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What is Functional Medicine?

Functional medicine aims to find the root cause behind health issues, examining genetics, environment, diet and lifestyle factors. It asks not only how, but why is this health concern occurring? It looks at every person as individualized and considers all components of human biology and how they interact with the environment. With more than 75% of healthcare costs coming from chronic illnesses, functional medicine offers a new care model that has the potential of providing long term solutions and reduced cost of care. Mainstream healthcare focuses on masking symptoms, with interventions such as pharmaceuticals, often leading to long term dependence on drugs. Although this approach can work well for acute care, it has been less than ideal for chronic conditions. Most primary care doctors have little knowledge about nutrition and its impact on the body's physiology. The food and drink you choose to consume, the amount you sleep, your activity and stress levels all have a profound effect on how your body performs. Many chronic illnesses are a result of poor diet and lifestyle factors, such as cardiovascular disease, lung disease, diabetes and fatty liver disease. Functional medicine investigates where your body is struggling and uses conservative, natural interventions to optimize your body's own physiology to facilitate wellness. This model also recognizes the idea that one condition can have many different causative factors and stems more from dysfunctions in your physiology and the biochemistry of the human body. Detailed testing is often used in conjunction with very thorough history taking to accomplish this. There is the perception that all lab work is the sam, but functional practitioners usually utilize more in depth testing. Not all labs are created equal and the standard screening panels often are short versions of tests checking for states of disease. Functional testing investigates vitamins, minerals, physiological processes such as amino acid breakdown and absorption, neurotransmitter production/metabolism, urea cycle and ammonia detox, glutathione production, inflammatory markers, methylation, exposure to toxic elements, energy production, circadian rhythm/adrenal stress index testing, plasma fatty acid profiles, liver detoxification, food allergies, microbiome panels, stool analysis, comprehensive hormone panels and more. This in depth testing really allows for a more complete picture of how your body is behaving and oftentimes reveals blocks in your body's performance that must be addressed. Functional medicine is an excellent in depth, systems oriented health model. That being said, it is also a team approach, involving both the patient and the practitioner. This model aims at shifting habits, addressing diet on a long term level, understanding genetic components, lifestyle and environmental factors to get the body’s physiology working the best it can. This is what makes functional medicine a personalized, effective and long term solution to promote optimal health.

Full Q&A From Oxygen Magazine

1. What are
the parameters/requirements that determine produce's

The Environmental Working Group (EWG) uses the USDA's test samples from fruits and vegetables to determine the produce with the least and most amounts of pesticides. They use this information to construct a shopper's guide of the "Clean 15" and "Dirty Dozen" to help consumers avoid pesticide exposure. 

 2. What about the farming methods?Pesticides? GMOs? Why are those 12 products "Dirty" and why should you avoid them? Are they really that scary?

Over half of all the produce sold in the United States is grown with pesticides. The "Dirty" list is made up of fruits and vegetables that tested highest in pesticide residues. One of the most popular pesticides in the US is made by Monsanto and is called RoundUp. It contains the active chemical Glyphosate, which is problematic to animals (including humans) in many ways. Glyphosate is an endocrine disrupting chemical, meaning that it can mimic certain hormones in your body and has the potential to make changes to your physiology, such as fertility issues. The actual mechanism of how glyphosate works involves its ability to inhibit the shikimate metabolic pathway. This pathway does not exist in animals, but it does exist in the trillions of microorganisms that colonize your body and make up your gut microbiome. By glyphosate disrupting this pathway, it not only effects your gut diversity (which we now know is very important for health), but it alters nutrient delivery, your gut barrier, inflammatory responses, production of aromatic amino acids (used to make neurotransmitters in the body such as thyroid hormone, serotonin and dopamine) and even genetic regulation. There is also some newer literature examining a possible link between pesticide exposure and non-alcoholic fatty liver disease. There are very few studies investigating the possible consequences of long term pesticide exposure. The World Health Organization and the International Agency for Research on Cancer has deemed glyphosate a probable human carcinogen based on human and animal studies. California's Environmental Protection Agency lists glyphosate as a carcinogenic chemical known to cause birth defects, reproductive harm and cancer. This is why agencies such as the EWG have made such an effort to inform consumers of the "Dirty Dozen" and "Clean 15"

3.Why does this list of items change? Why do things get kicked off
these lists and added to them?

It's all determined by the pesticides found on testing conventional produce items and farming practices/pesticide uses has some variability from year to year.

 4. Who makes these decisions on
dirty or clean? 

It is a list produced by the EWG (Environmental Working Group) to help inform consumers of produce items with the highest and lowest amounts of pesticides. The conventional produce with the highest amount of pesticides found from their testing are the "Dirty Dozen" and the "Clean 15" are the fruits and vegetables with the lowest concentrations. 

5. Can you "wash" a product and make it go from
dirty to clean? Why or why not? 

There was a study that found soaking produce in baking soda water for 12-15 minutes can remove a significant amount of pesticides. You use 1 teaspoon of baking soda for every 2 cups of water. 

To check out the full article online:

Healthy Habits While Social Distancing

Q&A From Thrive Global interview: - Even though it might be more
difficult, why is it so important to continue eating healthy
foods and moving our bodies at this point in time? Healthy eating is imperative to maintaining a healthy immune system. For example, high sugar intake have been shown in studies to  decrease immune activity, specifically NK cells, for several hours after consuming the sugary food. Partially hydrogenated fats you'd get in fried foods have an impact on your antioxidant status, which is important when your body is faced with an infection. Antioxidant/flavanoid rich foods in general like dark leafy greens, blueberries, blackberries, acai and raspberries are helpful in improving your antioxidant status, which declines as we get older. One of the most important antioxidants that your body produces is glutathione. Sulfur containing vegetables such as cabbage, broccoli, cauliflower, etc can help encourage your glutathione production. So you really do have a lot of power over your health and immunity by supporting your body with beneficial foods and healthy eating styles. - What are
some strategies to avoid stress-eating/reaching for comfort
foods during this time? Only purchasing healthy food items can really help. We can't go out unless it is for essential things during this quarantine, so keeping problematic foods out of your house can be a great way of preventing detrimental eating habits. Stick to your list when you go shopping and keep unhealthy foods off of it. Also paying attention to your emotions when you go to reach for food is important. Are you eating because you are truly hungry or because of an intense emotion? This strategy can help with identifying eating patterns. - How can we still make healthy food
choices as we are limiting trips to the grocery story and
largely relying on pantry/shelf-stable foods? Meal prepping is essential. I have been making stews, veggie quinoa mixtures and soups. I make them in bulk and then freeze them in individualized portions, so I still have access to fresh delicious food. I'm also buying a lot of frozen leafy greens and other vegetables that are quick and easy to prepare. You can also buy canned items such as tuna, chickpeas, black beans, coconut milk, jackfruit and other healthy items are available and last a very long time. I stocked up on many gluten free legume pastas and bought bulk quinoa as well. You can definitely find healthy pantry/shelf-stable foods. - What are some
strategies for fitting movement into the day while we are
staying home and not going to the gym? My favorite way to exercise is HIIT training. Science has shown that this type of exercise is excellent for your mitochondria (the powerhouse of the cells in your body), helps burn belly fat, boosts metabolism and increases insulin sensitivity. In fact, it is one of the most efficient exercise methods for reducing visceral fat and total trunk/abdominal fat. It has also been shown to stimulate production of human growth hormone, which can slow down the aging process, improve bone density and muscle mass. I really enjoy HIIT because I can do it in the comfort of my own home and it only takes a short amount of time to preform and to see/feel results. There are tons of free videos on youtube that you can use as guides, or you can just make up your own routine. I usually do some combo of forearm planks, jump squats, plank jacks, lunges and donkey kicks, but I like to switch it up with videos.

5 Immune Boosting Superfoods

1. Broccoli is a low glycemic, antioxidant rich superfood with plenty of fiber, vitamin C and vitamin A. It also contains an important phytochemical called sulforaphane which assists with liver detoxification, reduces inflammation, has pain suppressing abilities, anti-cancer properties and has been shown to improve insulin resistance. Studies have also shown that sulforaphane has immune boosting effects, especially when it comes to your immune cell's antiviral responses. This amazing phytochemical is also found in other cruciferous vegetables such as cabbage, brusselsprouts and cauliflower. 2. Dark leafy greens such as Swiss chard, kale, collard greens, spinach, etc, are all nutrient packed superfoods with notable amounts of calcium, carotenoids, vitamin C and antioxidant phytochemicals. They have antioxidant and anti-inflammatory compounds that have been shown in research to protect against cancer and reduce your risk of chronic illnesses such as cardiovascular disease and diabetes. These carotenoid rich superfoods can help protect your body from disease by supporting a healthy immune system. 3. Asparagus is a fiber packed, antioxidant rich, anti-inflammatory superfood. It's a rich source of vitamin C, A, E, K, B6 and folate. Something you may not know about this vegetable is that it is a great source of inulin, which is an important prebiotic for your gut health. That means it promotes the growth of good bacteria and also has anti-cancer properties. It's important to remember that most of your immune cells live in your gut and diversifying your gut microbiome can help modulate and improve immune activity to help protect against infections. 4. Turmeric is a powerful anti-inflammatory spice with many immune boosting properties. It has been used in Chinese medicine for centuries to fight infections, improve digestive complaints and help inflammatory conditions. The active polyphenol in turmeric is called Curcumin and acts as a natural COX inhibitor, much like NSAIDS such as aspirin, but without the gastrointestinal side effects. This means it can help regulate inflammatory responses and important immune cells involved in adaptive immunity. Studies have demonstrated turmeric's anti-oxidant capabilities can help lower inflammatory markers such as CRP, which can be useful in helping with infections, preventing cardiovascular disease, neurodegenerative conditions, pain and arthritic flares. 5. Ginger has powerful anti-inflammatory, antiviral, antioxidant and antibacterial effects that can help with colds and flu. This is because of its ability to boost immunologic function by stimulating important immune cells. It's especially useful in soothing a sore throat, because of its ability to combat pain through its anti-inflammatory mechanisms. Ginger contains powerful antioxidants such as oleoresin, which act as a natural cough suppressant and has been shown to improve symptoms of asthma.

All About Elimination Diets Q&A

What exactly is an elimination diet? Could you clarify its medical basis, and that it’s not just cutting out sugar or carbs to lose weight? An elimination diet is designed to help identify foods that are potential triggers for inflammation, allergens, intolerances and sensitivities. It is used as a tool by practitioners who are attempting to help patients get to the root cause of their condition, symptoms or health concerns. Certain conditions ranging from acne to IBS, may be triggered by unidentified problematic foods. Potential food triggers can also lead to vague symptoms such as gas, bloating, heartburn, abdominal pain, abdominal rigidity, bowel changes, cough, congestion, fatigue, joint pain, feeling swollen, skin problems (acne, rashes, eczema), sleep disturbances, headaches and more. While testing is available for allergies, sensitivities and intolerances, these tests can be flawed and expensive, which is why I often times prefer using an elimination diet. For instance, many of the mainstream tests used to identify problematic foods only utilize IgE testing, which identifies a type of reaction that has the potential to cause anaphylaxis. While this is an important thing to know, this type of allergy is only one of several different ways your body may react to a particular food and is often already known by the patient . This is because IgE food reactions cause severe, often life threatening responses (these patients usually have to carry an epi-pen). Some reactions to food don't involve IgE responses, but are mediated by your digestive tract and other physiological responses. These reactions more so represent your body having difficulty breaking down a food. Symptoms take much longer to appear than an IgE allergy and may be less severe. An example of a food intolerance is lactose intolerance, where your body does not produce enough of an enzyme (lactase in this case) to properly digest a food. These reactions are not often investigated by conventional practitioners and testing. Food intolerances can also be a temporary problem, caused by a more complex GI issue such as an infection or gut bacteria imbalance. Additives/preservatives, flavorings, certain lectins, histamine rich foods (or histamine producing foods) and other chemicals added to food can also cause these type of reactions. Common foods leading to intolerances include wheat, dairy, processed foods with artificial sweeteners/colorings/chemical additives. Another issue with food testing is that most companies test using raw food proteins, rather than cooked. The protein structure of a raw food vs cooked is different, resulting in less accurate testing. An example of this would be receiving a test result indicating you have a problem with eggs, but the testing company may have used a raw egg protein rather than cooked to assess this. You may in fact be fine with cooked eggs, but only have a problem with raw eggs, which I'm assuming many of your aren't eating to begin with. If someone is having medical issues, how can they know if food is the culprit? Why is an elimination diet a good thing to try? It is sometimes difficult  to know whether a food is the cause of certain symptoms. This is why trying an elimination diet with a qualified practitioner is a must. A knowledgable practitioner is going to be informed when it comes to symptoms caused by food issues and will be versed in what conditions may be influenced by certain foods. How do you assess someone and determine what foods they should start cutting out? The elimination diet is some what standardized to remove the biggest food offenders for everyone, which are: gluten (wheat, rye, barley, etc), dairy, corn, chemical additives/preservatives, refined sugar, peanuts and soy. Depending on the health condition at hand, your practitioner may choose to add additional foods to the elimination list. Research has demonstrated that certain foods have the potential to cause something called "molecular mimicry", which can cause enhanced autoimmune responses in the body. An example of this is gluten with Hashimoto's disease. Patients with Hashimoto's may actually worsen their autoimmune response to their thyroid by eating gluten, so removing it is essential when it comes to promoting health. Specific conditions may merit eliminating additional foods such as eggs, beef, chicken, legumes, shellfish, nightshades or foods that the person eats more than 3 or 4 times per day. It just depends on the condition and an experienced practitioner will know what is best for your individual case. What food groups tend to cause the most problems, generally? Generally speaking gluten, dairy and soy are the biggest offenders. How do elimination diets work? Is it best to cut out one food at a time or a bunch all and once and slowly reintroduce them? A true elimination diet works like this: Step 1: Eliminate all foods on elimination list for 2-3 weeks (gluten, dairy, corn, chemical additives/preservatives, refined sugar, peanuts and soy). You will likely show improvement in your symptoms. This is because it takes about 2-3 weeks for inflammatory cascades in your body to be reduced. The aim is to resolve these responses completely before testing problematic food and noting responses. Step 2: At completion of your first 2-3 weeks, start reintroducing problematic food list in its purest form, one at a time. You must consume the food you are reintroducing 2-3 times in one day and wait 24 hours before testing a new food. An example of this is eating wheat berries (gluten) 3 times on Monday, eat no wheat berries on Tuesday and then start testing dairy on Wednesday. Journal symptoms of how you feel after reintroduction. How long does someone typically need to give up a food to determine its effect? How do you recommend patients keep track of everything? It is imperative to remove all potential problematic foods for at least 2-3 weeks. This is to give the body time to calm down inflammation and immune responses that may be causing symptoms and gives the patient a "clean slate" to assess foods and symptoms upon reintroduction. I have my patients keep a food journal to jot down symptoms, so it's easy to identify problematic foods. What conditions/health issues can the elimination diet commonly help with? I know you can’t share patient specifics, but do you have a couple of specific examples of how an elimination diet helped someone? I've found the most benefit in utilizing an elimination diet with autoimmune patients or with those experiencing gastrointestinal problems. Many times patients with IBS or acid reflux are actually just consuming unidentified foods that their body is reacting to. Foods can be triggers in patients with migraines and chronic acne as well. I've seen the use of an elimination diet be incredibly helpful when it comes to improving acid reflux, arthritis, various skin issues, and autoimmune problems (such as Hashimotos, psoriasis, SLE, rheumatoid arthritis, etc). Why are treatments like elimination diets sometimes better than medications or other treatments? Medications are designed to treat symptoms. Elimination diets are aimed to get to the cause of your symptoms, but identifying problematic foods. By finding the root cause of your problem, you can prevent the symptoms from occurring by avoiding the food, rather than putting a bandaid on the symptom once it's there. For example, the elimination diet may help you realize that eating gluten is what triggers your acid reflux and other gastrointestinal problems. These symptoms may be completely eliminated if you just adhere to a gluten free diet. This dietary change could prevent the need for long term medications with side effects to manage the acid reflux and GI problems. It would also help you avoid the financial burden of continued medical care and medication, along with any side effects the medication may have. What is often misunderstood about the elimination diet? I think many patients don't actually understand the basis of the elimination diet or the importance of following the elimination time frames or reintroduction periods. The elimination diet guidelines were actually developed based on your body's physiological responses. So you want to give the body time to calm down inflammatory responses by eliminating all the possible problematic foods for 2-3 weeks and then upon reintroduction, wait for delayed symptoms to show up. If you're not strict with the timeframes, it may alter your results. It can be a tedious process, but it works and is really a small amount of time to commit to in the long run.

Why I choose to use natural deodorant...

Why do I choose to use natural deodorant? 1. Conventional deodorant and antiperspirants contain parabens, which are used to extend shelf, life as well as prevent bacteria and mold growth. Long chain parabens (which can mimic estrogen) are particularly harmful, causing hormonal shifts, fertility problems and are now linked to cancer. Examples of long chain parabens are butylparaben, isobutylparaben, propylparaben and isopropylparaben. 2. Aluminum accumulation from antiperspirants can be concerning, because it does have the capability of damaging DNA and acting as a carcinogen. A recent animal study (Aluminium chloride promotes tumorigenesis and metastasis in normal murine mammary gland epithelial cells) investigated this further using aluminum chloride in doses comparable to deodorant in mice and scientists found it did encourage the formation of metastatic tumors. Human studies have shown mixed results and merit further investigation. Earlier reviews (in studies before 2014 such as Systematic review of potential health risks posed by pharmaceutical, occupational and consumer exposures to metallic and nanoscale aluminum, aluminum oxides, aluminum hydroxide and its soluble salts) found no evidence that aluminum-based antiperspirants caused breast cancer in humans. Another more recent study (Use of Underarm Cosmetic Products in Relation to Risk of Breast Cancer: A Case-Control Study) found that not only did women with breast cancer have higher amounts of aluminum in their breast tissue than those without, but women who used antiperspirants were at higher risk of breast cancer. As with any heavy metal that accumulates in your body, aluminum accumulation causes other physiological issues as well. As far as I'm concerned, there are too many effective alternatives to these products than to risk the potential health concerns. 3. Deodorant and antiperspirants are also a source of triclosan (an antibacterial), which is often not listed on these products as an ingredient. Triclosan was originally developed as a pesticide, but is now purposely put in many personal care products (such as Colgate toothpaste). The CDC now found triclosan to be detectable in 75% of Americans, with one of the highest exposure groups being young women and teens. Triclosan has been shown to directly interfere with thyroid hormones and may also cause changes in reproductive hormones. There is also some evidence that higher triclosan levels may contribute to increased risk of allergies. 4. Most natural deodorants aim at providing safer ingredients and leave out aluminum, parabens, phthalates, artificial fragrances/colors/flavors, propylene glycol and PEG and sulfates. They also aim at improving odor, but don't necessarily prevent sweat, which is a necessary function of the body for detoxing and important for temperature regulation. I feel it's important to facilitate the body's natural physiology and avoid endocrine disrupting chemicals.

What happens when you cut your sleep short?

Sleep is how your body regenerates your brain and body. The normal neurological functions of your brain create byproducts that must be flushed out by your glymphatic system (a brain waste clearance system) at night. This is also when your body regenerates your immune system, regulates important hormones, heals damaged cells and recovers from the various activities of the day.⁣

When you cut your sleep short, there isn't enough time for your body to go through these processes and can result in sluggish neurological function, brain fog, mood changes, poor memory and even experiencing unhealthy food cravings (due to hormone changes). ⁣

What can you do to improve your sleep cycle?⁣

Exposing yourself to light in the morning when you wake up and keeping your evenings dim can really help with normalizing sleep patters. Even modest alcohol consumption, poor eating habits and blue screens can interfere with regular sleep patterns. I personally try to keep semi-sheer curtains in my bedroom to help the light wake me in the morning and attempt to eat a well portioned/balanced meal at least 3 hours before I go to sleep. About an hour before I want to go to bed, I turn off most/all of the lights in my home to help my brain realize it's time to get sleepy.⁣

Sleep is essential for health. Practice these habits to restore your natural rhythms. ⁣

Stress Reduction Strategies

Lets talk about the stress response in your body, which is designed to keep us safe from danger. A good example would be once upon a time, you are a primitive human gathering fruit when all of a sudden you see a tiger. Your body immediately senses this danger and begins a stress breathing pattern (using not just your belly to breathe, but your chest which requires the use of neck accessory breathing muscles), in addition to producing stress hormones which will help you escape being eaten. ⁣

Todays world is much different and most of our stressors do not require running away from a predator; which would be a great way to purge all those stress hormones and help put an end to the stress breathing patterns that are initiated. So what can you do?⁣

1. Learn how to breathe. A great way to let your brain know that danger is over, is train yourself on how to deep belly breathe. Try putting one hand on your chest and one on your belly and practice only raising your belly as you take deep breathes. ⁣

2. If you can't shake that feeling of stress, exercise! This will help put those stress hormones to use and when your exercise is complete, it will signal your body that the threat is over and you are now in a safe space. ⁣

3. Meditate: Try to establish a mediation practice centered around a "safe space". This safe space can be anywhere you'd like, as long as you feel nice and calm. This meditation practice can help you transition into a more "rest and digest" nervous system mode.⁣

4. Practice connection and kindness: make an effort to be kind/nice to everyone you encounter. Give someone you care about a hug, play with your pets, laugh with some friends. These moments can actually alter your mood and help shift your body into a calmer, happier state. Don't underestimate the power of connection, whether it be from a human or an animal! ⁣

5. Go be in nature. Spending time in nature has been shown to actually reduce the production of stress hormones, help people feel more connected and can even aid in healing your body. Try finding a nice green space to spend some time in when you're feeling stressed. Taking a break in nature can really help. ⁣

How Plastic Harms Your Health and How to Reduce Use

Plastics have become a significant problem for our environment and our bodies. Many chemicals found in plastic, such as, BPA, BPS and phthalates have been proven to disrupt hormones, cause fertility issues and have even been linked to insulin resistance. ⁣

What are some strategies on minimizing your use of plastic?⁣

1. Instead of buying disposable drinks such as bottled water, invest in a glass water bottle or travel container to reuse for beverages. It is estimated that in 2016 alone, 480 billion plastic bottles were sold worldwide. ⁣

2. Use reusable grocery bags. It's estimated that 1 trillion plastic bags are used every minute. ⁣

3. Make your own cleaning products in refillable glass bottles. Not only will this minimize plastic use, but it will help you avoid toxic chemicals in your home, which can also cause issues such as hormone disruption. ⁣

4. Eat whole, unprocessed foods. Many processed food items and prepared meals are packaged with plastic or with cardboard that has been coated with plastic. Buying in bulk can help with this. Storing food in glass storage containers or wrapping in parchment paper, rather than using plastic wrap/plastic tupperware is also a great idea. ⁣

5. Think twice about your cookware. Invest in ceramic rather than nonstick pans. Nonstick cookware is commonly made with fluoropolymer plastic coatings.

Natural Interventions for Cold and Flu Season

Keeping your immune system in good shape during cold and flu season is crucial. This means optimizing your vitamin and mineral status and being especially aware of the importance of vitamin D! Vitamin D levels tend to drop in the winter, making people more susceptible to colds and seasonal effective disorder. Making sure your gut microbiome is healthy, getting sufficient sleep, eating a balanced diet (don't over do it on carbs and sugar during the holidays), staying active and practicing healthy stress management techniques are a must. ⁣

The majority of colds are caused by viruses, meaning antibiotics are not an effective treatment option. There are some general strategies to follow if you do end up catching a cold:⁣

-Sleep as much as you can. Insufficient amounts of sleep have been linked to decreased immunity and an increase in inflammation. ⁣
-Avoid sugar: this can actually weaken your immune system and worsen inflammation.⁣
-Limit dairy: which can cause additional inflammation and mucus production. ⁣
-Hydrate: When you are under the weather, your body requires additional hydration to recover. Drinking at least half your body weight in ounces of water can be a good hydration goal. If you notice a decrease in your appetite, drinking bone broths can help provide your body with much needed nutrients when you're sick. ⁣
-Eat the rainbow: eating a variety of vegetables and fruits can provide your body with much needed vitamins, minerals and antioxidants to help boost your immune system. ⁣

Supplements that I like to take when I have a cold include high doses of liposomal vitamin C, garlic (which is an antiviral and antimicrobial) and zinc lozenges. These natural interventions can help reduce cold symptoms, strengthen your immune system and reduce the duration of your cold. Ginger tea has powerful anti-inflammatory and antibacterial effects that can help with soothing a sore throat. It also contains powerful antioxidants such as oleoresin, which act as a natural cough suppressant!.

Malnutrition in Older Individuals

Older individuals are at a particularly high risk of malnutrition because of specific co-morbidities, oral issues (such as compromised chewing/swallowing), appetite challenges and natural decline in senses such as smell and taste. Malnutrition typically occurs as a result of unhealthy, nutrient negative diets that are higher in refined carbohydrates/sugar and inflammatory fats. Older individuals also experience changes in body composition and energy expenditure, leading to different nutritional needs than younger people.⁣

Signs of malnutrition in the elderly include: anemia, lethargy, mood changes, muscle weakness, muscle loss, difficulty recovering from illness, pale/cold skin, fatigue, inadequate wound healing, digestive issues, hair loss, weight loss, dry skin and cognitive impairment. Often times malnutrition has to get severe before noticeable symptoms arise and many chronic illnesses can in turn, be influenced by nutritional status. A common example of this is sarcopenia which is a loss in muscle mass due suboptimal nutrient status, lack of activity and and other complicating medical conditions. In general, the most common nutrient deficiencies in older individuals include vitamin D, calcium, magnesium, folate, B12, B6, vitamin E and vitamin C.⁣

How can you prevent malnutrition in older individuals? Make sure dental issues, chewing or swallowing problems are properly addressed, maintain a healthy weight, stay active and making an effort to eat a nutrient dense diet is key. Cooking with fresh herbs can be useful in addressing taste and smell decline. Focusing on plant based foods and lean protein will ensure sufficient nutrient, protein and fiber requirements. Avoiding excess sugar, processed foods and fast foods can increase chances in maintaining optimal nutrient status. It is also important to note that avoiding alcohol, tobacco and addressing any GI issues that may contribute to malabsorption are important to address. Taking a good quality multivitamin and multi-mineral, along with eating smaller meals throughout the day may also aid in appetite challenges that older individuals experience.⁣

Red Yeast Rice

Red yeast rice is a supplement created from monascus purpureus yeast that is grown on rice. Red Yeast rice inhibits cholesterol synthesis through a well known mechanism, inhibiting the enzyme HMG-CoA reductase.This is also a mechanism of statin drugs. In fact, Monacolin K is a statin monacolin found in red yeast rice, that is chemically identical to lovastatin. Lovastatin is an ingredient in the common statin drugs known as Mevacor and Altoprev. It has been shown in various studies that red yeast rice supplementation can effectively lower LDL, total cholesterol and triglycerides in about three months. There is also some evidence to support improved blood glucose homeostasis, insulin sensitivity and modest blood pressure reduction in patients with metabolic syndrome. There is also some newer research documenting possible anti-cancer properties of this supplement, through it's antioxidant and anti-inflammatory properties. Since human studies regarding this are very limited, additional research is needed to fully evaluate this potential.⁣

It's important to know that since the mechanism of red yeast rice is the same as a statin, it can cause identical nutrient depletions and similar side effects to a statin drug. Side effects may include headache, heartburn, gas, muscle weakness/pain, increased liver enzymes and sleep disturbances. Taking CoQ10 would be a good idea with this supplement, since CoQ10 is made in the same pathway red yeast rice inhibits, leading to depletions. Although red yeast rice does effect the HMG-CoA-reductase enzyme the same way as a statin, it contains an array of monacolins (while a statin only has one) that may also play a part in reducing cholesterol. Getting a high quality supplement is a must with red yeast rice, so as to avoid a mycotoxin called citrinin which has the potential to cause renal and liver damage. This is why I always recommend getting supplements from a licensed practitioner or sourcing websites such as to make sure you are purchasing a high quality supplement.⁣