By Whitney Crouch, RDN, CLT
​
Our children are often our greatest pride, our greatest challenge, and sometimes our greatest frustration. However, they are not small adults, and they often remind us of this around meal times when the plate full of veggies goes untouched, but the pizza is ravenously inhaled. Behaviours aside, children’s growing bodies are different from adults and require higher proportions of some nutrients.

As parents, we may know what our children should ideally be eating for breakfast, lunch, dinner, and snack times, but sometimes we just can’t seem to persuade our children to actually eat those veggies.
“Will my child be getting enough nutrition if she only eats a few bites of each meal?” “What if she relies heavily on processed, carbohydrate-rich foods?” “How can I support my picky eater in choosing a wider variety of foods?” These are valid concerns that many healthcare providers and dietitians hear from worried parents. Added to those questions is the recent government data that states, according to the 2011-2014 National Health and Nutrition Examination Survey (NHANES), many children are not meeting current nutrient recommendations.1 There are multiple factors why this is the case, and we will explore the food sources of nutrients, nutrient gaps, and strategies to help improve dietary intake of important nutrients in children.

Nutrition intake: Where are we today?The 2015–2020 Dietary Guidelines Advisory Committee (DGAC) determined that several nutrients: vitamins A, E, and C; folate; magnesium; and iron (in adolescent females) were under-consumed in children relative to the Estimated Average Requirement (EAR) or Adequate Intake (AI) levels set by the Institute of Medicine. These were characterised as “shortfall nutrients.”1 In addition to the aforementioned micro-nutrients, fiber is another nutrient that is often under-consumed. Consider these daily recommendations for fiber range based on age, sex, and calorie needs:2

• 14 g (age 1-3 years)
• 17-20 g (age 4-8 years)
• 22-25 g (age 9-13 years)
• 25-31 g (age 14-18 years)

If your child falls into the category of a “frequent processed food eater,” he or she is likely not getting enough fiber each day, which can lead to difficulty producing regular bowel movements and could possibly lead to additional nutrient deficiencies and adverse health issues.

In children 2–18 years of age, milk has been shown to be the primary source of calcium, vitamin D, and potassium.3 Dairy products, especially milk and yogurt, also provide protein, saturated fatty acids (SFA), riboflavin, vitamin B12, and phosphorus. But over the past 30 years, fluid milk consumption has declined from 247 pounds per person to 154 pounds per person, with an increase in cheese and yogurt consumption.1 The increased cheese and yogurt intake has led to increased intake of saturated fat and sodium in the diet.4 Despite the decreasing trend in cow’s milk intake, younger children appear to be consuming adequate dairy, but many will decrease consumption as they age, especially girls, despite an increased need by volume. Reasons for milk intake decreasing as children become adolescents include beliefs around dairy (females may think dairy will make them “fat”, whereas males may think it will help them grow stronger), access to milk products (sometimes limited due to parental beliefs around dairy), skipping meals that would normally contain dairy, and more.5

As recommended by the USDA, children 2-3 years old should be consuming 2-cup equivalents of dairy per day, while 4-8-year-olds need 2.5-cup equivalents, and 9-18-year-olds should be consuming around 3-cup equivalents per day.6 The American Academy of Pediatrics (AAP) adopted the American Heart Association’s (AHA) 2006 guidelines, which recommend similar intake of 2 cups/day of reduced fat or nonfat milk for ages 2-8 and 3 cups/day of reduced fat or nonfat milk for ages 9-18 years.7-8
Significantly, children 9-18 years old actually have higher calcium needs than adults, requiring 1,300 mg of calcium daily to support increased needs for skeletal development leading up to and during puberty.9
Of note, while the AAP and AHA may be aligned on low or nonfat dairy for children ages 2+ years, recent studies have shown reduced rates of obesity when higher fat dairy is consumed, and no ill effect on adult blood lipids.10

When children are meeting the recommended intake for dairy, discretion should be used to serve children low-sugar products that are nutrient-dense. To reduce sugar and improve nutrient density, parents should limit their children’s intake of flavored milks, read product labels, and avoid purchasing yogurts (and other food products) with large amounts of added sugars. Greek and Skyr type of yogurt products can be great sources of protein and often provide 9 grams or less sugar per serving and without the use of artificial sweeteners.

Nutrient needs and portionsParents usually have the best intentions at heart when it comes to their children, but if they don’t have enough information to make informed choices, can you blame them if their children aren’t meeting all of their nutrition needs?
Calorie and portion needs change as children grow. Below is a quick reference guide to better layout children’s evolving nutrition needs. Parents’ intuition and knowledge of their child’s habits are the best gauge of a child’s daily needs.

FOOD GROUP                  2 year olds           3 year olds               4-5 year olds
Fruits                                 1 cup                      1-1 ½ cups                 1-1 ½ cups
Vegetables                       1 cup                      1-1 ½ cups                 1 ½-2 cups
Grains                                3 ounces               3-5 ounces                 4-5 ounces
Proteins                            2 ounces               2-4 ounces                  3-5 ounces
Dairy                                  2 cups                   2-2 ½ cups                   2 ½ cups

(www.choosemyplate.gov, 2018)
*Older children’s needs are higher and based on age, sex, height, weight, and activity level.6
Portions:11

• ½ cup of fruit: ½ cup mashed, sliced, or chopped fresh fruit; ½ cup of 100% fruit juice (try watering it down 50% with ½ cup flat or sparkling water); ½ small banana, 4-5 large strawberries
• ½ cup vegetables: ½ cup mashed, sliced, or chopped vegetables; 1 cup raw, leafy greens; ½ cup vegetable juice (choose low-sodium versions); 1 small ear of corn
• 1 ounce grains: 1 slice bread; ½ cup cooked oatmeal, rice, or pasta; 1 6” tortilla
• 1 ounce protein: 1 ounce cooked meat, poultry, or seafood; 1 whole egg; 1 tablespoon peanut butter; ¼ cup cooked legumes (pinto, kidney, black beans; lentils; peas)
• ½ cup dairy: ½ cup low-fat or nonfat milk; 4 ounces low-fat, low-sugar yogurt; ¾ ounce cheese

In the second part of this two-part series, we’ll discuss filling the nutrient gaps and provide helpful ideas to get picky eaters the nutrients they need.

References

1. O’Neil CE et al. Food Sources of Energy and Nutrients of Public Health Concern and Nutrients to Limit with a Focus on Milk and other Dairy Foods in Children 2 to 18 Years of Age: National Health and Nutrition Examination Survey, 2011-2014. Nutrients. 2018;10(8):1050.
2. Office of Disease Prevention and Health Promotion. Dietary Guidelines 2015-2020. Appendix 7. Nutritional goals for age-sex groups based on dietary reference intakes and dietary guidelines recommendations. ​https://health.gov/dietaryguidelines/2015/guidelines/appendix-7/ Accessed December 5, 2018. 
3. Keast DR et al. Food sources of energy and nutrients among children in the United States: National Health and Nutrition Examination Survey 2003–2006. Nutrients. 2013;5:283–301.
4. Thorning TK et al. Whole dairy matrix or single nutrients in assessment of health effects: Current evidence and knowledge gaps. Am J Clin Nutr. 2017;105:1033–1045.
5. Racey M et al. Barriers and Facilitators to Intake of Dairy Products in Adolescent Males and Females With Different Levels of Habitual Intake. Glob Pediatr Health. 2017;4:2333794X17694227. Published March 21, 2017.
6. United States Department of Agriculture. Choose MyPlate. https://www.choosemyplate.gov. Accessed December 5, 2018.
7. Gidding SS et al and endorsed by the American Academy of Pediatrics. Dietary Recommendations for Children and Adolescents: A Guide for Practitioners. Circulation. 2005;112:2061–2075.
8. Dietary Recommendations for Healthy Children. American Heart Association. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/dietary-recommendations-for-healthy-children. Reviewed April 16, 2018. Accessed January 6, 2019.
9. Calcium. National Institutes of Health, Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/. Published 2018. Accessed December 10, 2018.
10. Beck AL et al. Full fat milk consumption protects against severe childhood obesity in Latinos. Prev Med Rep. 2017;8:1-5.
11. Fulgoni VL et al. Foods, fortificants, and supplements: Where do Americans get their nutrients? J Nutr. 2011;141(10):1847-1854.

Whitney Crouch, RDN, CLT Whitney Crouch is a Registered Dietitian who received her undergraduate degree 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 creating educational programs or writing about nutrition, 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.Whitney Crouch is a paid consultant and guest writer for Metagenics.

By Whitney Crouch, RDN, CLT

Filling nutrient gaps in kids’ diets 
A large study of 16,110 individuals aged 2 years and older, known as the National Health and Nutrition Examination Survey (NHANES) found 25-70% of those surveyed to be eating less than the EAR for vitamins A (34%), C (25%), D (70%), and E (60%); calcium (38%); and magnesium (45%).1 Enrichment and fortification within the food supply largely contributed to the levels of vitamins A, C, and D, thiamine, iron, and folate reaching levels that were attained by diet.1 These statistics shed light on both the importance of nutrient fortification of certain foods in our food system and on the importance of nurturing healthy nutrition habits early and often.

Top 5 foods to help fill the gaps:

1. Vitamin A: liver, sweet potato, carrots, pumpkin, spinach
2. Vitamin C: acerola cherry, sweet bell peppers, peaches, mustard greens, broccoli
3. Vitamin D: mushrooms (exposed to UV light), salmon, sardines, whole egg, cow’s milk
4. Vitamin E: sunflower seeds, almonds, peanuts, avocado, spinach
5. Calcium: sesame seeds, cheese, tofu, sardines, edamame
6. Magnesium: pumpkin seeds, edamame, almonds, Swiss chard, black beans

Enriched and fortified orange and apple juices are also good sources of vitamins C, D, and calcium, but watch out for sugar content. Cod liver oil is also a great source of vitamins A and D.2
You may be thinking, “Okay that’s great, but my child will not eat liver, mushrooms, or broccoli.” According to child feeding specialist Ellyn Satter, there is a division of responsibility between parent and child when it comes to meal and snack time nutrition intake.3 What does this mean?

A parent’s job is to: 

• Choose and prepare the food
• Provide regular meals and snacks
• Make eating times pleasant
• Step-by-step, show your child by example how to behave at family mealtimes
• Be considerate of your child’s lack of food experience without catering to likes and dislikes by providing one or two side dishes your child likes at each meal and include something he or she is still learning to like
• Avoid excess foods and beverages (except for water) between meals and snack times
• Let your child grow into the body that is right for him or her

Part of your feeding job is trusting that your child will:  

• Eat the amount he or she needs
• Learn to eat the food you eat

Bottom line: According to Ms. Satter, you are responsible for what, when, and where your child eats; your child is responsible for how much and whether to eat or not.8 Get creative in the kitchen, share the cooking experience, and lead by example with nutrient-dense food choices regularly. If you have a creative flair, creating “artwork” with the food on the plate, or using cookie cutters to create new shapes can be a great way to spark your child’s interest in the food and an opportunity for fresh conversation at the family table.

Nutrient-boosting ideas
​When it comes to optimal growth and development, filling nutrient gaps is an important factor. Even children with the best of diets and diverse palates can enjoy including new ways of incorporating fruits, veggies, and other nutrients into their diet. For children with more narrow palates, these ideas can be great ways to introduce flavors or nutrients using new delivery methods:

• Smoothies:

• Incorporate a high-quality children’s nutrition powder into a fruit and veggies smoothie. Try blending water, low-fat cow’s milk, or a fortified dairy alternative as a base, plus ½ frozen banana, ½ cup frozen berries, a handful of spinach, ¼ avocado, and a serving of children’s nutrition powder.

• Fruit and veggie muffins:

• Get your child involved! Pressed or chop fruits and veggies but have your child empty the ingredients into a mixing bowl while you talk about the health attributes of each ingredient and how delicious the muffins will taste.

• If you’re new to the kitchen yourself, don’t be intimidated; there are plenty of recipes out there on the Internet that are great for even newly chef-hatted parents. Look for whole wheat or gluten-free flour-based recipes with ingredients like grated carrots, steamed broccoli, shredded zucchini, and mashed banana to cook up colourful, nutrient-dense and fiber-rich treats for your family.

• Chews or gummies:

• Offer age-appropriate multivitamin chews or gummies by incorporating these nutrient gap-filling tools as a treat or a part of your child’s daily routine. You can buy premade or experiment with making your own!

• Liquid or powdered vitamins:

• Standalone vitamins, like vitamin D3, can be added to foods like yogurt, applesauce, milk, or oatmeal for an added boost of commonly fortified vitamins.

References

1. Fulgoni VL et al. Foods, fortificants, and supplements: Where do Americans get their nutrients? J Nutr. 2011;141(10):1847-1854.
2. US Department of Agriculture (USDA), Agricultural Research Service, Nutrient Data Laboratory. USDA national nutrient database for standard reference, legacy. Current version: April 2018. Internet: http://www.ars.usda.gov/nutrientdata
3. Division of responsibility in feeding. Ellyn Satter Institute. https://www.ellynsatterinstitute.org/. Accessed December 9, 2018.

​Whitney Crouch, RDN, CLT Whitney Crouch is a Registered Dietitian who received her undergraduate degree in Clinical Nutrition from the University of California, Davis. She has over 10 years of experience across multiple areas of dietetics, specialising in integrative and functional nutrition and food sensitivities. When she’s not creating educational programs or writing about nutrition, 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.Whitney Crouch is a paid consultant and guest writer for Metagenics. Whitney Crouch is a paid consultant and guest writer for Metagenics.

By Whitney Crouch, RDN, CLT

Collagen: It’s the most abundant structural protein in the body, and it’s more than just a hip, new trend popularised by different lifestyle personalities and brands. It takes the shape of a triple helix composed of the continuous repetitive motif, Gly-X-Y, where Gly is glycine, X is proline (Pro), and Y is hydroxyproline (Hyp).1 The latter two amino acids are specific to collagen structures. These protein building blocks make up the structure in skin, tendons, bones, and teeth and are integral in the health and maintenance of these structures over our lifetime.

Collagen is found naturally in the connective tissue of land animals such as humans, cows, and chickens, as well as some marine life, including fish. It makes up about 25% of our bodies’ protein content and is helpful in soft-tissue repair.2-3

People who consume animal protein regularly in their diet are consuming some collagen; however, muscle-meat proteins largely lack the rich proteins found in connective tissue. Individuals who routinely sip traditionally prepared bone broth benefit from the collagen extracted from the cartilaginous tissue used in the broth’s preparation. Furthermore, studies show that easily digested and absorbed forms of collagen, like those found in quality dietary supplements, can have an even greater rate of absorption than traditionally prepared foods.

Different types of collagen
Whether from animal or marine sources, all collagen comes from amino acids, the building blocks of protein in the body. Animal and marine collagens are constitutionally the same—that is, they’re made up of the same amino acids—however, animal sources have a larger quantity of some amino acids (proline and hydroxyproline, specifically).4

Research shows there are more than 28 different types of collagen, but the three most abundant are Types I, II, and III. These collagen types form the structural fibrils of tissues, while the others take part in the association of these fibrils with other tissues.2

• Type I: This is the most abundant form of collagen and is found in tendons and throughout the body. It is a key building block for hair, skin, nail, blood vessel, and teeth health.5
• Type II: This type of collagen structure is found most often in joint cartilage.6
• Type III: This is the second most abundant form of collagen and is always found in association with Type I collagen.5

What is the difference among hydrolyzed collagen, collagen peptides, and gelatin?

• Gelatin is the denatured form of collagen, but it is packaged in a different structure from other forms of collagen. It’s created by partial hydrolysis (breaking apart) of the full-length protein, and depending on the extraction process used, gelatin may vary in functional properties, despite having the same amino acids content as collagen. Gelatin, also considered the cooked form of collagen, usually undergoes extensive processing which decreases its bioavailability.7 Gelatin mixes well with hot water and becomes a gummy solid when cooled.
• Hydrolyzed collagen (also called collagen hydrolysate) is the result of the enzymatic breakdown (or hydrolysis) of the full-length collagen protein, extracted and dehydrated (into a white powder). It contains a mixture of different types and combinations of collagen peptides. Because of its smaller size, hydrolyzed collagen is easier to digest and use. The absorption rate of hydrolyzed collagen is said to be over 90% compared to only 27% or less in food.1
• Collagen peptides (another name for hydrolyzed collagen and collagen hydrolysate) involve the breaking down of the molecular bonds between individual collagen strands to peptides. These are specific peptides fragments, usually 2 to 20 amino acid residues in length, which have biological activity. Due to their smaller size, these peptides show higher bioavailability and are better absorbed into the bloodstream.1 Collagen peptides mix well with hot or cold liquids, and these mixtures remain liquid when at room temperature and when cold.

Outward appearance
In addition to improving structural integrity and elasticity of the skin, the consumption of Types I and III collagen also improves skin’s ability to retain moisture and may fight UVB photodamage, which in turn promotes healthier and younger looking skin, according to studies.8-10
There is also mounting clinical evidence of collagen’s benefits in strengthening the collagenous structures of hair and nails. A study in the Journal of Investigative Dermatology reveals that collagen is strongly deposited in hair follicles, and the lack of collagen delays hair cycling and growth, suggesting that collagen could be a potential area warranting further investigation.11
In a six-month study looking at brittle nails, researchers found that daily supplementation with collagen resulted in increased nail growth and improved brittle nails in conjunction with a notable decrease in the frequency of broken nails.12

Inner strength and resilience 
Additional evidence shows that supplementing with oral collagen stimulates collagenic tissue regeneration by increasing not only collagen synthesis, but minor components (glycosaminoglycans and hyaluronic acid) synthesis, as well. One such study used validated self-perception questionnaires to measure joint comfort and overall joint health in study subjects. After 90 days of intervention, 78% of subjects in the test group reported to have less joint discomfort, and more than 60% of the subjects agreed their joint health improved by increasing joint flexibility, mobility, and reducing joint stiffness. There were no statistically significant changes in the control group.13

As if the benefits of adequate dietary collagen seen in hair, skin, nails, and joints aren’t enough, there is also evidence to support collagen and gelatin’s role in bone health. In bone, approximately 95% is Type I collagen, providing viscoelastic strength, torsional stiffness, and load-bearing capacity. Type II collagen is also involved in bone formation, even though it is mainly found in cartilage.14
While the body of evidence around collagen supplementation continues to grow, the benefits of daily supplementation with collagen peptides (hydrolyzed collagen) can already be seen. There are uses for both gelatin and collagen peptides in cooking, baking, smoothies, and other means; however, the higher rate of digestion and bioavailability of the peptide form makes this supplement a great addition to anyone’s health routine.

References

1. Fu Y et al. Exploration of collagen recovered from animal by-products as a precursor of bioactive peptides: Successes and challenges. Crit Rev Food Sci and Nutr. 2018;2:1-17.
2. Rodriguez MIA et al. Collagen: A review on its sources and potential cosmetic applications. J Cosmet Dermatol. 2018;17:20-26.
3. Eastoe JE. The amino acid composition of mammalian collagen and gelatin. Biochem J. 1955; 61(4):589-600.
4. Fazli S et al. Marine collagen: an emerging player in biomedical applications. J Food Sci Technol. 2015;52(8):4703–4707.
5. Lodish H et al. Molecular Cell Biology. 4th edition. New York: W. H. Freeman; 2000. Section 22.3, Collagen: The Fibrous Proteins of the Matrix. https://www.ncbi.nlm.nih.gov/books/NBK21582/
6. Buckley MR et al. Distributions of types I, II and III collagen by region in the human supraspinatus tendon. Connect tissue res. 2013;54(6): 374–379.
7. Eastoe JE. The amino acid composition of mammalian collagen and gelatin. Biochem J 1955; 61(4):589-600.
8. Shimizu J et al. Oral collagen-derived dipeptides, prolyl-hydroxyproline and hydroxyprolyl-glycine, ameliorate skin barrier dysfunction and alter gene expression profiles in the skin. Biochem Biophys Res Commun. 2015;456(2):626-30.
9. Nozomi J et al. Optimization of dose of collagen hydrolysate to prevent UVB-irradiated skin damage. Biosci Biotechnol Biochem. 2016;80(2):356-9.
10. Proksch E et al. Oral supplementation of specific collagen peptides has beneficial effects on human skin physiology: a double-blind, placebo-controlled study. Skin Pharmacol Physiol. 2014;27(1):47-55.
11. Chen P et al. Lack of collagen VI promotes wound-induced hair growth. J Invest Dermatol. 2015;135(10):2358-2367.
12. Hexsel D et al. Oral supplementation with specific bioactive collagen peptides improves nail growth and reduces symptoms of brittle nails. J Cosmet Dermatol. 2017;16(4):520-526.
13. Clark KL et al. 24-week study on the use of collagen hydrolysate as a dietary supplement in athletes with activity-related joint pain. Curr Med Res Opin. 2008;24(5):1485-96.
14. Czajka A et al. Daily oral supplementation with collagen peptides combined with vitamins and other bioactive compounds improves skin elasticity and has a beneficial effect on joint and general wellbeing. Nutr Res. 2018;57:97-108.

​Whitney Crouch, RDN, CLT

Whitney Crouch is a Registered Dietitian who received her undergraduate degree 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 creating educational programs or writing about nutrition, 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.
Whitney Crouch is a paid consultant and guest writer for Metagenics.

Introducing SPM Active

New & Improved

SPM Active New & Improved delivers a greater concentration and dosing size of specialized pro-resolving mediators (SPMs) compared to the previous formula

What has Changed?
Double the concentration of 18-HEPE and 17-HDPA as compared to original SPM Active.
Softgel size is now double that of the original SPM Active.

What are the benefits for your patients?
Greater concentration and dosing size facilitates patient compliance.
Supplementing with SPMs may help facilitate the body's natural resolution process 

What hasn't changed?
The price
 
Why Metagenics SPM Active?
It offers a targeted nutritional approach that is designed to boost the body’s natural capacity to respond to physical stress and promote resolution.
Study in research models suggests that a short-term, high-fat diet may negatively impact natural production of specialized pro-resolving mediators.
Clinical case study results with SPM Active show significant improvement in biomarkers of activated immune function, increased quality of life, and reduced interference of symptoms during general activity.
Specialized pro-resolving mediators may help promote resolution of physical stress after an episode of strenuous physical exertion.

Metagenics set the standard for delivering SPMs based on activity for use in nutraceutical formulas in collaboration with world-renowned SPM experts.
 

MetaKids Multi Soft Chew is a convenient, great-tasting formula kids will love. Each soft chew provides 15 essential vitamins and minerals to help meet the nutritional needs of growing, active children along with unique phytonutrients from fruit and vegetable powders
 
Benefits of MetaKids Chews:

• Optimised with 16 essential vitamins and minerals, to help safeguard the nutritional needs of growing, active children
• Intelligent combination of fruit and vegetable powders and extracts including beetroot, kale, carrot, apple, cranberry and blueberry
• Designed to provide multidimensional support to promote overall health and well-being
• Kid-tested and approved, juicy flavour
• Ideal for children and adults who would rather not swallow tablets or capsules
• Individually wrapped for extra convenience

Available now in  30 chews

​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

1. The New York Times. Rao T. Turmeric Tea. https://cooking.nytimes.com/recipes/1018548-turmeric-tea. Accessed June 7, 2018.
2. Andrew Weil, MD. Anti-Inflammatory Golden Milk Tea. https://www.drweil.com/diet-nutrition/anti-inflammatory-diet-pyramid/anti-inflammatory-golden-milk/. Accessed June 7, 2018.
3. Shoba G et al. Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta Med.1998;64(4):353–356.
4. Fu S et al. Enhanced bioaccessibility of curcuminoids in buttermilk yogurt in comparison to curcuminoids in aqueous dispersions. J Food Sci. 2016;81(3):H769-776.
5. Arthritis Foundation. What is Osteoarthritis? https://www.arthritis.org/about-arthritis/types/osteoarthritis/what-is-osteoarthritis.php. Accessed May 30, 2018.
6. Arthritis Foundation. Rheumatoid Arthritis. www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/. Accessed May 30, 2018.
7. Priyadarsini KI. The chemistry of curcumin: from extraction to therapeutic agent. Molecules.2014;19(12):20091–20112.
8. Aggarwal BB et al. Anticancer potential of curcumin: preclinical and clinical studies. Anticancer Res.2003;23(1A):363–398.
9. Perkins K et al. Efficacy of curcuma for treatment of osteoarthritis. J Evid Based Complementary Altern Med. 2017;22(2):156–165.
10. Jurenka JS. Anti-inflammatory properties of curcumin, a major constituent of Curcuma longa: a review of preclinical and clinical research. Altern Med Review.2009;14(2):141-153.
11. Belcaro G et al. Product-evaluation registry of Meriva(R), a curcumin-phosphatidylcholine complex, for the complementary management of osteoarthritis. Panminerva Med. 2010;52(2 Suppl 1):55–62.
12. Ghosh SS et al. Curcumin-mediated regulation of intestinal barrier function the mechanism underlying its beneficial effects. Tissue Barriers. 2018;6(1):e1425085.
13. Tayyem RF et al. Curcumin content of turmeric and curry powders. Nutr Cancer. 2006;55(2):126–131. 
14. USDA National Nutrient Database for Standard Reference. 02043, Spices, turmeric, ground.Accessed June 7, 2018.

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?

• More than just turmeric and collagen, Golden Fusion is formulated using high-quality, targeted ingredients.
• Features CurQfen, a unique, patented, stable curcuminoid (from turmeric) and galactomannan (from fenugreek) compound designed for increased bioavailability
• Curcumin, a major curcuminoid found in turmeric, may beneficially modulate signalling molecules that influence immune function
• Offers VERISOL® Bioactive Collagen Peptides® that help support skin and nail health
• Combines turmeric with collagen peptides for an innovative twist on traditional golden milk

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?

• Primarily type I and type III.
• The collagen is hydrolyzed (pre-digested, resulting in bioactive collagen peptides)

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:

• Heavy metals
• Pesticides and herbicides
• Pharmaceuticals
• Plasticizers
• Flame retardants
• PCBs (polychlorinated biphenyls)
• Solvents

The human body can mitigate these toxins, but there comes a time where there is just too much, tapping out the body’s own resources.

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:

• B vitamins, especially B2, B3, B6, B9, and B12
• Glutathione, the body’s major antioxidant
• Protein, especially branched-chain amino acids
• Flavonoids
• Phospholipids
• Vitamins A, C, and E
• Selenium
• Copper
• Zinc
• Manganese
• Coenzyme Q10
• Thiols
• Silymarin (found in milk thistle)
• Pycnogenol

Many of the molecules needed for conjugation are amino acids, so protein is important to support phase two. Specific nutrients necessary for this phase include:

• Glycine
• Taurine
• Glutamine
• N-acetylcysteine
• Cysteine
• Methionine
• B vitamins, especially B6, B9, and B12
• Sulfur
• Antioxidants and phytonutrients

Don’t forget about getting the toxic metabolites out of your body through supporting your elimination processes. This includes sweating, whether from exercise, saunas, or something else. You also want to ensure you are hydrated and consume plenty of fiber!

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:

1. Norman RE, et al., Environmental exposures: an unrecognised contribution to noncommunicable diseases, Rev Environ Health. 2013;28(1):59-65.
2. Moulton PV, Yang W, Air pollution, oxidative stress, and Alzheimer’s disease, J Environ Public Health. 2012;2012:472751.
3. Fourth National Report on Human Exposure to Environmental Chemicals Updated Tables, January 2017, Volume One. https://www.cdc.gov/exposurereport/pdf/FourthReport_UpdatedTables_Volume1_Jan2017.pdf.
4. Liska D, et al., Detoxification and biotransformational imbalances, Explore (NY). 2006 Mar;2(2):122-40.
5. Marinković N, et al., Polymorphisms of genes involved in polycyclic aromatic hydrocarbons’ biotransformation and atherosclerosis, Biochem Med (Zagreb). 2013;23(3):255-65.
6. Hodges RE and Minich DM, Modulation of Metabolic Detoxification Pathways Using Foods and Food-Derived Components: A Scientific Review with Clinical Application, J Nutr Metab. 2015;2015:760689.
7. Oates L, et al., Reduction in urinary organophosphate pesticide metabolites in adults after a week-long organic diet, Environ Res. 2014 Jul;132:105-11.

​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

1. Stress
   We all deal with stress, but when it becomes acute and chronic, studies show it can have a physical impact on the gut microbiome, even leading to such gastrointestinal disorders as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), peptic ulcers, and gastroesophageal reflux disease (GERD).
2. Birth Method
   Studies show, babies born by C-section have reduced bacterial diversity and lower levels of good bacteria than babies born via the birth canal.
3. Exercise
   Lack of exercise has been linked to reduced bacterial diversity in the gut and when it comes to the gut, the more types of good bugs, the better. (It’s time to get moving!)
4. Antibiotics
   Taking antibiotics can disrupt the delicate balance of bacteria in the gut, as it kills off microorganisms—the bad and the good.
5. Diet
   Diets low in fiber and high in sugar can have a negative impact on gut bacteria. While fiber feeds good bacteria, sugar feeds bad bacteria, yeast, and parasites. Additionally, excessive alcohol consumption can reduce the good bacteria in your gut.

Do any of these situations apply to you? Fortunately, there are a few things you can do. Lifestyle changes, like effective stress management and more exercise, and dietary modifications, including cutting back on sugar, are a place to start. In addition, a probiotic supplement can help support healthy and balanced intestinal flora by recolonizing the gut with good bacteria.* When choosing a quality probiotic, work with your healthcare practitioner to select one with identified strains at clinically proven doses.
*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:

1. University of Colorado Boulder. Gut Check: Exploring Your Microbiome. Coursera.https://www.coursera.org/learn/microbiome. Accessed August 19, 2016.
2. Konturek PC, Brzozowski T, Konturek SJ. Stress and the gut: pathophysiology, clinicalconsequences, diagnostic approach and treatment options. J Physiol Pharmacol. 2011;62(6):591-9.