Review: Essential Oil Use During Pregnancy

Essential Oil Use During Pregnancy

In recent years, the interest in essential oils has soared. Many people have heard aromatherapy can work wonders on a number of concerns. They’ve also heard warnings against improperly using essential oils, especially during pregnancy. You may find some of your clients turning to you to help them safely navigate the burgeoning world of essential oils.

While safety is something to be mindful of at all points in the lifecycle, its use during the prenatal period warrants extra caution and attention.

Pregnancy is a time of rapid change for both mom and baby. Because foreign substances can affect fetal development and add an additional burden to a pregnant woman’s already taxed body, it’s wise to be cautious when using essential oils. This doesn’t mean that pregnant women should avoid them altogether. In fact, with proper use, essential oils can be a powerful self-care ally for many pregnant women.

What Does the Research Say?

Truthfully, not a whole lot. At least not for humans. Which isn’t all that surprising when you consider the ethical implications of testing any substance for safety on a pregnant woman. The same is true for most pharmaceutical drugs, over the counter medications, and ingredients found in foods, cleaning products, and personal care items.

Most of our recommendations for essential oil use during pregnancy comes from animal research, educated guesses based on the effect of specific chemical constituents found in essential oils, and anecdotal data.

Essential Oils to Avoid During Pregnancy

Despite the lack of rigorous studies on the safety of most essential oils, there are some essential oils women are advised to avoid because:

  • the oil is high in a specific molecule we know poses a danger to an unborn baby or a pregnant woman
  • there has been an incident where a pregnant woman intentionally induced abortion by consuming a large amount of the oil
  • animal studies have revealed a potential danger lies in using that specific oil

Based on the data we do have, the following oils should be completely avoided during pregnancy:

How to Safely Use Essential Oils During Pregnancy

Avoiding unsafe oils is only one part of aromatherapy safety. Of equal importance is choosing the right dilution and delivery method.


During pregnancy, a 1% dilution is the highest recommended concentration. To dilute essential oils, drops of oils are added to a carrier. A few common carriers are vegetable oils like coconut, avocado, and olive oil, whole milk, hydrosols, and water.

Below is a quick guide to essential oil dilution:

Delivery Methods

The safest aromatherapy delivery method is inhalation. Only a small portion of inhaled essential oil molecules make it to the blood stream, which greatly reduces the potential chemical effects on both mom and baby.

Inhalation includes diffusion, air spritz, fabric spritz, directly sniffing an oil from an inhaler, piece of fabric, or tissue, and steam inhalation.

The next safest route is topical. Think massage oils, creams, lotions, etc. Again, proper dilution is key. Though topical use is generally considered safe during pregnancy, special care should be taken when using potentially phototoxic oils.

These oils can increase the risk of sun burns. If they’re used topically, the sun should be avoided for 24 hours or the skin should be covered and protected.

The least safe route is internal use. Oral ingestion, rectal, and vaginal delivery are all types of internal usage. They should only be used with great care under the supervision of both a clinical aromatherapist and a physician. This doesn’t include the essential oils found in commercial food or oral care products flavored with essential oils. Eaten or used in normal amounts, these shouldn’t cause a problem.

Essential Oil Recipes for Common Pregnancy Problems

Lower Back Pain

Peppermint Massage Oil

  1. Add 6 drops of peppermint oil to 1 oz (30 ml, 2 tbsp) of a carrier oil of your choice.
  2. Massage into the lower back using gentle circular strokes.


Lavender Essential Oil

  1. Add 1 drop of lavender oil to 1 tsp(5 ml, .17 oz) of a carrier oil of your choice.
  2. Massage the mixture into the temples and back of the neck.

Nausea/ Vomiting

Lemon + Ginger Inhaler

  1. Use a small glass tube packed with coarse salt or an essential oil inhaler with a wick.
  2. Add 10-15 drops of ginger oil and 10-15 drops of lemon oil, or 20-30 drops of either to the wick or tube.
  3. Waft under nose, taking deep slow breaths to alleviate nausea.


Essential oils can be a wonderful ally for pregnant women. With the proper precautions and information most pregnant women can safely and comfortably use essential oils to find relief from many common pregnancy complaints.



Kendra Tolbert MS, RDN, CDN, CLC is registered dietitian, certified aromatherapist, and certified lactation counselor specializing in women’s health. Her website, Live Fertile, is packed with fertility, pregnancy, and women’s health wellness information. She currently lives in Alexandria, VA where she can usually be found taking a yoga or belly dance class.

Finding Equilibrium with Meditation

Interest in mind-body practices like meditation, yoga, and acupuncture is on the rise. These practices have been around for centuries, but researchers have only recently started to study the tangible health benefits. This post focuses on the positive health benefits of meditation, various types of meditation and how to get started.

Why meditate?

Meditation cultivates mindfulness through sitting and observing oneself. Mindfulness brings attention to the present, including your thoughts, actions, and emotions, and helps you accept them without judgment. With the constant stimulation of modern life, sitting quietly and acknowledging our feelings is becoming harder. Practicing meditation regularly has many health benefits.

These benefits include: 

  • Stress reduction
  • Improvement in concentration and memory
  • Increased self-esteem and happiness
  • Increased awareness of yourself and others

Meditation can also help with weight management in the following ways: 

  • Helping to reduce binge eating and emotional eating by increasing your awareness of emotional and physical hunger cues.
  • Helping with weight maintenance and possibly weight loss when combined with nutrition and lifestyle change.
  • Assisting with lowering blood pressure for those at risk of hypertension by facilitating a calmer and more balanced mind. Meditation also helps our body limit the “flight or fight” response in times of emotional distress.

Types of Meditation

All forms of meditation will evoke similar results. Some popular methods are:

  • Zazen means “seated meditation.” Derived from Buddhism, this seated meditation focuses on posture while observing your breathing and mind, like lying on the grass while watching clouds.
  • Kundalini Yoga incorporates a variety of movements, breathing practices, and chants to stimulate the dormant energy held at the base of the spine. As the energy is channeled, it will move upwards and out of the crown of the head and increase consciousness.
  • Yoga nidra also known as “yogic sleep” is a guided relaxation. Although “nidra” means “sleep,” you’re not actually snoozing. Rather, you are in a state between being awake and asleep. During this time, the teacher will lead you through a series of exercises to help discover and make peace with your true intentions and desires.
  • Mindfulness based Stress Reduction was created by John Kabat-Zinn. This technique is led by trained providers where the focus is primarily on the body and breathing. Practitioners will participate in body scans and focus on inhaling and exhaling, reducing stress and tension.

Getting Started with Meditation

As a novice, these methods can be intimidating. Luckily, there are apps to help you get started:

  • Headscape has a free 10-day introductory course for beginners. Each daily meditation lasts 10 minutes and includes a fun video illustrating the ins and outs of meditation.
  • Inscape offers “Today’s Inscapes” for users to meditate a few times throughout the day. It changes daily and practices vary. This app is great for meditators of all levels. As an added bonus, Inscape also has a physical space you can visit in New York City.
  • Yoga Nidra – Deep Relaxation Practice offers 10-, 20-, and 30-minute sessions so that you can pick the session that best suits your time. These sessions can be reused to help bring you deeper into consciousness.


Stacy Leung, RDN, CDN, CLC believes changing your health starts with learning, understanding, and seeking support from those you trust. Moonlighting as a yoga instructor, she focuses on using mindfulness and functional nutrition to help her clients reach their goal. She enjoys traveling, immersing herself in other cultures, and baking cookies. You can find Stacy on Twitter @stacykleung.

Insight into Autoimmune Diet Protocols

Can diet really help cure or prevent autoimmune disease? Anecdotes about the Autoimmune Paleo (AIP) Diet and Wahls Protocol, claiming to do just that, breed warranted skepticism. Popularity amongst the generally healthy public concern many dietitians, as these autoimmune diet protocols restrict otherwise wholesome and nutrient-dense foods. However, for people struggling with autoimmune disorders, these protocols deserve a second glance.

What is Autoimmune Disease

Autoimmune disease is a complex, multi-faceted process that the scientific community is still striving to fully understand. Today it is particularly relevant, with a large prevalence of several diseases and disorders such as type 1 diabetes, rheumatoid arthritis, psoriasis, thyroiditis, multiple sclerosis, and many others. Theorized causes of autoimmunity range from chronic stress, to leaky gut, to vitamin D insufficiency or deficiency, among many others.

While there are several other autoimmune diet protocols that claim to mitigate autoimmune disease, the Wahls Protocol and the Autoimmune Paleo diet are discussed here.

The Wahls Protocol

This protocol was developed by Dr. Terry Wahls, a clinical professor at the University of Iowa, who was diagnosed with progressive multiple sclerosis. She combined her knowledge of functional medicine and paleo diet principles to develop the Wahls Protocol. After a year of following this diet, in addition to neuromuscular electrical stimulation, she halted and even began to reverse the progression of her MS.

Since then, she has fully developed an autoimmune diet protocol that aims to optimize mitochondrial function by ramping up intake of 31 micronutrients that support the mitochondria.

Foods emphasized:
• 9 cups of vegetables per day
• Berries
• Grass-fed meats
• Wild fish
• Bone broth
• Fermented foods
• Organ meats
• Seaweeds and sea vegetables

Food restricted:
• Gluten
• Eggs
• Dairy
• Refined oils
• Refined sugar
• Processed foods
• Food additives

*Note: these foods are just restricted on the basic level of the Wahls Diet. There are more strict Paleo versions of this.

Dr. Wahls has continued doing research on diet and lifestyle interventions targeting multiple sclerosis patients, testing her protocol, like the one found here.

Autoimmune Paleo Diet

The Autoimmune Paleo diet emphasizes all foods encouraged in the Wahls protocol, but additionally restricts the following foods:

• Grains
• Legumes
• Nuts
• Seeds (particularly cocoa, coffee, spices made from seeds)
• Nightshades (eggplant, tomatoes, potatoes, peppers)
• Alcohol

There has been a fair amount of anecdotal evidence supporting this type of regimen with remittance of autoimmune symptoms, such as seen with Dr. Sarah Ballantyne (also known as The Paleo Mom) and her followers.

The Take Away

The basis for restriction of the foods discussed in these autoimmune diet protocols are that they may cause an immune-mediated reaction in susceptible individuals.

Does this mean that everyone with an autoimmune condition should restrict all of these foods? Absolutely not. As always, diet must be personalized.

Before delving into any of these restrictive eating patterns, a standard elimination diet may be a better place to start (testing gluten, dairy, soy, eggs, corn, shellfish, etc). Because there is a lack of strong evidence supporting these autoimmune diet protocols, they may serve better as a reference for experimentation, rather than a rigid tool for those with autoimmune disorders or diseases.


Christina Stapke is a dietetic intern at Bastyr University and received her B.S. in Clinical Nutrition at UC Davis in 2015. She has a passion for addressing the underlying causes of chronic illness, as well as optimizing the body’s ability to heal itself. She is excited to see what the rest of the year will bring as an intern and plans to incorporate these ideologies in her future practice as an RDN. In her free time she enjoys cooking, yoga, surfing (when by the beach), and hiking.

In the Kitchen: Sheet Pan Suppers

I love sheet pan suppers — chop all the ingredients, place onto one pan, top with your favorite oils/seasonings, and roast till done!

Sheet pan dinners are perfect for anyone! For the novice cook, they require limited kitchen appliances or complex cooking techniques.  For the busy professional struggling to find a balance between busy social and professional schedules can still find the time to make nutritious home-cooked meals. I encourage you to “put your best fork forward” and dig into some of my favorite sheet pan supper recipes.

Sheet Pan Italian Salmon

Lindsay at The Lean Green Bean created this simple salmon recipe using just 5 ingredients!  Even though the lemon slices are optional, I like to use them to brighten the flavor of the salmon and vegetables. As Lindsay suggests, I line the sheet pan with foil, which makes clean-up a breeze. In the past, I have made this meal swapping asparagus for the green beans.  While it does work, I found the asparagus had to be cooked a little longer compared to the salmon (25 minutes at 400 degrees F). This is sheet pan supper perfection!

Mediterranean Nachos

Kath with Kath Eats Real Food gives the classic nachos recipe a Mediterranean makeover.  She swaps pita chips for traditional tortilla chips and tops her sheet pan nachos with cherry tomatoes, capers, roasted red pepper hummus, olives, artichokes, feta cheese, and seared tofu.  If you dislike tofu or simply wish to have less dishes, I have skipped steps 1-2 and started at step 3 in the recipe with success.

Lemon Parmesan Pecan Crusted Chicken with Asparagus

Kristy at Chocolate Slopes developed this one pan chicken meal, perfect for a busy week night!  While Kristy recommends whole wheat Panko, I had difficulty locating it at my local grocery store and opted for whole wheat breadcrumbs instead.

Sheet Pan Shrimp Dinner

Chelsey over at C it Nutritionally suggests simple, healthy meal preparation doesn’t have to be dull or lackluster in flavor.  Her 20-minute shrimp sheet pan dinner recipe is packed with veggies and seasoned with lemon juice, Italian seasoning, smoked paprika, and oregano for added taste. The perfect sheet pan supper!

Steak Fajitas

Kelli at Hungry Hobby RD shows you how to make sheet pan supper steak fajitas with bell peppers.  Kelli also makes homemade fajita seasoning using minimal amounts of salt and sugar. When making this recipe, I substituted canola oil for avocado oil and served fajitas with sides of brown rice and sliced avocado.


Mary White, MS, RD, LD is a registered dietitian residing in Travelers Rest, SC.  She is currently a PRN clinical dietitian at Pelham Medical Center.  Mary studied Food Science at Clemson University and proceeded to complete her dietetic internship at Texas A&M-Kingsville University.  Passionate about nutrition counseling and children’s programming, she volunteers with community organizations to promote sustainable dietary changes and nutrition education activities. In her spare time, Mary enjoys yoga, cooking, kayaking, and cuddling with her dog, Maggie. 

Research Review: Autism and the Gut Microbiome

If you follow health and nutrition, it can be hard to walk out the door these days without running into a new revelation about the gut microbiome. The more we look, the more connections we find between our microbes and every facet of health, from our bones to our brains.

A study published in early 2017 investigates one of the newest microbiome interventions: fecal microbiota transplant (FMT) for children with autism spectrum disorders (ASD). Let’s take a closer look.

Fecal Microbiota Transplant

First things first: FMT is a therapy in which processed fecal matter from healthy donors is transplanted into the GI tracts of sick patients. The goal is to replace a dysfunctional gut microbiome with a healthy one. At this time, it is FDA-approved only for the treatment of recurrent c. difficile infection, and doctors must apply for a permit to use it in other situations. FMT is being studied for a variety of digestive and immune disorders, such as irritable bowel syndrome and inflammatory bowel disease.

How does this relate to autism? As it turns out, alterations to the microbiome, digestive disorders, and immune dysregulation are hallmarks of ASD.

The Complex Causes of Autism Spectrum Disorders

ASD is defined not by any common cause, but by symptoms: impaired social communication and restricted, repetitive behaviors and interests.These symptoms are caused by a variety interrelated of factors, which vary for each person:

A recent article illustrated one view of their complex relationships. As you can see below, there are many possible paths to ASD symptoms. For example, genetic and environmental factors can directly lead to symptoms, or they can work indirectly, through gut dysfunction and dysbiosis. There is not a direct chain of cause and effect: dysbiosis can cause immune dysregulation, or immune dysregulation can cause dysbiosis.

© Vuong H, Hsiao E. Emerging Roles for the Gut Microbiome in Autism Spectrum Disorder. Biological Psychiatry. 2016.

Pilot Study

Now that we have taken a closer look at FMT and ASD, let’s return to the recent study. In this study, 18 children with ASD had two weeks of antibiotics, a bowel cleanse, and then 8 weeks of FMT treatments. Stool samples were collected throughout the process, and compared to samples from children without ASD. Gastrointestinal (GI) symptoms and ASD symptoms were tracked.

They found that GI symptoms improved by 80% on average, and only two participants did not improve by at least 50%. ASD symptoms improved as well, as measured by 5 different assessment tools. For example, there was a 22% reduction in scores on one test of core ASD symptoms, and another test showed a 1.4 year increase in developmental age. They also found that the GI and ASD symptoms were related: worse GI symptoms were associated with worse ASD symptoms.

The FMT was effective at restoring microbial diversity and abundance, and at the end of the study the participants’ microbiomes were similar to the control group. The microbiome changes and the improvements in GI and ASD symptoms lasted through the end of the study: 8 weeks after the treatment ended.

This was a pilot study, and thus was not blinded or placebo-controlled, which is a limitation. However, it did demonstrate that the treatment is safe, tolerable, and potentially effective. The research group is now planning a larger randomized, double-blind, placebo-controlled trial as a follow up. I look forward to seeing the results of future studies.

Moving Forward

ASD is incredibly complex, and there is not an easy cure on the horizon. Yet, it is exciting that our understanding of autism spectrum disorders is growing, and that this could lead to new, targeted treatments.


Janie Jacoby is a graduate student in Nutrition and Dietetics at Colorado State University. She is passionate about functional and integrative medicine, and is founder and president of the CSU student organization Holistic Health Alliance. She also works for the CSU Extension Office, where she writes and develops nutrition education materials. When not working, Janie can often be found concocting something in the kitchen, practicing yoga, or hiking and camping in beautiful Colorado. Her sporadic blog posts can be found at


Food as Medicine: Cauliflower

Making the Case for Cauliflower

Cauliflower is a staple vegetable that is not only versatile in the kitchen, but it also packs a nutritious punch. It provides a good source of vitamins A, C, and K as well as folate, potassium, and magnesium.  A cruciferous vegetable, cauliflower runs in the same family as broccoli, cabbage, Brussel sprouts, kale, radishes, collards, and watercress, among others. Cruciferous vegetables like cauliflower contain phytochemicals that reduce inflammation and protect against cancer.

Sulfur-Containing Compounds and Cauliflower

Cruciferous vegetables contain glucosinolates, the sulfur-containing compounds that cause the bitter flavor and strong aroma of cauliflower. When cruciferous vegetables are chopped or chewed, myrosinase plant enzymes catalyze the hydrolysis of glucosinolates and bioactive compounds are produced, including indoles and isothiocyanates. These hydrolysis products may protect against cancer by altering cell-signaling pathways, eliminating carcinogens before DNA damage occurs, and by affecting metabolism or hormone activity to impede hormone-sensitive cancers from developing.

Cruciferous Vegetables and Genetics

Genetic variants also may play a role in the effectiveness of cruciferous vegetables in cancer prevention. Some genetic polymorphisms have been identified that result in lower activity of glutathione S-transferase (GST) enzymes that eliminate isothiocyanates from the body.  Lower activity of these enzymes could result in isothiocyanates remaining in the body for longer periods of time.  In fact, research has shown inverse associations between intake of cruciferous vegetables that produce isothiocyanates and risk of colon and lung cancer in individuals with these genetic variants. GST enzymes are also important for the detoxification of carcinogens, so consuming cruciferous vegetables is even more critical for individuals with lower amounts of GSTs.

Cauliflower is Versatile in the Kitchen

Although cauliflower is a nutrient-dense vegetable with great benefits, it may not be at the top of your grocery list or those of your patients and clients.  As previously mentioned, cauliflower has a bitter flavor and strong aroma caused by sulfur-containing glucosinolates, potentially making it less appealing.  However, cauliflower can be prepared in a number of ways that make it a satisfying and tasty food.

Below are a few recipes to help you reap the benefits of cauliflower and enjoy a scrumptious meal:

Try this cauliflower rice recipe with a blend of kidney beans, diced bell peppers, and green onions as a flavorful and filling dish.

Serve cauliflower mashed potatoes as a side to your favorite entrée:

Create a nutritious, powerhouse dish with this roasted turmeric cauliflower recipe from The Endless Meal:

Swap beef, pork carnitas, or shredded chicken for cauliflower in this cauliflower bean burrito recipe:

Try this cauliflower pizza crust recipe and add your favorite toppings to create a filling, delicious meal that your whole family will enjoy:

You can also try cauliflower recipes to make bread, “steak,” soup, stir fry, “Alfredo sauce,” tacos and more! The possibilities are endless with this cancer-fighting, delicious veggie.



Kathleen Walters is a dietetic intern at Virginia Tech University.  She earned her BA in Political Science and Spanish from the University of Notre Dame in 2008 and BS in Food and Nutrition from the University of Alabama in 2015.  She is passionate about nutritional genomics, food policy, and nutrition education and promotion.  In her free time, she enjoys ballroom dancing, hiking, cooking, and traveling with her husband.


How to Store Produce to Reduce Food Waste

How to store produce properly to prevent food waste Do you find yourself reaching into your refrigerator for a much-anticipated fruit or veggie only to find it’s already gone bad? Or maybe you’ve become hesitant to buy fresh produce for fear of wasting your money by throwing it out before you’re ready to use it. While planning ahead for cooking is always helpful, utilizing a few produce storage strategies may help extend the life of your fruits and vegetables and prevent some extra frustration.

Not only will reducing food waste at home save you money, but the Environmental Protection Agency also recognizes other benefits of reducing food waste, such as the reduction of methane emissions from landfills and conservation of energy and resources.

How to Store Produce

Storing your produce properly will help maintain its integrity and flavor much longer. Generally, fruits and vegetables should be stored out of direct sunlight and away from any additional sources of heat if they’re stored on the countertop.

If storing food inside of the refrigerator, make sure the temperature is set below 40 degrees F. Some fruits and vegetables are best when left on the counter to ripen and then placed in the refrigerator to extend its peak ripeness. It’s best to store fruits and vegetables away from each other due to the ethylene that’s given off by some fruit (apples, especially). This ethylene is responsible for causing produce to spoil faster. On the other hand, if you’re looking to speed up the process of ripening, like for an avocado, you can take advantage of the ethylene properties of apples by storing your apples with the avocados.

How to store produce properly to prevent food waste

Tips to Prevent Food Waste

  • Wash berries only right before eating to prevent mold growth.
  • Cut the tops off of carrots and beets prior to storage.
  • Store produce you’ve had the longest toward the front of the refrigerator to encourage eating them first (this applies to leftovers too!).
  • If you want to prep fresh produce for easier cooking or snacking later, store them in clear storage containers in the refrigerator. Mason jars and glass containers are great, if using plastic choose BPA-free.
  • Store half-used salad fixins like tomatoes, peppers, cucumbers in reusable storage containers for your next salad.
  • Take advantage of the freezer if you need long-term storage.

Speaking of the freezer, frozen fruits and vegetables are a great option for quick healthy meals. Frozen produce I always have on hand include: peas, corn, edamame, broccoli, cauliflower and mixed fruit for smoothies.

While on the topic of reducing food waste, consider investing in both reusable grocery bags and reusable produce bags to reduce plastic bag waste. Keep these bags near the front door or in the glovebox of your car will get you into the habit of automatically reaching for them when taking a trip to the grocery store. If you happen to forget, choose paper instead of plastic at the checkout line.

There are many more resources and tips online for more produce storage tips and tricks. For example, check out these storage tips from Washington’s Green Grocer for storing vegetables and fruits without plastic.

Anna Pashkova, ACSM EP-C is a medical dietetics student in the coordinated master’s degree program at The Ohio State University. Anna earned her bachelor’s degree in Exercise Science at Gardner-Webb University where she also played volleyball and found her passion for food and nutrition. Her interests include plant-based nutrition, using food as medicine, nutrigenomics and food sustainability. In her free time, Anna enjoys trying new recipes and local food restaurants, practicing yoga, playing volleyball and finding the best local coffee shops in every town.

Health Benefits of Fermented Foods

Fermented foods seem to be having a moment right now. Through a surge in the number of products available and increased media attention, they seem to be expanding from the natural food aisle and hitting the mainstream. This begs the question…

Are fermented foods worth the hype?

Consumption of these foods provide several health benefits to the consumer. Fermented foods are a source of probiotics, which help to populated the ‘good’ bacteria in our GI tract. Broadly, fermented foods contain high amounts of Lactobacillus and Bifidobacterium which help promote a healthy balance within the gut bacterial populations. Additionally, there is evidence that the fermentation process can improve bioavailability of various minerals and macronutrients. The act of fermentation through bacterial processing can improve the bioavailability of zinc, iron, and calcium in some foods, and can improve protein quality in some plant protein sources.

Finally, prospective studies looking at traditional dietary patterns that include regular consumption of fermented foods (in particular, fermented soy products) indicate there may be improved mental health overall, including a decrease in depressive symptoms.  Taken together, the evidence points to the benefits of fermented foods reaching beyond the immediate nutritional benefit.

Foods that contain these beneficial bacteria include fermented dairy (kefir, yogurt, and some cheeses), fermented vegetables (sauerkraut, kimchi, pickles), and fermented bean and soy products (miso and tempeh).

Not all fermented foods are created equally. Make sure you choose the most effective sources to ensure you’re getting the gut benefits of these products.

3 tips for choosing and preparing fermented foods:

  1. Choose fermented foods that are in the refrigerated section of the grocery store. Shelf-stable versions of these foods have been heat treated to kill all bacteria within the foods, including the beneficial bacteria.
  2. Similarly, eat the fermented foods in their raw state. Applying heat to these foods will also kill the beneficial bacteria and decrease these health benefits.
  3. When choosing a product, look on the label for a description on the bacterial strains present. This will let you or your client know that those good bacterial strains are present.

7 Dietitian-approved recipes to get you started:

Tempeh Skillet Enchiladas 

Easy Vegan Kimchi

Fermented Carrot Pickles

Savory Yogurt Parfait

Miso Kale Caesar

Wild Blueberry Kefir Smoothie

Mushroom Miso Soup

Kimchi Fried Rice

Beth Golden is a Graduate Student and Dietetic Intern in the Medical Dietetics program at The Ohio State University. She received her Bachelors of Science in Molecular Biology from University of Illinois at Urbana-Champaign and found her love of dietetics after spending time as a bench researcher. She is passionate about nutrition counseling, integrative medicine, and providing nutrition education to underrepresented populations. In her free time, she loves cooking, running and dabbling in urban beekeeping.

The Sweet Truth About Digestive Bitters

For millennia, traditional cultures around the world have endorsed the importance of balancing the five major flavors—sweet, salty, sour, bitter, and umami–for optimum health. Of these, the power of digestive bitters has been harnessed most often in herbal and medicinal preparations for the effects it elicits on the digestive system.

For millennia, traditional cultures around the world have endorsed the importance of balancing the five major flavors—sweet, salty, sour, bitter, and umami–for optimum health. Of these, the power of digestive bitters has been harnessed most often in herbal and medicinal preparations for the effects it elicits on the digestive system.

In this modern world where salty and sweet flavors dominate most palates and bitter compounds are systematically bred out of conventional crops, there is no denying most westerners’ over-reliance on pharmaceuticals to treat digestive disorders. In contrast, bitter foods are thought to stimulate appetite and digestive function by increasing the secretion of saliva, stomach acid, and digestive enzymes. Throughout history they have been prescribed by doctors and herbalists for disorders such as low hydrochloric acid production, indigestion, gas and bloating, and poor appetite.

Recent research reveals that bitter taste receptors are actually present throughout the body, including in thyroid, lung and bronchial tissue. Bitter receptor sites along the gastrointestinal tract are found not only in the oral cavity, but also the esophagus, stomach, and pancreas. Though in these locations they do not stimulate taste receptors in the brain, they are able to sense nutrients and activate metabolic processes including the release of hormones such as ghrelin, glucagon, and insulin that regulate appetite and blood sugar balance. Further studies are being conducted to determine how bitter agents may be useful in treating metabolic disorders such as type II diabetes and obesity.

To balance the deficiency of bitter foods in western diets, traditional medicine practitioners often prescribe supplemental bitters in the form of tonics, teas, and tinctures. These preparations usually contain one or more bitter herbs such as gentian, angelica, aloe, orange peel, chamomile, yarrow, milk thistle, and dandelion root. Similar formulas (often named “digestive bitters”) can often be found in the supplement section of most health food stores.

Food Sources of Digestive Bitters


Available in most Asian markets, bitter melon looks like a bumpy cucumber and can be used in soups and stir-fries.

Try this Asian Bitter Melon Stirfry, along with some preparation tips, from Serious Eats:


Found in abundance at springtime farmers markets, dandelion leaves can be used in salads, smoothies, soups, and juices.

Try this Dandelion Pumpkin Seed Pesto from TheKitchn:

Dark Chocolate

The higher the cacao content, the bitter better! Try these gorgeous dark chocolate treats:

Raddichio, Arugula, Endive & Watercress

Amp up salads with these colorful bitter digestive leaves. Not sure how to dress them? Check out these tips from Bon Appetit!


Turmeric can be used dried or fresh in soups, curries, smoothies, and juices, or sip on this traditional Ayurvedic brew.


Julia Pleasant, RDN, LD, is a registered dietitian in Honolulu, HI. She currently works as a clinical dietitian with the Native Hawaiian, Native Alaskan, and American Indian communities on Oahu and co-owns a wellness business, Tru Change, with her husband. Julia’s interests include whole-foods nutrition, mindfulness-based stress reduction, nutrition counseling, and sustainable agriculture.

Announcing! DIFM Research Fellow

In a follow-up to the 2015 publication, “Integrative Medicine: Education, Perceived Knowledge, Attitudes, and Practice among Academy of Nutrition and Dietetics Members,” DIFM and DPBRN have teamed up again to study the critical thinking skills and processes that proficient and experienced Integrative Medicine (IM) RDNs use in providing patient care.

This collaborative project seeks to understand the practice roles, service delivery models, reimbursement, practice facilitators and challenges unique to integrative medicine RDNs. Together, we aim to produce a decision-making framework that could guide novice IM RDNs to help weigh evidence and provide the best patient care through shared decision-making, safety and risk management.

To assist in the completion of this project, DIFM has selected a one-year fellow, Emily Goodman MS, RD, LD, to work with DIFM workgroup members and the Director of DPBRN, Rosa Hand MS, RD, LD.

About Emily:

Emily’s passion for natural sciences brought her from her hometown New Hartford, NY to Emory University in Atlanta, GA where in 2012 she earned her Bachelor’s of Science in Neuroscience and Behavioral Biology. While engaging in rare-disease research at Emory, Emily was astonished by the complete absence of nutrition as an element in any course of disease treatment, inspiring Emily to pursue a career in dietetics. In 2016, Emily graduated with honors from the Master’s degree Coordinated Program at Georgia State University. At Georgia State, she was a research assistant for Dr. Dan Benardot and worked with players from NFL’s Atlanta Falcons and Georgia State University athletes. She developed a keen interest in functional foods and nutrients and their ability to improve athletic performance and overall well-being. Exploring this further, Emily completed her Master’s thesis, “The Relationship between Sun Exposure, Diet and Muscle Soreness in Collegiate Football Players.” Emily currently lives in Austin, TX, where she enjoys tacos, Longhorn football games, and the company of her cat, Fig.