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Integrative Pet Vet column: What’s up with my cat’s rodent ulcer?

Cats can have a variety of inflammatory skin problems. Some can result in ulcers in the lips or feet and nodular lesions in the skin. Rodent ulcer is an old term that has been replaced with indolent (or eosinophilic) ulcer. Today it is known to be part of a group of inflammatory skin disorders called the eosinophilic granuloma complex (EGC). Affected EGC areas may not bother the cat, or they can be very itchy as a result of certain cells (eosinophils) mistakenly releasing inflammatory substances into the tissues. Lesions can start as mild and progress to being ulcerated, discharge can be present, and can they can become infected. The progression can be accelerated and recovery complicated when the cat licks and chews at the inflamed areas. The trigger for the release of inflammatory substances is not always clearly defined but is thought to be part of a poorly regulated allergic reaction.

The EGC name was developed years ago to refer to a group of skin problems involving the eosinophil. The eosinophil is a white blood cell that is part of the immune system. It is involved with allergic reactions and defense against parasites like roundworms. Eosinophils circulate in the blood, but they also concentrate in the tissues, which is why they play an important role in EGC.

When activity of the eosinophils becomes excessive or poorly regulated, EGC can appear. These excessive or dysregulated eosinophilic activities have been associated with allergy reactions to food and/or environmental allergies, insect bite allergies (i.e. fleas and mosquito bites),or parasite, bacterial and viral infections. Since there are multiple possible allergens that trigger a reaction, identifying the offending allergen can sometimes be difficult.

There are three basic forms of EGC: 1) eosinophilic or indolent (rodent) ulcer, 2) eosinophilic plaque and 3) eosinophilic granuloma. Cats can have one or more of these forms at the same time. The eosinophilic granuloma form is the most common. It can be found anywhere on the body, including the tongue, palate, hind legs and foot pads. Affected areas on the legs can have raised, linear or nodular granuloma lesions. The eosinophilic plaque can also appear anywhere on the body but is most commonly seen on the abdomen. They can appear as red, angry hives. The eosinophilic ulcer is seen on the upper lips.

Diagnosis involves evaluation of the lesions, review of the medical history, and a thorough physical exam of the cat. This is important because there are other skin problems like bacterial and fungal infections, abscesses and skin or oral tumors that can look like EGC. Laboratory testing including specific blood tests and skin biopsy may be necessary.

Interestingly, EGC is seen more often in young cats (2-6 years of age) and is observed two-fold more frequently in females. There is speculation that there is a genetic predisposition in some cats. Fortunately, sometimes these lesions will spontaneously disappear. However, some will become progressively worse and require treatment. Typical treatment includes controlling bacterial infections if present, identifying the source of the allergen (and avoiding that allergen), and the use of glucocorticoids (steroids). In some situations, other immunosuppressive drugs may be needed. Food trials to identify food allergies may be helpful for management. In addition, efforts to identify the allergies to environmental allergens may be necessary. This may require keeping the cat indoors to limit exposure to common outdoor allergens or performing intradermal skin or serum testing. However, it is important to note that there are indoor allergens like dust mites that can trigger EGC. Skin parasites like fleas should be treated if present. EGC is a problem that can require lifelong support and management.

Integrative supportive approaches include evaluation of the intestinal biome (gut flora) for its potential role in immune modulation that may affect the cat’s ability to properly regulate the immune reaction to allergens. Providing probiotics for cats undergoing antibiotic therapy can be beneficial for management of the intestinal biome. While cats are relatively resistant to the side-effects of steroids, it can be helpful to provide support for the adrenal and liver during steroid therapy. Some cats respond to essential fatty acids found in fish oil. These steps can become important for cats with stubborn or difficult to mange EGC lesions.

If you have questions about EGC in your cat, contact your veterinarian.

Ron Carsten, DVM, PhD, CVA, CCRT was one of the first veterinarians in Colorado to use the integrative approach, has lectured widely to veterinarians, and has been a pioneer in the therapeutic use of food concentrates to manage clinical problems. He is also the founder of Colorado Animal Rescue (CARE). In addition to his Doctor of Veterinary Medicine, he holds a PhD in Cell and Molecular Biology and is a Certified Veterinary Acupuncturist and Certified Canine Rehabilitation Therapist. He practices integrative veterinary medicine in Glenwood Springs.

Docor’s Tip: Whole grains have a whole lot of benefits

All nutrition experts agree that processed (refined) grains are bad for us. Whole (unprocessed) grains, however, are good for us, and are another one of Dr. Michael Greger’s daily dozen — foods we should eat every day as discussed in his book “How Not to Die.”

In spite of unfounded claims on the internet that whole grains cause inflammation, they do not, and actually reduce inflammation. They lower blood markers for inflammation such as CRP (C-reactive protein), and they reduce severity of inflammatory diseases (for example, oatmeal baths for skin inflammation). They also reduce risk of heart disease, type 2 diabetes, obesity and stroke.

In order to make wise decisions when shopping for grains, you need to know the following:

•COLOR: As with fruit and vegetables, intense color means an abundance of antioxidants and other micronutrients. Avoid white rice, because most of the nutrients have been lost through processing. Choose brown rice, or even better, black rice. Choose red over white quinoa, blue corn and blue popcorn over yellow. Be aware that food companies try to fool you by, for example, adding ingredients like raisin juice concentrate to darken white bread to make it look healthier.

•MISLEADING ADVERTISING: When buying packaged grain products, if the label says “multigrain; “stone-ground;” “100% wheat;” “cracked wheat;” “seven-grain” or “bran,” it usually is not a whole grain product.

•PHYSICAL CHARACTERISTICS: Wheat berries and oat groats (available at Natural Grocers) are completely unprocessed except that the indigestible hull has been removed. When you cook and eat these as cereal, they have a low glycemic index — meaning that blood sugar and insulin levels remain stable. Furthermore, they pass through the digestive system slowly and trigger hormones that tell you that you’re full; and when they reach the colon they feed the gut microbiome. However, if grains such as wheat or oats are pulverized into flour, they pass quickly through the stomach and go right into the blood stream, raising blood sugar and insulin levels, meaning they have a high glycemic index. Repeated spikes of blood sugar and insulin over the years lead to heart disease and diabetes, plus the gut microbiome suffers.

•FIVE TO ONE RULE: When buying whole grains such as black or brown rice or oat groats, there is no need to check the food label. But Dr. Greger recommends the 5 to 1 rule when shopping for grain-based products such as bread, tortillas, crackers and pasta. Look at the nutrition facts label, see what the total carbohydrate number is, and right below that what the fiber number is (don’t pay any attention to the percentage column to the right, which just confuses people). Multiply the fiber number by 5. For the product to be healthy, the result should be the same or greater than the number for total carbs. For example, the healthiest bread is Ezekiel low sodium, which is kept in the cooler and can always be found at Mana in Carbondale and Natural Grocers in Glenwood. It is made from sprouts instead of flour, has zero sodium and sugar, and 15 grams of total carbs per serving (1 slice) and 3 grams of fiber. Five times three is fifteen, so this product has lots of fiber and whole grains.

Dr. Greger’s favorite whole grains are barley, brown rice, buckwheat, millet, oats, popcorn, quinoa, rye, teff, whole-wheat pasta and wild rice. He recommends 3 servings a day, with serving sizes being 1/2 cup of hot cereal, pasta or corn kernels; 3 cups of popped popcorn; or 1 tortilla or slice of bread. Air pop your popcorn and consider sprinkling on nutritional yeast, no-salt salt (potassium instead of sodium) and chlorella or cinnamon.

Oats deserve special mention because they contain unique anti-inflammatory compounds called avenanthramides. As noted above, oat groats are unprocessed but take some time to cook. Steel cut oats are minimally processed, thick rolled oats somewhat more. Avoid instant oats, which are processed enough that they have a high glycemic index.

Bottom line: Avoid processed grains, but eat whole grains daily. As Dr. Greger says, “Eat plants, but avoid foods made in a plant.”

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.

Valley Life for All column: Skills camp at the Aspen Camp for the Deaf

Student Ehat Kpaw Say with instructor Kevin Berrigan

Editor’s note: the Post Independent, in conjunction with Valley Life For All, publishes a monthly series about fostering inclusion.

The sound of hammers and hand drills compete with the sing-song rippling of Snowmass Creek, which wends its way through the Aspen Camp for the Deaf and Hard of Hearing. Other than that, there is silence.

The young people constructing benches and a stage for an amphitheater are not using their voices, but their hands and facial expressions to communicate about where to drill in screws, where to lay boards on the stage, and how to follow the teachers’ instructions.

The Aspen Camp for the eaf and Hard of Hearing (ACDHH) held its first Tri-State Job SkillsTraining Camp the first week of May. Eighteen students from Utah, New Mexico and Colorado gathered to learn from carpenters from the hearing and deaf communities the skills to build with tools, wood, paint and concrete.

Ehta Kpaw Say, from Utah, is 18 and hard of hearing. This is his first time at a deaf camp. As he drills in screws, he signs to his friends and teachers. “Learning these skills at a hearing camp would take a lot of courage to speak up for myself,” he says, using his voice and sign language. “But here, I’m like all the kids. I feel confident, and it feels like home.”

Ehta is with a group of junior and senior high schoolers with a deaf instructor named Kevin Berrigan. “He taught me to measure and to use tools safely,” he says of Kevin.

Kevin, who is deaf, is proud of Ehta’s progress. He signs, “He’s an excellent young man, works hard and is reaping the benefits that the skills camp provides, that he can apply to his future.”

The ACDHH reopened on a limited basis in 2021, and although the plans are to fully open, board member Zeph Williams says the camp isn’t quite ready; funds and leadership are still in the works. However, there are two family camps in July as well as a women’s program in August and a fall retreat planned, potentially for CODAs (Children of Deaf Adults). The camp provides instructors and interpreters that are bilingual in speaking and sign language.

Ehta continues to lay out patterns with screws and hand drill. A deaf teen instructs him as the teacher and others gather around to watch.

It’s not really silent after all, beyond the noise of the tools and the creek. The sounds of light slapping is made when they use their hands to sign; whispers and throaty sounds are made as their lips enunciate visually for emphasis. American Sign Language (ASL) is not silent, it’s a form of communication.

For more information, please go to aspencamp.org or call 970-315-0513

Local nonprofit Valley Life For All is working to build inclusive communities where people of all abilities belong and contribute. Find us at www.valleylifeforall.org or on Facebook.

Doctor’s Tip: Nonberry fruit is also good for you

Last week’s column was about berries, which have super health-promoting capabilities. Nonberry fruit is good for you, too, and is another one of Dr. Greger’s daily dozen in his book “How Not to Die.”

Dr. Greger’s favorite nonberry fruits are apples; dried apricots; avocados (technically a fruit): bananas; figs; grapefruit (especially pink); honeydew; kiwifruit; peaches; lemons; limes; lychees; mangos; nectarines; oranges; papaya; passion fruit; pears; pineapple; plums (especially black); pluots; pomegranates; prunes; tangerines; and watermelon. He recommends three servings of nonberry fruit a day, examples of a serving being: 1 medium-sized fruit, 1 cup of cut-up fruit or 1/4 cup of dried fruit.

As noted in previous columns, intense color in fruits and vegetables indicates lots of health-promoting anti-oxidants and other micronutrients. A good way to tell the amount of antioxidants present in various fruits is how long it takes them to turn brown (oxidize) when left out. For example, peeled bananas, a white fruit, turn brown (oxidize) quickly. When an apple is cut in half, the white part rapidly turns brown, whereas the intensely-colored peel doesn’t. A mango, which is intensely-colored throughout, doesn’t turn brown for days.

Following are examples of the health benefits of a few non-berry fruits:

•While bananas don’t have a lot of antioxidants or other micronutrients, green bananas contain resistant starch, which, like fiber, feed the health-promoting bacteria in the gut microbiome.

•Two kiwifruit one hour before bedtime can help with insomnia. And kiwifruit boost immune function.

•Compounds in citrus fruits concentrate in breast tissue and help prevent breast cancer, due to repair of DNA damage and other mechanisms. There are even more of these cancer-preventing compounds in the peel, and ground orange peel is available at Natural Grocers. If you grate your own, be sure you use organic oranges or grapefruit and wash it well.

•Watermelon doesn’t have a lot of antioxidants, but the seeds do, so avoid seedless. Yellow watermelons in particular contain a compound called citrulline that dilates blood vessels, producing a Viagra-like effect, and human studies confirm that it works. Also, eating 2 cups of watermelon prior to intense physical activity reduces muscle inflammation and soreness.

•An apple a day is said to keep the doctor away, but maybe the mortician as well. Unpeeled apples eaten on a regular basis lower blood pressure and improve the function of the endothelium — the organ that lines arteries — lowering the risk of heart attacks, the No. 1 killer in the U.S. Studies show that people who eat at least one unpeeled apple a day have a 35% lower risk of dying prematurely.

•Dates have been shown to stop growth of colon cancer cells in the lab. Date paste (take the pit out and mash) is a whole food and the only sweetener recommended by Dr. Greger in his “How Not to Die Cookbook.”

•Avocados contain lutein and zeaxanthin, which contribute to eye health. These micronutrients are most plentiful in the thin, dark green layer just beneath the peel, so be sure you include that when eating avocados. Although the fat in avocados is a relatively healthy fat, it’s still fat and is therefore calorie-rich. So people needing to lose weight should stick to no more than 1/4 of an avocado a day.

Bottom line: In addition to berries every day, eat a variety of nonberry fruit daily. Consider citrus fruit in the morning (plus grated peel if you are at risk for breast cancer); an apple or plum after lunch; and berries after dinner for dessert. (A traditional Japanese dessert is a mikan — like a tangerine). If you have sleep issues, eat two kiwifruits and some goji berries an hour before bedtime. The sugar in whole fruit does not raise blood sugar, but avoid fruit juice, which does.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.

 

Vidakovich column: Running with a tough crowd

Mike Vidakovich

As I write this, I know they are out there on the roads running, training. As soon as I stop typing this, I had better get out the door and get in some miles. The need to try to keep up is always present. The 60- to 69–year old age groupers are a tough crowd to run with.

I began distance running in early August of 1980. I would circle the Glenwood High School track four times after a night of basketball in the gym. Most evenings I did the mile with Jim Richmond, and we ran our first of many races together about a month later on a Friday night in Aspen. It was a 10K called “Take the Money and Run,” and we both ran in our high top basketball shoes with times in the mid 40-minute range. Not bad for a couple of beginners who had no idea of how tough 6.2 miles at 8,000 feet could be or the type of pace needed for a respectable time.

A few weeks later, I purchased my first official pair of running shoes at the Athlete’s Foot in Grand Junction. They were the top-of-the-line Nikes, with soles that looked like a giant waffle iron that protruded out on each side and in the back. I think I paid $39 for them. My, how the times have changed.

Since that Friday night in Aspen, I have probably done somewhere around 500 races of varying distances from 1 mile to 15 miles. I have never attempted a marathon or even had the desire to do one. I will retire someday from running races without the mystical 26.2-mile distance as part of my resume.

In the early years, it was difficult for me to place in most races running in the 20-29, 30-39 or 40-49 age groups. There were some tough distance runners in the area, and it was usually the case that I was on the outside looking in when the top-three runners in my age division were announced at the post-race awards ceremony. It was even a major chore back then to keep up with Paul Driskill and Bob Willey, a couple of running legends who were much older than me and nowhere near my age group.

I mistakenly thought that once I got a little older and landed in the old guy divisions, I would start to see a few more ribbons and medals for my efforts. But running now at age 61 has proven to be a bit more difficult, and placing in races requires as much preparation and focus as was the case decades ago. I guess I have to admit that the work I put in could be much better. Running only 10-12 miles a week with no speed work on the track leaves me looking at the backside of a lot of running shoes in races.

With the likes of Brad Palmer, Bob Dubois, John Stroud and Ron Lund around, the prospect of me walking away from the local 5K with any hardware becomes dim indeed. If you throw in the folks who don’t do many races but are talented runners like Richmond, Rick Chavez, Charlie Wertheim and Dennis Webb, I face the gauntlet among the over-60 crowd.

With all this being said, I don’t believe I have ever gone into a race with the main goal being to place in my age group or in the top 10 or 20 overall. It’s nice when those milestones are achieved, but I have always derived the most satisfaction in running from knowing that I get out the door many mornings to get in some miles in beautiful surroundings, and that I run as hard as I can in races, competing mostly against myself and the clock. It’s always interesting to see how I will react when the fatigue sets in, and taking another step toward the finish line is like pushing the proverbial boulder up the hill. It’s important, though, to keep going no matter how you feel. That comes into play in most avenues of life, also.

It’s always good to see everyone that I mentioned above at the local races. I could give many more names in varying age groups who can be counted on to show up at most all of the running events in the area. It’s a society of distance runners who share a bond that many people wouldn’t begin to understand unless you have spent the time out on the roads and alone with your thoughts.

The races will keep rolling along, and so will the competition. Maybe if I’m still around for the running times in the 70 and over age group, I will begin to hit my stride. Of course, at that age, I will probably be satisfied if my own stride doesn’t trip me up and I don’t go skidding along the pavement.

If I do go down for the count, I will get up and get to the finish line any way I can. You can bet on it. I have to keep trying to run with that tough crowd until my legs run out of steps forever.

Glenwood Springs native Mike Vidakovich is a freelance sports writer, teacher and youth sports coach. His column appears on occasion in the Post Independent and at PostIndependent.com.

Torres column: 6 lessons I have learned to get results

Cosmetic surgeries are very popular nowadays. Social media has done a good job of brainwashing people into getting surgery for weight loss.

However, people who have not identified the real problem regain the weight.

For example, I have interviewed at least five people who have done liposuction. After a couple of years, their weight is back. The negative side of this is that they have to risk their health yet still gain weight back on certain areas (arms, back, butt, thighs and neck) and end up with a disproportionate body.

Many people go into this surgery without really thinking about the real problem.

They think their body is the problem, and they don’t look into their life habits.

They are not focusing on reality. They are focusing on what they want. The reality is that they are overweight because of their habits. What they want is that their body stays attractive with surgery.

First lesson: Focus on reality and not on what you want to be reality.

I am amazed by human psychology. We are naturally egocentric unless we are conscious about what we desire for the rest of humanity.

I have many clients who have seen great weight loss results, and they started to tone their body. People who are jealous about their achievement criticize our members in many ways with phrases like, “You are looking like a man,” “You are losing too much weight,” “You are not the same,” “Can you be normal and stop changing your food?”

These members come to me and tell me that they don’t want to continue losing weight and lifting weights because of the verbal attacks of others. I take my time to explain to them that this is normal. There will be attacks from others, even loved ones, who feel left behind when we are moving forward. So instead of you paying attention to the attacks, focus on your goal. You will never reach your goal if you try to look good in front of everyone else.

Second lesson: Worry about your goal and stop thinking about what others have to say about you.

I am not perfect by any means. I have my struggles and internal fights. I know I am stronger in some areas than other areas of my life. Nevertheless, most of the time, I take a moment to think about the consequences of the action I am taking. For example, I have two cars, one is old and ready to be replaced and the second one still has a long way to go. I am used to having a second for emergencies. Since I am getting rid of my old car, I want to buy a new car for me which is a little expensive. I can afford it, but I would miss out on my investment goal (the car is more a desire than a goal, and the investment is a goal). So I need to stop and think and hold my emotions, not buy the car and invest my money.

I do the same thing I do when eating or exercising, reading or doing some tedious projects at work. If I don’t exercise, I don’t have to go into uncomfortable pain. If I eat anything, I don’t have to worry about cooking or eating things I don’t like, enjoying the delicious taste of junk food. And if I don’t do my tedious work, I don’t have to be bored at work, and I can do something fun. But what would happen in the long term? What is the benefit of me doing all these instead of avoiding them?

Third and fourth lessons: Third, know your goal and your desires. They are not the same. Four, discover the short-term and long-term consequences of the decisions you are making every day.

If you exercise like a habit and push to your limits, you probably know that pain is inevitable. I have many members who need to understand pain. I usually take my time to explain the reasons why they are experiencing knee, back, hip and shoulder pain, but it seems difficult for them to understand these types of pain. I do understand that. We are a generation who have been taught that pain is bad.

I never ignore our members’ pain, but I have enough experience to know the type of pain they are experiencing, and I know when it is not chronic. I don’t ignore them, but I don’t spoil them. I only see good results from those members who learned how to deal with pain.

Also, I know that a divorce, loss of a loved one, a catastrophic event, loss of a job and emotional disasters are painful, but all we can do is dwell on them for a couple of days, learn and continue moving forward with pain until it stops.

If we get paralyzed by pain each time we experience it and don’t move forward, we will be wasting time, and we are never going to reach our goal.

Fifth lesson: Learn how to deal with pain, and don’t let it stop you from moving forward.

When it comes to being on time, I am not the best one, but I can tell you that I am almost always on time to my meetings. However, when I am late, I feel embarrassed, and I apologize for being late. I have members who love to be on time. But just like me, they are not perfect. They are also late to some of their training sessions.

On the other hand, I have those members who are late most of the time. When I ask them why they are late, they blame everything except their discipline: the traffic, the snow, the lights, their significant other, the state patrol in front of them, parking, you name it. The real reason they are late to their training and meetings is because they don’t take responsibility for being late in the first place. If they blame anything other than themselves, there is nothing they can do, because it’s not under their control, according to their way of thinking.

I remember when I dislocated my knee in Mexico. In Mexico we play this game called burro entamalado when we are young. It is fun to play.

There are two teams of more than five people. The losing team makes a serpent with all members bent over using the legs of the front person to support their heads. The winning team jumps on top of the losing team with two goals in mind, 1) to make its link weak and make them fall and 2) to get all its members on top of the losing team.

I was on the losing team one time when we decided to play as adults, and two guys jumped on top of my back. The guy on top of me was hugging me very strongly, and the guy on top of him was hugging him very strongly. Back then I already exercised, so I had a strong core. Therefore, when both friends were falling to the side, instead of me falling with them, I made an effort to twist my core not to fall. That was a terrible mistake.

Imagine a table with four legs, one leg tilting in. If you put enough weight on top of the table, the leg tilting in will slide inwards and the table will fall. That was exactly what happened to my leg, but the knee dislocated, causing it to completely sprain from the bone of my anterior and posterior cruciate and my medial collateral ligaments.

The surgery was very expensive. Who is to blame? Even though the doctor said that my friends should be paying for my surgery, it was an accident. If I had been in my friends’ positions, I would have contributed with whatever I could for the surgery.

However, it is my responsibility to take care of my health and knee, nobody else. I was the one who decided to play. They did not force me to do it. If someone hits your car and drives away, even though it is someone else’s fault, it becomes your responsibility to fix your car. This is not about being fair or just. This is about becoming responsible for what happens to us.

Sixth lesson: If you want to achieve your goal, take responsibility for everything that happens to you even though it is not your fault; that way you can have control over the situation.

These lessons have helped me to achieve many of my goals. If your goal is to lose weight, I recommend you put these lessons into practice. Remember that is not how much weight you can lose, it is about changing your life so you don’t regain the weight back.

Sandro Torres is owner of Custom Body Fitness in Basalt, Carbondale and Glenwood Springs and author of the books “Lose Weight Permanently” and “Finding Genuine Happiness.” His column appears on the third Wednesday of the month.

Doctor’s Tip: Berries are very good for you

Berries are another one of Dr. Michael Greger’s daily dozen in his book “How Not to Die” — foods we should be eating every day for optimal health. A large study funded by the Bill and Melinda Gates Foundation in 2010 determined that the leading cause of death and disability in this country is the American diet, and that one of the most important things we can do to improve our diet is to eat more fruit.

A recurring theme in these columns is that we should eat fruit and vegetables with intense flavor (herbs and spices) and/or intense color. That’s because these foods have the most antioxidants and other micronutrients — oxidation in our bodies contributes to many health issues, such as aging, heart disease, diabetes and cancer.

In the case of fruits, berries win for intense color. Dr. Greger’s favorite berries are acai berries, amla (Indian gooseberries), barberries, blackberries, blueberries, cherries, concord grapes, unsweetened cranberries, goji berries, kumquats, mulberries, red or black raspberries and strawberries. He recommends 1 serving of berries a day, a serving being 1/2 cup of fresh or frozen berries or 1/4 cup of dried berries. He recommends avoiding fruit juice, which is basically flavored sugar water (even if you make your own). It’s interesting to look at the antioxidant power of various fruits: bananas (a white fruit) have 40 units of antioxidant power; apples 60; strawberries 310; blueberries 380; and blackberries, which have the most intense color, have 650 units.

Following are a few examples of how berries can improve your health:

• Amla (powdered Indian gooseberries, which can be found on the internet) can lower cholesterol 35-40% (as much as a statin); lower Lp(a), a particularly harmful form of bad cholesterol (LDL); lower blood sugar in diabetics; prevent clotting; reduce inflammation; and prevent growth of cancer cells in the lab.

• Goji berries, which are bright red, have high concentrations of melatonin, the “sleep hormone” — if eaten in the evening they promote sleep. An antioxidant in goji berries called zeaxanthin helps prevent macular degeneration (a small amount of fat such as a few nuts, helps with absorption of this antioxidant). Goji berries can be found locally at Natural Grocers, or they can be bought for less money at Asian markets as Lycium berries.

• Bilberries, blackberries, strawberries, aronia berries, elderberries, black raspberries and blueberries (especially the smaller, wild variety) contain a powerful antioxidant called anthocyanin.

• Dr. Greger groups cherries with berries, and notes that tart cherries have strong anti-inflammatory properties and can be used to prevent and treat gout.

• Cranberries have been shown in the lab to suppress growth of several types of human cancer cells, due to the pigment anthocyanin. Cranberries are tart, so mix them with other fruit. Avoid dried cranberries, which usually contain added sugar.

One way to enjoy berries and to check off this daily dozen item first thing in the morning, is to put them on your cereal (ideally oatmeal). Costco sells large, cost-effective bags of frozen organic blueberries as well as mixed berries, or at Natural Grocers you can find large bags of wild blueberries, which have twice the antioxidant power as regular blueberries. Consider a bowel of berries with unsweetened almond or soy milk for dessert right after dinner. You can also add berries to a green smoothie, although it should be consumed over 30 minutes to prevent a rise in blood sugar. Another option is to blend frozen berries in a food processer, and eat them as “ice cream.”

What about the sugar in fruit? Added sugar causes health problems such as liver damage, weight gain, high blood pressure, pre-diabetes/diabetes, heart disease and tooth decay. However, eating unprocessed fruit does not harm your health, due to the fiber, antioxidants and other micronutrients in whole fruit. According to Dr. Greger, many human studies including some involving diabetics, have confirmed the sugar in whole fruit does not cause a rise in blood sugar.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.

Doctor’s Tip: Bring on the beans

Legumes (beans, lentils, chick peas, split peas) are another one of Dr. Michael Greger’s daily dozen. In his book “How Not to Die,” he recommends three servings a day; examples of serving sizes are 1/4 cup of hummus or bean dip; 1/2 cup of cooked beans, split peas, lentils, tofu or tempeh; or 1 cup of fresh peas or lentil sprouts.

A few years ago, the Post Independent did a series on aging in the Roaring Fork Valley, and the highlight at the end was a presentation about the Blue Zones — five places in the world where people live particularly long and healthy lives. Common threads in these populations are frequent, low level physical activity; a primarily plant-based diet; and that they all eat a lot of legumes — which stood out the most.

Here are some of the reasons legumes are beneficial:

• All vegetables have protein, but legumes have the most.

•They contain lots of fiber, which feeds the health-promoting bacteria in the gut microbiome.

• They have phytates and other cancer-fighting nutrients including phytoestrogens in soy, which lower breast cancer risk in women.

• They lower cholesterol.

• When legumes pass down to the colon and the gut bacteria start feasting on them, chemicals are produced that cause a feeling of fullness for hours afterwards, a phenomenon called “the second meal effect.” This results in better blood sugar control in diabetics and weight loss in people who are overweight.

• Legumes help with loss of belly fat — a type of fat that leads to prediabetes, diabetes and cardiovascular disease.

When patients are advised to increase their legume intake, they sometimes express concerns about gas. It’s true that for several days after increasing intake of beans and to a lesser extent other legumes, more gas occurs, but once people are on a consistent daily high-legume intake, the problem resolves after several days. Edamame (soybeans) and tofu are almost always well-tolerated. Here’s what Kaiser Permanente recommends in their pamphlet “The Plant-Based Diet, a Healthier Way to Eat” to cut down on gas after starting to eat more beans: Put the beans in a large pot and cover with 2 inches of water, bring to a boil for three minutes, cover and set aside for one to four hours, then rinse and drain well, then cook (raw beans can be toxic).

While talking about gas, it should be noted that the rotten egg smell of flatus (and stool) is from hydrogen sulfide, which is associated with an animal-based but not a plant-predominant diet.

In summary, eat more beans, and canned beans are an option as long as the label says no added salt. Consider cooking beans in a pressure cooker, which cuts the cooking time down to about 30 minutes. Frozen edamame (organic is recommended for all soy products) can be added to salads and stir fry and make a good snack for kids. Consider making your own, oil-free hummus from chickpeas. Add beans to soups, and try making three-bean chili.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.

Doctor’s Tip: Dr. Greger’s daily dozen — other vegetables

This column is another in a series about Dr. Michael Greger’s daily dozen, described in the second half of his book “How Not to Die.” So far, we have covered greens, green smoothies and cruciferous vegetables.

“Other vegetables” is another one of Dr. Greger’s daily dozen, and his favorites are artichokes, asparagus, beets, bell peppers, carrots, corn, garlic, mushrooms, okra, onions, purple and yellow sweet potatoes, pumpkin, sea vegetables (arame, dulse and nori seaweed), snap peas, squash, tomatoes and zucchini. He recommends two servings a day, and examples of serving sizes are 1/2 cup of raw or cooked nonleafy vegetables, 1/2 cup of vegetable juice and 1/4 cup of dried mushrooms.

In order to keep his daily dozen at 12 instead of a baker’s dozen (13), Dr. Greger includes mushrooms with other vegetables, even though mushrooms are a fungus rather than a vegetable. Mushrooms have important immune-enhancing and cancer-preventing benefits, and should be eaten two or three times a week. They should not be eaten raw, due to a toxin that is destroyed by cooking. Morel mushrooms have a particularly high level of this toxin, which even when cooked can react with alcohol, so Dr. Greger doesn’t recommend that variety.

The Allium family of vegetables shares the spotlight with cruciferous vegetables (discussed in last week’s column) for cancer prevention. It includes onions, garlic, leeks, chives and shallots. In the laboratory, garlic, for example, has been shown to destroy cancer cells without having any adverse effects on normal cells. Garlic and onions in particular have been shown in human studies to help prevent several types of cancer. Dr. Greger and other nutrition experts recommend eating some Allium vegetables every day.

Sweet potatoes (along with the cruciferous vegetable red cabbage) have the most nutrients per dollar of any food on the planet. They are healthier than white potatoes, but purple potatoes offer the most health benefits. Purple sweet potatoes, especially eaten with the skin, have been shown to have super antioxidant and anti-inflammatory power, and have been shown to lower blood pressure.

Some vegetables have been shown to prevent prostate cancer, others to prevent brain cancer, others breast cancer, others heart disease, etc. Pharmaceutical and supplement companies are always trying to come up with the “silver bullet” ingredient that they can put in a pill and sell. However, the power of food comes not from a single ingredient or a single super food, but from eating a variety of vegetables, fruit, whole grains, nuts, and seeds — what Dr. Caldwell Esselstyn calls “a symphony of whole plant foods,” with different ingredients and the interaction of these ingredients with each other offering different health benefits.

What’s the best way to eat vegetables? For the most part, you get most nutrients from veggies if you eat them raw, and a green smoothie is one way of doing that (75% tightly packed greens with some cruciferous vegetables and flax meal and 25% fruit). However, there are exceptions. For example, you get more vitamin A if you cook carrots; you get more lycopene from tomatoes if you cook them. Steaming may improve the bile acid-binding capacity of vegetables, which may help lower breast cancer risk. In general, though, the best way to eat vegetables is whatever way you will eat the most.

Six cooking methods were studied — baking, boiling, frying, griddling (cooking on a thick frying pan with no oil), microwaving and pressure-cooking. Clearly, we should avoid deep frying, which results in formation of carcinogens in both meat and plant foods. Although it depended somewhat on the vegetable, griddling and microwaving resulted in retention of the most antioxidants and other nutrients.

When it comes to vegetables, here’s the bottom line: It’s important to eat a variety of deeply colored vegetables for optimal health. An important side benefit is that eating a variety of fiber-containing whole plant foods results in an optimal gut microbiome, which also contributes to good health.

One other point, given that last Friday was Earth Day: Eating at the bottom of the food chain by eating unprocessed plants has the least environmental impact.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.

Integrative Pet Vet column: What’s with my sneezing dog?

Everyone sneezes sometimes, because occasional sneezing is normal. The cause of sneezing in dogs includes normal play-related behavior and reactions to minor irritations to more serious conditions that require therapy. Some dog breeds, like French bulldogs and pugs, are more prone to sneezing because of the shape of their face. Awareness of normal sneeze behaviors and the causes of sneezing can be valuable when deciding about medical attention.

Sneezing is a forceful expulsion of air through the nose. However, sometimes dogs have a sneeze that involves inhaling air during the sneeze. This is known as a reverse sneeze.

Usually sneezing is a reaction to something minor like dust or an irritant. These sneezes are often brief and do not continue once the irritant is gone. With more serious problems, sneezing episodes can be more frequent, last longer and be more distressing to the dog. Nasal discharge can be from one or both nostrils and be purulent, bloody or a combination. The cause of serious problems range from sinus infections, foreign bodies like grass blades or seeds, nasal mites, tooth infections and tumors to nasal trauma. Diagnosis of these problems can sometimes be challenging, so it is important to be observant of your dog’s normal activities, the character of the sneeze, if there is discharge from one nostril or both and the features of the discharge. Social interactions and travel history may become important for chronic or poorly responsive sneezing situations.

Allergies can result in sneezing. This is often seasonal when the allergen is present. However, some allergens like dust mites can be present year-round. Nasal discharge associated with allergies is often clear but produced in higher than normal amounts.

Nasal foreign bodies can be difficult to diagnose and treat. As with other nasal issues, sneezing, nasal discharge, rubbing or pawing at the muzzle can all be signs of a nasal foreign body. Nasal discharge is from one side of the nose — the side with the foreign body. Keep in mind that the discharge from one side of the nose can be an important clue for focusing diagnostic testing and symptomatic therapy. Problems like an infected tooth, oronasal fistula (abnormal hole between the mouth and the nasal cavity) and nasal tumors can have nasal discharge from one side.

Unfortunately, the nasal cavity is the site of a common inflammatory disorder known as idiopathic lymphocytic-plasmacytic rhinitis (LPR). The cause is unknown, but certain cells like lymphocytes and plasmacytes infiltrate into the lining of the nasal cavity resulting in inflammation (rhinitis). LPR is the second-most common chronic problem associated with the nasal cavity in dogs. It is associated with sneezing and the appearance of difficulty inhaling a breath. The nasal discharge varies from bloody to cloudy with a greenish color. Even though LPR generally affects both nasal cavities, it can present with discharge from one or both sides. Diagnosis involves ruling out other causes and obtaining a tissue biopsy from the nasal lining.

Nasal mites can cause sneezing sometimes. They are transmitted between dogs through contact, but the mites can live in the environment for short periods. Once established in the nasal cavity, the mites can trigger sneezing, reverse sneezing and sometimes a bloody nasal discharge. However, not all dogs sneeze when they have nasal mite infections. This means that some nasal mite infestations remain unrecognized, allowing for continued spreading. The mites are not always visible in the nasal opening, and diagnosis may require examining the nasal cavity under anesthesia with specialized equipment or treating for mites if suspicion is high.

Obtaining a diagnosis for a sneezing problem can sometimes be challenging. Treatment and supportive care depend on the diagnosis. Unfortunately, some issues, like LPR, are prone to reoccurring. Definitive treatment should always be sought including: foreign body removal, infection treatment, tumor management, dental care, nasal mites treatment and allergy control based on the source of sneezing. Additional supportive care can focus on herbs like marshmallow root that can sooth the membranes lining the nasal cavity and boswellia that has anti-inflammatory properties. Vitamins like A and C can be beneficial for improving function of the nasal cavity lining.

If your dog is sneezing or has an abnormal discharge, contact your veterinarian.

Ron Carsten, DVM, PhD, CVA, CCRT was one of the first veterinarians in Colorado to use the integrative approach, has lectured widely to veterinarians, and has been a pioneer in the therapeutic use of food concentrates to manage clinical problems. He is also the founder of Colorado Animal Rescue (CARE). In addition to his Doctor of Veterinary Medicine, he holds a PhD in Cell and Molecular Biology and is a Certified Veterinary Acupuncturist and Certified Canine Rehabilitation Therapist. He practices integrative veterinary medicine in Glenwood Springs.