Your Internal Ecology

People as Ecosystems

On this blog, we stress that individuals are not isolated units, and nowhere is this more apparent than in the microbial ecosystem that is the human body. We are in fact hosts to microbial organisms that outnumber our own cells by more than 10 to 1! These organisms can be both helpful, like the species of Staphylococcus bacteria that competitively inhibit pathogenic Staph strains; and they can be harmful, like the C. difficile that causes colon inflammation. The Human Microbiome Project, a $115 million research effort with the NIH, attempts to catalogue the variety of species and genetic material in that very local ecology.  The results have already turned up a startling diversity among the microbiomes of the 250 participants--as well as the conclusion that no two individuals host the same organisms.

You Are What--And Whom--You Eat!

The gut is a particularly important site for microbial life, and the profile of flora there is referred to as the enterotype. A seminal article in a 2011 issue of Nature identified three major enterotypes that occur in humans, though there is recent debate as to whether those types are discrete categories or represent points on a spectrum, along which any individual's gut microbiota may slide over time. Whether static or not, though, it is clear that the composition of gut bacteria plays an important role in metabolism, immunity, and even mental health. The vagus nerve, which connects the brain to the gut (and in fact is the only cranial nerve to innervate the body), may be a connection that future psychiatrists exploit to improve mental health via the gut.

Perhaps unsurprisingly, the enterotype has been shown to vary with diet.  Regular consumption of meat, carbohydrates, and alcohol can alter proportions of various microbial strains.  The diet connection also is apparent in disease states. A 2012 study examining the effects of concentrated milk fats in the Western diet showed that these fats, found mostly in processed foods, "disrupt the delicate truce between the immune system and the complex but largely beneficial mix of bacteria in the intestines."  The imbalance can eventually trigger immune disorders like inflammatory bowel disease.  Conditions like diabetes and obesity are being linked to specific microbial conditions as well, suggesting some hope that health providers could intervene in those disease states via manipulations of gut microbes.

The ingestion of antibiotics is another factor that significantly affects microbial composition. The indiscriminate knockout of gut flora with a broad-spectrum antibiotic triggers an ecological succession event, somewhat like logging in a complex forest ecosystem.  The destruction creates opportunities for pathogenic bacteria to take hold in a less competitive environment.  While treatments with antibiotics in cases of serious infection are often life saving and absolutely necessary, the routine ingestion of antibiotics may undermine the health of an individual's gut ecosystem.

Living Foods

Probiotic foods contain microorganisms that promote a healthy gut ecology.  The recent popularity of these foods reflects a growing public awareness about the importance of eating smart to host good inner bacteria.  Probiotic options include more familiar items, like yogurt and pickles, as well as their exotic cultured and fermented friends--like kefir, kimchi, sauerkraut.  Probiotic capsules are also increasing in availability, and offer a serious doses of friendly bacteria to your gut.

So next meal, think about all the other organisms waiting eagerly to see what's on their plate.  Consider sending them some real food to thrive on--or some probiotic comrades--and see how tending your inner microbial garden improves your health!

Hybrid Farming and a Sustainable Future

             Which is more sustainable: conventional agriculture or organic agriculture? Depending on who you ask, you might receive answers like: “Conventional!  Organic farming uses more acreage and is more expensive in the marketplace”; or “Organic! Conventional farming poses an environmental threat by releasing greenhouse gases, using up water resources, and diminishing biodiversity.” Looking into the future, many scientists favor organic farming for its minimal environmental impact. But questions still remain about whether organic farming can produce enough food to provide food security to the growing global population. In other words, can organic food feed the world?

            A recent study, conducted by researchers from McGill University and the University of Minnesota, seems to raise doubts about the possibility of an organic world food system.  It found that the yields from organic agriculture were generally smaller (25% lower) than those gathered from conventional agricultural practices, especially for cereal crops. However, the yield gap was found to be much smaller for certain crops in optimal growing conditions like legumes (soybeans) and perennials (fruits). In other words, the yield gap between organic and conventional farming varies widely across crop types, species, and growing conditions. At best, organic farming produces a 13% lower yield even when using best management practices.

            With these results, the study suggests that to provide a sustainable, secure, global food system, we will need to utilize many different farming techniques including both organic and conventional farming systems as well as hybrid systems “to produce more food at affordable prices, ensure livelihoods to farmers, and reduce the environmental costs of agriculture.”

            These results are not entirely shocking, but the study does reveal an underlying issue surrounding the debate over organic versus conventional farming. When we look at the question in such black-and-white terms, the real goal--creating a sustainable food system—becomes subordinate to an ideological clash.  Do you believe in saving the environment or creating more food for the growing world population? When determining the benefits of different farming systems, yields and environmental impacts are only a small part of the broader economic, social, and environmental factors that affect farming. Perhaps it is time to begin to see the bigger picture.

“Instead of asking if food is organically grown, maybe we should be asking if it’s sustainably grown,” noted one researcher.  “By combining organic and conventional practices in a way that maximizes food production and social good while minimizing adverse environmental impacts, we can create a truly sustainable food system.”

Pumpkins: More Than Just For Halloween

With Halloween in the air, pumpkin sales are at their peak all around the country. According to the United States Department of Agriculture (USDA), however, the majority of the pumpkins sold to the public in the month of October are sold not for consumption, but for decoration. Pumpkins are used more for carving Jack-O'-Lanterns than for actually eating. The USDA reports that "after October, demand [of pumpkins] drops off drastically…the quantity of pumpkins remaining in retail markets after Halloween is small and is usually non-existent after Christmas". But could a pumpkin be worth adding to your plate, Halloween or not?

Pumpkin in fact packs a serious nutritional punch.  One serving of pumpkin, which is about one cup, contains 100% of the recommended daily consumption of Vitamin A. Our bodies need Vitamin A to maintain proper immune function, vision, reproduction, and cellular communication. It also supports cell growth and is critical in the maintenance of the heart, lungs, kidneys, and other essential organs. One serving of pumpkin also has a mere 20 calories, making it an ideal food for low-calorie diets. Finally, pumpkins contain a diversity of phytochemicals, such as flavonoids, which may contribute to protection against diabetes and cancer, as indicated in the December 2010 issue of “Nutrition Research Reviews”.

            So how can you actually turn that future jack-o-lantern into food? When buying a pumpkin for consumption, select a 2 to 4 pound pumpkin with smooth, unbroken rinds. As with many produce items, the smaller the product, the tastier it is! A ripe pumpkin has a consistent orange color and may seem heavy for its size. Steaming is then an easy way to cook your raw fruit (yes, fruit!). First, cut off the top stem and scoop out the seeds and pulp. Next, cut it in half and cut it length wise into strips that are about 2 inches wide. Steam for 12 to 15 minutes until a fork goes easily through the pulp to the skin. Now, your pumpkin can be used for make soup, mashed pumpkin, or any other recipe you desire!

Like most Americans, it is likely that you have bought a pumpkin with the intention to carve it in celebration of Halloween. Rather than tossing the pulp and seeds, why not use them to provide your body with the many nutrients they contain? The pulp of the pumpkin can be cooked and used in cooking or baking. Pumpkin seeds can then be toasted in the oven with a tablespoon of oil and a pinch of salt to give you a crispy, healthy, and most of all, delicious snack!

Enjoy your pumpkins, and Happy Halloween!

100% Organic by 2022

            Refreshing news out of the small, Himalayan country of Bhutan yesterday:  the agricultural industry aims to be entirely organic in the next 10 years.  Bhutan’s primary crops are oranges, apples, rice, and potatoes, and while only a small portion of the country’s mountainous and forested landscape is farmable, about 80% of the population relies on agriculture as their source of income.   Such a progressive goal is hardly surprising coming from a country that values Gross National Happiness over Gross National Product, but it is reassuring to see that the reasoning behind setting such a goal is rooted in science as well as an effort to keep Bhutan competitive within the agricultural industry without compromising traditional farming techniques and biodiversity.

There is plenty of science to support the fact that organic and “non-conventional” farming practices, such as the avoidance of synthetic pesticides and fertilizers, crop rotation, and use of compost enhance soil quality, increase plants’ ability to sequester carbon and recycle nutrients, reduce erosion, and increase productivity.  A wonderfully comprehensive study produced by the Organic Farming Research Association in August 2012 explains that not only are organic farming practices better for the environment, but also for businesses - organic products are in demand and the organic agricultural sector has experienced consistent growth for the past decade.  Critics often argue that organic agricultural practices cannot produce as great a yield as conventional farming techniques, but a study published in Nature in May of 2012 scoured literature on organic farming to show that disparities in productivity are often contextual and that  organic practices can in fact be competitive with conventional methods provided the conditions are right.   Bhutan and the US are certainly operating on a different scale in terms of the agricultural industry, but what if our government set such a goal?  Something to keep in mind as we approach Election Day!  Where does your candidate stand on the importance of organic farming practices?

Should You Take Your Vitamins?

Multivitamins, the most common dietary supplement in America, are taken by at least one-third of US adults and account for billions of dollars of spending each year. Two weeks ago, the Journal of American Medical Association published a study that found taking a daily multivitamin supplement reduced the incidence of cancer by 8%.  

13,641 male doctors over 50 participated in the 11 year prevention study, which was the largest of its kind. Although statistically significant, the 8% reduction did not apply to any specific kind of cancer or cancer mortality – rather, it affected total cancer rates.

The study made headlines not only because it was the largest of its kind, but because it’s good news for the vitamin/supplement industry. Past studies including a meta-analysis published in JAMA and a 2009 multivitamin study of women failed to find any statistically significant correlation between vitamins and chronic disease. Although some may be skeptical, there aren’t many other studies out there that have shown to reduce cancer risk by almost 10%.

So is it time to run to your nearest GNC? Maybe not. Remember, this study only looked at men over 50 – and the findings can’t carry over to young men or women, or even older women, for that matter. Also, the American Cancer Society continues to recommend getting your nutrients from a healthy diet, rather than from supplements. But, if you do choose to take supplements, it seems (at least at this point) that multivitamins may be your best bet.

Today is Food Day!

Food Day 2012

October 24 marks Food Day--"a nationwide celebration and movement for healthy, affordable, and sustainable food."  This event comes from the Center for Science in the Public Interest (CSPI).  Food Day looks for organizations to host events, so hopefully by the time next October 24 rolls around, we will have our own events to participate in the celebration!

Food Day Events in Boston

Boston hosts many events, including over 200 schools committing to "Eat Real!" on October 24, nutritional workshops, Cabot creamery food samplings at Shaw's, and farm-to-table restaurant dinners.  Some events that caught our eye:

• dinner at Harvest Restaurant in Cambridge (Oct. 24, 6-8pm, reservations required)
• Harvard Sustainable Food Project film & discussion (Oct. 24, 7-9pm) at the PHBA Parlor Room
• the Boston Vegetarian Food Festival (Oct. 27-28)
• cider sampling and apple sale at Brookline Town Hall Plaza (Oct. 24, 12-3pm)

You can also always make your own commitment to eating good food on October 24 and beyond!

Cooking with Cauliflower

A Beautiful Brassica

While the fields may seem bare in winter, there is in fact a bounty of flavorful, fascinating produce to be discovered.  One of the more familiar winter items is the cauliflower.  This veggie hails from the Brassica genus, which includes broccoli, turnips, and radishes.  The brassicas are also known as cruciferous vegetables, referring to the cross-like (crucifer, cross-bearing) arrangement of the flower petals.

Cauliflowers are notable for the fractal patterning of the "curds," the small flat flowers that constitute the traditionally white head.  Often, to preserve the whiteness of the head, farmers will "tie" the plants, fixing the outer leaves over the top to prevent the dirt or sun from compromising the pure color that consumers seek.  While you may be used to white varieties of the plant, cauliflowers in fact come in orange, purple, and green cultivars as well.  All these plants prefer cooler weather, which explains their place in a winter CSA.

Nutritional Profile

The health benefits of cruciferous vegetables like the cauliflower abound.  The consumption of these items have been linked to lower rates of cancer, presumably through the activity of sulforaphane, a glucosinolate phytochemical that induces anti-cancer enzymes (the transcription of tumor suppressor genes).  They also have been shown to decrease oxidative stress, the buildup of free radicals that has been linked to cancer and cardiovascular disease.

One cup of cauliflower has only 26 calories, but 86% of your daily vitamin C, 21% of your vitamin K, and 15% of your folate.  The vitamin C contributes to the antioxidant properties of cauliflower, as well as promotes immune system function.  The vitamin K is critical to blood clotting function; but it is also a reason to avoid cauliflower if on blood thinners for stroke prevention, since the "K" comes from the German word "Koagulationsvitamin" (coagulation vitamin).  The folate, or folic acid, promotes healthy red blood cell formation and fetal development, making it one of the most widely consumed prenatal vitamins.

Playing with Cauliflower

Cauliflower is a versatile vegetable, and can often be used as a lower-starch replacement for potatoes in many recipes.  Turning the bulky white head into a pile of (relatively unmessy) florets can be a challenge, though.  We recommend cutting the head into quarters with a knife before attempting to break off the individual pieces.  As with any of the harder raw vegetables, it's a good idea to try to make pieces more or less the same size prior to cooking, so that each piece cooks through an equal amount.

Once you have the florets collected, you can always just call it a day and eat them as they are.  Cauliflower is a staple of any raw veggie platter, and goes well with a variety of dips and sauces.  Alternatively, you can include the florets in a sautee.  Steaming and boiling tend to overcook cauliflower, making it mushy for any stand alone dish.  However, that mushiness can sometimes be harnessed to thicken soups and stews.  Overboiling cauliflower in a soup, and then submitting the concoction to a stick blender or energetic spoon-wielding cook, can turn a pot of boiling winter veggies into a hearty, creamy winter soup.  Throw in a bit of cheddar cheese, and you have a perfect one-bowl meal for a cold night in.

Boston Parklets: Concrete Jungles No More!

by Maria Barsky

A park that can fit in your pocket

Urban jungles have been traditionally void of greenery, with the exception of that one city park. Recently, however, there has been a push to provide city dwellers with oases of nature, or pocket parks. In a proposal to create miniparks all over the city next spring, Boston’s mayor Menino has declared that "the car is no longer king in Boston." The parks are cheap to maintain and continue in the spirit of improving our neighborhoods. Cities like New York and San Francisco have already begun to create these nature sanctuaries.  And besides being adorable and aesthetically pleasing, studies show other benefits to even miniature exposures to nature.

Cute, and good for you too!

A rooftop parklet

The parklets in mind won't necessarily be outdoor health clubs, or give residents the chance to chisel themselves a hot bod; after all, few of us are willing to circle one hundred laps around the park square to run that one mile. However, there has been substantial evidence that even a little greenery in a neighborhood impacts the mental capacity and health of inhabitants. Horticultural therapy is used today in community-based programs, geriatrics programs, prisons, developmental disabilities programs, and special education.  Terry Hartig, a professor of environmental psychology at Uppsala University in Sweden, explores the link between greenery and mental health. In one of his studies, he performed tests designed to mentally exhaust participants; he then asked them to take a 40 minute walk through nature, a 40 minute walk through an urban area, or to sit quietly and read magazines. Afterwards subjects were asked to perform a mental test. Subjects that took a walk through nature performed better on the task.  We wonder what results would have come from a group sitting quietly in nature--controlling for the exercise variable and thus exploring the impact of greenery alone on mental functioning.

A study of the Philadelphia campaign to increase pocket parks by Branas et al. demonstrated lower levels of stress in occupants of neighborhoods with more greenery; the study was controlled for socioeconomic factors.  Kuo et al. performed a similar study involving parents of 96 children diagnosed with ADHD, which found that the greener the play environment, the better the children's functioning. Another researcher, Kathleen Bagot  summarizes many of the European studies  done on urban greenery projects: “European studies show that children tend to be stronger, more flexible, and have better motor coordination skills and balance from playing in forest-like playgrounds compared to asphalt ones.”

Kuo study also examined the effect of vegetation on crime. Kuo’s research focused on the housing projects of Chicago. She found that compared with housing blocks that had little or no vegetation, housing blocks with high levels of greenery had 48 percent fewer property crimes and 56 percent fewer violent crimes. Branas also showed a reduction in gun assaults and vandalism in the areas of Philadelphia that were “greened”.

Not all results are positive; studies of the pocket parks in Houston showed no significant reduction in crime in neighborhoods with pocket parks. However, there was a greater perception of safety in the neighborhoods with greenery. One aspect ignored by these studies is the variety of vegetation in the mini-parks. A recent study demonstrated that gardens with more biodiversity are superior to the more monotonous one-plant gardens.

Take home message

Local governments are finally starting to realize that urban environments could house lush inlets of nature.  These parklets are not the answers to all our health and societal problems, but there is substantial evidence that they can make us happier.  More importantly, these initiatives from our governments can inspire us to create parklets of our own. 

So feeling sad?  Find a patch of land, no matter how small and create your personal pocket park.  All that digging and planting might give you that hot bod after all.

Learn more about urban greening:

http://www.metro.us/boston/boston/article/1153967--boston-paving-the-way-for-parklets

http://bostoncompletestreets.org/whats-new/mayor-menino-seeks-parklet-designs/

http://sfgreatstreets.org/wp-content/uploads/2011/06/ParkletStudy_InitialConditions.pdf

http://depts.washington.edu/hhwb/Thm_Crime.html

http://www.nytimes.com/2009/12/13/opinion/13prochnik.html?_r=0

http://www.communitygarden.org/docs/learn/articles/multiple_benefits.pdf

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=17504734&dopt=Citation

http://eab.sagepub.com/content/33/3/343.short

http://www.apa.org/monitor/apr01/greengood.aspx

http://www.eastshorepark.org/benefits_of_parks%20tpl.pdf

Take a Bath in the Forest

Nature Deficit Disorder

Many of us spend our days fundamentally separated from nature.  We work indoors, tracking time by the perpetual circling of the hands of the clock, and following the seasons by the cycle of Starbucks specials.  The demands of working life progress independently of any natural rhythm--and even when brief escapes afford us the chance to notice some resilient natural presence in our lives ("Oh right, I'm part of a large, complex, magnificent network of living things!"), it is all to easy to fade back into the grey of indoor life.

In Last Child in the Woods, writer Richard Louv coins the term "nature deficit disorder."  NDD describes this very phenomenon of our alienation from nature, and orients it in relationship to contemporary epidemics of behavioral problems, mood disorders, and obesity.  While Louv's book focuses on children, many adults can read his work and identify with the alienation from nature and impacts he describes.  Perhaps NDD is at the root of our feeling drained after the workday, of a sense that we are somehow always falling short of truly thriving.  The conclusion seems simple then--anyone wandering around with NDD can just go outside, right?  And yet few conventional resources exist for individuals who suffer, knowingly or not, from nature deficit.  Those who seek medical care for their symptoms are often recommended drugs or therapy; those who do not are in effect penalized for their inability to participate as efficiently as possible in a production-oriented society.  Even those who may vocalize their need to restore meaningful connections with nature are hampered by 9-to-5 office work schedules, or dismissed as somehow less serious or hardworking than their stressed out, fluorescent-lit superiors.

Shinrin-yoku

In Japan, spending time outdoors is an accepted recommendation for healthy living, captured in the concept of "shinrin-yoku."  Shinrin-yoku translates as "forest bathing," and describes the regular practice of going to a natural area to rejuvenate both mentally and physically.  In a 2010 study, Tsunetsugu et al. summarize the existing research on how the sensory environment of the forest affects physiological markers like salivary cortisol levels, blood pressure, and immune system activity.  While the paper cedes that many of this existing work has been small scale, the Society of Forest Medicine organizes Japanese M.D.s and Ph.D.s to continue exploring these effects of shinrin-yoku on a more ambitious level.  Pursuing similar leads, researchers within the U.S. also are turning to nature as a powerful therapeutic tool, looking at how exposure to nature decreases mental fatigue, improves recovery post-surgery, and supports more complex psychological experiences of nonduality and transcendence.

In the context of this growing evidence, there seems to be a great deal of potential in advocating shinrin-yoku for patients exhibiting signs of nature deficit disorder.  Certainly our traditional medical practice could accommodate prescribing nature walks in a serious way, in conjunction with whatever treatments are presently indicated for NDD symptoms.  As treatments go, getting outside is certainly a low cost option, and one that could be initiated without much risk even while more robust empirical evidence accumulates.  So while we may not leave the doctor with a prescription for nature anytime soon, we certainly are in a position to try it ourselves.  We can drive to a local farm, to conservation land; we can walk to one of our community parks.  If we take responsibility for scheduling ourselves some nature baths, we may find ourselves pleasantly surprised by how refreshed we feel.

Does Lifestyle Intervention Matter?

The NIH Look AHEAD Study

A recent update from the NIH Look AHEAD study, a long-term lifestyle intervention trial for obese patients diagnosed with Type 2 diabetes, concluded that the intensive interventions did not impact outcomes for cardiovascular events and deaths.  The "surprising result" made headlines in the New York Times and other news organizations.

The official NIH statement described how 11 years of lifestyle intervention resulted in an average 5% weight loss for participants, but no associated decrease in rates of heart disease, stroke, heart attack, and cardiovascular-related deaths.

Results in Context

While results like those from the NIH study may initially seem discouraging proponents of lifestyle change, there are several considerations that put the results into context.  First of all, the "meaningful weight loss" achieved by the study was only 5% of initial body weight for the overweight and obese participants.  For an overweight individual, clinically defined as having a BMI greater than 25, that may mean dropping from 170 to 161.5 lbs (if you are 5'7"); for an obese individual, whose BMI exceeds 30, that weight loss could be going from 200 to 190 lbs (also based on being 5'7").  These decreases in body weight are laudable, but in neither case constitutes sufficient weight loss to be no longer considered overweight or obese, respectively.

Put this way, the results of the study could be interpreted in two ways: 1) that the lifestyle intervention maintained over the course of the study was not intensive or perhaps efficient enough to produce significant weight loss, which was the factor directly impacting cardiovascular risk; or 2) that intensive weight loss effort is futile to pursue past a certain threshold in patients who have progressed to the full diabetic disease state.  Since the NIH protocol defines its interventions by low-fat diet and increased exercise, we wonder whether the nature of prescribed diet (for which the primary option was two meal-replacement shakes and a frozen dinner entree) and types of exercise (175 minutes/week) may have been too narrow a program for "lifestyle intervention."  Also, we worry whether characteristics of full-blown diabetes actively undermine the efficacy of certain interventions--a conclusion that would impact the seriousness of the diagnosis, and necessitate intervention prior to diagnosis all the more.

Of course, the cardiovascular outcomes are only one metric for assessing the value of lifestyle intervention.  Other dimensions of health, such as mobility, mood, sleep, and overall quality of life may respond in a more encouraging manner to sustained lifestyle change in diabetic individuals.

Welcome!

Welcome to the Nourish Boston Blog!

We are diving in right away with our blog!  This site will offer followers the chance to update on our organizational news, current research in health and sustainability, recipes, Boston area events, and other materials related to our effort.