At this time of year thoughts often turn to things in our lives we would like to change, personal qualities we would like to foster, habits we would like to build. In cultures around the world the new year is thought to be a time to reflect on the past and resolve to be kinder, try harder, and make a change in the coming year.

These are excellent intentions, but they are in direct conflict with the human tendency to resist change. It may seem simple to begin exercising for 30 minutes 4 times a week; simple is not the same as easy. In order to make a change time must be carved out. New habits need to be created to overcome our very natural tendency to inertia. In order to carry through with our intentions we need a strategy.

Below are 3 approaches to help manifest change.

Temptation bundling – One clear way to motivate is to combine something we don’t want to do with something we enjoy. This is slightly different than a reward system because things are done together to create a positive association. For example – every time I go to the gym I get to read a book for pleasure or watch video, two things I enjoy but rarely have time for in my day to day life. In fact I reserve certain videos for the gym, so that it is my special treat during that time.

Another example is diet change. We can’t just eliminate all the familiar comfort food. No matter how determined we are, it is a setup for failure. The people who do best with dietary change are people who like the food on their new plan. We need to find things we really enjoy on our new diet and let ourselves have them!

Know the worth of your goal and be able to track your progress. What is the purpose of making this change? Is it a long term goal like staying healthy into your 80s. If so, you need to be convinced the goal is valuable and reachable. Vague belief is not enough to motivate. Read the research – a lot of it. Have objective ways to measure your goal like labs showing lower cholesterol or better blood sugar control.

Short term goals are easier to see. Examples of these type of goals are training for an athletic event, doing one kind thing every day for a month, or losing  a set amount of weight. These goals offer more immediate gratification, but you still have to believe in the value of your goal or your will not have the commitment to reach it.

Get support – Some people thrive when they have a buddy with a shared resolution. It is extremely helpful if at least one person in your household chooses to make a diet change along with you. The support of a group can also very valuable. This is the purpose of writer’s groups. Writing can be such a solitary activity. Having a group of people to assess your work, give feedback and support can be the difference between continuing to write and giving up.  

Even without a structured buddy system or group, the support of friends and family is vital to success. Without the positive reinforcement and the willingness to occasionally pick up the slack, making meaningful change is difficult.

Finally – Change should not be punitive or trigger deprivation. For long term success, approach the change you seek as an opportunity – a gift.


Demystifying a Breast Cancer Diagnosis

A diagnosis of cancer can feel overwhelming. Understanding terms like stage, grade, and surgical margins requires you to learn a new language overnight. But it is time well spent. To make the most informed decisions about treatment it is important to understand your diagnosis. In order to help interpret your biopsy report, scans and cancer type, I am pleased to post this informative article by naturopathic oncologist Dr. Katherine Neubauer of Survive and Thrive Cancer Care, a national integrative oncology consulting practice.

Breast Cancer Overview

A new breast cancer diagnosis brings a lot of information. The good news is that the prognosis is good when breast cancer is caught early. For advanced breast cancers, there are still many good treatment options.

When making treatment decisions, it is important to know your breast cancer type. Some breast cancers respond to hormone therapy, while others don’t. Chemotherapy is beneficial for some tumors and not others.

It’s also helpful to develop an overall approach before beginning treatment. For example, some types of surgery need subsequent radiation, while others don’t. And, the timing of breast reconstruction is affected by whether you need radiation.

How do I know my breast cancer type?

There are a few key pieces of information to review in your biopsy, scans, and blood tests:

Kind of breast cancer Invasive ductal carcinoma is the most common type. Others include lobular carcinoma and inflammatory carcinoma. Ductal carcinoma in situ (DCIS) is a precancerous condition.

Tumor’s response to hormones For example, a tumor can be “ER positive” if it uses estrogen to grow, or “ER negative if it is not sensitive to estrogen. ER-positive tumors can respond to hormonal therapies like Tamoxifen, while ER-negative tumors do not.

Genetic studies These tell us how aggressive the tumor is likely to be. Her-2 positive tumors are more aggressive than Her-2 negative tumors. However, Her-2 positive tumors can respond to the drug Herceptin. Ki-67 indicates how quickly the tumor cells are growing. BRCA mutation indicates aggressiveness. BRCA mutations increase the risk for other kinds of cancer and the gene is inherited, so this may also guide health care for you and your family.

Tumor grade tells us how similar the tumor is to normal breast cells. It is a good thing if the tumor is “high grade” or “well differentiated”. This means that the tumor is more similar to normal cells, and is less likely to grow or spread. Tumors that are “poorly differentiated” or “anaplastic” may need more thorough care.

Tumor stage explains where the tumor is in the body, as well as how large it is. Stage is expressed as a number between 1 and 4. 1 is a small tumor that is only in the breast. 2 and 3 are tumors that are larger or have spread to nearby tissues. 4 is a tumor that has spread to other organs. Stage is often written as a Roman numeral, from I to IV.

Surgical margins If you’ve had a mastectomy or lumpectomy, the pathology report will specify the size of the surgical margins. To reduce the risk of leaving tumor cells behind, the surgeon tries to cut out a border of healthy tissue from around the tumor. This healthy tissue is the surgical margin. While the surgeon makes every effort to get a good margin, the pathologist may later find microscopic tumor cells that were invisible to the surgeon. This is an “involved margin”. If you have a poor or involved margin, it may be wise to get radiation and additional surgery.

Oncotype Dx Score some tumors clearly benefit from chemotherapy. For others, the decision is less clear. This test can be done on a sample of your tumor tissue from a lumpectomy or mastectomy. The results can tell you how beneficial chemotherapy would be.

gluten free millet meatloaf

Millet Meatloaf

This simple loaf is a meal in itself.  The grain and vegetables disappear and even picky children love it.  The recipe is very versatile. For a traditional meatloaf try ground beef with carrots, celery, onion and rosemary.  With ground turkey try sage and thyme.  Many of the cruciferous vegetables like broccoli or cabbage work well in this recipe.

–       2 lb of ground grass fed beef or lamb or beef, or organic ground turkey

–       2 cups of minced vegetables (equal parts onion, carrot and celery work well)

–       ½ cup of millet (or use corn meal)

–       1 ½ teaspoons of salt.

–       2 teaspoon of fresh herbs such as rosemary, thyme, sage or basil, or use 1 teaspoon of dried herbs

Grind the millet in to coarse flour in a coffee grinder or food processor. Place all of the vegetables and the herbs in a food processor and chop them to a fine mince, or mince them by hand.  In a large bowl combine the minced vegetables, millet flour, salt, herbs and meat and mix them well.  Form the mixture into a loaf and place it on a cookie sheet. You may top it with catsup or bacon slices (before baking)if desired.  Bake the loaf at 400 degrees F. for ~ 45 minutes or until the internal temperature reaches 180 degrees F.  Cool the meatloaf for 10 minutes before slicing it.  Serve it with roasted brussel sprouts and a green salad. This loaf freezes well after slicing so try making a double batch.

crunchy cruciferous brussel sprouts

Easy Roasted Brussel Sprouts or Broccoli

This is a delicious preparation of brussel sprouts when they are in season.  Roasting them yields crispy outer leaves with a soft, sweet center.  It is also a great way to prepare broccoli year round.

–       2 cups of brussel sprouts or broccoli florets

–       2 tablespoons of olive or coconut oil.

–       ½ teaspoon of salt

–       (optional) ½ teaspoon of dried thyme

 Preheat the oven to 400 degrees F. Prepare the brussel sprouts by cutting off the rough base and removing any tough outer leaves.  Toss them in a bowl with the oil and salt.  Spread them on a cookie sheet that has been lined with parchment paper and bake them for ~30 minutes, stirring occasionally.  The vegetables are ready when they are easily speared with a fork.  Serve them hot or at room temperature.

Sugar is essential for life, but chronically elevated blood sugar leads to a host of health problems (see the recent post “What About Blood Sugar” Luckily, diet has a huge impact on blood sugar. What we eat and how we eat it can make the difference between health and disease. There are three major ways to lower blood sugar with diet – reduce the consumption of simple sugars, reduce the consumption of complex carbohydrates and slow the digestion of complex carbohydrates.

avoid soda

To understand how the foods we eat affect blood sugar it is important to understand the difference between simple sugars and complex carbohydrates. Most of the sugar in our blood is a specific type of sugar called glucose*. In its simple form (a single molecule) glucose is found in fruits and vegetables and in concentrated sweeteners like sugar or honey. Complex carbohydrates (aka starches) are long chains of glucose molecules. They are found in a variety of foods including rice, pasta, and potatoes. When complex carbohydrates are digested the chains are broken and glucose is released.

Simple sugars are absorbed quickly; it takes very little time for them to enter the blood stream and raise blood sugar. Because complex carbohydrates need to be broken down before they can be absorbed, they enter the blood stream more slowly. Certain foods slow the digestion of complex carbohydrates when they are eaten at the same time. These are foods rich in fats, proteins and fiber. There are many benefits to delaying carbohydrate digestion. The energy released from the food is slow and steady. Because food stays in the stomach longer hunger is abated and there are no sharp rises in insulin leading to increased fat production .

Here are some examples.

–         A soda (or fruit juice) has lots of concentrated simple sugars. These will be absorbed quickly and cause the blood sugar to rise quickly.

–        A bowl of brown rice will be digested fairly quickly and will cause blood sugar to rise ~ 1-2 hours after eating.

–        A bowl of brown rice that is eaten with a piece of chicken or fish and some olive oil will be digested slowly over ~ 3-4 hours. The sugar from the rice will be absorbed over a long period of time and there will not be a sharp rise in blood sugar.

balancing protein and complex carbohydrates can balance blood sugar

Eating in a balanced way can lead to sustained energy and facilitate weight loss. Most importantly, keeping blood sugar level and low can help to prevent numerous health problems. Don’t miss the recipes in next weeks post!

*There are two other types of simple sugars – fructose and galactose. These are metabolized somewhat differently than glucose. In order to keep things simple and clear we will not be discussing them in today’s post.

The bridge to Marin County, CA

I want to thank everyone for their patience during my relocation to California. If there are topics that you would like to see covered in the future, please send me a comment and I will do my best to include them.

Be Well,

Dara Thompson N.D.

Pork and Pumpkin Stew

This simple stew is satisfying and delicious.  It is best with an heirloom variety of pork like Berkshire.  Pork has a reputation for being unhealthy. Indeed factory farmed pork is full of unsavory chemicals.  Organic, vegetable-fed pork from small family farms is a much better choice. Pigs serve and important function on small farms, eating the scraps that people don’t want.  Because pigs are not ruminant (grazing) animals they don’t produce very high levels of greenhouse gasses.  Raised in this way, pork is lower in saturated fats and many toxins than either beef or lamb.  Of course, it is always a good idea to trim the fat off of meat before cooking.

–          ~ 3 lb. of stewing pork, such as loin chops or Boston butte

–          2 teaspoons of sea salt

–          1 medium onion, chopped

–          2 cloves of garlic minced

–          1 tablespoon of fresh rosemary, minced

–          1 tablespoon of olive oil

–          1 large bunch of kale or collard greens, chopped

–          ½ of a sweet kabocha pumpkin (or use another type of winter squash) peeled, seeded and chopped onto 1 inch cubes

–          (Optional) 1 cup of additional chopped vegetables such as celery, carrots, turnips or green beans .

–          3 cups of water

Dice the pork into bite sized cubes and toss the pieces with the salt, coating them evenly.  Set them aside.  Heat the olive oil in a deep, heavy bottomed pot.  Add the onions and sauté them over medium heat until they are golden brown.  Add the garlic and rosemary and continue to cook the mixture until the garlic just begins to brown.  Add the meat cubes and stir them into the onion-garlic mixture.  Continue to cook the meat uncovered for ~ 5 minutes stirring frequently.  Add the water and kale.  Bring the mixture to a boil, stir it well and then reduce it to a simmer.  Cover the pot and allow the stew to cook over low heat for ~ 1 hour, stirring occasionally.  Taste the stew and add more salt if desired.  Then add the pumpkin and additional vegetables.  Bring the mixture back to a boil and then reduce the heat to a simmer again.  Cover the pot and cook the stew for an additional 30 minutes.  Test the meat and make sure it is tender; if not simmer it for an additional 30 minutes.  Salt to taste and serve. This stew may be served alone or over a whole grain like brown rice, buckwheat, millet, or quinoa.

Variation #1 – Instead of pork, try grass-fed beef or organic turkey thighs

Variation # 2 – Replace the rosemary with 1 teaspoon each of ground cumin and coriander and ½ teaspoon cinnamon.

Pickled Beets

This tangy side dish is an excellent liver and gall bladder tonic.  The brine is lite.  If you want a stronger pickle just increase the ratio of vinegar to water and add a bit more salt.

–          6 medium beets washed and trimmed, but not peeled

–          1 cup of apple cider vinegar

–          1 cup of filtered water

–          1 teaspoon of salt

Place the beets in a pot with water to cover them.  Bring the water to a boil and then simmer them for ~ 30 minutes, until they are tender when pierced with a fork.  Drain the water and allow the beets to cool to room temperature.  Peel the beets and dice them (note: Beets should slip out of their skins easily after they are cooked.) Place them in glass container with a tight fitting lid.  Mix the apple cider vinegar, water and salt together.  Pour the brine over the beets and stir it well.  Refrigerate the mixture for 2 or more days shaking it occasionally. Remove the beets from the brine before serving.

Blood sugar (glucose) is the body’s main source of energy.  Muscles need it for movement.  The heart needs it to pump blood.  The brain needs in order to think and process information.  But when blood glucose levels go to high a host of health problems can arise.

The trouble with too much sugar in the blood is that is tends to get stuck to other things.  This process is called glycation and its products are called AGEs (advanced glycation end products).  AGEs have been implicated in a variety of diseases.  They promote inflammation and oxidation.  It is easy to measure the level of glycation that is happening in the body by testing a specific AGE, glycosylated hemoglobin or HA1C.

Another problem with elevated blood glucose is that it causes an elevation of insulin.  Insulin is the one hormone in the body that lowers blood sugar.  It does this by increasing the uptake of glucose into cells.  For example if insulin binds to a muscle cell it will cause that cell to absorb more glucose from the blood.  This is insulin’s primary role.  However insulin has secondary roles of increasing fat stores in the body and increasing the production of cholesterol by the liver.  This can lead to obesity and elevated cholesterol.

In order to prevent many chronic diseases it is important to control blood sugar and try to keep it the ideal range.  In this range there is plenty of sugar available to run all of the body’s processes.  But it is not high enough to cause excess glycation or elevated insulin.

Strategies for balancing blood sugar through diet, exercise, supplements will be discussed in upcoming blog posts.  As always, there will be lots of delicious recipes included!