Nutritional Tips for Inner and Outer Beauty

beauty skin

As we grow into adulthood and enjoying what life has to bring, we worry about how we look through this journey. As we learn about our bodies in teenage years, embrace the adventures of our 20’s and grow into our 30’s, what we care about changes. We once felt indestructible, had energy all day and night long, but now we get tired midday. We feel aches and pains we never had before, not to mention the change in our skin. As a health professional, many times I observe friends and colleagues paying more attention to their health only when something is bothering them or a scare hits within their family and close friends. As youths, we often go out in the sun without protecting our skin, and use various techniques to promote faster tanning not realizing that we have increased our chances for premature skin aging and cancer later in life.  This got me thinking about some simple inner and outer health tips that can be adopted at any age for health and wellness promotion.


Simple tips:


  1.      Hydrate – that is right, water and any non-alcoholic fluid can help you stay hydrated. A dehydrated and even a sub-optimal hydrated body have negative effects on whole body metabolism and the appearance of your skin. Some health professionals believe a goal for daily hydration (from beverages and the fluids found in fruits and vegetables) is equal to half your body weight (but in ounces). For example, if you weigh 100 pounds, your aim is to get 50 ounces of total fluids per day.
  2.      Eat Fish – Fish, such as salmon, mackerel, sardines and certain types of tuna are rich in omega-three fatty acids (omega 3’s). Omega 3 fatty acids play a huge role in the body for heart health (inner beauty) and as an anti-inflammatory (inner and outer beauty). Research has found that those people with low levels of omega 3’s in their diet often have more mood disturbances than those who include omegas in their diet. Great thing is, taking omega 3’s in as little as two-three times per week offers health benefits.
  3.      Enjoy colorful fruits and vegetables – the more colorful a fruit or a vegetable is, the more diverse amount of phytochemicals and nutrients that it contains. Research shows those with a wide variety of colorful fruits and veggies in their diet have lower levels of heart disease and cancer risk (inner beauty). We, in nutrition often ask people to get a total of five to nine servings of fruit and veggies per day. With so many organic and natural juices on the market, there are many ways of getting fruits and veggies in you.
  4.      Don’t skimp on Protein – Protein is so important to the body, in fact, your immune system is based mostly on protein. Protein is the backbone of your immune system and if you are not eating adequate protein, overtime you can get a weaker immune system. Protein is also essential for muscles maintenance and muscle tone, a person with insufficient protein will have weaker and smaller muscles, making daily activities more challenging. Also, your skin contains proteins, which is used for skin elasticity, skin integrity and appearance. Protein aids inner and outer immunity. One way to make sure you are getting enough protein in your diet is to ingest about half your body weight in grams (e.g., weigh 100 pounds, goal is a minimum of 50 grams protein daily).
  5.      Sleep – Of course, Sleep! Getting enough sleep helps our body renew and reduce adding more stress onto your body. Some health promoters say outside of not smoking that getting adequate hydration and rest are two keys to maintaining inner and outer beauty. Everyone is different, and to determine how many hours of sleep you should need is not easy to say. However, we do know those individuals whom get less than four or five hours sleep per night tend to have more illnesses and obesity in their life. Do not underestimate the need for sleep to promote inner and outer beauty!


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To your health!

-Douglas Kalman PhD, RD


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Weight, what does sleep have to do with it, have to do with it?!?!?!?!


More than 78 million adults (or 35.7%) and more than 12.5 million children (or 16.9%) in the U.S. are classified as obese. By increasing the risk for cardiovascular diseases, Type 2 diabetes and most cancers, obesity contributes to 1 in 10 deaths, making it the second leading cause of preventable death in the U.S. Obese individuals with diabetes or high blood pressure have a 26% greater risk of death than healthy-weight individuals.

You know that old song, “the thigh bone is connected to the leg bone”. Well, with sleep, “the sleep bone is connected to the weight bone”, so to speak.  Interruptions in sleep may contribute to hormonal changes and fatigue, which may result in less exercise, increased appetite, insulin resistance and diabetes.

Body Mass Index (BMI) is calculated from a person’s weight and height and correlates to measures of body fat. A BMI of greater than 30 is considered obese. Two thirds of people with obstructive sleep apnea (a sleep disorder characterized by loud snoring with repetitive blockage of the upper airway causing arousals from sleep) are obese. Interestingly, neck circumference (your shirt collar size) is associated with obesity and appears to be a risk factor for obstructive sleep apnea (greater than 16 inches for women and greater than 17 inches for men). Losing 10-20% of total body weight can improve the severity of underlying obstructive sleep apnea

Here’s an interesting tidbit. Did you know the timing of food intake, in relation to our internal body clock and the time we sleep, can predict weight gain and weight loss? In an experiment where mice were forced to eat only during the day, the reverse of their normal nighttime eating habits, the mice gained two and a half times more weight, even when their caloric intake remained unchanged. The message to us as humans:  “If you eat earlier and don’t graze with food and snacks after dinner, you’ll be more likely to lose weight”.   Even the timing of when you go to sleep can affect weight. Studies have shown that even changing your sleep schedule on the weekends, the way many of us do by shifting to a later sleep time on a Friday and Saturday night, can contribute to obesity. Not getting enough sleep can contribute to weight gain. A sleepy brain appears to not only respond more strongly to junk food, but also has less ability fight the impulse to eat more, less healthy foods. Remarkable as well is the observation that sleep disturbances in children with sleep apnea my lead to either weight gain or even a “failure to thrive” with actual weight loss.  

Medical research has recently discovered specific hormones which effect weight and appetite. Leptin comes from adipose cells (fat cells) and normally signals satiety = “makes you feel full”.  Ghrelin is another hormone (from the GI digestive tract), which signals increased appetite, tells you to “eat more”.  Stanford University and the University of Wisconsin looked at about 1,000 volunteers who reported the number of hours they slept each night. Doctors then measured their levels of ghrelin and leptin and charted their weight. The result: those who slept less than eight hours a night not only had lower levels of leptin (felt less satiety or less full) withhigher levels of ghrelin (increased appetite), but they also had a higher level of body fat. What’s more, the level of body fat seemed to correlate with their sleep patterns. Specifically, those who slept the fewest hours per night weighed the most.

Parasomnias are sleep disorders defined as “undesirable physical events or experiences occurring during or around sleep”. The typical example is sleepwalking. Well, there exists a phenomenon known as aSleep Related Eating Disorder” characterized by episodes of involuntary eating and drinking during arousals from sleep with no memory of the events.”  We believe this may be a variant of sleep walking and is more common in women than men. It can occur during any time in the sleep cycle with people often eating peculiar forms or combinations of food. The good news is it’s often very treatable.

Dr. Matthew P. Walker, professor of psychology and neuroscience at the University of California, Berkeley seems to have summed it up quite well when he stated,

“It is increasingly clear from the medical literature that there is not a single tissue in the body that is not beneficially affected by improved sleep.  It’s the single most effective thing people can do every day to reset their brain and body health.”


-Dr. Timothy L. Grant, M.D., F.A.A.S.M.

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Spirulina: The Superfood



It’s not easy being green…but if you want to add color to your life some under the sea algae may help. Could we call algae “food”? You bet…and if there is such thing as superfood it can be applied to Spirulina. This algae (cyanbacteria) is incredible high in protein, essential aminoacids and nutrients, rich in Chlorophyll, and known for its high B-12 and iron content.

Does it taste good? On its own probably not unless your taste runs on the fishy side…but think about its great nutrition content. Spirulina has high content of protein and contains all essential amino acids. It is particularly rich in the essential fatty acid gamma linolenic acid (GLA), which has gotten a lot of attention as an anti-inflammatory. Spirulina is rich in Omega-3s and  Chlorophyll, it has a high concentration of bio-available iron.  Spirulina is a great source of vitamins B-1(thiamine), B-2 (riboflavin), B-3 (nicotinamide), B-6 (pyridoxine), B-9 (folic acid), vitamin C, vitamin D, vitamin A and vitamin E. It is also a good source of potassium, calcium, chromium, copper, iron, magnesium, manganese, phosphorus, selenium, sodium and zinc. Spirulina is also very high in calcium even more so than milk.

So go ahead take the green splurge without diving into the ocean and add some Spirulina to your smoothies. Fish should not be the only ones to benefit from its goodness!


-Dr. Jackie Miodownik-Aisenberg M.D. PhD – Internist

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What Probiotic should I take?

Couple eating in park

Probiotics are the latest supplement craze and have been widely promoted to improve an individual’s health by improving the bacteria balance in the intestines. Recent studies have found that the body’s immune system interacts with the bacteria that live in the intestine and can produce both positive and negative effects. Probiotics improve the balance of bacteria in the intestine to help a number of symptoms and conditions.

Research is difficult to interpret but there have been studies that showed benefits of probiotics in patients with IBS, Travelers Diarrhea, Antibiotic effects on the GI tract, constipation, Inflammatory Bowel Disease, eczema, and possibly some autoimmune disorders.

But, how does one choose the best probiotic? To make matters worst, there are several different strains of probiotics, each product has different amount of bacteria, and then some need to be refrigerated. In general, it is very difficult to choose.

The most common probiotic strains include Lactobacillis, Bifidobacterium and Sacchromycis, which actually is a fungus. There are few studies comparing different strains of probiotics and therefore it is hard to determine which is best for you.

Second, some probiotics are refrigerated and some are liquid and some are in a pill or capsule form. I recommend taking a Probiotic from a reputable manufacturer whose product has been tested at time of ingestion for viability of the bacteria.

Finally, how many bacteria is ideal in a probiotic is something that is not clear and labels are difficult to read. Many patients think that if 1 billion CFU are good 10 billion CFU are better. This is difficult to determine, as there are few clinical studies performed on this topic.

So, in general I recommend discussing Probiotics with your Physician and taking a single strain product that is not refrigerated from a reputable manufacturer who has done studies to make sure the probiotic is viable when swallowed and can survive the acidic environment in the stomach.

-Dr. Howard Schwartz M.D. – Gastroenterologist

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Have Your Heard the News?


Aha! You might be asking what news? The news about the missing Malaysian airliner? The news about Harvard’s basketball team making it past the first round in the NCAA March Madness basketball tournament? No! No I say! Rather, the news, most important news about how chocolate is good for your gastrointestinal system and even for your supporting immune health! For the facts about this most recent chocolate and health study, let’s examine what the researchers from Louisiana State University found.

At the most recent National Meeting of the American Chemical Society, Dr. John Finley and associates presented a most appetizing study. In short, when we eat certain types of chocolate, the bacteria that line the stomach and gastrointestinal system help digest that chocolate and in turn release other compounds that circulate in the body yielding wide array of health benefits.

The bacteria that line the stomach and GI system have their own world and biological functions within all of us “humans”. This system is known as the microbiome. Within the micobiome, the Bifidobacterium and lactic acid bacteria impart positive effects in aiding in food digestion. A side-note here – you might recognize the word or name “bifidobacterium” as this is also a type of probiotic often found in yogurts and specialty dietary supplements.

Both Bifodobacterium and lactic acid helps ferment the compounds within chocolate (polyphenols, for example) and in turn release natural anti-inflammatory compounds to help health throughout the body. No one knows yet if a dark chocolate bar enriched with extra bifidobacterium can replace the trusted Advil® or Naproxen®, however the reality is dark chocolates and probiotics are functional food items/dietary supplements that can yield health benefits.

The food for thought from this first study of interest by Dr. Finley and his group is that dark cocoa might offer health benefits to the body as an anti-inflammatory. These benefits can be extended, if your diet contains a good mix of colorful fruits, vegetables and green tea as these foods also contain healthy polyphenols. Dr. Finley also stated that prebiotics mixed with cocoa (dark chocolate) can potentially improve the body and overall health. One day, we may just see a dark chocolate that contains pro and prebiotics to act as a positive health promoter. Fortunately, if you are interested in being proactive about anti-inflammatory health, you can utilize a pro and prebiotic dietary supplement combined with a small amount of dark chocolate now, and enjoy both the taste and the inner-health benefits.

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To Your Health!

-Doug Kalman PhD, RD



Alpha- Lipoic Acid

Antioxidant Food

Alpha-lipoic acid (ALA) is a man-made version of lipoic acid, a naturally occurring chemical in plants and animals with potent antioxidant properties. It is found in every cell of our bodies, and it helps turn glucose into energy. As an antioxidant, ALA helps fight free radicals. Free radicals are waste products of metabolism that cause harmful chemical reactions that can damage cells in the body. There is evidence that suggests that alpha-lipoic acid may help regenerate other antioxidants and increase their activity. Another characteristic of ALA is that it is both fat- and water-soluble which means it can work throughout the body. Other antioxidants work only in water (like vitamin C) or fatty tissues (like vitamin E).

There is evidence that alpha-lipoic acid can improve the function and conduction of neurons in diabetes. For this reason it has been used for years in Germany to treat peripheral neuropathy, which produces pain, burning, itching, tingling, and numbness in arms and legs as a result of nerve damage. As a dietary supplement, alpha-lipoic acid appears to help increase insulin sensitivity, and may be especially useful in addressing metabolic syndrome.

Dietary sources of ALA include red meat, organ meats (such as liver), and yeast. Also spinach, broccoli, and potatoes are good sources of alpha-lipoic acid. To ensure proper supplementation make sure you buy from reputable source and talk with your doctor about how much alpha-lipoic acid you should take.

-Dr. Jackie Miodownik-Aisenberg M.D. PhD – Internist

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Is Testosterone Replacement Safe?


Testosterone use in men has exploded. It has been heavily promoted as a cure all for low energy, decrease libido, depression, decrease muscle mass, and obesity in middle age and elderly men. Not all men who have these symptoms have low testosterone but for those you do, there are treatment options. Currently the options for replacement include:

  1. skin gels and patches
  2. intramuscular injections.
  3. implants under the skin
  4. t Transbuccal systems placed between the cheek and gums

Historically we had been concerned about the risk of benign prostatic hypertrophy, Prostate Cancer, abnormal liver toxicity, hyperviscosity, erythrocytosis, and worsening of sleep apnea. Recently a new study found that in men over 60 and men under the age of 60 with a history of vascular disease  the risk of having a heart attacks doubled during the first 90 days after starting therapy

It is my opinion that one needs to weigh the pros and cons of Testosterone Therapy . It is clear that some patients will benefit and some will have dramatic side effects. Make sure you become well informed prior to instituting therapy. It is important to ask your physician if he or she has evaluated reasons why your testosterone is low.  It is important that  you are monitored by Physician who is well trained to manage Low-T

-Dr. Howard Schwartz M.D. – Gastroenterologist

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The Dangers of Sugar

Flickr/JMR Photography

Flickr/JMR Photography

Do you recall as a child perhaps hearing the saying “a spoonful of sugar helps the medicine go down?” One of the reasons that our collective parents and grandparents told us that was that liquid medicines typically do not taste good and that by adding the sweetness of sugar, it was easier to take the medicine. The United States Department of Agriculture (USDA) has estimated that we all on average ingest as little as 76 pounds of sugar per year and top out at 90 pounds per capita. Contrast this, sugar is a type of carbohydrate. Carbohydrates contain 4 calories per gram. There are 454 grams in a pound (or 1,816 calories in a pound of sugar). If you are ingesting 90 pounds of sugar per year, the amount is also known as 163,440 calories in a one-year’s period (this is equal to ~36 pounds that the body might gain from added sugars alone). If losing weight, maintaining a healthy body weight, living in good health, avoiding diabetes or high triglycerides is a concern to you, so should your sugar intake.

Sugars can occur naturally in food – such as fructose in fruits and lactose in dairy or be added to foods such as bakery items, cereals, soda, candy, processed foods and more. Typically the added sugars are refined cane and beet sugars or high-fructose corn syrup. Interestingly enough, 33% of all added sugars in the diet come from sodas and the next greatest percentage group (26%) from foods like ketchup, canned vegetables, fruits and peanut butter. Did you know that the World Health Organization (WHO) recommends that sugars equal no more than 10% of total caloric intake? Do you know how much sugar you eat daily?

Recently scientists from the Centers for Disease Control and Prevention (CDC), Emory University and Harvard School of Public Health examined the association of sugars intake and cardiovascular disease (CVD). Data from the study revealed that the current average American ate around 15% of their total calories from added sugars in the diet. The amount of people ingesting 25% of their calories from added sugars is also growing. The data strongly revealed that that those people who consume more than 10% of their total calories from sugar/added sugars might be at significantly added risk for cardiovascular disease and more importantly, cardiovascular mortality. This means, the greater your sugar intake, the greater the likelihood is that you may develop cardiovascular disease!

Literally, we now believe and know that sugar, having too much sugar can kill you.

General tips to lower sugar intake:

  1. Cut down slowly. Look to cut intake by 50% at a time, after about three to five reductions of sugars intake, you will not even relate to or want to go back to having added sugars in your diet.
  2. If you are a soda drinker, start mixing ½ regular with ½ diet until you are ready to make the total switch to a healthier lower-sugar intake lifestyle.
  3. Only eat pre-portioned foods. Helps limit total caloric intake.
  4. Start reading food labels, look for hidden sugars, than stop eating these foods!
  5. When reading a food label, look for foods with less than 5-7 grams of sugar per serving, this is an easy way not to over-sugar the meal.
  6. For easy to implement methods to decrease your sugar intake now, follow the guidelines in this link
  7. Remember not to skip meals or go more than four to five hours without quality nutrition being ingested.
  8. Remember alcohol calories, while not technology carbohydrate or fat, is 7 calories per gram and wine calories also contain sugars.
  9. Drink more water.
  10. Don’t forget the benefits of exercising daily!

-Douglas Kalman PhD RD

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Stress Relief Through Others

We have all experienced the benefits of reaching out to and leaning on others to get us through a difficult time. And we also know that we seem to derive more comfort from talking to some people rather than to others. Now, researchers from the University of California, University of Southern California and University of Leuren in Belgium have conducted a study which may clarify an important component of this phenomenon – emotional similarity. In other words, to what degree does the person we are turning to either feel the same thing we are feeling, or has been through something similar to our situation and can relate to what we are feeling. The study design called for placing pairs of individuals in anxiety-provoking situations, measuring how similar they were feeling during the waiting period, and then measuring their stress response when they were finally exposed to the anxiety-inducing situation. Essentially, the results indicated that if the individuals perceived each other to be feeling in a similar fashion, they were able to better tolerate the stressful situation and get through it with less anxiety.

Apparently, misery really does love company, but only if the company we are in is just as miserable as we are. The practical application of this study is that we will experience some comfort and increased capacity to handle a stressful situation when we have someone accompanying us – particularly if that individual is either in the same boat as we are or we perceive that that person has the experience to empathize with us and understand the emotions that we are feeling.

-Dr. Rafael Rivas-Vasquez PsyD – Psychologist

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Bacteria: The Good, The Bad and The Ugly

There is a lot of new information coming out right now about bacteria – which ones are good for us, which ones are bad for us – how do we find the perfect balance. What is the reason for wanting to strike a balance – very simply – its health. The more we learn about ourselves, the genome project, the crazy infections that affect just about everyone every flu season – the more we are beginning to understand that not all bacteria are created equal – some cause infections and some protect us from infections.

We are now starting to understand that certain types of bacteria determine what kind of chronic diseases we develop through our life times, including arthritis, diabetes, and the like. Science is finally starting to catch up with the concept that it’s the balance of our bacteria, not the elimination of, that is necessary for health. We are still very far away from truly knowing what is that exact balance and how to achieve it, but advancements have been made. Some of our foods and supplements already contain some of the forms that have been found to be beneficial – namely the probiotics. It’s a good start. We have a long way to go.

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-Dr. Olga Kromo M.D – Rheumatologist