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Essential Fatty Acids ‘Menu’

Essential fatty acids (EFAs) are “essential”.  Our body can not make these fats. EFAs must be obtained by eating certain foods and taking dietary supplements. You have heard the term, saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), and unsaturated fatty acids (PUFAs). EFAs are a type of PUFA  categorized into one of two classes: Omega-6 or Omega-3.  The essentiality of two of these omega fats, linoleic acid (LA, an omega-6), and alpha-linolenic acid (ALA, an omega-3) is because humans, do not have the enzymes to make them from other fats in the diet.  We get them from eating animals that have consumed plants and have now accumulated them in their body fat stores.

Aim for at least 4 grams of omega-3s, which you can easily get from food and supplements. I take the Standard Process General Health Daily Fundamentals packets which contain tuna omega-3 oils.

Think of your supplements as insurance!



Gluten Intolerance

The inability to digest gluten, which is the protein found in wheat, rye, and barley, is affecting many patients. Celiac disease – an incurable immune reaction to gluten – is the extreme sensitivity to gluten. People who react to gluten but not as severe as Celiac Disease call  it gluten intolerance.

Celiac disease is incurable and a permanent conditions. Gluten Intolerance has some good treatment options. The only way to avoid their damage is to avoid eating even tiny amounts of wheat, rye, or barley.

I ask my patients with chronic digestive issues and chronic joint inflammation complaints to  go gluten-free for a 21 day challenge.

I recently had dinner with a friend at a local LA restaurant. The waiter and chef both knew what “no gluten” meant, and even left the bread off an appetizer plate we shared so that there would be no cross-contamination. There was no flour in anything he ate that I could see. Yet, shortly after dinner he began having digestive distress (bloating). Luckily we could walk back to my office where I had an enzyme to give him that digests gluten. Quickly his symptoms disappeared.

Going gluten free is a challenge –  even a smidgen of flour on a cook’s hands or a splash of soy sauce in a sauce can set off digestive problems or silent inflammation in some people.

Feel free to schedule an appointment to discuss if you need enzymes that digest gluten. Taking them can make the difference between being successful on a gluten-free diet and failing.

Meanwhile, watch out for the obvious: wheat, barley, rye; fish and chicken dusted with flour; and salad dressing made with soy sauce.


Benefits of eating nuts

The consumption of nuts could help to boost levels of the neurotransmitter serotonin, possibly leading to improved heart health, decreased feelings of hunger and increased well-being in people suffering from metabolic syndrome. The research, published in the Journal of Proteome Research, reports a link between eating nuts and higher levels of serotonin in the bodies of patients with metabolic syndrome (MetS). The Spanish researchers found that just one ounce of mixed nuts—raw unpeeled walnuts, almonds and hazelnuts—per day resulted in increased excretion of serotonin metabolites in the urine. 

 The researchers pointed out that the study provides the first evidence in humans of the beneficial effects of nut consumption in reducing levels of substances in the body associated with inflammation and other cardiovascular risk factors in patients with metabolic syndrome. 

 Andres-Lacueva and her team explained that the rise in obesity around the world means more and more patients are suffering from metabolic syndrome—the symptoms of which include excess abdominal fat, high blood sugar and high blood pressure, all of which increase the risk of developing type 2 diabetes and heart disease. Serotonin is a substance that helps transmit nerve signals and decreases feelings of hunger, makes people feel happier and improves heart health. They added that previous research has suggested that dietary changes—including the regular consumption of nuts—may help patients with MetS shed excess weight and become healthier.

Journal of Proteome Research; 10(11):5047-5058, 2010


Paleo Diet

The Paleo diet doesn’t restrict carbohydrates, it promotes unlimited veggies and fruits. For some patients I do restrict the number of fruits. I recommend eggs, poultry, and meats. I allow sweet potato and yams. The monounsaturated fats are avocado, hazelnuts/fliberts, macadamia nuts, and olives. These are all great choices. A lot of my patients are switching to coconut oil/butter/flakes and milk for cooking and snacks. 

Research concludes that low carbohydrate diets in which fruits and vegetables are not restricted – like the Paleo Diet – result in lower all-cause and cardiovascular disease mortality rates. I’m after making a difference in cardiovascular disease, metabolic syndrome, and other chronic illnesses which typically afflict my patient population.

Stick with a diet based upon seasonal unlimited veggies, lean meats and seafood.


  1. Fung TT, van Dam RM, Hankinson SE, Stampfer M, Willett WC, Hu FB. Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies.Ann Intern Med. 2010 Sep 7;153(5):289-98.
  2. Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009 Jul 16;8:35.
  3. Frassetto LA, Schloetter M, Mietus-Synder M, Morris RC Jr, Sebastian A. Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr. 2009 Aug;63(8):947-55.
  4. Osterdahl M, Kocturk T, Koochek A, Wändell PE. Effects of a short-term intervention with a paleolithic diet in healthy volunteers. Eur J Clin Nutr. 2008 May;62(5):682-5.
  5. Jönsson T, Ahrén B, Pacini G, Sundler F, Wierup N, Steen S, Sjöberg T, Ugander M, Frostegård J, Göransson L, Lindeberg S. A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs. Nutr Metab (Lond). 2006 Nov 2;3:39.

Leucine Supplements Boost Muscle Synthesis by 33% During Exercise

Consumption of leucine-enriched essential amino acid supplements during endurance exercise may enhance the synthesis of muscle protein by 33%, says a new study from the U.S. Army.

In addition to the implications for sports nutrition, results of the randomized crossover study, published in The American Journal of Clinical Nutrition, may have implications for populations susceptible to muscle loss due to conditions such as sarcopenia.

“… increasing leucine provision during endurance-type exercise by dietary supplementation enhances muscle protein anabolism in recovery,” wrote researchers from the U.S. Army Research Institute of Environmental Medicine, Tufts University, and Louisiana State University System.

The effects of resistance exercise on the metabolism of protein in muscles and the effects of endurance exercise on protein metabolism is not well established. “Increasing the concentration of leucine within an optimal dose of EAA [essential amino acid] does not have an added stimulatory effect on resting and post-resistance exercise muscle protein synthesis,” explained the researchers, led by the U.S. Army’s Stefan Pasiakos.

“In contrast with resistance exercise, sustained endurance exercise is mainly catabolic, yielding simultaneous reductions in muscle protein synthesis and plasma leucine concentrations during exercise, which may be attributed to the metabolic demand for branched chain amino acids in exercising skeletal muscle.”

Eight volunteers consumed 10 grams of protein drinks with either 1.87 or 3.5 grams of leucine during a cycling test.

Results showed that the leucine-enriched beverage was associated with a 33% increase in muscle protein synthesis, compared with the control beverage. “[In addition] whole-body protein breakdown and synthesis were lower and oxidation was greater after consumption of [leucine-enriched essential amino acid supplement] than after consumption of [essential amino acid supplement],” added the researchers.

“These data indicate that increasing leucine availability during steady state exercise promotes skeletal muscle protein anabolism and spares endogenous protein,” wrote Pasiakos and his co-workers.

“Our findings indicate that increasing the leucine content of protein supplements provided for those populations susceptible to muscle loss, including proteolytic conditions—such as cachexia, sarcopenia and calorie deprivation—may warrant further exploration,” they added.

American Journal of Clinical Nutrition 94(3):809-181, 2011


Marriage Tips: Eye rolling, sex & fights

In her book, “For Better: the Science of a Good Marriage,” author and health journalist Tara Parker-Pope applies rigorous research to the big things in a relationship — sex, money, kids, fighting — and more interestingly to the (seemingly) small things — housework, snoring, eye rolling, even the way couples retell the story of how they met.

 Wed couples are actually having more sex than anyone, conflict can be a good thing and more than 50 percent of us are staying married. 

Tara Parker-Pope: People can study couples and see patterns that can predict a better marriage or a problem in a marriage and we can learn from it. 

Is there some evidence- based advice for how to make a marriage better? TPP: Successful couples that register high on marital happiness scales understand that small things do matter. [Researchers] see that how couples manage conflict, how they start and end a fight, and the positive things they do matter almost more than the negatives. Do they celebrate the small victories that life hands them? Do you grunt and say, “Oh that’s nice honey,” or do you say, “You got a raise today? That’s terrific; let’s go celebrate.” Those little things, we often take for granted as couples. We think the stuff that matters is the big fight or the conflict we’re having, and I don’t think we appreciate how much the kiss good-bye in the morning, or the pat on back or holding a partner’s hand [matters]. For some reason, we think that kind of stuff doesn’t count, and the research shows that kind of thing counts a whole lot in a good marriage.

Sex counts — the more often couples have sex, the happier the marriage. How can couples have more sex? TPP: Well, it’s pretty specific to a couple. Remember that line from “Annie Hall” when the therapist says to Diane Keaton and Woody Allen in separate meetings, “Well how often do you have sex?” And she says, “Oh, constantly, three times a week,” and he says, “Hardly ever, three times a week.” And that sort of tells you, if it works for you, then it works. If it doesn’t work for you, then it’s not enough. But overall, it’s important for a married couple to know that it’s normal for sex to decline in a marriage. You’re still having more sex than a single person; there’s definitely a correlation between the couple’s satisfaction with their sex life and their satisfaction with the marriage. So frequency is definitely associated with a happier relationship, but it doesn’t have to be frequency. It’s just whether or not you’re both satisfied with the amount of sex that’s in the relationship.

No-sex or a low-sex marriage, is really a difficult problem for couples. There’s a big loss, an emotional loss when your sex life goes away in a marriage, and it’s a tough thing to repair. One of the pieces of advice that Helen Fisher, an anthropologist at Rutgers University who really knows a lot about love research, gives couples is that if you are having problems, have sex — even if don’t feel like it. Because just the act of having sex unlocks a lot of these bonding hormones and brain chemicals. It is a shortcut, in a way, for restoring intimacy and getting over bad times in a relationship. Even if you don’t feel like it, once you get started, you do feel like it because biology sort of takes over. Sex is pretty essential.  Focusing on your sex life is not just something enjoyable, it’s truly good for your marriage, for your relationship.

The book says that simple interactions, like rolling your eyes at your husband, can indicate you’re headed for divorce. How can such a simple thing be such a strong indicator? TPP: There’s a noted marriage researcher named John Gottman, and he has watched a lot of couples have conflict discussions, and he has these very sophisticated computer analysis programs and heart rate monitors and different ways to assess the state of your relationship, and he’s quite skilled at this. And, unfortunately, we can’t all go to his lab, so I asked him what can we look for. He said one of the really simple things to look for is the eye roll. Because it’s a sign of contempt, it’s a sign that your relationship has gone to a place that is not good. Couples that do this in his studies have consistently had bad outcomes. It’s a simple thing to look at, and it’s a relatively easy thing to stop. If you’re an eye roller, and if you’re on the receiving end of it, it’s legitimate to say to your partner, “I wish you wouldn’t do that. It doesn’t make me feel good, and can we work on this issue?.” You’re dismissing what the other person is saying. It’s a behavior we typically wouldn’t even do to our friends, but you do see it in married couples. Again, it’s one of the many little things that goes on that can be a big deal over time in a relationship.

If you feel you’re at risk for divorce, is it possible to get the marriage back on track? TPP: There’s a lot of psychology that would suggest that [fun] is what brought you together in first place, and what keeps you together long term. There is some science out of Stony Brook University suggesting that rediscovering some of those early behaviors and doing new and different things together as a couple improves your marital happiness. I do think that once a couple starts talking about divorce and thinking about divorce, being divorced is a real possibility. [Once you are] discussing divorce with friends and people outside the marriage, you are pretty far down a path, a not so good path. That doesn’t mean that you can’t turn around, but I think it’s pretty good advice to not use the D word lightly. There’s some research to suggest that once you start talking about divorce, it will create change.

Regarding fights. You don’t have to worry about what you’re fighting about or how often you fight. Really you just have to think, “Okay, if I want to protect my relationship, I need to make sure that I start the fight correctly, that I don’t let it escalate and that I learn how to de-escalate.” I think that de-escalation thing is a skill we can all use. The ability to de-escalate, to take a breath and to calm things down is just a good skill to have, especially for people in a marriage. So couples don’t have to go from fighting a lot to not fighting at all to improve their marriages — you just have to go from fighting however you’re fighting now to fighting better, to fighting more fairly. 

Conflict is really good for the relationship. Conflict is moving you toward a better place, because you’re working things out. When you don’t work those things out, they catch up with you. So a little bit of conflict, a little bit of fair fighting, productive conflict, goes a long way.

Seventy percent of marital conflicts never get resolved. They bring these couples into the lab, and they listen to them fight about the dog or the mother-in-law or the socks on the floor, and 10 years later they’re still fighting about the dog — it might be a different dog — but the socks on the floor or the motherin- law, they’re still fighting. Thirty percent of conflicts do get resolved, and you figure things out, and people learn to adjust and compromise. Personally, what I think these data suggest is that 70 percent of the stuff we fight about doesn’t matter. It’s there; it’s part of having a relationship, but it’s kind of irrelevant. The most important thing is you don’t beat each other up if you’re disagreeing. Be nice. You can be nice and still fight.

The book ends with seven strategies couples can use to stay happy and keep their marriages strong. TPP: The small, kind things we do in a marriage matter a lot. There are many different ways to look at this. But being nice to your partner is really the best way to take care of your marriage. It’s such a simple piece of advice, but how often have we heard couples just rip each other up, and how often have we done it ourselves? And I think these small things, like celebrating the good times and making a fuss over the small victories that life hands you, help you sustain a better relationship, not letting your marriage get boring and doing new and exciting things. You’re not only creating novelty and reactivating that kind of crazy love you had at the very beginning, but you’re creating other experiences, and all of that is good for a marriage. And I do think sex is such an easy shortcut. That’s not all it takes, but that’s a simple one. I think remembering that everything you do, not just the big blowup, signals the health of your relationship. It’s those little things you do every day that hold you together.


Prostate Cancer Prevention

Men over the age of 50 pay attention. 

Avodart and Proscar are drugs in a class known as “5-ARIs.”

This class of drugs was developed to treat enlarged prostate (also known as BPH, or benign prostatic hyperplasia). 

In a 2010 New England Journal of Medicine study, about 3,300 men at high risk of prostate cancer took Avodart for four years. A second group of men — also at high risk — took a placebo.

Compared to placebo, the relative risk of any level of prostate cancer was reduced by nearly 23 percent in the Avodart group.

Sounds pretty good, right? I mean…based purely on that number, you wouldn’t blink if your doctor encouraged you to take a 5-ARI if you’re at high risk of prostate cancer. And keep in mind that every man between the ages of 50 and 75 is considered high risk. 

Patrick Walsh, M.D., is a Professor of Urology at Baltimore’s Johns Hopkins School of Medicine where he served as Urologist-in-Chief for 30 years. In an editorial he wrote that appears in the same NEJM issue as the Avodart study, Dr. Walsh points out that Avodart and Proscar, “do not prevent prostate cancer but merely temporarily shrink tumors that have a low potential for being lethal, and they do not reduce the risk of a positive biopsy in patients who have an elevated PSA level.” 

“Men will believe that it prevents cancer, will be pleased that their PSA levels fall, and will not understand the potential danger of undiagnosed high-grade disease.” Speaking specifically about the Avodart study, he said the results showed, “there was a 23% reduction in low-grade tumors that the patients would never have known they had. Does this sound like an indication to take a pill with sexual side effects that costs $4 a day?” 

In the NEJM study, sexual dysfunction was higher in the Avodart group, and — even more important — subjects in that group were nearly TWICE as likely to experience heart failure compared to placebo.


Low Intensity Sample Workout

This is a perfect workout to get your energy flowing but not your sweat! 

March in place for two minutes.

Vertical Push-Up: Stand at arm’s length from a wall. Keeping your elbows at shoulder level, place both hands against the wall, shoulder-width apart. Lean into the wall, bending your elbows as you come forward… and straightening them out as you push back. Try to do 10-12 reps.

Squats: Stand one foot away from a chair, facing away from it. Bend at your knees, lean forward and bend – keeping your back straight – until you are seated in the chair. Rest for a second, place your hands on your thighs, and push off using your legs… and stand. Try to do 8-12 reps.

Crunches: Sit on a desk, bench, or other straight surface. Cup your ears with your hands. Bring your left knee up and across to your right elbow. Pause, tighten your ab muscles, and return to your starting position. Bring your right knee up and across to your left elbow. Pause, tighten your ab muscles, and return to your starting position. Try to repeat 6–10 times.

Do 10-12 more wall push-ups. Do 8-12 more squats. And finally march in place for two minutes.



Getting Started With Exercise?

Are you just getting started with exercise? Congratulations! Whatever your motivation is, improved health, fitting back into your ‘skinny jeans’, or you want more energy, it’s important to come up with goals. Here are some things to think about: 

Goal 1: Find a Time & Remain Committed 
Figure out when you’re going to head to the gym or workout at home. Whether it’s weight loss or building  new muscles you have to have a regular, consistent time to workout. 
Goal 2: Follow Through 
Start out with three days a week for two to three months. The amount of time doesn’t matter – it could be ten minutes, twenty minutes and even longer. Let’s just get started and get it into your schedule. Short bouts are better than nothing and makes it easier to stick with exercise for the long haul. 
Goal 3: Keep a Workout Diary 
Exercise is a priority in my life. Every day I work out I write down what I did and I might include how much weight I lifted or the number of reps completed. I like looking over a few weeks of my workouts. If  weight loss is your goal, get a body fat analysis performed, or once a week write down your weight. Over time, you’ll be able to see improvements in all these areas. Just pick a statistic and follow it, such as your lowered blood pressure or how much longer you can stay on the treadmill now than when you first began.