Discover the chilling tale of the 1518 Dancing Plague, a mysterious outbreak that baffled medieval Europe. Uncover the potential causes of this historical anomaly. Medical Marvels by Stuart M. Caplen, MD   On July 14, 1518 in Strasbourg, France (then part of the Holy Roman Empire) a woman named Frau Troffea began to dance uncontrollably in the street and would not or could not stop.  She kept dancing for nearly six days until she collapsed from exhaustion.  Soon after she started, about three dozen other people joined in and also started dancing uncontrollably.  By August the “dancing plague” had affected a total of about 400 victims. A poem reportedly written at the time described the 1581 dancing plague event: Many hundreds in Strassburg [sic] began, To dance and hop, women and men, In the public market, in alleys and streets, Day and night; and many of them ate nothing Until at last the sickness left them. This affliction was called St Vitus’ dance. As an Amazon Associate FibonacciMD earns from qualifying purchases. If you're looking to dance through the ages without the exhaustion of a 16th-century plague victim, these STELLE Character Shoes  provide the perfect blend of 2-inch stability and timeless style for everything from salsa to the office. [ https://amzn.to/40AwHZD ] Local physicians thought the malady was caused by “hot blood” and suggested they allow and encourage the dancers to continue to dance, to free themselves of this malady.  A stage was built, and musicians and professional dancers were brought in to assist in that endeavor.  However, people started collapsing from exhaustion and some even died from dancing in the summer heat, reportedly up to 15 people dying in a day. After Frau Troffea had collapsed, she was sent on a several-day journey to the shrine of Saint Vitus where she was cured.  As the “plague” spread to more people and the dance cure was failing to stop the epidemic, local officials felt enough was enough, and stopped the musical accompaniment, banned street dancing and started sending the dancers to the shrine of Saint Vitus for healing.  There they were given crosses, red shoes with crosses on them that were sprinkled with holy water, and engaged in chanting.  After some of the worst afflicted were sent to St. Vitus and cured, the rest of the dancers were shipped off by the town for this treatment.  By September the “dancing plague” was over. Interestingly, this was not the first time this type of dancing mania had occurred and there had been several other outbreaks in earlier times in medieval Europe.  The most well-known was in 1374 affecting several towns along the Rhine River. As to the cause, there are several theories.  One is that ingesting rye flour contaminated with ergot, a fungal disease of grain which can cause hallucinations and convulsions, might have been the precipitant.  In fact, ergot is the source of lysergic acid from which LSD is produced.  However, while ergot can acutely cause problems, this is unlikely to make someone dance for days on end. St. Vitus Dance A more likely theory is that the unusual behaviors demonstrated during the dancing plague were from a mass psychogenic illness (in the past sometimes called mass hysteria), which can occur under times of great stress.  At the time there were a series of famines due to poor harvests, high grain prices, as well as fears about infectious diseases such as plague and syphilis spreading through Europe.  There was also the possible influence of the St. Vitus superstition, which was that the saint had the power to curse people with a dancing plague which was known as the St. Vitus’ dance. If you enjoyed reading this article, you may be interested in reading Benjamin Frankin, Mesmerism, and the First Use of Placebos in Science  References Waller J. A forgotten plague: making sense of dancing mania. The Lancet, Volume 373, Issue 9664, 624 – 625. February 21, 2009. Retrieved from: https://www.thelancet.com/article/S0140-67360960386-X/fulltext Andrews E. What Was the Dancing Plague of 1518? History, A & E Television Networks. Updated: November 3, 2023 , Original: August 31, 2015. Retrieved from: https://www.history.com/news/what-was-the-dancing-plague-of-1518 Bauer P. Dancing Plague of 1518. May 18, 2017. Encyclopaedia Britannica. Retrieved from: https://www.britannica.com/event/dancing-plague-of-1518 Miller LJ. Divine Punishment or Disease? Medieval and Early Modern Approaches to the 1518 Strasbourg Dancing Plague. Edinburgh University Press. Volume 35, Issue 2. 2017. Retrieved from: https://www.euppublishing.com/doi/full/10.3366/drs.2017.0199 initially published 11/2024

While some people choose a vegan diet for religious or environmental reasons, others make this choice to improve their health. But is a vegan diet healthy? Culinary Medicine by Lori Smolin, Ph.D. and Mary Grosvenor, M.S., R.D. Did you know that to compensate for lower iron absorption, the RDA for iron for vegetarians, including vegans, is 1.8 times higher than for those who eat meat. The number of Americans eating a vegan diet has increased by over 500% in recent years; most surveys estimate that about 4% to 6% of the U.S. population identifies as vegan. [1] This dietary pattern excludes all animal products, including meat, fish, poultry, eggs, and dairy products such as milk, butter, and cheese; some vegans even exclude honey because it is made by bees. A vegan diet includes only foods of plant origin such as grains, vegetables, legumes, fruits, nuts, seeds, and plant oils. While some people choose a vegan diet for religious or environmental reasons, others make this choice to improve their health. But is a vegan diet healthy? Can this dietary pattern meet all your nutrient needs, or will it put you at risk of nutrient deficiencies? Health Benefits Vegan dietary patterns offer an impressive list of health benefits. They are associated with a lower body mass index and hence a reduced risk of obesity when compared with diets that include animal products. Vegans have lower total serum cholesterol, LDL cholesterol, glucose, blood pressure, and levels of chronic inflammation compared with omnivores. These parameters are associated with a lower incidence of chronic diseases including cardiovascular disease (CVD), diabetes, hypertension, and certain types of cancer. [2,3] The health benefits of vegan diets are believed to be related to the nutrients and other dietary components that are plentiful in this dietary pattern as well as to those that are limited. The most obvious difference between a vegan diet and a standard North American diet is the exclusion of meat and dairy. These foods are the only source of cholesterol and provide most of the saturated fat in the American diet. Cholesterol and saturated fat have long been tied to an increased risk of CVD. [2] Diets high in meat, particularly red meat, are associated with an increased risk of colon cancer. Recent evidence also suggests that there is an association between red meat intake and the development of type 2 diabetes.[4] Vegan diets are high in whole grains, legumes, nuts, vegetables, and fruits, making them high in fiber. Diets high in fiber have been shown to reduce the risk of colon cancer and other diseases of the digestive system. Fiber is believed to act by diluting the colon contents and speeding transit through the gut, both of which reduce the amount of contact between the colon epithelium and potentially cancer-causing substances in the feces. When fluid intake is adequate, diets high in fiber increase fecal bulk and lessen the pressure needed for defecation, reducing the risk of constipation, hemorrhoids, and diverticulosis. Fiber in the colon also causes changes in the intestinal microbiota that protect against the development of colon cancer and inflammatory bowel disease.[5] Diets high in fiber are also associated with a reduced risk of obesity and type 2 diabetes. This connection is related to differences in the caloric density of vegan compared with omnivorous diets and the effect of these diets on insulin sensitivity and the gut microbiome. [6] Vegan diets based on minimally-processed plant foods are high in water and fiber, which add volume to the diet, but few calories, lowering caloric density. Since people tend to consume the same volume of food at meals vegans feel full after consuming fewer calories than meat eaters. Vegan dietary patterns improve insulin sensitivity; increased insulin sensitivity reduces the risk of weight gain and the development of type 2 diabetes. The gut microbiome, which is affected by diet composition, influences energy balance; the predominant bacteria in the microbiome of vegans reduces the risk of weight gain by reducing both appetite and nutrient absorption. The prevalence of fruits, vegetables, legumes, grains, and nuts makes vegan diets higher than omnivorous diets in antioxidants. This includes the antioxidant vitamins A (in the β-carotene form), C, and E, as well as phytochemicals that act as antioxidants. A higher intake of dietary antioxidants has been associated with a reduced incidence of diseases related to oxidative stress, including CVD, cancer, and diabetes.[7] Health Risks Despite the positive health associations of eating a vegan diet, this dietary pattern doesn’t guarantee good health. Compared to omnivorous diets, vegan diets are associated with lower intakes of protein, long chain omega-3 fatty acids, vitamin B12, and several other vitamins and minerals.[8] Protein intake is lower in vegan diets because plant foods are typically less concentrated sources of protein than animal products. In addition, the amino acid composition of animal proteins is a better match to that of human proteins than are plant proteins, so more plant protein is needed to meet protein needs. Nonetheless, adequate protein is rarely a problem in vegan diets that contain a variety of protein sources, such as legumes, grains, nuts, and seeds. The amino acids provided by legume proteins complement those in grain, nut, and seed proteins, hence providing a complete mix of the amino acids needed by the human body. Intake of the long-chain omega-3 fatty acids DHA and EPA is low in most vegan diets because the primary source of these is fish. DHA and EPA have a number of regulatory roles that help protect against inflammatory and other chronic diseases.[9] They can be synthesized in the body from the essential omega-3 fatty acid, α-linolenic acid, as long as intake of this fatty acid, found in foods such as canola oil, walnuts, and flaxseed, is adequate. Vitamin B12 deficiency is a particular concern in vegan diets. This vitamin is not synthesized by plants or animals. It accumulates in the meat and milk of ruminants through a symbiotic relationship with the bacteria in ruminant stomachs, and in fish and shellfish who acquire it from plankton and pass it up the food chain.[10] To get adequate vitamin B12, vegans need to take supplements or consume products fortified with this vitamin such as plant-based milks, breakfast cereals, and nutritional yeast. Low intakes of calcium and vitamin D, which are needed for bone health, are a risk for vegans because they do not consume dairy products, the primary source of these nutrients in the North American diet. In one study vegans had a 30% greater risk of bone fracture than meat eaters, but this difference disappeared in vegans who consumed the recommended amounts of calcium. [11] Good vegan sources of calcium include high-calcium vegetables such as broccoli, kale, and Bok choy, as well as legumes and tofu processed with calcium. Calcium and vitamin D can also be found in fortified plant-based milks and breakfast cereals, and vitamin D can be synthesized in the skin with exposure to sunlight. Although the amount of iron in vegan diets is comparable to or higher than that in diets containing animal products, vegans are more likely to have reduced iron stores than nonvegetarians. [9] This is likely because the absorption of iron from plant foods, such as leafy green vegetables and whole and enriched grains, is much lower than it is from meat. To compensate for lower iron absorption, the RDA for iron for vegetarians, including vegans, is 1.8 times higher than for those who eat meat. Zinc is lower in vegan than in omnivorous diets and, as with iron, the forms found in plant foods such as whole grains, wheat germ, legumes, and nuts, are less absorbable than those found in meat. Iodine is a nutrient of concern if iodized salt is not used because fish and dairy products, which are the primary sources of dietary iodine, are omitted from vegan diets. Conclusion Despite the potential risk for nutrient deficiencies, the Academy of Nutrition and Dietetics has determined that vegan diets can meet the nutritional needs of people of all ages and at all stages of the lifecycle, from infancy to late adulthood and during pregnancy and lactation. [9] The Academy recognizes that vegan diets can provide significant health benefits but suggest that to meet all nutrient needs these diets must be carefully planned. Simply taking animal products off your plate can result in a boring meal plan that does not provide enough of all the essential nutrients. But choosing a diet that relies heavily on highly processed vegan foods can exceed recommendations for added sugar, salt, and calories. For more information making healthy vegan choices see “How to Plan a Healthy Vegan Diet”. References [1] Bourassa L. Vegan and plant-based diet statistics for 2023. January 9, 2023. https://www.plantproteins.co/vegan-plant-based-diet-statistics/#population . Accessed April 20, 2023. [2] Koutentakis M, Surma S, Rogula S, Filipiak KJ, Gąsecka A. The effect of a vegan diet on the cardiovascular system. J Cardiovasc Dev Dis. 2023;10(3):94. doi: 10.3390/jcdd10030094. [3] Appleby PN, Key TJ. The long-term health of vegetarians and vegans. Proc Nutr Soc. 2016;75(3):287-93. doi: 10.1017/S0029665115004334. [4] Wolk A. Potential health hazards of eating red meat. J Intern Med. 2017; 281(2):106-122. doi: 10.1111/joim. [5] Sakkas H, Bozidis P, Touzios C, et al. Nutritional status and the influence of the vegan diet on the gut microbiota and human health. Medicina (Kaunas). 2020;56(2):88. doi: 10.3390/medicina56020088. [6] Najjar RS, Feresin RG. Plant-Based Diets in the Reduction of Body Fat: Physiological Effects and Biochemical Insights. Nutrients 2019; 11(11):2712. doi: 10.3390/nu11112712. [7] Aune D. Plant Foods, Antioxidant biomarkers, and the risk of cardiovascular disease, cancer, and mortality: A review of the evidence. Adv Nutr. 2019;10(Suppl_4):S404-S421. doi: 10.1093/advances/nmz042. [8] Bakaloudi DR, Halloran A, Rippin HL, et al. Intake and adequacy of the vegan diet. A systematic review of the evidence. Clin Nutr. 2021;40(5):3503-3521. doi: 10.1016/j.clnu.2020.11.035. [9] Melina V, Craig W, Levin S. Position of the Academy of Nutrition and Dietetics: Vegetarian diets. J Acad Nutr Diet. 2016;116(12):1970-1980. doi: 10.1016/j.jand.2016.09.025. [10] Watanabe F, Bito T. Vitamin B12 sources and microbial interaction. Exp Biol Med (Maywood). 2018;243(2):148-158. doi: 10.1177/1535370217746612.

Is a personalized diet better than the RDA? Explore the science of precision nutrition, DNA analysis, and how customized eating plans improve long-term health. Culinary Medicine Precision Nutrition: Finding the Healthiest Diet for You by Lori A Smolin, PhD  and Mary B Grosvenor, MS, RD Are you one of the eight out of ten Americans who says they would like to eat a healthier diet?[1] If so, how do you plan on doing so? An internet search yields an endless assortment of diets claiming to be the most nutritious. Which one is best for you? In general, a healthy eating plan is one that will boost your health today and maintain it in the years to come.[2] The plan should also be affordable, appealing, and meet your social and cultural needs.  Precision nutrition is an approach used to create a customized eating plan based on your genetic background, individual health markers, and lifestyle. If you were provided with such a plan, would you change your diet to follow it?    Beyond the RDA: Is Precision Nutrition Better Than General Dietary Guidelines? A healthy diet provides the nutrients you need to optimize wellbeing while at the same time limiting dietary components that increase your susceptibility to disease. A variety of population-wide nutrition guidelines  have been developed to help the general public select such a diet. The Recommended Dietary Allowances (RDAs), for example, offer goals for energy and nutrient intake that will meet the requirements of nearly all healthy individuals.[3] MyPlate and the Dietary Guidelines for Americans suggest food choices that make up a healthy eating plan.  While these nutrition guidelines can be helpful in planning a healthy diet for the overall population, they are not necessarily optimal for each individual. For example, what about that friend who can eat anything they want without gaining weight, while you gain weight seemingly just by looking at food. This contrast is because the response to food and nutrient intake varies among individuals. Research confirms that different people eating identical meals have different changes in blood glucose, triglycerides, and other metabolic parameters in response to the meals.[4] Our genetic make-up determines not only these metabolic differences but also our susceptibility to chronic diseases. For example, even when consuming a similar diet, African Americans have a higher risk of hypertension than Caucasian Americans and people who inherit   familial hypercholesterolemia have a higher risk of developing heart disease than those who don’t.  Designing Your Healthiest Diet: A Personalized Precision Nutrition Approach What you know about your health risks can help you plan a healthy diet and your health care providers can help tailor dietary recommendations based on your current intake, health history, and laboratory data, but such diet plans still rely on assumptions. For example, one would assume that if your grandfather died of a heart attack you would also be at high risk of heart disease. Precision nutrition, also known as personalized nutrition, is an emerging approach to designing the healthiest diet for you that is based on your genetic profile as well as other individual variables including your metabolic parameters, microbiome, health history, physical activity, and dietary habits. The dietary pattern recommended by precision nutrition has the potential to help prevent and treat chronic diseases to which you are susceptible.[5]    How Genetic Testing and DNA Analysis Shape Personalized Diets An internet search for precision nutrition will direct you to a number of programs that offer dietary recommendations based on an analysis of your DNA. These analyses   look for variations in single genes associated with  the risk for specific conditions. They can determine predispositions such as sensitivity to caffeine or alcohol or a propensity for weight gain or hypertension.[6,7]  Participants in such a program receive a report showing which gene variations they have and recommending an eating plan based on these results. However, dietary recommendations based just on these DNA results have shortcomings. Having a gene variant for a particular disease does not mean you will develop the disease or whether a change in diet would be beneficial. The  genetics of nutrient metabolism and disease is more complicated than single gene variations. Identifying a genetic variant doesn’t explain the extent to which that gene is expressed, or which other genes interact with it to determine the overall risk of developing a specific disease.[8.9]  In addition, environmental, biological, genetic, and socioeconomic components also impact how genes affect health.   So, while DNA analysis offers insight into your risk for nutrition-related diseases, a more comprehensive precision nutrition approach  is needed to accurately determine individual responses to food and dietary patterns.[10]  This approach interprets gene interactions within the context of other individual factors such as dietary and health history, laboratory values, and microbiome composition. So, for example, if your genetic profile shows you have a propensity for elevated blood cholesterol, linking this information with your cholesterol values and an analysis of your typical diet, will help determine if you need to change your diet to reduce your heart health risk. If you have elevated blood glucose, a profile of the types of bacteria that live in your microbiota can guide dietary recommendations to promote changes in your microbiome composition to improve blood glucose control. [11] This more comprehensive form of precision nutrition is still a developing science. T he NIH Nutrition for Precision Health Initiative is collecting this type of data from participants across the country and using artificial intelligence to analyze it and develop algorithms that predict responses to dietary patterns and generate precision nutrition advice . As this science develops, the analyses  currently available will also likely advance and so will our ability to predict your healthiest diet.   Will Precision Nutrition Improve Your Diet? Does a Personalized Diet Improve Health Outcomes? If you were prescribed a diet that eliminates your favorite foods, would you follow it? Individual eating patterns are engrained and can be difficult to change. Would you be more likely to change your diet if you had access to precision nutrition advice rather than just general nutrition guidelines?  For some, knowing their genetic predispositions may reduce motivation to make changes because they feel doomed to develop these conditions. [9] For others personalized advice might inspire them to change their diet to reduce risk. There is some research to suggest that individuals who are offered dietary advice based on their individual DNA analysis make healthier and longer lasting changes than when offered conventional advice.[12] One study showed that a personalized nutrition approach resulted in greater improvements in heart health risk factors than standard dietary guidance.[13] While most research suggests a diet personalized by genetic testing yields only modest dietary changes, even small improvement such as eating more fruits and vegetables can have a significant impact on health. [9] As the science advances, will recommendations based on more comprehensive precision nutrition promote greater dietary improvements?  Are We Ready for Personalized Precision Nutrition? We are not yet able to fill our plates based on comprehensive precision nutrition prescriptions and unfortunately many of us are not even filling our plates based on the general recommendations for a healthy diet. Even though precision nutrition advice will target our individual needs better than general guidelines, the question remains: Are we willing to change our diet for our long-term health? [14] Explore More in Culinary Medicine If you found Precision Nutrition  insightful, you may want to explore how specific dietary patterns and ingredients impact your long-term health. References [1] American Heart Association. Alarming trends call for action to define the future role of food in nation’s health. Published June 10, 2024. https://newsroom.heart.org/news/alarming-trends-call-for-action-to-define-the-future-role-of-food-in-nations-health [2] U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. https://www.dietaryguidelines.gov . Accessed October 3, 2024. [3] What are Dietary Reference Intakes? In: Institute of Medicine (US) Food and Nutrition Board. Dietary Reference Intakes: A Risk Assessment Model for Establishing Upper Intake Levels for Nutrients. Washington (DC): National Academies Press (US); 1998. https://www.ncbi.nlm.nih.gov/books/NBK45182/# . Accessed October 3, 2024. [4] Berry SE, Valdes AM, Drew DA, et al. Human postprandial responses to food and potential for precision nutrition [published correction appears in Nat Med. 2020 Nov;26(11):1802. doi: 10.1038/s41591-020-1130-y]. Nat Med. 2020;26(6):964-973. doi:10.1038/s41591-020-0934-0. [5] Voruganti VS. Precision nutrition: Recent advances in obesity.  Physiology (Bethesda) . 2023;38(1):0. doi:10.1152/physiol.00014.2022. [6] Guasch-Ferré M, Dashti HS, Merino J. Nutritional genomics and direct-to-consumer genetic testing: an overview. Adv Nutr. 2018;9(2):128-135. doi:10.1093/advances/nmy001. [7] de Toro-Martín J, Arsenault BJ, Després JP, Vohl MC. Precision nutrition: a review of personalized nutritional approaches for the prevention and management of metabolic syndrome. Nutrients. 2017;9(8):913. Published 2017 Aug 22. doi:10.3390/nu9080913. [8] Fuchsberger C, Flannick J, Teslovich TM, et al. The genetic architecture of type 2 diabetes.  Nature . 2016;536(7614):41-47. doi:10.1038/nature18642. [9] Mullins VA, Bresette W, Johnstone L, Hallmark B, Chilton FH. Genomics in personalized nutrition: can you "Eat for your genes"?.  Nutrients . 2020;12(10):3118. Published 2020 Oct 13. doi:10.3390/nu12103118. [10] National Institutes of Health. NIH Launches Largest Precision Nutrition Research Effort of Its Kind. May 16, 2023. https://allofus.nih.gov/news-events/announcements/nih-launches-largest-precision-nutrition-research-effort-its-kind . Accessed September 8, 2024. [11] Harvard T.H. Chan School of Public Health. The Nutrition Source. Precision Nutrition. https://nutritionsource.hsph.harvard.edu/precision-nutrition/ . Accessed September 2, 2024. [12] Celis-Morales C, Livingstone KM, Marsaux CF, et al. Effect of personalized nutrition on health-related behaviour change: evidence from the Food4Me European randomized controlled trial.  Int J Epidemiol . 2017;46(2):578-588. doi:10.1093/ije/dyw186. [13] Bermingham KM, Linenberg I, Polidori L, et al. Effects of a personalized nutrition program on cardiometabolic health: a randomized controlled trial. Nat Med. 2024;30(7):1888-1897. doi:10.1038/s41591-024-02951-6. [14] Kirk D, Catal C, Tekinerdogan B. Precision nutrition: a systematic literature review. Comput Biol Med. 2021;133:104365. doi:10.1016/j.compbiomed.2021.104365.

Is Dr. Valter Longo's "Longevity Diet" the secret to hitting 120? Read our review on the science of fasting, plant-based nutrition, and increasing healthspan. Nutrition | Culinary Medicine The Longevity Diet Review by Zachary A. Knecht, PhD It’s no surprise that the quantity and quality of our food impacts our health and life span. Eat nothing and you won’t live long, but eat too much and too poorly and you also risk a plethora of negative outcomes. To this point, a substantial body of research in organisms ranging in complexity from yeast to monkeys has shown that some degree of restrictions on food intake (in contrast to continuously available food), whether via reduced calories, or intermittent fasting can substantially increase healthy lifespans.[1,2] In The Longevity Diet (2018) the aptly named Dr. Valter Longo, brings the fruits of this research right to your recipe book and calendar. In the book, Dr. Longo, director of the Longevity Institute at the University of Southern California, collates research on nutrition and the benefits of fasting into an easily digestible mix of recommendations: stick to high-nutrient, plant-based foods, avoid animal proteins and sugars, and incorporate fasting in specified periods.[3] Dr. Longo plans to live to 120 by following his own recommendations.[4] A healthy vegan salad with vegetables and microgreens. Cold pressed oil from a reusable bottle. One should always approach diet fads with healthy skepticism. In this case, Dr. Longo’s nutritional recommendations bear similarity to the well-known Mediterranean diet, but presumably have similarly positive impacts on mortality and cardiovascular disease.[5,6] Meanwhile, his recommendations on intermittent fasting are based on the aforementioned body of research that demonstrates increased health and longevity in animal models. Research in humans has been similarly promising, showing a wide range of health improvements in insulin resistance, hypertension, and inflammation, and beneficial cognitive effects on memory, executive function, and cognition, so he’s certainly not pulling his recommendations out of a hat.[7] In all, it’s no great revelation that for the environment and our own sake, we should be striving to eat more healthy plant based foods, less animal protein, and less sugar. Intermittent fasting, meanwhile, can clearly be beneficial and is largely considered safe,[8] but there is still a large gap in understanding regarding the mechanisms that lead to the observed benefits. Still, if you’re looking to improve your diet and health, and possibly live a bit longer, The Longevity Diet seems like a good place to start, as it provides recipes and fasting schedules to incorporate into your daily life. Unfortunately we won’t know for sure if this diet can extend human lifespans as seen in lab animals until Dr. Longo’s 120th birthday in 2087. So until then, we’ll just have to take his word for it by eating well and hoping for the best. Editor’s note: If considering intermittent fasting, please discuss with your physician first. References Uno, M., Honjoh, S., Matsuda, M., Hoshikawa, H., Kishimoto, S., Yamamoto, T., Ebisuya, M., Yamamoto, T., Matsumoto, K., & Nishida, E. (2013, January). A Fasting-Responsive Signaling Pathway that Extends Life Span in C. elegans. Cell Reports , 3 (1), 79–91. https://doi.org/10.1016/j.celrep.2012.12.018 Colman, R. J., Anderson, R. M., Johnson, S. C., Kastman, E. K., Kosmatka, K. J., Beasley, T. M., Allison, D. B., Cruzen, C., Simmons, H. A., Kemnitz, J. W., & Weindruch, R. (2009, July 10). Caloric Restriction Delays Disease Onset and Mortality in Rhesus Monkeys. Science , 325 (5937), 201–204. https://doi.org/10.1126/science.1173635 Fasting Mimicking Program and Longevity 2 . (2019, September 22). Valter Longo. Retrieved September 27, 2022, from https://www.valterlongo.com/fasting-mimicking-program-and-longevity/ Shiffer, E. (2021, December 7). How Longevity Expert Valter Longo Plans to Live to 120 . Medium. Retrieved September 27, 2022, from https://elemental.medium.com/how-longevity-expert-valter-longo-plans-to-live-to-120-334b508d7b28 Fung, T. T., Rexrode, K. M., Mantzoros, C. S., Manson, J. E., Willett, W. C., & Hu, F. B. (2009, March 3). Mediterranean Diet and Incidence of and Mortality From Coronary Heart Disease and Stroke in Women. Circulation , 119 (8), 1093–1100. https://doi.org/10.1161/circulationaha.108.816736 Lopez-Garcia, E., Rodriguez-Artalejo, F., Li, T. Y., Fung, T. T., Li, S., Willett, W. C., Rimm, E. B., & Hu, F. B. (2013, October 30). The Mediterranean-style dietary pattern and mortality among men and women with cardiovascular disease. The American Journal of Clinical Nutrition , 99 (1), 172–180. https://doi.org/10.3945/ajcn.113.068106 de Cabo, R., & Mattson, M. P. (2019, December 26). Effects of Intermittent Fasting on Health, Aging, and Disease. New England Journal of Medicine , 381 (26), 2541–2551. https://doi.org/10.1056/nejmra1905136 Varady, K. A., Cienfuegos, S., Ezpeleta, M., & Gabel, K. (2022, February 22). Clinical application of intermittent fasting for weight loss: progress and future directions. Nature Reviews Endocrinology , 18 (5), 309–321. https://doi.org/10.1038/s41574-022-00638-x

Clinical Differences Between the Ketogenic and Paleo Diets for Long-Term Health Culinary Medicine Bariatric Medicine Ketogenic vs Paleo Diet by Stefanie Schwartz, MS, RD, CDN and Richard Strongwater, M.D. The two eating plans, Ketogenic and Paleo, that have been in the news, outlining pros and cons, share some similarities but developed for different purposes. The keto diet focuses on 3 macronutrients: fat, carbs, and protein – so in a sense – science is at its core. The Paleo diet, first described in 1975 by Walter Voegtlin, a gastroenterologist, is considered a low carbohydrate diet, and is more about food choices and a philosophy – that if modern men/women eat like our Cave ancestors – we’ll be healthier. The Paleo Diet In A Nutshell The Paleo diet ( AKA Caveman diet or the Paleolithic diet) encourages consuming foods that were available during the Paleolithic era: primarily meat and protein. Proponents of the diet argue that the Paleo diet is suited to the original design of our bodies. The diet advocates limiting our foods to those that were readily available during the evolution of Paleolithic humans [2.5-million and 10,000-years ago]. Food choices consist primarily of fruit, vegetables, nuts, roots, meat, fish, and oils derived from fruits (olive, coconut, palm). The diet restricts consumption of refined carbohydrates and fats, processed sugar, grains, and dairy. It also stipulates no processed foods or salt, excludes cereal grains, legumes (except green beans and peas), dairy, potatoes, refined carbohydrates, and refined fats/oils, and discourages meats other than that which is grass-fed. To date, randomized clinical trials comparing the Paleo diet with others are lacking, but some evidence suggests that the Paleo diet: Has similar effects on weight loss as the Mediterranean diet, and the benefits of the Mediterranean diet Improved insulin sensitivity Reduced circulating triglycerides triglycerides in overweight, postmenopausal women The Ketogenic Diet an Overview The ketogenic diet ( AKA keto diet), on the other hand, was developed as a tool to fight diseases like epilepsy – (and other epileptic disorders) not for weight loss. Keto diets have been used since the 1920s for epilepsy to control seizures. In recent years, studies have shown a keto diet to be effective for controlling hunger and appetite, and to lower triglyceride and blood pressure levels. It’s been found that following a keto diet, insulin levels drop, allowing fat to be burned for energy, resulting in weight loss. According to a 2004 study in Experimental & Clinical Cardiology , the keto diet can help increase HDL and lower LDL cholesterol and glucose . Today research is underway looking at the effect the keto diet has on cancer and Alzheimer’s Disease. The keto diet is a very low-carbohydrate, high-fat diet that averages 75% fat, 20% protein, and 5% carbohydrate (generally, less than 20 g/day of carbohydrates). The American Academy of Family Physicians defines low-carbohydrate diets as diets that limit carbohydrate intake to 20-60 g/day. One gram of carbohydrate provides 4 calories. A keto diet puts the body into ketosis , a state where the body burns fat instead of glucose. Ketones , produced in the liver from the metabolism of fat, are used as an alternative fuel for the body and brain when blood glucose is in short supply. It takes about a week for the body to adapt to the state of ketosis. Afterwards, people say they have improved mental focus, less severe swings in blood glucose, and, in some cases, greater energy for endurance activity. Commonalities between Paleo and Keto: whole foods, minimal processing both eliminate grains and legumes both eliminate added sugar (but Paleo allows for honey and maple syrup) both support unrefined healthy fats (no trans fat) both allow plant-based refined oils (polyunsaturated and mono-unsaturated fat) Differences between the 2 regimens: The Paleo diet is considered a low-carb diet; however, there is less emphasis on the carb and fat percentages as long as you avoid the non-Paleo foods The paleo diet allows carbs as long as they come from “whole foods” (fruits, vegetables, unrefined sweeteners like honey, maple syrup, Jerusalem artichoke syrup) The paleo diet restricts all soy products (no legumes) and most dairy foods The paleo diet generally permits grass-fed butter The keto diet encourages whole foods, but more importantly specifies fat, protein, and carb percentages. The keto diet restricts carbohydrate intake regardless of source The keto diet permits dairy, especially high fat dairy like high-fat cream and high-fat yogurt, but ice cream and milk are not permitted because of their higher carb content Soy milk is also not allowed because of its higher carb content Final Note : Both diets have health benefits for specific medical conditions beyond weight loss including diabetes, coronary heart disease, and hypertension. And, like any diet, if adhered to for a short period of time – neither appears to be dangerous unless you’re pregnant, breastfeeding or on diabetic medication. The healthcare provider should carefully consider any possible contraindications before advising a particular diet regimen. References Jabr F. How to really eat like a hunter gatherer: why the paleo diet is half-baked. Scientific American Web site. https://www.scientificamerican.com/article/why-paleo-diet-half-baked-how-hunter-gatherer-really-eat/. June 3, 2013, Accessed August 22, 2017. Thompson RC, Allan AH, Lombardi GP, et al. Atherosclerosis across 4000 years of human history: The Horus Study of four ancient populations. Lancet. 2013;81:1211-1222. Tarantino G, Citro V, Finelli C. Hype or reality: Should patients with metabolic syndrome related NAFLD be on hunter gatherer (paleo) diet to decrease morbidity? J Gastrointest Liver Dis. 2015; 24:359-368. Mellberg C, Sandberg S, Ryberg M, et al. Long-term effects of Paleolithic-type diet in obese postmenopausal women: a 2-year randomized trial. Eur J Clin Nutr. 2014;68:350-357. Samaha FF, Iqbal N, Seshadri P, et al. A low carbohydrate as compared with a low fat diet in severe obesity. N Engl J Med. 2003;348:2074-2081. Bueno N, Vieira de Melo I, Lima de Oliveira S, Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomized controlled trials. Br J Nutr. 2013;110:1178-1187. Hill, A. What’s the difference between Paleo and keto diets? Healthline. June 13, 2018. https://www.healthline.com/nutrition/paleo-vs-keto Dashti H, Mathew T, Hussein T. Long-term effects of a ketogenic diet in obese patients. Exp Clin Cardiol. 2004 Fall; 9(3): 200-205. ORIGINAL POST: 5/22/2019

Beyond Weight Loss: Understanding How Intermittent Fasting Patterns Impact Glycogen, Ketones, and Long-Term Health Culinary Medicine Nutrition Intermittent Fasting - A Review in Progress By Zachary A. Knecht, PhD Atkins, South Beach, Paleo, Keto, Macro—fad diets come and go. One day we are stocking up on bacon and throwing out eggs, and the next we are avoiding any food that might contain a trace of preservatives. As our understanding of metabolism and nutrition improves, however, losing weight and eating a healthy diet evolves into a highly complex and individualized science. Enter the recent trend of intermittent fasting, which promotes an eating pattern that is different from the traditional three meals a day that most of us consume. With intermittent fasting, individuals spend extended periods of time eating little-to-no food and short periods eating normally on a recurring basis. The specifics of such an eating plan diet vary substantially. For example, a person could eat every other day, have many fewer calories than used on a daily basis, consume only a certain number of calories 2 days a week, or even just restrict eating to a specific time of day. Simply changing the timing and frequency of meals can help maintain better health, and intermittent fasting may both help weight control and promote positive changes in metabolism and behavior. The Evolutionary Context of Caloric Scarcity During human evolution, food sources were fundamentally scarce. Early hunters could have successfully brought home a kill, but chances are that they did not. Our ancestors could never count on a meal, and they often went for extended time periods without eating. Just as most animals do, humans became adapted to conserving energy. The liver and adipose tissues (fat) evolved to bank excess calories when food was plentiful so that energy could be available when food was scarce. Today, however, food is so plentiful that it's difficult not to eat more than needed. Indeed, the body’s instincts work against humans by assuming that extra energy will be needed at some point and encouraging that as much food as possible be consumed. Clinical Insights: How Intermittent Fasting Triggers Metabolic Shifts Since the 1980s, research teams have recognized that restrictive feeding patterns could confer health benefits including longer life, disease resistance, and higher cognitive function in animals from rats to worms. More recently, intermittent fasting became popular among people living in the Silicon Valley of California. And even though eating patterns vary with the type of intermittent-fasting plan followed, studies in animals and humans have shown metabolic changes that could point to improved health. These include better maintenance of blood glucose levels, depletion of glycogen stores, and increases in byproducts of fat breakdown (eg, fatty acids, ketones). In addition, changes in levels of circulating leptin and adiponectin, the molecules produced by fat cells to help control blood sugar and satiety, have been noted. Disease Prevention and Potential Hormonal Risks These encouraging metabolic benefits may even translate into cancer prevention and better outcomes for patients with type-II diabetes and age-related disorders. Variations among different intermittent-fasting regimens, however, have made comparisons between plans difficult, and the superiority of one plan over another has not been proven. Anyone who follows an intermittent-fasting plan must be careful not to overindulge when food is allowed, since episodes of binge eating could easily occur. Further, recent research has suggested that even though intermittent fasting leads to short-term weight loss, it also could damage the pancreas, affect insulin function, and ultimately lead to type-II diabetes among healthy adults. Conclusion: Proceeding with Scientific Caution In total, although intermittent fasting is a very exciting weight control plan that is backed by strong scientific foundations, it should be implemented with caution and skepticism until more information on its long-term impact on the human body is revealed. REFERENCES Bonassa ACM, Carpinelli AR. Intermittent fasting for three months decreases pancreatic islet mass and increases insulin resistance in Wistar rats. Endocr Abstr. 2018;56:P519. Goodrick CL, Ingram DK, Reynolds MA, Freeman JR, Cider NL. Differential effects of intermittent feeding and voluntary exercise on body weight and lifespan in adult rats . J Gerontol. 1983;38:36-45. Goodrick CL, Ingram DK, Reynolds MA , Freeman JR, Cider NL . Effects of intermittent feeding upon growth and life span in rats. Gerontology . 1982;28:233-241. Johnson JB, Summer W, Cutler RG, et al. Alternate day calorie restriction improves clinical findings and reduces markers of oxidative stress and inflammation in overweight adults with moderate asthma. Free Radic Biol Med. 2007;42:665–674. Mattson MP, Longo VD, Harvie M . Impact of intermittent fasting on health and disease processes. Ageing Res Rev . 2017;39:46-58. Solon O. The Silicon Valley execs who don’t eat for days: ‘It’s not dieting, it’s biohacking.’ Theguardian.com Web site. https://www.theguardian.com/lifeandstyle/2017/sep/04/silicon-valley-ceo-fasting-trend-diet-is-it-safe. September 3, 2017. Accessed September 9, 2019. Initially published April 2022

The GOLO Program: Balancing Whole Foods and Proprietary Supplements— An Evidence-Based Look at Insulin Resistance Claims Culinary Medicine by Mary B Grosvenor, MS, RD, CDE  and Lori A. Smolin, PhD   GOLO is a commercial weight loss program based on a dual approach; the GOLO for Life Meal Plan along with Release, their proprietary dietary supplement. GOLO claims that the combination of the diet and the supplement reduces insulin resistance and increases metabolic rate to promote an average weight loss of 1-2 pounds per week. The program also encourages a minimum of 15 minutes of exercise daily and offers online social support and information on topics such as meal preparation and behavior change. The GOLO website presents anecdotal reports of weight loss from 20 to over 100 pounds in those who take Release and follow the Meal Plan. The GOLO Program is available only by purchasing the Release supplement. A 30-day supply of Release costs about $60; the Meal Plan and online support are provided at no additional cost. Discussion The Meal Plan encourages eating whole foods while minimizing highly processed ones. It recommends consuming 3 meals daily with choices from 4 food groups: Proteins (lean meats, dairy, and soy), Carbohydrates (legumes, fruits, and whole grains), Vegetables (green, starchy, and other vegetables), and Fats (butter, olive oil, avocados, nuts, and seeds). Processed foods, sugar, and sweetened baked goods and beverages should be limited. Calorie recommendations generally range from 1,300 to 1,800 Calories per day depending on the individual’s gender, age, weight, and activity level. The Release supplement is a combination of minerals and plant extracts to be taken 3 times per day with, or following, meals. GOLO claims that this supplement promotes weight loss by regulating metabolism, reducing insulin resistance, and diminishing food cravings and triggers for emotional eating. They also assert that Release improves mental focus, sleep, and immune function; reduces anxiety; and increases energy and stamina. While the minerals in Release, magnesium, chromium, and zinc, are all necessary for normal insulin action and blood glucose regulation, intakes in excess of recommendations have not been shown to improve insulin function. The plant extracts in Release have not been shown to have any negative effects in healthy individuals. However, there is little data that the amounts in the supplement promote weight loss; reduce blood glucose, anxiety, or food cravings; or increase energy level and stamina. Because Release is a dietary supplement, the FDA does not regulate its safety or efficacy. According to the GOLO website, the effectiveness of Release is supported by over 100 research studies. This is an exaggeration. Although there are many studies on the effects of the various components of the supplement on weight and other outcomes, there are only two studies of the GOLO program – both of which are funded by GOLO. One is a small pilot study that concluded that GOLO participants lost weight and had improved glycemic control. The other is a larger study that compared the effect of the GOLO diet with and without the supplement. The supplement group lost about 6 pounds more than the placebo group over the 13-week study and showed greater improvement in metabolic parameters. Despite these promising results, there is no data to indicate that the long-term effectiveness of GOLO is any better than any other diet. Bottom line: The GOLO Meal Plan is based on solid nutrition principles; it can promote weight loss and improve blood glucose levels. While some of the claims made regarding the Release supplement are not supported by substantial peer reviewed research, there is little risk associated with taking Release or following the meal plan. Contraindications The Release supplement is not recommended during pregnancy or lactation. Individuals with diabetes should work with their primary care provider while on the program as their medication needs may change. References Buynak RJ. A randomized, double-blind, placebo-controlled study evaluating the effects of the GOLO weight management program with and without Release supplement on weight and metabolic parameters in subjects with obesity. Trends Diabetes Metab. 2019; 2:1-2. doi: 10.15761/TDM.1000109 Buynak RJ. Pilot study on the Effects of the GOLO Weight Management Program and RELEASE Supplement on Weight and Glycemic Control in Patients with Type 2 Diabetes Mellitus and Obesity. Diabetes Updates 2019; 5: DOI: 10.15761/DU.1000125 Forbes Health. Lauretta A. GOLO Diet Review (2023): Cost, Benefits And More. https://www.forbes.com/health/body/golo-diet-review/ . Accessed June 28, 2023. GOLO for Life. https://www.golo.com/. Accessed June 28, 2023.

Can a low FODMAP diet reduce the symptoms of irritable bowel syndrome (IBS) and small intestine bacterial overgrowth (SIBO), such as cramping, diarrhea, gas, and bloating? F ermentable O ligosaccharides, D isaccharides, M onosaccharides A nd P olyols (FODMAP) Culinary Medicine by Lori A Smolin, PhD and Mary B Grosvenor, MS, RD FODMAP is an acronym for F ermentable O ligosaccharides, D isaccharides, M onosaccharides A nd P olyols. A low FODMAP diet restricts the intake of these poorly absorbed short-chain carbohydrates found in a variety of fruits, vegetables, legumes, grains, dairy products, nuts, and sweeteners. Limiting FODMAP intake has been shown to reduce the symptoms of irritable bowel syndrome (IBS) and small intestine bacterial overgrowth (SIBO), such as cramping, diarrhea, gas, and bloating. This diet program temporarily eliminates foods high in FODMAPs until symptoms are improved. Then, based on the patient’s preference, individual high FODMAP foods are reintroduced one at a time. If the newly reintroduced food can be consumed for several days without symptoms, it can be permanently added back to the diet. Indications A low FODMAP diet is an important treatment option for IBS and SIBO because over 80% of patients link their symptoms to eating specific foods. This diet program may also be helpful in anyone with digestive problems who wants to determine which foods are causing their symptoms. Adverse Effects If the diet is not carefully planned, it may be low in fiber, resulting in constipation. Because the diet eliminates so many foods, energy and nutrient deficiencies can occur if the restriction is continued in the long term. Pearls to Know • The process of eliminating and then reintroducing foods is most successful when monitored by a Registered Dietitian (RD); RD input also helps to ensure nutritional adequacy in the long-term. • A recent double-blind study found a low FODMAP diet to be more effective than a gluten-free diet in the treatment of IBS. Examples of high and low FODMAP foods are given in the table. More information is available in our culinary medicine BLOG and in our APP . F ermentable O ligosaccharides, D isaccharides, M onosaccharides A nd P olyols (FODMAP) References Liu J, Chey W, Haller E, Eswaran S. Low-FODMAP diet for irritable bowel syndrome: What we know and what we have yet to learn. Ann Rev Med. 2020;71:303-314. doi:10.1146/annurev-med-050218-013625. Cleveland Clinic. Low FODMAP diet. https://my.clevelandclinic.org/health/treatments/22466-low-fodmap-diet . Accessed August 27, 2023. Bellini M, Tonarelli S, Nagy AG, et al. Low FODMAP Diet: Evidence, doubts, and hopes. Nutrients.;12(1):148. Published 2020 Jan 4. doi:10.3390/nu12010148. Nordin E, Brunius C, Landberg R, Hellström PM. Fermentable oligo-, di-, monosaccharides, and polyols (FODMAPs), but not gluten, elicit modest symptoms of irritable bowel syndrome: A double-blind, placebo-controlled, randomized three-way crossover trial. Am J Clin Nutr. 2022;115(2):344-352. doi: 10.1093/ajcn/nqab337.

Reduce Inflammation with Food - Learn how to combat chronic inflammation and improve your overall health through a diet rich in anti-inflammatory foods.  Discover the science behind diet and inflammation and practical tips for incorporating inflammation-fighting foods into your daily meals. Culinary Medicine by Lori A Smolin, PhD  and Mary B Grosvenor, MS, RD Whether you scrape your knee, strain your ankle, or develop a sore throat, your body responds with inflammation. The pain, warmth, redness, and swelling of inflammation is the immune system’s first response to an injury or infection. Taking an Advil or other anti-inflammatory medication can reduce the symptoms, and the inflammatory response stops when the injury or infection heals. Sometimes, however, inflammation becomes chronic, persisting even when there is no longer a discernible cause.[1] When inflammation becomes chronic, this process, meant to help heal the body, now causes harm. It damages cells throughout the body and increases the risk of developing a number of chronic diseases. To help reduce chronic inflammation, try reaching into your kitchen rather than into the medicine cabinet. A dietary pattern that includes an abundance and variety of anti-inflammatory foods can decrease chronic inflammation and your risk of illness. Causes and Consequences of Chronic Inflammation Although there is no single obvious cause of chronic inflammation, it has been associated with unresolved infections and exposure to environmental toxins as well as lifestyle factors such as high levels of stress, lack of exercise, and poor dietary choices. [1,2] The risk of developing chronic inflammation increases with increasing age and body weight. Chronic inflammation causes nonspecific symptoms including fatigue, insomnia, depression, gastrointestinal disorders, and frequent infections.[2] And it is linked to chronic diseases, including heart disease, cancer, obesity, and diabetes, which are significant causes of death worldwide. [2] Unfortunately, laboratory tests that quantify inflammation do not distinguish the cause of inflammation or whether it is chronic or acute.[3] Diet and Inflammation The foods you include in your diet can increase or decrease chronic inflammation.[4]  Some have a direct effect on inflammation and others increase the risk of conditions such as obesity, diabetes, and heart disease that are associated with inflammation.[5,6] T o assess the impact of diet on chronic inflammation, research has examined the effects of specific nutrients and food components as well as whole foods and dietary patterns.   The types of fats and carbohydrates in your diet can affect inflammation. For example, the saturated fatty acids found in red meats can increase inflammation, while monounsaturated fatty acids, which are plentiful in olive oil and nuts, have anti-inflammatory effects.[6]  And while a diet high in omega-6 polyunsaturated  fatty acids, such as those found in corn and safflower oils, can increase inflammation, balancing these with higher intakes of omega-3 fatty acids, found in foods such as salmon, walnuts, and flax and chia seeds, will keep inflammation at bay. [7,8] A diet high in fiber, found in whole grains and fresh fruits and vegetables, is associated with low levels of inflammation, whereas a diet high in added sugars, such as those in sugar-sweetened beverages and baked goods, increases inflammation.[6] In the long term, a diet high in added sugars can also promote the development of obesity, which in itself increases inflammation. [6,8]  Several minerals, including magnesium, zinc, and iron, also impact inflammation. For example, magnesium and zinc help regulate immune function and low magnesium status and zinc deficiency are associated with elevated levels of inflammation.[9] Nutrients and phytochemicals that function as antioxidants can reduce inflammation by preventing the oxidative tissue damage that triggers inflammation. For example, vitamin C is an antioxidant that reduces levels of free radicals before they cause oxidative damage. Polyphenols, phytochemicals found in foods including blueberries, Brussels sprouts, and broccoli, and spices such as turmeric and ginger, also protect against inflammation due to their antioxidant properties.[10, 11]  Each of the nutrients and phytochemicals discussed above can influence the level of inflammation, but our diet is made up of foods, not individual nutrients. A diet that includes whole grains, fruits, vegetables, and dairy products has been demonstrated to help reduce inflammation.[6] This is due in part to the combinations of nutrients in, and antioxidant properties of, these food groups. It may also be related to their effect on the population of microbes that live in the gastrointestinal tract, known as the gut microbiome. An imbalance between helpful and potentially harmful bacteria in the microbiome can trigger inflammation. Whole grains, fruits, and vegetables are useful sources of fiber, which provide food for a healthy microbiome and fermented dairy products such as yogurt and kefir, add living healthy bacteria. [1,6]  Build an Anti-inflammatory Dietary Pattern  Chronic inflammation can be reduced by choosing a dietary pattern such as the Mediterranean diet that includes foods that reduce inflammation and limits those that promote it. This pattern is based on whole grains, fruits, vegetables, and legumes. It generally includes dairy products, fish and other lean proteins, and healthy fats while limiting red meats and foods high in added sugars (See table). Vegetarian and other plant-based dietary patterns, which further limit animal products, are also associated with lower levels of inflammation.[6,12]  To see how close your current intake is to these recommendations start by asking how many sugar-sweetened beverages you drink, how many fruits and vegetables you eat each day, and how often you opt for steak or a hamburger when dining out. You can improve your diet by making small changes and building on them. Replace one soda a day with water. Have a bowl of berries for dessert. Choose fish or a plant-based protein for at least two meals a week. Replace some chips with nuts to limit fried foods. Switch to canola and olive oil to increase your anti-inflammatory fats. Make your meals more interesting with antioxidant spices such as pepper, garlic, or turmeric. Need a treat? Enjoy some dark chocolate – it is an anti-inflammatory food. Do not forget regular exercise; it also reduces chronic inflammation. And enjoy what you eat! No one food will make or break your diet – it is the overall pattern of intake that determines its effect on inflammation. Build an Anti-Inflammatory Dietary Pattern  - Daily Recommendations Food groupings Suggested Servings (serving size) Tips for increasing anti-inflammatory foods Fruits & vegetables 5 to 10 (1/2 cup) Enjoy a bowl of berries for dessert to add vitamin C and fiber Mix leafy greens like spinach or kale into your salad to increase anti-inflammatory magnesium Toss some peppers and onions in with your eggs Grains, breads, and starchy vegetables  5 to 10 (½ cup or one slice) Increase your fiber with whole grain bread Try new grains: barley, couscous, quinoa or bulgar Enjoy starchy vegetables such as corn, peas, squash, and potatoes in stews and casseroles High protein foods 5 to 7 (3 oz meat, one egg,  ½ cup beans, 2 Tbsp nut butter) Bake some salmon to boost omega-3s Choose a plant-based burger to reduce saturated fats Grab a good old a peanut butter sandwich Dairy or dairy substitutes 3 (1 cup, 1 oz cheese) Choose low fat or nonfat dairy to limit saturated fat intake  Try a plant-based milk if you do not want dairy Add a slice cheese to your sandwich Nuts and seeds 3 (¼ cup) Snack on walnuts for anti-inflammatory omega-3s Choose raw, unsalted, or dry roasted nuts  Have a nut allergy – try sunflower and pumpkin seeds  Fats and oils 3-5 (1 Tbsp) Choose a soft margarine Add avocados and olives to your salad Rely on olive and canola oils Beverages To quench thirst (About 64 oz per day) Limit sweet teas and fruits drink - they have added sugars Drink water – it keeps you hydrated without calories or additives Sip coffee and tea – they reduce inflammation Baked goods & snack foods Occasional treats Limit your portion by measuring chips into a bowl rather than munching from the bag Making cookies, add some healthy nuts You do not have to skip them just limit them Editor’s comment- your expanding waistline at the level of your navel may be indicative of increased inflammation within your body. Waistline circumference coincides with visceral fat (intraabdominal fat). Visceral fat cells are biologically active and produce more inflammatory molecules with potentially more harmful health effects. [13]  Downloadable PDF available  References [1] Mayo Clinic Chronic inflammation: What it is, why it’s bad, and how you can reduce it. Mayo Clinic. June 14, 2024. Accessed August 27, 2024. https://mcpress.mayoclinic.org/dairy-health/chronic-inflammation-what-it-is-why-its-bad-and-how-you-can-reduce-it/ .  [2] Pahwa R, Jialal I, Goyal A. Chronic Inflammation. NIH.gov . Published June 4, 2019. https://www.ncbi.nlm.nih.gov/books/NBK493173/ [3] Ross Y, Ballou SP. Reliability of C-reactive protein as an inflammatory marker in patients with immune-mediated inflammatory diseases and liver dysfunction. Rheumatology Advances in Practice. 2023;7(2). doi: https://doi.org/10.1093/rap/rkad045 [4] Eatrightpro.org . Published 2023. https://www.eatrightpro.org/news-center/practice-trends/what-is-an-anti-inflammatory-diet [5] Rohm TV, Meier DT, Olefsky JM, Donath MY. Inflammation in obesity, diabetes, and related disorders.  Immunity . 2022;55(1):31-55. doi: https://doi.org/10.1016/j.immuni.2021.12.013 [6] Grosso G, Laudisio D, Frias-Toral E, et al. Anti-Inflammatory Nutrients and Obesity-Associated Metabolic-Inflammation: State of the Art and Future Direction.  Nutrients . 2022;14(6):1137. doi: https://doi.org/10.3390/nu14061137 [7] Djuricic I, Calder PC. Beneficial Outcomes of Omega-6 and Omega-3 Polyunsaturated Fatty Acids on Human Health: An Update for 2021.  Nutrients . 2021;13(7):2421. doi: https://doi.org/10.3390/nu13072421 [8] 5 Top Foods That Cause Inflammation. Cleveland Clinic. https://health.clevelandclinic.org/foods-that-can-cause-inflammation [9] Weyh C, Krüger K, Peeling P, Castell L. The Role of Minerals in the Optimal Functioning of the Immune System.  Nutrients . 2022;14(3):644. doi: https://doi.org/10.3390/nu14030644 [10] Hussain T, Tan B, Yin Y, Blachier F, Tossou MCB, Rahu N. Oxidative Stress and Inflammation: What Polyphenols Can Do for Us?  Oxidative Medicine and Cellular Longevity . 2016;2016(7432797):1-9. doi: https://doi.org/10.1155/2016/7432797 [11] Kocaadam B, Şanlier N. Curcumin, an active component of turmeric (Curcuma longa), and its effects on health.  Critical reviews in food science and nutrition . 2017;57(13):2889-2895. doi: https://doi.org/10.1080/10408398.2015.1077195 [12] Haghighatdoost F, Bellissimo N, Totosy de Zepetnek JO, Rouhani MH. Association of vegetarian diet with inflammatory biomarkers: a systematic review and meta-analysis of observational studies.  Public Health Nutrition . 2017;20(15):2713-2721. doi: https://doi.org/10.1017/s1368980017001768 [13]  Yu  J,   Choi  W, Lee H,  Lee  J, MD. Relationship between inflammatory markers and visceral obesity in obese and overweight Korean adults. Medicine (Baltimore).  2019 Mar; 98(9): e14740.  doi:  10.1097/MD.0000000000014740

Are seed oils truly "toxic" or a heart-healthy staple? Explore the science behind omega-6 fatty acids, inflammation, and the impact of ultra-processed foods on chronic disease. Culinary Medicine photo by Mary Grosvenor   by   Lori A Smolin, PhD   and Mary B Grosvenor, MS, RD   Seed oils are a hot topic of debate. These oils, extracted from the seeds of plants such as corn, soy, canola, safflower, and sunflower, are among the most widely used oils in homes, restaurants, and processed foods. Online influencers argue that the types of fatty acids they contain promote inflammation and that our increased consumption of seed oils is responsible for our expanding rates of chronic diseases such as obesity and heart disease.[1] In addition they suggest that the way these oils are processed introduces toxins into our diet. However, major scientific and health organizations recommend choosing plant-based oils, including seed oils, as part of a healthy diet. Should we avoid seed oils?  The ABCs and Health Impact of Fats and Oils   Fats and oils are made up of mixtures of fatty acids. Saturated fatty acids are found primarily in animal foods such as meat and dairy products. A high intake of saturated fatty acids contributes to cardiovascular disease by raising blood cholesterol levels.[2] Research has repeatedly shown that cardiovascular disease risk is significantly reduced when saturated fats are replaced by unsaturated fats.[3] Unsaturated fats include mono- and polyunsaturated fats. Monounsaturated fatty acids are found in olive, canola, and avocado oils. Diets high in monounsaturated fatty acids have been shown to reduce the risk of heart disease.[4] Polyunsaturated fatty acids include omega-3 and omega-6 fatty acids, which are dietary essentials. Good sources of omega-3s include nuts, seeds, fish, and beans. Omega-6s are also found in nuts and seeds as well as seed oils. In the body, omega-3 and omega-6 fatty acids compete for pathways that form regulatory molecules that affect levels of inflammation and other metabolic processes, such as blood clotting and blood pressure. The type of regulatory molecule formed depends on the starting material. For example, if the starting material is the omega-3 fatty acid alpha-linolenic acid, the resulting molecule can decrease inflammation. And if the starting material is the omega-6 fatty acid linoleic acid, the resulting molecule can increase inflammation.   Do Seed Oils Contribute to Chronic Inflammation?   Inflammation is an essential component of our immune response. In the short term, inflammation helps eliminate harmful substances and initiate healing, but persistent, unresolved inflammation, referred to as chronic inflammation, contributes to the risk for chronic diseases. Studies have identified a number of factors that might promote chronic inflammation.[5,6] One of these is a high ratio of dietary omega-6 to omega-3 fatty acids.[7,8] Since seed oils are generally higher in omega-6 than omega-3 fatty acids, their use has been proposed as a cause of inflammation.   [9] However, this hypothesis is not well supported. Human studies have found that an increased intake of omega-6 fatty acids does not increase in blood concentrations of most inflammatory markers.[10,11] And, epidemiological studies have found little relationship between the omega-6 to omega-3 ratio in the diet or the blood and the risk of cardiovascular disease.[6] The likely reason this hypothesis is not supported is that it considers only pro-inflammatory omega-6 fatty acid metabolites. It does not consider anti-inflammatory omega-6 fatty acid metabolites or other factors that affect levels of inflammation and the risk of chronic disease. [6] Aging, stress, lack of exercise, and a diet high in ultra-processed foods are risk factors for chronic inflammation.[5] Does the Processing of Seed Oils Introduce Risk?  The potential negative health effects of seed oils have also been attributed to the refining process. Seed oils are most often produced by chemically extracting the oil from the seeds using the solvent hexane. Hexane is known to cause central nervous system symptoms such as muscle weakness and numbness when it is inhaled, but the effects of ingestion are not fully understood.[12] Most of the hexane used in extracting oils evaporates but traces may remain in the oils. Critics of seed oils claim that this residual hexane is a hazard to health. Currently, the FDA does not monitor residual hexane in seed oils but considers the levels too low to have any effect on human health.[13] If you are concerned that hexane is a health hazard, you can avoid it by choosing organic, expeller-pressed, cold-pressed, or unrefined seed oils.[14] Has the Rise in Seed Oil Consumption Contributed to Chronic Disease?  The rise in seed oil consumption has paralleled increases in obesity and other diet-related chronic diseases, but association does not mean causation.[15] Advances in food technology in the early 20 th  century allowed for the mass production of neutral flavored, heat-stable vegetable oils, including seed oils. [16] The wide availability of these inexpensive oils high in polyunsaturated fats has significantly increased our intake of omega-6 fatty acids.[8,17] But neither the oils themselves nor the omega-6 fatty acids they contain are likely to be the cause of the rising rates of chronic diseases in the United States.[18] Seed oils are abundant in ultra-processed foods such as chips, cookies, and snack bars, which now provide more than half of the calories consumed at home by U.S. adults.[19] These foods are high in calories, refined carbohydrates, added sugars, and salt and excessive intake is recognized as a risk factor for diet-related diseases.[20] Therefore, ultra-processed foods are a more likely contributor to the increased incidence of chronic disease than the seed oils they contain.[15,17]  Bottom Line    Simply stated, there is no conclusive evidence that seed oils increase health risks. There is evidence that replacing saturated fats with unsaturated fats, including those in seed oils, reduces the risk of cardiovascular disease. [6] To optimize the benefits of unsaturated fats, it is best to include a variety of them in your food choices. Most of us get more than enough omega-6 fatty acids in our diets. To up your omega-3s, eat more fish, walnuts, and seeds such as pumpkin, sunflower, flax, and chia seeds.  To increase your monounsaturated fat intake, choose olive, canola, and avocado oil for cooking and sauces. You can further increase the overall healthfulness of your diet by limiting ultra-processed foods and basing your meals and snacks on whole and minimally processed foods. Mary Recommends As an Amazon Associate FibonacciMD earns from qualifying purchases. A heart-healthy kitchen staple, La Tourangelle Organic Canola Oil  is an expeller-pressed, non-GMO  oil with a neutral flavor  and high smoke point —ideal for all your everyday sautéing and frying. [ https://amzn.to/4aztf7p ] Not a seed oil, but a great heart-healthy alternative, La Tourangelle’s Sear & Sizzle Avocado Oil is a handcrafted, high-smoke point  oil.[ https://amzn.to/4qQCuF3 ] More oil topics: " The History of “Snake Oil” and “Snake Oil Salesmen ” Once a remedy, snake oil became shorthand for fraud. Explore the surprising story behind the term and the salesman who made it infamous. " CBD Oil: Promising Treatment for Arthritis and Inflammation " If arthritis pain hasn't responded to other treatments, CBD may be the answer for pain and inflammation " Olive Oil Consumption and Reduction of Dementia-Related Death " References [1] Aleccia J  Associated Press. Kennedy and influencers bash seed oils, baffling nutrition scientists. KSAT. Published March 7, 2025. Accessed January 4, 2026. https://www.ksat.com/health/2025/03/07/kennedy-and-influencers-bash-seed-oils-baffling-nutrition-scientists/ [2] Maki KC, Dicklin MR, Kirkpatrick CF. Saturated fats and cardiovascular health: Current evidence and controversies.  Journal of Clinical Lipidology . 2021;15(6):765-772. doi: https://doi.org/10.1016/j.jacl.2021.09.049 [3] Sacks FM, Lichtenstein AH, Wu JHY, et al. Dietary Fats and Cardiovascular Disease: A Presidential Advisory from the American Heart Association.  Circulation . 2017;136(3):e1-e23. doi:10.1161/CIR.0000000000000510 [4] Jimenez-Torres J, Alcalá-Diaz JF, Torres-Peña JD, et al. Mediterranean Diet Reduces Atherosclerosis Progression in Coronary Heart Disease: An Analysis of the CORDIOPREV Randomized Controlled Trial.  Stroke . 2021;52(11):3440-3449. doi:10.1161/STROKEAHA.120.033214 [5] Pahwa R, Jialal I, Goyal A. Chronic inflammation. National Library of Medicine. Published August 7, 2023. https://www.ncbi.nlm.nih.gov/books/NBK493173/ [6] Wang DD, Hu FB. Dietary Fat and Risk of Cardiovascular Disease: Recent Controversies and Advances. Annual Review of Nutrition. 2017;37(1):423-446. doi: https://doi.org/10.1146/annurev-nutr-071816-064614 [7] Simopoulos AP. The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases.  Exp Biol Med (Maywood) . 2008;233(6):674-688.  doi: https://doi.org/10.3181/0711-MR-311 [8] Simopoulos AP, DiNicolantonio JJ. The importance of a balanced ω-6 to ω-3 ratio in the prevention and management of obesity.  Open Heart . 2016;3(2):e000385. doi: https://doi.org/10.1136/openhrt-2015-000385 [9] Ball S. Understanding Seed Oils. Eatright.org . Published 2025. https://www.eatright.org/health/essential-nutrients/fats/understanding-seed-oils [10] Innes JK, Calder PC. Omega-6 fatty acids and inflammation.  Prostaglandins Leukot Essent Fatty Acids . 2018;132:41-48. doi: https://doi.org/10.1016/j.plefa.2018.03.004 [11] Su H, Liu R, Chang M, Huang J, Wang X. Dietary linoleic acid intake and blood inflammatory markers: a systematic review and meta-analysis of randomized controlled trials.  Food Funct . 2017;8(9):3091-3103. doi: https://doi.org/10.1039/c7fo00433h [12] Cravotto C, Fabiano-Tixier AS, Claux O, et al. Towards Substitution of Hexane as Extraction Solvent of Food Products and Ingredients with No Regrets.  Foods . 2022;11(21):3412. Published 2022 Oct 28. doi: https://doi.org/10.3390/foods11213412 [13] US Department of Health and Human Services. Agency for Toxic Substances and Disease Registry. Public health Statement. N-Hexane. CAS #10-54-3. July 1999.  https://www.atsdr.cdc.gov/ToxProfiles/tp113-c1-b.pdf [14] Hexane: The Chemical Solvent Seeping Into Your Food Without You Knowing. https://medium.com/@media_93416/hexane-the-chemical-solvent-seeping-into-your-food-without-you-knowing-b7ab77404921 [15] Williams S. Five things to know about seed oils and your health. News Center. Published 2025. https://med.stanford.edu/news/insights/2025/03/5-things-to-know-about-the-effects-of-seed-oils-on-health.html [16] Robinson R. The story of modern seed oils. PCC Community Markets. Published 2025. https://www.pccmarkets.com/sound-consumer/2025-04/the-story-of-modern-seed-oils/ [17] Blasbalg TL, Hibbeln JR, Ramsden CE, Majchrzak SF, Rawlings RR. Changes in consumption of omega-3 and omega-6 fatty acids in the United States during the 20th century.  Am J Clin Nutr . 2011;93(5):950-962. doi: https://doi.org/10.3945/ajcn.110.006643 [18] Lee JH, Duster M, Roberts T, Devinsky O. United States Dietary Trends Since 1800: Lack of Association Between Saturated Fatty Acid Consumption and Non-communicable Diseases.  Frontiers in Nutrition . 2022;8(8). doi: https://doi.org/10.3389/fnut.2021.748847 [19] Howard B, Henry K. Ultraprocessed Foods Account for More than Half of Calories Consumed at Home | Johns Hopkins Bloomberg School of Public Health. Johns Hopkins Bloomberg School of Public Health. Published December 10, 2024. https://publichealth.jhu.edu/2024/ultraprocessed-foods-account-for-more-than-half-of-calories-consumed-at-home [20] Pagliai G., Dinu M., Madarena M.P., Bonaccio M., Iacoviello L., Sofi F. Consumption of ultra-processed foods and health status: A systematic review and meta-analysis. Br. J. Nutr. 2021;125:308–318. doi: 10.1017/S0007114520002688

The Ultimate Seed and Nut Superfood Crunch: A Nut-Forward, Seed-Synced Snack Creative Cooking for the Health-Conscious Gourmet FibonacciRECIPES  | Culinary Medicine   Photo is by Mary Grosvenor  by Mary B Grosvenor, MS, RD and Lori A Smolin, PhD   Packed with protein, fiber, and unsaturated fats, this wholesome treat is perfect as a snack or an addition to your yogurt or cereal. The mixture of pumpkin, sunflower, sesame, and chia seeds combined with almonds and cashews is baked in honey and maple syrup for a naturally sweetened crunch. It will satisfy your craving for sweets without sending your blood sugar skyrocketing.  Ingredients ¼ cup unsalted cashews [ https://amzn.to/3OyxNSW ] ¼ cup almonds, slivered [ https://amzn.to/4cdQpl8 ] ¼ cup pumpkin kernels (pepitas [ https://amzn.to/3MOten1 ]) 1 Tbsp sunflower seeds, shelled [ https://amzn.to/3N3QFZz ] 2 tsp whole flax seeds [ https://amzn.to/4tPyVBT ] 1 tsp sesame seeds [ https://amzn.to/4saksPk ] 1 tsp chia seeds [ https://amzn.to/4qQHz03 ] 1 Tbsp honey [ https://amzn.to/3OGV2tZ ] 1 Tbsp maple syrup [ https://amzn.to/4cMBA9d ] ¼ tsp salt Mary Recommends As an Amazon Associate FibonacciMD earns from qualifying purchases. Bob's Red Mill Seeds organic   pumpkin seeds  as well as chia , sesame  and whole flax seeds . 365 Organic Grade A Amber Maple Syrup  [ https://amzn.to/4cMBA9d ] Nate's 100% Pure, Raw & Unfiltered Honey  [ https://amzn.to/3OGV2tZ ] Instructions Preheat oven to 300 degrees. Prepare a mini muffin tin with liners. Combine cashews, almonds, pumpkin kernels, sunflower seeds, flax seeds, sesame seeds and chia seeds in a bowl. Mix honey, maple syrup, and salt in a small bowl and microwave for 15 seconds.  Pour the honey/maple syrup mixture over the nuts and seeds and stir well to coat.  Spoon about 2 tsp of the sweetened seed/nut mixture into muffin liners and bake for 20 minutes. Cool for at least 15 minutes before eating. Makes 16 clusters  Nutrition information per cluster   Calories 48, Total Fat 3.5g, Saturated Fat 0.5g, Cholesterol 0 mg, Total Carbohydrate 3.5g, Dietary fiber 0.8g, Protein 1.6g, Potassium 55mg, Sodium 43mg Authors’ Notes You can substitute walnuts and/or pecans for the almonds and cashews. You can substitute any edible seeds for those in the recipe. If you don’t have a mini muffin pan, you can bake these on a cookie sheet. Spray pan with cooking spray before using. If the clusters run together during cooking, let the mixture cool on the pan and then break into bite-size pieces. For a savory snack, add ¼ tsp of chili powder or paprika to the honey mixture. Editor’s Note- this recipe is appropriate for a low calorie, low cholesterol, low saturated fat, and low carb vegetarian dietary regimen. Read more about " Seed Oils: Facts and Fallacies "

From Humble Roots to Fine Dining: Why 2026 is the Year of the Cabbage The rich history, gut-healing benefits, and cooking tips that turned cabbage into a global trend. Culinary Medicine  by Lori A Smolin, PhD and Mary B Grosvenor, MS, RD Cabbage has been declared the "Vegetable of the Year" for 2026. [1] This lowly vegetable that has long been thought of as a food for the working class is now being featured by upscale restaurants.[2] Recently cabbage has taken British restaurants by storm where is it served charred, barbequed, and in curries.[3] In U.S. restaurants the number of menu items using the word “cabbage” increased by over 20% per year for the past 2 years.[1] How did this humble vegetable make its way to the top? Cabbage Cultivation and Culture  Cabbage is a hardy, cool-season vegetable that is a member of the Brassica plant family, which also includes broccoli, cauliflower, Brussels sprouts, and kale.   [4] Cabbage comes in a variety of colors – green, white, purple, and red, and the leaves may be smooth or crinkled. Common varieties in the U.S. include, green cabbage, red cabbage, napa, bok choi, and savoy. Cabbage has been consumed and cultivated for over 4,000 years.[5] It grows well in cool climates and produces abundant yields on small plots of land. Its resilience, adaptability to different climates, and long storage life made it a staple in places like Ireland, Germany, Russia, and China, especially for peasants and laborers; it was a common survival food during food shortages, such as the Irish potato famine.[2]  Today it is grown in over 150 countries, with China being the largest producer worldwide.[6] It is found in signature dishes from cultures around the world: kimchi in Korea, cabbage rolls in Eastern Europe, sauerkraut in Germany, corned beef and cabbage in Ireland, and coleslaw in the U.S.   Nutrition and Health Cabbage is a leafy green vegetable that is high in fiber, low in calories, and a good source of folate, vitamin C,  and vitamin K. Cabbage is also a source of a variety of phytochemicals, including sulforaphane, an antioxidant known for its anti-cancer properties.[7,8] Cabbage is also rich in other antioxidants including the carotenoids, beta-carotene, lutein, and zeaxanthin. Red and purple varieties of cabbage contain anthocyanins, which are powerful antioxidants that give them their vibrant color.   [8] The antioxidant and anti-inflammatory phytochemicals in cabbage may help to reduce the risk of heart disease and diabetes, as well as cancer.[9,10]    The fiber in cabbage promotes digestive health by adding bulk and softening the stool, speeding transit through the gut, hence promoting regular bowel movements. Fiber also acts as a prebiotic, promoting the growth of beneficial bacteria in the gut. Fermented cabbage dishes such as sauerkraut and kimchi provide an additional boost because they contain probiotic bacteria, further adding to the beneficial bacteria in the intestinal microbiome.[8] A healthy microbiome promotes immune function, modulates inflammation, and improves mental and physical health.   [11]  In addition to promoting health, cabbage has been used medicinally for thousands of years to treat ulcers, wounds, digestive disorders, and respiratory ailments. Today, naturopaths and herbalists continue to apply cabbage leaves topically in the treatment of wounds, mastitis, and arthritis and to use oral cabbage juice as a remedy for ulcers, gastritis, and acid reflux. [12]  Despite the many health benefits of cabbage, there are a few health cautions. Too much can cause gas, bloating, and diarrhea. This is due to the fiber and raffinose, a poorly digested sugar, in cabbage. When these reach the large intestine, they are digested by the microbiome, producing gas. These symptoms can be minimized by increasing cabbage intake slowly and choosing cooked and fermented cabbage; these are less likely to cause gas because some of the fiber and raffinose have already been broken down.  Cabbage Cuisine The reasons this often-maligned vegetable has now become trendy are the same as those that made it a staple; it is available, inexpensive, versatile, and highly nutritious. Its long shelf life means that it will easily outlast the head of lettuce in your refrigerator. For those that have trouble getting past the memory of cabbage as that smelly vegetable boiled with corned beef on St Patrick’s Day, try a new way to prepare it. Cooking it quickly until just tender will avoid the release of sulfur compounds that cause the strong odor.[13] To cultivate your cabbage enjoyment, try slicing some raw red cabbage into your salad or add napa cabbage or bok choy to your ramen. You can stir fry some savoy with onions, ginger, and garlic or roast a slice of green cabbage with some olive oil or maybe be adventurous by trying some kimchi.  Mary Recommends As an Amazon Associate FibonacciMD earns from qualifying purchases. Effortlessly prep professional-grade coleslaw and salads with this Multifunctional Cabbage Shredder , featuring stainless steel blades  and an ergonomic design  for fast, uniform slicing and grating. [ https://amzn.to/3Nt4gKb ] Fun Fact:  Brussels sprouts are actually miniature members of the cabbage family! Learn more in our: "Brussels Sprouts: From Dreaded to Delectable " . Cabbage is one of the low-potassium food to add to your diet if you have chronic Hyperkalemia - read more in " Elevated Potassium - Hyperkalemia" Culinary Medicine Recipes with Cabbage Ingredient: Vegan Bierocks Easy Minestrone Soup Recipe or in our FibonacciMD.app - Cabbage Soup Recipe  (free APP access with your email). References [1] Schewitz K. 2026 will be the year of the cabbage. Business Insider. Published December 15, 2025. https://www.businessinsider.com/year-of-the-cabbage-soup-recipe-gut-health-2025-12 [2] Muckenhoupt M. University of Chicago Press. Published December 2025. https://press.uchicago.edu/ucp/books/author/M/M/au31040770.html [3] Nierenberg A. Cabbage Is London’s Sexiest Produce Star. The New York Times. https://www.nytimes.com/2025/08/26/dining/london-cabbage.html . Published August 26, 2025. [4] Cabbage and the Benefits of this Overlooked Superfood  | Brown University Health. Brown University Health. Published 2023. https://www.brownhealth.org/be-well/cabbage-and-benefits-overlooked-superfood [5] Utah State University. Cabbage Chronicles: Surprising Facts and a Delicious Savory Stew Recipe. Usu.edu . Published 2024. Accessed March 3, 2026.  https://extension.usu.edu/createbetterhealth/blog/factsaboutcabbage [6] Cabbage Production. Worldmapper. https://worldmapper.org/maps/cabbage-production/ [7] Isothiocyanates. Linus Pauling Institute. Published March 12, 2019. https://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/isothiocyanates [8] Morales-Brown P., Cabbage: Health benefits, facts, research, updated. www.medicalnewstoday.com . Published November 2, 2017. https://www.medicalnewstoday.com/articles/284823 [9] Cruciferous Vegetables. Linus Pauling Institute. Published January 2, 2019. https://lpi.oregonstate.edu/mic/food-beverages/cruciferous-vegetables [10] Nawaz H, Shad MA, Muzaffar S. Phytochemical Composition and Antioxidant Potential of Brassica. Brassica Germplasm - Characterization, Breeding and Utilization. Published online October 24, 2018. doi: https://doi.org/10.5772/intechopen.76120 [11] Shahbazi R, Sharifzad F, Bagheri R, Alsadi N, Yasavoli-Sharahi H, Matar C. Anti-Inflammatory and Immunomodulatory Properties of Fermented Plant Foods.  Nutrients . 2021;13(5):1516. doi: https://doi.org/10.3390/nu13051516 [12] Hobbs C. Cabbage Dr. Christopher Hobbs, Ph.D. Published December 16, 2024. Accessed March 3, 2026. https://christopherhobbs.com/herbal-therapeutics-database/herb/cabbage/ [13] Walker J. 12 things you didn’t know about cabbage, plus 3 recipes. NOLA.com . Published March 14, 2015. Accessed March 3, 2026. https://www.nola.com/entertainment_life/eat-drink/12-things-you-didnt-know-about-cabbage-plus-3-recipes/article_8e0a3ebf-ff3f-5488-9da9-c37b0357eb94.html