Spring 2011   

"Support for Your Healthy Lifestyle"

Susan Fekety, RN, MSN, CNM

In this issue:
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This newsletter comes to you after a VERY long dry spell -- and don't think I wasn't aware that your inbox has been empty of my name for many months now. I figured you needed a break! And now it's spring again, and it's too darn dreary and rainy and cold to contemplate a romp in the garden, even to revitalize the compost pile. That's unfortunate! Still, there is an unmistakable feeling of potential at this time of year, which can be intoxicating if you give in to it. Let's nurture that, and see what magic we can create together.

There are quite a few new endeavors in my life that I want you to know about:

Thing one -- I recently wrote an article about natural pre-pregnancy care and fertility support for Natural Solutions magazine. This was my first article in print on a national scale (well, except for in midwifery journals) and I am terribly excited to have had this opportunity. So watch your newsstand -- if you know anyone thinking about getting pregnant, this might be of particular interest to her. Targeted for the June issue but you know how that goes -- might get bumped to later in the summer.

Thing two -- for several years now I have yearned to undertake focused post graduate education in nutrition; as I see more and more how powerful it can be for folks to eat well, this desire has become completely compelling. So I'm thrilled to say that I just was accepted into the program for Board Certification in Clinical Nutrition! Sounds like it will be a lot of work, but the good kind. Hoping to have more to share with you soon!

Best wishes for a juicy delicious warm weather season for you. Remember to be nice to your body!


ps: Archived newsletters and articles are on my Web site; they're quick and easy reads covering a wide variety of topics, and worth checking out if you're curious about something. Also some news and events, upcoming talks and classes -- stay in touch!

*Established True North patients wanting to communicate with me by email please use sfekety@truenorthhealthcenter.org. Thanks!

GROCERY STORE SUPPORT: Are You Ready To Go (Coco)Nuts?

Back when I was actively practicing midwifery, one of my (our) favorite home remedies for newborn eye infections (simple conjunctivitis) was for the mom to put a few drops of fresh breast milk in the affected eye. It was one of those "passed down through the ages" remedies, which makes sense to us now because of our understanding of the natural antibacterial properties of breast milk, part of Mother Nature's extremely elegant grand plan.

Why am I talking about eye infections in an article that looks like it's supposed to be about coconuts? Funny you should ask. The connection involves a family of unique fatty acids which have a special ability to dissolve the fatty cell wall* of (and thus kill) bacteria, viruses, and even some parasites, and which show promise in the treatment of such things as H. pylori, candida (yeast) infections, herpes infections, measles, influenza, and even possibly HIV/AIDS. Guess what? These substances are present naturally ONLY in breast milk and in coconuts. I am not kidding.

Interesting that a tropical food would have this quality, isn't it? The tropics being a place where if you WANTED to acquire a nasty bug you'd have an easy time of it. How handy to have a readily available natural food remedy lying right there in the sand! Coconut oil has been used traditionally in Ayurvedic medicine for thousands of years, and this is likely one of the reasons why.

So, this anti-septic quality is probably part of the reason for the explosion of coconut-based products in the health food store -- heck, now even in the regular supermarket. Coconut products run a fascinating gamut. On my counter I have coconut juice/water, coconut butter, organic coconut oil, coconut seasoning sauce, 2 forms of coconut milk (canned, and packaged like cow's milk in a cardboard carton,) coconut cream, shredded coconut, coconut sugar crystals ("low glycemic!" but still sugar, okay?) -- and there used to be an organic chocolate covered coconut candy bar but I ate it. I've also seen coconut ice cream treats. Wander your local grocery, you are probably seeing all this too. You know how Americans are when something is being promoted as having health effects: we want to eat it, bathe in it -- heck, we'd shoot it IV if that didn't hurt and get messy. (In the 90s I would argue that we did that with soy -- now we are a little more moderate in our consumption of it.) (I hope.)

But coconut products scare people like conventionally trained health providers and some nutritionists -- all that FAT! And it's SATURATED! How can that possibly be okay to eat? For years we've been taught that saturated fat is bad, evil, dangerous, a stealth killer, a biochemical terrorist! Worse than witches! Nutritionists still admonish us not to let these foods pass our lips. And you know what: it's time for everyone to settle down and grow up. The science just does not support that position.

Here's my take. Saturated fats occur naturally in foods and are very biochemically stable
-- very resistant to heat and oxidation. Stable fats will have a long shelf life -- perfect when you want to let your cookies sit in a dusty supermarket storage facility for ages without spoiling. (That's why they used to be used routinely in manufactured food products, until the refined oil industry geared up and switched us all over to hydrogenated fats, and you know how THAT went. Hydrogenation was invented to replicate that stable quality with inherently UNstable (and usually cheap) oils, but ended up creating a toxic fat molecule that your body has no idea what to do with.) (Promise me you've eliminated the "h" foods by now; if not, I beg you to get label-savvy on that pronto and do not let any hydrogenated or partially hydrogenated fats enter your home or cross your lips.) The natural shelf life of coconut oil is a couple years; I suspect that this is because it takes a really long time for the shell of the coconut to decompose and the seed to sprout -- so nature has provided a super-stable source of fat food for the baby coconut palm.

Just as we once had to swallow the bitter pill that the world is not flat, it's time to cop to the fact that all saturated fats are not "bad" and in fact, that all saturated fats are not the same. In fact, it's starting to look like a sizeable chunk of the 60s-era research vilifying saturated fats was done using fats that were saturated via hydrogenation (oops) or within research studies that were lacking in the good-design-for-drawing-conclusions- from category. As you can imagine, this is controversial -- and candidly, I have to tell you that digging through reams of literature about lipid metabolism is rather a yawn.

Still, you need to know that coconut saturated fats (plant-based saturated fats) have a different molecular structure than animal saturated fats do, and as a result, they operate entirely differently in your body. I like you, so I won't bore you with the molecular stuff (call me if you want to hear about that anyway) (no wait, actually, please don't) but in a nutshell, the saturated fats in coconut products are "medium chain fatty acids" and are processed more easily than the "long chain fatty acids" found in, say, that hunk of prime beef dripping beurre blanc. (I am still working on deciding about how I really feel about animal saturated fats -- I suspect the issue with them is not are they good or bad, but what are you eating them WITH. More on that later. )

There is a groundswell of interest in medium chain fatty acids like coconut fats because they appear to have a favorable effect on body composition and may help people lose weight. The coconut people are going to great lengths (hiring our friend Jillian Michaels for their coconut milk ads) to share some provocative research findings suggesting that medium chain fatty acids actually stimulate fat burning and raise one's metabolic rate. More water soluble than longer fatty acids, medium chain fatty acids are digested directly through the liver and are converted to usable energy more quickly than are other fats. (I've read claims that these fatty acids also stimulate the thyroid gland but have not been able to locate original research about that.)

So here we go gobbling up medium chain fatty acids to obtain easy passive weight loss. Can it possibly be that easy? I suspect not, even though I am an open-minded sort of woman in general. Fat's fat, and a high-calorie per gram food compared to carbohydrates and protein. If you eat too much of it (pretty easy to do) you'll risk having an "energy excess" -- just too much food for your body, and guess where that ends up. Calories aren't everything when it comes to body size and weight -- but they're not nothing, so you do want to be mindful.

Still, coconut offers a nice fat with distinct advantages over refined oils. Since it's saturated, it tolerates higher temperatures than many other things you might cook with. I'd recommend getting a nice jar of organic coconut oil (for starters) and trying it for high-heat sauteing where you might otherwise use butter or another more fragile oil. I have not found that there is a coconut taste to good quality coconut oil, so it won't spoil your flavors. (You might want to get two jars and keep one in the bathroom. Coconut oil makes an absolutely fabulous skin emollient -- slather that on after your shower and tell me you don't feel delicious, I dare you.)

I also like coconut foods for people with various allergies or food intolerances. You can make a terrific creamy milky soup or sauce using coconut milk in place of mammal milk if you are sensitive to dairy foods and/or nut milks. Even the reduced fat ("lite" -- how I hate that word) coconut milk is uber creamy, and does not taste coconutty. Ditto coconut oil or butter -- luscious on toast (though most of us are not eating a lot of toast anymore . . . ) Coconut seasoning sauce (kind of like a lower-sodium version of soy sauce) is tasty and if you are sensitive to soy can be a useful addition to a stir fry. I have yet to meet a person allergic to coconuts -- not that it's not possible, just of low likelihood.

Coconut juice/coconut water has become a popular post-workout sports rehydration drink -- it's full of potassium and has a little carbohydrate for energy (and it tastes good!) -- my only concern here is that it is missing the sodium that also needs to get replaced after a big sweaty workout, so you might want to pop down some salted nuts or something as well. I'd avoid the coconut drinks that have a lot of sugar added -- check the label before you commit.

Speaking of sugar . . . just in case you were thinking coconut --> Mounds Bars and macaroons: you do want to avoid the sweetened, dusted-with-chemicals (propylene glycol!) bagged shredded coconut you probably grew up with. You can get fresh unprocessed grated coconut -- Bob's Red Mill is good, and our local Whole Foods market offers a house brand that's inexpensive and tastes good.

Finally, personally -- I just wish fresh coconuts weren't so difficult to get into. I mean, physically. I don't keep a machete in my kitchen (nor do I want to) -- and the darn things are just utterly refractory! I remember as a kid some challenging attempts at coconut-opening involving large knives, hammers, and my grandfather's awl -- with the coconut skedaddling across the counter if we hit it wrong, or juice water leaking everywhere, or practically breaking your fingers trying to pull the thing open once you'd punctured and cracked it. When I've mastered this, I'll let you know. Till then, I must continue to depend on the kindness of strangers.

*You do know that the walls of most of the cells in your body are made out of fat, don't you? Especially the cells in your brain? And that this is one major reason why you don't want to be fat-phobic like back in the dark ages of nutritional biochemistry?

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ENTERTAINMENT: What's Your Nutritional APGAR Score?

In the birthing business there is a convention called the Apgar score that pretty much everyone uses to describe a newborn's "transition to extrauterine life." Named for Virginia Apgar, the anesthesiologist who invented it, it's a 5-item scale where you evaluate a baby at one and five minutes and depending on their score, you may need to do things like rub the baby, give a little oxygen, or in an extreme case (i.e., a very low score) actually start resuscitation.

Apgar invented the score in the 1950s, when women were given heavy drugs and anesthetics in labor; babies were typically born rather, um, drugged and anesthetized, and it was usually the anesthesiologist's job to get them breathing and pink. (If you think this is archaic and bizarre, I couldn't agree with you more.) It was useful, though, for providing a common language for birth attendant staff who might have otherwise gotten into arguments about what to do.

The Apgar score became such an essential part of the birth culture that it was retained even when the drug situation changed. Now even for non-medicated labors, babies get 0, 1, or 2 points for their Appearance, Pulse, Grimace, Activity, and Reflexes. Of course it's set up so that the higher the score the better. This is an area of some competition for obstetrical staff, to have a track record of high-Apgar babies. (Some experts assert that no baby can get a "10" at one minute, but I suspect that these folks had to endure an over-critical upbringing or suffered some other sort of psycho-emotional trauma that made them sour and hypercritical.)

Back when I was at Baylor, my brilliant colleague Lisa Summers developed a variant on the Apgar score she called the "Cosmic Birth Score." This was in the 1980s when cosmic-ness was all the rage. As I recall, the Cosmic Birth Score evaluated characteristics like Mother's Attire at Delivery (hospital gown, 0 points; her own nightie, 1 point; moonbeams, 2 points), and Crying at the Birth (baby cries, 0 points; mother cries, 1 point; midwife cries, 2 points), Nutrition in Labor (IV D5W, 0 points; jello and chicken broth, 1 point; oatmeal chocolate chip cookies fresh out of the oven, 2 points), and so on. We thought it was hysterical -- it was one of those pieces of creative genius that can only be inspired by too many hours in the on-call room.

Anyway -- I recently found myself thinking about how so many folks I work with are striving to make Better Food Choices, and how sometimes we just have to leave the Ideal Food Choices for later. (I am all over Better Choices, and will give credit for them even if you don't.) Pile up a bunch of Better Choices and you will eventually get where you're going, I promise.

You will not be surprised to learn that this line of thought eventually resulted in the development of my Nutritional Apgar Score, which I am tickled to share with you here. Do your food choices need a bit of resuscitation? (This tool is absolutely not for professional or other serious use.) I just hope you get a kick out of it!

2 points   1 point   0 points

Locally made artisanal goat cheese with herbs

  Low fat Alpine Lace Swiss cheese slices   Kraft singles

Organic turkey burgers

  Natural ground beef patties   Frozen beef patties from Sam's Club

Green and Black organic 70% cocoa content chocolate

  Dove dark chocolate squares   Hershey's Kisses
Sweet potatoes roasted in olive oil, sea salt, and a pinch of cayenne   Sweet potatoes mashed with maple syrup and butter   Mashed potatoes with margarine and bacon bits
Raw almonds   Peanuts roasted in sea salt   Beer nuts
Homemade tomato salsa   Organic ketchup   Purple ketchup
Homemade apple butter on whole-grain toast   All-fruit no sugar added jelly on an English muffin   Marshmallow fluff on a chocolate bagel
Fresh vegetable spring rolls with peanut sauce   Fried egg rolls with duck sauce and mustard   Frozen cocktail mini-eggrolls

13-16 points Foodie
9-12 points Let's have lunch!
0-8 points We need to talk

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GREAT BOOKS: The Best Non-Trashy Trash Novel Ever

Chris Northrup turned me on to this book ages ago and I count it among the many beneficences she has provided to me over the years. Diana Gabaldon's novel Outlander is my favorite recreational reading suggestion for women who need a portable escape from an over-busy life. Not only is it a ripping good, beautifully written yarn, I'd say that Outlander contains the best literary sex I've ever encountered. (Gentlemen, with all regrets, this is pretty much a chick book, I think -- though you might be interested to learn something more about what turns many of us on.)

Gabaldon is one of the smartest (a PhD in biology, for Pete's sake!) and juiciest fiction writers around. You might recoil at the premise (20th century woman explores Scottish standing stones and gets whisked away to the 18th century where she meets a dashing fellow with whom she Falls in Love and Has Adventures involving time-travel) but really, I haven't met a person yet who started it and didn't find their laundry piling up neglected. Take it on vacation or to the beach; probably don't want to take it to work if you want to get anything else done. If you like it there are several more in the series, though I must say that Outlander stands alone and is by far the best of the lot. And just to be clear, it's not total trash -- along the way, you'll learn some actual history, like who was Bonnie Prince Charlie anyway. Look -- I'll make it easy for you to get your own copy at Amazon!

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Five Years Of Better Living

In September 2010, we celebrated the five-year anniversary of True North's FirstLine Therapy® program. In case you haven't heard of it, I like to describe FirstLine Therapy® as a 12-week "lifestyle tune-up solution" that combines a custom nutrition prescription with support for pleasurable movement and emotional relaxation. Those three elements are the foundations for good health -- and who doesn't want more of that? I LOVE coordinating this program.

I have to tell you -- I am so excited to reflect upon five years of experiencing the really remarkable changes ordinary people have made in their health and happiness by being nice to their bodies with this powerful Functional Medicine approach. Hundreds of people! Feeling strong and confident and aware that they have cut their risk for chronic diseases, kicked up their energy, and reversed some fairly toxic habits. Men and women both, from their teens to their wisdom years. This totally floats my boat!

A particularly gratifying aspect, for me, is the way people who have started the program look so good and feel so good that their friends and families want a piece of the action. "What are you doing? Can I get a slice of that too?" I have one lovely family where three generations of women (yes, with an age range from the 30s to the 80s!) and a dad are thriving on FirstLine -- proving that it is NEVER TOO LATE.

If you've heard about the program and are thinking that maybe YOU might want some of that for yourself, please don't be shy! If you're curious about why it's different from every OTHER "diet" you've been on (it's not a "diet, for starters), or how you get started (just call, anytime, to get rolling), or what is that weird test anyway (electronic BioImpedance Analysis, or BIA, is a sophisticated, painless test of your lean body mass, fat mass, fluid status, and calorie demand that lets us watch your body get healthier over time) I would love an opportunity to share what I know.

Spring is a wonderful time to start your own makeover -- especially one that will involve consuming and enjoying a lot of fresh produce. Give a call and let's set a time to talk about whether it might be right for you -- that would be for free, on the phone or in person, at your convenience.

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New Test Available -- Maybe Right For You?

One of the things I strive to provide in my practice is INFORMATION. Whether in the form of a little mini-seminar about how your hormones work, or what happens when you eat an apple, or a handout article relating to this or that thing we've discussed, the way I see things, my job is to give you the tools you need to make robust personal choices.

To that end, let me tell you about a novel test that is becoming quite popular among Functional Medicine practitioners and which you might want to consider. It's called "Perspective™" and it's run by Genova Diagnostics, which I would identify as the best Functional Medicine laboratory in the United States. Perspective™ is a sort of general functional biological survey, and includes some important elements you can take action on for better health. It would be great to do in conjunction with your annual (or whenever) physical, just like you now probably do cholesterol screens and such. All you need to do is endure the inconvenience of providing us with a fasting blood sample and some spit. Costs around $200 (depending on your insurance situation, which our staff can explore with you.)

Perspective™ tells us about how your adrenal hormone system is responding to whatever stresses you have in your life (falling in love, sick parent, psychotic boss, crazy food habits, etc.); tests you for a range of common food sensitivities (dairy food, corn, eggs, gluten, peanuts, shellfish, soy, wheat, yeast); looks at your blood sugar metabolism (fasting blood sugar and insulin) and inflammation (high sensitivity CRP, which you know about if you've heard my talk on Eating to Beat Inflammation); and measures your antioxidant status (aka, whether you have a fruit and vegetable deficiency!) How cool is THAT?

This would be something for us to discuss if you are interested in a general wellness survey or are just not feeling up to snuff lately and wondering why. I might recommend combining Perspective with some other tests (for instance, a Vitamin D level, tests of hormones and metabolism, and/or an expanded glucose tolerance test if you really do seem to have risk factors for diabetes/pre-diabetes) -- but even without those this is a really good broad evaluation of some stuff you might not look at other wise, for a really good price.

Functional Medicine tests can give us really good information -- but they've historically been cost-prohibitive for many people, especially if you do a bunch of them. This is different, and I'm rather jazzed about it. If you have questions feel free to contact me for more information and we'll get you set up.

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Spiced Coconut Spinach
(Adapted from Heidi Swanson's 101 Cookbooks . . . Thanks, Sharon V., for turning me on to this wonderful resource!)

Serves 2-3, says the recipe, but I could eat it all by myself.

1 shallot
1 large clove of garlic
1/4 teaspoon sea salt
1 tablespoon coconut oil
1/4 teaspoon yellow mustard seeds
1/4 teaspoon whole cumin seeds
1/4 teaspoon red pepper flakes
7 oz / 200g spinach, well washed, and chopped
Squeeze of lemon
1-1/2 tablespoons unsweetened coconut, lightly toasted

Place the shallot and garlic on a cutting board, sprinkle with the salt, and chop/mash everything into a paste.

Heat the oil in your largest skillet over medium heat. Add the seeds, cover with a lid, and let them toast a bit. Remove the lid, stir in the red pepper flakes and let cook for a minute. Stir in the garlic-shallot paste and all of the spinach. Keep stirring until the spinach starts collapsing a bit, and brightens up - barely any time at all - perhaps a minute. Finish with a bit of fresh lemon juice and sprinkle with the coconut.

Download and print this recipe.

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"I make my own rules."

Download and print an 8-1/2" x 11" PDF of this affirmation.

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Be well and happy -- and stay in touch!
To your best health --


© Copyright 2011 by Susan Fekety. All rights reserved.
202 US Route 1, Falmouth, Maine 04105 | (207) 781-4488
susan@susanfekety.com | www.susanfekety.com