Category Archives: Portfolio


Super Simple School Lunches

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Social media is filled with images of school lunches containing a variety of foods. It’s usually something like a sandwich, a fruit, a vegetable, a homemade muffin, and a little “treat.”

Now I’m not against all the foods I listed above, but I don’t think all of them are necessary. In fact, they may even be wasteful.

Let me explain….

Today kids have 20–30 minutes for lunch while at school. This includes the time it takes to get to the lunchroom, sit down, settle down, open and unpack their lunch, eat, clean-up and lineup for what’s next. This means they have an average of 10 minutes (if that) to actually eat.

So…if you want your kid to eat a healthy lunch (and not waste food), packing a large variety of food is not the best approach. Especially if there are several containers and packages that your child must open.

And in many cases, your child may eat the “treat” and homemade muffin, and then run out of time to eat the healthier stuff.

Therefore, I recommend keeping school lunches super simple. Less stress for you AND your child. Because some children, especially picky eaters, get overwhelmed with too many options and an abundance of food in front of them

Think about what you would serve at home for lunch. A sandwich with a piece of fruit. Or a bowl of pasta with a veggie.

At most, all you need to pack is TWO THINGS. A main dish and a fruit or veggie. That’s it! And in some cases, one thing is all you need.

Before I share some specific examples of what to pack, here are a few tips to keep in mind when packing school lunches:

  1. Use containers that are easy to open. If your child has trouble, he or she will need to waste time trying to track someone down to help. I recommend using a two compartment bento box of sorts. I have personally been using the same ECOlunchbox since 2013.
  2. Save new foods for home snacks and meals. If you pack something your child isn’t familiar with, there is a good chance he or she won’t eat it. Therefore, stick to foods you know your child will eat.
  3. Don’t forget utensils! Again, if you forget the utensils, your child will need to spend precious time searching for them.
  4. Use an ice pack. This will ensure the food stays at a safe temperature until lunchtime.
  5. If you’re packing a hot lunch, Thermos brand containers work great to keep food warm. These containers are also great for liquid cold foods, such as yogurt.
  6. Ask your child not to dump the food he or she doesn’t eat. This will allow you see what’s working and what’s not. To (calmly) talk to your child about it. Are you packing too much or too little? If you notice there is something that your child never eats, maybe you should save that food for home.
  7. Avoid packing foods that are difficult to chew. For example, celery can be difficult to chew for some children (including my son). So, I stopped packing it in his lunch and only serve it at home when he has more time to eat. Whole nuts can also be hard for kids to chew. However, chopping them into smaller pieces often makes it easier.
  8. Pack foods that are easy for your child to get into his or her mouth. For instance, some younger kids may struggle with utensils. If this is the case, finger foods are probably best. I use these adorable metal picks for my son’s lunch. They are fun and easy to use.
  9. Pack foods that are ready to eat. While I love the idea of “building your own” sandwich or tacos, most kids just don’t have the time. Chopping and slicing meats, fruits, and veggies are also essential. Your child doesn’t have time to cut up his or her steak.
  10. Pack water to drink. It’s the healthiest option. Plus, it will save you money. I recommend using reusable stainless steel water bottles. I have personally been using the Thermos brand FUNtainers since 2011.
  11. Create a weekly lunch calendar and get your child’s input. He or she will then know what to expect. Many children, especially picky eaters, don’t like to be surprised when it comes to food.

So…what do super simple school lunches look like?

Most often it’s a main dish with a fruit or veggie on the side. But some main dishes are enough.

Consider the following main dishes that don’t necessarily need anything extra:

  • Soup, stew, or chilli (e.g. chicken vegetable, split pea, beef stew, black bean soup)
  • Yogurt parfaits – full fat plain Greek yogurt with berries and a little raw honey. Chopped nuts, seeds, and/or granola are also nice additions.
  • Overnight oats – these can be prepared overnight and include fruits, nuts, and seeds for a complete lunch
  • Salad with protein (e.g. chicken Caesar salad)
  • Pasta with a veggie and protein (e.g. broccoli and chicken or broccoli and meat sauce)
  • Bean or meat and veggie burritos
  • Quinoa veggie bowl
  • Bean salad with veggies

Now for some two item lunch ideas, use the chart below. Pick one item from each column. Mix and match to find combinations your child will eat. And consider getting your child’s input.

Also, I can’t emphasize enough that leftovers work great. I would never cook my son a piece of chicken or a pork chop in the morning just to pack in his lunch. If it’s in his lunch, it’s because we had it for dinner the night before or earlier in the week.

Leftovers can also be used to make new meals. For example, roasted chicken can be used to make chicken salad.

And, as your child grows, simply pack larger portions.

Main Dishes

Veggie or Fruit

Egg salad Carrot sticks or slices
Tuna or salmon salad Red pepper slices
Hard boiled eggs Berries
Chicken salad Apple slices
Chicken Orange slices
Pork chop Banana
Steak Celery sticks
Sandwich or wrap* Melon cubes
Shrimp Pineapple cubes
Salmon (or other fish) Pomegranate seeds
Meatballs Fermented pickles
Lentil pasta Cucumber slices
Beans with cheese Avocado slices
Fajita or taco meat Cherries
Deviled eggs Grapes
Homemade granola (with nuts or seeds) Pear slices
Ham and cheese cubes Diced mango
Lasagna Sugar snap peas
Pulled pork or chicken Coleslaw
Hummus and pita Potato salad
Mac and cheese Cherry tomatoes
Cottage cheese Applesauce

There are endless possibilities for sandwiches and wraps. However, most commercial brands of bread contain main unnecessary ingredients, including sugar.

My favorite brand of bread is Berlin Bakery. They make a whole grain spelt bread and a sourdough spelt bread that contain only the necessary ingredients.

Homemade bread is also great if you have the time. Sprouted bread is the next best but still check the ingredient list.

Some sandwich ideas include:

  • Uncured deli meats and cheese
  • Smoked salmon and cream cheese
  • Peanut or sunbutter with raw honey
  • Hummus and avocado (tomato and/or cucumber also work)
  • BLT (bacon, lettuce and tomato)
  • Egg salad
  • Chicken salad
  • Tuna or salmon salad

To Sum It Up…

The idea is to KEEP IT SUPER SIMPLE. Save the fancy stuff for the weekends when you have more time. And when your kids have more time to eat and enjoy your fun creations.

Keeping it simple will save you time, money, and your sanity. And most importantly, your child will eat a healthy lunch.

Why is Nutrition SO Important- (6)

Heart Health

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Heart disease is the leading cause of death for both men and women in the United States. It claims approximately one million lives each year.

And despite a booming cholesterol-lowering statin drug industry, rates of heart disease keep increasing. In fact, experts predict it will be the number one cause of death worldwide by 2020.

This is because conventional medicine focuses mostly on cholesterol as the major risk for heart disease. Therefore, statins are far too frequently prescribed to reduce cholesterol levels. And statins do effectively lower cholesterol. But that’s it.

Statins relieve a symptom (high cholesterol), but they don’t address the underlying risk factors that can lead to heart disease.

The truth is diet and lifestyle play a critical role in the development of cardiovascular disease even when a genetic predisposition exists. Therefore, we must address these factors to end the heart disease epidemic.

How Heart Disease Begins

We now know heart disease begins with damage to a single cell lining of the arteries, known as the endothelium, that pump blood to the heart. When the integrity of the endothelium is compromised, fat cells, oxidized LDL cholesterol, immune cells, cellular debris, and calcium begin to build-up within the coronary arteries.

This “sticky” substance is often referred to as plaque. If the plaque grows large enough, it starts to restrict blood flow to the heart. Another complication occurs when the plaque ruptures. The body instantly forms a blood clot (thrombosis), which further blocks the flow of blood and prevents the heart from efficiently and effectively receiving critical nutrients as well as oxygen. This often leads to a heart attack or in some cases sudden death

In some cases, a heart attack is the first sign of heart disease. And sometimes individuals have no symptoms before a heart attack occurs. Others may experience the following symptoms:

  • Abnormal heart beat
  • Shortness of breath
  • Fluid in lungs
  • Dizziness
  • Angina (chest pain)
  • Swollen feet and ankles
  • Fatigue
  • Anxiety

Leading Cause of Heart Disease

We also now know that inflammation and oxidative stress are the leading causes of endothelium damage, which leads to the development of heart disease.

In fact, LDL-cholesterol (the “bad” cholesterol) is not all bad. It is only dangerous once it becomes oxidized. The process of oxidation makes it sticky and more likely to adhere to the arterial wall.

To make matters worse, once plaque begins to accumulate in the arteries, it causes further inflammation, oxidative stress, and other conditions such as high blood pressure and vascular autoimmunity.

Comprehensive List of Risk Factors

Inflammation and oxidative stress most often result from a nutrient deficient diet high in trans-fatty acids and refined grains and sugars. Other factors that cause and/or worsen inflammation and oxidative stress include:

  • Lack of exercise
  • Poor sleep
  • Obesity and visceral fat
  • Diabetes
  • High insulin levels
  • High blood sugar
  • Insulin resistance
  • High triglycerides and/or cholesterol
  • Elevated homocysteine levels
  • High blood pressure
  • Chronic stress
  • Heavy metal exposure
  • Environmental toxins
  • Smoking
  • Alcohol abuse
  • Chronic infections
  • Autoimmune diseases
  • Inflammatory diseases

Genetic Risk Factors

While inflammation and oxidative stress are at the top of the list, it is important to note there are also genetic factors involved in the progression of heart disease. Genetic predispositions associated with heart disease include:

  • Family history of early heart disease
  • Male-pattern baldness
  • Diagonal earlobe crease and hairy earlobes
  • Short stature (men < 5’5” | women < 5’)
  • Tall (men > 6’ | women > 5’8”)

However, it’s extremely important to understand that various individual factors can and do influence your genetics. This is known as epigenetics, which means you have the power to defy your DNA. And a healthy diet and lifestyle can prevent the expression of your “disease” genes.

Additional Risk Factors to Consider

Other unique risk factors include:

  • Defective heart muscle and/or function
  • Age (55 in men | 60 in women)
  • Gender (males are at higher risk until a woman hits menopause)
  • Osteoporosis at menopause
  • High levels of estradiol (form of estrogen) in men
  • Hormonal deficiencies
  • Kidney disease

Why Conventional Treatment Isn’t Working

As you can see, there are many risk factors associated with heart disease. Not just cholesterol or high blood pressure. And this is why administering medications to lower cholesterol and/or blood pressure will not reduce your risk of developing heart disease.

In fact, research has even shown cholesterol-lowering statin drugs can actually accelerate the progression of heart disease. While there are several ways in which this happens, two specific mechanisms include the depletion of CoQ10 and the inhibition of vitamin K2 synthesis. And these are two nutrients essential to optimal heart health.

The Functional Medicine Approach to Preventing Heart Disease

Heart disease is 100% preventable. However, it requires identifying and addressing all sources of inflammation and oxidative stress (the underlying causes).

Dietary support should rely heavily on anti-inflammatory and antioxidant foods. Therefore, I always recommend a nutrient-dense whole food diet rich in a rainbow of fruits and vegetables, high-quality proteins and fats, nuts, seeds, herbs, and spices. In addition, targeted nutrient support may be necessary.

Stress management, restful sleep, and exercise are also critical lifestyle factors to arterial and heart health.

My goal as a functional medicine doctor is to help you identify your individual risk factors as well as create a personalized diet and lifestyle plan to prevent heart disease as well as achieve vibrant health.


Bowden, J., Sinatra, S. T., & Rawlings, D. (2015). The great cholesterol myth: why lowering your cholesterol won’t prevent heart disease – and the statin-free plan that will. Beverly, MA: Fair Winds Press.

Houston, M. (2012). What Your Doctor May Not Tell You About Heart Disease. New York, NY: Grand Central Life & Style.

Hyman, M. (2012). The Blood Sugar Solution. New York, NY: Little, Brown and Company.

Rath, M. (2003). Why Animals Don’t Get Heart Disease…But People Do! Fremont, CA: MR Publishing, Inc.

Okuyama, H., Langsjoen, P. H., Hamazaki, T., Ogushi, Y., Hama, R., Kobayashi, T., & Uchino, H. (2015). Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms. Expert Review of Clinical Pharmacology,8(2), 189-199. doi:10.1586/17512433.2015.1011125

Petursson, H., Sigurdsson, J. A., Bengtsson, C., Nilsen, T. I. L., & Getz, L. (2012). Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid? Ten years prospective data from the Norwegian HUNT 2 study. Journal of Evaluation in Clinical Practice18(1), 159–168. Doi:10.1111/j.1365-2753.2011.01767.x

Bowl of fresh mixed berries and yogurt

What Are Food Intolerances?

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Well, it’s first important to understand that a food intolerance is NOT the same as a food allergy.

Food allergies are reactions to food that trigger the immune system. On the other hand, food intolerances are reactions to food that do not initiate an immune response.

Causes of Food Intolerances

Enzyme deficiencies and digestive dysfunction are the most common causes of food intolerances. Let’s take a closer look…

Enzyme Deficiencies

Different types of enzymes are necessary to successfully digest some substances in food. And if your body lacks a specific enzyme, then you may react to a certain substance.

For example, lactase is an enzyme that breaks down lactose (a sugar) found in dairy products. Thus, those suffering from lactose intolerance simply lack the enzyme lactase. Symptoms then arise from the inability to properly digest lactose.

In addition, some people may lack an enzyme known as diamine oxidase, which is responsible for breaking down histamines naturally found in food. Thus, they may experience unpleasant symptoms when they consume foods high in histamine (i.e., fish, cheese, and fermented foods).

Digestive Dysfunction and Disorders

Two of the main responsibilities of the digestive tract are to neutralize potential threats and digest food into their basic components. But if you’re digestive system is not functioning properly, you’re more likely to experience reactions from the food you ingest. Thus, the health of your gut highly influences how your body reacts to food.

Gut infections, bacterial imbalances, and intestinal permeability (leaky gut) are just some of the digestive related conditions that may trigger food intolerances.

One specific example of an intolerance due to digestive dysfunction is known as fructose intolerance (or malabsorption). Fructose is a type of sugar naturally found in fruit as well as highly refined sugars, such as agave nectar and high fructose corn syrup.

For one reason or another, some people are unable to fully absorb fructose. Thus, it remains in the digestive tract and eventually begins to ferment. And the fermentation process typically causes uncomfortable gas and bloating.

Signs & Symptoms of Food Intolerances

Food intolerances typically cause delayed reactions as opposed to allergic reactions that usually occur within two to four hours. Thus, food intolerances are often more difficult to diagnose.

The most common signs and symptoms of food intolerances include:

  • Gas
  • Bloating
  • Fatigue
  • Diarrhea
  • Constipation
  • Abdominal pain

In addition, the frequency and severity of symptoms may fluctuate. As previously mentioned, gut health is a big factor. And sometimes the dose matters. Maybe you can tolerate a small dose of an offending food, but you react when that food is consumed in larger quantities.

It’s also worth noting that while these symptoms are not life-threatening, they can severely (and often do) impact your sense of well-being and quality of life. Thus, diagnosis and treatment are critical to achieving optimal health.

Food Intolerances and Irritable Bowel Syndrome

Food intolerances share many of the same symptoms of irritable bowel syndrome (IBS), which include gas, bloating, constipation, diarrhea, and abdominal pain.

And IBS is typically diagnosed when all other intestinal disorders are ruled out. Thus, it’s possible that food intolerances are an underlying factor. Especially since most medical doctors only test for food allergies.

So…if you’ve been diagnosed with IBS (as 15% of the U.S. population has), you may want to consider working with a nutrition professional, functional medicine practitioner, or naturopath to help identify problematic foods.

Common Food Offenders

You can be intolerant to any food for a variety of reasons. However, some of the most common offenders include:

  • Dairy
  • Fructose

What are FODMAPs?

FODMAPs stand for fermentable oligo-, di-, and monosaccharides and polyols. In laymen terms, this means fermentable carbohydrates.

For some, FODMAPs are poorly absorbed by the small intestine. Thus, similar to fructose, they remain in the digestive tract where they are fermented by gut bacteria.

Examples of FODMAPs include specific carbohydrates found in:

  • Wheat
  • Garlic
  • Onions
  • Legumes
  • Seeds
  • Dairy
  • Fruit
  • Sweeteners (natural and artificial)

How to Identify Problematic Foods

One of the best ways to identify problematic foods is by keeping a food journal. Essentially, you’ll need to start tracking the foods you’re eating and how they make you feel.

Maybe you’ll notice that you feel bloated when you drink milk. Or, that fruit gives you gas.

Another option is to consider implementing a low FODMAP diet. Essentially this means limiting your consumption of foods with high concentrations of fermentable carbohydrates. If your symptoms improve, it may be a sign that FODMAPs are problematic for you.

Finally, if you suspect dairy is a source of your digestive distress, there is a lactose intolerance test known as the hydrogen breath test. After consuming a solution containing lactose, the test measures the amount of hydrogen in your breath over the course of several hours.

If you’re successfully able to digest lactose, your hydrogen breath levels will be low. On the other hand, if lactose remains in your digestive tract, the fermentation process releases gas as well as hydrogen. Thus, if your hydrogen levels are high, it may be a sign of lactose intolerance.


Generally, it is recommended to avoid problematic foods. However, gut-healing protocols are often put into place as well. And once the gut heals, you may be able to tolerate small doses of certain foods again.

In Conclusion

Food intolerances are:

  • reactions to food that do not involve the immune system;
  • most often related to enzyme deficiencies and digestive dysfunction
  • difficult to diagnose because symptoms are delayed and not always consistent;
  • best identified by journaling your food intake and symptoms; and
  • treatment often involves the elimination of offending foods as well as gut healing protocols.


Hayes, P. A., et al. (2014). Irritable Bowel Syndrome: The Role of Food in Pathogenesis and Management. <em>Gastroenterology &amp; Hepatology</em>, <em>10</em>(3), 164–174.

Manzotti, G., et al. (2016). Serum diamine oxidase activity in patients with histamine intolerance. <em>International Journal of Immunopathology and Pharmacology,29</em>(1), 105-111. doi:10.1177/0394632015617170

Pasqui, F., et al. (2015). Adverse food reaction and functional gastrointestinal disorders: role of the dietetic approach. <em>Journal of Gastrointestinal and Liver Diseases,24</em>(3). doi:10.15403/jgld.2014.1121.243.paq

Ross, E., et al. (2016). The Low FODMAPS Diet and IBS: A Winning Strategy. <em>Journal of Clinical Nutrition &amp; Dietetics,02</em>(01). doi:10.4172/2472-1921.100013

Turnbull, J. L., et al. (2014). Review article: the diagnosis and management of food allergy and food intolerances. <em>Alimentary Pharmacology &amp; Therapeutics,41</em>(1), 3-25. doi:10.1111/apt.12984

Zopf, Y., et al. (2009). The Differential Diagnosis of Food Intolerance. <em>Deutsches Ärzteblatt International</em>, <em>106</em>(21), 359–370. doi:10.3238/arztebl.2009.0359

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5 Key Benefits of Keeping A Food Journal

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If you’re trying to lose weight, improve your health, or prevent disease, you must to take a closer look what you’re eating (and what you’re not). And there is no better way than keeping a food journal.

In fact, I require all of my clients to keep food journal. And here are my top 5 reasons why:

Compares Perceptions to Reality

Keeping a food journal is truly the only way to determine whether or not your perceptions match reality. Many people think they’re eating healthy, but often find it eye opening when they see their food intake on paper. Because it’s not just about what you eat. It’s also about your eating habits.

Helps to Improve Your Diet

When you keep track of what you eat, you get a more detailed picture regarding your nutritional intake. For instance, are you eating enough protein? Are you eating too much sugar? Is your diet lacking sources of healthy fats?

Thus, you can use your food journal to help create a more balanced and nutrient-rich meal plan.

Helps Break Unhealthy Eating Habits

A good food journal keeps tracks of what you eat, but also how much you eat and when you eat.

You might learn that you eat more when you’re dining with others than solo. Or, maybe you’ll notice you always reach for sugar in the mid-afternoon. Seeing these patterns will help you make the necessary changes to break any bad habits.

For example, maybe you need to be more mindful when eating out with friends. Or, maybe you need a more balanced lunch to ward off your 3:00 PM sugar craving.

Identifies Food Allergies, Sensitivities, and Intolerances

Even the healthiest foods can wreak havoc on some. Thus, for weight loss and optimal health, it’s really important to learn what foods work for you and what foods don’t.

For example, a food journal might help you realize that cheese is what causes your bloating, which may be a sign of a dairy sensitivity or lactose intolerance.

Connects the Dots Between Food and Your Health

What we eat affects every aspect of our physical and mental health. We can’t expect to eat poorly and feel great. Some foods may energize you, while others drain you. And some foods may lift your spirits, while others weigh you down.

Thus, by examining your food journal, you can learn a lot about how food affects YOUR body and mind. And once you connect these dots, I guarantee reaching your health goals will be much easier.

Food Journaling Tips

Food journaling may seem time-consuming, but it doesn’t have to be. While you certainly can carry your journal around with you, you can also take a picture of your meals and snacks with your phone and send them to yourself with notes about your energy level and mood before and you ate. Then, each night before bed you can use your photos and notes to complete the food journal.

In Conclusion…

Keeping a food journal is one of the best strategies you can implement to help improve your diet, break bad eating habits, prevent disease, and successfully achieve all your health and wellness goals.


Glaucoma in Dogs

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Glaucoma defines a group of eye conditions that are characterized by an elevated intraocular pressure, which typically leads to optic nerve damage. It’s a painful condition and the most common cause of blindness in dogs.

What is Intraocular Pressure?

The shape and size of the eyeball is regulated by fluid known as aqueous humor. Essentially, the eye is a fluid-filled ball, and the pressure of this fluid is known as intraocular pressure (IOP).

Eye fluid is constantly produced and contains nutrients and oxygen necessary for the eye to function optimally. Excess fluid is released through the “drainage angle” to maintain optimal IOP.

If fluid does not drain effectively, the IOP rises. Subsequently, the eye often gets larger and may take on an irregular shape. If not addressed immediately before this happens, the increased pressure can damage the optic nerve, which typically leads to vision loss.

An increase in pressure is what causes the pain, which most likely resembles a headache or even a migraine.

Early Warning Signs and Symptoms

Early intervention and treatment are necessary for the best possible outcome. Therefore, it’s extremely important to recognize the initial signs and symptoms.

At the onset of glaucoma, your dog may experience one or more of the following:

  • Red and/or cloudy eye(s)
  • Bloodshot eye(s)
  • Abnormally small or large pupil(s)
  • Abnormal blinking
  • Squinting or fluttering eyelids
  • Loss of appetite
  • Lack of interest in playing or socializing
  • Rubbing eye with paw or on the floor (due to pain)
  • Tearing or watery discharge
  • Crust around eye(s)
  • Bumping into walls and furniture
  • Swollen eye(s)
  • One eye larger than the other
  • Intolerance to light
  • Third eyelid elevation

Types of Glaucoma

Glaucoma is classified as either primary or secondary.

Primary Glaucoma

Primary glaucoma often occurs suddenly without warning. It’s believed to be genetic and caused by a physical or functional abnormality that prevents eye fluid from draining properly. For example, the drainage angle may be deformed or the opening may be too small.

Primary glaucoma typically starts in one eye and then moves to the other. Thus, always check for differences between the two eyes.

The age of onset is usually between four and ten years. However, it is possible at any age.

While primary glaucoma has been documented in mostly all dog breeds, some breeds are predisposed, which include:

  • Cocker Spaniel
  • Basset Hound
  • Wire Fox Terrier
  • Boston Terrier
  • Chow Chow
  • Shar-Pei
  • Norwegian Elkhound
  • Siberian Husky
  • Samoyed
  • Cairn Terrier
  • Maltese
  • Miniature Poodle
  • Beagles
  • Dalmatian
  • Chihuahua
  • Magyar Vizsla

In North America, the prevalence of primary glaucoma in these predisposed breeds can be as high as 5.5%.

Secondary Glaucoma

Secondary glaucoma occurs when IOP increases as a result of another eye related disease or damage to the eye. Such conditions include:

  • Cataracts
  • Tumors
  • Lens dislocation
  • Penetration of the eye
  • Infection
  • Inflammation (anterior uveitis)
  • Scarring from injury
  • Bleeding and blot clots
  • Retinal detachment

As a result, diagnosis and treatment of these conditions is also time sensitive to prevent the occurrence of glaucoma. Further, dogs with these disorders should routinely have their IOP measured.

While secondary glaucoma is not considered hereditary, the underlying conditions may be, such as cataracts and lens dislocation.

The combined prevalence of primary and secondary glaucoma is approximately 2% in the general canine population.

It’s also worth noting that the prevalence of cataracts (a common cause of secondary glaucoma) is estimated to be as high as 3.5% within the general canine population. However, for breeds with genetic predispositions, the prevalence has been calculated as high as 11%. Further, several of the same breeds predisposed to primary glaucoma are also more likely to develop cataracts, including cocker spaniels, terriers, and miniature poodles.

Inflammation caused by anterior uveitis is also very common in dogs.


As previously mentioned, immediate medical treatment is necessary if your dog exhibits one or more of the symptoms listed above. Complete loss of vision is more likely to occur the longer you wait. In some cases, blindness can occur within hours.

The veterinarian will perform an eye examination as well as measure the fluid pressure with an instrument known as a tonometer.

For a majority of dogs, a normal IOP is between 15 and 25 mmHg. Early stages of glaucoma typically produce IOP results between 20 an 30 mmHg. Moderate cases reach IOP levels between 30 mmHg and 40 mmHg. With advanced stages, IOP can rise between 40 and 50 mmHg.

If the pressure is raised above normal, and there are no other obvious explanations, glaucoma is diagnosed.

Promptly you will need to see a veterinary ophthalmologist whom has all the necessary equipment to further evaluate the eye to determine the best course of action. Specifically, the ophthalmologist uses special tools to examine the drainage angle and the optic nerve. X-rays and ultrasounds may also be required to rule out the presence of tumors, injuries, and abscesses.


Treatment depends on the severity of damage, and each case is different.

In general, the key goals of treatment are to:

  • Reduce pain
  • Reduce intraocular pressure
  • Increase drainage
  • Decrease fluid production

If there’s a chance to save your dog’s vision, medical treatment will be administered to reduce IOP. The drug or combination of drugs your ophthalmologist chooses with depend on the level of pressure and condition of the optic nerve.

Some medications are given orally, while others get placed directly in the eye. The most commonly prescribed drugs include:

  • Osmotic diuretics – reduce fluid production
  • Carbonic anhydrase inhibitors – reduce fluid production
  • Miotics – promote fluid release by constricting the pupil
  • Adrenergic drugs – promote fluid release
  • Prostaglandin analogs – promote fluid release
  • Beta – blockers – reduce fluid production

With secondary glaucoma, the underlying disease or dysfunction must also be treated. This may involve medications to reduce inflammation (i.e., corticosteroids) or treat an infection (i.e., antimicrobials).

While medication can reduce pain and delay disease progression, it’s not an effective long-term solution. Thus, once IOP has been reduced, surgery is most often necessary.

Some surgical procedures aim to reduce fluid production. However, other more successful procedures involve the use of implants to promote better fluid drainage. Specifically, a small hollow tube is placed in the eye to prevent blockages.

In either case, success is not guaranteed and complications are possible. Thus, the eye will need to be carefully monitored on a regular basis. Unfortunately, repeat surgeries may be necessary.

Further, certain medications (i.e., cholinesterase) may be prescribed to slow the progression of disease in the unaffected eye. As previously mentioned, primary glaucoma almost always occurs in both eyes.

In the case of irreversible vision loss, which occurs in approximately 40% of cases, surgical removal of the eye is recommended. It’s truly the best way to alleviate pain and prevent further complications.

Cost of Treatment

As discussed above, primary glaucoma can develop suddenly without warning. Further, treatment is required immediately after diagnosis.

Below is a summary of the expenses you will most likely incur if your dog is diagnosed with glaucoma:

  • Emergency veterinary hospital visit
  • Ophthalmologist office visit
  • Eye examinations (i.e., IOP measurement, optic nerve imaging, ultrasound, X-rays)
  • Medications (immediate and ongoing)
  • Surgery (possibly more than one)
  • Follow-up office visits

In addition, if your dog’s vision is lost, you may need to make certain modifications in your home to ensure his or her safety.

Needless to say, the cost of treatment can reach as high as $3500 in a very short period of time.

In Conclusion

  • Glaucoma affects the eye and is one of the leading causes of blindness in dogs
  • Identifying early warning signs is essential since the disease progresses quickly
  • Prompt treatment is necessary and most often involves medications as well as surgery
  • Cost of immediate and ongoing treatment is high


Gelatt, K. N. (2014). Essentials of veterinary ophthalmology. Ames, IA: Wiley Blackwell.

Gelatt, K. N. et al. (2005). Prevalence of primary breed-related cataracts in the dog in North America. Veterinary Ophthalmology,8(2), 101-111. doi:10.1111/j.1463-5224.2005.00352.x

Gelatt, K. N. et al. (2004). Prevalence of the breed-related glaucomas in pure-bred dogs in North America. Veterinary Ophthalmology,7(2), 97-111. doi:10.1111/j.1463-5224.2004.04006.x

Gelatt, K. N., at al. (2004). Secondary glaucomas in the dog in North America. Veterinary Ophthalmology, 7(4), 245-259. doi:10.1111/j.1463-5224.2004.04034.x

Johnsen, D. A., et al. (2006). Evaluation of risk factors for development of secondary glaucoma in dogs: 156 cases (1999–2004). Journal of the American Veterinary Medical Association, 229(8), 1270-1274. doi:10.2460/javma.229.8.1270

Mellersh, C. S. (2014). The genetics of eye disorders in the dog. Canine Genetics and Epidemiology,1(1), 3. doi:10.1186/2052-6687-1-3

Miller, P. E., et al. (2015). Clinical Signs and Diagnosis of the Canine Primary Glaucomas. The Veterinary Clinics of North America. Small Animal Practice, 45(6), 1183–vi.

Researchers Advance New Glaucoma Treatments. (2015, February 3). Retrieved March 10, 2017, from

Tinsley, David M., et al. (1993) Glaucoma: Past and Present Management Techniques. Iowa State University Veterinarian, 55(1).

salmon dinner

7 Reasons Why You Should Be Meal Planning

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(Originally written for Pure Plates)

salmon dinner

If your goal is to eat healthier to lose weight and optimize your health, then meal planning is the way to go. Hands down.

In addition to having nutritious meals at your fingertips, there are many other benefits of meal planning. Let’s take a closer look…

Top 7 Benefits of Meal Planning

Saves You Time

While you might spend 10 to 15 minutes once a week meal planning, you’ll still actually have more time in your week for other (hopefully relaxing) things.

For example, meal planning involves creating a shopping list of only the things you need. Thus, you’ll be able to get in and out of the grocery store much faster.

In addition, you should only need to make one weekly trip to the store. And, you’ll be sure to have everything on hand when dinnertime rolls around. Thus, no more last minute pit stops.

Eliminates Food Waste

If you head to the grocery store without a plan, you’re probably buying items without knowing what you already have at home and what you’re going to do with the foods you buy. In addition, you may forget about various events or activities in which you need extra food for guests or no food at all.

Thus, when you get home, you might find you’re missing a key ingredient or two. Or, you might be wondering what to do with the foods you got. And after a long day, take-out starts sounding much better than heading back to the store or finding a new recipe with the ingredients you do have.

As a result, some foods are likely to get tossed by the end of the week. However, with a meal plan, everything you buy has a purpose.

Saves You Money

With a meal plan, you’ll only be spending money on foods you truly need. You can also create your plan around your budget. In addition, planning ahead gives you the opportunity to take advantage of sales and coupons.

Reduces Your Stress

Having a meal plan takes the stress out of healthy eating. It gives you one less thing to think about. And, there’ll be no more scrambling last minute trying to figure out what’s for dinner, especially at the end of a busy day.

Adds Variety & Balance to Your Diet

Meal planning sets the stage for eating a variety of foods and well-balanced meals throughout the week.

For instance, when you see your plan on paper (or your computer or phone), you’re less likely to pencil in the same foods back to back. You’re also able to see whether or not your meals have a good balance of proteins, carbs, healthy fats, and (lots of) vegetables.

Gives Kids an Opportunity to Get Involved

Kids love to have a voice when it comes to dinner. Thus, meal planning is a perfect opportunity to get your little ones involved. For example, let each child pick one meal for the week. Or, let your children choose a veggie side dish.

They’ll be more excited about home cooked meals. And, they’ll learn how to meal plan, which will help foster healthy eating habits.

In addition, your kids will stop asking, “what’s for dinner” when you post your meal plan on the fridge for all to see. And, if they know what to expect, they’ll be less likely to complain at the dinner table.

Eat Healthier

Now let’s circle back to your original goal of eating healthy. Based on all the benefits of meal planning we discussed above, it would be almost impossible not to eat healthier with a meal plan.

Meal planning leads to more home cooking as well as more variety and well-balanced meals. Thus, it naturally leads to less take-out and fast food. And these things lead to weight loss and better health.

Meal Planning Tips

Meal planning shouldn’t be difficult. In fact, there are many online meal planning services as well as apps available. Some that even do all the work for you.

In addition, you don’t need to plan a home cooked meal every night. Most likely you will eat out a night or two. And one night you may have dinner at a friend or family member’s house. In addition, some nights you can even add Pure Plates meals to your plan. However, it’s still important to include those nights in your plan to reap all the benefits of meal planning discussed above.

And if you’re looking for a complete solution, Pure Plates offers a 30-Day Fresh Start Program, which provides a 30-day meal plan along with all your meals. It doesn’t get any easier than that!

In Conclusion…

The benefits of meal planning are substantial, especially when it comes to your health (and sanity). Thus, we hope you’ll give it a try.

And, if you’re already a meal planning pro, we’d love to hear from you! What are some of your best meal planning tips and tricks?


Why You Need to Healthy Fats to Thrive

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(Originally written for Pure Plates)

There’s a lot of buzz about fat in the media these days. And while dietary fat was never the leading cause of obesity and heart disease, this message is slowly reaching mainstream.


Fat is Not the Enemy

Since the 1970’s, we’ve been warned of the dangers of fat. We’ve been told dietary fat is what makes us fat. And saturated fat specifically clogs arteries and leads to heart attacks. However, these theories were never proven by science. In fact, according to this article published in the Journal of the American Medical Association, the sugar industry paid scientists to produce studies that would paint fat as the villain and shed doubt on sugar’s role in the development of heart disease.

This means fat was never the enemy. And there is plenty of scientific evidence (herehere, and here) proving there is no direct link between saturated fat and cardiovascular disease.

Nevertheless, this topic is still controversial. Thus, we think it’s important to understand the key functions of fat to get a better understanding of why we need fat in our diets.

Key Functions of Fat

  • Fat is required for the absorption of essential fat-soluble vitamins, which include A, D, E, and K. For instance, leafy greens are especially high in vitamin A (as beta-carotene) and vitamin K. Thus, adding a source of healthy fat to your salad will increase your nutrient intake.
  • Fat is used to synthesize hormones, including estrogen, progesterone, and testosterone. Therefore, diets void of fat may lead to hormonal imbalances as well as infertility.
  • A membrane consisting of fat molecules encapsulates every cell in our bodies. Therefore, we need fat in our diet to produce healthy cells capable of obtaining nutrients, removing toxins, and communicating with other cells.
  • Our brains are mostly made of fat. They need a constant influx of fat molecules for optimal development and performance. Therefore, low fat diets can negatively impact your memory, productivity, and mood among other things.
  • Fat protects our organs, and it insulates nerve cells to assist with the transmission of nerve signals.
  • Fat is involved in the regulation of body temperature as well as metabolism. It can also be used as energy source in the absence of carbohydrates.
  • Fat gives food flavor! When manufacturers removed fat from their products based on faulty dietary guidelines, they added more sugar and other food additives to improve taste and texture. And we think most people would agree that veggies roasted or sautéed in olive oil or coconut oil taste much better than steamed veggies.

Based on all of the above, we think it’s safe to say dietary fat is an essential component to a well balanced and nourishing diet.

Eating Fat Doesn’t Make You Fat

Now if you’re wondering if eating fat makes you fat, the answer is “no.” The truth is eating an excess of refined carbohydrates (i.e., pasta, bread, crackers, etc.) and sugar is what triggers your body to store fat. And while these foods are easy to over consume, high fat foods are not. For example, a half of an avocado or a handful of olives or nuts are much more filling than an entire bag of chips.

Further, we’re not suggesting eating as much fat as you can. But we are saying that eating foods with fat and cooking with oils is healthy (and delicious).

Not All Fats are Created Equal

Now that we got that settled, it’s important to understand that not all fats are created equal. While some promote optimal health, others promote disease.

All foods with fat consist of multiple different types of fat. However, they are characterized by their predominate type of fat. There are four types of dietary fats:

  • Saturated fat
  • Monounsaturated fat
  • Polyunsaturated fat
  • Trans fat

The difference in these fats comes down to structure. A saturated fat is solid at room temperature ((i.e., butter or coconut oil). And an unsaturated fat is liquid at room temperature (i.e., olive oil).

Saturated Fats

Saturated fats are mostly found in foods such as cheese, butter, eggs, meats, and cream. The best saturated fats come from healthy and humanely treated animals.

Coconut (and it’s unrefined oil) is another healthy source of saturated fat. In fact, coconut oil doesn’t require a complex digestive process. Therefore, it passes quickly into the bloodstream to provide an instant source of energy.

Monounsaturated Fats

Unsaturated fats are broken down into two categories – mono and poly. Monounsaturated fats are found mostly in avocados, olives, and some nuts. There is little debate about the health benefits of monounsaturated fats. They are a staple in the diet of many healthy cultures.

Polyunsaturated Fats

Polyunsaturated fats are found in nuts, seeds, fish, and vegetable oils. They are broken down into essential Omega-3 fatty acids and Omega-6 fatty acids. Omega-3 fatty acids are well known for their anti-inflammatory properties. They also play an important role in heart health, immune function, and brain development. Unfortunately, they are often lacking in the standard American diet.

On the other hand, Omega-6 fatty acids are often consumed in excess since they are found in most packaged and processed foods in the form of highly refined vegetable oils (i.e., canola, corn, soy, sunflower, and safflower).

Omega-6 fatty acids promote inflammation, which is necessary to fight infections among other things. But an excess of Omega-6 fatty acids can lead to chronic inflammation, which is now believed to be an underlying risk factor in many modern diseases. Therefore, we recommend getting a healthy dose of polyunsaturated fats from whole foods, including seafood, nuts, and seeds.

Trans Fat

Now the worst type of fat comes in the form of “hydrogenated” oils (a.k.a. trans fats). Hydrogenated fats are artificially altered to produce unsaturated fats that are solid at room temperature. While this creates a cheap, highly stable oil, it’s also very damaging to the body.

Trans fatty acids have the ability to replace natural fats in our cells (including our brain cells), which can negatively impact their functionality. Further, trans fats have been linked to heart disease, diabetes, cancer, and obesity.

The medical and nutrition community agree that no levels of trans fat are safe. Fortunately, the FDA has banned their use. However, manufacturers have until 2018 to completely remove them from their products.

To Sum it Up…

Dietary fat is not only needed to survive, but it’s also needed to thrive. However, not all fats are created equal. We recommend steering clear of heavily processed vegetable oils and trans fat. Instead, we suggest eating and cooking with naturally occurring and unrefined fats and oils from whole foods to boost nutrition and flavor.

Tired young blonde woman sitting in her pyjamas on her bed having her morning coffee

Adrenal Health

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adrenal glandsYour adrenal glands are found just above your kidneys, and they secrete reproductive hormones as well as stress hormones. Needless to say, they play an important role in how your body responds to stress.

When faced with danger (real or perceived), a series of events takes place internally to ensure you have the energy and clarity needed to deal with the situation at hand. This response to any stressor starts in the brain and activates the HPA axis.

What is the HPA Axis?

HPA axis stands for hypothalamus-pituitary-adrenal axis. The hypothalamus is a structure within the brain. When there is a perceived threat, the hypothalamus first sends a signal to the adrenal glands to release epinephrine (also known as adrenaline).

Epinephrine makes the heart beat faster to pump more blood and nutrients to vital organs. It also causes rapid breathing to supply more oxygen to the brain and increase alertness. In addition, epinephrine raises blood glucose levels to facilitate energy production.

After the initial burst of epinephrine, the hypothalamus releases a hormone known as corticotropin-releasing hormone (CRH). This hormone triggers the pituitary gland to release adrenocorticotropic hormone (ACTH), which signals the adrenal glands to release cortisol.


Cortisol keeps the body fueled with energy and on high alert. During this time, all other bodily functions are halted. Once the threat has passed, the body resumes normal functioning.

It’s important to understand that this stress response is normal and essential for survival. It evolved to protect humans from life-threatening circumstances. However, the HPA axis wasn’t designed to handle constant threats. And unfortunately, chronic stress is far too common in our modern society.

As a result, the HPA axis may become dysfunctional. This may cause either abnormally high or low cortisol levels in the body.

Symptoms Related to HPA Axis Dysfunction

HPA axis dysfunction can lead to a variety of physical and mental symptoms. Some of the most common symptoms include:

  • Fatigue
  • Lethargy
  • Weight gain or loss
  • Anxiety
  • Depression
  • Brain fog
  • Poor memory
  • Insomnia
  • Frequent illnesses
  • Thyroid dysfunction
  • Blood sugar imbalances
  • Infertility
  • Allergies
  • Dry or itchy skin
  • Cold hands and feet
  • Food cravings
  • Heart palpitations
  • Muscle and joint pain

Adrenal Fatigue

Adrenal fatigue is typically described as having low cortisol levels along with several of the symptoms above. And it’s believed to be caused primarily by chronic stress.

Therefore, one key factor to adrenal health is reducing and managing stress. However, it’s important to recognize there are many potential sources of stress.

Potential Sources of Stress

Psychological stress is almost always a factor involved in HPA axis dysfunction. Sources of psychological stress often include:

  • Unhealthy relationships
  • Poor work-life balance
  • Family responsibilities
  • Finances
  • Health status
  • Significant life events (i.e., divorce, relocation, career change)
  • Poor self-image
  • Social pressure

However, several other external and internal stressors may also be at play, which include:

  • Digestive dysfunction
  • Imbalanced gut bacteria
  • Environmental toxins
  • Food allergies, sensitivities, and intolerances
  • Chronically low or high blood sugar
  • Physical injury or trauma
  • Sleep deprivation
  • Nutritional deficiencies

Functional Medicine Approach to Adrenal Health

Unfortunately, adrenal fatigue is quite common. And HPA axis dysfunction is linked to all other systems in the body as well as many other serious health conditions, including autoimmune disease, diabetes, mental illness, and heart disease.

There is also evidence that HPA axis dysfunction during pregnancy can affect fetal development. Therefore, your adrenal and HPA axis health is not something to be ignored.

If you suspect you might be suffering from adrenal fatigue or HPA axis dysfunction, consider the following questions:

  • Do you find it hard to get out of bed in the morning despite a good night’s sleep?
  • Are you having trouble losing weight despite a healthy diet and exercise?
  • Do you need a pot of coffee (or more) to get through your day?
  • Do you find you just aren’t “in the mood” anymore?
  • Are you struggling with a chronic illness?
  • Do you feel like you need a bottle of wine to get through the evening?
  • Do you struggle to fall asleep and/or sleep soundly?
  • Do you have a hard time concentrating or focusing on your responsibilities?
  • Is your memory not as good as it was in the past?
  • Have you been told you have a hormonal imbalance?
  • Is your anxiety and/or depression holding you back?
  • Do you experience frequent colds, flu and other types of infections?
  • Are you sick and tired of feeling sick and tired?

If you answered “yes” to one or more of the questions above, functional medicine can help.

Functional medicine strives to identify and treat the root cause of disease or dysfunction. When it comes to adrenal health, my job is to help you uncover all potential sources of stress and HPA axis dysfunction. To do this, I rely on your health history and symptoms as well as comprehensive laboratory testing.

Based on what we find, we’ll create a holistic treatment plan to begin the healing process and ultimately restore your health and vibrancy.


Guilliams, T. G. (n.d.). The Role of Stress and the HPA Axis in Chronic Disease Management. Point Institute.

Guilliams, T. G., & Edwards, L. (2010). Chronic Stress and the HPA Axis: Clinical Assessment and Therapeutic Considerations (2nd ed., Vol. 9, Rep.). Point Institute.

Herman, J. P., McKlveen, J. M., Ghosal, S., Kopp, B., Wulsin, A., Makinson, R., … Myers, B. (2016). Regulation of the hypothalamic-pituitary-adrenocortical stress response. Comprehensive Physiology, 6(2), 603–621.

Xiong, F., & Zhang, L. (2013). Role of the Hypothalamic-Pituitary-Adrenal Axis in Developmental Programming of Health and Disease. Frontiers in Neuroendocrinology, 34(1), 27–46.


How to Help Your Child Eat (and Enjoy) Vegetables

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Do your kids throw a tantrum when you serve vegetables? If so, you’re not alone!

But in all fairness, children do have sensitive palettes and a natural preference for sweets. Thus, bitter vegetables such as broccoli and leafy greens can be a bit overwhelming.

But don’t despair! Getting your kids to eat vegetables (and enjoy them) is possible.

Exposure, exposure, exposure!

Many kids are naturally wary of new things, including new foods. Thus, the more you expose your kids to vegetables, the less “new” vegetables become. And without even taking a bite, there are many opportunities for exposure.

Boy at Farmers Market

Seeing, touching and smelling vegetables can bring your kids one step closer to tasting and accepting. Consider the following ideas:

  • Take your kids to the grocery store or farmers’ market. Have them grab the vegetables on your shopping list. Ask them to pick a new vegetable they’d like to try.
  • Invite your kids into the kitchen. Task them with washing the vegetables or even chopping them if they’re old enough to handle a knife.
  • Plant a vegetable garden. Kids love to eat food they grow.
  • Serve veggies as often as possible. Remember, even seeing them helps.

Give Your Kids a Choice

We all know kids seek control. So give your kids a choice when it comes to veggies whenever possible. It’s a great way to eliminate power struggles at mealtimes.

But avoid open-ended choices. Simply ask if they want broccoli or spinach with dinner. Or carrots or celery packed in their lunch.

Don’t Focus on Nutrition

It’s true we want our kids to eat vegetables because it’s the healthy thing to do. But honestly, young kids aren’t too concerned. They mostly want food that tastes good.

While fun facts (in bite sizes) can be helpful, focus mostly on how delicious vegetables taste instead.

Practice What You Preach

Getting your kids to eat vegetables means you better be eating them yourself. And while you’re eating them, don’t forget to mention how yummy they are.

Spice Up Your Veggies

Most adults don’t like their vegetables plain. So we shouldn’t expect our little ones to enjoy them either. Here are some tasty suggestions to try:

  • Serve raw vegetables with yummy dips, such as guacamole and hummus.
  • Sauté or roast veggies with healthy fats, such as butter and olive oil. Fats add flavor, but they also help with the absorption of fat-soluble vitamins.
  • Add a sprinkle of sea salt. So simple, but it can make a big difference.
  • Add their favorite seasonings or serve with their favorite sauce. Sprinkle cinnamon on sweet potatoes. Or top zucchini with pesto.
  • And don’t forget about cheese. Melted cheddar cheese or grated Parmesan cheese. Kids love cheese!

Whatever You Do, Don’t Give Up!

Getting your kids to eat vegetables isn’t always easy. It may even drive you crazy. But it is possible (and important).

Stay calm. Be consistent. And keep trying. Exposure often leads to a bite. And one bite will eventually lead to another.