and personal care product you rub into your skin. Some interesting reading on that here.

So what’s the effect of eating all this linoleic acid day in and day out? Inflammation for one. Increased inflammation is associated with just about every disease, from heart disease, to diabetes, to autoimmune disease to cancer. Polyunsaturated fats are not very stable and go rancid (oxidize) easily when exposed to air, light, and warm temperatures. Think of the sticky neck of the vegetable oil bottle that you’ve had in the cupboard for while. Think of that in your body and on your skin.

These oxidative processes can damage enzymes and other parts of cells, and especially their ability to produce energy. The enzymes which break down proteins are inhibited by unsaturated fats, and these enzymes are needed not only for digestion, but also for production of thyroid hormones, clot removal, immunity, and the general adaptability of cells. The risks of abnormal blood clotting, inflammation, immune deficiency, shock, aging, obesity, and cancer are increased. Thyroid and progesterone are decreased. Since the unsaturated oils block protein digestion in the stomach, we can be malnourished even while “eating well.” ”  - Dr. Ray Peat (4)

Why do some experts recommend eating MORE of these fats? Studies show a substitution of saturated fats with polyunsaturated fats like linoleic acid can reduce cholesterol levels, but, this reduction in cholesterol levels does not translate into reduced mortality rates (5). And many experts are now questioning the widespread public health support for a high linoleic acid intake.

In a review paper on dietary fatty acids and heart disease risk that was published earlier this year that reviewed the the effect of dietary fatty acids on heart disease, the authors concluded:

the pattern of findings from this analysis did not yield clearly supportive evidence for current cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of saturated fats. Nutritional guidelines on fatty acids and cardiovascular guidelines may require reappraisal to reflect the current evidence.” (6)

So, what to do? You don’t have to move to a farm and become a hermit to reduce omega-6 linoleic acid in your diet. Here are some pretty easy, actionable steps you can take to change your health for the rest of your life:

  • Use olive oil, butter, and coconut oil at home, and quit buying and using vegetable oil, margarine, and shortening.
  • Cook more at home and eat out less. Eat fewer fried foods at restaurants.
  • Eat fewer packaged and boxed foods made with seed and vegetable oils. Be a label reader.
  • Don’t buy mayonnaise or commercial salad dressings – make your own.
  • If you eat meat, eat more grass-fed and pastured meats and vary your types. Many Americans OD on chicken, which can have a lot of linoleic acid, depending on how it was raised.

I believe there is enough evidence to reduce linoleic acid in my diet. If you need more convincing, Israelis’ high heart disease, diabetes, and cancer rates may be regarded as a population-based experiment of the effects of a high omega-6 diet (7).

Some food for thought.

1. http://chriskresser.com/how-too-much-omega-6-and-not-enough-omega-3-is-making-us-sick

2. http://wholehealthsource.blogspot.com/2012/02/my-tedx-talk-american-diet-historical.html

3. http://wholehealthsource.blogspot.com/2011/08/seed-oils-and-body-fatness-problematic.html

4. http://raypeat.com/articles/articles/unsaturated-oils.shtml

5. http://ajcn.nutrition.org/content/77/2/521.full

6. http://annals.org/article.aspx?articleid=1846638&atab=7

7. http://www.ncbi.nlm.nih.gov/pubmed/8960090

The Whole Picture

When I was a health conscious teenager drinking skim milk, I remember I used to look at my grandmother drinking whole milk with a bit of self righteousness.

“Doesn’t she know any better?” I would wonder. “Whole milk is full of saturated fat and cholesterol!”

My, how times have changed! These days, I enjoy full-fat dairy, and I’m much more likely to tell my clients to drink whole milk, rather than skim or 1%. Especially my fertility clients!

Why the 180? Eating full-fat dairy fits into my “eat real food” philosophy. This philosophy has been cultivated year after year, the more I study food and nutrition. And it’s reinforced year after year, as new research emerges that shows the foods my grandmother ate may be healthiest for us after all. Butter and whole eggs have both seen a healthy renaissance recently. Now it looks like whole milk may see a similar revival.

Consider two recent studies that conclude the consumption of whole-fat dairy is associated with reduced body fat. In a study published last year in the Scandinavian Journal of Primary Health Care, middle-aged men who consumed high-fat milk, butter, and cream were significantly less likely to become obese over a period of 12 years compared with men who never or rarely ate high-fat dairy. (1)

In another paper, published last year in the European Journal of Nutrition, researchers reviewed 16 other studies and concluded that the evidence does not show that high-fat dairy foods contribute to obesity or heart disease. In most of the studies, high-fat dairy was actually associated with a lower risk of obesity! (2)

Moreover, full-fat dairy has been a recommendation for women trying to get pregnant since 2007, when research from the Nurses Health Study showed intake of high-fat dairy foods may decrease the risk of anovulatory infertility.

How can this be? Well, the fat in whole milk can curb appetite and slow the release of sugar into the bloodstream, reducing the amount that can be stored as fat. Also, fat-free dairy products can potentially disrupt hormone balance, an important factor in fertility and weight. The process of removing fat from whole milk removes estrogen and progesterone, which are bound to the fat. This leaves behind higher portions of androgens, insulin-like growth factor one (IGF-1), prolactin, and male hormones in the watery layer, therefore causing an imbalance. (3)

So does that mean you can go on an ice cream and cheese-eating bender? Not quite! It means you can stop feeling guilty if you keep whole milk in the house for the kids and you drink it too. It means you can enjoy the 2% Greek yogurt, instead of the 0%. It means cheddar and apples can be a balanced afternoon snack. Incorporate modest amounts, 1-2 servings, of full-fat dairy into your diet, even if you’re trying to lose weight. And let your grandmother tell you, “I told you so!”

1. http://www.ncbi.nlm.nih.gov/pubmed/23320900

2. http://www.ncbi.nlm.nih.gov/pubmed/22810464

3. Victoria Maizes, “Be Fruitful.”

Why we killed 48 chickens last weekend

When Karl and I moved out to this house on 33 acres nearly a year ago, we knew one of the first things we wanted to do was buy chickens. Not just for the eggs and for meat, but for the fruits and vegetables. Yes, that’s right – fruits and veggies. Karl and I are both very much influenced by Joel Salatin’s model of farming. We want to avoid monoculture – growing a single crop or focusing on a single animal year after year on the same land, in the absence of rotation through other crops. We love his ideas on polyculture, the traditional rotation of crops and livestock. It’s a symbiotic relationship of everything on a farm. It’s better for both the land and people. Polyculture, when done right, automatically replenishes what is taken out, which makes it sustainable with minimal effort. You have healthier animals, healthier soil, and easier to grow fruits and vegetables with little need for fertilizer and pesticides.

Karl built Salatin-style pens for the broilers (meat chickens). The pens protected the chicken from hawks, foxes, and other predators, while still allowing for sunshine, grass, and fresh air. They were moved to a fresh patch of grass daily so they could eat bugs and fertilize the ground. The patches of grass where they were moved over ten weeks are now noticeably super green and healthy! While Salatin is known for his meat products, he calls himself a grass farmer above all else. Everything he does, he does with the health of the grass in mind.


The chickens grow super fast! We waited until they were about 4 lbs each, about 8-10 weeks. You’re allowed to process up to 1000 chicken on your property a year, and usually people rent the equipment. But Karl spent weeks prepping and he built an entire chicken processing set-up from scratch. Even an electric chicken plucker! Moving out here, I’ve seen an entirely new side of my husband, that’s for sure!


Karl’s family raised chickens for meat and eggs when he grew up, so his parents came down to help supervise on processing day. We also had friends and family who are interested in food and agriculture come for the day/weekend to help out. Everyone watched videos and read the manual to get a general idea. But no manual is as good as Karl’s mom showing us exactly how to do it! We processed and packed 48 chickens into our deep freezer.


I won’t go into the nitty gritty of how to process and butcher a chicken. I just wanted to write about WHY we did it and I hope this gave you a better idea. Someone at Karl’s school last week asked him why he should buy pasture-raised poultry over supermarket chicken. I gave Karl some talking points – fewer inflammatory fats, no hormones or antibiotics, soil health, happy chickens, blah, blah, blah. But ultimately, he needed a one-line, easy to understand answer. An elevator speech. What did Karl and I come up with?

“It’s healthier.”

Haha. Not very good, I know! We’re working on it :)

Are You Eating Enough?

In case you didn’t know/don’t remember, I veered off on a newish career path ten months ago when we moved. I went from working in nutrition policy and communications to counseling people on nutrition at an integrative health clinic. Integrative medicine and nutrition (also called functional medicine/nutrition), addresses the underlying causes of disease. It focuses on the whole person, not just an isolated set of symptoms. The doctors I work with are more interested in finding the ‘why’, rather than covering up symptoms with prescriptions.

I have been interested in integrative health since I became an RD in 2007. I even started this blog as an outlet for my musings in 2009, so it seems funny to me that I waited so long to explore this type of nutrition career. I really am loving it. It’s very rewarding and satisfying to talk to people about nutrition and their diet. Most days, I feel like I really make a difference.

I’ve learned so much in the past months, but the most significant, surprising thing I’ve learned is in regards to weight loss. The mainstream approach to overweight and obesity emphasizes energy balance – calories in/calories out. Cutting calories equals weight loss, right? Well, I’m going to tell you that 8 out of 10 of my overweight/obese patients don’t eat enough.

Patients think they’re being so “good” when they tell me that they had yogurt for breakfast, a “healthy” frozen meal for lunch, and a grilled chicken salad with light dressing for dinner. “Why am I always hungry? Why am I not losing weight?” Patients are always flabbergasted when I tell them to eat more.

Not eating enough means the body isn’t getting enough fuel to function properly. Think about this – function properly. Your body needs fuel in the form of calories to do anything – make hormones, fight disease, grow hair, digest food properly, build muscle, etc. The list is endless. The body will do whatever it can to burn fewer calories, including burning muscle for fuel, because muscle requires more calories to maintain than fat. That’s a double whammy for those trying to lose weight.

Most people can realistically consume 2000 calories a day. Sound like a lot? Plug in your info into these calculators:

  • http://www.health-calc.com/diet/energy-expenditure-advanced
  • http://www.womenshealthandfitness.com.au/energy-counter

Track your calories with MyFitnessPal or LoseIt for two weeks and then tell me you don’t feel better all around. Some people can naturally and instinctively consume the number of calories that will support a healthy weight, but most people need a little retraining. That’s why I recommend calorie counting, if only for a short amount of time. People need to see how much food 2000 calories looks like.

Stop eating the puny breakfast. Stop binging at night or eating massive restaurant meals. Eat three squares a day, a healthy snack or two, and fuel your body!

Postpartum Update

Greetings from motherland – where I don’t do much besides sleep, feed, and gawk at my new baby daughter. E is 10 weeks old now and smiling! I’m relishing every second, and moving things like blogging (and housework!) down on my priority list. But I’m back at work and re-inspired professionally, so I felt called to the ol’ blog. I’m updating a few things on the site, so don’t mind the current appearance.

I’ll be back in the next few months to write about my first garden, grape maintenance, and our 50 Cornish Crosses (broilers – chickens for eating) we’re raising! But I wanted to write a quick postpartum update. Not that the postpartum period is over! I think it takes a full year to recover from pregnancy and childbirth.

Exercise – Many women dive back into strenuous physical activity after their six week check-up. My midwife (who works with a physical therapist) says that that’s the reason many women have that lower abdominal “pooch.” The abdominal muscles take a long time to heal and fuse. Isometric exercises are best – think planks instead of sit-ups. I’m going to Mom & Baby yoga and slowly adding kettlebells back into my routine. I’m still loving my walking and seem to have lost my desire to run. Maybe one day I’ll have the urge again. It’s been nearly a year and a half since I’ve been on run!

Food – We had a lot of frozen meals (that we made in January) and people cooking for us until recently. I’ve been spoiled and now have to get back into meal planning and cooking. My new favorite recipe site? Real Simple. The recipes are fast, tasty, and….real simple. My sister recently introduced me to ZipList. Brilliant! I’ve been using the site and the app to tag recipes, plan meals, and make grocery lists.

I eat three balanced meals plus snacks, and eat to appetite. I’m breastfeeding and I know that most of the pregnancy weight will come off eventually.

Mood – I had the typical sleep-deprivation-induced weepiness once or twice during those first few weeks. But besides that, I’ve been feeling pretty great. I had my doula encapsulate my placenta. You can read more about it here. Even if my placenta pills had nothing to do with my postpartum mood, at least I got to skip the standard postpartum iron prescription!

Sleep – I’ve been focusing on getting lots of rest the past ten weeks. I think sleep is SO important. It significantly affects nearly every health outcome. My biggest advice to new moms regarding sleep is not the often heard “sleep when the baby sleeps,” but sleep when it’s dark! I’m not a great napper during the day. But when E was waking up every few hours, if I went to bed at 8pm and slept until 7am – even with the wakings, I felt remarkably okay the next day.

Room-sharing is going well. I wrote about not having a nursery here. I have no plans to move her into her own room anytime soon. She’s been sleeping well in her Snugabunny Rock n’ Play sleeper since birth. I don’t have a plan for what we’ll do when she outgrows it, eek! I love our Sleep Sheep white noise machine, or a white noise app on my phone. But the white noise is for my benefit, not hers! Babies are noisy : )

Be back soon!

Prenatal Chiropractic Care

About halfway through my pregnancy, I started experiencing lower back pain. I thought yoga and physical activity would protect me, but apparently that hormone relaxin is pretty powerful stuff! It works to loosen your hips to prepare you for labor and delivery. Based on where my pain was at, I knew it was my sacroiliac (SI) joint causing me trouble – where the sacrum meets the pelvis. I put up with it a few weeks. I skipped yoga, I rested, I iced. But the pain was preventing me from living my life, so I stopped by the chiropractor’s office that was located in my office building.

I did absolutely NO research, which is unlike me. The pain was bad enough at work one day that I just walked over to the office at lunch and said, “Help!” Little did I realize that the chiropractor I ended up seeing was certified in the Webster technique. It’s a widely practiced prenatal chiropractic technique that promotes a “relaxed uterine environment” and allows the baby to move into the optimum birth position.

Cool, right? As soon as I got home I started reading up on it. I couldn’t believe I never had heard about it before! I did a lot of reading about pregnancy and childbirth in early pregnancy and prenatal chiropractic care never came up. Some people may see chiropractic care as “fringe” or alternative, but even the American Pregnancy Association recommends it. And I found several studies in PubMed that showed clear benefits, including significantly shorter labor times and reduced incidence of c-sections and breech and posterior babies (which causes the dreaded back labor!). And there are no known contraindications to chiropractic care throughout pregnancy. Even if the chiropractor didn’t make my back pain go away, I was sold!

The first appointment was about an hour and included a thorough assessment of my spine and gait. She did ultrasound therapy on my SI joint, trying to relieve some of the inflammation. Then came the adjustment. I’ve seen it done in movies, and my sister and dad have talked about it, but nothing could prepare me for the “crack.” She twisted me up like a pretzel (all upper and mid-spine, not my lower body where the baby was), threw her weight on me, and achieved that satisfying sound. Ahhhhhh. She also did my neck, which gave me the heeby jeevies, but also felt wonderful. She taught me how to massage my round ligament, and gave me some much-needed advice on how to sit at my desk and told me to stop crossing my legs, a lifelong bad habit of mine.

I continued to see her once a week throughout the rest of my second trimester and all of my third trimester. The back pain took a few sessions to go away, but it did go away. From what I’ve heard/read, the muscles and joints take a while to be “trained.”

And what about labor and delivery? I gave birth to a healthy baby girl mid-February. I was induced (scary!), but once we hit active labor, interventions were discontinued. She was head down, anterior, and active labor was less than five hours. Pushing lasted 20 minutes. Obviously, I have nothing to compare it to. Maybe my body would have done that on its own without chiropractic care. However, seeing the chiropractor during pregnancy was so enjoyable, I would definitely do it again if I have another baby.

A Trip to the Grocery Store

My main nutrition message for the past 7+ years has always been “Eat Real Food.” Eat whole foods. Eat food as close to the source as possible. It’s the one thing I keep coming back to as I learn more and more about nutrition, and as I counsel patients and see real life diet results.

Headlines, studies, and advertising are confusing the heck out of people. Consequently, people say “screw it” and eat what they want, or they eat according to the research and not intuition. Consequently, we have a whole generation of people eating margarine, Egg Beaters, diet drinks, and other fake foods and doing their bodies a huge disservice. It’s mind-blowing to me when I see a patient who won’t eat steak because “red meat is unhealthy,” yet in their food log I see daily Fiber 1 chocolate chip candy bars….err, excuse me – “granola” bars. Because, you know, “fiber is healthy.”

This type of eating has got to stop! This focus on health claims and nutrients as ingredients is detrimental to health.

I try to teach people to ignore the headlines, ignore health claims, and just eat food. Fruits, vegetables, meat, dairy, whole grains, legumes, and nuts are all food. Once you venture down the packaged food aisles, it gets trickier, but if you just take a quick peek at the ingredients list, it’s easy.

Come take a trip with me to the grocery store.

Bread Aisle













Edible bread-like substance








Dairy Case









Cottage cheese








Edible cottage cheese-like substance








Edible yogurt-like substance





















Edible butter-like substance








Peanut butter








Edible peanut butter-like substance








Freezer Aisle

Ice cream








Edible ice cream-like substance













Snack Aisle

Snack bar








Edible snack bar-like substance





















Edible cracker-like substance












Cereal Aisle









Edible oat-like substance








Bottom line?

1. Eat more foods without ingredients lists!

2. When buying packaged food, read the ingredients list. If you see ingredients that you recognize, go for it. A long list of chemicals? Skip it.