No Bake Choco-Oaties & Savoy Truffles

I created a delicious treat that reminds me of the no-bake cookies that you make with oatmeal, peanut butter & chocolate.  My healthy version is YUMMY and uses almond butter instead of peanut butter!  I store them in the freezer so they stay firm. (recipe below)  Also, I made Savoy Truffles from Rawvolution by Matt Amsden.  These are delicious carob/coconut balls that are rolled in coconut.  They also stay in the freezer.  If you don't have this book, it is a great one to have in your library. Below is my Raw Choco-Oaties creation and the Savoy Truffles.


NO BAKE CHOCO-OATIES
Printable Recipe

1 1/4 cups whole rolled oats
3 tbsp. raw cacao powder
1/2 cup raw agave
1/4 cup almond butter
Extra cacao powder to roll balls in.

Mix ingredients together and roll into balls.  Dough will be sticky. Then roll dough in cacao powder. Store in freezer for a more firm ball.

Savoy Truffles
Printable Recipe
Makes 20

2 cups raw almonds, finely ground in a food processor
1/2 cup carob or raw chocolate powder
1/3 tsp. sea salt
1 cup shredded unsweetened coconut
3/4 cup agave nectar
2 tablespoons olive or coconut oil

In a mixing bowl, combine the almonds, carob or chocolate powder, salt, and shredded coconut, and mix well.  Add the agave nectar and oil and mix until a dough like consistency is reached.  Using your hands, roll the mixture into ping-pong sized balls. Roll in coconut flakes.  Serve as is or cover and freeze before serving until thoroughly chilled for  a more solid consistency.

The Weird Al Yankovic School of Nutrition (WAYS Nutrition)

In the comments section of the last post, recent 180 newcomer Chief reminded me of Weird Al’s sage advice when it comes to your food. “Just Eat it.”

I figured it was finally time to confess. No, I am not Chief. But I will admit that everything I learned about nutrition came from Weird Al Yankovic, Board certified Musicianal Nutritionist. That whole “independent health and nutrition exploration” thing was really just a cover-up. I’ve never read any of the books I claim to have read. I just listened to every word of every album produced by Weird Al Yankovic, and developed my health and nutrition philosophy from it.  I am indeed a graduate of the WAYS Nutrition Program.  I had excellent grades as well, graduating Dim Sum. 

In today’s post, we take a glimpse into the exciting and pioneering health and nutrition insights offered up in song by Yankovic, M.D. (Musical Doctor). Yankovic gives some sound advice, particularly on the dangers of overconsumption of sugar, but it is hard to get a clear grasp of his nutritional philosophy as a whole…

Weird Al is actually a bit of a dietary prophet in my view, but I'm concerned that he leans towards the 30bananasaday crowd when he states, in Eat It, to...

"Have a banana, have a whole bunch, it doesn't matter what you have for lunch, just eat it."

But he sends some mixed messages in the song Taco Grande when he says...

"I love to stuff my face with tacos al carbon, with my friends or when I'm all alone."

In the same song he notes gluten intolerance in the form of physical addiction...

"My only addiction has to do with a flour tortilla, I need a quesadilla."

But he does show signs of weight gain when eating to appetite...

"I eat uno, dos, tres, cuatro burritos, pretty soon I can't fit in my Speedos."

He also suggests that white flour is fattening in the song Lasagna when he claims that eating more Ravioli...

"You will get Roly Poly, a nice-and-a-big-a like your cousin Luigi."

Yankovic also appears to have Bulemia as well, that is triggered by Bologna specifically...

"Never gonna stop, eat it up, such a tasty snack I always eat too much, and throw up... my, my, my, my, my, whoo! Mamamama my bologna!"

But my greatest concern is over Yankovic's sweet tooth...

He claims to love "the white stuff in the middle of an Oreo" and acknowledges that "you might get a pimple or two" and "his teeth are rotted clear through."

And he has mentioned problems with sugar addiction in the form of Rocky Road ice cream as well, and has been known to have "a gallon” in a single sitting, which he shows marked enthusiasm for by adding an emphatic “baby” after “a gallon.” He also encourages others by requesting that you "have another triple scoop with me." He consumed plenty in the privacy of his own home as well, and not just with others. When he’s all alone, he just grabs himself a cone.

Yankovic seems to have battled lifelong weight fluctuations as well, being so fat at one point that he claims to have needed “his own zip code,” which he presumably treated with the Grapefruit Diet if his song “Grapefruit Diet” is any indication.

And, on the topic of Circadian Rhythms and late night eating, I find this set of lyrics to be particularly revealing – perhaps being central to his tireless struggles with obesity…

I'm never satisfied with three meals a day
While the world is sleeping I'll be munching away
Gonna sneak into the kitchen, gonna tiptoe down and turn on the light
Right, yeah, if no one's around to see you
It don't matter if you snack all night

A million chicken bones are under my bed
A pile of Twinkie wrappers all 'round my head
Jelly doughnuts to the left of me
Got a bag of chocolate chips on the right
Right, yeah, if you don't mind the calories
It don't matter if you snack all night

Yankovic even appears to have spent time in the localvore scene getting some real, local foods. Is Yankovic a member of the Weston A. Price Foundation? Perhaps. He has “churned butter once or twice” during his time in what I assume is Lancaster county Pennsylvania, better known as “Amish Paradise.”



He might perhaps be into eating high meat as is commonly practiced by Aajonus Vonderplanitz, as his refrigerator is apparently filled with food that is unidentifiable and "living" as this lecture suggests...



And, if you are a woman and you find a strange desire to want to eat during the middle of the day, not really having a desire breakfast or dinner or brunch, there may be an innate biochemical  reason for it.  According to Yankovic's pioneering research, "Girls Just Wanna Have Lunch."

Anyway, it’s an interesting discussion. Below I’ve included some of Yankovic’s most powerful lectures on diet and health for further study.  His treatise on Rocky Road in particular is very inspirational, and speaks to the power of sugar addiction, the uniquely fattening property of ice cream, and the impacts of sugar on dental health...   


 

 

 

 

Raw Fruit and Greens with Papaya Seed Dressing

I found this gorgeous salad over at Foods for Long Life. Joanne's recipes are not only beautiful to look at, but extremely healthy. Butter lettuce, strawberries, avocado, papaya & raspberries make this so delicious. In this salad, I liked that Joanne used the salad ingredients to make the dressing, which is something I like to do as well. I also loved that she used a tablespoon of the seeds.  Read her post about the benefits of papaya and get her recipe.  Here are pictures of my salad and delicious papaya:)

Lemon Chia Fudge

Okay, doesn't everyone deserve a treat once or twice a year? (alright, maybe more often.) Especially one with lots of health benefits. Or, maybe you just want to make a delicious treat for someone special.  Here is a healthy version of fudge I created.  It has been tested and has received extra awards from my household.  This particular fudge is made with semi-sweet Vegan chocolate chips, so it has a dark chocolate taste. Very smooth and tasty with a hint of lemon. Great treat for the holidays.  I used Chia seeds because they are a good choice of Omega-3, anti-oxidants, calcium, protein, fiber, and many other vitamins & minerals and they work perfect in this recipe. Just one tablespoon would keep the Aztec warriors going all day.  Because Chia seeds absorb so much water, and have high soluable fiber levels, they help release natural, unrefined carbohydrates slowly into the blood system.  Unlike flax seed, chia seeds do not need to be ground up before eating them. Chia is so rich in antioxidants that the seeds don't deteriorate and can be stored for years without becoming rancid. Your body easily digests them with 7 grams of fiber. You can eat them straight from the bag, mix them in your favorite drink, top them on your fruit or vegetable salads or just about anything.
     I used raisins to sweeten the fudge.  Raisins have tons of antioxidants, contain calcium to build strong bones and contain a considerable amount of iron. You may think they are harmful for the teeth, but on the contrary~raisins are good for healthy gums & teeth. They help kill bacteria that causes tooth decay. They are also good for your eyes and help prevent macular degeneration.
     Walnuts are one of the best plant sources of protein. They are rich in fiber,  B vitamins, magnesium, and antioxidants, such as vitamin E. In 2003, the FDA recognized the benefit of nuts and their role in heart disease prevention by approving a health claim for 7 kinds of nuts (almonds, hazelnuts, peanuts, pecans, some pine nuts, pistachios and walnuts).
     Lemons give this fudge a delicious flavor and add extra vitamin C.
    You can feel good about eating this fudge!

LEMON CHIA FUDGE
Printable Recipe

1 cup Vegan chocolate chips (melted)
3/4 cup organic raisins
1 tbsp. organic vanilla extract
2 tbsp. Organic Chia seeds
1 lemon (juice only)
1/2 - 1 cup raw walnuts (chopped)

Melt chocolate chips in a saucepan on low.  In small food processor or blender mix raisins, vanilla, chia seeds and lemon juice.  Process until smooth. Pour in melted chocolate and mix well.  Stir in walnuts and pour into small (very small 6" x 7" container). I used a small glass pyrex dish and used 3/4 of the dish by smoothing it to the size I liked. Also, smooth top of fudge with a little water on your finger tip so it looks perfect.  Place in freezer and watch carefully for fudge to firm up, but not get too firm so you can slice easily.  Slice into squares and either put back in freezer or leave out at room temperature. ENJOY!

Balancing the Nervous System with Cassandra Damiris

The following is a guest post by health and fitness professional Cassandra Damiris.  Sandra contacted me many months ago when she decided to fully embark upon RRARF.  She followed the guidelines religiously, had a big rise in body temperature and many health improvements, and has since lost her excess body fat (mostly through Intermittent Fasting) without any damage to her large body temperature gains.  The following article puts RRARF into the context of balancing the sympathetic and parasympathetic Nervous Systems.  Big thanks to Cassandra!!!  Her contact information is at the end of this post.  To enlarge any of the images below, simply click on them...

If this is your first time reading the 180 Degree Health Blog, then I'm honoured that the first post you're seeing is one of mine.

I've been a fan of the RRARF (Rehabilitative Rest & Aggressive Re-Feeding - CLICK HERE FOR THE FREE RRARF EBOOK) protocal since it was known as the "The High Everything Diet" (HED). As a personal trainer that's worked with hundreds of people, I've been exposed to (and legally bound) to prescribe nutrition advice based on universal principles that don't take into account a person's unique constitution.

I think I've seen it all. Clients of all sizes, ages and fitness levels striving to achieve ideals only found within the various filters and graphic elements of Adobe Photoshop. I've trained women who continuously gain weight while eating 800 calories a day, men who take steroids and lost their ability to manufacture testosterone, teenage girls that drink coffee and smoke all day while running on a treadmill to nowhere, and desperate people who have resorted to gastric by-pass surgery as a last resort.

And for all this, I'm to prescribe nutritional advice based on a pyramid built by lobbyists and bureaucrats within an inner government circle? I don't think so. I quit training people last spring, but will be starting again very soon. What has transpired since then has completely rocked my world in terms of understanding human physiology, and what you're about to read is a fundamental component of what I've learned.

We're all biologically different, come from different genealogical backgrounds, live in different places, and are exposed to different stress and stimuli. Matt, through putting himself through various diets, has demonstrated to us the fallacy of following a universal strategy and how destructive it can be to our health. Since our constitutions are unique, our health issues must be approached at a root level that takes into account the various factors we encounter every day.

Getting to the root of one's physical, mental and emotional heath issues is an essential component of any holistic health and rejuvenation program. Much of what is discussed here on 180 Degree Health involves hormones, autoimmune disease, exercise and nutrition protocols and a key component to understanding these issues involves the nervous system and that's what we'll focus on in this article.

In a nutshell, the nervous system is the information superhighway of the body. Certain organs work with others, while glands send out messengers through the master control centre, the brain. The goal is homeostasis: an equilibrium of all processes in the body. A body in balance is healthy, lean and vibrant - one that transcends the physical into a mental state of well being.

A truly holistic approach to diet and exercise involves an understanding of how the various parts of the body work and communicate with each other – the interplay between organs, glands and hormones, and how they all work within the nervous system. This article is about the interplay between the nervous systems and how bringing them into balance could be the missing element in any holistic health program, like RRARF.

Understanding the Components of the Nervous System

The Nervous System is a collective network of neurons that work together with organs to coordinate movements and transmit signals between different parts of the body. There are two main branches to the nervous system: the Central Nervous System (CNS) and the Peripheral Nervous System (PNS).(1)

The CNS functions as the control centre, and is composed of the brain and spinal column, receiving information from the PNS, and developing an appropriate response to stimuli. The PNS monitors our body parts and organs and sends information to the CNS via a system of nerves connected to the extremities of the brain.(2)

The PNS can then be divided into two more branches, the Somatic Nervous System (SNS) and the the Autonomic Nervous System (ANS). The SNS, derived from the Greek word Soma (Σώμα) or body, coordinates bodily movements while reacting to external stimuli such as heat or cold. We're able to monitor the SNS in action as it is under our conscious control – we can feel ourselves shivering in the winter and we voluntarily raise our hands to grab objects. The ANS on the other hand is a system we are largely unconscious of, as it largely controls visceral or organic (organ) functions.

This article will mainly focus on the ANS, as this is the system the governs the processes we're most interested in here on 180 Degree Health: energy, digestion, repair and relaxation. The ANS can be further divided into two final branches: The Sympathetic and the Parasympathetic Nervous Systems. These can be thought of as complimentary processes: the sympathetic branch is often associated with outward energy production and response to stress/stimuli while the parasympathetic branch promotes rest, digestion and repair.

The Sympathetic Nervous System

When this system is activated, the body experiences the following effects(3):

• the digestive process is slowed down due to decreased blood flow away from the gastro-intestinal (GI) tract
• more blood is diverted towards the lungs and muscles
• lung function increases as a result of greater oxygen exchange
• peristalis, the action of muscles in the digestive tract (which push digestive food forward), is inhibited
• the kidneys produce a hormone, renin, that regulates blood pressure

The Parasympathetic Nervous System

In contrast to the Sympathetic Nervous System, the Parasympathetic Nervous system slows down many processes of the body that were formerly active, and promotes the following effects(4):

• digestion is stimulated by increased blood flow to the GI tract
• peristalsis is activated/accelerated, promoting digestion and absorption of nutrients
• pupils are constricted as a result of a process called accommodation, where the vertebrate eye changes it's optical power
• blood circulation to non-vital organs, such as the skin
• removes and detoxifies wastes from the skin, the extremities, the digestive tract, reproductive organs
• fuel storage (increased insulin activity)

Following is a diagram that outlines the organisation of the nervous system as it was explained above:

So now that we understand the framework of the various digestive, rest and repair functions, we need to insert the missing element in this analysis: the 'messengers' that send these signals to various parts of our body through these channels.

There is another system that works with these two to keep the body working in order, and that is the endocrine system - a hormone-based system run by glands that regulate body temperature, metabolism, tissue function, and mood, among many other processes. Certain glands are activated by the sympathetic branch of the nervous system while others are activated by the parasympathetic system. Let's take a look at the glands and hormones written about extensively in the 180 Degree Metabolism eBook, in context of the activities of the parasympathetic and sympathetic nervous systems:

Adrenal Glands & Cortisol

The adrenal glands are shaped like triangles and can be found on top of the kidneys. They are primarily activated by the sympathetic nervous system and release cortisol in times of stress.(6)

Adrenal Glands & Adrenaline

Adrenaline is released by the adrenal glands, and is triggered by acute stress, stimulants (nicotine, caffeine), dieting and lack of sleep.(7) It's production is activated by the sympathetic nervous system.

The Pancreas & Insulin

Insulin is considered to be a 'rebuilding hormone'.(8) The parasympathetic nervous system activates the storage of glucose, via increased insulin production and insulin sensitivity.(9)

How RRARF can help balance the Nervous System

Since many people subject their body to stress such as increased caffeine, meal-skipping, exhaustive exercise and restrictive diet regimes, we can assume that they are overproducing adrenaline and cortisol, which over time puts a lot of stress on the adrenal glands. The various components of RRARF, such as the reintroduction of unprocessed carbohydrates, decreased caffeine intake, decreased exercise and relaxation are essential in correcting the sympathetic-dominance imbalance plaguing so many people.

The next essential component to rehabilitation would be movement/exercise geared towards activating the parasympathetic system and relaxing the body. This involves breathing exercises, meditation and various training regimes such as Tai Chi and Yoga. Stay tuned for my next post, where I'll be delving further into that side of things.

Cassandra is freelance personal trainer based in Toronto, Canada
You can reach her through facebook, http://www.facebook.com/cassandra.damiris

References:

(1) Nervous system. (n.d.). In Wikipedia. Retrieved September 21, 2010, from http://en.wikipedia.org/wiki/Nervous_system
(2) Can-Fit-Pro. Foundations of Professional Personal Training. Windsor, 2008. Print.
(3) "Your Kidneys and How They Work." WebMD. Web. 21 Sep. 2010.
(4) The Parasympathetic Nervous System (PNS). Veronique Mead, MD. Retrieved September 21, 2010, http://www.veroniquemead.com/pns.php
(5) Per Brodal. The Central Nervous System: Structure and Function. Oxford University Press US, 2004.
(6) Adrenal gland. (n.d.). In Wikipedia. Retrieved September 21, 2010, from http://en.wikipedia.org/wiki/Adrenal_gland
(7) Diana Schwarzbein, MD. The Schwarzbein Principle II. Health Communications
Inc. Deerfield Beach, FL, 2002.
(8) Diana Schwarzbein, MD. The Schwarzbein Principle II. Health Communications Inc. Deerfield Beach, FL, 2002.
(9) The Parasympathetic Nervous System (PNS). Veronique Mead, MD. Retrieved September 21, 2010, http://www.veroniquemead.com/pns.php

Corn and Cashew Nut Curry with Perfect Brown Rice

I am having a lot of fun with curry this week as you can see. This is a hearty dish with a mild flavor.  I love the blend in this dish and the cashews were so good. I used lemon grass stalk in both the curry dish and in my brown rice as it was steaming.  This recipe gives you another chance to use your Thai red curry paste.
Lemongrass can be purchased at an Asian Market.






Corn and Cashew Nut Curry with Perfect Brown Rice
Printable Recipe
Serves 4

3 cloves garlic (minced)
1 red serrano pepper (thinly sliced)
1/4 yellow onion (sliced)
2 Tbsp extra virgin olive oil
1 cup raw cashew nuts
1 tsp Thai red curry paste
4 medium red potatoes (cut in cubes)
1 lemon grass stalk, fnely chopped
1 14 oz. can chopped tomatoes
1 1/2 cups water
1 14 oz. can corn (drained)
4 celery stalks (sliced)
2 Tbsp tomato ketchup
2 Tbsp soy sauce
2 tsp. sweetner of choice
4 scallions thinly sliced
sliced basil leaves

1.  Heat oil in frying pan or wok.  Add the garlic, red pepper and onions.  Cook over medium heat for 2 minutes.  Add the cashew nuts and stir-fry a few more minutes until they are golden.

2.  Add the red curry paste and cook for 1 minute, then add potatoes, lemon grass, tomatoes and boiling water.

3.  Bring water to boil, then reduce heat, cover and simmer for 15-20 minutes or until potatoes are tender. 

4.  Stir in the corn, celery, tomato ketchup, soy sauce and agave.  Simmer for 5 more minutes.  Spoon into bowl and sprinkle with the sliced scallions and basil with brown rice.

PERFECT BROWN RICE

1 tsp. olive oil
1 cup brown rice
1 lemon grass stalk (remove outer leaves & cut lower piece into 4 chunks)
1 tsp. Thai red curry paste
2 cups water (or vegetable broth)
2 basil leaves

Cook 1 cup rice, chopped lemon grass and curry paste in olive oil until light golden brown(about 5 minutes stirring constantly). Add 2 cups water and sliced basil leaves all at once. Bring back to a boil and then turn down to simmer for about 30-40 minutes.  
Perfect brown rice. Season as desired. You can replace water with vegetable broth.

                                                                    Health Seeker's Kitchen
                                                                           Lemon Grass

Promoting Health: Interval vs Steady Running vs Strength Training

The optimum physical exercise regimen for promoting health is a key public health issue.  Aerobic exercise can be obtained via running either using a steady pace or an interval-based approach.  Interval approaches typically includes high intensity exercise over shorter bursts of time.  Additionally, strength training provides a variety of health benefits and it’s role compared to aerobic exercise is unclear.

A Danish study was designed and recently published to compare the health benefits of interval training, prolonged steady paced running and strength training.  The key elements of the three interventions were:

• Interval training: 5 minute warm-up followed by 5 two minute intervals at near-maximal running with heart rate above 95% maximum (3 times per week)—total exercise time over 12 weeks approximately 480 minutes
• Steady running: one hour of continuous running three times per at 80% of maximum heart rate—total exercise time over 12 weeks 1800 minutes
• Strength training: progressive heavy-resistance strength training primarily in lower extremities for one hour twice a week—total exercise time over twelve weeks 1500 minutes

Subjects participated in their respective programs for twelve weeks and had a variety of baseline performance, physiologic and lab measures collected.  The main findings showing differences between the groups were:

• Maximum oxygen uptake improvement better in interval group than other two groups
• HDL to total cholesterol improved in the steady running group, remained the same in the interval group and tended to worsen in the strength training group
• Blood glucose (fasting and two hours after glucose load) improved in both running groups but not the strength training group
• Body weight/body fat/muscle mass: Only the steady running group decreased body weight and fat percentage, strength group increased weight, increased lean body mass 

This study helps understand the relative contribution to health promotion for a variety of exercise programs.  Interval training provides the most bang for the buck in increasing oxygen uptake and in glucose metabolism.  Steady running seems superior to other techniques for weight loss and cholesterol reduction.  Strength training alone has limited health promotion benefits primarily in the development of lean body mass.

Since the health benefits of the three types of training studied in the experiment are complementary, it seems reasonable to consider a workout routine using all three types.  Although combining the three would lead to a significant time demand that many are unable to accommodate.  A good study is needed that answers the following question: “Given one hour to exercise, what is the optimum combination of steady running, interval training and strength training?”

Photo of fish from Oklahoma Aquarium (modified using psychedelic mode in iPad Photogene app) courtesy of Yates photography.

Nybo L, Sundstrup E, Jakobsen MD, Mohr M, Hornstrup T, Simonsen L, Bülow J, Randers MB, Nielsen JJ, Aagaard P, & Krustrup P (2010). High-Intensity Training Vs. Traditional Exercise Interventions for Promoting Health. Medicine and science in sports and exercise PMID: 20195181

Should Every Child with Autism Have an EEG?

TED presentation by Dr. Aditi Shankardass brings up an important question--should all children with autism (or those undergoing an assessment for autism) have an EEG.  The presenter notes that in her experience in India, up to 50% of children referred with a diagnosis of autism have a seizure disorder or some other neurodevelopmental disorder.  The TED talk is posted above (7 minutes) and here are my notes from the presentation.

• 1 in 6 children suffer from developmental disorder
• Most diagnosed solely on symptoms
• Accuracy of diagnosis improved with laboratory measures
• Technology holds hope for diagnosing brain disorder
• She worked in a Harvard lab studying mathematical models to measure brain activity
• Statistical probability mapping combines EEG and statistical science
• She is setting up this technology in India

• Case study--seven year old referred with a diagnosis of autism
• EEG study was quite helpful
• Child did not have autism but had a seizure disorder
• Antieplileptic medication resulted in dramatic improvement
• She has found a significant number of children diagnosed with autism that had seizure disorders in the Indian referral population, this may be up to 50% of cases

So what about assessment guidelines for autism in the United States and Europe?  One of the best autism guidelines I could track down came from the Scottish Intercollegiate Guidelines Network.  This free guideline pdf document can be located here.  The guideline is titled:  "Assessment, diagnosis and clinical interventions for people with autism spectrum disorders. A national clinical guideline".

The guidelines provide a comprehensive review of the evidence supporting a variety of measures in the assessment process. The recommendation from the guideline related to standard EEG assessment is summarized: "Whilst epilepsy is common in children with ASD, there is no indication for an electroencephalogram (EEG) in the absence of other clinical criteria."  This recommendation comes with a citation from a 2005 review article by Kagan-Kushnir.

This review notes that seizures occur in 20-30% of children with autism and EEG abnormalities have been found in 10 to 72% of study samples.  Subclinical EEG abnormalities have been found in 6-30% of samples.  The authors note "There is insufficient evidence to recommend for or against the use of screening EEGs in autistic patients.  Given the frequency of seizure disorders in this patient population, a high index of clinical suspicion should be maintained for subtle symptoms of seizures".

The EEG technique referenced by Dr. Shankardassappears to be quantitative EEG or qEEG, a more complex EEG analysis than that done in a clinical setting.  qEEG research is ongoing at the TRANSCEND Research laboratory at Harvard directed by Dr. Martha Herbert. Dr. Herbert and colleagues have investigated a variety of EEG research measures in autism.  Recent findings indicate that autism subjects show decreased synchrony between the right and left brain hemispheres.  The clinical implications of these findings are unclear at this point.

It is unlikely that the percentage of undiagnosed clinically significant seizure disorders in autism in developed countries is high.  Nevertheless, clinicians and parents should be alert to potential subtle and non-subtle signs of seizure disorder in those with autism.  Additionally, it is not common for a child diagnosed with epilepsy to be misdiagnosed as autistic and to be "cured" by anti-epileptic therapy in the U.S. or Europe.  Although not unheard of, this misdiagnosis is reduced with comprehensive multidisciplinary assessments.  Concurrent autism and epilepsy (and EEG abnormalities) is a more likely clinical scenario than one disorder being misdiagnosed an the other.

The clinical diagnosis of autism and differential diagnosis of epilepsy continues to be one made primarily by careful history, observation and application of diagnostic criteria. Although this approach is not perfect, it does approach the reliability and validity found for other common medical conditions. When applied in a multidisciplinary setting, this approach is unlikely to misdiagnose a child with epilepsy as having autism alone.

So I think the question of need for an EEG in the context of autism should be left to the discretion of the managing physician.  Many will need an EEG as part of the assessment and differential diagnosis.  Some may not need them and the the managing physician is best able to make this distinction.

Kagan-Kushnir T, Roberts SW, & Snead OC 3rd (2005). Screening electroencephalograms in autism spectrum disorders: evidence-based guideline. Journal of child neurology, 20 (3), 197-206 PMID: 15832609

Isler JR, Martien KM, Grieve PG, Stark RI, & Herbert MR (2010). Reduced functional connectivity in visual evoked potentials in children with autism spectrum disorder. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology PMID: 20605520

The Neurobiology of Anxiety Disorders

A key question in the classification of anxiety disorders is whether the DSM-IV classification system describes distinct useful categories.  There is a great deal of overlap in clinical populations.  You do not find many individual who have one unique disorder.  Typically, someone with say panic disorder is likely to have one or more additional anxiety disorder such as social phobia or PTSD.  A key question is whether there is a broader anxiety disorder phenotype that might include a variety of symptoms found in specific anxiety disorders.

If specific anxiety disorders describe specific phenotypes, there should be evidence from what we know about the neurobiology of these disorders.  A recent comprehensive review of this issue has been published in the 2009 September issue of Psychiatric Clinics of North America and has been republished in Clinical and Laboratory Medicine.  The authors of this review make the argument that “there exist many distinguishing features that support the continued classification of individual anxiety disorders that are distinct from each other and from major depression.”  I will summarize some of their highlights for several of the individual anxiety, disorders.  The authors group their findings into anatomical and functional imaging findings, neuroendocrine and neurotransmitter, and genetic domains.  I will focus on the anatomical and functional imaging domains and refer the reader to the original manuscript for the other domains.

Panic Disorder

• Decreased glucose metabolism in parietal lobe and overall decreased cerebral blood flow
• Elevated glucose metabolism in amygdale, hippocampus, thalamus, midbrain and cerebellum
• Elevations normalize with successful treatment with behavioral or pharmacotherapy
• Panic attacks are linked with hyperactivity burst in right amygdale
• Anxious visual stimuli provoke increased activity in inferior frontal cortex, hippocampus, anterior and posterior cingulated cortex and orbitofrontal cortex

Posttraumatic Stress Disorder

• Severity of PTSD linked to greater activation of amygdale in response to fearful faces
• Ventral activation of anterior cingulate cortex with fearful faces predicts poor response to cognitive behavioral therapy
• PTSD patients activate the executive function network with combat-related images—this network is typically not activated in normals for emotional/affective processing tasks
• PTSD patients anxiety overwhelms brain inhibitory network producing more errors with cognitive tasks

Social Phobia

• Anticipation of public speaking tasks excessively elevates activation of subcortical, limbic and lateral paralimbic regions
• Response to trazodone in social phobia linked to decreased blood flow to ventral and dorsl anterior cingulate cortex and prefrontal cortex and increased cerebral blood flow to middle cingulated cortex, left hippocampus and parahippocampal gyrus
• Misinterpretation of social cues due to dysfunction of the cortico-striato-thalamic network

Generalized Anxiety Disorder

• Pediatric patients with generalized anxiety show enlargement of amygdale
• Elevated prefrontal cortex resting activity felt to be an anxiety compensatory response
• Elevated amygdala and insular cortex activation with angry faces
• Venlafaxine drug response tied to lower pretreatment amygdala activity and higher anterior cingulated activity

One of the methodological problems with imaging, neurotransmitter and genetic studies in anxiety disorders is the issue of identifying individuals with a unique anxiety disorder.  Even this strategy may be problematic.  Studying a young adult patient with a unique panic disorder diagnosis does not account for the possibility of later development another anxiety disorder such as social phobia or PTSD.

Although a great deal of progress has been made in the neurobiology of anxiety disorders, the challenge of understanding the best classification strategies remain.  Clinicians are typically, left with a implementing a trial of a selective serotonin re-uptake inhibitor or cognitive behavior therapy in patients with a single or multiple anxiety disorder diagnoses.  The jury is out whether neurobiology can lead to improved and more specific treatments.  

Photo of Tiger Woods Chipping at 2010 PGA Championship Courtesy of Yates Photography

Martin EI, Ressler KJ, Binder E, & Nemeroff CB (2009). The neurobiology of anxiety disorders: brain imaging, genetics, and psychoneuroendocrinology. The Psychiatric clinics of North America, 32 (3), 549-75 PMID: 19716990

Tofu and Green Bean Red Curry

This is a delicious recipe that everyone needs on their list of regular meals.  It is so delicious!!  The red peppers, cilantro & lemon/lime peel make this unique and so flavorful.  The tofu and Portobello mushrooms take on the flavor of the Thai red curry  paste.  You have to try this~we all loved it.

Tofu and Green Bean Red Curry
Printable Recipe
Serves 2

1 13.5 oz. can light coconut milk
1 tablespoon Thai red curry paste
3 tablespoons soy sauce
2 teaspoons agave nectar
3 cups Portobello mushrooms (cut into squares)  (2 mushrooms)
1 cup green beans
6 oz. firm tofu (Rinsed, drained and cut squares)
lemon and lime zest (use a citrus zester to get long thin pieces)
2 small red chili peppers (sliced thinly in circles)
fresh cilantro leaves to garnish

Pour 4 oz. of the coconut milk into a pan.  Cook on medium for about 3 minutes.  Add the red curry paste, soy sauce and agave to the coconut milk.  Add mushrooms, stir and cook for 1 minute.  Stir in the remaining coconut milk.  Bring back to a boil, then add the green beans and tofu cubes. Turn heat down and simmer for 5 minutes.  Spoon the curry into a dish and garnish with the sliced red chili peppers, lemon & lime peel and fresh cilantro leaves.
I served it with both chop sticks and a spoon.

Fresh Garden Salsa & Fantastic Refried Beans

My son & daughter-in-law brought over some of their garden tomatoes, peppers, spaghetti squash & yellow squash a few days ago and they were all gorgeous! Their garden is sure doing a lot better than mine this year. I decided to make some homemade salsa and it turned out delicious.  This is my daughter-in-law, Jeni's, foolproof recipe!  It is always a hit whenever she makes it.  Also, for quick and easy, I made some refried beans to go with it.  I made the refried beans from Fantastic World Foods and added 1 tablespoon of my garden salsa & 1 tablespoon of fresh lime juice.  I served it up with some whole grain corn chips. YUMMY!

Fresh Garden Salsa
Printable Recipe

1/4 large white onion
1/4 bell pepper
1-2 cloves of garlic
1/2 lime (You can add the flesh of the lime or just the juice)
1 hot pepper - i.e. Jalapeno or Serrano (you can add whole or half or a combination)
2-3 sprigs of cilantro (you can also use dry cilantro.  About 1/2-1 tsp.)

5 Roma tomatoes
1 tsp. salt

combine first 6 ingredients in a blender/chopper until chopped finely.  Set aside in a bowl. (I do this to ensure the peppers and onions are chopped finely so you don't get a whole mouthful of onion or pepper.) Chop tomatoes and salt in blender/chopper. Combine onion/pepper mixture with tomato mixture.  Mix and serve!!  (Sometimes it is better to make in advance to allow the flavors to meld together for a couple of hours.)

Ending Emotional Eating

First of all, man am I glad to be back home. New York City was awesome this trip, and I’ll be writing about my food adventures there at http://180kitchen.wordpress.com/ very soon. But all in all it felt like a competition to see how much caffeine, alcohol, sugar, nitrates, and vegetable oil I could get into my system. I’m more than ready for a breather from that. I’ve never been so glad to see ground beef, coconut oil, sweet potatoes, and spinach. In fact, the burger I ate for breakfast this morning was so large I started singing “Everybody Wants Some.” I actually filmed it below. Any resemblance to a young John Cusack is purely coincidental.



Anyway, time to discuss what is a huge and extremely prevalent problem in the modern world – emotional eating.

As discussed in many prior posts, food triggers a response in the pleasure centers in the human brain, acting on pleasure neurotransmitters like serotonin and dopamine. It is no surprise that when many people feel a sense of chronic stress, anxiety, shame, guilt, and so on – food becomes not just a way to fuel oneself, but a form of psychoactive medication. And in general, what provides the highest pleasure response is…

1) Rapidly-absorbed foods like white flour and liquid sugars
2) Sweets, whether natural as in honey, refined as in sucrose, or non-caloric
3) Calorie dense foods – like French fries, pizza, brownies, ice cream, or cheesecake
4) Alcohol and caffeine-containing drinks and substances
5) Foods with flavor enhancers like MSG found in most fast food and highly-flavored stuff like Cheetos or Doritos
6) Foods with low water content – that are therefore very calorie dense (butter, oils, nuts, dried fruit, chips, crackers, cookies, bread)
7) High-calorie liquids such as soft drinks, fruit juices, whole milk, half n’ half
8) Large quantities of food in general, of any kind

This is a 2-way street, as eating some of these foods, particularly those with the highest capability of triggering a pleasure center response like a fast food meal with a large sugary drink and a dessert all mixed together in one hit, can in turn cause massive emotional fluctuations. First a high, followed by a crash, which is addiction pathology 101 and can be caused by anything that is unusually, and unnaturally, pleasurable.

It works the other way as well. Chronic stresses such as the loss of a loved one, self-esteem issues, relationship problems, being in an abusive situation, financial stresses, and other problems that are of a chronic nature have a tendency to activate the same hormonal changes that a famine is capable of inducing. That is, an increase in cortisol production as well as synthesis in fat cells themselves. Hypercortisolemia, induced by any form of chronic stress from famine (the reason we are designed to have this fat storage response to stress in the first place – marked by a drop in metabolism, reduction in fat burning, increased production of fat storage enzymes, increased appetite, increased cravings) to depression to sleep deprivation can all trigger an increased appetite for the things on the above list.

This is why calorie restriction combined with a huge exercise load has the following impacts on a typical person…

1) Increased alcohol, sugar, and caffeine cravings – along with foods with very high calorie density and huge quantities of overall food in general
2) Increased appetite
3) Reduced body temperature
4) Increased risk of infection
5) Decreased desire for physical activity (as well as sex and other calorie-burning activities)
6) And so on

Likewise, following the guidelines laid out in the THIS FREE EBOOK brings about the exact opposite set of changes.

Anyway, ending emotional eating is not difficult. In fact, most people have emotional eating issues to begin with because of chronic dieting, undernourishment, insufficient sleep, and excessive stress in the first place. It all starts with feeding yourself well as the FREE EBOOK explains.

Helpful tips include eating a diet that keeps you even keel emotionally. No one ever could have convinced me of the power of eating a well-balanced, calorically-sufficient, whole foods diet without excessive exercise and adequate sleep on emotions until I actually tried it religiously. Like Jon Gabriel mentions in this fantastic interview, “there are no more good days and bad days.” You are more or less anti-dieting at that point.

Another helpful hint is to eliminate substances you know you are addicted to WHILE EATING WELL and RESTING WELL. Eliminating addictive or problem foods that have been a target of emotional eating binges for years does not work if you are depriving yourself of anything. Otherwise you will increase your cravings for those “problem” foods as each day passes. With the right set of nourishment and minimal stress from intense exercise regimens – as well as plenty of time for rest and relaxation, there is simply no low serotonin and dopamine state occurring in your brain that causes the outrageous cravings to eat foods that spike those feel good neurotransmitters into the stratosphere.

By keeping yourself even keel with consistent sleep patterns, regular mealtimes, no skipped meals (or at the very least not skipping meals when you are hungry), and plenty of calories at each feeding to leave you feeling satisfied – there is simply no low state in need of medicating with food and drugs.

The real problem is that people are under all kinds of emotional stress, work stress, lack of sleep, and more while at the same time thinking it’s healthy to eat as little as possible, or at the very least go to war with fat, carbohydrates, or animal products while exercising as much as they can stand to.

This is what CAUSES emotional eating in the first place, exacerbated of course by the halo of guilt that a person experiences after eating junk food and the shame and loss of self-esteem that they feel over whatever excess fat they carry after each episode.

In short, emotional eating is caused by being at war with yourself and asking much more of your body and mind than you give in return. The big picture answer to emotional eating is to end that war.

Would you try to raise a healthy baby by depriving it of food, making it feel constantly scared, torturing it, yelling at it for being fat, weak-willed, and lazy, not letting it sleep, and forcing it to do a lot of exercise? No. Then why are you pursuing health by trying to do that to yourself?

Physical, emotional, and mental health is obtained by obeying your physical, emotional, and mental needs – not ignoring them and then beating yourself up over your cravings, fatigue, depression, and body fat.

Stressful Live Events and Suicide

The role of stressful life events in suicide attempts and completed suicides has been a key area of study in the epidemiology of mental disorders.  Although suicidal behavior often occurs in the context of acute and chronic stressor, this does not prove a causal link.  We all could probably report serious life stressors throughout out lives and these could be interpreted as a reason for suicidal behavior.  So these associations could simply be a coincidence and not have anything to do with suicidal behavior.

A recent analysis of the WHO (World Health Organization) World Mental Health Surveys attempts to shed some light on this issue.  This study focussed on traumatic life events, a subset of life stressors that are associated with the development of PTSD.  The traumatic events studied included:

1. natural and man-made disasters
2. combat, war and refugee experiences
3. sexual and interpersonal violence
4. witnessing or perpetrating violence
5. death or trauma to a loved one

These more serious stressful life events provide a opportunity focus on events everyone would agree as significant.  The authors then looked at five lifetime categories related to suicide:

1. suicide ideation
2. suicide attempt
3. suicide planning in those with ideation
4. suicide attempt in those with a suicide plan
5. suicide attempt in those without a plan

The most common traumatic events reported by respondents across the 20 country survey included: death of a loved one (30.5%), followed by witnessing violence (21.8%), interpersonal violence (18.8%), accidents (17.7%), exposure to war (16.2%) and trauma to a loved one (12.5%).

The authors of the study perform complex analysis of the individual and cumulative effects of traumatic events.  The key findings summarized by these analyses include:

• experiencing interpersonal or sexual violence appeared to have the strongest effect on suicidal ideation and suicide attempt
• suicidal ideation and attempts had a dose-response effect with traumatic experiences--the more number of experiences, the higher the risk although this effect plateaued after experiencing about 4 events
• traumatic effects had limited effect on the progression from suicidal ideation to a suicide attempt
• effects of traumatic events occurred across low-, middle- and high income countries
• it was estimated that elimination of traumatic life events could reduce population suicide ideation by 15% and suicide attempts by 22%

The study was not able to analyze the effect on the most important variable--completed suicide.  This would add significant weight to attributing a link between traumatic life events.  Nevertheless, this study provides additional insight into stressful life events and suicide ideation and plan.  Traumatic events appear to be important although playing a relatively minor role.  Presence of a serious mental disorder, i.e. major depression, bipolar disorder, substance abuse, schizophrenia, severe personality disorder continues to be the most important risk factor for suicide.

Photo of Baby Duck in Grass Courtesy of Yates Photography

Stein DJ, Chiu WT, Hwang I, Kessler RC, Sampson N, Alonso J, Borges G, Bromet E, Bruffaerts R, de Girolamo G, Florescu S, Gureje O, He Y, Kovess-Masfety V, Levinson D, Matschinger H, Mneimneh Z, Nakamura Y, Ormel J, Posada-Villa J, Sagar R, Scott KM, Tomov T, Viana MC, Williams DR, & Nock MK (2010). Cross-national analysis of the associations between traumatic events and suicidal behavior: findings from the WHO World Mental Health Surveys. PloS one, 5 (5) PMID: 20485530

Carrot Raisin Salad

Back in my college days I made carrot raisin salad all the time.  I love the combination together.  Today for lunch I created a new version of my former recipe. It ended up being so delicious and easy. And yes, I did eat the whole batch.  This recipe is enough for one person or several people as a side dish.  It is very filling with 3 carrots, 2 apples & 1/4 cup raisins.

Unlike most vegetables that carry a high source of one vitamin or another, carrots are concentrated with Vitamin A, beta carotene, fiber and numerous other vitamins which work together to solve a number of maladies. Whether you consume them cooked, raw or juiced, carrots will provide your body with its beneficial nutrients. If you want to boost your immune function and stay healthy this winter, eat carrots every day.  If you can juice them with some greens you will absorb more of their wonderful health giving nutrients. One thing that is wonderful about carrots~they are so inexpensive to buy. Enjoy carrots in a variety of ways.  Be creative!

Carrot Raisin Salad
Printable Recipe

3 large carrots grated
1 1/2 apples grated (leave peelings on)
1/4-1/2 cup raisin
2 basil leaves (thinly sliced)
Walnuts (chopped for top)

Dressing:
1/2 apple (remove peelings)
1 lemon (Juiced)
1 Tab. raisins

To make dressing put 1/2 apple, juice of one lemon, and raisins in small bender &  blend until completely smooth.  Pour on top of grated carrots, apples, raisins & thinly sliced basil leaves. Mix well.
Lightly sprinkle on chopped walnuts.

Resetting Your Circadian Clock

Your typical health geek knows very little about Circadian rhythms, but real researchers know that there is a tremendous significance behind our daily biochemical rhythms. For those that don’t know, the circadian rhythms are basically just secretions of various chemicals and enzymes that take place during the 24-hour cycle that are set like a clock.

For example, during the evening it is natural for humans, a diurnal creature, to see a drop in cortisol and a rise in serotonin. This kills your appetite and makes you calm, sleepy, and ready to hit the hay after the sun goes down.

In the morning you see cortisol peaking in a normal, healthy human with ideal circadian rhythms. This helps to promote hunger, whereas having low cortisol levels throughout the night lends itself to a lack of hunger, helping you sleep soundly without needing to go on a midnight cupboard rampage. Anyway, you get the idea.

I first came across the importance of circadian rhythmicity when reading T.S. Wiley’s Lights Out: Sleep, Sugar, and Survival (2001) many years ago. In the book, Wiley makes a strong argument for the importance of sleep in avoiding metabolic syndrome due to the sleep cycles impact on circadian rhythms – cortisol in particular. And yes, it’s true, humans are sleeping increasingly less as the decades pass. Shawn Talbott, in the Cortisol Connection, mentions how the average night’s sleep has decreased from nearly nine hours of ZZZ’s to a measly seven over the past century. More and more studies seem to be emerging lately showing that lack of sleep is synonymous with metabolic syndrome.

During that same time, you see people drifting away from eating traditional breakfast classics like steak and eggs and moving to smoothies, Nutri-Grain bars, bagels, pastries, and Special K - the choice of a new, and pretty pathetic, generation. Being in New York City this morning, the white flour capitol of the world, and passing 2,784 bakeries and smoothie shops trying to find a place that serves something besides coffee, bagels, pastries, and smoothies was a great reminder of just how pervasive this poor excuse of a breakfast has become.

Keep in mind that these are the business establishments designed to serve those who DIDN’T wake up to sugary breakfast cereal or a smoothie they made themselves.

Anyway, that’s a separate tangent. What I’d really like to focus on is something that is a simple well-known fact that my own personal observations have reinforced over the years…

People with various signs and symptoms of metabolic syndrome seem to almost always have circadian rhythms that are totally out of whack.

To describe what I mean, I’ll explain what I believe to be a day in the life of someone with proper circadian rhythms…

1) Wake up in the morning spontaneously without an alarm clock at dawn no matter what time you fell asleep, full of energy and in a good mood with a strong appetite – like the family dog when he was in his prime

2) Eat a large and substantial breakfast

3) Desire to exercise early in the day, or at least get some kind of physical activity. Jittery and hyper if exercise is not possible

4) Have energy throughout the day without fatigue, drowsiness, irritability, feelings of depression or elation, mental fog, etc.

5) Good strong appetite at lunch but no panicked need to eat. Could skip lunch if he/she had to

6) Decreasing hunger levels throughout the day

7) Eat a normal-sized early dinner with no cravings or hunger afterward

8) Become sleepy early in the evening but not exhausted

9) Have no trouble falling asleep or nighttime hunger or cravings

10) Sleep soundly without hunger, without waking in the middle of the night, no need to urinate during the night

This is generally what a day in the life of a person with ideal circadian rhythmicity is like.

A short summary would be to simply say that most of the hunger and energy levels occur early in the day, while hunger and energy levels both decrease later, which results in no nighttime cravings for sugar or alcohol, no restless tossing and turning with your mind churning a million miles an hour or restless legs when you’re trying to fall asleep, and a solid night of deep sleep that you pop right out of early in the morning with no grog, fog, or zombie foot shuffling across the floor to get to the coffee maker. The day starts with bright-eyed energy, enthusiasm, and optimism with sort of a clean slate feeling.

Your typical obese person, or someone with the classic metabolic syndrome profile, often describes himself or herself as “not a breakfast eater” and “a late-night snacker.” Every morning is like having a hangover with no desire to eat and an unshakable feeling of drowsiness, fog, irritability, and fatigue. Hence the need for coffee at the very least, and something sugary and “light” if anything is eaten at all before noon.

At night things are equally screwed up, and even more annoying. Instead of winding down for a good night’s sleep, your typical metabolic syndromer starts winding up, and would love to go to sleep but hunger, cravings, and a feeling of restlessness seep in and get in the way – not to mention the normal chemicals that are supposed to be secreted in the evening that reduce the need to urinate aren’t secreted. What otherwise could have been complete sleep cycles is interrupted by a mega urge to whizzle if nagging hunger and cravings doesn’t get ‘em first.

Anyway, this is not meant to be a deeply revelatory blog post or anything like that. Rather, I want to put the importance of normal daily rhythms in the forefront of everyone’s mind.

In an evening of nonstop chatter and good times here in New York with Chek-certified trainer and health specialist/author Antonio Valladares, I mentioned that Circadian rhythms were something I was hoping to address in the near future. Valladares, who has spent years testing hundreds of clients with saliva tests taken at 4 times throughout the day to get a sense of such rhythms, responded to this by saying that “just knowing about Circadian rhythms puts you ahead of 99.9% of health and nutrition authorities out there.” I also asked him just how prevalent abnormal adrenal tests are, to which he said – “dude, it’s EVERYBODY.” And keep in mind this is just the saliva test, which says exactly NOTHING about the activity of the 11-HSD-1 enzyme that regulates corticosteroid activity in fat cells which I believe to be far more significant than levels detected in blood and saliva of adrenal hormones such as cortisol.

Coming up later we’ll definitely be focusing on some tricks to reset the biological clock. But in my experiences with resetting my clock and becoming more or less a new man years ago when I started really geeking out hardcore on all this health stuff, the most prominent keys to resetting the circadian rhythms go something like this…

1) Establish a regular bedtime. It’s better to go to sleep as close to sunset as possible, going to bed early. However, more important than the actual time you go to sleep is the regularity and consistency. Going to bed at almost the exact same time daily is a huge tool if you are seeking to better regulate your circadian rhythms.

2) Eat almost all of your calories within the first 8 hours of waking up. Eating an early breakfast that is pretty high in meat (and monstrous) is a great tool. If you are not a morning person and would like to become one, eating a big slab of something good in the morning is a powerful tool. An ideal day for me consists of about 80% of my calories being consumed during a very early breakfast and a midday lunch (interestingly, THIS STUDY that Riles passed along shows big differences in intermittent fasting when it comes to giving the food during daylight hours vs. giving the food at night. Our official 180 IF guinea pig, Collden, has also noticed much better circadian rhythms when eating food earlier in the day).

3) Stagger exercise towards the morning hours vs. the evening hours. This is still the hardest for me, but people that wake up to yoga, or a good workout, or a morning walk almost always notice a re-calibration of circadian rhythms (they shift to have more energy in the morning and be spontaneous “morning persons”).

4) Don’t watch too much late night tv, drink too much alcohol in the evening, or stuff yourself with a dessert after a full meal in the evening.

More on this to come as I delve deeper into this. But in general, the idea is to raise stress hormones in the morning with protein-rich foods and physical activity and keep them low at night. The carbohydrate to protein ratio discussed in the last post as well as the concepts here address that very simple fundamental.