Weekend Reading, 10.5.14
October 5, 2014

Weekend Reading | The Full Helping

Happy Sunday! I hope you’ve all had nice weekends so far. Yesterday was all drizzles here in the NYC, but today has delivered that wonderful fall weather I’ve been pining for. I also took a little time away from work this weekend to relax with the boy, and I’m feeling so glad I did. While I was at it, I found some delicious recipes and reads for you all.

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I love, love, love the combination of tomatoes and rice. I think it might be a Greek thing. But anyway, I’m just drooling over Merrill Stubb’s tomato rice, via Food52. Substitute Earth Balance for butter, and you have the best kind of dinner: easy, filling, delicious, healthy.

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Also via Food52, an avocado and marinated kale sandwich. So, all of my fave things in between bread. Cool. (Omit the cheese to make it vegan!)

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 Hannah’s butternut squash gnocchi look seasonal and fantastic.

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Nava Atlas is one of my culinary heroes. Allyson shares her scrumptious recipe for pasta with hearty lentil and spinach sauce–as well as a review of her new book–on her blog.

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For dessert, Heathy’s raw carob cream squares. Enough said.

Reads

1. A lot of incredible articles this week. First, a haunting piece from Yoga Journal about yoga and eating disorders. The piece left me feeling sad and, frankly, a bit unsettled, because I like to think about yoga as being such a safe space for body issues. Nevertheless, I can’t say I haven’t observed a lot of the behaviors touched upon in the article, and of course there is something about yoga practice that can feed the desire to be “light.”

Yoga was integral to my recovery, and I am so glad that it never evoked those urges for me. But I think it’s the responsibility of all yogis to be aware of these issues and to continue having a dialog about them.

2. So, a company in the Bay Area called Real Vegan Cheese is developing a vegan cheese that will use the milk protein casein, but without the input of a cow. The casein will be manufactured from baker’s yeast and will be totally vegan, as well as GMO free. For the many folks who are curious about going vegan, but feel that life would be unbearable without cheese, this is a very real and very powerful potential solution.

My friend Ginny wrote a blog post about it this week. In it, she addresses on a scientific basis the fears some vegans have expressed about the casein in cheese. Those fears were based upon studies in which rats were fed high amounts of isolated casein, and the problem, as Ginny rightly notes, is that a) rat studies are hardly a foolproof indication of what would happen in human bodies; numerous rat studies have yielded data that couldn’t ultimately be applied to humans, and b) isolated casein and casein in dairy are not one in the same.

As Ginny notes, it’s hard to make a scientifically founded case against moderate dairy consumption, because the data we have simply doesn’t support it. “And as it turns out,” she goes on to say, “it may actually not be in our best interests—or the best interests of the animals—for us to try to make that case. It’s possible that efforts to portray all animal foods as deadly to human health will leave us with fewer options for helping animals. Because, if vegans believe that casein causes cancer, they are less likely to support a product—like Real Vegan Cheese—that can help more people go vegan and save millions of animals.”

I know that there will be a lot of resistance to Real Vegan Cheese on the grounds that it’s been developed in a lab, too. This reminds me of a lot of the pushback against Just Mayo. But I’m all for these products, because a) they’re intended to save thousands upon thousands of animal lives and b) just because they’re developed with the aid of technology and biochemistry, that doesn’t make them harmful to our health. Not everything we eat must be plucked directly from mother earth; the point is to eat fresh food more often than not. Taking an absolutely rigid stance against everything that isn’t technically a “whole food” can become a bit myopic, not to mention impractical. The hemp milk in my fridge right now (commercial) didn’t come straight from soil or branch, and neither did my Earth Balance, or the frozen veggie burgers in my freezer, nor the carton of Luna and Larry’s gingerbread ice cream I swooned over on Friday. Yet these are all pretty healthy products (OK, maybe not the ice cream, but it’s healthy to have a little dessert now and then, too!).

If a product comes about that has no ill effects upon our health, serves a vital purpose in helping animals, and has been created with the help of science and innovation, then I say bring it on.

3. According to Radar Programs (an eating disorder treatment facility), 69 percent of young girls in a study said that magazine models influence their idea of the perfect body shape. Out of those, 47 percent said magazine photos influence them to want to lose weight, but only 29 percent were actually overweight when the study was conducted.

Sobering, but not surprising facts. And now Seth Matlins, a former advertisement executive, and his wife, Eva, are trying to fight back against impossible body ideals put forth in the media with their Feel More Better movement. Matlins has joined forces with with various ED advocacy groups to get legislation introduced in Congress that willthat will call on the Federal Trade Commission (FTC) to regulate Photoshop in the United States. His petition has received 35,000 supporters. You can read more about his work and intentions here.

4. Great (really really really great) article from my friend Liz Dee on exerting influence as a vegan in restaurants. Via Our Hen House.

5. An interview with Benjamin Mazer, the med student who’s trying to place regulations on quakery and bad science being put forth on the Dr. Oz show. Ben has started a site, Doctors in Oz, that spreads information about bad claims made on the show and gives people who have suffered from misconceptions put forth by the show a platform. Mazer also wrote policy for the Medical Society of the State of New York [where Dr. Oz is licensed] and the American Medical Association asking them to more actively address medical quackery on TV and in the media. The New York policy was passed in modified form.

It may seem like a whole lot of vitriol pointed at one person — after all, countless physicians, wellness professionals, gurus, and personalities endorse quack medicine, and/or mislead the public. But Mazer’s argument is that Oz has an unprecedented platform, and that his recommendations can (and often do) introduce mistrust or conflict into physician patient relationships (i.e., a physician suggests an evidence based approach to weight loss, which a patient resists because he or she saw a supplement on the Oz show that’s purported to have the same, or a faster, effect).

I’m on board with most all of this, and I have very strong feelings about quack medicine and how harmful it can be. But I do think that this dialog misses an important point, which is that, for all of the problems with the Dr. Oz show, it’s a program that seeks to make people feel empowered. That sense of empowerment, of belief in one’s body and its capacity to heal without excessive drugs or intervention, is not often enough respected in what I’ll call “mainstream” medicine.

Is healing always possible without drugs or surgeries? No, of course not, and thank goodness we have them. But it’s a profoundly discouraging experience for a patient who could actually experience lifestyle change through diet, sleep, fitness, and mind-body care to be told otherwise, or prescribed a drug pro forma. And until more physicians learn to incorporate information about diet and lifestyle into their practices, patients will be so frustrated that they’ll seek out such information elsewhere. Sometimes they’ll find it from credible sources, and sometimes they’ll find it from unreliable sources. But those sources alone aren’t to blame. This is a systemic problem, a failure of evidence-based medicine to understand that patients are hungry to take a more proactive role in their own healing. Dr. Oz and his miracle cures are a symptom and a result, not a root cause.

So much to think about this week! I’ll return soon.

xo

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    19 Comments
  1. Hi Gena,

    The first thing that I love about this post is your approach to diet as not needing to be 100% “straight from the Earth”. It often is very triggering to me when someone talks about shaming products that contain more than 1 ingredient, because I myself have products such as snack bars and soy milk that I have come to love, and for someone to tell me that I need to go completely natural is endlessly frustrating. My dietitian and therapist have helped me develop an approach to food that welcomes food from different sources and processes, which I believe is integral to recovery. Yesterday, there was an article on CNN about orthorexia, and it included a link to a blog of a woman who has “recovered”. While I had visited the website for inspiration, I found it to be loaded with triggers, as this woman still shuns products that are not “superfoods” or, as you mention, that do not come straight from the Earth. I must admit that the fact that CNN included such a link and description bothered me deeply.

    • Thanks so much for your comment, Astha. I agree with you. The fixation on “clean eating” and “whole foods” has gone too far; of course a whole foods philosophy is wise overall, but I don’t think that all foods that are packaged or premade or which have undergone some processing are inherently unhealthy, bad, or shameful.

  2. Interesting bit about Dr. Oz! I too have encountered patients who refused to make lifestyle modifications to benefit their health because they believed that taking an Oz-endorsed supplement would do the work for them. Thanks for posting and spreading the word!

    I do want to say that I disagree with your concluding sentiments about patient empowerment. In my experience, doctors constantly encourage lifestyle modifications (healthy diet, active lifestyle, reducing alcohol and tobacco consumption) before recommending pharmaceuticals to treat the “lifestyle diseases” such as type 2 diabetes, obstructive sleep apnea, and so on. They also offer resources such as referral to a nutritionist or diabetes educator to help the patient with such difficult lifestyle changes. However, patients very rarely respond to these efforts. What Dr. Oz offers these patients is not empowerment; it’s an easy, effortless fix to a problem that would otherwise require thought and hard work by the patient. Why do you say that offering an herbal supplement that is claimed to work miracles is more empowering than offering a pharmaceutical medication that is proven to reduce morbidity and mortality? Either way, the patient is taking some pill that is supposed to fix something in their body for them.

    As a fourth-year medical student on my way to a career in internal medicine, I find it frustrating that there exists such antagonism toward doctors with regards to being “pill pushers” rather than people who fix the underlying lifestyle-related problems. We spend the majority of our time counseling patients on what they should be doing to improve their health, yet many (for a variety of reasons) do not heed this advice, and so we are forced to do the next best thing and prescribe a medicine. Taking metformin to improve glycemic control is not as good as losing weight to fix the diabetes, but it’s way better than taking useless supplements while going blind or having a heart attack or losing a leg.

    • First of all, I think this is a great comment. Thank you so much for sharing your perspective. It’s good to hear that the doctors you’ve shadowed and worked with have been so dedicated to addressing the root causes of chronic illness.

      I want to be clear about my vantage point here. First, I bear no antagonism toward doctors. I did a post-bacc degree a few years ago, and even though I wasn’t lucky enough to get admitted to med school, it was an illuminating experience in many ways, and I did spend quite a bit of time in hospitals. I was universally impressed with the compassion and energy of the physicians I worked with; it’s the same compassion I witnessed from the patient side when a close family member of mine had cancer ten years ago, and it’s what inspired me to try to become a doctor myself.

      I also do not by any means “say that offering an herbal supplement that is claimed to work miracles is more empowering than offering a pharmaceutical medication that is proven to reduce morbidity and mortality,” and that’s not what I said in the post. I am very skeptical of most supplements, and have written critically in the past about lack of regulation / knowledge about the supplement industry. I almost never recommend supplements to my nutrition clients — a stance that often disappoints them! So no, I don’t think there’s anything empowering about a so-called magic pill. But I do think that it’s empowering for patients to be told that they can participate in the healing process to whatever degree that’s possible, and to be given lifestyle and nutrition tools *in addition to* important medications.

      You say that doctors constantly try to give patients such tools and such participation. That’s great. My observation has been that this often happens, but it’s often halfhearted and cursory. And I’ve also observed that in fields of medicine that do not relate directly to “lifestyle diseases,” but in which there is still room for meaningful conversations about nutrition, those conversations are often not had. I have spent many hours of my life in GI doctors offices, and I can’t tell you how rarely food was ever mentioned (when in fact it has proven to be effective in the management of nearly all GI diseases and syndromes, including mine). I worked in DC for a gastroenterologist who received constant referrals of patients who had had similar disheartening experiences.

      My views on this are also informed by my nutrition work; many clients tell me that they were not given the tools they needed to address lifestyle change in concert with drugs. Is it possible that my clients are overstating their doctors’ laxness in this arena because they resent having to take a drug at all? Sure. Is it possible that they’re mischaracterizing their doctors’ behavior because, as you say, they don’t want to do the hard work of nutrition change and lifestyle alteration, and would rather have a quick fix? Maybe, though I can’t imagine why they’d then see me, because nutrition counseling is nothing but hard work.

      I think to some extent that this may be generational; you likely get to see a lot of younger doctors at work, and perhaps your generation of physicians is far more committed to working on the lifestyle component with patients than previous generations have been. In any case, I think it’s absolutely untrue that all doctors are “pill pushers” who are too lazy to talk about nutrition, which is, as you say, the very unfortunate stereotype. But I think it’s also untrue that *all* physicians give patients adequate lifestyle tools, or emphasize the tools strongly enough.

      That’s fine. Physicians can’t be perfect, and I think they’re expected to be more than any other professional group, which isn’t fair. But my point is simply that this isn’t a black-and-white issue. Is there any excuse for magical thinking or quack remedies or quick fixes that aren’t evidence based? No. But I do think that some patients still feel a lack of interest and guidance in the realm of nutrition and lifestyle, and I think that’s the reason they often turn to resources like the Dr. Oz show, or online health gurus, or supplement lines. Some of it is probably driven by the desire for a quick fix, but–having seen up close and personal how sincere and committed to health many of these disenchanted patients are–I think that some of it is driven by a genuine and dedicated desire to take health into one’s own hands, even if that means hard work.

      Hopefully physicians like you will continue to give patients the empowerment they need in all ways, lifestyle guidance and life-saving interventions both.

  3. Here’s a sentence that I found a little disturbing: “Because, if vegans believe that casein causes cancer, they are less likely to support a product—like Real Vegan Cheese—that can help more people go vegan and save millions of animals.”
    I don’t think our nutritional knowledge should be constrained by “belief” and whether or not it supports a philosophy. Our knowledge of nutrition should be based on what the scientific data shows. Of course, there are other concerns which influence what foods we choose to eat, but the simple statement “casein causes cancer” should be able to be supported or not supported by scientific evidence.

    • Anne, I totally agree. And I think that’s Ginny’s point, that the bias against casein is not founded in data/research.

      • Thanks Gena! That’s important information to have. For now, I’ll stick to my “casein free cashew cheese”, but it’s encouraging that we all agree nutrition information should be based on what the science supports. It’s so hard to get unbiased information (in general, not just on this topic)! Part of our natural human inclination, I think.

  4. Thanks for a great read as always. You offered such great insight into the criticism of Dr. Oz. I thought your synopsis was spot on. I am fortunate to work closely with a few thoughtful and open minded doctors. However, I have encountered many doctors over the past ten years, and in my experience, the vast majority of mainstream physicians do not have a solid foundation in nutrition or lifestyle factors that influence healing. It may be shocking to some, but I have found that many physicians don’t know much more about nutrition than the average lay person. Despite this lack of knowledge, they tend to be quick to dismiss nutrition or alternative therapies as quackery without any investigation. The truth is that most lifestyle interventions have the potential to heal and have no side effects. Therefore, even if the lifestyle treatment were ineffective in improving a patient’s condition, it would not have caused any harm. That is not the case with medications. Many drugs frankly don’t work that well and can have very serious long term effects. For example, the medications used to treat autoimmune diseases and kidney disease in young people can cause malignancy, infertility and osteoporosis later in life. I can’t blame patients for being cautious with medications like these and attempting an alternate approach.
    What is also alarming is that many of the “evidence based guidelines” that are the gold standards in mainstream medicine turn out to be WRONG. We have to be so careful with “evidence based medicine” It’s so important for clinicians to be mindful of overconfidence and remain open minded.
    I think you’ll enjoy these articles- one is by Dr. John Mandrola (a great physician and writer)
    http://www.drjohnm.org/2013/07/changing-the-culture-of-american-medicine-start-by-removing-hubris/
    http://www.medscape.com/viewarticle/829866#vp_4

  5. Still kind of mesmerized by Susan Minot’s piece on the Nicholas Nixon photographs in the Times magazine this weekend (Forty Portraits in Forty Years – did you see it?) – I found the four sisters as beautiful in their sixties as they were in college. And Kinfolk magazine had a great issue a short while ago with stunning photographs of aging women. I think authenticity, or realness, or truth, is an element of beauty, and Photoshop introduces an element of artifice that may render subjects more aesthetically appealing on one level, but it does subtract from their beauty. It would be sad, I think, for a bride to Photoshop away her wrinkles or blemishes or unwanted pounds, or for students to Photoshop their yearbook photos. But I would hate to see use of the application regulated, in particular, in fashion magazines, because fashion photographers are artists, not photojournalists (who do adhere to much stricter standards). Because it strikes me as a kind of censorship, and everything in me rebels at the thought of it.

    • Hi E,

      Yes, I think there’s something a little troubling about the idea of this initiative, especially if we think about fashion photography as an art form (I’d never vote to censor art). But I thought it was interesting that someone addressed this issue so head-on.

      G

  6. I found the article about yoga and eating disorders to be very interesting and the writing in the article was thoughtful and considerate – which is why I was then saddened to reach the end of the article and spot the links to the rest of the YogaJournal site, with labels like “Cleanse Tips”, “Juicing”, “Poses to Speed up Metabolism”. “Weight Loss” and “Yoga Diets”. A bit disappointing.

  7. Plenty of food for thought there. I guess the answer to the casein issue would be to treat Real Vegan Cheese as an occasional food not a staple and have it in moderation. home made raw vegan cheeses are great too for most things.

    • They are indeed, but I think this is a great option for those who desire such a product, but simply may not be inclined to make nut cheeses at home.

  8. Loved the yoga article, I personally pulled away from my practice during the height of my ED and returning to class was part of my recovery. But i have to be incredibly careful with the classes I go to and the teachers who teach them. I’ve grown increasingly saddened by the difficulty of finding a vinyasa-based class that isn’t all about going harder, faster, stronger. A class where the teacher doesn’t just say, “listen to your body. I’m just your guide” but also offers a variety of modifications AND paces the class so we can incorporate modifications. I’ve had to again take a step back due to some chronic injuries and realize what I miss the most is the freedom to be me on my mat. I wasn’t getting that from my most recent practice where I felt I had to push. Yes some of this is ego and work I need to do but it’s incredibly hard when the supportive, safe environment isn’t created. For now I’ve found a beautiful restorative class that incorporates reiki and it’s providing the safety and gentleness I need to heal mind and body, though yoga was therapeutic to me, i can easily see how the same cues and comments which inspire shame and lack of worth for my inability to do certain poses could feed an ED.

  9. Interesting about the Real Vegan Cheese, I hadn’t heard of it before, thanks for bringing it up! I read Ginny’s article too. I need to brush up on my casein research, I can’t remember exactly what’s out there on it, but I’m definitely with you on the “not every single thing we eat must be plucked from mother earth”. People can get really crazy about ‘WHOLE FOODS PLANT BASED” and while I love that the interest is there, there’s no need to obsess over it. Part of health is not driving yourself insane worrying about health, good grief! And cheese is SUCH a barrier for people that I think this could be HUGE! Awesome!

  10. Thank you as always. The yoga/eating disorder article was really interesting and surprising. I personally have overdone yoga in the past and let it become a part of my ED, and it took me a long time to realize and admit it. Reading articles like this are always good reminders for me that gentle yoga is okay, an hour is plenty, and skipping a day is fine. Somehow it’s always easier to see that logic in some one else’s story.

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