How to Enjoy a Healthier Passover

Every year I hear stories of people who have experienced gastric upset during the holiday of Passover.  In fact, some of the problems encountered by eating too much matzoth include constipation severe stomach pains and even obstructive bowel disorders.  The problem is that matzoth, made from white flour, contains almost no fiber, is dry, and can expand in the intestinal tract when it mixes with fluid causing obstruction and pain.  Here are a few tips to keep you healthy this year.

1. First, try eating whole-wheat matzoth, the Shmura matza we buy for our house is made of whole-wheat and has a higher fiber content.  Consuming more fiber can help prevent constipation.
2. Drink a glass of water before eating matzoth the water will help the matzoth expand in the stomach before reaching the intestinal tract and fill you up faster preventing over eating.
3. If you have the custom of eating foods like matzoth brie and matzoth balls you will find they are easier on the stomach–because they have been allowed to be soaked in water first before being prepared.
4. While eating matzoth is a mitvah on Passover there is no additional blessing if you eat the whole box and make yourself sick.  Instead try eating foods like vegetables, soups and casseroles made from potatoes.
5. Make your Matzoth brie more nutritious by adding vegetables to the preparation—here is how we make matzoth brie in our house to increase fiber content.

2. Pieces of Shmurah Matzoth
3. Eggs beaten

1.     medium chopped onion

½   chopped bell pepper

1      large tomato chopped

2      Tablespoons of cooking oil

Salt and pepper to taste (garlic powder optional)

Soak two round whole-wheat shmurah matzoth (broken in pieces) in warm water for 5 minutes and than transfer to beaten egg mixture.

Sauté onion until golden brown and than add bell peppers after a few minutes add soaked matzoth and  cook until slightly browned add tomatoes and sauté an additional 5 minutes, salt pepper as needed and serve (may add garlic powder as well).  We also like to make matzoth brie with mushrooms, spinach and other vegetables we have in the house.

Have a very healthy and happy Passover!

Surviving Chanukah: How to Keep Your Light Shining Bright During the Holiday Season

During all eight days of Hanukkah these lights are sacred, and we are not permitted to make ordinary use of them except for to look at them in order to express thanks and praise to Your great Name for Your miracles, Your wonders and Your salvation.
-Hanerot Halalu

One of the most common conditions I seem to treat in my office is fatigue. Fatigue and or exhaustion can have many causes, and be expressed with multiple symptoms that include: feeling tired, cranky, and or sleepy, fearful, depressed and listless. If a person is not sleeping properly, or is not getting adequate nutrition, they may begin to feel exhausted and lack energy.

Some of the most common causes of exhaustion I have seen in my office include: Adrenal fatigue, anemia, sleep deprivation and or sleep apnea, anemia, a low grad infection or influenza, chronic disease and depression.

In the case of adrenal exhaustion, or fatigue, a person may have long periods of stress and begin to feel that they are “burning the candle at both ends.” People with this kind of exhaustion should be encouraged to learn relaxation techniques, like breathing exercises and mediation. I also recommend they try a class of herbs called “adatogens.” Adaptogenic herbs like, Rhodiola, Ashwagandha, Holy Basil, and Siberian ginseng. Adaptogenic herbs help heal and tonify exhausted adrenals.

In the case of anemia a person may be “blood deficient,” for a number of reasons that include: poor nutrition and fad diets, internals bleeding (like stomach ulcers and or post partum), malabsorption (such as the body’s ability to absorb nutrients due to conditions like celiac disease), genetic condition (like pernicious anemia) and parasites. When feeling run down and suspecting anemia you should contact your doctor and have a full blood panel done.
In the case of an influenza or bacterial infection people usually will bounce back from exhaustion after a few days. When exhaustion persist with flu-like symptoms (like body aches and fever) it is important to see your doctor as soon as possible to pin point what could actually be wrong.

Sleep apnea (pauses in breathing during sleep) and sleep deprivation can go undetected for years. A person may go to bed and think they are sleeping a full 8 hours but never feel truly rested. The person’s spouse may notice that they often snore, toss and turn excessively at night, or have periods where they cease breathing all together. Sleep disorders and sleep apnea are serious conditions and should be monitored and treated. Left untreated they can pose series health risk. Ask your doctor about a comprehensive sleep study, as this may be the cause of your exhaustion.

Depression can be an incredibly debilitating condition that can make even the most menial task difficult to complete. the causes of depression can be: nutritional depletion, hormonal fluctuations, chemical imbalances, or due to real situations in a person’s life that may seem difficult to handle (like the death of a loved one). While depression can be a natural response to such tragedies, depression that persist unabated for several months should be addressed by seeing a trained professional so that the cause can be found and treated.

If you are feeling tired and exhausted take the time to see your doctor to determine what the cause is. Most of the time, exhaustion can be treated simply, with minimal medical intervention, and need not continue to persist.

You Think What You Eat

Since maintaining a healthy and sound body is among the ways of God — for one cannot understand or have any knowledge of the Creator, if he is ill — therefore, one must avoid that which harms the body and accustom himself to that which is healthful and helps the body become stronger. (Maimonides, Mishneh Torah, Book of Knowledge 4:1).
While there is a saying, “you are what you eat,” many people do not realize that we also think what we eat. The food we consume, the calories we take in, fuel the very thoughts and ideas we have throughout the day.
The brain is an amazing organ—it can take up sugar directly from the blood stream with out the need of insulin. Consequently, too much or too little sugar can have a negative impact on mental function.

While a student in Jerusalem, I once remember another student remarking to me about how giving up sugar and moving towards a whole foods kosher diet, had had a remarkable impact on her ability to retain what she was learning. As she ate better, her brain function improved so dramatically that she was able to remember and retain much larger amounts of information than she had ever had before, and she became a much better student as she cleaned up her diet.

But it is not just sugar dysregulation that can negatively impact the brain. A brain without adequate amounts of the right amino acids can also struggle to function properly.
Amino acids are the building blocks of substances know as neurotransmitters. Neurotransmitters act as messengers in the brain effecting mood and behavior. Persons on extreme diets without adequate amounts of the right proteins, can easily become depressed and suffer from low energy. Furthermore, the brain, without adequate amounts of the right co-factors, cannot make these neurotransmitters (Common co-factors include: B3, B6, B5, B12, and magnesium).
A lack of the right nutrition can have a negative impact on sleep, mood, and even the choices we make on a daily basis. I often hear patients tell me that the worse decisions they have ever made took place when they were either exhausted or profoundly depressed. Finding the right diet, and the right supplementation, can have a profound effect on emotional health. And can change a person’s life in positive ways never before imagined.

New Studies Shows Link Between Youth Violence and Consumption of Soft Drinks

A recent article published in Injury Prevention has shown a link between the sugar and caffeine levels in soft drinks and youth violence.
While not a surprise to nutrition experts, or public health advocates, a possible link has been found between aggressive behavior in children and the consumption of carbonated beverages, and according to David Hemenway, MD, professor of public health, and director of the Injury Control Center at the Harvard School of Public Health, Boston, Massachusetts (who over-saw the research) “This is the first study to suggest such an association.”
The research, which controlled for sex, age, race, body mass index, typical sleep patterns, tobacco use, alcohol use, and having family dinners, found that high consumption of carbonated, non diet soft drinks showed a positive association with an 9% to 15% greater likelihood of engaging in aggressive behaviors. In fact, heavy soft drink use had about the same effect as tobacco and alcohol on violence.

While the exact amount of sugar and caffeine that can lead to aggression in currently not known, and Dr. Hemenway feels additional research needs to be carried out, the data suggest a possible cause-and-effect relationship between high soft drink consumption and aggression.

The research, carried out by Dr. Hemenway and coauthors, found that teenagers who drank more than five 12-ounce cans of carbonated soft drinks each week were more likely to carry a weapon and commit violence against friends, dates, and siblings. The study also found that the relationship appears to be a dose–response relationship, with the strongest relationships shown for teenagers drinking 14 or more cans per week. Of those adolescents, 42.7% carried a gun or knife, 58.6% were violent toward their peers, 26.9% were violent toward dates, and 45.3% perpetrated violence toward other children in their family.
Heavy soft drink use was also associated with, getting insufficient sleep and using alcohol and tobacco within the past 30 days.
Critics of the research, site the fact that data was collected using self reporting and that correlation does not necessarily lead to causation. Poor children often drink more soft drinks, and the study tended to look at a poorer minority populations of children, and children possibly more prone to violence, a population of children soda companies tend to market to.

Yom Kippur: Tips For Enjoying An Easier Fast

Every year we hear about suggestions that are made to help people have an easier fast on Yom Kippur. Many of the suggestions can be quite helpful, and some are not. So this year I have decided to compile a list of, what I hope will be, helpful suggestions based on a Naturopathic medical perspective.

*First off, before beginning your fast: begin to wean off any substances you might be addicted to, such as caffeine, and or foods that are simply not nutritious, (like cookies and candy bars). This list should also include chocolate, coffee, soda pop, black tea, aspartame, sugar, corn syrup and any other substances that you either cannot pronounce (or are convinced was invented in someone’s laboratory or basement experiment). This is because many people suffer from withdrawal headaches, when they give up substances, like caffeine, making fasting a very unpleasant experience.

*A few days before the fast begin drinking plenty of fluids. I have heard people suggest drinking plenty of water (and that is a good idea). But I am more inclined to recommend people drink liquids that contain electrolytes in addition to water. My favorite is coconut water (which has a higher amount of potassium per glass then nearly 3 bananas). If you don’t care for coconut water, you might want to try drinking sports drinks that are high in electrolytes (though I would avoid sports drinks high in sugar or corn syrup), they will give your body the fluid and electrolytes you need in order to avoid dehydration.

*Begin decreasing your salt intake a full day before the start of the fast (the meal before your fast should contain no added salt). Excessive salt can make going without water for 25 hours extremely difficult. Also, avoid eating cured or overly salted meats, like brisket or canned goods like tuna fish, that have added salt (canned tuna that is unsalted is fine), and salty sauces like pasta sauce and gravy.

Many people will mistakenly eat large meat meals, like brisket, before a fast only to be wracked by thirst a few hours afterward. So avoid any meat dishes that are high in salt. In general, I advise people not to eat red meat at all. Red meat requires plenty of water to be digested and eliminated from the body, and even when salt isn’t added to red meat it is easy to become thirsty after eating it. In our house we eat a meal, before the fast, that is either vegan or milk based and avoid eating meat all together.

*Avoid processed foods (these include, microwavable meals and ready to serve meals high in sodium and laden with man made chemicals). Instead, keep your meals simple and flavor them using a little lemon juice or a dash of curry powder for extra flavoring.

*Begin loading up on carbohydrates a few days before your fast. Carbohydrates are stored in the liver and bind to water-keeping you hydrated. They can give you added energy throughout the day. Good choices for complex carbohydrates include whole-wheat pasta, whole grains, and root vegetables like carrots, yams, and sweet potatoes.

*Have a little protein before your fast. This can be in the form of baked or boiled chicken or a vegetarian dish of beans, like humus, or some other bean dish. Beans burn slowly, are versatile, and are high in fiber-keeping you full longer. A simple meal of humus and whole-wheat pita is a great pre-fast meal.

*Avoid overeating before the fast. If you overeat you may become uncomfortable and thirsty early on. Instead, eat until you are satisfied but no more.

*Do not over-exert yourself on Yom Kippur. If you must walk long distances to get to the Synagogue; avoid exposure to direct sunlight by walking on the shady side of the street or think about arriving to synagogue a little early if it is too hot later in the day.

Make sure to rest when you can and pace yourself.

Hopefully, with these simple suggestions, the holiday will be a far more pleasant experience with far less discomfort.

Improving Our Health During the Holidays

The High Holidays are a wonderful time of the year. While each community has its own traditions about how it celebrates the holidays, there are common themes. The rabbis teach us that the High Holidays are a time of rest, reflection, remembrance, repentance and community gathering.

As a doctor, this is also the time of year when I hear from many new patients. Many people see the New Year as a time to reflect back on their lives and become newly committed to improving their relationships and their health.

I often think of the principles of naturopathic medicine as they might apply to the Jewish faith. Like Judaism, naturopathy takes a holistic view of health encompassing the mind, body and spirit.

Naturopathy’s emphasis is on prevention and removal of the obstacles to cure. Naturopathy believes in the ability of an individual to grow, heal and recover from illness, even if the past actions of the individual may have greatly impacted their health.

From a naturopathic standpoint, this is a return to the natural order of things, the innate ability we all have to heal. This ability is inherent in all human beings. We believe, in keeping with Jewish thought, that it is never too late to change. For these reasons, many Jews seek care from alternative health care providers during the High Holidays. This desire to improve their lives and become better people is one of the most inspiring aspects of caring for people I experience as a doctor.

Magnesium For Your Health: Why This May Be The Most Important Supplements You Will Ever Take

One of the most common supplements I prescribe in my practice is Magnesium. While found in a variety of foods, it is often deficient in the average American diet (nearly 32% of Americans do not get adequate Magnesium). Symptoms of Magnesium deficiency include: muscle cramps, irregular heartbeat (arrhythmia), an increased risk for osteoporosis and, insomnia, anxiety, depression.

In fact, anxiety and depression, or a depression that does not readily improve with medication, is one of the first signs of a Magnesium deficiency (this is because Magnesium has a calming effect on the brain). Causes of Magnesium deficiency include: digestive problems of malabsorption and maldigestion or a poor diet that does not supply adequate magnesium.

Usually when I place a person on magnesium they feel markedly better within a few days, sleep better, and report and general feeling of overall health.

There are several forms of Magnesium on the market. I advice people to avoid Magnesium oxide, which is too hard on the stomach, and instead choose Magnesium citrate or Magnesium glycinate either in liquid, powder or capsule.

Currently the company Floradix supplies a kosher Magnesium drink that has a great flavor and seems to be easily digested. I usually advice people, who think they may be deficient in Magnesium, to begin by taking dosages of between 300mg to 750mg a day (as higher doses of Magnesium citrate can cause diarrhea in some people). If you suffer from insomnia, try taking it at night, as it can act as a sleep aid.

Common sources for Magnesium include: nut and seeds (like pumpkin), whole grains and beans, green leafy vegetables (like spinach), and fresh fish. Switching to a whole foods diet rich in plant based nutrients is one of the surest ways to get adequate Magnesium in your diet.

Need a Daily Dose of Omega 3’s In Your Diet? Try Eating Flax Seeds

One of the most important nutrients that we can take for our health, and one of the easiest to become deficient in, is the family of oils called “Omega 3’s.” The family of Omega 3’s include Alpha Linolenic Acid (ALA), Eicosapentaenoic acid (EPA), and Docosahexaenoic acid (DHA). These important oils are found in fish, algae, flax, walnuts and chia seeds.

Flax seeds are high in the Omega 3 oil ALA, and ALA is important because our bodies can make both EPA and DHA from ALA. ALA reduces inflammation in the body, and reduces our risk of blood clots that can lead to stroke and heart attack. Inside our bodies, ALA can also make EPA, this omega 3 reduces inflammation, helps in brain health, and is often recommended by doctors to reduce our risk of heart disease (EPA is also helpful in reducing chronic pain brought on by arthritis). Finally, DHA is most helpful in brain health and brain development, and is made in our bodies from EPA. We recommend women who are pregnant take DHA in order to help the baby’s brain develop normally, and continue on while breast-feeding for additional support. DHA is also found in the eyes and help with eye health.

For anyone who wishes to keep kosher, finding a kosher source of fish oil can be a challenge (fish oil may also be rancid or contain trace amounts of mercury or other toxic metals if it is not sourced properly), so it is advised to take flax seeds instead.

Flax can be ground and added to a smoothie or protein shake in the morning for a quick nutritious breakfast. Or it can be added to yogurt, tossed in a salad or added to any dish. The seeds should be either bought ground or ground at home, once ground they should be storied in the refrigerator sealed for freshness and used within 2 weeks.

Remember, never cook flax seeds, they are best eaten raw. Two large tablespoons of flax-seed not only gives you a healthy dose of ALA, it also gives you 4 grams of fiber. Fiber helps prevent constipation and reduces our risk of polyps hemorrhoids and other digestive problems. Flax has a natural nutty flavor, and is an easy, inexpensive, and important addition to just about every ones diet. Enjoy!

Eating Animals: A book review

The Physician’s Prayer
My God, heal me and I shall be healed,
Let not Thine anger be kindled against me so that I be consumed.
My medicines are of Thee, whether good
Or evil, whether strong or weak.
It is Thou who shalt choose, not I;
Of Thy knowledge is the evil and the fair.
Not upon my power of healing I rely;
Only for Thine healing do I watch.
-Yehudah Ha-Levi

As of late, I have immersed myself, as only an anthropologist can, in the culture of the animal rights movement and the curious world populated by proponents of a vegan lifestyle (a diet that abstains from any food derived from animals including; dairy, eggs, fish and meat). During my studies, I fell upon the book “Eating Animals”, by Jonathan Safran Foer. Foer’s book, which became a national bestseller in 2009, was a glaring expose on the current escalation of factory farming in the United States, along with all of its horrific consequences, from the environmental devastation of factory farming, to the inhuman treatment of animals and the effect that eating large amounts of factory farmed meat on America’s overall health. Among the glaring statistics mentioned by Foer, are the fact that factory farms account for more than 40 percent of the global warming in our country (due to the astronomical amounts of methane gas being produced), loss of natural habitat, contamination of hundreds of lakes and streams, due to the run off from massive amounts of animals manure, pandemics (like Swine flu), and multiple medical problems like heart disease, diabetes, autoimmune disorders, and obesity.

When I hear various different religious authorities talk about how it is a mitzvah to eat meat on Shabbat, I wonder if they are aware of the current state of animal welfare in the United States, and these same authorities have really examined the animal welfare issue and the problems with factory farming. Even an animal that is slaughtered in a kosher manner, is still, ultimately, a factory farmed animal, destined to live its days under extremely horrific conditions before dying a horrific death.

When kosher laws were created, thousands of years ago, animals were slaughtered by the people who raised them. They lived out their lives in a natural setting, free to live on the land and be true to their natures as animals. Today’s factory farmed animal lives under cramped conditions with little to no room to move, often the animals entire life is spent indoors. Instead of a natural diet, the animal is fed feed that creates obese sick animals. Animals are forced to live under the most inhumane conditions before being slaughtered often resulting in sick terrified animals that engage in violent and even cannibalistic behavior. Why proponents of kosher slaughter emphasize that the animal might have died humanely, they fail to take into account the horrific life the animal lived before it was slaughtered. Even animals raised on organic feed or grass-fed often undergo horrific abuse, as Foer points out in his book, almost no truly humanly produced meat is currently available in the United States.

Also Sprinkled within the pages of this exhaustively well-researched book, are stories of Foer’s own childhood, as the grandchild of a holocaust survivor, and the significance that culture plays on our view of food and our food choices. The point being, that food is not just eaten for its taste, but also holds significant emotional meaning for us. Certain foods, such as traditional holiday foods, can be eaten together with others in order to help create community and shared experiences. When we “break bread” with another human being, we are also creating bonds and shared experiences. A person who chooses to change their diet to a vegan diet does more than simply decide not to eat meat s/he chooses to challenge those old bonds and traditions. An example would be deciding to host a vegetarian Thanksgiving, instead of a traditional one with turkey. Perhaps this new Thanksgiving might create new traditions and a new community, but not with perhaps straining old ones.

Perhaps the thing that most influenced me about Safran’s book, peppered with dozens of studies citing the reasons not to eat meat, was his first hand accounts—by slaughterhouse workers—of horrific animal abuse they either witnessed or engaged in on a daily basis. While in some distant and abstract way I understood that animals are slaughtered in order that I eat meat, I had never really taken the time to thoroughly examine what goes into making meat on my plate so inexpensive and available.

The images in this book haunt me, and left me committed to finding a way to make it possible for both myself, and my patients, to choose a vegan lifestyle that was affordable and healthy. This book changed my life, made me re-evaluate the way I live and why I became a doctor in the first place. I became re-dedicated to my work as a health educator and to the firm commitment to contribute to a form of medicine that takes into account not only the health and welfare of the individual, but the planet as a whole. This book comes highly recommended.

Tisha B’ Av: making an appointment with grief

JERUSALEM

Beautiful heights, city of a great King,

From the western coast my desire burns towards thee.

Pity and tenderness burst in me, remembering

Thy former glories, thy temple now broken stones.

I wish I could fly to thee on the wings of an eagle

 And mingle my tears with thy dust.

 -Yehudah Halevi

For many Jews, celebrating Tisha B’Av is both a sad and solemn time of the year.  The Holiday commemorates both the destruction of the First Temple (sometime between 587-422 BCE), as well as the Second Temple in 70 AD, and several other tragedies (such as the Inquisition).

Traditionally, the holiday is spent fasting from sun up to sundown, refraining from listening to music, enjoying any forms of entertainment (such as films or sports) and even refraining from studying the Torah; because to do so would be considered an enjoyable pastime. Instead, the day is spent reading from the Book of Lamentations and Kinot (sad liturgical poems). Some families also read the Book of Job.

For many outsiders these traditions may seem to suggest that Tisha B’Av is a day when one makes an appointment with grief, and they would be right. Therapist, who specialize in grief counseling, explain that grief is a natural response to loss, pain and suffering, and that by allowing ourselves the time to grieve, we can begin the slow process of healing and rebuilding our lives.

In the Jewish tradition, we understand that there are moments in our lives that are filled with great joy and happiness (such as the birth of a child, a wedding, or simply time spent with those we care for deeply).  However, within Jewish tradition there is an understanding that time should also be taken to honor grief.

During times of grief (such as when a mourner is sitting Shiva) it is customary, in Jewish tradition, for friends and family who console the mourner to be mostly silent. Compassion exist without the necessity of words. This is because Jewish tradition understands that true healing can often occur simply when we hold the space for another human being (create a quiet and safe place for healing to take place). By sitting in silence, healing happens naturally and without force. Furthermore, Just as when a mourner grieves, on Tisha B’ Av, we understand that building a strong and supportive community is integral to health and recovery.

May this Tish B’ Av be one where you are surrounded by supportive loved ones, mutual respect, compassion, and understanding, as you move through this day of profound shared grief and mourning.