Lower Sodium With No Salt Spice Blends

Lower Sodium With No-Salt Spice Blends

No salt spice blends are a great way to reduce your sodium intake, while still eating high flavor meals! In the recently published 2015-2020 Dietary Guidelines for Americans, it’s recommended to reduce sodium intake to less than 2,300 mg/day.  If you are African American, have recently been diagnosed with diabetes, hypertension, or chronic kidney disease, or if you are 51+years of age, your intake recs are even lower at 1500 mg/day.

Unfortunately, 90% of Americans are at or above sodium recommendations.  On average, most people consume over 3400 mg/day. To understand what that looks like, it’s equivalent to the amount of salt in 18 orders of medium-sized McDonald’s French fries PLUS 18 ketchup packets!

Benefits of Cutting Back On Salt

Why should you cut back?  The most compelling reason is that dies low in sodium may help prevent and treat hypertension and reduce cardiovascular disease and stroke risk.

Slashing Sodium Intakes: Salt-Free Seasoning Blends

One way to cut back on the extra salt is ditching the salt shaker and trying salt-free seasoning blends.  Commercial salt free blends typically have ingredients such as dried herbs, dried red bell pepper, citric acid, and dried, minced aromatics (i.e., shallots, garlic, etc.).  Having ready prepared salt-free spice blends on hand makes cooking at home easier, without the temptation of adding salt or salt-based seasonings during food preparation.  By making your own homemade salt-free seasonings, you can easily customize spice blends to you and your family’s personal tastes.

3 Salt Free Blends to Spice Up Dinner

Basic Spice Blend

With just 3 ingredients, this all-purpose seasoning is great for all kinds of meals!  I particularly like to put it on poached fish or oven roasted chicken.  For an additional flavor, try adding fresh lemon zest to the basic spice blend for homemade lemon pepper seasoning.


  • 1½ tbsp black pepper
  • 1 tsp. garlic powder
  • ¼ tsp. onion powder


Mix all ingredients together in a mason jar.  Label, date, and store.

Italian Seasoning Blend

Many store-bought versions of Italian seasoning have salt as the first or second ingredient.  This version can be sprinkled into pasta or pizza sauces, folded into homemade meatballs, or used to dress up sliced tomatoes and cucumbers.  I often use this seasoning to make an oil and vinegar dressing with ¼ cup olive oil, 1/3 cup red wine vinegar, and 1 tablespoon of seasoning blend. NOTE: The fennel seed and crushed red pepper flakes are listed as optional.  I love this seasoning blend included with both, but I find most children prefer it when these ingredients are omitted.


  • 2 tbsp. oregano
  • ½ tsp. garlic powder
  • ½ tsp dried basil
  • ¼ tsp onion powder
  • Pinch red pepper flakes, optional
  • Pinch fennel seed, optional


Mix all ingredients together in a mason jar.  Label, date, and store.

Tyrolean Seasoning Blend

Try this seasoning blend with grilled pork chops or as a sheet pan meal with chicken breasts and roasted vegetables.  Note: This seasoning blend includes bay leaves. For your safety, please remove the bay leaf after cooking!


  • 1 tbsp. brown mustard seeds
  • 1 tbsp. dried thyme
  • 1 tsp. garlic powder
  • 2 tsp dried sage
  • 1 bay leaf


Mix all ingredients together in a mason jar.  Label, date, and store.


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. 

New! Integrative & Functional Nutrition Training for Dietitians

DIFM has developed an Online Certificate of Training Program to provide Dietitians valuable training in Integrative & Functional Nutrition!

The future is ours, are YOU ready?

As a DIFM member and an Integrative RDN, you already have a distinct advantage when treating your patients and clients. You combine evidence-based research, practice-based evidence, your unique experience, valuable resources, and meaningful collaborations into your practice. You are making strides in the dietetics arena by applying Medical Nutrition Therapy in a dynamic and influential way with integrative and functional medicine at the helm (IFMNT).

But you want MORE. You want specific training, detailed resources, and practical examples of the application of IFMNT.

We hear you loud and clear!

DIFM has upped the ante to further your knowledge, expand your integrative toolbox, and broaden your skill set as the nutrition expert. We’ve been working hard to fulfill our vision and mission to optimize health and healing with integrative and functional nutrition and empower our members as leaders in the field.

Integrative and functional nutrition is an ever-evolving area in dietetics. From nutrigenomics to the microbiome, epigenetics to functional foods, it’s imperative that RDNs be at the forefront, leading this evolution.

We know many RDNs have not received the in-depth, advanced training that’s necessary to excel and may not understand how IFMNT can be applied to their own practice or how it can enhance outcomes and influence change.

This is why we’re so excited to announce this new training.

Together with the Academy’s Center for Lifelong Learning, DIFM has developed an Online Certificate of Training Program to provide valuable training for RDNs wishing to further their knowledge in integrative and functional nutrition.

We are honored to have top experts in the field of IFMNT (some with 30+ years of experience) contribute and develop these modules as a labor of love for DIFM. Expert contributors include Kathie Swift, Mary Beth Augustine, Kelly Morrow, Sheila Dean, Lisa Fischer, and Beth McDonald.

Who Should Take This Training?

This training is for any RDN who wishes to further their knowledge base in integrative and functional nutrition.

What’s Included in the Training?

The certification consists of five separate modules emphasizing the foundational pillars of IFMNT. Each module builds upon the next in application and depth.

Module 1: Introduction to Integrative and Functional Nutrition

This module is designed to provide an introduction to integrative and functional nutrition. In this module, we will examine the integrative healthcare landscape including the evolution of the current language and concepts used in this area; outline the guiding principles of both integrative and functional medicine; and provide a primer on how we apply the integrative and functional medicine constructs in practice. We will finish up by exploring some of the challenges and opportunities in this evolving area and outline some educational resources useful in practice.

Module 2: Digestive Health

This module provides a science-based whole systems approach to digestive health and integrative and functional nutrition therapy (IFMNT) for functional gastrointestinal (or GI) disorders, intestinal permeability, intestinal pathogens, and imbalances within the GI microbiome that impact human health and disease, including inflammation, motility, functional GI disorders, obesity, liver disease and cancer.

Module 3: Detoxification

This module provides a science-based, whole-systems approach to hepatic detoxification, biotransformation and elimination of endogenous and exogenous toxins. To accomplish this, diet and nutrition interventions utilize cofactor micronutrients, phytonutrients, amino acids and antioxidants to support Phase 1 and Phase 2 hepatic detoxification. Taken as a whole, the information provided in this module demonstrates that the proper diet for a specific patient can influence detoxification function in a clinically important manner.

Module 4: Inflammation

This module covers the integrative and functional nutrition approaches to managing systemic inflammation. The goal of this module is to review the antecedents, triggers, and mediators of acute and chronic inflammation and to provide dietetic professionals with science-based integrative approaches and practice-based recommendations for managing inflammation in chronic diseases.

Module 5: Dietary Supplements

This module will cover the prevalence of use of dietary supplements among Americans; FDA’s guidance documents and regulatory information; risk management; clinical and client decision making; and ethical, legal and scientific integrity considerations for nutrition and dietetics practitioners.

Academy members enjoy a reduced rate of $24 for each module ($120 total). Complete all five modules and earn 10 hours of CPEUs (CPE level 2) and Certificate of Completion. Click HERE to register for module 1 and get started today!

For more information and to register, visit http://www.eatrightstore.org/products/cpe-opportunities/certificates-of-training

The future is ours, your future is NOW.

Tomatoes and Lycopene: a Review of the Science

Tomatoes are a versatile vegetable with an endless number of uses in the kitchen. They also offer an array health benefits that may aid in the prevention of disease.  Research suggests that consuming tomatoes (and tomato products) is associated with a decreased incidence of cardiovascular disease and reduced risk of prostate, lung, breast, and digestive cancers. These health benefits are derived mainly from the lycopene, vitamin C, and quercetin found in tomatoes.  Each of these bioactive food components has important mechanisms of action that make tomatoes a nutrition powerhouse, but lycopene is particularly touted for its powerful effects!

Lycopene and Cancer Prevention

Lycopene is a type of carotenoid that provides the taste and red color of tomatoes.  Among the family of carotenoid pigments, lycopene’s claim to fame is having the greatest antioxidant potential. Research using in vivo animal cancer models shows lycopene can inhibit prostate, breast, and lung cancer growth by demethylating promoter DNA tumor suppressor genes. By reducing the formation of DNA oxidation products, lycopene prevents the DNA damage and abnormal cell development associated with tumors. Lycopene may also interfere with the production of insulin-like growth factor 1 (IGF-1), a protein associated with cancer cell growth.

Lycopene also helps decrease prostate cancer progression. Prostate cancer patients who supplemented their diets with lycopene showed reduced IGF-1 plasma levels by almost 30%. Lycopene also helps maintain proper gap junction communications (GJC) between cells. Since tumor cells don’t have GJCs that function correctly, lycopene corrects the dysfunctional GJCs, reducing the risk of prostate cancer progression.

Lycopene: Protecting the Heart and Busting Fat

In addition to protecting against cancer, lycopene is important in preventing cardiovascular disease and obesity.  Lycopene is inversely associated with the thickness of blood vessel inner walls, calcified plaques in the abdominal aorta, and LDL oxidative damage, all of which are markers of atherosclerosis. Lycopene also suppresses visceral fat accumulation and increases brown adipose tissue (BAT) weight. Since BAT helps to increase thermogenesis and thereby increase oxidation of lipids as opposed to storing lipids, this can help to fight against obesity.

Bioavailability of Lycopene in Foods

The way in which tomatoes are processed affects the bioavailability of lycopene. Lycopene is easier to absorb when its compounds are in the cis configuration, due to the increased solubility of the cis-isomer in bile acid micelles. Food processing can increase the cis-isomer formation, making heating and cooking great options for food preparation. Tomato products with the highest amount of lycopene include tomato paste, ketchup, tomato sauce, and spaghetti sauce.

Although a specific amount of lycopene has not been recommended for daily consumption, recent research has shown that as little as 27 mg of lycopene per day may reduce inflammatory markers related to cardiovascular disease. Whether consumed as a tasty sauce with whole-grain spaghetti or diced and sautéed with a bowl of lentils, there are countless ways to obtain the great benefits of this important food component.



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.

What Will Replace Trans Fats?

palmfruitTrans fats may be out, but what will replace them?

In 2015 the FDA declared that partially hydrogenated trans fats are not a safe food ingredient, and must be phased out by 2018. Food companies had already begun phasing out partially hydrogenated oils in many foods, due to decades of concern about its link to increased heart disease. The question remains, what will replace trans fats?

Dietitians everywhere breathed a sigh of relief that this harmful ingredient would finally be removed from our food supply.  However, what we didn’t realize is that the ingredients that are replacing partially hydrogenated oils (PHO) have their own set of concerns, from health effects to human rights. These replacements include palm oil and interesterified fats, as well as a new biotechnology technique, CRISPR, which is poised to bring new genetically-altered fats into the marketplace.

Palm Oil

Palm oil is a common replacement for PHO because it has a similar texture and is shelf-stable. Its use has skyrocketed, and it is now found in about half of all packaged foods! However, as the Rainforest Action Network describes, palm oil production has a devastating impact in countries such as Indonesia and Malaysia.

Palm oil plantations are one of the worst perpetrators of forced labor, child labor, and human trafficking.  The plantations lead to the destruction of the natural resources that people rely on for their livelihoods. In addition, habitat destruction is devastating for critically endangered animals such as orangutans.

As far as health goes, palm oil is not inherently harmful, like trans fats. Unrefined palm oil is even a source of antioxidants and nutrients such as vitamin E. However, palm oil is typically highly processed, fractionated, and often goes through a process called interesterification, which long-term effects are unknown.

Interesterified Fats

Triglycerides are composed of a glycerol backbone with three fatty acids attached. These three fatty acids are not necessarily the same, some may be saturated, some unsaturated. Food manufacturers use enzymes or chemicals to rearrange these fatty acids among triglycerides to create a fat with the characteristics they need. Like partial hydrogenation, this process creates novel fat molecules which are not found naturally.

Research is scarce, but some studies suggest the possibility of negative health outcomes if these fats replace trans fat in the food supply. A 2014 review study reported that the fats can have negative impacts on lipoprotein metabolism, glucose and insulin metabolism, immune function, and liver enzymes. A 2016 review study found that the science does not currently show health issues, but that gaps in the research mean we do not know the short and long-term impact on metabolism, inflammation, and other factors.

As interesterified fats increase in our food supply, another source of new fats is emerging; researchers are using new gene-editing technology such as CRISPR to modify crops in a variety of ways, including by changing their fatty acid content.


CRISPR is a method of genetically modifying crops. This biotechnology is capable of snipping out genes, rather than inserting genes from another organism, as other GM crops are made. Because the method is so new, it is not regulated, and the crops are developed and grown without oversight.

Researchers have used gene-editing to create soybeans with higher levels of monounsaturated fats and lower levels of polyunsaturated fats. This makes them more stable and extends their shelf-life, just like the partial hydrogenation process.

Proponents say that this method is more precise than older GM methods, and more acceptable to consumers. Critics say that there are still unknown consequences, and that there need to be safety assessments and regulations in place. A governmental committee is currently investigating new biotechnologies and how they should be regulated. Read on for information about how to stay informed on this topic!

Healthy-Fat Plan of Action

Consider avoiding products that contain refined palm oil and check ingredient labels for signs of interesterified fats.

These include:

  • Palm oil or palm kernel oil
  • Fully hydrogenated oil
  • Palm oil -or- fully hydrogenated oil, and another oil (such as soybean oil), listed together
  • Monoglycerides, diglycerides

Sign up for updates about upcoming changes to biotech regulations, or submit your input to the regulatory committee here: http://nas-sites.org/biotech/

We still have a lot to learn about the impacts of these fats and food technologies and what is the best way to replace trans fat in the diet. When the science is uncertain, my personal philosophy is that prioritizing whole foods (and fats!) over processed ones is the healthiest choice.


janie-jacobyJanie 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 foundationalplate.com.

Academy Position Paper Update: Vegetarian and Vegan Diets


Vegetarian and Vegan Diets

Just last month, the Academy of Nutrition and Dietetics (AND) released an updated position paper on vegetarian diets. The paper explores the nutrition of vegetarian and vegan diets, in various stages of life, in chronic disease, as well as some helpful information for RDNs and NDTRs for clinical practice. The Academy also noted an environmentally beneficial aspect of vegetarian diets.

The position statement of the Academy is as follows:

“It is the position of the Academy of Nutrition and Dietetics that appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes. Plant-based diets are more environmentally sustainable than diets rich in animal products because they use fewer natural resources and are associated with much less environmental damage.”

Nutrient Highlights


As long as calorie needs are met, protein intake in a vegetarian diet is typically adequate and not a nutrient of concern. Additionally, a diet rich in a variety of foods will ensure that all of the essential amino acids are consumed. Legumes and soy products are good sources of protein and other essential nutrients for vegetarians.

Omega-3 Fatty Acids:

Dietary intakes of ALA are similar in vegetarians and non-vegetarians, while EPA and DHA intake is lower in vegetarians. The health effects of the lower intakes are not yet known, although vegetarian children have not shown any issues with vision or mental development and adults continue to have lower risks of cardiovascular disease. It may be a good idea for vegetarians to eat concentrated sources of ALA, which the body converts to EPA and DHA at a low rate, which include various seeds, walnuts and their oils.


The intake is similar between vegetarians and non-vegetarians, although iron stores are much lower in vegetarians. Although this may seem like a bad thing, it could actually be advantageous as higher levels have been “independently associated with a risk of developing metabolic syndrome.” Additionally, plant sources of non-heme iron are absorbed at a lower rate than animal sources, but research highlighted in the position paper shows that vegetarians can actually adapt to absorb non-heme iron more efficiently over time and lower iron losses.


Intake of zinc is similar between vegetarians and non-vegetarians and may be lower in some vegetarians. Serum zinc concentrations are also typically lower in vegetarians, but are still considered to be in the normal range. There haven’t been any noticeable effects of the lower zinc levels, which may be due to the body’s natural ability to adapt to the diet. Some good sources of zinc include legumes, soy products, grains, cheese, seeds and nuts.


Vegetarian diets may be slightly low in iodine, especially in vegan diets. Vegans are recommended to consume iodine-rich foods such as iodized salt or sea vegetables to avoid deficiency. Additionally, women who are vegan and are of child-bearing age are recommended to take supplements of 150 micrograms of iodine per day to avoid a deficiency.


Lacto-ovo-vegetarians generally get enough calcium in their diet, while vegans may vary and sometimes fall below the recommended amount. The bioavailability of calcium in some plant foods is a concern because it can be influenced by oxalate, phytate and fiber, which may reduce absorption of calcium. Several high oxalate foods include spinach, beet greens, and Swiss chard. Because of this, other high sources of calcium should be consumed as well such as low oxalate vegetables including kale, turnip greens, Chinese cabbage, and bok choy. Fortified milks, calcium-containing tofu, and foods such as white beans, almonds, tahini, figs and oranges also contain calcium but at a lower bioavailability.

Vitamin D:

Levels can vary greatly in vegetarians because of the individual variability in sun exposure, consumption of vitamin D fortified foods and supplement intake. Low vitamin D intakes and low 25-hydroxyvitamin D blood levels have been seen in vegetarians and vegans, more prominently in the winter and spring and also those who live at higher latitudes. Sources of vitamin D fortified food include cow’s milk, some nondairy milks, fruit juices, breakfast cereals. Eggs and mushrooms treated with UV light can also contain vitamin D. Depending on individual factors; it may be beneficial to supplement vitamin D.

Vitamin B12:

Of all nutrients, it may be most difficult to get vitamin B12 in a vegetarian diet because it is not in any plant foods. While there may be some B12 in fermented foods, nori, spirulina, chlorella algae and unfortified nutritional yeast, this may not be adequate. Some options of getting enough B12 include either consumption of B12 fortified foods or supplements. It is best to eat the fortified foods twice per day because of the absorption mechanisms involved. Some examples of fortified food include breakfast cereals, fortified milks, and fortified meat replacements.

For more information on vegetarian diets including the beneficial effects on overweight and obesity, cardiovascular disease, diabetes, cancer, and osteoporosis, as well as recommendations in various life stages and environmental impacts, you can check out the entire position paper article here.


annabio2Anna 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.

8 Essential Mobile Health Apps for Integrative Dietitians

With many holistically-focused mHealth apps to choose from, the possibilities for their use in integrative and functional nutrition are ever-expanding!As an Integrative Dietitian committed to engaging your clients and patients in their own healing process, there is no denying the value mobile health applications (a.k.a. “mHealth apps”) can bring to your practice. It’s estimated that up to 80% of Americans now own smartphones, with the number of mHealth apps available on Apple and Android platforms now numbering in the hundreds of thousands. With many holistically-focused mHealth apps to choose from, the possibilities for their use in integrative and functional nutrition are ever-expanding!

8 Essential mHealth Apps For Your IFN Toolbox

Integrative and Functional Medicine 

  • About Herbs: Developed by the Integrative Medicine Service at Memorial Sloan Kettering, About Herbs describes the structure, uses, side effects and interactions of various herbs, supplements, and therapies. Users can search by product name or medical condition. Content available when offline. (iTunes) (Google Play) (iOS/Android, free. Avg. user rating 4/5)
  • Nutriguides: Nutriguides by the Academy of Nutrition and Dietetics contains 300+ recommendations from the EAL that can be filtered by disease/condition or topic. Recommendations are rated based on how well-supported they are by evidence-based research. This is a handy reference to have on hand and it will likely improve with future versions. (iTunes) (Google Play) (iOS/Android, $1.99. Avg. User rating 3.5/5)


  • In The Moment: Created to help users practice body awareness and mindfulness around food, In the Moment encourages healthy coping skills for triggers that might otherwise end up in emotional eating. (iTunes) (Google Play) (iOS, $1.99; Android, $0.99. Avg. user rating 4.5/5)
  • Buddhify: Buddhify offers 80 guided meditations that are categorized by occasions, such as Work Break, Going to Sleep, Feeling Stressed and more. The app provides community interaction and statistics for usage and progress. (iTunes) (Google Play)  (iOS, $4.99; Android, $2.99. Avg. user rating 4.4/5)
  • InsightTimer: InsightTimer has 3,500 guided meditations, music playlists, and teachings from experienced yogis and meditators worldwide. Community features include discussion groups and local meet-ups. (iTunes) (Google Play) (iOS/Android, free. Avg. user rating 5/5)

Food Allergies and Intolerances

  • mySymptoms: With mySymptoms, users can track foods, activities, medications, and other factors that may contribute to allergic symptoms, which the app then analyzes to identify correlations between symptoms and likely offenders. (iTunes) (Google Play)  (iOS/Android, $2.99. Avg. user rating 4.4/5)
  • Find Me Gluten Free: Find Me Gluten Free allows users to search for local gluten-free dining options, view menus, get restaurant information and see other users’ ratings and reviews. Database includes both local establishments and national chains. (iTunes) (Google Play) (iOS/Android, free. Avg. user rating 4.5/5)
  • Low FODMAP Diet: Developed by Monash University, the low-FODMAP diet is one of the most commonly recommended therapies for IBS. Using a red/yellow/green circle rating system, the app provides accurate information about FODMAP-containing foods. Users also have access to recipes, a shopping list generator, and symptom tracking. (iTunes) (Google Play) (iOS, $7.99; Android, $9.00. Avg. user rating 4/5)

As with all technology, mobile applications are a dynamic world and new apps are being created and improved constantly. Before recommending any apps to your patients or clients, test them out yourself to see how they can benefit your practice.

Juliapleasant2Julia 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.

An Integrative Approach to Seasonal Affective Disorder

Symptoms of Seasonal Affective Disorder

photo credit: http://www.accesshealthcareservices.com/beating-winter-blues-guide-seasonal-affective-disorder-sad/

4 Ways to Combat Mood Imbalances This Winter

Do you or someone you know struggle with poor moods, fatigue, and lethargy during the winter months? About 11 million people in the U.S. suffer from Seasonal Affective Disorder (SAD), a type of recurrent depression that is associated with the seasonal transition into winter with around 25 million people also suffering from a milder form of the “winter blues,” a subtype of SAD.

Possible Causes of Seasonal Affective Disorder

Though the exact cause of SAD is unknown, but a few potential causes include:

  • Disturbance of circadian rhythms (includes overproduction of melatonin)
  • Decreased sensitivity of the retina
  • Dysregulation of neurotransmitters (specifically serotonin)

Integrative Therapies

There are several lifestyle changes that can mitigate the symptoms associated with SAD or the “winter blues” by supporting the body’s circadian rhythm and neurotransmitter regulation.

Bright Light Therapy

Light therapy has been proven to be effective in treating winter-specific Seasonal Affective Disorder and may also be effective in treating non-seasonal depression. Standard light boxes for administering this kind of therapy emit 10,000 lux, where bright midday sun is around 50,000-100,000 lux.

Two separate meta-analyses indicate that bright light therapy can be effective in around 60 percent of people with SAD. It was also found that light therapy was most useful if done earlier in the morning as opposed to later in the day.

Improving Vitamin D Status

Vitamin D deficiency has been associated with depressive symptoms, and is thought to play a role in serotonin activity. When days become shorter, people are naturally exposed to fewer UV rays, which are necessary to convert Vitamin D into its active form in the body.

For those that live in higher latitudes during winter or are generally exposed to less sunlight throughout the year, it is possible for the body to become depleted or deficient of Vitamin D over time.

However, there are a few food sources with naturally occurring Vitamin D:

  • Cod liver oil
  • Fatty fish (swordfish, salmon, tuna, sardines)
  • Beef liver
  • Eggs

For some, eating these foods alone may not be able to restore Vitamin D levels completely. In this case, taking a high-quality supplement at a tailored dosage may be necessary.

Prioritizing Sleep

Getting a good nights rest is important for circadian rhythm entrainment and neurotransmitter regulation, both of which play an important role in regulating mood.

This includes avoiding bright light around 2 hours before sleep (especially blue light from phones, televisions, and computers) as well as getting an adequate amount of sleep, between 7-9 hours per night.  Chronic sleep deprivation can lead to inflammation and dysregulation of neurotransmitters, both of which can exacerbate mood imbalances such as Seasonal Affective Disorder.

Increasing Aerobic Exercise

Exercise supports healthy brain function by increasing blood flow and therefore nutrients to the brain, increasing mood boosting endorphins, and increasing mood regulating neurotransmitters. More specifically, getting an hour of aerobic exercise 2 to 3 times per week has been shown to mitigate symptoms of seasonal affective disorder, or the winter blues.

For some, making these lifestyle changes can help kick the winter blues for good. For others, there may be other underlying sources of inflammation that must be addressed.


christina-stapke2Christina Stapke is a dietetic intern at Bastyr University and completed her undergraduate degree 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.

Healthy Post Holiday Eats

How to eat healthy post holiday from #DIFMRDs! Tis the season of giving and, unfortunately for many people, gaining weight.  According to the New England Journal of Medicine, the average American gains about 1 pound of body weight during the holiday season.  While 1 pound may not seem like much, overweight or obese individuals tend to gain more weight compared to normal or underweight adults.  Also, people that tend to experience holiday weight gain are also less likely to lose the weight in the future.

Oftentimes back-to-back celebrations can be a source of anxiety that leads to mindless eating.  During the holiday season, many people are bombarded with eating situations that include buffet-style parties and gatherings, easy access to finger foods, heavy hors d’oeuvres, and free-flowing alcohol. The opportunities for over-eating are likely to occur from Thanksgiving all the way through New Year’s Day.

Below are a few favorite healthy recipes from DIFM dietitian bloggers. They are perfect for the post-holiday season (or any other time of the year!). Remember to make these recipes your own and experiment with different flavor combinations for an even tastier treat.  Whether your nutrition goals are to maintain or lose weight, consume more fruits and vegetables, or begin eating breakfast, I hope these recipes inspire you to nourish body, mind, and soul in the New Year!

Strawberry Topped Brie


Regan over at Healthy Aperture makes this festive appetizer that is perfect for parties or family gatherings. While the brie may be a bit decadent, the strawberries provide fiber and antioxidants to round out the cheesy deliciousness. This recipe uses dried rosemary, but I substituted about 1 teaspoon fresh chopped thyme and it worked out great!

Maple Baked Salmon


Kath at Kath Eats Real Food shows you how to make this super easy baked salmon.  The hardest part is waiting for the fish to marinate!  Serve with brown rice and steamed broccoli or a side salad for dinner.

Chai Spiced Gluten Free Apple Pie Mug Cake


EA Stewart over at the Spicy RD created her version of apple pie cake….in a mug!  It’s taste just as amazing as it is perfectly portioned!

Chicken Salad with Greek Yogurt


Abbie from Culinary Nutrition Cuisine makes this simple chicken salad with nonfat Greek yogurt instead of traditional mayonnaise.  Chicken salad can be made quickly using rotisserie chicken for an easy weeknight dinner or kept in the fridge for lunches.  Try adding dried cranberries or fresh chopped tarragon to brighten the salad without adding any additional fat.

Mean Green Smoothie


This is a great on-the-go green smoothie recipe that can easily be adapted to fit one’s personal preferences. I like to swap the ¾ cup orange juice for unsweetened almond milk, which gives the smoothie a less sweet taste but creamier consistency. While not a Registered Dietitian, Tieghan Gerard posts a mixture of comfort food style and healthy dishes on her blog, Half Baked Harvest, which is inspired by seasonal flavors.

Note: This recipe calls for spirulina.  Spirulina is a type of algae, which is a good plant-based source of iron, B vitamins, and protein.   However, spirulina may be contaminated with toxins, heavy metals, or other pollutants.  When choosing spirulina products or supplements, remember to research about the company’s quality assurance policies and testing practices.     


marycarneybioMary 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.

Diet, Alzheimer’s Disease and Brain Health

Reclaim your Brain with Food and Functional Medicine

Reclaim your Brain with Food and Functional Medicine

Alzheimer’s disease afflicts 5.4 million Americans, and 1 in 9 of those aged 65 and older. Non-Alzheimer’s cognitive impairment affects even more, and as our population ages, the number of individuals affected will continue to skyrocket. The impact of this is devastating, not only for those afflicted, but also for our caregivers and for our society.

As is the case with many diseases, people often think of Alzheimer’s to be caused by genetics, and assume that we are helpless in preventing it. However, promising new research shows us that not only can neurodegeneration be prevented, it can also be reversed. This knowledge gives us a great opportunity to empower people to improve their brain health.

The MEND Therapeutic Program

Dale Bredesen at UCLA published a paper in 2014 describing a therapeutic program called MEND, which stands for “metabolic enhancement for neurodegeneration.” Instead of the usual monotherapeutic or one-therapy approach, this program addresses many possible targets at once, is personalized to each patient, and addresses the underlying causes of neurodegeneration. The numerous targets include: inflammation, insulin levels, autoimmunity, heavy metal toxicity, stress, sleep, exercise, hormone balance, zinc/copper ratio, and oxidative stress.

Common features of the individualized programs include:

  • A personalized diet that is low glycemic, low inflammatory, and low in grains
  • Fasting for 12 hours each night, and not eating within three hours before bed
  • Stress relief, such as meditation or yoga
  • Exercise on most days
  • Supplements such as CoQ10, coconut oil, methylcobalamin, vitamin D, citicoline, curcumin, and omega-3s

The results from this study are stunning. Out of 10 patients with Alzheimer’s or cognitive impairment, 9 sustained substantial improvements after 3-6 months of treatment. Some had been forced to quit work due to their illness, but after treatment, they could return to work. The only person who did not show improvement had very late stage Alzheimer’s.

In a 2016 follow-up study, the researchers presented 10 case studies, with quantitative MRI and neuropsychological test results. Patients saw dramatic improvements, such as unprecedented increases in hippocampal volume and cognition scores. Each of the patients “met criteria for Alzheimer’s disease or MCI prior to treatment, but failed to meet the criteria … following treatment.” Thus, the researchers showed that what is considered an irreversible disease can in fact be reversed.

The Alzheimer’s Prevention Clinic

In 2016, the Alzheimer’s Prevention Clinic at Weill Cornell Medical College published a groundbreaking paper. The paper describes their personalized and comprehensive treatment program for neurodegeneration. The clinic targets three primary etiologies: insulin resistance, dyslipidemia, and oxidative stress. Exercise, cognitive activity, sleep, antioxidant intake, toxins, and supplements are all emphasized. Preliminary results show that patients are experiencing significant improvements in brain health. I look forward to seeing further research from this clinic.

The MIND Diet

Another tool we have for addressing brain health is the MIND diet (the “Mediterranean-DASH Intervention for Neurodegenerative Delay”). It was developed by Martha Clare Morris, based on the observation that both the DASH and Mediterranean diets are associated with improved cognition. The MIND diet adopts foods from these two diets that are associated with improved brain health. These foods are great sources of nutrients such as antioxidants, lutein, vitamin E, and omega-3s.

The diet emphasizes foods such as berries, fish, and leafy greens, while limiting foods such as sweets and fast food. Studies show that the MIND diet is strongly associated with improved cognition. One study showed a 53% decreased rate of Alzheimer’s in those who most closely followed the diet pattern.

 Try the MIND diet to beat Alzheimer's disease; "Mediterranean-Dash Intervention for Neurodegenerative Delay


Key Goals for a Healthy Brain

  • Maximize antioxidant intake via vegetables, herbs, and spices
  • Minimize simple carbs and processed foods
  • Fast for 12 hours each night
  • Prioritize stress relief and stay cognitively active
  • Exercise aerobically most days
  • Consider targeted supplementation
  • Prioritize foods in the MIND diet

Going Forward

This post illustrates only a sample of the exciting research being conducted on the relationship between diet and brain health. And while the Alzheimer’s Association still positions that “there is no treatment to cure, delay or stop the progression of Alzheimer’s disease,” I’m excited about the research showing this may not be true!

Together, we can change the current paradigm. Let’s use this information to empower people to reclaim their brain health for years to come!

janie-jacobyJanie 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 foundationalplate.com.

Beginner’s Guide to Dairy Free Milk

Beginners Guide to Dairy Free Milks


With so many new dairy free milk alternatives appearing on grocery shelves, it can be overwhelming to keep up. From soymilk, to nut milks, pea milk, and even animal-free dairy milk, the options continue to expand. Whether you’re new to dairy milk alternatives or are looking to learn more, this post will explore some of the most common and up-and-coming dairy free milk options.

Why Choose Dairy Free Milk?

Milk Allergies: Some people have allergies to the proteins in milk such as whey, casein, or lactalbumin. An allergy involves an immune response that occurs on exposure to the same food or part of food. Allergies can be mild to life threatening, which is why some people cannot drink dairy milk. Milk allergies are most common in infants and young children and most outgrow them.

Lactose Intolerance: An intolerance is different than an allergy because it does not cause an immune response. Lactose intolerance occurs when the body does not produce enough of the lactase enzyme to digest the lactose in the milk. As we age, our bodies naturally produce less lactase, which is why adults tend to experience symptoms of lactose intolerance more frequently than children.

Dietary Restrictions: Many people choose to avoid consumption of dairy milk or animal products, in general. Some restrict dairy as a matter of taste and others, like vegans and ovo-vegetarians, consume only eggs, but not dairy. Reasons for dietary restrictions can vary from person to person due to health issues, ethics, environmental reasons, or a combination of these.

Ethical Reasons: The ethics behind avoiding dairy milk stems from how dairy cows are raised, fed, and slaughtered in industrial farming systems. There is also a belief that cow’s milk is unnatural to consume, as it is intended for the calf, not for humans.

Environmental Reasons: The production of dairy products causes emissions of greenhouse gases (methane, nitrous oxide, carbon dioxide) that have been shown to impact climate change. These gases are produced from the production of a cow’s feed, manure, dairy processing, and cow burps. Producing dairy milk also consumes a large amount of water, contributes to fertilizer and manure runoff that pollute water sources, requires large amounts of land, and contributes to soil erosion.

Alternative Milk Options

Note that all of these options, if fortified, contain 50% more calcium than dairy milk, 45% daily value of calcium and 25-30% of daily values for vitamin D. The main differences are in taste, texture and protein content. Additionally, many are also fortified with other vitamins such as vitamin B12.

Pea Milk

One company, Ripple, has recently developed pea milk this past summer utilizing yellow peas. Peas are easily digested, hypoallergenic and full of branched chain amino acids. This milk is nut-free, lactose and dairy free, gluten-free, and 100% vegan. Although this milk contains the same amount of protein as dairy milk at 8 grams per cup, it is not a complete protein source. It also has 32 mg of omega-3 fatty acids from algal oil.

• Consistency: comparable to whole fat dairy milk or soymilk
• Taste: milder and less bitter than nut milk, great for plant-based milk newbies

Soy Milk

Soy milk has been around for awhile and was one of the first dairy free milk alternatives. Soy milk has a similar protein content as dairy milk and is a complete protein source. Many versions and flavors exist today, even fermented or probiotic soy milk exists for added benefits. It is also generally recommended as a heart healthy alternative to dairy milk. Soy milk  has 7 grams of protein per cup and is a good source of potassium, vitamins A and B12 and isoflavones.

• Consistency: thick, smooth and creamy
• Taste: bean-like (unsweetened and unflavored versions)

Nut Milks

Nut milks contain very little protein. One cup of both almond and cashew milk have zero grams of protein, while macadamia milk has 1 gram of protein. Nut milks are generally 50% lower in calories than pea milk, dairy milk, hemp milk and soy milk, which may help if you drink milk frequently and are trying to reduce overall caloric intake. Nut milks may also be a good option if you have a soy allergy or find that you simply prefer the taste.

Cashew milk
• Taste: sweet, least nutty flavor of all nut milks
• Consistency: creamy, smooth

Macadamia milk
• Taste: semi-sweet
• Consistency: rich, creamy, similar to cashew milk

Almond milk
• Taste: nutty almond flavor, sometimes slightly sweet and can have hints of bitter
• Consistency: varies by brand – some are thick and creamy, while others are thin

Hemp Milk

Hemp milk is high in riboflavin, phosphorous, iron, magnesium and omega-3 and omega-6 fatty acids. It also contains all of the essential amino acids. It typically has a nutty flavor with a creamy texture. It is also easy to digest and has approximately 3 grams of protein per cup.

• Taste: nutty and buttery, similar to a pine nut
• Consistency: creamy

Rice milk

Rice milk is the least nutrient-dense of all of the dairy free options and has approximately 1 g of protein per cup. Because of this, it may be beneficial for those with allergies or intolerances to dairy milk. It is also easier to digest than other milks.

• Taste: very neutral
• Consistency: thinnest of all milks


Animal-Free Dairy Milk

This type of dairy free milk is set to hit the shelves in 2017 and has a very interesting conception. It uses technology to create a beverage that looks, tastes, and has the same components as traditional cow milk, without the use of any cows. The company is called The Perfect Day and on their website they explain the process as being similar to craft brewing. The process uses dairy yeast, which is fed by sugar from renewable sources. Fermentation occurs, producing the same milk proteins that are found in cow’s milk – casein and whey. Nutrients similar to those in milk such as calcium, vitamin D and omega-3 fatty acids are also added. Plant fats, sugars and minerals are then used to create a desirable texture and consistency, while avoiding the use of stabilizers, hormones, and lactose. It is also vegan, lactose-free, and gluten free. While it is GMO-free, genetic engineering is used to create the yeast that produces the milk proteins, which is also used to make insulin, ethical vanilla, and vegetarian rennet. There is no nutritional data available on this product yet, but this is definitely something to keep an eye out for!

Final Tips

Choose unsweetened versions and opt for the refrigerated dairy free milks over the shelf-stable kind. These will have less preservatives and artificial ingredients. If you’re extra adventurous, you can make your own! There are plenty of tutorials online if you’re interested.




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.