Feeding the "Multivore" Family

By Ellen Kanner, Contributing Writer

The New Year brings a post-holiday parade of patients streaming into your office resolving to eat healthier (maybe after a little urging from Multivore Tableyou). It’s among everyone’s top New Year’s resolutions.

But by the early Spring, many grow discouraged as they find that they are unable to uphold their resolutions.

The reality is that major dietary changes are among the hardest resolutions to keep, with so many barriers to success. For many people, the biggest barriers may be the people they live with and love. Their spouses, parents and children.  

“The choice of individual family members to walk a distinctly different path from the rest of the clan can pose challenging problems in family dynamics,” says Seattle-based naturopathic physician, Dr. Herb Joiner-Bey.

Feeding a “multivore” family—where each member has distinct and divergent dietary restrictions and preferences--is challenging, says Joiner-Bey. But it is doable: all you need is some “good common sense.” A little guidance and encouragement from a clinician who understands the quandaries also helps!

Some might call it multivore madness. I call it life. I’m a vegan married to an omnivore, and the daughter of a man who thinks meat and sugar are the two basic food groups. We love each other and love to eat together. It beats walking a lonely path or eating alone.

How do we make it work?

It starts with a conversation. We need to talk about what’s at stake here. Maybe it’s a medical necessity— losing weight to avoid surgery, changing diet to manage out-of-control diabetes, avoiding gluten and the bloat, inflammation, and leaky gut associated with it.

Perhaps it’s an ethical lifestyle choice—the desire to go vegetarian or vegan to eliminate animal cruelty and lighten one’s environmental impact. In other cases, the intention to change one’s diet comes from wanting to look terrific at an upcoming high school reunion.

When making dietary recommendations to your patient, it’s important to gather information about his or her family life—and how the proposed changes will likely affect family members and other loved ones. Does the patient live with people who will support or undermine their efforts to change their eating habits? Though it might not seem like a “clinical” issue, the answer to this question will have profound impact on the likely outcome.

Even in the most supportive families, change can be challenging. It’s important for you—and your patients—to anticipate this and to deal with the realities each individual will face.

Challenges may be even greater within certain cultures. My hometown of Miami has a distinctly Latin flavor. Cafecito breaks are a beloved afternoon tradition — and meat is on the menu at every meal. It’s not a coincidence the leading causes of death among Latinos are cancer and heart disease, but try telling that to a doting abuela. Many other cultural and regional eating habits can also be very challenging: going gluten-free in a pasta-loving Italian family, or becoming a vegetarian in a steak n’ potatoes household is no easy feat.

So how can you help your patients succeed, especially when they’re meeting resistance at home?

Begin by asking them how they plan to meet their goals and what eating healthier — or eating cleaner — the term of the moment — means for them. No gluten? Less processed food? Less sugar? And how much less? For my father, healthier eating means only one dessert a day. Nice try, Dad. But that may not be enough to move the needle.

When making dietary recommendations to your patient, it’s important to gather information about his or her family life—and how the proposed changes will likely affect family members and other loved ones. Does the patient live with people who will support or undermine their efforts to change their eating habits? Though it might not seem like a “clinical” issue, the answer to this question will have profound impact on the likely outcome.

That’s where the why--the motivation-- comes in. Clarifying the incentive ups the odds of achieving wellness results your patient — and you — want.

Help your patients focus on the positive, on getting the outcomes they want and maybe discovering some happy surprises along the way. Changes to diet offer an opportunity to explore new cuisines, new flavors.

“Culinary herbs and spices make food exciting,” says Joiner-Bey. They add no sodium, no sugar, no calories. Just pleasure.

The most important conversations, of course, happen not in your office or any other clinical setting, but around the dinner table. Mealtime is a great opportunity for your patients to talk with their families about why they’re making different food choices.

Though you won’t be there at those discussions, you can be a valuable ally. Collaborate with your patients so instead of initiating “food fights,” they go in with clear strategies and explanations.

Victoria Moran, vegan author and lifestyle coach, and founder of the Main Street Vegan Academy keeps peace at the multivore table with a technique she calls DINE:

  • Dedicate — at least one night a week to a family meal.
  • Involve — everyone. The whole family stands to gain by your patients’ success and they can all have a part of the process, be it planning or preparing meals or researching recipes or wellness benefits on the web.
  • Negotiate — find points where everyone can agree. My suggestions: no special meals and no sniping. “Nobody is more zealous about a belief system than a recent convert,” warns Dr. Joiner-Bey. The food police are not welcome at the dinner table. Neither are cell phones, but that’s another article.
  • Entertain — This may sound like extra work, but trust me on this, inviting friends for a meal coaxes — or forces — family members into better behavior.

Anna Thomas, the Los Angeles-based James Beard Award-winning cookbook author (Love Soup, Vegan, Vegetarian, Omnivore) believes, as I do, that the solution to multivore madness starts in the kitchen.

It’s not about making a regular meal (whatever that is), and a gluten-free meal and a vegan meal. “Start with the food everyone eats,” Thomas says. “I love to start with a great grain – a risotto or tabbouleh or a formidable, hearty pilaf of farro and black rice – and build a meal around that.”  

Cook up a mountain of whole grains, a bushel of beans or a big pot of soup, thick, rich and oomphy with spices and seasonal vegetables. Yes, vegetables — they’re the #1 dining trend, and you can make them the stars of the meal.

Everything else — gluten, dairy, animal products — can have optional supporting roles.

It’s an unfortunate fact that all-too-often, diets divide us, as Dr. David Katz, of Yale University’s Prevention Research Center, so aptly points out.

But that’s only if we let them. There are so many wonderful foods and flavors that everyone can enjoy. It’s a matter of finding the ones that work for your patients and their family. You can help your patients see their food choices as a means to achieving their wellness goals and as an opportunity to bring their families together. Everybody wins!

Wild Rice with Winter Greens,
Lemon, Pine Nuts & Raisins
Wild rice is actually a grass, and is naturally gluten-free. An old Sicilian trick, balancing the bitterness of winter greens with rich pine nuts and sweet raisins, yields a whole grain dish that’s fortifying, fabulous and brings the multivores together.
1 cup wild rice
4 cups vegetable broth or water
2 lemons, zest and juice
1 tablespoon olive oil
1 onion, chopped
1 bunch winter greens — collards, cabbage or kale, tough center ribs removed, leaves sliced into skinny ribbons
1/4 cup pine nuts, lightly toasted
1/4 cup raisins
1 good pinch red pepper flakes
sea salt to taste
In a large pot, bring water or broth to boil over high heat. Add wild rice. Cover and reduce heat to low and simmer for half an hour. Turn off heat; leave the pot on the burner for another half hour or so, until all the liquid is absorbed. (May be done the day ahead. Cover and refrigerate. Bring back to room temperature before proceeding.)
In a large skillet, heat oil over medium-high heat. Add chopped onion and sauté stirring until it softens, about 5 minutes. Add chopped winter greens, which will shrink in the heat to a fraction of their volume. Continue cooking until greens are just wilted — another 3 to 5 minutes.
Tip in cooked rice and stir mixture gently to combine. Grate in the zest of both lemons, squeeze in lemon juice, stir in sea salt and pepper flakes. Add pine nuts and raisins just before serving.
Serves 4 to 6.

ENDEllen Kanner 2017 11 30 04761 RETOUCH web version

Ellen Kanner is the author of the award-winning book, Feeding the Hungry Ghost: Life, Faith and What to Eat for Dinner (VegNews’ 2013 Book of the Year and PETA’s Book of the Month Club debut pick). She is also Huffington Post's Meatless Monday blogger, the Miami Herald syndicated columnist Edgy Veggie, and contributor to print and online publications including: Bon Appetit, Eating Well, VegNews, Salon, Every Day with Rachael Ray and PETA Prime.

Honoring "Father Nature" Jim Duke

By Erik Goldman

James DukeJim Duke, PhDIn the world of botanical medicine, Jim Duke, PhD, stood like a mighty Redwood tree: bridging earth and sky, creating a vast ecosystem around him, and casting a long shadow.

One of the nation's foremost ethnobotanists, Duke has played a central and pioneering role in the establishment of modern herbal medicine as we know it today, while at the same time safeguarding ancient herbal knowledge, as well as the indigenous peoples who've kept it for centuries. And then there's the plants themselves.

Duke, who died at his Maryland home on December 10, at the age of 88, had dedicated his life to the preservation of medicinal plants, and the ecosystems in which they grow. He was particularly enamored with the Amazon, and spent much of his time walking barefoot in the rainforests learning from the people who've lived there for centuries.

Beloved by his friends and colleagues for his intellect, humor, and humility, Duke was equal parts scientist and folklorist. He was born in Birmingham, AL, on April 4, 1929, and showed an early talent for music, mastering Bluegrass fiddle by age 16. His musical chops led him to performances at the Grand Ole Opry, and he continued to perform in Dixieland Jazz bands throught his college years at the University of North Carolina, Chapel Hill, where he studied botany. 

He began his career at the US Departmetn of Agriculture, studying and cataloguing crop diversity. He later became the chief of the USDA's Medicinal Plant Laboratory, and later, the head of USDA's Economic Botany Lab. During his tenure, USDA participated in a joint project with the National Cancer Institute to collect plants from all over the world and screen them for potentially anti-neoplastic compounds.

From the early 1990s on, Duke took leadership roles at the Amazon Center for Environmental Education and Research, an organization that has played a vital role in protecting the rainforests and their peoples, preserving medicinal plants, and teaching the rest of the world.

Throughout his long and storied career, Duke published more than 20 books, and hundreds of research papers, and compiled several foundational texts and databases like the USDA's Phytochemical and Ethnobotanical Database (which began it's life as Dr. Duke's "Father Nature's Farmacy"), the CRC Handbook of Medicinal Herbs, and his popular 1997 bestseller, The Green Pharmacy.

Alongside his academic credentials, he cultivated his artistic sensibility and his taste for the quirky. In 2008 he published Duke's Handbook of Medicinal Plants of the Bible, a treatise on what he mirthfully called "faith-based farmacy." In the same spirit, he issued a now out-of-print compendium of his humorous plant-themed poems called Herbalbum--An Anthology of Varicose Verse. Some of these made it onto an album of bluegrass tinged songs Duke recorded with his musician friends.  To whit:

I’m plowing up my herbs, they’re much too hard to grow.
Gonna move to the suburbs, and grow me some placebo.

--from, Hushpuppy-The Sad Saga of St. John

In 1997, at their home in Fulton, MD, Jim and his wife Peggy established the Green Farmacy Garden, where they've preserverd and cultivated hundreds of helpful garlic graphic edited 3and healthfull species. The Dukes regularly hed herb walks and education sessions at the Garden, and Jim himself was especially fond of leading herbal study tours through remote parts of the Amazon.

In his touching portrait of Duke, plant photographer Stephen Foster recalls his first jungle voyage with Duke:

Jim leaned over and said, “You’re going to get the tropical bug.”

”What do you mean, tropical disease?”

“No,” Duke comforted, “I mean, after you come to the tropics once, you will want to return as often as you can.”

“He was a brilliant, dedicated, funny, and humble man, who earned the admiration, respect, and love of thousands of scientists and herbal enthusiasts,” said Mark Blumenthal, founder and executive director of the American Botanical Council, of which Duke was also a co-founder. “Jim’s huge body of work, love of plants and people, sense of humor, and generosity of spirit are positive examples for all of us.”

Michael McGuffin, president of the American Herbal Products Association, shares Blumenthal's respect and admiration.

"Beyond Dr. Duke's invaluable contributions to the herbal industry, he was a humble man who personified the Southern gentleman," said AHPA President Michael McGuffin. "His sincere passion for understanding how humans used plants as medicine to promote health and well-being helped numerous individuals improve their quality of life using herbs and botanicals. Jim's passing will be mourned by the herbal community, but his work and legacy will not be forgotten."

Duke is survived by his wife, Peggy, and their two children Cissy and John.

Cissy and the family have posted a page honoring the legacy of James Alan Duke, and celebrating his spirit.









Fig Extract Tempers Blood Sugar Surges

By Erik Goldman, Editor

A standardized extract of figs---a fruit rich in a compound called abscisic acid (ABA)—can attenuate blood glucose surges following consumption of sugar-containing foods or beverages.

New Amendment to Hippocratic Oath Stresses Physician Self-Care

By Erik Goldman

WMA LogoIt's been a while since the 2500 year-old Hippocratic Oath underwent a major revision. The last one was in 1964.

But earlier this month, the World Medical Association voted unanimously to amend the venerable declaration to include a statement underscoring the need for physicians to take care of their own health with the same acumen and attention they apply to their patients.

The new clause, authored by a Queenstown New Zealand physician named Sam Hazledine, states: "I will attend to my own health, well-being and abilities in order to provide care of the highest standard."

Hazledine--a physician, entrepreneur, and professional skiier-- says his objective is to draw attention to the reality that burnout, depression, addiction, and physical illness are very common among physicians worldwide, and they are extremely detrimental to the quality and efficacy of patient care.

"This might just seem like small words, but they signify a course-correction for our profession," Hazledine told the New Zealand Herald. "It's not that we have de-prioritised our patients, it's that we have now acknowledged one of the most important components Sam HazledineSam Hazledine, MDto serve them."

The WMA, a sort of "United Nations" of medicine, is comprised of 112 medical organizations worldwide which collectively represent more than 10 million physicians.

At its 68th General Assembly in Chicago, delegates enthusiastically embraced Dr. Hazledine's proposal, and voted to add the self-care clause to the Declaration of Geneva--the modern, secular version of the Hippocratic Oath.

The Oath is used in medical schools worldwide. In some countries it is legally binding, though this is not the case in the US. But for many, if not most physicians, it stands as it has for millennia as the profession's ethical map and compass.

WMA president, Dr. Yoshitake Yokokura says the move reflects the fact that "the life of physicians today is completely different to what it was in 1948 when the original Declaration of Geneva was adopted." That's to say nothing of the vast difference between now and Hippocrates' era!

The revision is a symbolic though important step in empowering clinicians to challenge a sick-care system that is not only abusive to patients but to practitioners as well.






Another Alzheimer's Drug Hits the Rocks

By Erik Goldman

Pharmaceutical fixes for Alzheimer's and other forms of dementia are proving very hard to find. The latest drug failure--Axovant Sciences' once-daily intepirdine--dashes hope in an entire mechanism once thoguht to be important for attenuating dementia.

Help celebrate our 20th year at TPC Forum at the TWA Hotel April 23 at 6pm
Help celebrate our 20th year at TPC Forum at the TWA Hotel April 23 at 6pm