Category Archives: General Health

An Apple a Day…

Ever wondered if there is any truth in that old saying “an apple a day keeps the doctor away”?

Apples from L to R: Grimes Golden, Baldwin, Black Oxford, and Esopus Spitzenburg

Turns out, there is!

In 2015 The Journal of the American Medical Association published a study looking to see if apple consumption was associated with fewer doctor’s visits.  While the study did not find a decrease in doctor’s visits in those who reported that they regularly consumed apples, it did find a significant decrease in prescription medication use in apple consumers.

While apple consumption may not be a panacea, it may be a delicious way to improve your health.  Consuming apples have been shown to be beneficial for lowering cholesterol, decreasing inflammation, promoting weight loss, promoting optimal digestive function, protective against lung and colon cancer, and lowering asthma risk.

The health benefits of apples are thought to be due to the presence a high number of antioxidant compounds along with the fiber and pectin content.  Many of the antioxidants in apples are found in highest concentrations in the skins, so for greatest benefit, do not peel them.

According to the Environmental Working Group, apples are among the 12 foods with the highest pesticide residues on them. Because of this, organic or minimally treated apples are best for individuals wanting to avoid pesticide associated health risks.  The skin contains the highest concentration of pesticide residue, so if left with no other option, peel nonorganic varieties.

There are many ways to enjoy apples, from eating them fresh off the tree, to making apple sauce, and apple pie.  Below is a recipe for a wheat free Caramelized Apple Pancake. Enjoy!

Davis MA, Bynum JP, Sirovich BE. Association between apple consumption and physician visits: appealing the conventional wisdom that an apple a day keeps the doctor away. JAMA Intern Med. 2015;175(5):777-783.

Caramelized Apple Pancake


  • 1 cup plain soy, rice, or cow milk
  • 1 large egg lightly beaten
  • 3 Tbsp. grape seed, coconut, or canola oil
  • 1 cup oat flour
  • 2 tsp baking powder
  • 3 Tbsp. maple syrup
  • 2 large apples, cored and cut into ¼ inch thick slices
  • 1 tsp cinnamon
  • Zest of ½ a lemon and a splash of lemon juice
  • ½ cup walnuts chopped.

Preheat oven to 500.  In a medium bowl, combine milk, egg, 1 tbsp. maple syrup, and 1 tbsp. oil.  Add in flour, baking soda, and salt.  Stir until combined.  Heat a cast iron or other oven proof skillet over medium high heat. Add 1 tbsp. oil.  Put apples in pan in single layer.  Allow to cook 4 minutes or until they begin to brown. Carefully flip apples and continue to cook until browned on second side.  Add 2 Tbsp. maple syrup, cinnamon, and walnuts.  Toss to just coat apples. Remove from heat. Using a pastry brush or piece of paper towel, coat sides of pan with oil.  Pour in batter.  Put in oven on middle rack. Reduce oven to 425 and cook for 12 minutes or until top is beginning to brown and the pancake is cooked. Slice into wedges and serve.


Just a Spoonful of Honey…

Camp 2013 025Last year, my wife and I began our latest hobby, beekeeping. Over the course of the summer our hives built up from fledgling colonies to robust pollinating and nectar collecting forces.  Despite getting our fair share of stings, by August we managed to harvest over 50 pounds of honey. This amount is staggering when you consider that it takes 12 bees their entire lives to produce 1 tsp of honey and that on average bees have to visit 2 million flowers to produce 1 pound of honey.  While 50 pounds sound like a lot, if all goes well, we may end up with four times that amount this year.   We have enjoyed eating and sharing our honey over the past nine months and have been constantly looking for new ways to use it in cooking.  While I think that honey is delicious, as a doctor I have been intrigued by the myriad of benefits it can have on our health as well.

While the rise in the interest in bees and beekeeping is a relatively new phenomenon, the use of honey as medicine is not. The Egyptians were using honey as medicine more than 4000 years ago and would put some in their burial chambers to take into the afterworld.  As a testament to its antimicrobial and antioxidant properties, samples of honey found in Egyptian tombs have been found to be perfectly preserved and still edible.

CSC_0125One of the prime ways that the Egyptians used honey was for dressing wounds.  Honey is still used for wound healing today and studies have backed up its effectiveness.  Honey acts a perfect wound dressing since it cleans the wound, acts as an antimicrobial, stimulates tissue regeneration and reduces inflammation.  Honey has been found to be useful in in a wide range of wounds including abrasions abscesses, bed sores, ulcers, surgical wounds, and burns.

In a time when pharmaceutical antimicrobials are becoming less effective against bacterial infections, honey has shown promise as antimicrobial agent inhibiting the growth of over 60 species of bacteria including MRSA. Unlike conventional antibiotics it does not appear that honey leads to the development of antibiotic resistant strains of bacteria.  Honey also does not seem to negatively affect our beneficial gut microbes and has even been shown to increase levels of Lactobacillus and Bifidobacteria.

Honey has other benefits for the gastrointestinal tract in addition to its impact on the microbiota.  Honey has been shown to speed the healing of gastric and duodenal ulcers and also to decrease inflammation of the stomach known as gastritis.  Use of diluted honey has been found to speed the recovery from cases of infectious diarrhea and gastroenteritis.  Taking a teaspoon of honey before meals has been found to decrease the incidence of heart burn or gastro esophageal reflux.

While the idea of pouring honey in your eye may sound strange, eye drops made from hone have been found to be helpful for various ophthalmological conditions including conjunctivitis, blepharitis, dry eyes, keratitis, corneal injuries and even chemical burns.

I typically recommend patients with increased cardiovascular risk and elevated cholesterol avoid sugar, but honey intake may actually decrease cardiovascular risk.  When natural honey was compared with artificial honey made of fructose and glucose, the natural honey was found to lower total cholesterol, LDL cholesterol, triglycerides, and CRP, a marker for inflammation.  In addition it caused a slight increase in the more beneficial HDL cholesterol.    Honey was also found to lower blood pressure and its high antioxidant content may further reduce cardiovascular disease risk.

Coughs in children can lead to sleepless nights for both the child and their parents.  A double blind placebo controlled study reported in the journal Pediatrics in 2012 may help give relief to children and their parents.   Children with night time coughs caused by an upper respiratory infection given a spoonful of honey before bed decreased coughing and improved sleep.  Just keep in mind not to use this remedy in children under 1 year of age as there is a small risk of botulism.

In addition to the properties that I have mentioned that have been studied, numerous anecdotal claims about honey’s healing properties exist.  One of the ones that I hear most frequently is the use of local honey to reduce the severity of seasonal allergies.  While studies looking at this effect have not been conclusive, my own experience has shown it to be beneficial.  When using honey for this use it is important for the honey to be as local as possible so that you are getting exposed to the pollens in your area.

a-jar-of-honeyWhen buying honey it is important to know that all honey is not the same and that much of what is sold as honey is actually not honey.  A study from 2011 found that 75% of what is sold as honey has actually had the pollen filtered out of it.  The removal of the pollen appears to decrease the beneficial properties of the honey and definitely decreases it effect on seasonal allergies.  When buying honey it is important to remember that you get what you pay for.  It was also found that inexpensive “honey” from China was actually honey diluted with high fructose corn syrup.

When you buy honey it is best to buy raw honey and the honey should say on it where it was collected.  If you are not able to find local raw honey in your grocery store, try looking at health food stores, farmers markets, or even stores devoted to the sale of honey, bee products and beekeeping supplies like Portland’s The Honey Exchange.  Owners Phil and Megan Gavin have a wide selection of local and non-local raw honeys and can tell you about where the honey comes from, what it tastes like and always have a number of delicious honeys available for sample.  You can also look inside their observation hive and see the bees in action.

For a refreshing thirst quenching summer time treat try this recipe for a honey rhubarb drink from Poland that combines that tang of rhubarb with the sweet floral taste of honey.

Can You Trust Your Supplements?

images35DGQ9E6If you are like more than 50% of Americans you took one or more dietary supplements today. The use of dietary supplements has been increasing over the past 20 years. What you once could only find in health food stores is now available in drug stores and grocery stores. It has even become common for conventionally trained medical doctors to recommend multivitamins, fish oil, probiotics and vitamin D. Most of the patients that I work with are taking multiple supplements before I start working with them.

While I recommend dietary supplements to many of my patients I do have concerns about the safety, interactions, and quality of dietary supplements. I will be addressing safety and interactions in future blogs, but in this blog I want to focus on quality issues with dietary supplements.

A recent quality evaluation by the company Consumer Labs found that 20% of the vitamin D products that they tested failed their quality testing. Two products contained almost twice as much vitamin D as was listed on the label, once product contained unacceptable levels of lead, and two products did not disintegrate within the expected 30 minutes. Trader Joe’s Calcium Citrate with Vitamin D contained 175% of the amount of vitamin D on the label and still had not disintegrated after an hour. So while you might save a little money on buying your calcium and vitamin D from Trader Joes, if it doesn’t break down in your digestive tract you might as well be throwing your money away.

In another evaluation they found that 16 of 42 multivitamins tested either had less of a nutrient or nutrients than the label stated, had more of a nutrient or nutrient than the label stated, or didn’t dissolve under normal circumstances. While the benefits of taking a multivitamin can be debated, if you are taking a multivitamin it would be good to know that it contains the amounts listed on the label and also that it is going to dissolve in your stomach as opposed to in the sewer.

Several years ago an analysis of Ayurvedic herbal products purchased from health food stores in the Boston area found that over 20% of them contained dangerous levels of lead, mercury, and arsenic. While the amounts in a single pill were not enough to cause a problem, if you were taking them every day for months, the toxic exposure could begin to have serious health consequences.

A study done at Bastyr University looking at the quality of probiotic supplements found that only one product out of twenty contained exactly what the label claimed it to contain.  30% of the products were contaminated with other organisms and 20% had no growth of any bacteria.

These examples unfortunately are just the tip of the iceberg. Other issues have included adulteration with anabolic steroids, high levels of toxic solvent residues, failure to contain the herb or probiotic species listed on the label, and inclusion of rancid oils.

While I have a great appreciation for dietary supplements, it has become clear to me that there is a great deal of variability in the quality of products sold as dietary supplements in the United States. While there has been an increased effort by the FDA to enforce basic quality standards, the supplement industry remains largely under regulated. The FDA does now require supplement companies to follow specific good manufacturing practices (GMP) in regards to the manufacturing of the product, but there is not the infrastructure to adequately enforce these and even if they did there is concern that the FDA standards may not be adequate enough to ensure that supplements are safe, free of contaminants and contain the substances that the label says that they do. The GMPs also don’t regulate the effectiveness of the product, the forms of the ingredients, where the herbs and nutraceuticals come from, or whether or not the additives or fillers used might have negative effects.

Fortunately there are some companies that have taken it upon themselves to make sure that they are producing high quality products. These companied not only follow the FDA regulations, they go beyond these standards to ensure that when you buy one of their products it contains the ingredients they say they do, in the amounts listed on the label and have been tested to make sure that they do not contain heavy metals, rancid oils, microbes, pesticide residues, solvents, or pharmaceutical drugs.

In order to find these companies, I have had any company that I recommend complete a detailed quality control survey so that I can tell if they meet the standards that I think are important to ensure that the supplements that I recommend to my patients are safe. In addition to the surveys I have sent out I have also had the students in the Supplementation and Whole Foods Nutrition course that I teach for the University of Western States send out the surveys as one of their assignments and so I have gotten to see a wide range of responses.

Based on those responses I have found several companies that I feel meet a high enough standard for me to recommend safely to my patients including: Thorne Research, Metagenics, Designs for Health, Integrative Therapeutics, Vital Nutrients, Biotics Research, Douglas Labs, and Pure Encapsulations.

Some of these companies can be found on the Order Supplements page of this website. In addition many of these can be purchased at Apothecary by Design in Portland and True North in Falmouth.

So the next time you are tempted to buy that cheap bottle of vitamins remember that you may be getting more (or far less) than you paid for! In my next blog I’ll take a look at some of the potentially dangerous interactions between dietary supplements and the medications that you may be taking.