When looking for a spread for your morning toast, it's hard not to be overwhelmed by the plethora of margarines and other manufactured spreads that promise everything from "lowering cholesterol" to "heart health."

So, what's a health-conscious, savvy consumer to reach for when faced with these choices? 
Let's start with a short history lesson on margarine... a version of the margarine we know today was developed in a lab in the early 1900s. Seeking to provide an alternative for those who couldn't afford butter, chemists came up with different blends of oils that underwent a process called hydrogenation to harden them to become spreads. These spreads include fake flavors to simulate the real taste and consistency of butter.

Over the years, the look, taste, and appearance of margarine has improved considerably, but is there really a health or heart benefit? Is there truth to the claims of improved health?

As Marion Nestle so elegantly writes in her book, What to Eat, "No matter what their labels say, all margarines are basically the same - mixtures of soybean oil and food additives. Everything else is theater and greasepaint."

What are the health reasons to avoid margarine?

1. It contains Trans Fat: hydrogenation, the chemical process required to harden soybean and other oils into a spread, significantly increases the risk of heart disease. Walter Willet, MD, Professor of Epidemiology and Chair of the Department of Nutrition at the Harvard School of Public Health, states that trans fat represents "the biggest food processing disaster in history." Even if you avoid using margarine on your morning toast, it is in everything from bakery products to packaged crackers, cookies and desserts. It's hard to avoid unless you are making all your own food and eating at home.

2. It contains omega-6 fats: omega-3 fats are the necessary fats both our brains and bodies need to help lower inflammation, insulin resistance and disease processes. Omega 6-fats are necessary in small amounts, but have a pro-inflammatory effect. Research shows that 100 years ago, the ratio of omega-6 to omega-3 fatty acids in our diet was approximately 2 to 1. Estimates show as our food supply has changed the ratio is as high as 20 to 1 and rising, which may be part of the health epidemic with inflammatory conditions on the rise like arthritis, cancer and heart disease.

3. It contains emulsifiers, additives, artificial flavors and colorings: since the color of margarine is grey, it is bleached white with yellow dye added for the appearance of butter. The artificial flavorings are also added to create a butter taste. Finally, preservatives like BHT are added to create stability.

4. Many have plant sterols added: although plant sterols have been advocated as "heart-healthy" by some healthcare professionals, and are added to margarines to lower cholesterol, these estrogen compounds can lead to endocrine problems and actually promote cardiovascular disease.

So what is the alternative? The best choice is to use a little organic grass-fed butter. It's a real food, free of trans fat and additives. You may be worried about the saturated fat, but in moderation, it's better for you than the trans fats or other ingredients found in margarine. You can also substitute extra-virgin cold-pressed olive oil high in monounsaturated fat. Your body prefers real whole foods in their natural state. Skip the man-made margarine and enjoy the taste of real fat for optimal health.

It was like being at Disneyland for me, with the array of organic foods, delicacies and treats spaced strategically around the store.

Upon entering, there was the usual display of beautiful flowers and plants, and the bakery products and breads. It was not your typical bread aisle, but composed of healthy breads made by the bakery in house.  I quickly walked by till I got to the rest of the store, which was peeking my curiosity.

Delicious Orchards is unlike a regular grocery store in that there are no aisles.  More than three quarters of the store is produce – every type of fruit, and vegetable imaginable in season, along with rows of nuts, and seeds.

The inviting space was organic and free flowing – very similar to an open air market – where one could mingle and give thought to how one would nourish themselves.

There were cases of various foods spaced throughout the floor plan like organic, grass-fed cheeses, organic yogurts, teas, coffee, baking necessities (Bob’s Red Mill organic flours, spices, etc.), dark chocolate, and cases of wild fish, and some prepared food for purchase.

I did not find much of a scent of processed foods in a box, except a few healthy whole-wheat crackers.  It made me long for the day’s of the old Mrs. Gooch’s.

The only comparable store in Los Angeles is Sprouts, which is now opening a new store in West Los Angeles.  Although not as gourmet as this store, Sprouts has a similar feel and look and avoids the commercialese of other health food stores. The Santa Monica Cooportunity also has a similar feel, but not nearly as beautiful and inviting.

Brennan had finished checking out our food, and I was still inside longing to linger, but time was running out for our family gathering to begin.  Being in that store felt very familiar and made me want to return to Colts Neck, New Jersey just to shop there.  Later I found out from my Mother she took me there frequently as a little girl.

Remember your life is not a dress rehearsal.  Healthy shopping and eating is of the essence if you want to avoid health ramifications.  Finding a pleasant and inviting place to shop can be beneficial to your health and eating experience since it’s not too late to start your health plan now.

I was able to more clearly see how moving to California and my current profession helped me escape the clutches of Italian food, diabetes and weight issues.  From the moment I was off the plane, the smells and sights of food were at my every step.

Navigating the menus of pasta, Italian pastries and goodies, I felt the full impact of my clients’ challenges with traveling and eating out.  How did I combine enjoyment with family, and the tradition of Italian food while still holding onto my clean eating?

Organizing your food for travel:

Although there is not too much you can bring on a plane, I always pack a quart-size bag of raw cashews, almonds, and pumpkin seeds so that no matter what I have a go to snack to pull out during the flight.

A few months back I got introduced to Simply Snackin’ – a beef and chicken jerky that is made from grass-fed beef along with limited healthy ingredients.  They are nicely packaged in single servings with approximately 8-12 grams of protein per stick.  I brought a few of these for Jeffrey and myself.

Finally, Jeffrey made 4 hard-boiled eggs and we brought a small blue ice to keep cold during the flight.  These snacks along with a few pieces of fruit and some raw veggies (carrots, celery) brought us to our destination without having to eat the less than optimal airline food.

Having a few items can not only be cost saving, but can leave your system energized and ready to go from avoiding overly salted processed airport and plane food.

Eating Out:

Sitting in a beautiful Italian restaurant on the Jersey shore looking at the ocean and the menus of pasta, pizza and the warm Italian bread at the table I thought about what one of my client’s had told me the previous week:  “Susan, I’m overwhelmed looking at menus.”   So what was my thought process? 

1. Thanks but no thanks – I ignored the pizza, pasta entrees and bread
2. I looked for the protein dishes, and found a chicken entrée, and a few fish and shellfish options
3. I asked myself what I felt like eating, what dish was authentic Italian and was there something I can’t readily get in California?

So what did I choose?  I did not really feel like fish and chicken is normally not that interesting but this chicken dish looked tasty and came with broccoli rabe and some other veggies.  When it came, although a bit salty for my taste, it was yummy and I was able to get my protein and veggies.

What did I do to enjoy a little of the Italian food that others were eating?  I got a forkful of al dente pasta with clams from my uncle and one of the porcini raviolis that were for the table.  Both were well worth the bite and all I needed for satiation.  I drank unsweetened iced tea as well as drinking in the view of the ocean and smell of the salt water.

Mother’s Day Italian Fest:

So what was on the menu?  Antipasto salad, cheese, grapes, assorted high carbohydrate appetizers, chicken cutlets, sausage and peppers, eggplant Parmesan, and baked ziti (baked pasta with cheese), in addition to multiple Italian pastries and cookies.

I had a small plate of the salad which, included veggies and cheese.  For the entrée I had one chicken cutlet that had melted cheese on top, a slice of the eggplant Parmesan and a few peppers.

I skipped the pastries and ate half of one of the anise biscotti since it was homemade from my cousin Tooter who taught Jeffrey and I how to make several wonderful Italian dishes we used for A Recipe for Life. 

For the rest of the meals, I had asked my aunt Marjorie to buy me plain Greek yogurt, cottage cheese and fruit so I could stay on track with my breakfasts’ and a few lunches that were free of family gatherings.  I went with my young cousin Brennan to this wonderful store Delicious Orchids (a future blog), where I found organic natural peanut butter for snacks with apples.

Flying home today I don’t feel like I have to detox from New Jersey eating.  I ate a bit more than I usually do, but nothing a few days of clean eating and exercise can’t fix.   Traveling and eating at family gatherings is not entirely within your control, but controlling what you can by bringing food and choosing as wisely as possible is doable for staying on the lifestyle track.  The last thing I wanted to feel today was a huge carbohydrate hangover and I can successfully report that did not happen.

I watched a recent you-tube video on “Debunking the Paleo Diet” that clearly showed that our ancestors ate differently than the current Paleo culture would advocate.  It is a fascinating talk by archelogical scientist Christina Warinner and worth the 22 minutes of your time.

However, this blog is not about the Paleo diet so if you are interested in my recommendations on it read this past blog.

This blog is about your gut and how important it is to overall health.  For starters, your gut is the biggest organ in your body and approximately 30 feet long.    Our intestines are the largest interface between the environment and us.  One single layer of cells separates the blood stream from the intestines.

Since food and health is my job, I constantly think about how health is affected by what we put in our mouths.  However, the last few weeks it’s really hit me how every morsel of food, where it comes from, and it’s integrity is key to overall health.

The gut is the organ that digests our food, is responsible for how it is processed for delivery to every organ and cell in our body.  If one is eating a processed diet with suboptimal nutrients this affects one at the cellular level. 

We all know that what we eat affects our health but do we really UNDERSTAND the ramifications of excess sugar, additives, preservatives, and toxic fats to our system, especially on a regular basis?

The take home messages from this video are sound:

We are evolved to eat fresh, whole foods.   Our guts are full of good bacteria that regulate and protect your immune system, and inhibit bad bacterial growth.  Whole foods have the complete package with fiber and roughage, which modulate metabolism and feed the good bacteria.

If we consume processed food full of preservatives we lose the connection and balance our bodies require.  The loss of fiber exacerbates risk of diabetes, obesity and cancer.  We lose the ability to know when we’re hungry or full.  Our gut stops protecting us from disease and dumps toxic substances into our system and we wonder why we don’t feel good or have the energy we want.

It’s all so simple:  eat whole real foods in season and stay away from the inside aisles of the grocery store.  You’ll know what’s in your foods, which will provide the nutrients and fiber you need for health.  Sounds to me like the gateway to better health!

A resounding question I hear each week is:

“I’m supposed to avoid bananas – they have too much sugar, right?”

To answer succinctly, I don’t think anyone gained weight or suffered ill health (unless allergic) just from just eating bananas but here’s the more scientific response.

A fellow RD, Sofia Layarda, MPH, RD, wrote a great blog on the comparison of bananas versus apples and grapes with the breakdown of calories versus sugar, total carbs and fiber so take a look and see that bananas are right in line with other fruits.

What I wanted to address was the topic of resistant starch.  And WHAT is resistant starch?

Resistant starch is one of those substances your gut loves since it is not digestible in the small intestine but passes through to the large intestine where the healthy bacteria in your gut change it into fatty acids.

These fatty acids contribute to colon health since they make the environment less hospitable to bacteria that cause illness or potentially toxic or carcinogenic compounds.

Resistant starch also adds bulk to the stool, which helps with improved digestion and absorption.  In addition, resistant starch is associated with positive changes in metabolism since it linked to a lowered glycemic response to food, lower cholesterol and triglycerides levels, and increased satiety.

Finally, bananas have been linked to improved mood since they can slightly alter serotonin and dopamine levels.

The disclaimer is that to get the most resistant starch make sure your bananas have a touch of green or are a bit under ripe.  Eating ripe and spotted bananas will not achieve the same effect.

A healthier gut, improved metabolism and mood, and feeling more full?  Since your gut is the key to health (stay tuned for a future blog), I’d say eat a banana a day.

As a disclaimer I am not an expert in either ADD or ADHD so if you are reading this, please consult a physician who is an expert is this field as well.

This blog addresses omega 3 fats, and their effect on the brain, particularly in children.

What are the omega 3’s and how do they help the brain?

The omega 3 fats are known as ALA, DHA, and EPA.  ALA is predominantly found in plants with the highest concentration in ground flax seed.  DHA and EPA are found in fish and fish oil. 

In prehistoric times, caveman ate a diet consisting of fish, and/or beef raised on grass (versus corn, grains or soy), which provided higher amounts of omega 3 fats than the standard American diet, which provides barely 100 grams of DHA per day.

Since the brain is 60% fat by weight, an average well-nourished brain should have about 20 grams worth of the omega 3 fat DHA on board at all times, or about 20 fish oil capsules.  If one consumes a regular amount of fish and/or fish oil per day this is easy to achieve.

My personal opinion is that ADD and ADHD is on the rise partly due to less omega 3 fats in the diet from all the processed food, and the way in which our animals are fed.  The Western diet is associated with more ADD and ADHD, which is less common in Asian countries that have more omega 3 fats built into their diet.

If the brain is not adequately nourished, prescribing medications may not be that helpful.

It’s called feeding the body from the brain down.  If the brain is happy, focused behavior is more likely to happen.

Take home message?

1. If your child has ADD or ADHD there is no harm in trying some omega 3 fats.  If your child is already taking medication, please check with the prescribing physician.
2. If your child consumes fish three times a week a supplement may not be needed.  Salmon is the highest concentration of omega 3’s at approximately 300 mg. per ounce.
3. If your child is not a fish eater, I recommend Barleans Omega Swirl since it has some great flavors and can easily be put in milk and/or a smoothie as a treat.  A dosage for each child varies, but I would start with at least 250-500 mg. each of DHA and EPA and then go up based on symptoms.  1-2 teaspoons of ground flax seed meets needs for ALA and can be put in the smoothie for a nutty flavor.  I don’t recommend the gummy omega 3 chews which have much less concentration with added sugar.
4. If your child does not mind the taste of lemon I like Carlson Lemon Fish oil and 1 teaspoon per day is adequate.

A happy Brain may lead to better behavior – what have you got to lose?

Simply put – NO!

Whole fruits and vegetables are healthy – they provide fiber, vitamins, minerals and nutrients called phytochemicals, which cannot be duplicated in a pill.

When you extract out the juices from the solid parts of the plant all you get is juice.  Although juice does contain vitamins it is total carbohydrate without the fiber to even out the blood sugar. 

Ounce per ounce most juice contains the same amount of carbohydrates as soda.

A few weeks ago a client decided to go on a “juice cleanse.”  She came clean and told me at her appointment.  She and I added up the carbs per day of the 8 glasses of juice she was consuming, which was composed of mostly of vegetables, and some fruit mixed in for sweetness. 

The total amount of carbohydrates was 250 grams per day.  To put that in perspective there are 15 grams of carbs in a slice of bread so she was drinking 16 pieces worth of bread without any protein or fat to stabilize out her blood sugars.

This increase in blood sugar can have a negative internal effect causing high insulin levels, which can cascade into just headaches, or more importantly inflammation. Inflammation can trigger higher blood sugars for diabetics, and symptoms of arthritis or other autoimmune issues triggered by high insulin levels.

I would not put that in the “health” category by any stretch.  My client told me it was quite expensive for those 8 glasses of juice, as are the “juicers” you buy from many companies.

I am not opposed to smoothies made in the Vitamix or Blendtec that combine protein, fat and carbohydrates, which can include veggies or fruits.  The advantage of these two high-powered blenders is that you can put the whole fruit or vegetable in the mix, which is then pulverized in its entirety so you are receiving the fiber and juice component.

Many people go on a juice cleanse thinking they will lose weight, which in theory sounds reasonable.  What really happens is that weight may initially drop due to less caloric intake.  However, true weight will not be lost, and it can quickly rebound into increased weight due to the nutrient imbalance and lowered metabolism.

Juicing or doing a “detox” cleanse without considering all the possible side effects may in fact be detrimental to your health.

Take home message:  eat your fruits and vegetables and if you want to drink them in moderation, make the investment in one of the above blenders.  You will be much more satisfied and your body will thank you!

The thyroid can control weight, or how quickly the body uses energy otherwise known as metabolism.  The 2 most thyroid hormones responsible are known as T3, T4.  TSH or thyroid-stimulating hormone controls how much T3 and T4 the thyroid manufactures.

Many a client who has weight issues frequently thinks it is due to a thyroid issue.  Although thyroid may be responsible for some weight issues, the problem is way over indulged leading to countless prescriptions for unnecessary thyroid medication.

What if you do have issues with your thyroid?  Should you change the way you eat?

A few important nutrients have been identified in thyroid health:

• Iodine:  a vital nutrient in thyroid health since thyroid hormones are made of iodine.  Iodine intake has dropped in the US due to more Americans getting their salt intake from processed foods, which don’t contain iodine, rather than iodine-containing salt.  Foods that contain iodine are seaweed, fish, dairy and grains.  Deficiency and supplementation have risks, especially for those with autoimmune disorders so proceed with caution if you are considering a supplement.  Using iodized salt in your recipes is the safest way to get your iodine along with a few of the foods that contain it.  However, increased salt intake can be problematic for other health issues, so balance is the key – i.e., cooking with some salt but not salting at the table.

• Selenium:  an essential trace mineral found in fish, shellfish, red meat, eggs, chicken and brazil nuts, selenium is essential component of enzymes important to the health of the thyroid.  Having too little or excessive amounts is not recommended.  Regular intake of foods containing selenium is important rather than taking a supplement.

Are there foods to avoid?  Yes and No.

If someone has low iodine stores, soy, some grains and vegetables can release compounds, which interfere with thyroid hormones.

Therefore, if you have thyroid issues or take medication, eating soy in moderation (once a week at most) is recommended.  Millet, a gluten-free grain may also suppress thyroid function, but only if you have low iodine stores.  Finally, cruciferous vegetables such as cauliflower, broccoli and cabbage should be cooked rather than eaten raw with thyroid imbalances.

If you have a healthy thyroid you do not need to take the above precautions.  If you question your thyroid health, have your physician check your T3, T4 and TSH on your next physical or visit.  Otherwise, make sure you are getting enough iodine and selenium as well as a well-balanced eating plan for optimal health and well-being.

She never moved far from the place she was born in Long Branch, New Jersey.   A wonderful wife to Uncle Joe, mother of twin girls Gina and Jodi, amazing grandmother and successful business owner, who was taken from this life too soon…and a wit that was infectious and memorable.

Since I have lived in California most of my life I did not spend a lot time with her till I became an adult.

My first favorite memory was at her house 13 years ago after the death of my grandmother.  I had to leave early to catch a plane home and as I was leaving she said, “Can I make you a sandwich, Susan?”  Not wanting to bother her I declined but she still made me 2 small Italian sandwiches to go.  As I was half way across the country eating one of the sandwiches I wondered why I had not asked her to make me a dozen of those tasty sandwiches….

Aunt Lydia could make a full Italian meal complete with sauce in a white suit without a speck on her clothes when she was finished.  She could make anything taste good. 

Six years ago Jeffrey and I were in NY for a diabetes conference and asked Aunt Lydia if we could come visit and get some cooking lessons in preparation for writing A Recipe for Life.  As we were on the train from NY to NJ I was worried that we had not had time for lunch before we left and would be arriving at an odd time after lunch.

Somehow I "forgot" we were going to Aunt Lydia’s house since the minute we got there she asked very sweetly “are you hungry?”  Music to my ears she quickly made us the most amazing lunch – Zucchini and Eggs (AKA Goo Gooze)– which is one of the recipes in the book.  It tasted wonderful and hit the spot.  You never had to worry about going hungry or wanting for tasty food staying with Aunt Lydia.  No matter how many times we recreate this dish we never fully capture that epicurean delight we had that afternoon.

Later that night we had chicken cutlets and eggplant Parmesan.  It was quite a feast.  We had stopped at the bakery to pick up Italian bread.  About 10 pm she asked me to toast some bread.  Being the carbohydrate sensitive person that I am, I made 2-3 slices for the 4 of us.  She said, “Susan, that is not enough toast” so I was instructed to make half the loaf, complete with butter.  How I relish in that evening now.

Jeffrey spent the next 2 days in the kitchen learning a variety of cooking techniques, which he still employs today when cooking or creating a recipe.   When cooking I know he is channeling his inner Aunt Lydia.

Farewell Aunt Lydia – long live your beautiful spirit and thank you for all your lessons – in the kitchen, and in life.  

I can hear your voice saying  “Susan, don’t take life so seriously.  Now go make yourself a piece of toast.”

• Sweet Ella Peanut Butter – I’ve been recommending Koeze’s Crème Nut Peanut butter for a while but this new one is beyond amazing.  Many of you know peanut butter is probably my favorite food and this one tastes very close to homemade. 

Not only it is just made with just peanuts and sea salt, but also it is organic, minimally processed and from a small company in Grand Rapids, Michigan.  If you’ve ever tasted Spanish peanuts they have in my opinion a cleaner taste and Sweet Ella’s uses this type of peanut.  Unfortunately it just debuted at the show so you have to order off their website.  I just ordered 2 cases if that tells you how much I like it.

•  Lifeway Plain Kefir – Drinking Kefir is a great way to get your natural daily probiotics.  Lifeway uses milk from grass-fed, hormone and antibiotic-free cows and contains 12 probiotics cultures.  Many Kefirs taste sour and although this one is still a bit sour it is much less than others and has a clean, fresh taste.  If you want to flavor it I recommend adding your own fruit and a little honey. 

•  Almond Honey RISE Bar – although I am not a big fan of bars, this one fits the criteria with only 3 ingredients – almonds, honey and whey protein.  It tastes a little like the Bit-o-Honey candy from years ago and contains 20 grams of protein per day.  It is non-GMO, gluten-free, and contains no soy.  A great find for a on the go between meal snack and small meal.

•  Nordic Naturals Ultimate Omega mini’s – I finally found an omega 3 fish oil pill that smells good without any fishy taste.  This one has a natural strawberry smell and taste so if you are making excuses not to take your fish oil, here’s a good solution to that problem.

• NuttZo Seven Nut and Seed Butter – one more nut butter but this one is worth knowing about.  They have 3 versions – the original, which contains peanuts, cashews, almonds, Brazil and hazel nuts, sunflower and flax seeds.  The second one has all those ingredients along with dark chocolate chips (70%).  The third one is peanut free and contains cashews, almonds, Brazil and hazel nuts, chia, flax and pumpkin seeds.  They all contain sea salt and that’s it – nothing else.  If you want a nice variation on peanut butter that keeps it interesting, here’s it is.

 As you can see here a few simple additions to add to your pantry…tasty, healthy and show stoppers…