A New Model of Health Care

stephanie_taylor

A Wellspring for Our Community Renewing Mind, Body and Spirit From Stephanie Taylor, M.D., Ph.D.

 

True wellness and deep healing is more than the application of a pill to a diagnosis. I have pioneered a new approach to healthcare that is based on personal and community wellness. Here is what this means:

The first community is you. Each person is a composite of their own life experiences and their own circle of support. Every factor needs to be evaluated to develop a picture of the whole person. Each element can then be recruited into the healing process.

The second community is where you live. The majority of public health research shows that the health of individuals is not separate from the health of the community. We have an obligation to ourselves to care for our community. This means taking the ecological initiative and also supporting the small businesses that are based in our community, especially our local farmers. Over time the community that you care for will also care for you.

The center of the program is the office visit. We offer 30 and 60 minute patient visits. This gives us enough time to really get to know you. The relationship does not end at the office visit. You will enter a supportive community linked by regular newsletters and educational programs. You will have the opportunity to re-discover yourself and the joys of living on the Monterey Peninsula. Visit Medical Program and Educational Program and see how this unique holistic program can benefit you and assist you in achieving your life’s purpose.

    Mini-Medical School #6- Fitness for 2018

    Mini-Medical School #6 December 2, 2017
    Fitness 2018
    by Stephanie Taylor M.D., PhD.

    Fitness historically referred to the ability to complete a task. What we now mean by “fitness” has no formal definition and it is highly context dependent.  A concrete fitness goal could be to achieve a specific percent body fat (26-31% body fat is normal for women, and 18-22% for men), or the ability to hike to the top of Garland Park.

    One hundred years ago, fitness meant being able to haul wood and carry water and walk to the town when the horse was lame. Our century has a very different definition of activities of daily living. Given our 2st century environment, today’s fitness would be defined as the ability to sit in front of a computer or television for hours!

    A recent article in the cardiology journal “Circulation” reported that most adults spend 6-8 hours a day in sedentary activities, and adults over 60 years of age averaged 9 sedentary hours a day. Sitting time increases risk of metabolic syndrome, diabetes, cardiovascular disease and all-cause mortality. Just two hours of extra TV time increases diabetes risk 14%. Fortunately, just 2 hours standing or walking decreases diabetes risk 12%.  There is a similar increase in cardiovascular disease from prolonged sitting. All-cause mortality also increases with the degree of sedentary behavior, with the most sedentary (70% of the time) showing a 6 times increased death rate.

    The physiology underlying increased morbidity and mortality involves many endocrine glands as well as muscles, fat and inflammatory and endothelial cells. One of the most important and well researched risks is the reduction in insulin sensitivity with sedentary behavior. Glucose from meals is intended to go to the cells for immediately available energy. If there is local resistance to the transfer of glucose into the cells, the level of glucose in the blood increases. If blood glucose goes past a certain threshold, it initiates a cascade of negative events specifically, increased inflammation, oxidative stress, endothelial dysfunction and an increase in sympathetic tone.

    How do you get folks to increase their activity when there are so many attractive distractions? There is research support for two interventions: changes in the workplace environment, and use of smart phone apps that remind users to take a walk break. It is ironic indeed that the very technology that caused the problem is being used to solve the problem! Even regular short breaks for a walk reduce risk.

    Bones and Muscles

    Astronauts can lose as much as 5% of their bone density per month. An extended deployment in space may return them with a bone density close to osteoporosis. This can be mitigated by exercising as much as 2 hours a day while they are weightless. Bones respond to muscle pull even in low gravity environments. Muscle pull and gravity are the two main forces that maintain bone density.

    Muscle pull on the bone stimulates bone to remodel. This constant remodeling is essential for good quality bone. There are two types of cells in bone-osteoblasts and osteoclasts. The former build bone and the latter dissolve bone. Usually they are in balance, but if the osteoblasts decrease activity, bone loss ensues. Physical activity is essential for good bone quality, but if there is a loss of bone structure, then it is essential to modify the exercises to prevent micro fractures. Exercises that involve flexion (forward lean) and rotation of the spine are particularly dangerous. You will have to say good bye to your crunches, toe touches, and toe touches with twist. Similar benefits can be obtained by modifying these exercises to maintain an upright posture. It is essential to work with an instructor who is trained to adapt exercises to individuals with low bone mass.

    The beneficial effect of gravity can be optimized by maintaining an upright posture. Slumping compresses the anterior aspect of the vertebral bone, and can cause micro-fractures. Slumping and lateral rotation also increase pressure on the intervertebral disc and can even cause it to slip, possibly causing a nerve compression. Slumping also reduces the area for your lungs to expand, and for your bowls to digest. Tai Chi Chuan, some Yoga and the Bones for Life program apply the beneficial effect of posture on bone density.

    The Turtle Wins

    Whatever you decide to do for exercise, pick something that you enjoy and start out slowly. One ligament tear will put you back six months. Be very mindful of your feet if you are fast walking or hiking. See an excellent podiatrist if you have any foot pain. Chronic foot problems decrease your activity level and always result in the accumulation of a few unwanted pounds.

    If you choose to start weight training, start with light weights and more repetitions. A good rule of thumb is to use a weight that fatigues you by about the 15th repetition.

    Make it social. You will be more consistent if you are gathering with friends. If you enjoy your private time, you can exercise with an audio book. Just be sure it is a page-turner!

    Resources

    Martin, Margaret. Exercise for Better Bones. Yoga for Better Bones. www.melioguide.com
    Switzer, Katherine. Running and Walking for Women over 40: the road to sanity and vanity
    Tai Chi ClassesOnline: https://www.onlinetaichilessons.com/

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    Mini-Medical School #5 October 2017-Cognitive Health

    Cognitive Health: food, fitness and community
    Stephanie Taylor MD PhD

    Knitting, crochet and quilting:

    “Our mission is to use knitting and other therapeutic creative activities to improve wellbeing generally, but also to complement medical treatments in the self-management of long-term health conditions. We are working closely with academics and clinicians, and as a direct result, therapeutic knitting and therapeutic knitting groups are being formally acknowledged by leading clinicians and academics for their benefits in mainstream healthcare. We have been successfully using knitting therapeutically in the NHS since 2006, so have a wealth of knowledge to share. This is just the beginning. Low-cost activity groups have the potential to not only revolutionise our individual lives but healthcare systems worldwide because they provide an affordable means of long-term support, motivation and monitoring.”  Accessed 10/6/2017 at www.stitchlinks.com

    The Benefits of Knitting for Personal and Social Wellbeing in Adulthood: Findings from an International Survey. British Journal of Occupational Therapy 76(2):50-57 · February 2013

    “This study aimed to identify the benefits of knitting for individuals' personal and social wellbeing as a prerequisite to investigating its therapeutic use. Method: An online survey was conducted through an internet knitting site. Responses were received from 3,545 knitters worldwide. Quantitative data were analysed statistically to establish relationships and differences among variables and qualitative data for key themes. Results: Respondents came from a virtual community of knitters. The majority were female white adults and frequent knitters, who commonly reported knitting for relaxation, stress relief and creativity. The results show a significant relationship between knitting frequency and feeling calm and happy. More frequent knitters also reported higher cognitive functioning. Knitting in a group impacted significantly on perceived happiness, improved social contact and communication with others. Conclusion: Knitting has significant psychological and social benefits, which can contribute to wellbeing and quality of life. As a skilled and creative occupation, it has therapeutic potential - an area requiring further research.”

    Locally there are quilting and knitting groups: The Monterey Peninsula Quilters Guild   http://www.mpqg.org/ and Monarch Knitting, Pacific Grove https://www.monarchknitting.com/

    Stitch'N Bitch.  These groups started more than 100 years ago. Women get together for needle crafts and social commentary. I leave the rest to your imagination.

    Learning new things-words, music and language:

    There are multiple research studies showing that learning a second language creates new neural networks.  Learning a second language increases grey matter density and white matter integrity.  This effect is observed in all age groups, including the “elderly”.

    There are also many studies that show that listening to and making music also contributes to preservation and enhancement of cognitive capacity.  Recent research (Rogenmoser et al., 2017) showed that compared to non-musicians, musicians have lower BrainAGE scores as determined by MRI studies of the brain. Amateur musicians stayed younger than professional musicians, an effect attributed to the stress of professional work or to over practicing a single skill.

    In “Apollo’s Gift” Altenmuller reviews the physiological data on music therapy, extending the benefits from the craft to include the subjective pleasure of music. The pleasure one finds in music “provokes motions and emotions”. There are changes in the areas of the limbic system which mediate emotion, motivation and long term memory.  This pleasurable component not only makes music listening more frequent, but actually facilitates neurotransmission and new connections.

    The Tasmanian Healthy Brain Project found that 93% of the education participants, 50-79 years of age, showed an increase in cognitive reserve compared to a control paired group that did not attend adult university courses. Locally, adult learning experiences are available at: Gentrain (http://www.gentrain.org/) at MPC, and the OLLI at CSUMB (http://olli.csumb.edu/).

    Exercise with support groups:

    Research on exercise robustly supports increased neuroplasticity and prevention of age related decline in mental capacity. We will return to the science in greater depth in December.

    However wonderful exercise is for your brain, there is little benefit if you cannot be consistent. Some of the best ways to exercise and keep exercising is adding a social component. Specifically, join a group.  There are many groups, and you need to pick one that suits your temperament and exposes you to people you enjoy. One great idea to find compatible people is to search on Meetup (www.meetup.com) for a hiking, running or sports/fitness group.

    If you are a bit of a loner, you can meet your coach on line.  There are many apps and on line programs. My Fitness Pal is one of the best apps and integrates with many of the advanced pedometers and sleep moitors. The sharing of success stories is enlightening and motivating, as you experience other people’s joy in achieving their goal.

    Stress management with Forest Bathing:

    Stress destroys neurons, and stress management is essential to healthy brain aging. Forest bathing therapy was developed in Japan. A forest bath is a short walk in the forest with time for viewing and appreciating the surrounding trees.
    The Forest Therapy Association (http://www.natureandforesttherapy.org/) has an excellent website. They have a research page summarizing the current studies, and also have a program to train guides. Overall, forest bathing reduces stress hormones, lowers blood pressure and improves immune function.

    Locally Mary Ann Rowe, PhD, will be leading some preliminary walks.  If you are interested, you can contact her at at 831-373-1017.

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    Food as Medicine-Mini-Med #4 2017

    Mini-Medical School #4
    Food as Medicine
    August 12, 2017

    Stephanie Taylor MD PhD

    The doctor of the future will give no medicine, but will interest his (her) patients in the care of the human frame, in diet, and in the cause and prevention of disease.” Thomas Edison

     

    What is Food?
    Protein, fats and carbohydrates=calories. Add a vitamin pill and you are all set, right? Not quite. Here is a list of the high nutrient value plants and their participating phytochemicals, which are not included in that simple formula.

    Phytochemical                                  Food Source                               Health Benefits

    Carotenoids

     

    Red, green, yellow fruits and vegetables

     

    Antioxidants1, decreased cancer risk

     

    Flavonoids

     

    Most fruits and vegetables, tea

     

    Antioxidants, antiinflammatory2

     

    Ellagic acid

     

    Strawberries, grapes, raspberries, apples

     

    Inactivates cancer causing chemicals3

     

    Phenolic acids

     

    Citrus, whole grains, berries, tomatoes, most vegetables

     

    Inhibits cell proliferation induced by carcinogens4, 1,2

     

    Indoles Cruciferous vegetables

     

    3

     

    Isothiocyanates

     

    Cruciferous vegetables

     

    4

     

    Lignans

     

    Flax seeds, berries, whole grains

     

     

    1,4

     

     

    Diallyl disulfide

     

    Garlic, onions, leeks, chives, shallots, scallions

     

    3

     

    Saponins

     

    All plants

     

    2,4

     

    Terpenes

     

     

    Oranges, lemons,
    grapefruit
    3, anti-ulcer

     

    Capsaicin

     

    Hot peppers

     

    2,3, pain reduction

     

    Coumarins

     

     

    Soybeans, Whole grains, cruciferous vegetables, cucumbers, squash, melons, flax seeds, green tea

     

    4

     

    Isoflavones

     

    Soy

     

     

    1,3

     

     

    Organosulfurs

     

    Garlic, onions, leek….

     

    3, inhibit cholesterols synthesis

     

    Phytosterols

     

    Whole grains, legumes

     

    3, primarily steroid induced

     

    Protease inhibitors

     

    All plants

     

    2,4, antiviral and antibacterial

     

     

    Reference: Power Foods by Stephanie Beling, MD, HarperCollins, 1997.

    Eat five different kinds of fruits and vegetables every day to recapture the disease preventing phytochemicals missing in the American diet. Taking vitamin and mineral pills will not prevent the diseases associated with a processed-food diet. Scientists cannot formulate into pills nutrients they haven’t yet discovered”. –Dr. James Duke, US Dept. of Agriculture

     

     

    Step One: Start with Good ingredients:

    Water: The Environmental Working Group just released its tap water analysis. Cal Am is in legal compliance, but has levels of arsenic, bromodichloromethane, chloroform, hexavalent chromium, dibromochloromethane, dichloroacetic acid, trichloroacetic acid, total trihalomethanes and above optimum health levels. Optimum health levels are not the same as legal limits. These chemicals are all carcinogens.    https://www.ewg.org/tapwater/#.WY3VUVWGPIU

    The fundamental error in safety testing is made by testing isolated chemicals for toxicity. The synergistic toxicity of simultaneous low doses of hundreds chemicals over a life-time is not evaluated.

    Plants: Local, organic and fresh.     Animal protein: Organic/grass fed and humanely raised.

    EXAMPLE 1-APPLYING WHAT YOU KNOW TO HYPERTENSION:

    Caution: Do not stop any medication without physician supervision!

    The DASH Diet is endorsed by the National Institute of Health and research reports a BP reduction of 10.7/5.2 mm Hg, which is comparable or exceeds medication results. More information is at:  https://www.nhlbi.nih.gov/files/docs/public/heart/dash_brief.pdf

    This table of the pharmacological actions of foods was prepared by a leading cardiologist:

    BP Medication                         Antihypertensive Food with similar mechanism

    ACE inhibitors Egg yolk, Fish, Garlic, Gelatin, Hawthorne berry, Milk casein, whey and sour milk, Sake, Kelp, Wakame, corn protein

     

    ARB Celery, Fiber, Garlic, Olive Oil, Nuts, Avocados, Olives

     

    Beta-blockers Hawthorne berry

     

    Calcium blockers Hawthorne berry, Celery, Garlic, Olive Oil

     

    Alpha-agonists Celery, Fiber, Garlic, Protein

     

    Diuretics Hawthorne berry, Celery, Protein

     

    From: Houston, MD, M. Nutrition and Nutraceutical Supplement for the Treatment of Hypertension, 2013, J. of Clinical Hypertension.

    EXAMPLE 2-APPLYING WHAT YOU KNOW ABOUT HEART DISEASE: Mediterranean Diet, including the right olive oil. It is the one that tastes peppery. Learn more at the Quail and Olive, Carmel Valley Village. Exercise and social support are essential.


    EXAMPLE 3-APPLYING WHAT YOU KNOW ABOUT DIABETES:
    Refined Sugar is actually a drug and is part of the triad of compounds (salt, sugar, fat) that the processed food industry uses to assure a return customer. Check out: Salt Sugar Fat: how the food giants hooked us by Michael Moss

    Lifestyle management is a more complex undertaking than just taking a daily pill. Change in diet, exercise, weight reduction, stress management, supplements are all part of this integrated treatment system.

    August is National Coffee Month! Research supports many benefits of coffee and tea drinking, just hold the sugar!  Research at the Coffee Institute: http://vanderbilt.edu/ics/coffee-news/ shows a reduction in Parkinson’s disease, colon cancer, liver cancer and Type II Diabetes.

     

    Additional References:

    Shanahan MD, Catherine. Deep Nutrition: Why your genes need traditional food. Flatiron Books, 2016.

    Houston MD, M. What your doctor may not tell you about hypertension. Warner, 2003.

    De La Fort, Rosalee. Alchemy of Herbs. Hay House, 2017.

    Chinese Medicine has a rich and complex system of Food Cures. Here are some books from that tradition:

    Pitchford, Paul. Healing with Whole Foods: Asian traditions and modern nutrition. Encyclopedic book requiring a basic understanding for five element theory.

    Thunderhawk, Denise L. Ac. The 5 Element Guide to Healing with Whole Foods. LuLu Press, 2016. This is a basic and quite good introduction to five element nutrition.

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    Whole Foods: The Re-discovery of Nature Mini-Med 2017 #3

    Mini-Med 20176 Whole Foods: the Re-discovery of Nature-Beef/Pork/Lamb
    Stephanie Taylor MD PhD
    June 3, 2017

    “Rather than focusing on more product for less price, we must focus on replenishing the soil. The weakening of our nation’s soil contributes to an unavoidable chain reaction leading to the destruction of energy and Life as we know it. A depleted soil begets our foods lack of nutrients. Food without proper mineralization begets bodies that lacking the energy and minds lacking the clarity to live a fulfilling life……Statistics from the USDA reveal that today’s food has 30-70% less nutritional value than food 50 years ago…..An unhealthy soil grows unhealthy plants.” from Son of a farmer, child of the earth, by Eric Helm, pg. 104-5.

    Our Third Mini-Medical School asked the question-Is some “organic” better than others? The answer was a resounding YES. The Washington Post recently published an expose of the organic factory dairies. In addition to data collection and aerial photography, they also compared the composition of the milk to conventional, non-organic milk. In this analysis, organic factory farm milk was essentially identical to non-organic milk, despite commanding a premium price.The full story can be found at:  https://www.washingtonpost.com/business/economy/why-your-organic-milk-may-not-be-organic.

    In an effort to level the playing field, the Organic Animal Welfare Standards were finalized under the Obama administration, but implementation has been delayed by the current administration. The USDA requested an additional public comment period and this was completed today, June 9, 2017. The improved regulations will clarify overly broad definitions and guidelines. For example, chickens labelled "cage-free, organic"can be running in a grassy pasture or spend their entire life in large buildings. They are un-caged, but certainly not “free  range”. While we wait for better regulations, you can use the Cornucopia scorecard results that follow to guide your shopping.

    The following chemistry lesson reviews three key markers of good organic animal products in the essential fatty acid family, and then lists candid recommendations for consumers. The scorecard was accessed at Cornucopica.org June 2, 2017.

    First some chemistry:
    Good fats are the Omega 3 essential fatty acids (EFA): alpha linolenic acid (ALA), EPA and DHA.
    Omega 6 essential fatty acids: Linoleic acid (LA).
    Conjugated linoleic acid (CLA): isomers of LA.

    Health Benefits of EPA/DHA: decreases cardiac arrhythmias, coronary heart disease, lowers triglyceride levels, diabetes, modulates immune function, improves mental health, and facilitates neural development.

    Health benefits of ALA: Coronary heart disease and possible cancer risk.

    Health Benefits of CLA: Cancer, heart disease and possibly diabetes and immune function.

    Health benefits of LA: heart disease.  Note ratio of Omega 6/3 is important. Historically this was 1:1 and now is 10:1.

    Current Private Party labeling standards for pastured ruminants:

    American Grass-fed Certification: Diet — Animals are fed only grass and forage from weaning until harvest. Confinement — Animals are raised on pasture without confinement to feedlots.
    Antibiotics and hormones — Animals are never treated with antibiotics or growth hormones.
    Origin — all animals are born and raised on American family farms.

    Food Alliance Certification: Healthy and humane animal treatment – with no use of growth promotants or sub-therapeutic antibiotics, Integrated pest, disease and weed management, Soil and water conservation, Safe and fair working conditions, Wildlife habitat and biodiversity conservation. Grass-fed option available.

    Animal Welfare Approved: Continuous outdoor pasture access is required for all beef cattle in addition to extensive animal welfare requirements.

    The Union of Concered Scientists (UCS) reviewed 13 studies on Fatty acid composition of beef. Here are the conclusions:
    Total fat was significantly lower in pastured (grass-fed) beef.
    Pastured beef has higher levels of ALA, EPA/DHA and CLA. The Ration of Omega 6/3 is more favorable in pastured beef.

    Is it possible to consume meat and dairy in a way that is good for the environment?

    Recent research on soil remediation shows that rotation grazing and careful management of ruminants actually improves soil quality and that healthy soil can trap significant quantities of atmospheric carbon.  California has initiated a Healthy Soils initiative which will be implemented in the late fall of 2017. This will bring the research directly to ranchers and provide an incentive for conservation practices.

    Here are pertinent general references if you wish more in depth coverage or research data support:

    California Healthy Soils initiative:    https://www.cdfa.ca.gov/oefi/healthysoils/

    From the Union of Concerned Scientists-

    UCS: Greener Pastures. How grass fed beef and milk contributes to healthy eating.

    http://www.ucsusa.org/food_and_agriculture/solutions/advance-sustainable-agriculture/greener-pastures.html

    A shorter version with cooking advice.

    California State University at Chico Grass fed Beef research data and recipes.

    http://www.csuchico.edu/grassfedbeef/

    Books-The references in each book are most edifying.

    Herm, Eric. Son of a Farmer, Child of the Earth: A path to Agriculture’s Higher Consciousness. Dreamriver Press, 2010.

    Miller, MD, Daphne. Farmacology: What Innovative family farming can teach us about health and healing  Harper-Collins, 2013.

    Salatin, Joel. Folks, this ain’t normal: A farmer’s advice for happier hens, healthier people and a better World. Hatchett,  2011.

    Gibbons, Euell. Stalking the Wild Asparagus: Fiftieth Anniversary Edition.  Alan Hood & Co., 1960. This is a favorite book, but be careful wildcrafting plants as they may be sprayed with herbicide. Only highly experienced persons should ever gather mushrooms. We have several poisonings annually and some are fatal. This includes your dogs!

    Shopping and Sourcing

    Where to buy pastured meats on the internet:

    http://www.fivemarysfarms.com/

    https://www.morrisgrassfed.com/

     

    Mini-Med 2017 June      Whole Foods: the rediscovery of Nature-Dairy
    Stephanie Taylor MD PhD

    Ranking of Organic Dairy Producers (incorporating Animal Welfare measures)

    Five Cow rating (Outstanding): All ratings from Cornucopia.org

    Organic Pastures Dairy Company    Milk, cheese, butter, colostrum, kefir
    Green Valley Organics- goat milk yogurt

    Four Cow rating (Excellent):

    Supernatural (Kalona Organics)-Yogurt
    Organic Valley (CROPP)-Full line of dairy products
    White Mountain Foods-Yogurt
    Julie's (Oregon Ice Cream)-Ice Cream
    Wallaby Yogurt
    365 organic (Whole Foods)-Fluid milk
    Cowgirl Creamery-Cheese
    Straus Family Creamery- Full line dairy
    Clover Organic Farms-Fluid milk products
    Stonyfield-Yogurt
    Lifeway-Kefir
    Sunnyside Farms (Save Mart, Lucky, Food Maxx)-Milk
    Sierra Nevada Cheese Company-Cheese

    One Cow-Private Label

    Clearly Organic (Associated Wholesale Grocers)
    Full Circle (Topco)
    Great Value (Wal-Mart)
    Kirkland Signature (Costco)
    O Organics (Safeway)
    Simply Balanced (Target)
    Trader Joe's

    NO COWS (Ethically Deficient) Most produce or purchase factory farm milk and/or refused to participate in the study:  Alta Dena, Back to Nature (Kraft), Borden Dairy (Dean Foods), Challenge Dairy products, Earth’s Best (Hain, Celestial), Green Mountain Creamery (Ehrmann Dairies), Horizon (White Wave), Humboldt Creamery (Foster Farm Dairy), Pavel’s Yogurt, Source Naturals (Protein Powder), St. Benoit Yogurt.   See more at: https://www.cornucopia.org/dairysurvey/index.html

    Yogurt  Yogurt is a superb health food but not if it has multiple additives. Recommended daily intake of added sugars is 24 Grams for women and 36 grams for men.  Yogurt scores based on organic score, and the presence of thickeners, carrageenan, artificial sweeteners, added sugar ( 4 grams=1 teaspoon), added coloring, added artificial flavors, synthetic nutrients, milk protein concentrate, or preservatives.  Printable yogurt scorecard at:
    https://www.cornucopia.org/yogurt-scorecard/docs/Yogurt%20scorecard%20Printable.pdf

    Mini-Med 2017 June      Whole Foods: the rediscovery of Nature-Eggs

    Ratings below are reported by Cornucopia.org
    Data Accessed June, 2017 at:

    https://www.cornucopia.org/organic-egg-scorecard/

     

    “5-egg” rating (2260-2700): “Exemplary”—Beyond Organic

    Producers in this top tier manage diverse, small to medium-scale family farms. They raise their hens in mobile housing on well-managed and ample pasture or in fixed housing with intensively managed rotated pasture. They sell eggs locally or regionally under their farm’s brand name, mostly through farmer’s markets, food cooperatives and/or independently owned natural and grocery stores and sometimes through larger chains like Whole Foods.
    Stueve's Certified Organic
    by Stueve's Certified Organic
    Redhill Farms
    by Vital Farms

    “4-egg” rating (2000-2250): “Excellent”—Organic Promoting Outdoor Access

    Producers in this category provide ample outdoor space and make an effort to encourage their birds to go outside. They provide an excellent outdoor environment, often either rotated pasture or well-managed outdoor runs, with an adequate number of popholes/doors for the chickens to reach the outdoors.
    Mary's Organic Eggs
    by Pitman Family Farms

    3-egg” rating (1800-2000): “Very Good”—Organic, Complying with Minimum USDA Standards

    Brands with a three-egg rating are very good choices. Eggs from brands in this category either come from family-scale farms that provide outdoor runs for their chickens, or from larger-scale farms where meaningful outdoor space is either currently granted or under construction. All producers in this category appear committed to meeting organic standards for minimum outdoor space for laying hens.
    Happy Egg
    by Noble Foods

    2-egg” rating (1000-1800): “Fair” —Some Questions Remain Concerning Compliance with Federal Standards

    These are either industrial-scale operations or others with outstanding questions or concerns regarding their compliance with USDA regulations. One of the primary features that distinguish these organizations from the ethically challenged brands below is their willingness to share with their customers (and Cornucopia researchers) some of the details as to how their chickens are cared for and how their eggs are actually produced.
    Clover Organic
    by Clover

     

    “1-egg” Rating (Name Brand) 0-1000: “ethically deficient - industrial organics/no meaningful outdoor access and/or none were open enough to participate.”

    Brands with a “1-egg” rating are generally produced on industrial-scale egg operations that grant no meaningful outdoor access. “Outdoor access” on these operations generally means a covered concrete porch that is barely accessible to the chickens. Means of egress from the buildings are intentionally small to discourage birds from going outside, and make it possible for only a small percentage of birds to have “access” to the outdoors. No producers in this category were willing to participate in The Cornucopia Institute’s project, and none shared their production practices with Cornucopia researchers. This is disturbing to many organic consumers, since transparency has always been viewed as a hallmark of the organic food movement.
    Alta Dena
    by Dean Foods
    Barnstar Family Farms
    by Nucal
    Glaum Egg Ranch
    by Glaum Egg Ranch
    Judy's Family Farm
    by Petaluma Farms
    Naturally Organic
    by National Food Corp
    "1-Egg" Rating (Private Label) 0-1000
    Private‐label, or store‐brand, eggs rated with one egg are sold by grocers or distributors who have the obvious desire of wanting to grow their presence in the organic marketplace. Unfortunately, there is an inherent limitation in private‐label organic products: organic consumers tend to want to know where their food is coming from and how it is produced, and private‐label products are anonymous by their very nature. Our research indicates that the vast majority of organic eggs for private label brands are produced on industrial farms that house hundreds of thousands of birds and do not grant the birds meaningful outdoor access.
    365 Organic
    by Whole Foods
    Archer Farms
    by Target
    Clearly Organic
    by Associated Wholesale Grocers
    Country Creek
    by Walmart
    Kirkland Signature
    by Costco
    O Organics
    by Safeway
    Trader Joe's  by Trader Joe’s

     

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    Mindfulness: Practical Applications

    Mindfulness: Practical Applications
    Mini-Medical School #2, April 8, 2017
    Stephanie Taylor MD, PhD

    Between stimulus and response there is a space.
    In that space is our power to choose our response.
    In our response lies our growth and our freedom.
    Viktor E. Frankl

    Mindfulness is attending to the present. There is nothing foreign, difficult or exotic about mindfulness. Mindfulness as applied to stress reduction is the most widely known practice, and was developed in the 1970s by Jon Kabat-Zinn at the University of Massachusetts Medical Center. It is, at its heart, a meditation practice that can be learned and used by anyone. It was initially applied in medical settings with excellent results on depression, anxiety and fear of disease recurrence.
    Mindfulness means attending to your current internal and external perceptions. This is greatly facilitated by attending to breathing. Here is a three minute body scan meditation:

    Begin by bringing your attention into your body. You can close your eyes if that’s comfortable for you. You can notice your body seated wherever you’re seated, feeling the weight of your body on the chair, on the floor. Take a few deep breaths. And as you take a deep breath, bring in more oxygen enlivening the body. And as you exhale, have a sense of relaxing more deeply. You can notice your feet on the floor, notice the sensations of your feet touching the floor. The weight and pressure, vibration, heat. You can notice your legs against the chair, pressure, pulsing, heaviness, lightness. Notice your back against the chair. Bring your attention into your stomach area. If your stomach is tense or tight, let it soften. Take a breath. Notice your hands. Are your hands tense or tight? See if you can allow them to soften. Notice your arms. Feel any sensation in your arms. Let your shoulders be soft. Notice your neck and throat. Let them be soft. Relax. Soften your jaw. Let your face and facial muscles be soft. Then notice your whole body present. Take one more breath. Be aware of your whole body as best you can. Take a breath. And then when you’re ready, you can open your eyes.
    From www.mindful.org

     

    Mindfulness based exercises are currently applied in a wide variety of settings.

    We will review several and give practical tips for application.

    Schools and Education

    http://www.mindfulschools.org/

    http://greatergood.berkeley.edu/article/item/research_round_up_school_based_mindfulness_programs/success

    Relationships and Parenting

    https://www.theatlantic.com/health/archive/2015/07/mindfulness-meditation-empathy-compassion/398867/

    Everyday Blessings: The inner work of mindful parenting by Jon Kabat-Zinn
    Veterans, First Responders, Police Officers

    In 2010 alone, 8,030 veterans died by suicide. This represents more loss of life than the total number of deaths in the Iraq and Afghanistan conflict since 2003.

    https://www.ptsd.va.gov/public/materials/apps/mobileapp_mindfulness_coach.asp

     Sports

    The Mindful Athlete: Secrets to Pure Performance by George Mumford, who was the mindfulness coach for the Chicago Bulls Basketball team.
    Here are his three principle points in quotes taken from Mindful Feb 2016, pg. 47-54 written by Hugh Delehanty, www.mindful.org:
    “Be still and know”: Mumford learned the power of stillness from Tai Chi practice. “When the mind is still you have an inner knowing when and how to strike.” This has also been describes as being in the flow.
    Forget Yourself, Find Yourself: “not how you are doing but what are you doing.”

    Mindfulness and more: “Steadiness of mind, right effort and wisdom.”

    Specific examples from Tai Chi Chuan Practice.

    Exercise in focused attention. Tai Chi walking for fall prevention.

    Tools: Useful cell phone apps: Headspace, and
    http://www.mindful.org/free-mindfulness-apps-worthy-of-your-attention/

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