Could You Be Allergic to Avocados?

As a dietitian working in a gastroenterology practice, meeting patients with chronic acid reflux and irritable bowel syndrome is my stock-in-trade. I can recognize the symptom patterns from a mile away, and have developed a sixth sense for what dietary remedies will work for whom.

But over the course of my career, there have been a small handful of patients who arrived at my doorstep with a diagnosis of GERD or IBS but differed from the rest of the pack. On the face of things, their symptoms matched those of everyone else: heartburn, chest tightening, bloating and/or urgent trips to the bathroom triggered by an offending food. But these patients were different.

For starters, they didn’t respond at all to any of the usual dietary remedies. The people with heartburn attacks weren’t provoked by onions, garlic, fatty foods or giant salads – nor did their symptoms respond to the usual acid-suppressing medications. Instead, they were reacting to seemingly random triggers like pumpkin cinnamon scones, cooked spinach and avocado toast.

Similarly, the folks with IBS-like attacks of diarrhea weren’t provoked by the usual culprits like ice cream, fried foods and salads. Instead, they were reacting to leftovers reheated for lunch, tomatoes and soy sauce. And frustratingly, they didn’t get any better from the most effective remedies for IBS like soluble fiber supplements, low-FODMAP diets or prescription medications.

So what looks like IBS and GERD, acts like IBS and GERD, but isn’t IBS or GERD? In these cases, it turned out to be a histamine intolerance.

Histamines are natural signaling chemicals that our bodies produce and use for all sorts of purposes. They play a role in the release of stomach acid and produce the swelling and inflammation essential to our immune system’s ability to heal infections. Of course, when we produce too much histamine – like in response to seasonal allergens – it can provoke unpleasant allergic symptoms like runny noses, sneezing and congestion. (This is why antihistamine medications are used to treat allergy symptoms.) High histamine levels can also cause itching, hives, headaches and asthma-like symptoms.

Some foods like spinach, soy, avocados, pumpkin and tomatoes are naturally high in histamines as well. Other foods develop histamines as a byproduct of aging, fermentation and spoilage. Leftover meat, beer and wine, aged cheese, cured meats, kombucha and yogurt fall into this category.

So what happens if someone – particularly someone whose histamine levels already run high as the result of seasonal or environmental allergies – starts eating lots of high-histamine foods? In come cases, they may experience an inflammatory reaction within the digestive system that produces symptoms very similar to IBS and GERD: chest tightening, heartburn, bloating and/or sudden onset diarrhea. Typically, the symptoms kick in within minutes of eating an offending food. This is called histamine intolerance.

It can be tricky to spot histamine intolerance, because your food reactions may vary based on season – worse in spring and fall; relatively better in winter and summer. You may not react to a small portion of a high-histamine food – leading you to believe it’s safe – or you may react more to certain high-histamine foods than others. If you’ve had traditional allergy testing with blood, it’s likely that none of your trigger foods will have registered as problematic. (But if you’ve had skin prick testing, the histamine control will likely have produced a gigantic wheal!) And unless you know what these seemingly random trigger foods have in common (a high amount of histamine), you’ll be left scratching you head as to why these attacks of digestive distress seem to come on out of nowhere.

But as complicated as identifying histamine intolerance can be, the solution is easy and effective: a low-histamine diet. The basics are below:

• Avoid foods naturally high in histamine: spinach, avocado, tomatoes (including ketchup and marinara sauce), pumpkin, eggplant, soy foods, brewer’s yeast and kidney (red) beans.
• Do not eat leftover meats or fish, and freeze fresh meats or fish until you are ready to thaw and cook them.
• Avoid fermented, cured or cultured foods: wine, beer, aged cheese, smoked fish, salami/prosciutto/pepperoni, kimchi, sauerkraut, kombucha, miso, tofu, soy sauce, yogurt and kefir.
• Watch out for vinegar-containing foods and condiments, including pickles and olives.
• Watch out for certain spices: cinnamon, chili powder, cloves, nutmeg and curry powder.
• Avoid foods that use sulfites as a preservative, like wine, dried fruits, certain frozen potatoes or seafood, shelf-stable lemon and lime juices, and frozen grape juice concentrates.
• Stay away from foods with artificial colors and chemical preservatives like BHA/BHT.

While there are additional foods (like certain fruits) that may trigger histamine release, the list above is a great place to get started. A registered dietitian who’s familiar with the low-histamine diet can help you home in on a meal and snack repertoire that helps keep your symptoms at bay. A great allergist/immunologist may also be able to devise a histamine-controlling medication regimen that allows you to comfortably expand your dietary repertoire.

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1-Hour Quick Pickled Onions

A few weeks ago, a listener left a comment one of our podcast episodes. In that episode, we recorded right from the kitchen of Jeanine of Love and Lemons, where she and I made a meal out of what was on hand in her refrigerator. It was a take on scrambled egg tacos, a non-recipe that’s pretty simple to whip up. We topped it with bright pink slivered onion slivers Jeanine had in her fridge. And, like any good taco, we added lots of hot sauce for good measure.

It was this episode where listener Amanda commented that she was planning to use the podcast in a lesson on meal planning with young adults. Turns out she’s a plant-based nutrition educator at a residential treatment facility that believes in food as medicine, or the power of food to heal. She teaches her students about eating lots of plants and how to cook, which helps them to be successful and stay healthy after they leave the program. How cool is that? I just heard back from Amanda about the class this week, and she said the class was successful. The students listened to Jeanine and I rifling through her fridge and deciding to make tacos with what was onhand. She showed them this picture of the final dish, so they could see what resulted was beautiful and delicious-looking. And she had them do an exercise creating an imaginary meal out of 4 leftover ingredients. However, she did mention that they weren’t too sure about the pickled onions.

It reminded me that pickled onions might need a little selling. Why make pickled onions? First of all, flavor: they bring a tangy brightness to a dish that’s unlike any other condiment. And second, color: the eye-popping fuchsia slivers make any dish look like a piece of art. Luckily, they’re also simple to make. Though you have 1 hour to wait, the hands-on time is only about five minutes.

What recipes are best for this hot pink garnish? More than you would imagine. Here are a few of our favorites:

• Tacos. Any taco is made more perfect with pickled onions. They’d be lovely on our classic lentil tacos, as we did here.
• Sopes. If you haven’t tried this authentic Mexican street food, you must. Here’s our homemade sopes recipe.
• Pizza. Pickled onions on pizza might sound crazy, but this pecan, grape, and pickled onion pizza is to die for.
• Salads. Throw a few pickled red onions on any salad to add a pleasant zing.
• Sandwiches. A sandwich is a perfect carrier for pickled onions; specifically, try our vegetarian banh mi.

This week, Amanda’s class will be trying out the pickled onions; she plans to have her students try them out on a sandwich. We look forward to hearing whether they’re converts! And let us know if you have other ways you like to enjoy pickled onions; we’d love to hear.

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I THOUGHT I WAS HEALTHY UNTIL MY HEART ATTACK

The scary truth: Each year, over half a million people in the U.S. die from heart disease, according to theCenters for Disease Control and Prevention (CDC). That’s one in every four deaths, making it the leading cause of death in both men and women — but not something successful television producer and director in Los Angeles, Kac Young, ever anticipated impacting her life.

Unlike many, Young considered herself a healthy eater, choosing chicken and vegetables as dietary staples. Young had been a vegetarian for 20 years, and never even craved red meat when she started incorporating lean meats back into her diet. At one point, she practiced yoga regularly and was planning on making it part of her life when she finished moving from Los Angeles to San Simeon, Calif., a small town located between Los Angeles and San Francisco with clean air, a slower lifestyle and breathtaking views of the Pacific Ocean.

The Turning Point

It was a suffocating 105 F outside when Young began packing up her home in Los Angeles with the help of her friends. Throughout the day, she noticed mild discomfort in her neck and chest, as well as shortness of breath. She chalked it up to the heat and exertion. When she didn’t feel better the next day, her friends convinced her to call her doctor.

“I’m a producer-director, and I’m used to being in a charge,” says Young. She asked the nurse if she could schedule a cardio workup in a few weeks’ time; the nurse told her to report immediately to the emergency room. Instead, Young finished packing and running errands. When she sat down for dinner that night, her partner asked if Young would agree to go the emergency room. She begrudgingly left for the hospital — and not a moment too soon. In early July 2006, 57-year-old Young suffered a heart attack.

Her blood pressure was 130/97, and she needed two stents put into arteries to remove blockages. Her doctors could have added a third stent, but with changes to her diet and exercise patterns, Young has avoided another surgery.

Naturally Lowering Her Numbers

Immediately after being discharged from the hospital, Young started to research heart disease to understand whether her genetics or environmental factors were to blame. She realized both were at fault. But, no matter how much research she did, she couldn’t find a healthy living plan that was universally agreed upon.

In her search for answers, Young received her doctorate in naturopathy. She took nutrition classes, and slowly weaned herself off of the post-operative prescriptions. “I decided I was going to be a natural health expert, and treat myself as best I could,” says Young. “I had to fight fire with fire.”

Young learned how different oils and cooking styles could make her meals healthier. She read labels, learning the various words for sugar, such as fructose, glucose or sucrose. She became wary of marketing around low-fat, low-calorie, and reduced-anything products. She added more whole grains by swapping wheat or brown rice pasta for regular pasta. And she learned to seek out foods with healthy benefits like increased fiber content and omega-3 fatty acids (Kellogg’s Raisin Bran® Omega-3 from Flaxseed cereal contains both) in order to make healthymeals, like “pasta salads” with quinoa or bulgur instead.

She recalls that the first meal she made for friends, post-attack, was a slew of healthy Mexican swaps for Cinco de Mayo. Her “friends drank low-calorie margaritas, as well as eating Mexican dishes made with healthier vegetables, soy cheese, and beans instead of meat,” says Young. “They didn’t even realize they were eating soy cheese!”

While she’s impressed at the variety of more health-conscious supermarkets out there, “we still have to be careful, whether we’re determining which whole wheat is in our bread or how much sodium is in our pasta sauces.” In addition to reforming her eating habits, Young does yoga and works out regularly.

Today, 64-year-old Young has her cholesterol under control; it was once 255, and has dropped to 179 through her vigilance, diet and healthy habits. “Keeping your body healthy is the best thing that you can do for yourself,” says Young. “If you let it be depleted, you’re setting yourself up for disease and other problems.”

Amber Greviskes is a health and fitness editor based in New York City. She enjoys most fitness classes, especially Pilates. She has written for AOL Health, That’s Fit, Parenting Magazine, Babytalk Magazine, LemonDrop and New York Metro Parents

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One Brave Man Tried Barre Class With His Girlfriend—And Lived To Tell About It

I came to my girlfriend’s Pure Barre class with the best intentions. But I fell short, and then I almost fell down.

For the unfamiliar, Pure Barre is a class featuring a lot of intense isometric exercises packed into 55 minutes. They market the program as designed for women, but can’t exclude men, I guess. Unsurprisingly, I was the only dude at my session.

I knew the class would be difficult. I intended to come mentally prepared and focused solely on determining whether or not guys should consider this program. I also figured, based on my vague understanding of what the class entailed, that it would be a good exercise for a skinny guy with a typical skinny-guy problem: my posture.

On the way over, I felt anxious. I had never taken an exercise class before, and I had visions of being the biggest embarrassment to my gender since Bobby Riggs. My girlfriend assured me that the instructor would define all the special terms used. Suddenly the whole thing felt like going to see David Lynch’s Dune on opening night, with a sheet explaining all the alien words and characters . The only difference was my flop would be literal.

Once we arrived, I made a point of going to the bathroom. Paranoid about my presence annoying my all-female classmates, I walked to the far corner of the main room, then very conspicuously all the way back to the bathroom to make sure I had put the seat down on the toilet.

The class began with the instructor saying there were a lot of new people (comforting) and explaining Pure Barre as a combination of Yoga and ballet. When it comes to things I know anything about, she may as well have said Pure Barre is a combination of theoretical physics and motorcycle repair. (Dance your way fit with High-Intensity Dance Cardio, the first-ever socanomics DVD!)

My girlfriend told me basketball shorts would be more comfortable than sweatpants. And if I can impart any wisdom on guys considering this class, let it be this: wear pants. A lot of the class involves binding your thighs together with a resistance band, which can be incredibly painful if you have hairy legs.

Along with the band, everyone was given a little dodgeball and pairs of two- and three-pound hand weights. Looking at these tools, the fatal hubris set in. How hard could something involving two-pound weights really be?

Really hard.

The class involves six stages. In hindsight this seems impossible, as six stages over 55 minutes is only about nine minutes per stage. But our instructor warned that “Pure Barre time” is longer than regular time.

The first and fourth parts—”warm up” and “flatten abs”—were the hardest for me as they involved many different kinds of sit-ups and crunches (bad posture, weak back).

The second stage, “sculpt arms,” was the easiest and maybe the least appealing to a male audience. Guys are typically concerned with bigger arms, not more-sculpted arms. I remember holding the weights behind my back and making small circular movements with my arms. The whole class is like this—small movements until the muscles being worked start to quiver.

Third was “tone thighs,” which happened mostly on the ballet barre. Having toned thighs is not super high on my fitness goals, but ballerinas are jacked, so I was game.

Then came “lift seat,” which featured the instructor often calling on us to “tuck.” Contrary to my girlfriend’s warnings, there weren’t a ton of terms of art. Really, the only thing I had to learn was “tuck,” though I’m still not entirely sure what it entails. Supposedly you “pull your abs in and tuck your hips under.” I think I was doing that, but a tape of my workout would probably show otherwise.

Finally, before the cooldown period, came the aforementioned ab-flattening. Toward the end, we did a kind of lying leg raise, in which you stick your legs straight up until your abs contract. Here is where I tapped out and tipped over. Around this time the instructor, sensing the newbie’s desperation, said, “You’re all in this together. Feed off each other’s energy.” An oddly reassuring combination of something you might hear in a foxhole followed by something you might hear at an Earth, Wind & Fire concert.

In the end, I was beat. I could definitely see a Pure Barre membership helping with my back, though a more traditional workout like this onewould too, and with less self-consciousness about how I left the bathroom.

For all the guys considering tagging along with a girl, I’d say go at least once. If nothing else, It could help her. My girlfriend said that laughing at my bad form really took her mind off the pain and helped her achieve personal-best reps. Who says I’m not supportive!

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White wine linked to higher risk of certain melanomas

Alcohol is responsible for about 4% of cancer cases worldwide, typically in the esophagus, liver, pancreas, colon, rectum, and breast. A possible explanation is that the ethanol in alcohol metabolizes into acetaldehyde, which damages DNA and prevents DNA repair.

A team of researchers from Harvard and Brown universities sought to determine whether alcohol consumption can also raise risk for melanoma—a potentially deadly skin cancer. They used data from three large prospective studies in which 210,252 participants completed questionnaires about their alcohol consumption. The researchers noted which people developed several types of cancer, including melanoma, over an average of 18 years.

Overall alcohol intake was associated with a 14% higher risk of melanoma per drink per day. While each drink of white wine was associated with a 13% increase in melanoma risk, beer, red wine, and liquor had no significant effect. The researchers speculated that white wine may be more likely than red to increase melanoma risk because it contains more acetaldehyde and a lower concentration of antioxidants to counter the effects than red wine does. The study appeared in the December 2016 issue of Cancer Epidemiology, Biomarkers & Prevention.

If you drink white wine, you might want to consider reserving it for special occasions. And you may want to sample a few reds as well.

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Don’t Throw Away Those Leftovers! Saving Food Will Save Energy

Don’t be too quick to throw away those Thanksgiving leftovers. By saving that turkey and stuffing to eat another day, you can help save a lot of energy from ending up in the garbage bin.

Each day, the average American household throws away a pound and a half (~0.7 kilograms) of food. Over the course of a single year, these pounds amount to the energy equivalent of throwing 350 million barrels of oil into the trashcan according to a study from the University of Texas at Austin that we have previously discussed here on Plugged In.

To put this figure into perspective – 350 million barrels of oil is the equivalent of:

• about 2% of total annual energy consumption in the United States
• about 20% of the nation’s net energy imports
• twice the amount of energy that Switzerland (with its more than 8 million people) consumes in an entire year

In their study, UT Austin Professor Michael E. Webber and his former graduate student, Amanda Cuellar, estimated the energy that is embedded in wasted food in the United States. In other words, they calculated how much energy was used to get food to our tables, which is wasted when that food ends up in the garbage bin. Their process involved calculating the energy intensity of the food production supply chain including the following steps for different types of food:

• agriculture (i.e. growing/raising food)
• transportation (i.e. moving food from field to processing plants)
• processing
• food sales
• storage
• preparation

You can read more of the details of the findings in this study here.

In the week after Thanksgiving, Americans will throw away almost 200 million pounds of turkey according to the Natural Resource Defense Council. If you want to save some money (and energy), explore some ways to use those leftovers (for those who like to cook, NPR has some ideas).

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8 disease signal in your urine

Many men will unconsciously have a look when pissing, in fact, this is a very good health habits. The urine is not only a normal product of metabolism of our body, but also a reaction of our health.

How many urinate every day, urinate feeling, urine color change, all of these may represent a reaction of the body, suggesting the existence of health risks.

Urine is not far

In Men’s Room often have similar prompt “a small step forward, one big step civilization”, reminding men try to pee in the urinal. For some men, they really want to pee in the “scope”, but it will be really hard for them to achive this, especially for older men, suggesting that there may be prostate hyperplasia.

With the increase of age, the various organs of the body are in the trend of shrinking, but prostate increases.

Man’s urethra is passing through prostate, the prostate hyperplasia will press urethra, cause urinate not free, not far.

Urinate flow thinning

“In the past, urinate is ease, far, and flow coarse. However, these two years, urinate flow began more and more thin?” maybe you will whisper like this. Please don’t ignore this hints from urinate, all these suggesting that there may be a benign prostatic hyperplasia. As hyperplasia prostate will be press urethra, cause urinate not free, the bladder will compensatory increase pressure at beginning, at the same time the abdomen will also increase pressure, to help the smooth urinate.

With the continuous hyperplasia of prostate, press on urethra will increasing together, bladder compensatory pressure increases. But bladder pressure increase has maximum limitation, but prostate hyperplasia is likely to continue. If not take right measures, urethral pressure increasing, the urine flow will become thin, not far, even at the end there will be not possible to urinate.

Urinate bifurcate

Urinate bifurcation has two situations: one kind of bifurcation does not happen often, probably due to anterior urethra and urethra opening temporary obstruction.

For example, the morning urinate bifurcate, that is because the overnight much urine is stored in the bladder, the bladder is in high pressure, make urethra tip changed temporarily. Sometimes after ejaculation, because some semen remains in the urethra, and cavernosa penis congestion has not completely disappeared, also can cause urinate not smooth, bifurcation occurs.

Long-term urinate bifurcate, that is a kind of disease. Expert explained, some people is suffering from urethritis, due to repeated of this urethritis, partial urethral tissue scarring after long time, cause urethral stricture, urinate bifurcation occurs and dysuria phenomenon.

During the acute urethritis, because urethral hyperaemia, swelling, increasing secretions, also can cause urinate bifurcate, must be timely treatment. Anterior urethral stones may also cause uric bifurcate.

Urinate waiting

Go to the Restroom takes 20 minutes, even half an hour, others thought he was to go to the stool, in fact just pee. Normal urination, after brain send pee order, urinate controlled sphincter will relax at once, and bladder detrusor contraction, and then urinate will happen after about 1 second, and with the positive feedback effect, detrusor contraction will increasingly to completely discharged urine one-time.

But urethral stricture (such as prostatic hyperplasia, bladder outlet obstruction) patients need to wait for some time to begin urination. This is because the bladder neck obstruction exists, and bladder sphincter and detrusor activity does not coordinate well.

When the latter is contracted, the former cannot be relaxed, if not, it will resulting in the bladder neck and urethra are not good opening, the urine cannot be discharged, but must take time to accumulate intravesical pressure, appear namely micturition symptoms of retardation. So, urinate waiting has relationship with urethra and bladder.

The urinate waiting is not a single factor formation, but psychological factors may also play an important role. Psychological factors often show as excessive stress or panic.

Urinate bubble

Many people have the tradition to see urine judge whether they are health or not, and some elderly people judge nephropathy according to urine bubble states. They think the bubble is caused by urine protein. This viewpoint is not 100% correct, and many nephropathy patients protein content in urine urination is high, the bubble will appear. But it is not necessarily a bubble urine proteinuria, high uric acid, or more concentrated urine, can also cause bubble. If you want to clear urine bubble is due to certain disease, regular hospital inspection is needed, such as urine routine check, 24 hours urine protein, urinary sediment check.

Hematuria

We ate some special food, may also cause the urine turns red, very “frightening”, such as the red pitaya. If excluded food factors, when your urine is red, it is hematuria. If hematuria accompanied by pain, suggesting possible infection or stone disease. If only the hematuria, without any pain, you should pay more attention, must check out whether it is caused by tumor or not.

Turbid urinate

After getting up in the morning, your find your urine is turbid, and even floating some oil. Do pay attention on this, as this is certain abnormal issue. How is this going on? Expert analysis, this may be chyluria. Much chyle in urine, because the lymphatic tube containing protein and fat lymph excreted in the urine. There may be prompted to filariasis or tuberculosis, cancer and so on, should immediately seek medical treatment or health check.

Gas urine

When your urine contains gas, this is called gas urine. The clinical common reason is to have a fistula between the urinary tract and intestinal tract, such as trauma, tumor, tuberculosis, Crohn’s disease and other diseases can cause gas urine. There are also some patients with emphysematous cystitis or emphysematous pyelonephritis caused gas urine.

Emphysematous cystitis is an inflammation of the bladder wall or the presence of gas cavity, high incidence in patients with diabetes. Emphysematous pyelonephritis is a rare fulminant infection in kidney, renal pelvis and renal all around gas, often complicated by sepsis, pyonephrosis, and necrosis. Urine except for gas, sometimes also discharged feces, food scraps, tumor parts, caseous material etc.

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Refried Bean Tacos with Chipotle Cashew Cream

For a weeknight meal, make the chipotle cashew cream in advance and store refrigerated until serving.

by: a Couple Cooks

Serves: 4 (2 tacos each)

WHAT YOU NEED

Supremely Simple Refried Black Beans

Chipotle Cashew Cream (below)

2 cups shredded green cabbage

½ red bell pepper

½ yellow bell pepper

2 tablespoons fresh lime juice (1 lime)

¼ teaspoon kosher salt

Fresh ground black pepper

8 One Degree Organicssprouted corn tortillas

1 large handful cilantro leaves

WHAT TO DO

Soak the cashews; see (below).

Make the Supremely Simple Black Beans.

Meanwhile, thinly slice the cabbage and peppers (cut off the rounded edges of the peppers so that the peppers are straight). Juice the lime. Just before serving, mix together the cabbage, peppers, lime juice, kosher salt and several grinds of black pepper in a large bowl.

Blend the cashew cream (below).

Warm the tortillas, or char them by placing them on grates above an open gas flame on medium heat for a few seconds per side, flipping with tongs, until they are slightly blackened and warm.

To serve, place refried beans in a tortilla, top with cabbage and pepper slaw, cashew sauce, and some torn cilantro leaves.

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Za’atar-Spiced Butternut Squash Soup

Salma: First I would recommend to arm yourself with some great Middle Eastern staples such as za’atar (a thyme and sesame seed seasoning) which can be added to almost any vegetable dish, along with sumac (a crushed berry spice) that adds a real kick to simple roast vegetables and soups. They are both great in stews too and sprinkled on almost anything and everything.

Buy pomegranates: they are a wonderful addition to any salad and can really transform a simple dish into something quite exotic. They are not only pretty to look at but add a very unique sweet/sour taste. For desserts, have a good stock of flavored waters in such as rose water or orange blossom. They can give most cakes or cookies a hint of the Middle East.

My traditional recipe suggestions would be to start with something such as Kibbeh. My ‘Nan’s Kibbeh’ is a spicy, sweet version that dates back generations in my family and is still a firm favorite. We have it almost every weekend to this day. ‘Grandma’s eggplant dip’ is a dish I have been cooking for 60 years; it gives real insight into how the simplest of ingredients make something quite wonderful. The eggplant is scorched over an open flame to bring out the flavor, which gives the dip a unique smoky taste.

There are also a few traditional lesser known Middle Eastern dishes that could be a great for home cooks new to this cuisine. Harisa (not to be mistaken with harissa, the Tunisian hot chili paste) is a celebratory barley dish often cooked on days of religious significance, in a huge cauldron at a village gathering. In my book, I have a version for home cooks that is very straightforward. Also, Mograbieh, also known as Israeli, pearl, or giant couscous. The version in the book is smothered in a fresh herb dressing. Recipes such as these are not yet well-known, but very reflective of how we eat in the Middle East.

Sonja: You moved to London from Lebanon. When was this, and what prompted the move? In London, did you ever experience any difference in treatment based on your ethnicity?

Salma: We moved in 1967, exactly 50 years ago. All of my family left Lebanon around this time, since politically it had become a difficult world to live in. At that point I had moved to Tripoli in Lebanon because it had more work opportunities, but with the bigger city came more disruption. It became a unsafe place to raise a family. My aunt and uncle invited us to come and live with them in London as a bit of a safe haven for a short time. We had to borrow the money for the airfare and had no idea where we were going or what we would do when we got there. During out first few years in London, I was so homesick I would take myself to the airport and sit there hoping to hear Lebanese people speak to remind me of home. I found adapting to the language extremely hard. I would work two jobs to take care of my family while trying to learn English in the evenings. After we saved up enough money for our first house in London, we immediately took in lodgers to help us pay our way.

We were always very sociable and so integrated with people in our community very quickly. However, there are always great challenges that come with being a first generation immigrant in any country. I was very honored to this year be included in The Immigrant Cookbook. It is wonderful what diversity of skills and cultures immigrants bring, particularly to places such as London and New York, which makes things like Brexit and Trump so devastating.

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5 habits that foster weight loss

5 Habits that foster weight loss

If you’re like many Americans, you’re still carrying an extra pound or two that you gained over the holidays. Over the years, that extra weight can really add up—and that added girth is hard on your heart.

Often, the hardest part about losing weight isn’t about knowing what to eat. You’ve heard it a thousand times: eat lots of vegetables, fruits, whole grains, and lean protein. The real challenge is changing your habits to make those healthy choices part of your everyday routine without feeling too deprived.

When you come home

Where to start? Try a little respect, says Dr. George L. Blackburn, professor of nutrition at Harvard Medical School. “Show respect for the food you’re eating. Before you sit down to dinner, lay out your meal on a white tablecloth, which will make you more likely to eat mindfully,” he says. Mindfulness—the practice of being fully aware of what’s happening within and around you at the moment—seems to help people make better food choices, in terms of both what and how they eat.

It’s also important to respect your hunger, which means you should eat as closely as possible to the time you feel hungry (but not starving). Finally, respect your cravings. “Select foods that taste good to you, because taste is king,” says Dr. Blackburn. You need to stick within healthy parameters, of course, and choose foods that follow the recommendations laid out by the Dietary Guidelines for Americans (see www.health.gov/dietaryguidelines/2015). But if you’ve got a hankering for a few French fries or a small brownie once in a while, go ahead. A complete ban of your favorite treats may leave you more likely to abandon your diet altogether and overindulge.

Dr. Blackburn has directed the Center for Nutrition Medicine at Beth Israel Deaconess Medical Center and advised overweight and obese people for more than four decades. The following are five proven strategies that many of his patients have found helpful toward their goal of lasting weight loss.

1. Make time to prepare healthy meals

Home-cooked food tends to be far lower in calories, fat, salt, and sugar than restaurant food and most processed food. But it takes time and effort to choose recipes, go to the store, and cook. Take a close look at your weekly schedule to see if you can carve out a few hours to devote to meal planning and shopping, which is more than half the battle, says Dr. Blackburn. It could be on Sunday afternoon or in 15- to 30-minute increments throughout the week.

To save time in the kitchen, take advantage of precut vegetables and cooked whole grains (like brown rice) from the salad bar or freezer case. And stock up on easy, wholesome snacks like fruit, nuts, and low-fat cheese sticks.

2. Eat slowly

The next time you sit down for a meal, set a timer (maybe the one on your kitchen stove or smartphone) for 20 minutes. That’s about how long it takes the “I’m full” message sent by the gut hormones and stretch receptors in your stomach to reach your brain, explains Dr. Blackburn. “If you can spend a full 20 minutes between your first bite and your last, you’ll feel satisfied but not stuffed.” Eat too quickly and you’re more likely to overeat. Tips for stretching out your mealtime include chewing each bite a little longer than usual, setting down your fork between each bite, and taking frequent sips of water during your meal.

3. Consume evenly sized meals, beginning with breakfast

Most people tend to eat a small breakfast (or none at all), a medium-sized lunch, and large dinner. But you may be better off spreading your calories out more evenly throughout the day. For one thing, a small or nonexistent breakfast can leave you ravenous by lunchtime, which may lead you to overeat. A morning meal also helps rev up your metabolism for the day, stimulating enzymes that help you burn fat. What’s more, eating at least 450 calories per meal can help you avoid hunger between meals, says Dr. Blackburn. If you eat a light supper (and avoid grazing late into the night; see tip No. 4), you may eat fewer calories over all—and actually be hungry for breakfast.

4. Don’t skimp on sleep

When you burn the midnight oil, you’re probably not also burning calories, but instead consuming too many. Many studies have linked shorter sleep duration with a higher risk of being overweight or obese. A recent review article suggests why: people who sleep fewer than six hours a night tend to have irregular eating habits—including more frequent, smaller, energy-dense, and highly palatable snacks (read: fatty, sugary foods like chips, cookies, and ice cream).

Only about 60% of adults get the recommended seven to nine hours of shut-eye per night. If you have a hard time falling or staying asleep, cognitive behavioral therapy—not sleeping pills—should be your first step. For more information on this talk therapy technique.

5. Weigh yourself often

If you don’t already have one, get a digital scale. Hang a calendar and pen above it, right at eye level, as a reminder to record your weight every day. Doing so only takes a few seconds and will keep you heading in the right direction. Most people find it difficult or tedious to track their calories, both from the foods they eat and those they burn via exercise. But a daily weigh-in tells you all you need to know—and the scale doesn’t lie. Also, research shows that people who weigh themselves often are more likely to lose weight and keep it off.

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