Archive for the ‘Nutrition for Health and Performance’ Category

Staying Fit on Vacation – Part I

April 11, 2014

In this two-part post, travel expert Kendra Thornton and I will discuss ways to stay fit and healthy while traveling. In this first part, Kendra offers her tips for healthful family vacations:

My family’s health is of utmost importance to me. At home, I regularly pack healthy snacks for the kids to take to school. The entire family exercises regularly, and each of my children is involved in sports. When we go on vacation, our routines are different, but I always make sure that we get healthy nutrition and plenty of exercise wherever our travels take us.

1. Checking In

Hotels today offer several amenities to fit the active, healthy family. I make sure to book hotels with well-equipped fitness centers because this is a great way for me to be able to get a quick workout completed in the mornings before my kids wake up. Some hotels offer other fitness amenities such as running trails or bike rentals. I was able to find one for our upcoming trip to Orlando. With so many hotels in Orlando sites like Gogobot can make the process a little easier. I also always refuse the key to the minibar to help my family avoid the temptations of midnight cravings. To combat high-calorie indulgences at the vending machine, I often stock our hotel fridge with healthy snacks such as fruit, fresh veggies or low-fat yogurt snacks.

2. Playing in the Water

Water sports offer lots of high-energy fun for families on vacation. My kids love boating, and we’ve enjoyed a variety of water-faring vessels as a family. Paddleboats and canoes are great for building muscle and getting an aerobic workout. Water sports such as skiing, surfing and parasailing also burn calories. You can even burn calories sailing or enjoying time on a Wave Runner. For fun without a boat, swimming or splashing in the water can provide plenty of activity.

3. Eating Out

You will eat out when you travel, but you can take steps to make adventures in eating out more nutritious and less caloric. I like to research local restaurants before going on vacation. I find places that serve local produce because I know the cuisine here will be healthier for my family. I also look for restaurants that feature lite-and-fit menu options or vegetarian fare. Mediterranean restaurants almost always have healthy offerings for my family to enjoy.

4. Playing Games

There are many ways to have a good time on vacation. My family tries to focus on staying active. Most popular vacation destinations have a wide variety of venues for getting active. You can play horseshoes, badminton, shuffleboard or catch at a lot of parks. On a vacation by the beach, you can have fun with Nerf items. Running foot races together is another way to work some healthy activity into your vacation. Depending on the age and fitness level of your family members, you might even enjoy a vacation centered around physical activities such as hiking or climbing.

Staying healthy is important for every family. I know my family has more fun on vacation when I take active steps to keep them healthy throughout the trip. We enjoy spending time together away from home, and sticking to a healthy routine helps us more easily return to life as usual when we come back. I hope my tips and tricks have inspired you to have a more healthy vacation with your family this year.

Join us next time for more healthful travel tips.  Until then….

Bon Voyage and Be Well,

Kendra and Carolyn

 

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Sodium: An Essential Mineral that Gets a Bad Rap

June 26, 2013

While we don’t need that much of it (a minimum of a quarter teaspoon, or 500 mg daily), sodium has many vital functions in the body. Excess sodium consumption from processed and fast foods is definitely a problem in the average American diet, but researchers are now questioning sodium’s role in causing high blood pressure. A recent research review found no cardiovascular benefits from dropping below 2,300 mg of sodium per day – the current maximum dietary recommendation.  Furthermore, many older adults who fear high blood pressure avoid sodium to the point where they can become dangerously deficient – leading to muscle cramps, brain fog, lethargy, weakness and even osteoporosis, since sodium helps make bone hard. Many health advocates also point out the high blood pressure more often results from a potassium deficiency than excess sodium, since most adults consume too few fruits and vegetables – one of the best sources of potassium.

One of sodium’s primary functions is regulating the water content of the body. Without sodium, you wouldn’t be able to retain the necessary fluid for all of your cells as your body is made up of 80 percent water. Salt also helps balance blood sugar levels and is vital for the generation of energy in cells. Sodium is also alkalinizing to the body, so it is important in the prevention of excess acidity from the cells in the body. It is also necessary for absorption of food particles through the intestinal tract and in the prevention of muscle cramps. This is especially true for athletes training and competing in hot climates such as the Hawaiian Ironman Triathlon where it is common for triathletes to consume salt tablets during the long, hot race.

I always thought it was strange that many people living in the midwest and the south salt their watermelon. My mother always claimed that it made the melon taste sweeter, but I’m wondering now if it served a need to help their bodies retain the water from the melon in those hot summertime climates. Salt does indeed bring out the flavor in many foods, but as someone who doesn’t crave salt, I often have to remind myself to salt my food when I’m training hard in hot weather, or taking a lot of Bikram Yoga classes as I don’t eat processed foods.

In fact 77 percent of the sodium consume most Americans consume is in processed foods and restauarant meals – not the salt shaker. On the other hand, if you eat a predominately whole foods diet, you may need to use your salt shaker –  as most unprocessed foods in their natural state contain very little sodium. Natural sea salt is a much preferably alternative to refined, processed table salt. It contains many trace minerals which are normally stripped in the table salt processing. One note of caution, however, be sure to buy a brand that contains iodine – as not all of them do.

So the bottom line is sodium is not evil and in fact it has an important role in your health. Too much of it can be harmful, but a moderate consumption, ideally from sea salt and not processed foods, provides a healthful, delicious accent to a nutritious diet.

Be Well,

Carolyn

Can Eating Healthfully Hurt? Oxalate Consumption and Pain

May 28, 2013

A few years ago a client of mine with fibromyalgia asked what I knew about the connection between joint and muscle pain and eating foods high in oxalate. She had read that eating foods high in oxalic acid can trigger fibromyalgia symptoms. She felt discouraged in that she had been making such an effort to eat healthfully to help improve her condition and her overall health. Ironically, many of the nutritious foods she was consuming may have turned out to exacerbate her pain rather than relieve it.

Oxalates are naturally occurring molecules found in some plants. Normally our bodies are able to excrete oxalates in our urine and feces, but if not, oxalate can bind with minerals – especially calcium- and form oxalate crystals, which are sharp, jagged edged objects that can lodge themselves into joints, muscles and mucus membranes and trigger pain and inflammation.

Most people have no problem metabolizing moderate amounts of oxalate in their diet. For those that do accumulate high levels of oxalates in their joints and soft tissue it can be due to:  Hyperoxaluria, a genetic defect which predisposes one to kidney stones; or  the lack of good bacteria in the gut – often resulting from the overuse of antibiotics ); or a vitamin b-6 deficiency; or a deficiency of magnesium  which binds to soluble oxalate and make it insoluble; or a high consumption of oxalate containing foods.Any or all of these causes can result in the accumulation of oxalate crystals in joints and tissues over time and can lead to problems, such as:

  • painful or inflamed joints
  • achy muscles or muscle cramping
  • burning urine or bowel movements, anal itching
  • vulvodynia – external female genital pain or irritation
  • eye irritation
  • kidney stones i.e. oxalates combine with calcium to form these
  • developmental disorders in children, including autism

In researching the answer to my client’s question, I wondered in the back of my mind whether my lingering hamstring and pelvic pain might be due to my own oxalate consumption which had recently escalated.Six months before my fiance moved in with me. We eat a lot of salads and he loves beets (very high in oxalates) so I started including them. In addition, as the weather grew warmer I began a nightly ritual of eating frozen blackberries, raspberries, blueberries and sometimes strawberries (all high oxalate) with my lactose-free milk. Because they’re so naturally sweet and delicious, I would often have two or more cups of mixed berries. Turns out, combining the high-oxalate berries with the calcium-loaded milk further encourages the crystallization of the oxalates. We were also eating more kale since it was becoming so much more available in stores. And while I’ve used turmeric (also high in oxalates) on my cooked veggies and salads for many years, recently I’d been adding more to my diet thinking it would help the joint and muscle pain I was experiencing because it’s an anti-inflammatory without realizing itI  was fueling the fire. Furthermore, overconsumption of oxalates (or the inability to excrete them) is often responsible for delayed healing as oxalates more easily bind to injured tissues. This might explain my lingering pain even after pursuing my usual healing modalities, including massage, aquatic therapy, acupuncture and rest.

As I dug deeper into the subject of oxalates I discovered that those with a leaky gut resulting form celiac disease or Crohn’s Disease, Colitis, or Irritable Bowel Syndrome are more susceptible to oxalate buildup and crystalization. A person with a healthy intestinal tract is able to process oxalate and excrete it in their feces. When someone has a penetrable gut, however, oxalate can “leak” into the bloodstream and travel wrecking havoc throughout the body. I think the fact that I had undiagnosed Celiac Disease for so many years has made me susceptible to this condition. So my problem with oxalates is not necessarily a recent development but one that has progressed over time to the point where my recent increase in oxalate consumption finally overloaded my system.

Figuring out which foods are high in oxalates can be confusing as many of the oxalate food lists on the web offer conflicting information. Oxalate levels can also depend on whether a food is raw or cooked. For example, some vegetables such as broccoli, brussels sprouts and especially kale and collard and mustard greens are lower in oxalate the more they are cooked (i.e. boiled verses steamed). Here’s one of the most comprehensive and reliable sources I’ve found.

CAUTION:  If you suspect oxalates may be triggering your pain, don’t eliminate all oxalate-containing foods from your meals in an effort to decrease pain.  There’s something known as “oxalate dumping” that can occur when a person abruptly ceases consumption of high oxalate foods and consequently their body starts to excrete stored oxalates at a rapid rate. This can cause an increase in symptoms.  Instead, cut back gradually starting with foods containing the highest oxalate levels.

Read below for updates I wrote after publishing this initial post on the subject back in 2013.

Be Well,

Carolyn

UPDATE:  7/11/13  Well it’s been exactly 8 weeks since I lowered my oxalate consumption – primarily by eliminating beets, berries and collard greens from my meals and reducing my kale and celery intake. I’ve also been eating apples mostly without the skin and boiling my broccoli and brussels sprouts instead of steaming them. I turned a corner this past week and my pain is noticeably less. In fact this week I’ve been able to run as far as I want to with no negative repercussions. I also went hiking for a couple of hours with my sister this week and for the first time in awhile I didn’t even notice my body on the hills – I was able to focus completely on our conversation.  My left hamstring and gluteal muscles are still tight but much better than they were when I began the oxalate reduction I’m also experiencing less pelvic pain in general. I’m still a bit uncomfortable driving or sitting in a car for extended periods, but even that’s improving. Like many people, I did experience a brief honeymoon period when I first reduced my oxalate consumption (perhaps too drastically) and then my pain increased for a few weeks, so I must admit that it was difficult sticking with it when I wasn’t sure if it was helping – and seemed to be making me feel worse. So if you’re reading this and you’re experimenting with lowering your oxalates, be patient, have faith and give it time to see what unfolds. I’m glad I hung in there.

UPDATE #2:  9/28/13 It’s been about 6 weeks since my last update and I’m happy to report that my joint and muscle pain have continued to decrease. I did have a bit of a setback with my Haglund’s deformity in my right foot after I stupidly did a toe stand in yoga class – something I hadn’t done in a long time and was excited I could still do, but I paid for it within 36 hours. My pelvic pain is almost gone and I was even able to sit in the car for a 9 hour car ride to Bend, OR twice in 5 days. The only other strange symptom I’ve had recently is some eye irritation after passing some small granules in the inside corners of my eyes. Apparently you can secrete oxalates through the fluid in your eyes. As a result, my left eye has been bloodshot (something that never happens to me – even after swimming without goggles). I’m guessing it is oxalate-related as my body is probably slowing releasing it through various avenues.

UPDATE #3 4/26/14 I can’t believe that it’s been so long since I’ve updated this post. I’m happy to say that it’s been almost a year since I drastically reduced my oxalate consumption (on 5/10/14). Things are much better than they were a year ago. I still get my “oxalate dump” days, but they’re more manageable and they don’t last as once. One product that has helped me tremendously is Magnesium Malate (I take capsules by Source Naturals). When I feel my symptoms coming on, the magnesium malate really helps reduce or eliminate them. I also still get some oxalate deposits in my eyes in the morning, but not as much as I used to. The best part is my pain level has greatly decreased and I’m back to being able to take long runs and bike rides without pain and without having to urinate frequently.

Be Well,

Carolyn

Yet Another Reason to Avoid Simple Carbs – They May Reduce Your Intelligence

September 2, 2012

By now you probably know that it’s smart to avoid simple carbohydrates (“unnaturally-occurring” sugars and refined starches) for disease prevention and weight control. But did you know that avoiding them may actually make you smarter today, while helping you avoid dementia in the future? For what you feed your body – you also feed your brain.

As if we need yet another reason to avoid high fructose corn syrup (HFCS), a study out of UCLA found that a diet high in fructose slows the brain, impairing memory and learning ability. Researchers found, however, that Omega 3 fats may help counteract this decline as was evidenced in groups of rats tasked with navigating a maze over a six-week period. The group that received the essential fats along with the HFCS solution piloted the maze far more swiftly than the fructose only group. The researchers concluded that the omega 3 fats protect against damage to the synapses (or chemical connections between brain cells that are responsible for memory and learning) that can occur with a high fructose consumption.

So if on occasion you do enjoy candy, cake, pie and cookies or white bread and it’s before an exam or other memory/learning challenge, you may want to add some salmon, grass-fed beef, walnuts, flax or chia seeds to your menu. I remember when I was growing up my parents always referred to fish as “brain food” and would often serve salmon before I had an important exam or school assignment. Thanks Mom and Dad!

Another study published in the Journal of Alzheimer’s Disease found that older adults who consumed a diet high in simple carbohydrates had an 89 percent increase in risk of mental decline. In contrast, those that ate the highest percentage of protein and fat were least likely to develop dementia.

This mind-body connection is clear:  what’s NOT good for your body is also NOT good for your brain. So think again when reaching for simple carbohydrates….play it smart and instead opt for complex carbohydrates (vegetables, fruits, legumes and whole grains), lean proteins and plenty of healthy fats – especially omega 3s.

Be Well,

Carolyn

Sugar Sugar Everywhere – Even in Foods that Aren’t Sweet!

June 6, 2012

I recently came across this list of 8 foods with surprisingly hidden, added sugars and it spurred me to touch on this not-so-sweet subject again. Unnaturally occurring sugars are everywhere these days – even in foods that aren’t sweet (such as Campbell’s tomato soup – which contains 12g-or 3 tsp- per serving). Believe it or not, sugar is even being added to some brands table salt (in the form of dextrose to act as a stabilizer) which is the last place you’d expect to find it! It’s come to the point where if you eat anything out of a package, you might as well assume it’s going to contain added sugars.

The number one source of calories in America today is high fructose corn syrup (HFCS)  in sodas and at 40g of sugar per can that’s more than the total daily amount recommended by the American Medical Association for all sugars consumed. In addition to sodas and juices, HFCS is used to sweeten virtually all processed, packaged foods because it’s cheaper than sugar. By the way, HFCS isn’t the only sugar you need to look out for in processed foods. Sugar comes in many different disguises. Check labels for: sucrose, fructose, glucose, dextrose, maltodextrin, rice syrup, dextrose, honey, agave syrup, maltose, galactose and molasses. Some of these sugar sources do contain small amounts of nutrients, but your body still responds to them the same as it does with all sugars you consume. Some sugars are easy to spot, but some aren’t. For example a 6-oz of nonfat fruit yogurt contains 32 gm of sugar – that’s the equivalent of 8 tsps!!!

Fruit naturally contains fructose, but it also is loaded with vitamins, minerals and other phytonutrients and fiber that make it a natural choice to satisfy a sweet tooth. If, however, you are diabetic or pre-diabetic or trying to lose weight, watching your sugar consumption from fruit sources is also important. Avoid fruit juices and don’t juice your fruit – better to eat it whole for greater volume and therefore satisfaction. For the same reason, choose fresh fruit over dried, which is an even more concentrated source of sugar and calories.

Not only does eating sugar and simple carbohydrates (white bread, sugar, pasta, pastries, cookies, and candy) in general raise your blood sugar and therefore trigger your body to release insulin and store any excess calories as fat, it incites your appetite for more. So not only are you not satisfied when you consume sugar and simple carbs, you actually end up eating more calories than your appetite originally called for. Furthermore, calories from simple carbs are relatively nutrient-poor so you’re not getting a lot of nutrition for the calories you’re consuming. Eating a lot of sugar and simple carb can also increase inflammation in the body, which is a major marker for heart disease.

In previous posts I’ve discussed ways to reduce your sugar intake. By far the easiest and most obvious way to consume less sugar is to consume fewer packaged, processed foods and beverages. Then you don’t have to even read labels to find out how much you’re ingesting.

Be Well,

-Carolyn


Exploring the Gut/Brain Connection

December 14, 2011

Have you ever experienced a “gut feeling” or a “gut reaction” or “butterflies in your stomach” when you’re nervous? If so – it wasn’t your imagination, you were likely reacting with your “second brain”, your so-called enteric nervous system. This second brain located in your gut can significantly influence your emotions, mood and behavior. Your second brain even produces serotonin. In fact the majority of the serotonin you produce is in your intestines, with only a small amount produced in your “first brain”. Perhaps it’s no accident then that when we experience psychological stress, many of us suffer physical symptoms – typically either a stomach ache (second brain response) and/or a headache (first brain response?).

Having the right balance of bacteria in your intestines may significantly influence the reactions of your second brain. Consequently, having a healthy balance of gut bacteria is critical for proper brain function, especially when it comes to your emotional well-being. Your first and second brain are connected by your vagus nerve and, according to research published earlier this year, this is the primary pathway your gut uses in communicating with your brain. The researchers concluded that probiotics can have a significant positive impact on your mind and emotions. Conversely, in other research, deficiencies of beneficial intestinal bacteria are being linked to obesity, diabetes, learning disorders, depression and other mood disorders.

On a personal note, I battled depression off and on from my teenage years until my early 30s when I was finally diagnosed with Celiac Disease. Eventually, after eliminating gluten from my diet, my intestines healed and I have not suffered anything more than the occasional situational depression ever since. While I advocate obtaining most nutrients from food rather than supplements, I’m a big believer in probiotic supplements as it’s difficult to obtain enough from food. Not only is the health of your gut bacteria critical to brain function, it is also the seat of your immune system. Probiotics can also help increase your absorption of nutrients from the foods you eat and the supplements you take. Furthermore, f you’ve had your appendix removed, it’s even more important to supplement with probiotics as researchers now believe that the appendix is a storage place for beneficial bacteria. Of course in addition to supplementing with probiotics,  by all means include foods naturally rich in beneficial bacteria (such as cultured yogurt, kefir, sauerkraut, etc) in your daily diet.

Be Well,

Carolyn

Yet More Evidence That it’s Best to Obtain Nutrients from Whole Foods

October 28, 2011

Two new studies recently published suggest it may be risky to rely on supplements for your nutrition. While previous studies have found no benefits from taking vitamin and mineral supplements, a new study found that the use of multivitamins, vitamin B6, folic acid, iron, magnesium, zinc and copper were associated with an increase risk of death among older women (average age 61 years). Calcium supplements, however, were associated with decreased mortality.

It is not too surprising that the correlation of increased mortality  was greatest with iron supplementation as post-menopausal women are advised to avoid multivitamins with iron after they cease menstruating. Because of iron’s oxidative properties, a build up of iron in the body can have multiple negative health consequences, including an increased risk of Alzheimer’s, Parkinson’s, arthritis, heart disease, osteoporosis and cataracts. For this reason, most “senior” multivitamin formulas don’t contain iron.

Another recent study found that Vitamin E supplementation may increase (rather than decrease) the risk of prostate cancer in men. The study actually began in 2001 to examine whether or not Vitamin E supplements decreased the risk of prostate cancer. Their initial findings after the study ended in 2008 suggested that it did not. A follow-up to the study, however, found that men in the study who took daily supplements of 400 international units (IU) of vitamin E (about 18 times the recommended daily dietary allowance of 22.4 IU) were 17 percent more likely to develop prostate cancer over a seven-year period than men who took a placebo pill.

In addition to relying on supplements for nutrition, many people also consume fortified foods, furthering their risk for over-supplementation. Though we cannot conclude from these studies that regular use of nutrition supplements (without severe deficiencies) increases mortality, these studies do suggest that it is not without potential risk. Obtaining nutrients from a diet of whole foods, by comparison, is the best, safest way to ensure that you are meeting all of your nutritional needs. Save your money on supplements (with the possible exception of a good probiotic and an omega 3 supplement if you avoid fish) and spend it instead on high-quality, unprocessed whole foods.

Be Well,

Carolyn

Proteolytic Enzymes: Nature’s Internal Cleaning Crew

August 13, 2011

You’ve probably heard of digestive enzymes and you may even take them with meals to help you digest the foods you eat. But, did you know that if you consume one type of digestive enzyme between meals, they can help break up scar tissue, reduce inflammation and boost your immune system?

Enzymes are catalysts and they initiate thousands of vital processes in your body. In fact, enzymes are responsible for every metabolic function in your body – from respiration, to muscle contraction.  Most of the metabolic enzymes in your body are proteolytic enzymes, which regulate protein functions in the body and which help digest the proteins we eat. Supplementing with these proteolytic enzymes between meals can help your body break down old proteins in your body and in doing so can help heal new and old wounds and reduce inflammation in general.

Proteolytic enzymes can also help boost your immune system as they help your immune system defenders literally “chew up” foreign invaders. Bacteria, viruses, molds and fungi are also protein-based so proteolytic enzymes can also help “digest” these invaders.

The major proteolytic enzymes include: trypsin, chymotrypsin, pancreatin, papain, and bromelain. Your body makes pancreatin, trypsin and chymotrysin, while papain and bromelain are naturally found in green papayas and pineapple respectively. Most digestive enzyme formulas will contain these proteolytic enzymes (though typically at a lower dosage) as well as the enyzmes amylase, which breaks down carbohydrates, and lipase, which breaks down fats.

Research supports the benefits of proteolytic enzymes. Personally, I have found them to be very effective in healing from oral surgery and in reducing the pain, and inflammation of bursitis. The challenge I find in supplementing with proteolytic enzymes is in taking them at the appropriate time. Ideally you want to take them no less than two hours after a meal and no less than 45 minutes before a meal. They tend to make me feel hungry so I find they work best for me if I take them at night. For some unknown reason they also make me a bit sleepy, so that’s another reason I typically take them at night.

Just a note of caution, however. While proteolytic enzymes can help your body heal post-surgery, always speak to your physician about any supplements you are taking before any surgical procedures.

Be Well,

Carolyn

 

When it Comes to Wellness, Sometimes it’s Best to Keep It Simple

July 26, 2011

In an effort to educate people and motivate them to take better care of themselves, the wellness industry generates a constant barrage of health and fitness information – much of which is contradictory and confusing. No wonder so many people throw up their hands when trying to decide what to eat and how and when to exercise!

So let’s just for a moment throw out all of the research and put aside all of the high tech gadgets that track your nutrients, calories and workouts and instead, get back to basics. When it comes to nutrition, the simplest way to improve your eating habits is to eat predominantly whole foods – foods that are unprocessed or unrefined or processed and refined as little as possible before consumption. Ideally, that means eating fewer packaged, processed foods. Unlike vitamin and mineral pills, powders and shakes, whole foods naturally contain nutrients in the ideal ratios proportions for optimal absorption.

If you’re trying to lose weight, rather than following a fancy diet or eliminating any food group, try simply cutting down on your portions. Furthermore, slow down when you’re eating and take smaller bitesClick here for some other simple tips.

If exercising regularly is a challenge for you, forget about target heart rates and perceived exertion levels, just focus on sitting less and moving more. Find a physical activity you enjoy and do more of it. Whether it’s dancing around your living room, playing Marco Polo in the pool with your kids, tending your vegetable garden, walking around a mall and window shopping – it really doesn’t matter. Just get moving!

Be Well,

Carolyn

 

Magnesium May Help Women Avoid Sudden Cardiac Death

July 12, 2011

As I’ve said before, magnesium is might mineral – an unsung nutritional hero. Research published earlier this year further supports this viewpoint by examining the relationship between magnesium intake and women’s risk of sudden cardiac death (SCD). The study included more than 88,000 women, who were followed for 26 years. Researchers found that women with the highest levels of magnesium in their blood had a whopping 41 percent reduction in SCD risk!

It’s important to note that the study looked at dietary intake of magnesium as well as the level of magnesium in the subjects’ blood. The researchers did not give magnesium supplements to the women in the study, so we cannot conclude from these results that taking supplemental magnesium would lower women’s SCD risk. As I always say, it’s best to get most of your nutrients from food –  where they are most bio-available and best absorbed.

A wide variety of nutritious whole foods are good sources of magnesium. Try to include some of the following foods in your meals on a daily basis:

  • Avocados
  • Almonds
  • Leafy green vegetables, such as spinach, kale and collard greens
  • Broccoli
  • Black and white beans
  • Peas
  • Lentils
  • Scallops
  • Sesame seeds
  • Pumpkin seeds
  • Almonds
  • Brazil nuts
  • Whole grains
Be Well,
Carolyn