 Going out tonight? Going on holiday?
Dining out and going on Holiday should be relaxing, but it’s not ALWAYS easy to stick to the Ketogenic Diet. This guide will help you and your patients to maintain your Keto eating style during the holiday season. Get ready for delicious food anywhere! 1. Being Prepared 2. Your Action Plan During the Meal 3. Drinking Wisely 4. Keto on the Go 5. What to order: Different Types of Cuisine 6. Keto During the Holidays 7. How to Get Back on Track After a Cheat Meal
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 by Whitney Crouch, RDN, CLT
What is Golden Milk? Popularized across social media, golden milk is a cross-cultural drink originating in Asian countries and consumed for its anti-inflammatory properties and pungent flavor. Also known as “golden milk latte” or “turmeric tea”, golden milk is made with freshly grated or ground turmeric, a pinch of freshly ground pepper, honey or lemon to taste, and hot water, milk, or dairy alternative.1-2 The addition of freshly grated or ground ginger adds extra flavor and additional anti-inflammatory characteristics, with cinnamon, cardamom, cloves and nutmeg rounding out the flavor.1-2 The Golden Milk “MVP”: Turmeric While turmeric is the star of the show with its golden color and unique flavor, golden milk is a purposefully designed elixir including ingredients that aid in the absorption and delivery of turmeric’s polyphenolic compound, curcumin, the primary curcuminoid found in turmeric. Curcumin is a poorly absorbed compound on its own, but the addition of piperine, the active ingredient in black pepper, increases the absorption by approximately 2,000%.3 Another well-designed feature of the golden milk beverage involves the use of whole fat milk or added fat (such as coconut milk or oil) to facilitate improved bioavailability of the fat-loving (lipophilic) curcuminoid phenols; leveraging a lipophilic design has been shown to allow for greater bioaccessibility of curcuminoids.4 Golden Milk and Arthritis Arthritis is an inflammatory condition characterized by swollen, painful joints. It affects children and adults and presents in many forms – autoimmune rheumatoid arthritis, osteoarthritis, and infectious arthritis, to name a few.5-6 While each condition has a different etiology, the clinical presentation includes stiff joints, muscle aches and pains, fatigue, rigidity, and inability to use the affected limb(s).5-6 Sometimes called degenerative joint disease, osteoarthritis (OA) is the most common chronic condition of the joints, affecting approximately 27 million Americans.5 OA can affect any joint, but it occurs most often in knees, hips, lower back and neck, small joints of the fingers and the bases of the thumb and big toe.5 In OA, the cartilage breaks down, causing pain, swelling and problems moving joints.5 Rheumatoid arthritis is an autoimmune disease in which the body’s immune system – which normally protects its health by attacking foreign substances like bacteria and viruses – mistakenly attacks the joints. Since this is a systemic condition, it may also affect organ and body systems.6 Turmeric (Curcuma longa) is a rhizomatous perennial plant of the ginger family.7 Curcumin, the medicinal compound found in turmeric root, has been used for thousands of years, but has only recently been studied extensively. A curcuminoid polyphenol (also called diferuloylmethane), curcumin has been used medicinally in Asian countries for its antioxidant, anti-inflammatory, anti-microbial, anti-mutagenic, and anti-cancer properties.8 Typical anti-inflammatory medications are successful in blocking the pro-inflammatory COX pathway, while curcumin’s benefits are seen via inhibiting actions of both COX and LOX enzymes, prostaglandins, and leukotrienes.9 Unlike many non-steroidal anti-inflammatory drugs (NSAIDs), curcumin does not irritate the gastric lining when taken with food.10 Recent studies have examined the role of curcumin in the gut, specifically its interaction with the gut microbiota. Highly concentrated amounts of curcumin have been used as a standalone or adjunct approach to many clinical conditions. Until recently the dose of curcumin ingested through daily food intake and its clinical relevance was not well understood. Oral administration of curcumin is beneficially involved in many health processes, including those underlying osteoarthritis and rheumatoid arthritis.11 Limited bioavailability and inability to detect curcumin in circulation or target tissues has hindered the validation of a causal role, however studies suggest the relationship between curcumin, microbiota, and gut tissue to be at the base of improved overall health and reduced inflammation with dietary intake of turmeric.12 In their review of current studies, Gosh, et al. theorize that the mechanism underlying the attenuation of metabolic dysfunction is a curcumin-mediated decrease in the release of gut bacteria-derived lipopolysaccharide (LPS) into blood circulation, by maintaining the integrity of the intestinal barrier function.12 In this role, lacking extensive systemic circulation, curcumin reduces the release inflammatory LPS molecules, thereby protecting several layers of the intestinal barrier.12 While the data on curcumin’s role in supporting healthy joints and combating arthritis is growing, it should be noted that the clinically effective doses studied range from 1000-1500 mg/day of curcuminoids. The typical golden milk recipe includes 0.5-3 teaspoons of turmeric, or approximately 3-9 grams of ground turmeric root.1-2,14 With the lower bioavailability of dietary curcumin, and the curcumin content of the turmeric root averaging 3.14% by weight,13 actual curcuminoid intake per golden milk drink ranges from 0.05-0.28 mg when preparing it with 0.5-3 teaspoons of turmeric (based on simple math). Golden milk tea is a wellness-promoting drink that should be incorporated into a nutrient dense, anti-inflammatory diet and lifestyle. While higher, more targeted doses of curcumin may be necessary to promote clinically significant changes in arthritic pain outcomes, the sum of all diet and lifestyle parts should be considered when approaching inflammation from a more natural, holistic perspective. Citations
Whitney Crouch, RDN, CLT Whitney Crouch is a Registered Dietitian with a BS in Clinical Nutrition from the University of California, Davis. She has over 10 years of experience across multiple areas of dietetics, specializing in integrative and functional nutrition and food sensitivities. When she’s not writing about nutrition or educating others, she’s spending time with her husband and young son. She’s often found running around the bay near her home with the family’s dog or in the kitchen cooking up new ideas to help her picky eater expand his palate.  Golden Fusion is a modern take on the centuries-old golden milk recipe that is both great-tasting and convenient. Golden Fusion features CurQFen - a highly bioavailable form of curcumin with fenugreek, along with grass-fed collagen peptides.
What is Golden Milk? Popularized across social media, golden milk is a cross-cultural drink originating in Asian countries and consumed for its anti-inflammatory properties and pungent flavour. Also known as “golden milk latte” or “turmeric tea”, golden milk is made with freshly grated or ground turmeric, a pinch of freshly ground pepper, honey or lemon to taste, and hot water, milk, or dairy alternative. The addition of freshly grated or ground ginger adds extra flavour and additional anti-inflammatory characteristics, with cinnamon, cardamom, cloves and nutmeg rounding out the flavour. Why Golden Fusion?
The Golden Milk: Turmeric While turmeric is the star of the show with its golden colour and unique flavour, golden milk is a purposefully designed elixir including ingredients that aid in the absorption and delivery of turmeric’s polyphenolic compound, curcumin, the primary curcuminoid found in turmeric. Curcumin is a poorly absorbed compound on its own, but the addition of piperine, the active ingredient in black pepper, increases the absorption by approximately 2,000%. Another well-designed feature of the golden milk beverage involves the use of whole fat milk or added fat (such as coconut milk or oil) to facilitate improved bioavailability of the fat-loving (lipophilic) curcuminoid phenols; leveraging a lipophilic design has been shown to allow for greater bio-accessibility of curcuminoids. How To Enjoy Golden Fusion: Mix one scoop with 150ml of hot water or your favourite milk (cow's, coconut, or almond) for a great-tasting and comforting way to supplement your diet with curcumin and collagen peptides. Frequently Asked Questions... What’s the Ancient Secret of Golden Milk? With roots in traditional Chinese and Indian recipes, golden milk dates back thousands of years, and is used within the ancient branch of Indian medicine known as Ayurveda as a nourishing, delicious tonic that supports the mind and body in several ways. The main ingredient in golden milk is turmeric, which gives it a beautiful yellow colour and healing benefits. Traditionally used to impart colour and flavour to Indian curries, the health benefits of turmeric are well-documented and researched. These include anti-inflammatory properties and support of detoxification, as well as the potential to improve cognitive function, blood sugar balance, joint health, and more. What is the source is of our golden fusion collagen? The source is grass-fed bovine collagen. What is the type of collagen used?
Why does Metagenics list “Predominantly Grass-Fed” Collagen Peptides? Grass-Fed designation is often desirable because some experts believe that these cows may deliver greater nutritional benefits. However, labeling grass-fed without qualifying with “predominantly” would be is false and misleading. The majority of cows are not exclusively grass-fed because they often eat other food, such as grain, when weather is bad and there is no grass to eat. Many other companies and suppliers do not disclose this information. We pride ourselves on quality and transparency and will continue to set the standard for clear and accurate labelling.  by Deanna Minich, PhD As you read through health magazines or blogs, you probably see all kinds of articles or ads promoting the next great miracle product: a detox or cleanse. The influx of products—many of which have no scientific evidence backing their promised efficacy—has led many to think that detox is just a scam or a fad. However, that is not the whole truth. Although some of these products might be ineffectual, there are also many reputable items and programs out there that actually do work. It is these that will withstand the test of time and demonstrate that true metabolic detox is not merely a fad. Not convinced? Read on and find out why you should give it a shot! We Live in a Toxic World The industrial, chemical, and technological revolutions greatly benefited us in many ways, but they have led to a highly toxic world. Environmental exposure to pollution, chemicals, and other toxins is linked to a variety of noncommunicable diseases,1 including cancer, asthma, neuro-development conditions, obesity, cardiovascular disease, diabetes, and neurodegenerative conditions like Alzheimer’s disease.2 Everyone is exposed to a number of toxins through their water, food, air, personal care products, and other elements in the environment. These include:
It Requires Support Your body has its own detoxification process, which in the scientific and medical community is often referred to as bio transformation. There are three steps to this process: bio transformation, conjugation, and elimination. During the first stage, toxic molecules, which might come from the outside world or from metabolites of your own body processes, get molecularity transformed into a different molecule. Sometimes it becomes less toxic, but many times, it actually becomes more toxic! Luckily, the next step mollifies it into a less toxic molecule. In this phase, the molecule combines with another molecule to create something that the body can eliminate. The third step is elimination, which in some discussions on detox is excluded but is just as important as the other two steps. Once your body has transformed the toxic elements into a benign molecule, it must be excreted through your urine, feces, or sweat. All of these processes occur whether you are on a metabolic detox regimen or not, but they often need help! Each phase requires certain vitamins, minerals, antioxidants, and other nutrients. If you have more toxins, then you will need more of these nutrients to handle the increase in the processes while your body tries to remove them from your system. Some people have genetic differences that alter their detoxification pathways. In some instances, it speeds up either stage one or stage two. In others, it slows a stage down. Certain foods, medications, and other factors also might impact the efficacy either positively or negatively. In these instances, you might also require additional support to handle the detoxification process. If two stages are not in sync, problems might arise. If you churn out more toxic molecules from stage one without being able to handle stage two at the same rate, then all of a sudden you have a backup of potentially troublesome molecules in the body. Similarly, if you finish stage two but cannot eliminate the toxins, they might get recycled, causing issues. Good detox programs provide you with the food, nutrients, and herbs that support your body’s own natural detoxification system to ensure it works smoothly, in sync, and at the speed you need. Nutrients Needed for Metabolic Detoxification You want to ensure that you have the nutrients necessary to support the bio transformation and elimination process to get rid of the toxins in your body. You can also incorporate foods known to support the process,6 such as green tea, curcumin, cruciferous vegetables like broccoli, and dandelion. Additionally, you want to support your liver, your kidneys, and your gut, the three systems most heavily involved in detoxification. First and foremost, the process needs energy to undergo the different stages of detox! Phase one requires antioxidant support, since it typically releases a lot of free radicals. Nutrients to ensure you consume to support your phase one include:
Creating a Metabolic Detox Diet Many of these nutrients are found in a generally healthy diet made up of primarily plant foods and whole foods. Thus, an essential step in providing your body with these nutrients is replacing calorie-dense foods with little to no nutrition, such as the highly processed foods rampant in the typical Western diet, with nutrient-dense foods, such as fruits, vegetables, whole grains, nuts and seeds, lean protein, and healthy fats. Furthermore, switching to an organic diet has been shown to significantly lower the level of pesticides in the body even in a short period of time. To take it a step further, you want to incorporate a detox diet that emphasises certain foods, nutrients, and herbs known to provide support for the pathways. A good detox diet not only provides you with the nutrients your body needs to process and eliminate the toxins you face every day, but it also should have the nutrients you need for all the other processes your body undertakes, as well as your daily activities! Don’t forget to mitigate your exposure to environmental toxins as much as possible through using air and water filters, consuming organic foods, limiting your plastic use, and more. So, is detox a fad? NO!In the highly toxic environment in which most people live, our body requires support to do its natural practice of eliminating toxins. In fact, it is essential not just to do a metabolic detox or a cleanse as a one-off, but to adopt a detoxifying lifestyle that provides a defence against the toxins to which you will be inevitably exposed. *These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.References:
 About Deanna MinichGuest blogger Dr. Deanna Minich is an internationally recognized health expert and author with more than 20 years of experience in nutrition, mind-body health, and functional medicine. Dr. Minich holds Master’s and Doctorate degrees in nutrition and has lectured extensively throughout the world on health topics, teaching patients and health professionals about nutrition. She is a Fellow of the American College of Nutrition, a Certified Nutrition Specialist, and a Certified Functional Medicine Practitioner. Currently, Dr. Minich teaches for the Institute for Functional Medicine and for the graduate program in functional medicine at the University of Western States. Her passion is bringing forth a colorful, whole-self approach to nourishment called Whole Detox and bridging the gaps between science, soul, and art in medicine.
View all posts by Deanna Minich →  When your body’s gut microbiome falls out of balance, there are many ways it can affect your health.
What’s a microbiome? It’s the genetic material of all microbes—bacteria—that live on and inside your body. The good bacteria that contribute to your intestinal microbiome are essential to your health, development, immune function, and nutritional status. Sound complex? It is! And it’s a delicate balance that can easily be disrupted. Here are five key ways your gut microbiome may be negatively impacted:1
*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. References:
 Eat a healthy breakfast. It sounds simple enough. But what exactly does that mean? While there is no definition of the “perfect breakfast,” it makes sense that there are ideal and less than ideal ways to energize your body. So let’s compare typical breakfast options to various types of fires and ways to fuel your morning right! The Cooking Fire: This fire is the equivalent of a stove range. It burns slowly, evenly and can literally last all day. The breakfast equivalent? A breakfast that will keep you energized all day with stable blood sugar levels should always have lean protein as its base. Like seasoned firewood, lean protein is a slow burn fuel. It improves glycemic response, inhibits the secretion of the hunger hormone ghrelin and stimulates the secretion of the satiety hormones peptide YY (PYY), glucagonlike peptide 1 (GLP-1) and cholecystokinin (CKK). 11 The net effect? You feel more satisfied and have fewer food cravings, which may also help maintain a healthy body weight. In addition to protein, some minimally processed fats, such as avocado, olive or coconut oil, not only add flavor but also further increase satiety. Carbohydrates should ideally be limited to whole food sources (fruits, vegetables, legumes, and whole grains)—as close to their natural form as possible. Think steel cut oats, rather than instant oatmeal. Here are some examples of slow burn breakfasts and tips to get you started.
The Kindling Fire: This fire burns hot and fast. It ignites quickly, then extinguishes once it has consumed its fuel: paper, leaves, etc. It’s all kindling, no logs. Think of the typical bagel and juice breakfast as a kindling fire. The more processed, more sugar-laden your breakfast, the faster your body burns it. In the big picture of long-term health effects, within reason, any breakfast is better than no breakfast at all. True, it gives you some fast energy. But keep in mind, it may leave you hungry and needing energy by mid-morning. No Fire: Do you skip breakfast? If so, you’re in good company. In fact, according to a national survey, “breaking the fast” is not on the morning agenda of 31 million American adults. How might skipping the most important meal of the day affect you? Research supports the importance of breakfast for better energy and healthier food choices throughout the day, wins for everyone. But if you fit the following criteria, you may have even more to gain from breakfast 1,2.
What’s your excuse for skipping breakfast?
 About Maribeth EvezichMaribeth Evezich, MS, RD is a functional nutrition and therapeutic lifestyle consultant. Maribeth is also a graduate of Bastyr University and the Natural Gourmet Institute. Whether she is in her kitchen experimenting, at her computer researching, or behind the lens of her camera, she is on a mission to inspire others to love whole foods. as much as she does. She lives in Seattle and is the founder of Lifestyle Medicine Consulting, LLC and the culinary nutrition blog, Whole Foods Explorer. Maribeth Evezich is a paid consultant and guest writer for Metagenics.
View all posts by Maribeth Evezich →  We all experience stress from time to time. The release of stress hormones, including adrenaline and cortisol, helps you cope with immediate challenges. But when your level of stress becomes chronic or goes beyond what your body can handle, it can compromise your physical, emotional, and mental health—which can make it even harder for you to cope with future stress and stressors.
Did you know you can control how your body reacts to friendly and not-so-friendly stressors? Finding quick and effective “tension tamers” that turn off the alarm response and turn on the relaxation response helps your body return to normal functioning following a stressful event. Try several of these techniques and find out what works best for you in times of stress. You’ll feel calmer within minutes!
You don’t have to make big changes in your life to reduce your stress level. Just lessen the impact that stressful occurrences can have on you. These quick and simple tips make it easy for you to change your response to stressors and live a more positive, fulfilling life. For more help with living a lower-stress lifestyle, talk to your healthcare practitioner.  When you first decide to supplement with fish oils to support your overall health, you may wonder: With so many product options available, how do I know what to look for? Watch for Purity Testing when selecting a fish oil supplement, know there are various forms of testing that can be done to ensure the source meets quality standards. You should feel confident that the fish oil you choose lives up to its purity and potency claims and has been extensively tested for contaminants that are potentially harmful. Here’s what you need to know. Something’s Fishy - Don’t settle for a lesser fish oil. Seek out a reputable supplement company that conducts potency testing in addition to testing for the following contaminants and toxins.
If you suspect a bad fish oil, remember: There are plenty of other fish in the sea! Fishing for Good Health Experience the benefits of fish oil by choosing a quality formula with proof of testing to meet your standards and support overall health.*  If modern life’s got you feeling frantic, you’re not alone. These days, it seems most of us are living in an almost constant state of ‘on,’ pulled in too many directions at once, pressured from all sides, over-tethered to tech and perpetually behind the eight-ball. Amidst the daily chaos, it can be mind-bogglingly challenging to find the respite that your brain and body so desperately need.
While a vacation by the sea or to the mountains always helps, in between getaways, it’s essential to find other ways to unwind your hyped-up mind, relax your too tense body, and feel more peaceful. How to do that without booking a trip to paradise? In a word: meditation. Yes, I know, you say you’ll get around to it when you’re less stressed, when the kids graduate college, when the cows come home, yada, yada, yada. But now, actually, when you’re in the middle of the “Stress-nado,” is as good a time as any to start (or re-start) your meditation practice. Not only is meditation an always-accessible, drug-free stress-buster, you’ll also be gifting your heart, brain and gut with system-wide health benefits no prescription drug can touch. Here are a few ideas to inspire your meditation practice and how to get started: Make meditation your emotional medication. Meditation cultivates adaptability and resilience and reduces reactivity. A steady practice can help you manage strong emotions and ride the choppy waves of life, be they in the form of an angry teenager, a demanding boss, bumper-to-bumper traffic, or just about anything in between. A regular meditation practice helps create a solid, more chilled-out foundation from which you can never be fully rocked. When you start the day from a calmer place, you’ll be less likely to fly off the handle when life triggers you – and that’s good news for everyone in your life. Think of it this way: meditation is medication without a single downside. Meditation will help keep your brain healthier, longer. Meditation also delivers plenty of physiological benefit too. This practice has a remarkably positive influence on keeping chromosomes young; helping to improve focus, attention, memory, processing speed, and creativity; and it may even slow brain aging, counteracting the age-related atrophy that can lead to cognitive decline and conditions like dementia. So, no more excuses, eh? Meditation will take the edge off anxiety and high blood pressure. Meditating is also linked to decreased blood pressure and reduced stress and anxiety, which is why a daily practice “primes the pump” for getting a good night’s sleep. You’ll help trigger the release of feel-good endorphins that boost mood, help curb anxiety and tame pain. You’ll also reduce stroke and heart disease risk. Best of all, you don’t need to retreat to a hut in Nepal to reap the enormous benefits of the practice. Regular sitting for as little as ten minutes a day can have positive effects. With practice, as your sessions grow longer, to 20 or 30 minutes or more, all those physiological and psychological benefits will to! Get into the groove – with as much assistance as you need. As for learning how to meditate, there are many options available. There are numerous books by established teachers and plenty of YouTube demos – all of which are great for getting your toes wet. But frankly, nothing beats working directly with a live instructor, in real time. Building a relationship with a teacher will help you develop and maintain a lifelong practice, and help keep you engaged and accountable through the peaks and valleys. Remember, meditation is a practice – the more you meditate, the better you’ll get at it, so be patient with yourself and keep practicing. For extra support between sessions with your teacher, you can also incorporate an app into your practice. Among them: Calm; The Mindfulness App; OMG! I Can Meditate! and Stop, Breathe & Think and Smiling Mind to name a few. Give brain and body a vacation, any time you need to. When you think meditation, images of ancient holy men in the Lotus position may come to mind. That, understandably, may not exactly be your speed. Feel free to sit with feet folded over your thighs if you like, but you can just as easily settle into a comfortable chair or meditate while standing, walking or lying down. Just shut your eyes (or keep them open, if you prefer) and focus on your breathing for a few moments and that will do the trick. The goal is to to put the brakes on your over-revved system and literally just breathe. You have the time. Seriously. You do. I know you’re probably saying, “But doc, there aren’t enough hours in the day!’ and yes, that’s true to a point. But I’m not asking you to put in hours every day. If you do, bravo! For everyone else, it’s about being creative with your time, and committing to a program that fits into the small slivers of time you do have, right now. Down the road, as your practice grows, you can make more time for meditation if you choose. But to begin, feel free to start small with these tips: 1. At the start or end of your day, trade 10 minutes of time-sucking social media, video games or TV for 10 minutes of meditation. 2. Two to three mornings a week, get up a few minutes earlier to meditate upon rising, before the rest of the family wakes up. 3. Meditate in the car before or after the drive, instead of listening to the news or making calls. 4. On the commuter train, put on a pair of noise canceling headphones, and meditate instead of reading email or the headlines. 5. At lunchtime, pop into a local house of worship and enjoy the silence while you meditate. 6. ‘Book a cushion’ at a drop-in meditation studio like MNDFL, for a 30-minute group lunchtime session.  A ketogenic meal is comprised of approximately 10% of calories coming from healthy carbohydrates such as leafy greens, non-starchy vegetables, and limited amounts of legumes and berries; 20% of calories coming from proteins such as omega-3-rich fish and grass-fed animal protein; and ~70% of calories coming from high-quality fats such as avocado, unsaturated and medium-chain triglyceride oils, nuts and seeds, and coconut. This 10/20/70 ratio is a guideline for the macro nutrient distribution for a given day, including meals, snacks, and beverages. You may recommend a slightly modified ratio based on your physical activity and personal health goals. The diagram below highlights how the calories provided from carbohydrate, protein, and fat differs between a standard American diet and a typical ketogenic diet.  Here are some healthy Keto options:
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