The Miracle Worker?
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Can Rye Brook functional medicine Dr. Susan Blum's immune boosting plan actually help you to reverse the effects of autoimmune dysfunction? In my family, we have an abundance of riches in the autoimmune disorder department, and recently, three different specialists taunted me with concern that I might just be developing some sort of autoimmune disorder of my own. I asked each of them what I could do to fortify my immune system to ward off this problem and head it off at the pass, and they shrugged. "Not really." "Nothing I've read". "Nothing I can say for sure".
When I heard that Dr. Susan Blum, the author of a book called "The Immune System Recovery Plan: a Doctor's 4-Step Program to Beat Autoimmune Disease" was coming to SHS to speak, I felt I had to go. Besides, she kind of put it out there that a happy immune system also meant more energy, better muscle tone, flat stomach, and excellent humor too. I figured I could help my kids fight off future would-be autoimmune assailants, and grow stronger, svelter, and nicer myself along the way. If what she said proved true, it would be a big win/win for all of us! I'd figure out how to get rid of autoimmune's menacing inflammation from my body, and reconnect with my inner, higher energy, sinewy, muscle-building wood nymph all at once.
But of course, I have grown weary of the purveyors of false hope, and I go to each new speaker these days with a healthy dose of skepticism. Many
of them are hucksters of hokum, long on hocus pocus and short on clinical evidence. But here comes Dr. Blum, actual MD, MPH with actual medical street cred: she is currently an assistant clinical professor in the department of preventive medicine at Mt. Sinai medical school and holds a masters in public health from Columbia in addition to her more "outside the box" training at the Center for Mind-Body Medicine and the Institute for Functional Medicine. She describes herself as a scientist who relies on a solid scientific foundation and builds on that to incorporate elements from integrative medicine as well. A few 10583 friends who couldn't make the lecture asked me to take notes and tell them all about it and where I thought she came down on the prophet/false prophet continuum...so here goes.
As the founder and director of the Blum Center for Health in Rye Brook, Dr. Blum practices what has come to be known as functional medicine. The idea behind this newish field is that, instead of treating symptoms, doctors put on their Dr. House hat like that prickly but endlessly wise TV show doc/diagnostician, and become diagnostic detectives, looking for the root cause of what ails you. Blum likes to quote Dr. Sidney Baker, one of the founders of this outgrowth of preventive medicine. "If you are sitting on a tack, the answer is not to treat the pain. Find the tack and remove it!" "The tack" in the example Blum uses, is the place where the immune system is in revolt...and taking it out on you. The pain or symptom is merely the result of that revolt.
Blum says you need to look at the whole patient, taking into consideration a variety of factors not always given proper credence—potential toxins in your environment, as well as lifestyle factors-- social life, stress level, relationships, diet, exercise, sleep habits and any symptoms you might be struggling with. She and her team integrate western medical practices with what are still regarded as "alternative" approaches of mindfulness and meditation.
The way Dr. Blum explains it, the immune system is your defense system. It starts with the gut which is responsible for 70 percent of the body's immune capacity and covers the surface area equivalent to that of a tennis court. The eyes may be the window to the soul, but the gut is the window to the heart....the joints...the health... the whole shebang. The mind ties in to all of this when stress comes into play—and so, the mind/body connection is very powerful both for its power to heal and to harm. When the gut is working properly, there are cell layers that stick tightly together and form a protective barrier that is hard to penetrate. This barrier manages how your immune system reacts to anything foreign.
In addition to stress, Blum names triggers she calls "The four A's-- antacids, antibiotics, alcohol, and Advil (or other NSAIDs)" for setting off the cascade of events leading to autoimmune dysfunction in the gut. Any of these factors can throw off the balance of flora in the gut, and when the balance is off, the barrier is compromised, and you have a condition called leaky gut syndrome. Having a leaky gut means that anything that is inside your intestines...good or bad bacteria, can be "seen" by the immune system and provoke a response. When this goes on for an extended period of time, the immune reaction begins to malfunction and your own cells can mistake your own tissue for foreign invaders. This, in turn, sends inflammatory molecules all over your body and causes pain in many places, like the pain of rheumatoid arthritis. When the gut is not working properly, the mitochondria or "furnace" of the muscles can't get the proper nutrients and therefore can't fire properly. Blum says problems within the gut are responsible for the lion's share of a huge variety of largely undiagnosed autoimmune ailments effecting some 23 million Americans.
What is Autoimmune Dysfunction?
It can come in the form of the classic allergic response (IgE), or the food sensitivity response (IgG), joint pain, foggy brain, hardening of the arteries, among others. It comes most often to those with a genetic predisposition to it, but not exclusively to them. Dr. Blum has come up with a four-point program to heal the immune system, starting with the gut.
Step One: Treat Food as Medicine.
Treating food as medicine means making good food choices that support good health and reduce inflammation, because, she says "All calories are not created equal. You must see calories as tools in your anti-inflammatory arsenal. Apples, for example, go to the cellular level and trigger reactions in cells providing vitamin C and phytonutrients. Watermelon even sends its nutrients to the cellular level. Pretzels, by contrast, are made up of yeast and wheat, and your body processes them just like sugar. Your body digests simple flours like that fast. This makes your blood sugar shoot up, and then, drop fast, and that quick up and down messes with the hormones controlling your body. I'll bet you didn't know that skim milk makes your blood sugar bump up too!"... she says, ending her breathless list of food sins and saviors. She guessed correctly! I did not.
"And the cheerios you always hear about being so healthy...they cause a big carbo load. They create inflammation and inflammation makes you tired."
This logic, called nutria-genomics, is the idea that one's nutritional choices effect the expression of the genes of the host organism, (i.e.: the health and well being of homo Scarsdalianus).
This is the cornerstone of Blum's food as medicine philosophy: you must make good food choices, but, not all good choices are created equal. One man's perfection, is another man's poison. Bad choices are foods to which you have food sensitivities, as opposed to just food allergies.
Regular allergy tests only test for anaphylactic allergies. But there are different foods and chemicals that each of us has sensitivities to as well, and they can do different kinds of damage in each of us. So Blum's first stop is to check for food sensitivities. And the best way to do that is with a rather severe elimination diet: get rid of the five leading inflammation-causing culprits for three weeks all at once, and then slowly add them back into your diet, one at a time every four days.
Blum's version of the five deadly food sins; her olfactory axis of evil: gluten, dairy, soy, corn, eggs. Bye bye, breadsticks. Hello, ancient grains.
Autoimmune Healing Step Two: Understanding the Stress Connection:
Blum explores all of the environmental and lifestyle issues affecting her patients, looking for evidence of stress in their lives and the effects of stress on their bodies. "Cortisol, the main stress hormone, suppresses the immune system, and tends to increase the waistline too, because people with high levels of stress and cortisol, tend to crave sugar and high fat foods that, in turn, tend to settle in around the waistline." This fat, often called "brown fat" in the medical community, behaves differently from other fat in the body and creates a great deal of inflammation, which, as we have discussed....is the devil's/ autoimmune disease's handiwork.
Blum says the key to managing the destructive power of stress is figuring out how to stop ruminating on and reliving the issues that cause stress in the first place. So she has programs to help patients with meditation and other mindfulness exercises. "Stress is believed to be a contributing factor in an amazing 80 percent of all chronic conditions, including autoimmune disease, heart disease, stroke, and cancer." Too much stress can lead to adrenal fatigue, and that leaves you vulnerable the kind of inflammation that leads to developing puffiness and stiffness in joints and muscles, and general exhaustion, and the autoimmune disorders associated with those symptoms.(rheumatoid arthritis, MS, Lupus...) No thanks.
Step 3: Healing Your Gut:
When they are not working properly, the cells lining your intestinal tract cannot recognize the difference between foreign invaders and your own tissue, and they treat both as enemies. These immune cells release many, many inflammatory molecules when they are activated...and that brings about...once again...you know the devil: inflammation. (are we sensing a pattern here?) So Blum says "The bottom line is that having enough friendly flora (probiotics) in your gut reduces the incidence of allergies and autoimmune diseases. You bring the outside world into your body through your mouth every day. You need to make sure there are plenty of good bacteria in there to keep things in balance."
Finally, Step 4, Supporting Your Liver:
The fourth front to take on autoimmune disease before it hits or to reverse it if it has, is removing the body's exposure to toxins. The liver takes out the toxins that your body takes in, so Dr. Blum says you need to support your liver to help it do its job. She says we all need to be aware of the environmental toxins we are routinely exposed to, and take steps to diminish that exposure. Our individual toxic load comes from our lifetime exposure to a wide range of substances that can damage cells from dry cleaning solvents, to glue, to paint, to pesticides, to heavy metals like mercury, lead, and arsenic. Too much exposure to toxins starts to clog up your liver, and that can lead to feeling puffy all over, muscle pain, tingling in your extremities, or unexplained weight gain.
When the liver, which functions as the body's strainer, is clogged with toxins, it is hard for the filter to work well, and it slows down. Blum offers a plan to boost the liver enzymes' detox functioning, remove heavy metals, and reverse disease. This part was the fuzziest for me, but if her clinical findings bear out over a larger group, she's got a very interesting plan.
Conclusion: So What Do We Make Of This?
After I told my rheumatologist about what I'd learned from Dr. Blum's lecture, she said, cautiously, that she HAD heard anecdotal evidence from patients to support Blum's claims, (taking gluten and dairy out of their diet gave them greater strength and energy) but since she hadn't read the program herself, she couldn't endorse it. Blum claims that too many doctors simply don't have or don't take the time to stay up to date on advancements in their fields, and if they did, they'd be hopping on the functional medicine bandwagon in droves. It certainly seems that it would be worth looking into.
So, where does this leave this me and my merry band of skeptics? While I am not a physician, and I can't claim to evaluate the merit of one study over another for anyone but myself and my family, but I can say that the old saw "an ounce of prevention is worth a pound of cure" makes good sense here. And while giving up bread and cheese does seem like some pretty harsh medical concessions to make, it beats prescription medications with unpleasant side effects. And if there is anything I can do to head off the risk of autoimmune disease at the pass, I want to try it.
As Blum says, "If you go to a GI doctor, they look for disease under a microscope. They do not measure flora. Disease takes time to happen. Why not do what you can to prevent it blossoming?" In the offices of two other specialists, I have been told I may have some sort of as yet not fully manifest autoimmune disorder in the works. Do I just sit there and wait for it to hit? I say no. But it's not going to be easy giving up those axis of evil foods. I'm the gal who jokes that if I ever got sent to prison on a bread and water diet it wouldn't be a hardship if the bread had a nice crust. Still, the upside is just too huge to ignore.
My gut tells me I just have to give it a shot!
Contributor Sharon Dizenhuz is a former reporter and anchor on New York 1 News and a Scarsdale mom.
Absurdly Addictive Asparagus from Food52
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I just discovered that former NY Times food writer and author Amanda Hesser has a terrific food website. Founded with partner Merrill Stubbs, Food52 features recipes from recognized chefs and community readers with a passion for food. The site is called Food52 and was founded to "bring cooks together from all over to exchange recipes and ideas and to support each other in the kitchen. We wanted to create a buzzing place for others who do what we do all day long: talk about food!"
Everything looks delicious on the site which is attractively designed and easy to navigate.
Here's just one of the appealing seasonal recipes I found this week:
Absurdly Addictive Asparagus by kaykay
"The title pretty much says it all. With her recipe, kaykay takes an already promising set of ingredients and artfully combines them in such a way that the resulting dish exceeds the sum of its parts. 2-inch lengths of asparagus, crisp-tender to the bite, take center stage in a savory tangle of leeks, pancetta, garlic, orange zest, parsley and pine nuts. The rendered fat from the pancetta, along with a knob of butter, is just enough to keep the vegetables from being dry without smothering the fresh flavors. The recipe is supposed to serve 4, but we could easily imagine polishing off an entire pan by ourselves."
Serves 4
4 ounces pancetta, cut into 3/8 inch to 1/4 inch dice
1 tablespoon butter
1 pound asparagus, woody ends trimmed and sliced into 2 inch pieces on the bias
1 1/4 cup leek, thinly sliced crosswise (white and pale green parts only)
2 cloves garlic, minced
Zest of one lemon
1 teaspoon orange zest
2 tablespoons toasted pine nuts
1-2 tablespoon Italian parsley, chopped
Salt and freshly ground pepper to taste
In a large non-stick pan, sauté pancetta, stirring frequently, over medium heat, until crisp and lightly golden.
Add 1 tablespoon of butter to pan. Add asparagus pieces and leek and sauté until asparagus is tender crisp, about 3-4 minutes.
Add garlic, lemon and orange zest, toasted pine nuts and parsley and sauté for about 1 minute, until fragrant. Season to taste with freshly ground pepper and salt and serve immediately.
This recipe was the winner of the Best Asparagus Recipe Contest. Check out Food52 for virtual inspiration in the kitchen.
Polpettina Expands Seating and Hours
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If you've been frustrated in attempts to get into Polpettina in Eastchester, give them another try. After a long battle with the Village of Eastchester they have finally expanded their dining room into the space next door and there are now many more tables. Famous for their delicious meatballs, pizzas and pastas, this homestyle eatery with locally-sourced ingredients will please foodies and "meat and potato" diners. For me, it's a challenge to order because between the regular menu and special items like lamb meatballs and foie gras, it's difficult to choose.
In addition to expanding the dining room, Polpettina has also expanded their hours. They are now offering family style dining for tables of 6-10 people every Monday through Thursday at 5 pm and 6:30 pm. The four-course week night dinner includes a selection of salads, appetizers like fried calamari and mussels fra diavolo and flavorful entrees such as eggplant parm, pasta Bolognese, porchetta and roasted chicken. All for just $30 including a dessert of zeppoles (donuts with powdered sugar) or gelato.
Poplettina is now also opens on Sundays at 10 am for brunch. The new menu looks like a good reason to get up and out of the house. Some of the items that caught my eye were the croissant French toast, featuring a Balthazar croissant, NYS maple syrup with sliced banana, the house cured salmon with bagel chips, hard boiled eggs, capers, marscapone and pickled red onion and the brunch pizza with sliced potato, LQ Farms prosciutto, egg and house-made mozzarealla. Sounds divine!
So even though they don't take reservations, now that they have doubled in size, getting into Polpettina should be a whole lot easier.
Polpettina
102 Fisher Avenue
Eastchester, NY 10709
polpettina.com
914-961-0061
Who Cooked Your Dinner? A Cautionary Tale
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When we booked our reservation at a highly recommended tapas restaurant in the village a few weeks ago, we never imagined we would get wrapped up in a public health incident that snared our family, friends and even friends of friends. Recently back from a short trip to Spain to visit my daughter, who is studying in Seville, I was enthusiastic about tapas and eager to sample some in New York. A foodie in the city suggested we try Alta on 10th Street, and rather than celebrate the second night of Passover with a Seder we invited our kids and a few friends for a festive evening out.
At first we had trouble finding Alta, which is below street level in a row of townhouses, but once inside, we were served up some very strong Sangria and the evening was off to a promising start.
We ordered quite a few tapas to share –and I must admit that time and the sangria have erased all memory of what we ate. I remember that everything was tasty and quickly consumed by our party of six. And we didn't stop with the tapas. When the waiter proffered the dessert menu we ordered some of that as well. Again, I can no longer recall exactly what we ordered but we left the restaurant in excellent spirits and when we found the car on the street without a parking ticket we deemed the evening a success.
That was until Saturday April 6, when I got an email from my foodie buddie quickly followed by another email from the mother of my daughter's friend who had joined us for dinner that night. Turns out that the dessert chef at the restaurant had been diagnosed with Hepatitis A, a potentially deadly virus, and a warning was being sent to everyone who had dined at Alta between March 23 and April 2 when this chef was on duty. The NYC Public Health Department advised that anyone who had eaten there between those dates, and specifically eaten dessert, get a vaccine against Hepatitis A. The Health Department had even gotten all the phone numbers of those who had reserved to eat at Alta during that time period and I received a phone call advising me to get the vaccine. The good news was that if we got vaccinated within two weeks of exposure we should all be fine.
My husband, who is a physician, thought about it briefly and decided that our 27 year-old son should get the vaccine, especially as he tends towards hypochondria, as he told a NY Post reporter at the clinic. When our 24 year-old daughter called from New Orleans my husband instructed her to go to the university health center and get the shot too, though she was pretty sure she never tasted the dessert. I also wanted to get the vaccine. My husband, figuring he was already immune from all his years of exposure to various diseases in the hospital, was leaning against the vaccination for himself. So – we hopped into the car and headed off to the NYC Health Department at Ninth Avenue and 28th street to check out the scene.
On the way into the city, my husband got in touch with his colleague Dr. Joel Ernst at NYU – who was an infectious disease expert. It took him less than a minute to tell my husband, in no uncertain terms, to get the vaccine. He told us that when he was a boy his father had fallen ill with Hepatitis A and was so sick that he went from, "thinking he would die to being afraid he wouldn't." Dr. Ernst also reassured us that the vaccine had few side effects and was not risky.
Though the NYC Health Department looked bare and institutional they had set up an efficient weekend team to vaccinate hundreds of diners. We filled out a series of forms and were then ushered into a small room with a very efficient Caribbean nurse named Marilyn. She completed even more paperwork and then instructed us to relax while she gave us a shot in the arm. It was surprisingly painless and was over in a flash. With a smile Marilyn said, "this is why you are so lucky to live in the United States." We sat in a waiting room for a few minutes to make sure we didn't get a reaction to the shot and then we were on our way.
My husband, who works at NYU Medical Center, was impressed with the entire operation of weekend workers who had come in on a moment's notice to avert what could have been a major health crisis. It reaffirmed his faith in government and demonstrated why we need to fund public health programs to safeguard our individual health and society as a whole.
Though I was grateful that the Health Department was able to intervene this time, the incident made me wonder how many other kitchen staffers at restaurants are sick with contagious diseases and never report them. We heard through the grapevine about a similar incident at a Scarsdale restaurant that was never made public. I guess what you don't know can hurt you!
When I woke up Saturday morning I never expected that I would find myself at the NYC Health Department in Chelsea, but when I woke up on Sunday, I was so happy I had gone.
My Day as a Manischewitz Judge
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Holy kreplach! I couldn't believe my eyes when, in January, I got a letter inviting me to be a judge in the 7th Annual Manischewitz Cook-Off, scheduled for the week before Passover.
"Does the Pope wear a tall hat?" I almost wrote back. But, I thought, wrong analogy.
Anyway, I was psyched. Pretty much everything I know about Judaism, I learned from watching Charlton Heston. Finally, a chance to reclaim my roots! And eat! I was SO in.
On March 21st, a limo whisked me away to Manischewitz's Newark headquarters, a compound of industrial edifices populated with friendly, hair-netted staff. I was ushered down a hallway adorned with Warhol-esque paintings of Manischewitz chicken-soup cans to the judges' room. There were six of us, including food bloggers and editors from The Huffington Post and Foodnetwork.com, plus Jamie Geller, a celebrity Jewish cookbook author. (My creds: I'm a senior editor at Parenting and past editor of the New York Daily News's Sunday food section.)
A company exec briefed us: Out of more than 2,000 entries, a panel of Manischewitz experts had selected the four tastiest, most original recipes; a fifth had been chosen through popular vote. The five semifinalists would get an hour to whip up their concoctions. Our job would be to monitor their progress, and, of course, taste-test.
We listened intently to the rules. There was some serious gelt at stake for the winner—a new Maytag kitchen and enough cash to cover the taxes, for a total value of $25,000. We weren't just playing for Afikomen money here!
Soon enough, we gathered in the festive contest-staging area, created by clearing away part of the factory floor. Pallets of soup cans were stacked to the ceiling! Kosher stoves and cook stations had been set up for the contestants.
An avid audience was on hand—media, VIPs, and even local kids. Many of those lucky folks got to take a factory tour (the matzo oven is the length of a football field!), but alas, I was too busy. After introductory remarks by the company's CEOs, the contestants' ovens were lit by rabbis, and it was game on.
The contestants were all Jewish (a flukey first for the contest, which is open to people of all faiths) and from all around the country. You Winning Recipe: Faux Pho
Two locals rounded out the list: Allison Hoschander, from Woodmere, NY, with a Chicken Potato & Leek Pie; and youngest-ever contestant Yitzi Taber, from Bergenfield NJ, just 17 years old and already slingin' Garlic Chicken Rollatini. What a catch for some lucky Scarsdale girl someday!
We'd been asked to rate each dish's ease of preparation and factor it into our overall scores, so I spent the hour assessing the chefs' efforts. Were they using tons of pans? Fretting as they fried falafel balls or chicken breasts? Why weren't they just reaching for the Chop Stix takeout menu instead, like I always do? Oh yeah...contest...prize...
As quickly as the hour passed for me, I'm sure it flew by for the semifinalists. Before we knew it, my fellow judges and I were seated at a long table, cameras trained on us as each contestant presented his or her dish. (Right about then, I noticed my name tag was misspelled "Skolnick," with a 'c.' But for as many times as I've misspelled 'Manischewitz,' I suppose it served me right.)
We took our nibbles, and rated each dish on factors like presentation, taste, and originality. It was tough to choose! Each was scrumptious in its own special way. Our score sheets where whisked away for back-room tabulation.
Contest Winner Josie Shapiro
I returned home with a lovely engraved serving tray, commemorating my service as a judge, as well as with some Manischewitz nibbles, like macaroons and latke mix. A happy holiday to all my Jewish (and non-Jewish) Scarsdalians, and if you should enter the 8th annual Manischewitz Cook Off, may the top prize not "pass over" you!
Deborah Skolnik is a Greenacres mother of two and big-time Manischewitz fan.
