Many diseases and conditions can cause bone loss and osteoporosis. If you have any of the following conditions, ask your healthcare provider if you should improve your diet and lifestyle habits and/or have a bone density test:

  • Ankylosing spondylitis
  • Blood and bone marrow disorders
  • Breast cancer
  • Chronic obstructive pulmonary disease (COPD), including emphysema
  • Cushing’s syndrome
  • Depression
  • Diabetes
  • Eating disorders, especially anorexia nervosa
  • Female athlete triad (includes loss of menstrual periods, an eating disorder, and excessive exercise)
  • Gastrectomy
  • Gastrointestinal bypass procedures
  • Hyperparathyroidism
  • Hyperthyroidism
  • Inflammatory bowel disease, including Crohn’s and ulcerative colitis
  • Kidney disease that is chronic and long lasting
  • Liver disease that is severe, including biliary cirrhosis
  • Lupus
  • Lymphoma and leukemia
  • Malabsorption syndromes, including celiac disease
  • Multiple myeloma
  • Multiple sclerosis
  • Organ transplants
  • Parkinson’s disease
  • Polio and post-polio syndrome
  • Poor diet, including malnutrition
  • Premature menopause
  • Prostate cancer
  • Rheumatoid arthritis
  • Scoliosis
  • Spinal cord injuries
  • Stroke
  • Thalassemia
  • Thyrotoxicosis
  • Weight loss

Note: This list may not include all diseases and conditions that may cause bone loss.

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Medicines Which May Cause Bone Loss

by Diane, M.P.H, M.S.

Some medicines can harm your bones, especially when taken in high doses or for a long time. One commonly used medicine posing a risk for bones includes steroid medicine taken to reduce inflammation in conditions like rheumatoid arthritis or asthma and for other reasons.

Ask your healthcare provider about the risks and benefits of any medicines you take and how they may affect your bones. Do not stop any treatment or change the dose of your medicines unless your healthcare provider says it’s safe to do so. If you require a medicine that causes bone loss, ask your healthcare provider for the lowest possible dose to control your symptoms.

Medicines which may cause bone loss include:

  • Aluminum-containing antacids
  • Antiseizure medicines such as Dilantin® or Phenobarbital
  • Aromatase inhibitors such as Arimidex®, Aromasin® and Femara®
  • Cancer chemotherapeutic drugs
  • Cyclosporine A and FK506 (Tacrolimus)
  • Gonadotropin-releasing hormone (GnRH) such as Lupron® and Zoladex®
  • Heparin
  • Lithium
  • Medroxyprogesterone acetate for contraception (Depo-Provera®)
  • Methotrexate
  • Proton pump inhibitors (PPIs) such as Nexium®, Prevacid® and Prilosec®
  • Selective serotonin reuptake inhibitors (SSRIs) such as Lexapro®, Prozac® and Zoloft®
  • Steroids (glucocorticoids) such as cortisone and prednisone
  • Tamoxifen® (premenopausal use)
  • Thiazolidinediones such as Actos® and Avandia®
  • Thyroid hormones in excess

Note: This list may not include all medicines that may cause bone loss.

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Roasted Onions With Garlic

by Diane, M.P.H, M.S.

For thousands of years garlic and onions have had a healing reputation. Twenty-two garlic-based remedies have actually been found in ancient Egyptian papyrus! Both vegetables belong to the Allium family and are rich in sulfur-containing compounds that are responsible for their pungent odors, as well as, many of their health-promoting effects.

Bulb or allium vegetables include elephant garlic, garlic, onions, leeks, chives, shallots, scallions (spring onions), and water chestnuts. These aromatic, low-calorie (40 calories per 100 grams) and low-fat vegetables contain water-soluble nutrients, such as vitamin C and vitamin B-complex, which contribute to healthy vision, central nervous system, and skin. Allium vegetables also support a normal appetite, the formation of red blood cells, and are an important part of a healthy diet which reduces the risk of conditions like heart disease, cataracts, high blood pressure, intestinal disorders, stomach and colon cancer, and type 2 diabetes.

Research has shown that garlic and onions:
  1. Provide vitamins B6, C, chromium, and selenium
  2. Reduce the carcinogenic effects of nitrosamines and N-nitroso compounds created during tobacco combustion and when meat is over-grilled
  3. Reduce the risk of cancer, especially of the kidney, prostate, and stomach
  4. Thin the blood and improve circulation
  5. Help regulate blood sugar levels which, in turn, reduces insulin secretion and insulin-like growth factor (IGF), and thus the growth of cancer cells
  6. Lower blood pressure
  7. Lower cholesterol (Garlic has been shown to lower cholesterol and triglycerides, while it increases high density lipoprotein [HDL] levels.)
  8. Lower the risk of atherosclerosis, heart disease, and stroke
  9. Decrease the tendency for blood to clot after a fatty meal
  10. Facilitate detoxification
  11. Act as powerful antioxidants
  12. Stimulate immune responses
  13. Fight infections due to their anti-bacterial and anti-fungal properties
  14. Reduce inflammation
Garlic and onions contain phyto-chemical compounds allium and allyl disulphide which are converted into allicin by enzymatic reaction when the bulb is disturbed through crushing or cutting. Studies have found that these compounds have anti-mutagenic (protect you from cancers) and anti-diabetic (help to lower blood sugar levels in diabetics) properties.
Allicin, the compound that gives garlic and onions their strong odor, is an antibiotic which may exceed penicillin and tetracycline in potency. It apparently reduces the risk of infectious agents responsible for tuberculosis, botulism, colds, flu, stomach viruses, and yeast infections.
Diallyl sulfide, another compound in garlic and onions, has been found to inactivate potential cancer-causing substances and prevent tumor growth.


Allium vegetables are not cures or treatments for health problems. If you are deficient in a specific vitamin or mineral, talk with your doctor about how to improve your lifestyle, diet, and whether or not you require vitamin/mineral supplementation.

Note that vegetables often lose some nutrients when boiled or canned. Organic vegetables may provide the most nutritional value, since herbicides, pesticides, and other chemicals used during growth of conventional produce can reduce nutrient bioavalability.


Roasted Onions With Garlic
  • 4-6 large Vidalia onions
  • 6 tablespoons extra-virgin olive oil
  • 4 tablespoons garlic, chopped
  • 1 teaspoon salt, or to taste (optional)
  • 1 teaspoon freshly ground black pepper, or to taste
  • 1 cup or more fresh basil or mint
  • 1/2 cup balsamic vinegar


  • Preheat oven to 350 degrees F.
  • Remove onion skins and trim ends. Cut onions in half from stem to root end. In a medium-sized bowl, stir together olive oil, garlic, salt, pepper, and basil, or mint. With your hands, coat onions with the mixture and place them in an onion roaster or baking dish. Bake for 30 minutes. Baste with the dish juices and continue roasting for another 15 minutes, or until the onions are soft when pierced with a knife. Remove from oven, drizzle generously with balsamic vinegar, and arrange on platter.

Servings: 8

Roasted Onions


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Osteoporosis (porous bone) is a condition in which bones become weak and can break easily from a minor fall, or in serious cases, from something as simple as a sneeze or bumping into furniture. The increased susceptibility to fracture is a result of structural deterioration and loss of bone mass, especially in regions of the hip, spine, and wrist. However, the condition can affect any bone in the body. While often diagnosed in older individuals, osteoporosis can develop at any age. Approximately 44 million Americans (55% of people 50 years of age and older) are at risk for this public health problem. Estimates indicate that 10 million individuals already have osteoporosis, and 34 million more have low bone density which increases their risk for future osteoporosis and broken bones.

Although diet alone will not cure osteoporosis, it can help halt progression of the disease. If you suffer from osteoporosis, talk with your doctor about a diet that provides enough minerals and vitamins for your health needs. Calcium, phosphorus, magnesium, fluoride, and vitamin D are  needed to form and stabilize the structure of bone. Deficiency of these nutrients may cause bones to weaken over time, whereas adequate levels may help prevent further bone damage.

In addition to increasing your intake of foods rich in calcium, phosphorus, magnesium, fluoride, and vitamin D, try to eliminate factors that contribute to and worsen osteoporosis (risk factors), such as alcohol, caffeine, salt (sodium), and soda consumption. A soy-rich diet may benefit some people with osteoporosis.

Engage in weight-bearing physical activity each day, such as walking, running, dancing, and weight training. This promotes the deposition of dietary minerals into your bones. Furthermore, when muscles work, they pull on the bones, enabling both your muscles and bones to grow stronger.

Before you begin any new diet or exercise program, talk with your doctor about your current medical history.

Factors which increase the risk of bone loss and subsequent osteoporosis:

  • Age older than 65
  • Female gender
  • Caucasian, Asian, or Hispanic heritage
  • Being small and thin (having low weight for height)
  • Missing periods (amenorrhea)
  • History of fracture or broken bones
  • Family history of osteoporosis or fracture
  • Cigarette smoking
  • Use of certain medicines like oral glucocorticoids and some anticonvulsants
  • Previous use of corticosteroids
  • Excessive intake of protein, sodium, and/or caffeine
  • Alcohol consumption in excess
  • Consumption of sweetened or artificially sweetened soda and drinks containing phosphoric acid: These also promote dental cavities, diabetes, and obesity.
  • Rheumatoid arthritis
  • Vitamin D deficiency
  • Poor nutrition, especially insufficient intake of calcium, phosphorus, magnesium, fluoride, and vitamin D
  • Anorexia nervosa
  • Thyroid or parathyroid hyperfunction
  • Celiac disease
  • Inactive lifestyle or prolonged bed rest
  • Estrogen deficiency in women (amenorrhea or menopause, especially early or surgically induced); testosterone deficiency in men



  1. DeBruyne, Linda Kelly; Pinna, Kathryn; Whitney, Ellie. Nutrition and Diet Therapy. Thomson Wadsworth: California. 2008: pp. 248-250.
  2. “Diet Cure for Osteoporosis.” (Source:  5367876  diet-cure-osteoporosis.html#ixzz1nALKUVGg)
  3. “How the Foods You Eat Affect Your Bones.” National Osteoporosis Foundation: 1150 17th Street, NW Suite 850 Washington, DC 20036. Copyright © 2011 All Rights Reserved. (Source:
  4. National Institutes of Health (NIH) National Resource Center: Information about the prevention, early detection, and treatment of osteoporosis and related bone diseases. 2005.


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The United States Preventive Services Task Force, a panel of independent experts in prevention and primary care appointed by the federal Department of Health and Human Services, issued a draft statement on June 12, 2012 recommending that healthy, postmenopausal women should not take low doses of calcium or vitamin D supplements to prevent fractures. The task force also stated that there is no evidence for healthy premenopausal women and men to take vitamin D with or without calcium to prevent fractures.

The panel based it’s recommendations on 137 studies which analyzed the effects of supplements, including randomized controlled trials, the gold standard for clinical evidence. The low doses studied were a typical daily level of 1,000 international units or less of vitamin D and 400 milligrams or less of calcium.

According to Dr. Kirsten Bibbins-Domingo, an associate professor of medicine at the University of California in San Francisco and a member of the task force, “It is clear that lower doses of calcium and vitamin D do not prevent fractures, and there is a small but measurable risk of kidney stones.” Dr. Bibbins-Domingo advises that ‘with no evidence of benefit, why risk harm?’

Taking calcium and vitamin D is not enough to treat or prevent fractures or osteoporosis, according to Dr. Ethel Siris, Director of Columbia University’s osteoporosis center.

While the panel’s recommendation did not apply to people with osteoporosis, it concluded that for most people sufficient doses of vitamin D and calcium can be obtained from a healthy diet.



  1. Internet Citation: U.S. Preventive Services Task Force. Vitamin D and Calcium Supplementation to Prevent Cancer and Osteoporotic Fractures in Adults: Draft Recommendation Statement. AHRQ Publication No. 12-05163-EF-2. Current as of June 2012. (Source:

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Skin is the largest organ in the body. It protects us against bacteria, viruses, environmental contaminants, and injury. Smooth, healthy skin reflects a carefully-tended body whose owner provides it with nutrients and fluids to sustain it, exercise to stimulate it, and enough rest to restore it’s cells.

Although the skincare industry focuses on what we put on our skin, it’s really lifestyle habits and what we put in our bodies that affect our skin most. Sometimes common sense and a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, rather than expensive lotions, is best for developing glowing, healthy skin:
  1. Drink plenty of water: To keep your skin supple and smooth, promote better circulation of nourishing blood to all organs, and flush excess sodium and toxins from the body (6-8 glasses daily, or as much as you need to feel and look good and prevent dehydration).
  2. Exercise frequently: Walk, swim, dance, ride a bicycle, work out in a gym or garden, etc., as often as possible.
  3. Get plenty of rest: To restore and repair your body’s cells and tissues.
  4. Avoid smoking: Smoking exposes skin to toxins which accelerate skin’s aging. It also increases the risk of most health problems, since it causes inflammation of the lining of blood vessels (intima), thus increasing the risk of atherosclerosis (hardening of the arteries), vascular damage throughout the body, respiratory disease, and a weakened immune system. Such a habit will only hasten the deterioration of all organs, including your skin.
  5. Limit excessive sun exposure: Wear a broad-brimmed hat, sun-protective, or darker, natural fabrics, long pants and sleeves, and sunglasses with UVA/UVB protection, when you must be out in the sun for extended periods of time.
  6. Avoid tanning salons.
  7. Fresh fruits and vegetables: These provide vitamin C, vitamin A, folate, magnesium, potassium, fiber, water, and many antioxidants which reduce free radicals (molecules with an uneven number of electrons that cause damage to cell membranes, lipids, proteins, and DNA), promote the healing of damaged tissues, help to modulate the skin’s oil production, and reduce the risk of skin-wrinkling in sun-exposed areas. Vitamin C is naturally anti-inflammatory, important for collagen production, and offers protection against sun damage. Carotenoids, the plant-based sources of vitamin A, are antioxidants that also protect skin from sun damage. Many fruits and vegetables naturally contain much water, including citrus fruits, melons, apples, berries, papaya, peaches, pomegranate, cucumbers, green leafy vegetables like bok choy, kale, spinach, squash, sweet potatoes, swiss chard, peppers of all colors, tomatoes, etc. Research shows that vitamin A-rich foods (Apricots, cantaloupe, carrots, squash, sweet potatoes) may improve psoriasis, since Retin-A, which is derived from vitamin A, and other vitamin A drugs have successfully treated it. Eating vitamin A-rich foods is safer than taking supplements. The body generally absorbs what it needs from a balanced diet of wholesome foods, whereas pills can lead to hyper-supplementation, resulting in excessively dry skin and more serious health problems.
  8. Melons: The high concentration of water in cantaloupe, honeydew, watermelon, and other melons can actually reduce water retention that leads to puffiness around the eyes. Water helps to flush excess sodium (which contributes to bloating and puffiness) from the body.
  9. Berries: Fruits and vegetables owe their vibrant colors to antioxidants, and berries are a great source. Include blackberries, blueberries, raspberries, strawberries, cherries, etc. in your diet, when in season.
  10. Pineapple: Contains enzymes and vitamin C which help break down the purple pigment in bruises. Bromelain, a herbal pill used to treat bruising, is actually a pineapple extract that many surgeons suggest using after cosmetic surgery. If you bruise easily, eating pineapple, as well as other fruits and vegetables, may help them clear sooner.
  11. Cruciferous vegetables including broccoli, brussels sprouts, cabbage, cauliflower: While eating a wide variety of vegetables is always best for good nutrition, make sure to eat these often, as they are high in vitamins A (a retinoid), C (antioxidant which promotes collagen production)), calcium, and K (helps bruises to heal), other phytonutrients, and fiber.
  12. Avocados: High in monounsaturated fats, with practically no sodium or cholesterol, and containing vitamins C and E (antioxidants which help to reduce damage from the sun’s ultraviolet rays). Note that latex allergy may be associated with cross-sensitization to avocado, banana, and kiwi.
  13. Vitamin A-rich foods: The orange color of apricots, cantaloupes, carrots, mangoes, squash, and sweet potatoes is due to high levels of beta carotene, a precursor to vitamin A. Vitamin A is an antioxidant which helps to decrease the skin’s oil production. There is also evidence that it may improve psoriasis. Other sources of vitamin A are leafy greens and vitamin A-fortified dairy products.
  14. Calcium and Vitamin D-rich foods: In addition to playing a critical role in mineralization and demineralization of bones and teeth, muscle contraction and relaxation, nerve functioning, blood clotting, blood pressure, and immune defenses, calcium and vitamin D may promote skin hydration and repair, as well. Calcium-rich foods include dairy products, oysters, small fish with bones, calcium-set tofu (bean curd), certain leafy greens, broccoli, and legumes. While vitamin D is synthesized in the body with the help of sunlight, excess sun exposure can increase your risk of actinic nevi, moles, wrinkles, and skin cancer. Dietary sources of vitamin D include fortified dairy products (kefir, milk, some yogurts), cereals and juices, as well as, egg yolks, fatty fish (herring, sardines, salmon, cod, and their oils), and liver. While only a few minutes of sun exposure a day are necessary to produce vitamin D, even that can be too much for those who are at higher risk for skin cancer. In such cases, the right dietary choices and a daily vitamin D supplement may be best. Select organic dairy products when possible.
  15. Fatty fish rich in Omega-3 fatty acids:* Wild Alaskan salmon, Arctic Char, Pacific cod, and tilapia are rich in Omega-3 fatty acids that help to reduce the risk of inflammation, depression, heart disease, and vascular problems. The human body cannot produce some essential fatty acids, so including them in the diet can reinforce your skin’s barrier, keep moisture in and irritants out. Since Omega-3 fatty acids decrease inflammation, they may improve chronic skin conditions such as atopic dermatitis, eczema, and rosacea. Ground flax seeds are an additional source of Omega-3 fatty acids, and a better choice than flax seed oil which is too concentrated. Many eggs are now fortified with Omega-3 too.
  16. Whole grains: Provide the body with energy, fiber, and B vitamins. Eat at least three servings a day. The healthiest choices include whole wheat bread, whole-grain cereals, whole-grain crackers, whole wheat pasta, brown rice, barley, millet and popcorn.
  17. Nuts and seeds: Almonds, flaxseeds, sesame, sunflower, etc., are rich in protein, fiber, and vitamin E, a powerful antioxidant which helps prevent signs of aging caused by free radicals and may even reduce the risk of dry skin and skin cancer. Studies suggest that vitamin E consumed orally can increase its levels on the skin’s surface and help heal dry skin. Since Vitamin E is fat-soluble and can reach excessive levels with supplementation, it is safer to obtain it from wholesome foods. Cook with vegetable oils, and snack on a handful of almonds each day.
  18. Lean sources of protein: Skin is primarily made up of protein. Fish is an excellent protein source for healthy skin. Other good protein sources include edamame, beans or lentils with whole grains (for complete protein), quinoa, skinless poultry, pork chops, beef tenderloin, and lamb chops.
  19. Limit intake of alcohol to one serving, or avoid it altogether: Drink lots of water if you do have alcohol! Alcohol promotes dehydration and flushing, particularly in those with sensitive skin prone to redness. While red wine is considered more heart-healthy than white wine, since it contains two powerful antioxidants, grape seed extract and resveratrol, alcohol generally promotes the formation of free radicals which attack collagen and elastin and speed skin aging.
  20. Avoid foods containing artificial colors, flavors, preservatives, partially-hydrogenated fats, tropical oils, and other trans fats.
  21. Avoid salty and sugary foods: Salt contributes to bloating and puffiness, in addition to high blood pressure and vascular damage. Sugar can wreak havoc on your system in more ways than one. As far as your skin is concerned, the primary concern is glycation, which occurs when glucose enters the bloodstream. Once in the bloodstream, glucose bonds with protein molecules, including collagen and elastin. As a result, those vital skin components become inflamed and stiff, and eventually cause skin to sag and wrinkle.
  22. Olive oil: Provides heart-healthy monounsaturated fatty acids, essential omega-6, and nonessential omega-9 fatty acids, and may even be applied topically to prevent or treat dry skin. Dark-colored olive oils contain more phytochemicals than lighter ones. The use of olive oil in place of other fats in the diet has been correlated with a lower risk of heart and vascular disease. Canola oil is a good alternative.
  23. Herbs and spices: In addition to making food taste better, many are rich in various antioxidants, minerals, vitamins, water, and help to heal and protect skin from free-radical damage. Examples include basil, chives, cilantro, cinnamon, cumin, dill, ginger, oregano, parsley, and rosemary. However, if you have rosacea, certain spices may worsen your symptoms by aggravating flushing and blushing.
  24. Green tea, pomegranate juice: Good sources of antioxidants which reduce free radicals. Green tea is better than black tea, since green tea leaves are steamed very lightly during processing, preserving more polyphenols with antioxidant effects, than black tea leaves which are steamed longer.
  25. Caffeine in moderation: Constricts veins, reduces facial flushing and inflammation (probably because caffeine acts like a diuretic), and may have antioxidant, anti-inflammatory, and anti-carcinogenic properties when consumed orally. Since caffeine also dehydrates the body, it should be consumed with lots of water.
  26. Dark chocolate: Cacao in dark chocolate contains high levels of polyphenol antioxidants. Look for high cacao concentrations (high quality chocolates will give a % on the label), because these have less sugar which can actually be bad for your skin. Dark chocolate contains less sugar than typical milk chocolate. It is sugar, rather than chocolate, that appears to exacerbate breakouts.
  27. Avoid touching blemishes: Popping pimples can cause scarring.
  28. Use petroleum jelly to moisturize rough, cracked feet, elbows, hands, dry cuticles, and peeling nails.
  29. Note that some skin care products contain fragrances and chemicals, including endocrine disruptors, which may cause or aggravate skin problems.
  30. Wear protective gloves when washing dishes or using household cleansers and chemicals .
  31. Moisturize after bathing to trap water in the skin: Reapply hand lotion often to prevent dryness and irritation of your skin, especially during cold winter months.
  32. Humidify the air in your home with plants or a humidifier.
*Why are fatty acids so important?
  • They strengthen the skin barrier, which keeps moisture in and irritants out of your skin.
  • They reduce the development of wrinkles and promote moister, firmer skin
  • They help form prostaglandins, hormones that assist cellular functions.
Cholesterol is one of the three components of our skin barrier. It is the fat (lipid) layer which keeps moisture in and irritants out. Vegetarians, people on low-fat or cholesterol-free diets, and those taking cholesterol-lowering drugs are more likely to have dry skin.

Types of fatty acids:
  • Essential fatty acids (EFA’s): The two main categories of EFA’s are Omega-3 and Omega-6. They are essential for good health, but not made by the body. Therefore, they must be obtained from foods or supplements.
  • Nonessential fatty acids: Omega-9 is essential for good health, but is called “nonessential,” since it can be produced by the body.
Food sources of essential and nonessential fatty acids:
  • Omega-3 essential fatty acids (alpha-linolenic [ALA], eicosapentaenoic acid [EPA], and docosahexaenoic acid [DHA]) : Leafy greens, cruciferous vegetables, flax seeds, hemp seeds, pumpkin seeds, sesame seeds, Brazil nuts, walnuts, wheat germ, wheat germ oil, soybean oil, and canola oil.
  • Omega-6 essential fatty acids (Linoleic acid): Nuts and seeds, olive oil, chestnut oil, corn oil, cottonseed oil, safflower oil, soybean oil, sunflower oil, olives.
  • Omega-3 and omega-6 fatty acids in proper proportions: Flax seeds, hemp seeds, sunflower seeds, grape seeds
  • Omega-9 fatty acids (Monounsaturated oleic acid: Reduces risk of heart disease, arteriosclerosis, cancer): Olive oil, olives, avocados. nuts including macadamia, pistachio, peanuts, almonds, sesame, cashew, pecan and hazelnuts.

Many oils used for cooking in the United States are comprised of linoleic acid, which is one reason why our Omega ratios tend to be unhealthy. Soybean oil, corn oil, sunflower oil, and cottonseed oil are routinely used in processed foods. Many of these oils are refined. To avoid over-consumption of Omega-6 fatty acids, reduce or eliminate refined oils and processed foods, and read ingredient labels.


  1. American Academy of Dermatology (AAD) : “Dermatologists’ Top Ten Tips;” “Skin Care on a Budget;” “Skin Health Tips;” “What Dermatologists Tell Their Patients.”  2012. (Source:
  2. Corleone, Jill. “The Best Foods to Improve the Skin.” 11/05/12. (Source:
  3. Cosgrove, M. “Dietary Nutrient Intakes and Skin-Aging Appearance Among Middle-Aged American Women.” American Journal of Clinical Nutrition. 2007.
  4. Purba, M. “Skin Wrinkling: Can Food Make a Difference?” Journal of the American College of Nutrition. 2001.
  5. “Skin Problems and Treatments Health Center: Image Collection-Human Anatomy- Picture of the Skin..” WebMD, LLC.  07/01/2009.
  6. “The Mediterranean Diet: Delicious, Nutritious, and Heart-Healthy.” (Source:
  7. “The Mediterranean diet is a heart-healthy eating plan combining elements of Mediterranean-style cooking.” Mayo Clinic Staff. (Source: www.mayoclinic.
  8. “The Oldways Mediterranean Diet Pyramid.” (Source:
  9. “What is the Mediterranean Diet?” Information regarding the Mediterranean Pyramid and Traditional Mediterranean Diet. (Source:
  10. Willet, Walter C. “Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating.” Free Press. 2005. (ISBN 0743266420)
  11. Willet, Walter C. “The Mediterranean diet: science and practice.” Public Health Nutrition: (1A). pp.105-10. 02/09/06.
  12. Willett, Walter C; Sacks, F.; Trichopoulou, A.; Drescher, G.; Ferro-Luzzi, A.; Helsing, E.; Trichopoulos, D. “Mediterranean diet pyramid: a cultural model for healthy eating.”  American Journal of Clinical Nutrition: 61 (6): 1402S–6S. 06/01/95. 06/01/95. (PMID 7754995)

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yogurt for protein
A great way to start the morning, or as an alternative to ice cream, a healthy way to end the day.
Both Greek and traditional American yogurt in their plain, low-fat and non-fat forms can be a part of a healthful diet. Both are low in calories and high in calcium and live bacterial cultures which promote digestive health and regularity. Greek yogurt is thicker and creamier than American, since it is extensively strained to remove most of the liquid whey and milk sugar (lactose). As a result, Greek yogurt tends to be less runny, has a more tart taste, and provides about twice the protein and half the carbohydrate and lactose content of American yogurt, in approximately the same calories. The heavier, thicker texture and higher protein content of Greek yogurt also satisfies one’s appetite more. A comparison of the two types of yogurt follows:
  • Protein: Greek yogurt is high in protein which promotes a sustained sense of fullness. A typical 6-ounce serving contains 15 to 20 grams, the amount in 2 to 3 ounces of meat. A 6-ounce serving of regular yogurt provides just 9 grams, meaning you may feel hungry sooner. One cup (8 ounces) of plain, non-fat Stonyfield organic “Oikos” Greek yogurt provides 23 grams of protein. This makes Greek yogurt especially appealing to vegetarians, who tend to avoid many sources of animal protein.
  • Carbohydrates: Greek yogurt contains about half the carbohydrates of regular yogurt, 5 to 8 grams compared with 13 to 17 per 6-ounce serving. One cup of plain, non-fat Stonyfield organic “Oikos” Greek yogurt provides 9 grams of carbohydrate. Since the straining process removes some of the lactose, Greek yogurt is less likely than regular yogurt to cause digestive problems in lactose-intolerant individuals. Note that both types of yogurt will contain higher amounts of carbohydrate if sweetened with sugar or other ingredients like honey, dextrose, fruit blends, etc. Try to select yogurt with less or no added any sugar.
  • Fat: Avoid whole milk yogurt due to it’s high saturated animal fat content. Seven ounces of “Fage’s” full-fat Greek yogurt contains 16 grams of saturated fat, or 80% of your total daily allowance if you are on a 2000 calorie diet (that’s more than in 3 “Snickers” bars). Dannon’s regular full-fat yogurt contains 5 grams of saturated fat per 8-ounce serving. Saturated animal fat raises total cholesterol, as well as harmful low-density lipoprotein (LDL) cholesterol levels, thus increasing the risk of heart disease. Always read nutrition labels carefully, and choose low-fat or non-fat yogurt.
  • Sodium: An 8-ounce serving of plain, non-fat Stonyfield organic “Oikos” Greek yogurt contains 95 milligrams of sodium, about half the amount in a similar serving size of most brands of American yogurt. Note that excess dietary sodium can elevate the risk of heart, kidney, and vascular problems. The federal government’s 2010 Dietary Guidelines for Americans recommend less than 2300 milligrams of sodium intake daily for healthy individuals, and less than 1500 milligrams daily for all African Americans, individuals over 50 years of age, and those with or at risk of high blood pressure (hypertension), diabetes, or chronic kidney disease.
  • Calcium: American and Greek yogurts are both excellent sources of dietary calcium, each providing about 30% of the recommended daily calcium requirement per 8-ounce serving. To further increase your dietary intake of calcium, include more low-fat or non-fat milk, beans, nuts like almonds, seeds like sesame, and green leafy vegetables like bok choy, collards, dandelions, mustard greens, swiss chard, and turnips.

Remember to always read nutrition labels and check expiration dates. Live bacterial cultures in yogurt and kefir tend to diminish over time. Therefore, try to finish these products well before their expiration date. Be careful of flavored varieties of yogurt which may contain extra calories from corn syrup, fruit purees, modified food starch, sugar and other sweeteners, and less of yogurt’s natural health benefits.

Nutritious and easy to prepare, the following recipe can be served at breakfast or lunch, as a snack, or in place of rich desserts:


  • Nonfat Greek yogurt (“Chobani”, “Fage”, “Oikos”, or any other natural yogurt)
  • Chopped, unsalted, and unflavored nuts and/or seeds, such as almonds, walnuts, pecans, peanuts, pumpkin, sesame, or sunflower seeds
  • Chopped fresh fruit or berries (optional)
  • Honey

Place yogurt in serving dish. Sprinkle chopped nuts, seeds, and fresh fruit, on top. Drizzle with honey. Enjoy!


  • Wheat germ or ground flax seeds may be substituted in place of other nuts and seeds.
  • Chopped fresh fruit, berries, dates, figs, raisins, and/or granola cereal may be added for more fiber and nutrients.
  • Fresh fruit, nuts, granola, and honey.
  • Use Greek yogurt as a cream substitute in sauces or curries. It’s much lower in fat than cream but still provides the same creamy taste. Just turn the heat off, allow the dish to cool slightly before adding the yogurt (so it doesn’t curdle), and then stir it in.

Kali Orexi – Bon Appetit 

Greek Waiter

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Baked Fish: “Psari Plaki”

by Diane, M.P.H, M.S.

In Greek, psari (psah-REE) means ‘fish’ and plaki (plah-KEE) means ‘spread out’ or ‘flat’. The word plaki is derived from Greek roots plak, plat, and platys, all meaning ‘broad’ or ‘flat’. Plak originally referred to an ancient griddle stone which functioned as a flat oven for food to be cooked on. Some English words derived from these roots include ‘plate’,’platter’, ‘platen’ (a flat plate in a printing press which presses paper against inked type, thus creating an impression; the roller of a typewriter)), ‘plateau’ (broad, nearly level, or flat surface of high elevation), ‘platform’ (flat, elevated piece of ground or flooring), and ‘platypus’ (flat-footed duckbill).

Plaki refers to a method of cooking, usually with olive oil, garlic, onions, tomatoes, parsley, and often other vegetables. While baked fish plaki is very popular, beans plaki and vegetable plaki are also made.

Psari plaki consists of whole small fish, or larger fish cut into steaks or cutlets, or fish fillets, laid flat while cooking in the traditional sauce. The recipe works well with any firm white fish: cod, tilapia, haddock, halibut, mackerel, snapper, or whatever type you have available.

The following oven-baked recipe is delicious, nourishing, heart-healthy, and easily prepared. Experiment and adapt the recipe to your liking, adding different ingredients, herbs, and spices to the sauce!

Servings: 6-9 servings


  • 2-3 lbs. fresh seasonal fish fillets or frozen white fish fillets, such as wild Alaskan halibut, wild Pacific Cod, haddock, or tilapia
  • Pepper and salt
  • Juice of 2 lemons
  • 1/2-1 cup olive oil
  • 2-4 large onions, chopped
  • 1/2-1 cup white wine
  • 4-6 medium-size fresh tomatoes, sliced, chopped, or diced, or 1 28-ounce can diced tomatoes, or 2-3 pints grape tomatoes
  • 1/2 cup (or more) chopped carrots, celery
  • 2-4 cloves garlic, crushed or minced
  • 1 cup chopped fresh dill
  • 1 1/2 cup chopped fresh parsley
  • 1 fresh tomato, sliced
  • 1 fresh lemon, sliced


  1. Arrange fish fillets in large baking dish or pan and sprinkle with lemon juice, pepper, and salt.
  2. In a large sauce pan, heat the oil and cook the onion until soft. Add wine, chopped vegetables and herbs (tomatoes, carrots, celery, garlic, dill, and parsley) , saving 1/2 cup parsley, fresh sliced tomato and lemon for later.
  3. Simmer the mixture for 15 minutes.
  4. Cover fish in pan with this mixture and add tomato slices, parsley, and lemon slices on top.
  5. Bake for 30-40 minutes at 350 degrees.


  1. Dried basil and/or oregano may be sprinkled on top of mixture before placing in oven.
  2. Chopped scallions, or larger amounts of chopped fresh dill and parsley may be added to above recipe. (My philosophy is that the more herbs and vegetables added to a meal, the more heart-healthy, nutritious, and satisfying it becomes. Many herbs, including dill, parsley, and scallions, provide various antioxidants, calcium, magnesium, potassium, folic acid, vitamin C, and have anti-inflammatory and bacteriostatic properties. I generally add both entire bunches of washed and chopped dill and parsley to the above recipe, as well as more of all the vegetables.)
  3. Tomatoes, scallions, parsley, and garlic may be sautéed in oil before they are added to the baking dish.
  4. Toasted, sliced almonds may be sprinkled over the warm fish before serving.
  5. Serve fish plaki with crusty bread and a seasonal salad, or boiled potatoes, or steamed rice.

Kali Orexi!    Bon Appetit!

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Animal studies have demonstrated that the colon is more vulnerable to inflammation when estrogen is given, and that estrogen alters permeability of the colon.

New research findings presented by Dr. Hamid Khalili, on May 20, 2012 at the Digestive Disease Week* meeting in San Diego, California, indicate that the use of oral contraceptives by younger women or hormone therapy by older women may be associated with inflammatory bowel disease. ** According to Khalili, a clinical and research fellow of gastroenterology at Massachusetts General Hospital in Boston:

  1. Birth control pills are associated with a higher risk for Crohn’s disease: The most common symptoms of Crohn’s disease include abdominal pain (often in the lower right side), diarrhea, weight loss, rectal bleeding, and fever. Inflammation of the lining and wall of the large or small intestine, or both, may occur. The lining can become so inflamed it bleeds. Another complication of Crohn’s disease is blockage or stricture of the intestine. This occurs when the disease thickens the bowel wall with swelling and scar tissue. The intestinal passage becomes smaller and smaller, until it is completely closed.
  2. Hormone replacement therapy (HRT) taken by some women after menopause is linked with ulcerative colitis: This disease of the colon (large intestine) or rectum is associated with abdominal cramping and pain, rectal bleeding and/or blood in the stool, ongoing bouts of diarrhea which do not respond to over-the -counter medications, and/or unexplained fever lasting more than a day or two.

Of the two findings, Khalili said the association with birth control pills and Crohn’s is the most relevant to patients and especially true for long-term users. “If you took oral contraceptives for more than five years, you have a threefold increased risk of Crohn’s disease,” he noted.

For the first study in younger women, Khalili and his colleagues analyzed data collected from approximately 233,000 women who had been enrolled in the large U.S. Nurses Health Studies I and II. Data from the beginning of the first study, 1976, through 2008 indicated 309 cases of Crohn’s disease and 362 of ulcerative colitis. Khalili’s analysis compared those who never used birth control pills to those who did. Current users had a nearly three times greater risk of Crohn’s disease. Those who used birth control pills had no increased risk of getting ulcerative colitis, compared with never-users.

In the second study, Khalili examined data collected from nearly 109,000 women past menopause who were enrolled in the Nurses Health Study that began in 1976 and followed through 2008. He found 138 cases of Crohn’s disease and 138 of ulcerative colitis. Those on hormone therapy had a 1.7 times higher risk of ulcerative colitis, compared to never-users. No link was found with Crohn’s disease.

While the studies uncovered an association between the hormone-based therapies and digestive problems, it did not prove a cause-and-effect relationship.

Although Khalili stated “We probably don’t have a clear mechanism,” he noted that animal studies have demonstrated that the colon is more vulnerable to inflammation when estrogen is given, and that estrogen alters permeability of the colon.

Dr. David Bernstein, a gastroenterologist and chief of hepatology at North Shore University Hospital in Manhasset, N.Y., indicated that the findings are probably of greater concern in younger women. According to Bernstein, the study of older women showed that “the risk may be present, but it seems to be quite small.” The link appears stronger for oral contraceptive use and Crohn’s disease. Older women on hormone therapy probably do not need to be concerned.

However, Bernstein noted that “younger women on oral contraceptives need to be told that there is an increased risk.”

Khalili agreed and advised that women on birth control pills who have a strong family history of IBD should be made aware of the research finding a link. A link is not a cause-and-effect relationship, but simply an association. Still, he said, they should be aware, in case they wish to choose another form of birth control.

The above findings should serve as a warning to all of us regarding the use of hormones by the meat and dairy industry, and the possibility of future use of growth hormones in the fish farming industry for salmon and tilapia, which is currently being discussed in Washington, D.C.

*Digestive Disease Week is jointly sponsored by the following four societies:

  1. American Association for the Study of Liver Diseases
  2. American Gastroenterological Association Institute
  3. American Society for Gastrointestinal Endoscopy
  4. Society for Surgery of the Alimentary Tract.

**Estrogen can increase cholesterol and reduce gallbladder motility. Women who are pregnant or who take birth control pills or hormone replacement therapy have higher levels of estrogen and may be more likely to develop gallstones.

A co-author on both studies reports consulting work for Pfizer, Millennium Pharmaceuticals and Bayer AG.

Because this research was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.


  1. Digestive Disorders Health Center: Gallstones. WebMD. LLC. 2014.
  2. Doheny, Kathleen. “Birth Control Pills, HRT Tied to Digestive Ills.” Health Day News: Health Day.May 21, 2012.
  3. Khalili, Hamed, M.D., M.P.H., clinical and research fellow, gastroenterology, Massachusetts General Hospital, Boston; David Bernstein, M.D., gastroenterologist and chief, hepatology, North Shore University Hospital, Manhasset, N.Y.; May 20, 2012, presentation, Digestive Disease Week meeting, San Diego, California.
  4. NIH Publication No. 06-3410; February 2006:


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Seafood Safety for Women

by Diane, M.P.H, M.S.

Fish is an excellent source of protein, omega-3 fatty acids, vitamin D, and other nutrients for people of all ages and an exceptionally good food for pregnant mothers and their developing babies. Research has shown that fish consumption may actually enhance development of the nervous system in the developing fetus, infant, and young child. However, contamination with toxic mercury, polychlorinated biphenyls (PCBs), and other environmental pollutants has cast a shadow over the nutritional benefits of fish.

Methylmercury is toxic to the fetal brain and nervous system, and many popular fish species are contaminated with it. The principal exposure route for the fetus is consumption of contaminated fish by the mother. Women who eat fish during pregnancy, even as little as a single serving of a highly contaminated fish, may expose their developing child to excessive levels of methylmercury. The toxic metal can cross the placenta to damage the rapidly developing nervous system, including the brain, of the fetus. The risk of learning deficits, developmental delays, neurological problems, future school problems and remedial special education, increase in children who have been exposed even to relatively low levels of methylmercury in the womb.

The accumulation of methylmercury, PCBs, endocrine disruptors,and other toxins in the food chain in general may also be contributing to the increasing incidence of attention deficit disorders (ADD, ADHD), hyperactivity, behavior and developmental problems, as well as autism.

What is the source of mercury in our seafood? Combustion in power plants of coal containing mercury is the major source of this environmental pollution. Mercury pollution from coal-fired power plants moves through the air, is deposited in water, and finds its way into fish, accumulating especially in fish that are higher up the food chain. Fish like tuna, sea bass, marlin, and halibut show some of the worst contamination, but dozens of species and thousands of water bodies have been seriously polluted.

The Environmental Protection Agency’s (EPA) safe exposure estimate for methylmercury was dropped twice in the past 16 years, as science identified adverse effects in children exposed in the womb at lower and lower doses. The current safe dose may drop even lower in the future (NAS 2000). No one knows how long a fetus can tolerate a dose of methylmercury above a “safe level” without observable adverse effects.

On January 12, 2001, government health officials issued warnings for women to limit fish consumption during pregnancy to avoid exposing their unborn children to unsafe levels of methylmercury.

The Food and Drug Administration (FDA), which regulates commercially sold fish, recommends that pregnant and nursing women and young children not eat any shark, swordfish, tilefish, or king mackerel, but then recommends 12 ounces per week of any other fish. The Environmental Protection Agency (EPA), which makes recommendations to states about safe mercury levels in sport fish, allows up to 8 ounces of any fish per week for pregnant women, with no limits on consumption of any individual fish caught recreationally.

While these restrictions are steps in the right direction, they need to be tightened significantly to adequately protect women and their unborn children from the toxic effects of methylmercury and other contaminants.

The lack of information for pregnant women regarding methylmercury risks and mercury levels in the fish they buy pose another serious problem. According to the Centers for Disease Control and Prevention (CDC), about 10 percent of all women of childbearing age have blood methylmercury levels above the dose that may put their fetus at risk for adverse neurological effects (CDC 2001). If these women were to increase their consumption of certain fish species in hopes of benefiting their babies during pregnancy, they could expose their fetuses to potentially hazardous levels of methylmercury.

The following list was recently published by the Environmental Working Group (EWG):


King mackerel
Tuna steaks
Canned tuna
Sea bass
Gulf Coast Oysters
White croaker
Largemouth bass


Mahi mahi
Blue mussel
Eastern oyster
Great Lakes salmon
Gulf Coast blue crab
Channel catfish (wild)
Lake whitefish


Blue crab (mid-Atlantic)
Fish Sticks
Flounder (summer)
Trout (farmed)
Salmon (wild Pacific)
Shrimp: Pink shrimp from Oregon, spot prawns from Canada *

* Shrimp fishing and farming practices have raised serious environmental concerns.

** Farmed catfish have low mercury levels but may contain PCBs in amounts of concern for pregnant women.

Data from the 1970s show high concentrations in the following species (No recent data available):

Orange Roughy
Lake Trout


  1. “Complete List of Seafood Eco-Ratings: Which fish are safe for you and the oceans?” Environmental Defense Fund (EDF), 257 Park Avenue South, New York, NY 10010. General Information: (800) 684-3322. Copyright © 2011 Environmental Defense Fund. All Rights Reserved. Posted: 10/03/08; Updated: 05/08/12. (Source:
  2. “Safe Seafood Selector.” Environmental Defense Fund (EDF). 05/02/12.(Source:
  3. “Seafood Selector: Fish choices that are good for you and the ocean.” Downloadable and printable Pocket Guide (PDF). Environmental Defense Fund (EDF). 06/2011. (Source:
  4. “Seafood Watch: National Sustainable Seafood Guide.” Monterey Bay Aquarium Foundation. January 2012. (Source:
  5. “What Women Should KnowAbout Mercury in Fish.” Environmental Working Group (EWG). Headquarters: 1436 U Street. NW, Suite 100. Washington, D.C. 20009.  (202) 667-6982. (California Office: 2201 Broadway, Suite 308, Oakland, CA. 94612; Midwest Office: 103 E. 6th Street, Suite 201, Ames, IA. 50010; Sacramento Office: 1107 9th Street, Suite 340, Sacramento, CA. 95814). Copyright 2007-2012.



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