Dark Leafy Greens: What You Should Know

The three words “dark leafy greens” are used so frequently in the health and wellness world that they roll off the tongue for most people. But what counts as a dark leafy green? What’s a health conscious person to do if they don’t like kale? Are the other leafy greens just as good? Here are some useful facts about this powerful category of foods.

Benefits of Dark Leafy Greens

For those who aren’t exactly sure why dark leafy greens are so commonly recommended, let’s break down their importance. These vegetables are high in fibre and rich in vitamins (like A and C) and minerals (like magnesium and iron), antioxidants and other plant chemicals. This makes them great for regulating bowels, reducing the risk of cancer, preventing nutritional deficiencies, reducing inflammation, improving mental health and improving overall health. Ideally, they should be eaten on a daily basis.

Examples of Dark Leafy Greens

In general, one dark leafy green isn’t necessarily superior to the rest. You can get benefits from all of them because many share similar nutritional properties. Consuming a variety of them can help ensure you maximize your benefits. Let’s explore some easy-to-use options.

Bok Choy: This is a cruciferous vegetable and a type of cabbage. It’s a great option to add to stir fries. 

Spinach: Both regular spinach and the immature form (baby spinach) can be used in salads and stir fries. You can replace iceberg lettuce in sandwiches with spinach to get more of a nutritional boost.     

Romaine Lettuce: This is another more nutrient-dense alternative to iceberg lettuce. It works great in salads and sandwiches. 

Swiss Chard: The leaves of Swiss chard and the colourful stalks can all be eaten. They are great cooked into stews, soups and stir fries. The leaves work well in salads too.

Kale: Kale is also a cruciferous vegetable. Its rise in popularity is a bit of a mystery and may be related to clever marketing and the power of food trends. That being said, it has the hallmark nutritional benefits of dark leafy greens (iron, vitamin A, vitamin C, other antioxidants, magnesium, fibre etc.). 

Disadvantages of Dark Leafy Greens

Dark leafy greens can be hard to digest for some people. Those with irritable bowels and bloating may struggle with these vegetables. Cooking them by steaming or stir frying or adding them to stews and soups can make them easier to digest. The question of whether vegetables are better raw or cooked is a complicated one that depends on the nutrient we’re considering and the cooking method. Many nutrients are actually better absorbed when cooked. Cooking with a minimum amount of water (like steaming) helps to prevent nutrients from leaching out into the water. Consuming the liquid that vegetables are cooked in (like in the case of stews) helps you to get back some leached out nutrients.

Dark leafy greens like spinach are often on the “dirty dozen” list meaning that they are high in pesticides. Getting these in organic form whenever it is financially realistic can be a way to reduce pesticide load.

Do you have any nutrition questions? Don’t hesitate to reach out! I love chatting with readers. 

Why It's Hard To Change Our Diets (And What To Do About It)

“I know what I should be eating but I can’t motivate myself to do it!” This is a common complaint I hear from patients. 

I want to first start off by reminding anyone who struggles with this to go easy on themselves. Food is a great source of comfort to people and carbohydrates and fats are fuels that our bodies are wired to gravitate towards. 

There are a number of underlying factors that could be contributing to this struggle. Below are just a few. 

Your Relationship With Food Needs Help  

If you constantly feel like you are trying and failing with some sort of weight loss diet (keto, paleo, sugar free etc.) the root issue could be that you have a negative relationship with food and body image. This could trap you in a perpetual state of hating your body, placing challenging demands on yourself to restrict food, feeling overwhelmed and eventually giving up on your diet plan. If this is the case, we need to work on healing this relationship with food and the body - something I love helping patients with.  

You Need Support With Anxiety Or Depression 

It’s hard to make food choices that nourish our bodies when our mental health is not in a great place. When we feel anxious, worried or down, we tend to want something that gives us a quick boost in mood. Foods higher in sugar, fat and salt can trigger more of a reward response in our brains - especially if we associate these types of foods with happier times. The root of the issue here may be that underlying anxiety, stress or depression is not being dealt with. Cravings may be a sign that your body needs some support with mental health - a topic that I’m passionate about.  

You’re Burnt Out 

When you’re depleted of energy and exhausted, the thought of preparing home cooked foods or even grocery shopping can be overwhelming. If you wish you could eat more fresh or home cooked foods but can’t muster the energy to do it, work on getting some help with addressing the fatigue. Fatigue can be caused by a number of things including hormonal imbalances and nutrient deficiencies. 

Food is a big deal. It’s a source of nutrition as well as joy and comfort. Don’t beat yourself up if you can’t craft your diet into a state of complete perfection (which is defined differently by everyone anyways). If you struggle with exploring a new way of eating that you’re interested in, rather than berating yourself for not having enough willpower, address the barriers that are getting in the way.  

B Vitamins for PMS

Premenstrual syndrome can take over a large portion of your life. If you experience negative symptoms for a week every month, that’s a quarter of your year spent feeling unwell! Some women experience physical symptoms like bloating, fatigue, water retention, headaches, cramps and breast tenderness. Some experience emotional symptoms like irritability, depression and anxiety. Many deal with both.   

It’s not clear what exactly is going on in the body when you experience PMS. It likely has something to do with hormones produced in your ovaries (like estrogen and progesterone) as well as brain chemicals like serotonin.

Research on B Vitamins

B vitamins have so many different functions in our bodies. They help to produce and metabolize neurotransmitters (brain chemicals that govern our mood and behavior). They also affect our hormones. 

An interesting study was published by the American Journal of Clinical Nutrition about B vitamins and PMS. It found a link between eating more B vitamin rich foods and reduced PMS symptoms. There are many different B vitamins but this study found significant benefits with B1 and B2 in the diet. 

Thiamine and Riboflavin

Vitamin B1 is called thiamine which is high in certain fortified grains, black beans, fish (like trout, tuna and salmon), beans (like black and navy beans), acorn squash, peas, asparagus etc. Vitamin B2 is called riboflavin which can be found in fortified grains, dairy products like yogurt and milk (interestingly, calcium also improves PMS), almonds, chicken, quinoa, spinach, apples, eggs etc. Note: this is not a complete list. 

The study found that foods rich in B1 and B2 needed to be consumed multiple times a day in order to see benefit. So many busy women find it hard to prioritize food. You may be eating some of these foods but it might not be often enough or a large enough quantity to get the benefits you’re hoping for.

Non-Diet Solutions

For those who struggle with diet, B vitamins in supplement form have been shown in other studies to provide some PMS relief, with certain ones being more promising than others.

There are pharmaceutical treatments for PMS like contraceptive pills and antidepressants but many women are interested in learning about how they can change their daily habits to manage PMS. This study is a great example of the power of nutrition for managing women’s health issues. 

If you would like to learn about foods that can help with symptoms of anxiety, be sure to sign up to get my free anxiety-soothing food list emailed to you.

Caffeine in Green Tea

People ask me all the time about the caffeine content of different beverages. Some people are really sensitive to caffeine and notice a major change in anxiety and sleep patterns from just a small amount. Others are less sensitive. Both coffee and green tea can be a source of comfort and enjoyment for a lot of people and they both have some health benefits.  

How Much Caffeine is Too Much?

Health Canada recommends that adults limit their intake of caffeine to no more than 400 mg of caffeine daily. This amounts to about 3-4 cups of brewed coffee assuming that each cup is 8 oz. This limit is lower for pregnant people and children/teens. Of course, the caffeine content of a beverage varies widely depending on how it’s prepared.

How Green Tea Compares

Green tea usually has less caffeine than coffee. While 8 oz of brewed coffee can have 95-135 mg of caffeine, 8 oz of green tea has about 30 mg. Decaf coffee is not completely caffeine free but it usually has less than 5 mg per 8 oz. Decaf green tea usually has little to no caffeine.

Take a look at your caffeine intake and calculate how many milligrams of caffeine you consume in a day!

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My Favourite Meatless Meals

A number people ask me about how they can moderate their meat and animal product intake and try more vegetarian or vegan meals. I incorporate a lot of vegetarian or vegan meals into my diet. Meatless meals are a pretty popular topic right now. There are so many new meatless food creations out there. My personal preference is to keep my meals full of whole foods that are not heavily processed and that are affordable. It’s also important that vegetarian meals contain an adequate amount of protein.  

Below are four of my go-to vegetarian/ vegan meals.

Vegetarian Chili by The Endless Meal

https://www.theendlessmeal.com/easy-vegetarian-chili-recipe/

This chili is super filling and flavourful. I add a third can of beans to increase protein content and add extra texture.

Kale Lentil and Quinoa Stew by Detoxinista

https://detoxinista.com/lentil-kale-quinoa-stew-vegan/

I assumed this recipe was going to taste boring because quinoa and kale aren’t my favourite foods but it’s actually delicious. This recipe is pretty perfect as is so I don’t modify it. I use regular canola oil if I don’t have coconut oil on hand.

Vegetable Panang Curry by Contentedness Cooking

https://www.contentednesscooking.com/vegetable-panang-curry/

I make a bunch of substitutions to this recipe to make it easier and to suit my preferences. I replace the mixed vegetables with a whole bok choy. Instead of using 4 tbs of red Panang curry paste, I just use a whole bottle of Thai Kitchen’s red curry paste (112 g). Out of the optional ingredients, I use cashews (I just throw them into the pot without cooking them in the way the recipe says) and maple syrup (but it tastes fine without maple syrup too). For added protein, I toast two containers of medium firm tofu on the side, seasoning with soy and Worcestershire sauce, and add them to the pot towards the end of cooking.  

Mexican Quinoa by Damn Delicious

https://damndelicious.net/2014/04/09/one-pan-mexican-quinoa/

For this recipe I use regular diced tomatoes (instead of fire roasted), regular salt and no jalapeno or cilantro and it still tastes great.

The Indian/ West Indian diet that I grew up with is full of protein rich vegetarian meals. I hand wrote these recipes while my mom taught me how to make them (and I’m still working on getting them to taste as good as her versions), but I’d be happy to share the recipes with anyone!

As we’ve all heard before, food can be medicine. To learn more about the connection between food and your mood, read my article on this topic by clicking HERE.

Anti-Aging Foods for Your Skin

I’m going to take a detour from my usual posts about mental health and focus on another area that I work with: skin health. Since I do facial acupuncture regularly, I often get asked what foods can promote anti-aging. More and more people want to work on skin anti-aging from the inside in addition to working on it from the outside. Research in this area is still growing but the good news is that most of the dietary recommendations that reduce aging in the skin are also good for your overall health.

One study done in 2007 on 4000 American women in their 40s-70s found that women who had a higher dietary intake of vitamin C had fewer wrinkles. Some good sources of vitamin C in the diet are citrus fruits (obviously), bell peppers (any colour), guava (a very rich source), rosehips and blackcurrants but vitamin C is found in many other fruits and vegetables.

This same study also found that women who ate more linoleic acid in their diet were less likely to experience the drying out and thinning of the skin that often happens with age. Linoleic acid can be found in things like vegetables oil, nuts (like walnuts), seeds and soybeans.

A more recent study done on about 3000 Caucasian women ages 45-60 found that higher dietary intake of alpha linolenic acid (ALA) and EPA was associated with fewer signs of aging in the skin. These are both omega-3 fatty acids. Flax is a great source of ALA but this fatty acid is also in walnuts and soy as well as some other foods. EPA is mainly found in fish – especially anchovies, mackerel, oysters, salmon and whitefish.

High fruit and vegetable consumption in general helps slow aging of the skin. It’s hard to find studies on what fruits and vegetables have been shown to be useful. Some sources recommend things like avocados, dark leafy greens, berries, orange vegetables like sweet potatoes and carrots and pineapples.

Things you should consider limiting in your life to keep your skin youthful are sugar, alcohol and excessive caloric intake. These things are popular in the anti-aging research right now.

If you would like to learn more about how naturopathic medicine can help you age well book a free 15-minute consultation today.

Vitamin B12: What You Should Know

Having enough B12 can make a big difference in how well you feel. Here are some quick facts about vitamin B12 that you should know about. Knowledge is power - especially when it comes to your health.  

Dietary Sources

Animal protein like fish and meat

Dairy and eggs

Fortified foods and drinks (e.g. some soy-based meat substitutes and beverages)

Signs and Symptoms of Deficiency

Note: you don’t have to have all of these symptoms to have low B12 levels (you don’t even have to have any of these symptoms).

Fatigue

Abnormal CBC results with blood work – this is often the first way that a B12 deficiency is discovered

Heart palpitations

Tongue inflammation

Pallor  

Changes in the skin like loss of pigment or darkening  

Potential impacts on fertility

In more severe cases it can affect the nerves (numbness, tingling), cognitive function and memory

Who’s Most at Risk for Deficiency

Note: Even if you don’t check off anything on this list, you could still have a deficiency. Also, being at risk does not mean you will definitely have a deficiency.

Patients with stomach and colon issues (e.g. surgeries, auto-immune gastritis, inflammatory bowel disease)

Those using certain medications: metformin, some medications for GERD or stomach ulcers

Vegans and vegetarians

Adults over 50-75 years old

Patients with an H.pylori infection

Testing and Results

The “normal” level for B12 varies widely between countries and even depending on which lab you go to! Anything below 150-220 pmol/L could be considered low. But sitting right at the bottom of the normal range doesn’t feel great for many people. I usually like levels to be comfortably above the low end of the reference range.   

Testing B12 isn’t excessively expensive. If your MD tests it, it’s usually covered by OHIP. If I test it, it’s either covered by your workplace/ private health insurance or it’s around $20 out of pocket.

Note that measuring B12 in the blood isn’t a perfect science. If your levels are normal or low-normal but a deficiency is still suspected, other testing may be warranted to confirm deficiency (i.e. testing methylmalonic acid or homocysteine). This extra testing is on the pricey side.  

Supplements: Oral Versus Injection

In many cases oral supplementation is just as useful as injections. But injections can have faster results and some people only seem to respond to injections. I wouldn’t consider injections as first line in most cases.  

I’m all about getting our nutrients from the diet over supplements but in the case of B12, absorption is often better via supplements than food. So if you’re deficient, supplements may be the way to go. Many B12 products come in a form that you dissolve under the tongue. We don’t know for sure if this is better than swallowing the pill.  

How Long Until You Feel Better?

Many patients feel better within a week of taking B12 but just because you don’t, doesn’t mean you should stop taking it. It can take several weeks (even a couple months) for CBC blood test results to normalize and for symptoms to improve.

For a free list of foods linked to lowering anxiety, click the link below.

Can This Diet Help Your Anxiety?

Treating anxiety is never a one-solution problem. But every useful strategy that we incorporate into a treatment plan can bring you one step closer to better managing your mental health. Diet is one strategy that is often overlooked in anxiety cases.

Two studies published earlier this year explore how the Mediterranean diet impacts anxiety and depression. A study published in Nutritional Neuroscience looked at over 3000 adults and found that those who adhered most closely to a Mediterranean diet had lower odds of psychological disorders like anxiety and depression compared to those who did not follow the Mediterranean diet closely.

But what part of this diet is really the most helpful for mental health? A study published this year in the European Journal of Nutrition aimed to answer this question. It was found that having more non-refined grains (e.g. whole grains) and more fruits and vegetables were associated with lower severity of depression, anxiety and fear.

An older study found that the DASH diet was associated with lower odds of anxiety and depression. The DASH diet has a lot of similarities to the Mediterranean diet. It involves high intake of fruits, vegetables, nuts, legumes and healthy grains and limitations on dairy, sweets, sodium, red and processed meats. Other older studies looking at various populations around the world have come to similar conclusions with the most common pattern being that more fruits and vegetables and less refined grains are important. The overall pattern of the diet is likely important too.  

At this point, there are not enough studies where researchers actually put depressed and anxious people on these types of diets and monitor their symptoms. Nutrition is complicated and difficult to study in this way, but fingers crossed we’ll get more positive trials like this in the future.

A good diet plan needs to incorporate your personal preferences, your schedule and your lifestyle. I always discuss diet with my patients when managing anxiety and depression. I often connect patients with local dietitians who can help them see what their meals will look like if they incorporate certain changes into their diet. It takes teamwork and multiple different strategies to thoroughly address mood disorders. Thorough treatment is what you deserve.