Help Fund High-Quality Research on Diet and Health

University of California, San Francisco researcher Dr. Ashley Mason has asked me to spread the word about a diet-health study she's preparing to conduct in collaboration with Dr. Lynda Frassetto.  Dr. Frassetto is a widely recognized expert on mineral metabolism and bone health, and also one of the few researchers who has managed to wrangle funding to study the health impacts of a Paleolithic-style diet.  Her findings have been quite provocative.  

Together with their collaborators, Drs. Mason and Frassetto are preparing another diet-health trial to study the impact of two different diets on polycystic ovary syndrome, or PCOS.  PCOS is a common hormonal disorder among reproductive-age women, and its signs and symptoms include ovarian cysts, excess hair growth, menstrual irregularity or absence, infertility, and obesity.  Its causes are unknown, but insulin resistance is a core characteristic of it and is thought to play an important role.  PCOS is thought to be influenced by diet and lifestyle. 

A research team including Drs. Frassetto and Mason, as well as Drs. Umesh Masharani, Heather Huddleston, and Michael Cohn will test a Paleolithic-style diet and an American Diabetes Asssociation diet to see if either or both improves insulin resistance and menstrual cycle regularity for women with PCOS.  Each diet will likely have beneficial effects, however it remains unknown which will be more effective at treating PCOS.

Currently, it's exceedingly difficult for researchers to land funding from the National Institutes of Health (NIH) to do nutrition-related research in the context of disease treatment or management, particularly if it involves a Paleo diet. Recognizing the important potential of fleshing out the relationship between diet and health, researchers are looking for other ways to fund their work.  This study will give them the early data they need to start large, truly definitive studies of the links between diet and insulin resistance, and you can help make it happen.

Please check out their crowdfunding website to learn more about the study, the researchers, and make tax-deductible donations to support their work. And, if you're attending the Ancestral Health Symposium, one of the "backer" rewards is having lunch with the researchers.

Click here to see their crowdfunding site! 


This post was prepared in part using content provided by Dr. Mason.

Introduction to Hypoliquidemia

The venerable University of Texas MD Anderson Cancer Center in Houston will accept patients with traditional Texas Medicaid health insurance, and some patients in Medicaid managed care plans. Memorial Hermann, another large health system in Houston, will accept traditional Medicaid patients and also those in Medicaid managed care plans. Neither institution will accept the Blue Cross Blue Shield HMO silver plan sold on the Affordable Care marketplace, according to NPR, and as clearly outlined on the MD Anderson website. As it turns out, the conservative state of Texas is able to obtain best in the world health care for its poorest and sickest citizens, while the private market representative, Blue Cross Blue Shield in this case, is barring its “customers” from the best and most popular Houston hospitals, including the public system (!), and all the doctors that go with these hospitals. This situation is hardly unique to the Lone Star state.

The Affordable Care Act (ACA) is mandating that insurance companies take as much money from people as they are presumed to be able to pay, then proceed to top it off with taxpayer subsidies to make up for any shortcomings, and engage in these activities without discrimination based on formerly diagnosed illnesses. For their part, the people are mandated to make these payments, whether collectively through the government, or individually through their own pocketbooks, or most often both. While the ACA prescribes in great detail the mandatory flow of money from the people to health insurance corporations, and the services due to the people in return, it leaves the definition of the means by which these services are to be provided largely to the wisdom of the corporations, as long as they can show that, theoretically, the services can be provided. And indeed in many cases, many people, in practically every state, are now receiving excellent theoretical coverage for theoretical medical services.

If you happen to have cancer, and are looking to purchase health insurance, no insurer can turn you down or charge you more because of your preexisting condition. Thanks to the generosity of the ACA, you can select any one of the diverse insurance plans offered by each payer. You can choose a plan with a tailored, high-performing network focused on keeping you healthy, which includes almost no cancer hospitals and no cancer specialists, or you can buy a lusher and more expensive plan that includes some cancer facilities and doctors, or you can buy an exorbitantly priced health insurance plan that includes the likes of MD Anderson Cancer Center. If your cancer is found after you enrolled in that affordable plan for healthy people, you can always decide to switch to a plan that treats cancer and pay the difference. It’s all up to you, and the cash in your wallet, because now you have choices you never had before the ACA was enacted. This has absolutely nothing to do with preexisting conditions. It has to do with high-performance, tailoring, focusing and all sorts of other patient-centered features and benefits.

With great choice, comes great responsibility. All but the most expensive plans available for your selection on the Affordable Care marketplace, and most employer based insurance plans as well, are consumer driven. Basically you get to make all the big decisions regarding your health care and you need to empower yourself to rise to the occasion if and when disease or accidental misfortune materializes in spite of the system’s best efforts to keep you healthy. For those with little expertise in insurance jargon the best illustration may come from the home mortgage market. See, your affordable health insurance plan is very similar to the pre-2008 affordable mortgage for your pre-2009 home. In addition to your affordable monthly payments, there is a balloon payment due the day you are diagnosed with cancer, heart disease, or just slip and fall while cleaning the gutters. This payment is also known as your high deductible, and unlike your mortgage balloon payment, your high deductible is a self-renewing source of anguish, which springs back to life every January 1st.

There are handy calculators available to let you estimate the size of your balloon payments, and hospitals are setting up specialty services to evaluate a new vital sign called “liquidity” before any procedures are undertaken. Think of it as an expanded pre-op clearance. If your liquidity is lower than the price of your treatment, hospitals may help you elevate liquidity levels through various financial instruments, such as credit card debt, and refinancing for your balloon payment. It is not by accident that entities with brilliant track records in financial markets, such as Citigroup, are seizing the emerging opportunities in the brand new health care financing market, and are introducing innovative solutions “designed to simplify and enhance the healthcare payment experience”.  Be on the lookout for more innovation here, since this market is projected to run into the hundreds of billions of dollars by the end of the decade.

To bridge the gap between our vibrant financial industry and our old and tired health care system, a new diagnosis seems to be in order. Hypoliquidemia is a disease of the financial system. It is characterized by low levels of liquid cash in your bank account, low credit scores and low socioeconomic status (SES). Other signs and symptoms may include anxiety, depression and various phobias. Hypoliquidemia is diagnosed through a series of evidence based standardized screenings, ported from the financial industry and administered by your whole-person oriented care team. Moderate hypoliquidemia is severely exacerbated by prolonged encounters with the medical system, and although not a life threatening condition in otherwise healthy individuals, it may be lethal when comorbid with other severe illnesses.  The secondhand effects of hypoliquidemia can be extremely debilitating to hospitals and physicians who fail to take the necessary financial stewardship precautions when treating large numbers of hypoliquidemic patients.

Physicians, primary care docs in particular, are at increased risk of being affected by the spread of hypoliquidemia, since they are usually the first point of contact for patients entering the health system, and also because they lack the sophisticated diagnostic tools needed to measure liquidity levels before medical services are provided. The most likely effect of treating low liquidity populations consists of increasing levels of uncollectable bad debt. The only known protection mechanisms for individual physicians are to require cash or credit card payments at the time of service, or to avoid encounters with potentially hypoliquidemic patients altogether, i.e. those with ballooning high deductible insurance plans. Finally, according to a must read article in Managed Care, hospitals are already setting up “financial screening techniques that stratify access to their services” because “having an insurance policy will not guarantee access to care in the future”.

Hypoliquidemia is reaching epidemic proportions in the U.S. and there is no cure in sight, and there will be no mercy either. For the desperate, there is an old folk remedy which has been used successfully by inadequately liquid citizens in need of nursing home care in their old age. To attenuate the effects of hypoliquidemia on serious comorbid conditions, you need to counterintuitively drive your liquidity levels to zero. You need to quit your job, assuming you have one, and deplete any and all meager assets you may still have. Since regulatory climate is extremely important to treating hypoliquidemia, you may have to move to a region with suitable environmental controls. Once all these steps are executed successfully, you should be able to qualify for Medicaid and gain access to academic centers of excellence, including places like MD Anderson Cancer Center, if that’s what you need to survive. The most common side effects of this remedy are: premature death before the course of treatment could be completed, persistent exacerbation of hypoliquidemic symptoms, suicidal ideations and universal health care delusions.

Naturally Sweetened Super Crunchy Buckwheat and Cardamom Granola

Naturally Sweetened Super Crunchy Buckwheat and Cardamom Granola

¼ cup flax seeds

½ cup raw buckwheat groats (not Kasha)

1 cup rolled oats

1 tsp ground cardamom

1 cup quite tightly packed dates (17 small, fresh dates)

2 tbsp coconut oil

Preheat your oven to 150^oC/300^oF and line a medium-sized baking tray. 

You'll need a bigger bowl than this one ;)

Place all dry ingredients in a rather big bowl and stir well. Put the dates and coconut oil in a separate bowl and blend with a hand blender until the mixture is smooth. You might want to add 1-2 tbsp of water for the right consistency. Then pour the date paste over the grains and stir until everything’s well coated.

Spread the granola out on the baking tray and bake for about 30-35 minutes. Remove the tray from the oven to give it a quick stir every ten minutes or so, we don’t want the top or edges to burn! (Confession: Mine was slightly burnt but it actually gave it a pretty nice and toasty flavor. I did have to throw some away though so make sure to watch it while it's in the oven!)

Once the cooking time has elapsed, turn the oven off but leave the granola in there to dry out (unless it already feels crunchy enough). I like to make this at night and then take it out of the oven the morning after. Store in an airtight container and keep in the pantry.

Crunch away!

Tilda

Love at First Bite - Basic Vegan Pancakes

We all love us a big stack of pancakes, don’t we? If your answer to that question is no, you’re obviously lying. I know you are. I used to be one of those (crazy) people claiming they don’t like pancakes. Here in Sweden, a pancake is usually a thin, flat disc that's quite dense in consistency. Growing up, I absolutely hated these. They were all too stodgy for my taste and nothing like the wonderfully fluffy American kind, which, I was yet to discover. So when each Sunday, my Instagram feed was flooded with beautiful stacks of golden pancakes, I felt nothing but perhaps a little envy of their gorgeous presentations. Then I decided to try it out for myself and everything changed. It was love at first bite. Pancakes are without question the ultimate comfort food and my previous attitude towards them could not have been more misguided.  

Although most people think of pancakes as an unhealthy treat, it’s actually very simple to make them both healthy and vegan. I’ll admit it took some tinkering around with this recipe before I was happy and confident enough to share it with you all but here it is, finally, my basic vegan pancake recipe!

Basic Fluffy Vegan Pancakes with a Caramel Sauce

Serves: 1

1/2 cup buckwheat flour (heaped) (70 g)

1/2 tsp baking powder

1/4 tsp baking soda

1 ripe banana, mashed (80 g)

1 tsp lemon juice or apple cider vinegar

1 chia egg (1 tbsp ground chia seeds mixed with 3 tbsp water), could sub for flax egg

3 tbsp almond milk (you may have to add a couple more tbsp if the batter is too thick!)

1 tsp melted coconut oil

Optional:

Coconut oil for frying 

1 tbsp maca or lucuma powder

1 pinch of vanilla powder

1. Start by preparing your chia egg: Grind one tbsp of whole chia seeds either by hand or in a coffee grinder, then mix the ground seeds with 3 tbsp of water. Stir well and let sit on the side for a few minutes to swell.
2. In a small bowl, mix all the dry ingredients with a fork until the baking powder is evenly divided. 
3. Mash/blitz the banana with the lemon juice (or vinegar) until smooth.
4. Pour in the chia egg, mashed banana, melted coconut oil and almond milk and stir until the batter is completely smooth. Let sit on the countertop for a few minutes (the batter should be THICK)
5. Fry in a spoonful of coconut oil (unless you have a non-stick frying pan) on medium heat for a couple of minutes on each side.

Caramel Sauce

2 tbsp peanut flour (or peanut butter if you don't have any peanut flour)

1 1/2 tbsp almond milk

1/2 tbsp date syrup

1/2 tsp maca powder

1. Mix all ingredients with a fork until you have a smooth, creamy sauce. You may have to adjust the amount of liquid if you use peanut butter instead of flour.

Put slices of banana in between the pancakes and top with the caramel sauce, quinoa pops and mulberries! Hope you like the recipe :)

Pancake-coma-love, Tilda

Instant Pot Electronic Pressure Cooker: Two Years Later

I've had several people tell me that the Whole Health Source post that changed their lives the most was one I published in 2012-- about a pressure cooker.

In 2012, I first reviewed the Instant Pot-- a "pressure cooker for the 21st century" that also doubles as a slow cooker and rice cooker (1).  Since then, we've used it more than 400 times, and it has saved us countless hours of kitchen drudgery.  It's indispensable for my current cooking style, and a major time saver for anyone who leads a busy life but still wants to cook wholesome food at home.  It's extremely satisfying to be able to put your ingredients into the Instant Pot, push a couple of buttons, do something else until it beeps, and then eat a healthy, inexpensive, and delicious meal.

Pressure cookers are one of the most time- and energy-efficient cooking tools, but electronic versions are even more efficient than traditional stovetop pressure cookers.  They're more time-efficient because you don't have to fiddle with them-- for example, adjusting the heat.  They're more energy-efficient because 1) they stop heating when the interior has reached the appropriate pressure, meaning that they're only using energy for part of the cooking process and they hardly vent any energy-wasting steam, and 2) they're insulated well enough that the sides never get hot.

I've used my Instant Pot for a wide variety of cooking tasks, and this is what it does best:

Read more »

Healthy Peanut Satay Dipping Sauce

I love Asian cuisine. Japanese sushi, Indian daal, Chinese dumplings… the list goes on. Although I’ve often ordered home the healthier options, I can never quite get those amazing flavours to really sing in my own kitchen. Or at least until yesterday I couldn’t. That was when this Healthy Peanut Satay Sauce came to life. Lord, am I glad to have succeeded with this one! It still has that yummy taste of peanuts, mixed with the sweetness from the dates (!) and the hot bite from the Thai red curry paste.

Conventional Peanut Satay sauce isn’t too “unhealthy” except for the sugar but my very unconventional version is both sugar-free and (in my opinion) easier to make than the original.

Healthy Peanut Satay Dipping Sauce

Serves: 1

1 tbsp unsweetened almond milk*

1 tbsp peanut flour*

1 tsp tamari (Japanese soy sauce, not as salty as Chinese)

1 peeled and pitted fresh date, soaked for a few hours if it’s really hard to peel

1 tsp Thai red curry paste (a scant tsp if you want it to be less spicy)

How to:

1. In a small bowl or glass, mash the date with a fork and 1 tsp of the almond milk until it’s a smooth “paste” that’s easy to mix with the other ingredients. 
2. Pour in the rest of the ingredients and stir until they’re all evenly mixed in. Have a taste. And another. And another. And another  ;-)

I served it with steamed broccoli, brown rice and soy meat skewers and a few crushed peanuts on top for a little crunch!

*Note: If you want to use coconut milk and/or peanut butter instead, go ahead! I think it’s easier to make this way but we all have different preferences.

Upcoming Talks

I have two talks planned over the next two months.  Hope to see you there!

Ancestral Health Symposium 2014: UC Berkeley, August 7-9

If you want to understand the most rigorous science available on leptin resistance-- a key mechanism of obesity and a major barrier to fat loss-- this talk is for you.  This is my primary area of professional expertise; I have years of firsthand research experience on the subject and I've published a number of related papers in peer-reviewed journals.  The talk will be accessible to nearly all levels of expertise.  AHS14 tickets are available here.  I've pasted the talk's abstract below.

What Causes Leptin Resistance?

Leptin is the primary hormonal regulator of body fatness.  Obese people exhibit a resistance to leptin’s effects in the brain, causing the brain to oppose fat loss by multiple mechanisms.  Research in animal models suggests that leptin resistance may be required for obesity to develop.  How does leptin resistance occur, and what causes it?  Research has not yet provided us with definitive answers, but several plausible possibilities have emerged.  This talk will review what is known about leptin resistance and its causes.

McDougall Advanced Study Weekend: Santa Rosa, CA, September 5-7

Dr. John McDougall invited me to speak at his yearly symposium after viewing my TEDx talk "The American Diet: a Historical Perspective".  I look forward to sharing my thoughts and interacting with a different audience than I'm used to.  The talk will be an expanded version of the one I presented at AHS13.  Tickets are available here.  I've pasted a modified version of my AHS13 abstract below.

Insulin and Obesity: Reconciling Conflicting Evidence

The pancreatic hormone insulin regulates the trafficking and metabolism of carbohydrate and fat, and its secretion is particularly stimulated by carbohydrate and protein.  Since circulating insulin is elevated in common obesity, and insulin influences fatty acid flux into and out of fat tissue, this has raised the possibility that elevated insulin causes common obesity, and that dietary carbohydrate is particularly fattening.  A large amount of evidence appears to support the hypothesis that insulin causes obesity, and a large amount of evidence appears to falsify it.  This presentation will outline a framework capable of reconciling this seemingly conflicting evidence.

Creamy Avocado Pasta Sauce

Avocados. Up until a few weeks ago, I had never in my life eaten a whole avocado. Sure, a few bits and pieces here and there when I couldn’t help it, but never voluntarily. Don’t ask what happened between then and now because today, I honestly can’t imagine a life without avocados. Pair it with some good carbs (yes, carbs are fantabulous), veggies and you have a fool-proof, healthy and most of all d-e-l-i-c-i-o-u-s meal.

Creamy Avocado Pasta Sauce

Serves: 1

 ½ ripe avocado

 1 small handful each of fresh basil and baby spinach

 ¼ - ½ clove garlic

 1 – 2 tsp lemon juice

1/2 tbsp olive oil

 Salt and pepper to taste

How to:

1. Blend all ingredients with a hand blender until smooth and taste to see if it needs more of anything. If so, season until you're happy, blend again and voilà, you’re done!
Best eaten cold with pasta and vegetables of your choice!

Avoc love, Tilda

"Cheezy" Butternut Squash Pasta Sauce

I’m so sorry I haven’t had the time to update the blog but I’ve been a busy bee these past few days. I decided to take a scuba diving course so that I can go diving when we travel and it has really kept me occupied. I’ve loved every single minute (okay, lie, the theory lessons weren’t that much fun) and I can’t wait to go diving for real!

So, to this recipe then. I’ve seen more vegan mac and cheese recipes than I can count and I’ve been dying to try it out for myself, my only problem has been that I haven't known where to find nutritional yeast. If you don’t know what nutritional yeast is, I suggest you google it but I can tell you briefly that it’s a vegan, de-activated kind of yeast that has a slightly nutty and somewhat cheesy flavour. Obviously a great choice when making vegan dishes with “cheese” in them. What’s even better is that more often than not, nutritional yeast is PACKED with B-vitamins, thus also the much coveted vitamin B12. Since vitamin B12 is hard to incorporate in a vegan diet without taking supplements, I see nutritional yeast as a great alternative to pills or shots.

Hope you like this recipe, feel free to play around with the quantities a bit!

"Cheezy" Butternut Squash Pasta Sauce

Yields: 2 servings 

1 clove garlic 

2 tsp coconut oil 

1 cup cubed butternut squash 

½ cup almond milk 

1 ½ tbsp. nutritional yeast 

½ tsp vegetable bouillon powder 

1 tsp Dijon mustard 

½ tbsp. brown rice flour (or thickening of your choice such as arrowroot powder)

How to:

1. Start off by steaming or boiling your squash until it’s soft all the way through, this will take approximately 20-30 minutes depending on how big your chunks are.

2. Meanwhile, sauté 1 finely sliced clove of garlic with coconut oil in a small saucepan on medium heat until the smallest pieces start to brown, then quickly add the almond milk, mustard, bouillon powder, nutritional yeast and lastly the brown rice flour (through a sieve to prevent clumping). 
3. Let simmer for about 10 minutes and make sure to stir continuously as you go.

4. As soon as the butternut squash is cooked, take it off the heat and blend, in either a food processor or using a hand blender (I prefer the hand blender). 
5. Blend the squash purée with the ‘cheeze’ sauce, taste and add a little more bouillon/nutritional yeast if you want. Serve with freshly cooked pasta and veggies on the side!

No-bake Vegan Chocolate Tart

This is one of my absolute favourite recipes; it’s super easy and quick to make and has the most wonderful, rich, chocolate-y taste, the perfect healthy alternative to satisfy those chocolate cravings!

No-bake Vegan Chocolate Tart

‘Crust’

 ½ cup cashew nuts

1/3 cup pitted dates

1 pinch of salt 

¼ tsp pure vanilla extract/powder

Chocolate Filling

1 can full fat coconut milk, chilled overnight in the fridge  
      

4 squares good quality dark chocolate

¼ cup pitted and peeled dates (soaked overnight to make them easier to peel if you’re not using fresh

1 tbsp. cacao powder

How to:
1. Start by blending all of the ingredients for your crust in a food processor until thick dough forms. 
2. Press the dough out in a lined pie dish (a small one, mine’s about 6” wide) and put it in the freezer while you prepare your filling.
3. Open the can of coconut milk and spoon out the thick, creamy layer that has formed on top of the ‘water’ and put it in the food processor along with the dates and cacao powder. Save the leftover coconut water to add in smoothies- it’s packed with beautiful coconut flavour, trust me. You could also save a tablespoon or two of the coconut cream to decorate with.
4. Blend the chocolate filling ingredients until they’re evenly combined- it might look like it has split but we’ll fix this in a moment. 
5. Melt the dark chocolate and pour into the chocolate filling while it’s still hot and blend again until you have a smooth mixture of chocolaty goodness.
6. With a spatula, pour the filling into the pie crust; decorate with coconut cream if you'd like and put it back in the freezer for a few hours (provided you can contain your inner chocolate monster for that long) to set. Eat frozen or let sit on the counter top for a few minutes for a creamier consistency!

Please let me know if you give these a try :)

Chocolate kisses, Tilda