Many dermatologists manage eczema with steroid creams. But is a steroid deficiency really the cause of dry, itchy skin?

Eczema – or, as we doctor-types like to call it, Atopic Dermatitis – has been on the rise in the western world, with an estimated 7 to 15 percent of the population affected

The main symptom of eczema is itchiness, particularly on the backs of the knees, in the elbow creases, and on the face, neck, forehead, backs of the hands, and toes.

Most cases are managed (note that I don’t say “treated”) with steroid creams like hydrocortisone and triamcinolone. These creams essentially work by telling the inflammatory chemicals in the skin to calm down, thus providing significant symptom relief in the short run. When used long term, however, these creams can thin the skin and break it down. Plus the unpleasant symptoms come right back once the tube of cream runs out.

Understanding the causes of eczema can help us find more natural – and much more effective – ways to reduce the frequency and severity of its symptoms, and maybe cure it permanently.

So… Where does it come from, you may ask?


There is a clear genetic predisposition to eczema within affected families. Although many patients think there’s nothing you can do about your genes, I prefer to think of it this way: what you inherent from your parents is a greater or lesser need for a certain set of nutrients.

So keep reading: just because your family members suffer from eczema doesn’t mean that you have to.

Eczema + Asthma + Allergies

Eczema tends to run in families, particularly in families where other member have eczema, asthma, and/or allergies. These conditions all share a common root cause, and indeed, many people are affected by all 3 conditions. Nearly 80 percent of children with eczema develop allergic rhinitis, and 30 to 50 percent develop asthma.

The underlying imbalance behind eczema, asthma, and allergies – collectively referred to as the atopic triad – is a tendency to be “hyper-allergenic” or “atopic.” (This is why eczema is called atopic dermatitis.)

Although everybody’s allergies are different, most people with eczema are irritated by skin contact with wool, lanolin, and sweat, and almost all (60 to 80 percent!) have food intolerances.

Food Allergies & Intolerances

It’s estimated that 60 to 80 percent of all cases of eczema are associated with food allergies and/or food intolerances

To successfully treat eczema, it is essential to identify the triggers. In medicine we refer to allergies and other triggers “obstacles to cure,” because while the trigger foods are still in the diet, full resolution of the condition is near impossible.

The easiest way to identify food allergies and sensitivities is to either get tested (available at Natura Integrative Medicine) or to do an elimination and challenge diet on your own to watch for reactions to common trigger foods (I’m happy to coach you through this process during a private visit).

The major offenders in eczema are eggs, milk, peanuts, soy, fish, and gluten. In babies with infantile eczema, I recommend avoiding these foods entirely until 18 months of age. It’s estimated that 26 percent of children who avoid a known trigger from this list for one year will outgrow the allergy! (J.Ped 1989)

Less common (but still worth mentioning) food triggers include citrus, tomatoes, strawberries, corn, chocolate, food preservatives, and artificial coloring. One study (J.Ped 1989) showed that if a child was triggered by one of these “minor” allergens and avoided that food for a year, there was a 66% chance of outgrowing the allergy altogether. That’s amazing! That’s a better success rate than with allergy shots!

Respiratory allergens – such as animal dander, smoke, and dust mites – are also a problem for many with eczema.

Babies at high risk for atopic conditions (those with a first-degree relative with eczema, asthma, or allergies) are less likely to develop these ailments themselves if they are exclusively breast-fed for at least 4 months. That means giving the baby no other food besides breast milk – not even formula – for the first 4 months of life.

Leaky Gut

Eating trigger foods and/or taking too many antibiotics can over time create inflammation in the gut, affect the integrity of the cells lining the intestine. The spaces between these cells (known as “tight junctions”) begin to break down in the presence of this inflammation, creating a condition known as leaky gut.

When the gut becomes “leaky,” pieces of protein and harmful bacteria can start passing through the spaces between the cells, wrecking inflammatory havoc. These proteins and bacteria stimulate the immune system to react, resulting in a myriad of symptoms from autoimmune disease to irritable bowel syndrome (IBS) to food intolerances to eczema.

Therapies that treat leaky gut invariably improve eczema symptoms.

Regardless of the patient’s age, probiotics have been shown to help a staggering number of those living with eczema. One study even found that babies given probiotics from birth onward were half as likely to develop eczema by age two when compared to babies who didn’t get probiotics (Lancet 2001). Likewise, glutamine has likewise been shown to reduce the risk (Arch Pediatr Adolesc Med, 2007; 161 (11): 1095-101).

For more information about leaky gut, check out this great blog post by one of my heroes, Dr. Aviva Romm (


Patients with eczema often have low levels of a chemical called cyclic adenosine monophosphate, or cAMP. cAMP is an important signaling messenger that regulates the production of many important substances within the body. Patients low in cAMP tend to have higher levels of histamine. (If you’ve ever had a rash or hayfever, then you’ve likely become acquainted with the unpleasant, itchy effects of histamine.)

I therefore often strive to increase cAMP levels in patients with eczema to reduce the itching and inflammation. One of the best ways to increase cAMP and lower histamine is through exercise, which is yet another compelling reason to start moving your body on a regular basis.

Brightly-colored foods like blueberries, raspberries, parsley, green tea, and oranges are rich in flavonoids, a nutritional compound that increases cAMP.

Some cAMP-increasing herbs include licorice, borage, black currant, evening primrose oil, and ginkgo – herbs that I often blend into custom formulations for my patients.


You’ve probably heard that inflammation is bad, and that anti-inflammatory foods and supplements can help a myriad of health conditions. This is particularly true for patients with atopic conditions like eczema.

It’s been found that patients with eczema are deficient in an enzyme that helps convert healthy foods and even supplements into anti-inflammatory chemicals in the body.

This enzyme, known as delta-6-desaturase, is essential for turning vegetarian health foods (such as nuts, seeds, and vegetables) and even supplements (like flax oil) into forms that can be used to fight inflammation. Without this enzyme, patients with eczema and other atopic conditions end up having higher inflammation than others.

Fortunately, nutrients such as vitamin B3 and zinc can support the function of delta-6-desaturase, strengthening its function in affected patients over time.

Fish oil supplements, which are rich in the anti-inflammatory chemicals EPA and DHA, do notrely on delta-6-desaturase to work in the body, and therefore help effectively fight inflammation in patients with eczema. This is why the patients with eczema in my practice are almost always put on a fish oil supplement and encouraged to eat fish rich in EPA (wild salmon, halibut, mackerel, herring, sardines) at least twice a week. (Assuming there is no fish allergy.)

delta 6 desaturase.jpg

Because patients with eczema have poor delta-6-desaturase activity and therefore possess higher levels of inflammation than others, it is further important to avoid inflammation-causing foods and substances. I strongly encourage my patients with eczema to eliminate poor quality fats from the diet, as these are known to promote inflammation in the body:  grain fed meats, fried foods, and hydrogenated oils. Anti-inflammatory diets low in gluten, sugar, alcohol, and nightshade vegetables also yield incredible results. (Check out the Anti-Inflammation Diet and Cookbook by Dr. Jessica Black for more information.)

In adults and older children, the importance of stress management cannot be overstated, as stress rather dramatically increases inflammatory cytokines in the body. Indeed, emotional health and stress management is all too often the missing piece in patient care.

Weaker Skin Defenses

The above-explained imbalances in the immune response lead to downstream imbalances in the skin. Although successful treatment lies in treating the deeper causes of eczema – namely through balancing the allergic response, strengthening the immune system, healing the leaky gut, and fighting inflammation – it’s also important to care for the skin directly to alleviate symptoms when they arise.

There tends to be a hyper-vigilance among North Americans when it comes to personal hygiene. Although frequent bathing and hand washing does indeed prevent the risk of transmitting bacteria and viruses, these practices tend to dry out the skin. I often recommend that patients bathe as infrequently as they can (while still maintaining social and hygienic standards), so that the oils naturally secreted by the skin can help keep it supple and strong. I also discourage patients from using anti-bacterial soaps, as these disrupt the normal and healthy bacterial balance on the skin’s surface.

It’s also important to moisturize the skin frequently with emollients like Eucerin, calendula oil, coconut oil, olive oil, almond oil and Lycrogel. Be sure to read labels and avoid any ingredients you’re allergic to (eg: if you’re allergic to nuts, don’t use almond oil!). I also recommend adding calendula oil or calendula succus (juice) to a store bought moisturizer to help facilitate skin healing.

Raw, unpasteurized honey (manuka is best) can also be rubbed into the raw and itchy areas, and has been shown to be quite helpful in relieving and resolving symptoms (Complement Ther Med. 2003 Dec;11(4):226-34). (Please note that honey is contraindicated in babies.)

Nourish the Body, Treat the Cause

The skin is where the body expresses deeper-seated imbalances. It’s clear that the conventional approach of treating eczema at the level of the skin alone is not working, as topical creams and steroids do little if anything to address the cause of this condition.

To effectively treat eczema, it’s essential that we start nourishing the body on a deeper level, namely through balancing the allergic response, supporting the immune system, strengthening the integrity of the gut, and fighting inflammation. This approach takes more work than the conventional model, but is also more effective in the long term. Your health is worth it, and I’m here to help you along the way.



7 Things Not to Say to the Parent of a Child With Sensory Processing Disorder

“Penny has sensory processing disorder.”

I remember saying this one simple sentence to family and friends shortly after my 3-year-old’s diagnosis this past fall. Every single person we told of Penny’s diagnosis asked, “What is sensory processing disorder, exactly?”

In short, sensory processing disorder (SPD) is a condition in which a person has difficulty both receiving and responding to information acquired through the senses. Every single child with SPD is different and will have different symptoms. SPD can be a stand-alone condition, but it is often diagnosed along with autism spectrum disorder or ADHD. In our case, our daughter does not have autism or ADHD, both of which can make the diagnosis of SPD even more confusing.

Most people don’t know how to handle a condition they’ve never heard of. At times, I’ve been frustrated by the things people have said to me, to my husband, and especially to my daughter. My hope is not to shame others, but to educate people on what SPD is and the appropriate way to respond to caregivers and children with sensory issues.

mother holding daughter

Brianna holding her daughter, Penny.

The following are seven things that I, as a sensory parent, feel you definitely should not say:

1. “But she’s so normal.”

What is normal anyway? Can we just do away with the word normal — forever and ever, amen? You often can’t see the person’s struggle with your own eyes. That is true. However, when you tune in with your mind and heart, you will begin to see the little day-to-day difficulties that make life a bit different for a child with SPD.

When you start to pay attention, hopefully you will feel some empathy — and even curiosity. A child with SPD will require special care but does not need to be alienated. No child, regardless of ability, should be alienated. So let’s do away with categorizing children as normal and not normal. Let’s just love them and care for them the way that they need.

2. “She’s just picky/spoiled.”

The most common statement we’ve received is that our child is incredibly picky. One of our biggest challenges has been eating, and for a long time we described our daughter as “the pickiest eater in the world.” Many provided well-meaning advice about how to feed her or get her to eat a wider variety of foods, but nothing worked.

We were all missing the heart of the issue, which was not that Penny is picky, but that her senses are different from ours. How can we expect a child to eat something when her senses are being overloaded and we have no idea how the food tastes to her? We no longer use the word picky, and certainly not spoiled, but many others haven’t quite received the message. Through occupational therapy, we have seen great improvement and learned that a gentle and slow approach is best with a child who has SPD.

3. “She’ll grow out of it eventually.”

I don’t believe that there’s a cure for sensory processing disorder; however, there is therapy that can help integrate the senses and expose a child to new experiences. We have noticed an improvement through therapy, but it’s still a daily challenge for her to eat, sleep, get dressed and learn new skills.

4. “This didn’t exist 20 years ago.”

The diagnosis may not have existed, but a child with sensory processing issues certainly did. How can I be so confident? Because I was a child with SPD, and I’m now an adult aware of my own sensory processing issues. I never did outgrow my SPD, but I have learned ways to cope.

As a teenager I was always known for unbuttoning my jeans; it was just one of my many quirks. Now, I understand that I needed to unbutton my jeans because I just couldn’t deal with the pressure of the button on my belly. Today, I rarely wear tight or constricting pants, but when I do, you can bet they’re unbuttoned before long.

5. “You just need to be tougher.”

Recently, my daughter and I were at the grocery store, and she took her shoes and socks off while sitting in the cart. She became very agitated when I explained to her that we had lost one of her socks.

“Penny, you’re not in trouble. We’ll just buy some new socks,” I explained.

I don’t have time to worry about every little issue that arises, and I certainly don’t have time to worry about lost socks. If you know anything about kids with SPD, you know that they sometimes hate socks and tags. If I made a big deal out of every spilled drink, every missing sock, or every meal skipped, I would have a very stressful relationship with my child.

Many think I’m too easy-going and that my lack of discipline is what has made my daughter “this way.” According to the professionals, my daughter is in the safest environment when I am relaxed and calm about the little blips in our day.

6. “My kid does that, too — and he/she is fine.”

I’m not sure why so many parents feel the need to compare their children to others’, but it happens more frequently than I’d like. I’ll admit, I was one of those parents who said to a friend: “My kid does that, too.” I have no issue with others noticing sensory processing issues in their kids.

I will often relay tools I have learned in therapy to them, to help them guide their children in the right direction.

Please know, a child with sensory processing issues will need special care and patience. Most kids with SPD are receiving therapy, and the typical “rules” or “methods” of parenting may not apply.

7.  “But your other child eats/sleeps/etc. so well.”

When my second daughter was born, I compared my children all the time. My oldest was too young to understand, and I was unaware of her sensory issues at the time. Regardless, I should never have done it, and I formed a bad habit of inwardly comparing them.

But once my second daughter started eating and sleeping well, I started receiving lots of comments comparing my kids, and I realized how wrong I had been to start such a bad habit.

Typically, these comments are directed at me, but they’re often said in front of my children — and sometimes they’re even directed right at them. This, I feel, is probably one of the hardest things to hear as a parent. I do not want my children growing up around comparisons. I never want my child to attach good behavior or bad behavior to the things that she eats or the way that she sleeps. If I can suggest one thing, it’s that you should never compare siblings to each other.

There are plenty of things that you can (and should) say to sensory parents. I would suggest asking questions, showing empathy and letting them know that they’re in your thoughts. The beginning stages of a diagnosis are typically difficult for a family — and support is always appreciated.

In our family, we have chosen not to talk about sensory processing disorder directly to our 3-year-old. She is just too young to understand it, so we have not used these exact words around her. If a parent doesn’t tell you of a diagnosis right in front of his or her children, you may not want to bring up the diagnosis around them.



How My Husband’s Cerebral Palsy is Like the Sprinkles on My Favorite Cake

A yellow cake with vanilla frosting that is encrusted in rainbow sprinkles. The cake was shot against a pale gray backdrop.

Dear cerebral palsy,

If my marriage was a cake, you would be the brightly colored, impossible to miss sprinkles covering the outer edge. You’re there, boldly covering the surface area of what me and my husband and family are.

At first, I didn’t think much of you. You were part of my childhood, there adorning the cakes of two of my closest friends. You weren’t this strange, foreign thing like blowfish or something that I had no experience with. Besides, this is a cake metaphor, and blowfish on a cake would be weird.  I knew you.  You were there, but you weren’t on my cake.

As I saw the impact you had on my husband, I started resenting you.  Seriously, sometimes sprinkles are just too much on a cake anyway. There were surgeries, physical therapy, more surgeries, wheelchairs, and… wait… more surgeries. And with every little thing, every sleepless night my husband endured, there you were. And believe me, you’re the first thing anybody sees when they look at us. People don’t see our love, our humor, or even his ability. They see his wheels. They see you.

Now, nearly seven years later, I have come to love you. Not just the “I guess I’ll deal with you” love, but a love filled with gratitude. As I grew, and saw my husband and now son grow, I see you for what you are.

Christine's son pushes his father's wheelchair.
Christine’s son pushes his father’s wheelchair.

You see, without you, cerebral palsy, my family wouldn’t be what it is today. We wouldn’t be the same people. Through the struggles, discrimination, pain, and frustration, my husband is more resilient and determined than anyone I’ve ever met. His faith is unbreakable and unwavering. He is getting his master’s degree, chasing his dreams. He is such a patient father, always encouraging but never forceful.  He understands himself, and his limitations, which gives him a much better understanding of those around him. He shows our son what perseverance and true strength are every day. He is the most loving, gentle, supportive husband.

Because of you.

Because of you, cerebral palsy, my son has grown tremendously in his faith, and has a true servant’s heart. He learned to walk pushing his daddy’s wheelchair. He holds doors, he waits patiently, he helps at every opportunity. He has no concept of disability. At 5 years old, he understands that all people do things differently, in their own way, and everyone does better working together. He believes from firsthand experience that God works all things for good.

Because of you, cerebral palsy, we believe without a doubt that God holds us all. We know that tomorrow isn’t promised, but to cherish each day as it comes. Every single moment is precious. Love is hard, and everything that’s worth having is worth the work it takes to keep.

Because of you.

Every single moment, eyes are on us. He can’t go to a job interview without you. You are a hidden blessing, cerebral palsy, because you help us see who is interested in the whole cake, not just making a judgement based on the decorating job. Anyone can make a cake look good, but it’s got nothing to do with how good the cake is. You force people to look beyond the exterior.

So thank you. Thank you for being part of our life. I know that we will always have the strength to fight and love more than we ever could without you. You’ve given us dreams, passion, drive, and with that, we can stand firm and show the world ability, and help them to ignore that silly little prefix that so many can’t look past.

You’re the sprinkles on my favorite cake.


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To protect yourself from malaria sleep with a chicken next to your bed

For the first time, scientists have shown that malaria-transmitting mosquitoes actively avoid feeding on certain animal species such as chickens, using their sense of smell. Odors emitted by species such as chickens could provide protection for humans at risk of mosquito-transmitted diseases, according to a study in the open access Malaria Journal.

Researchers at the Swedish University of Agricultural Sciences and Addis Ababa University, Ethiopia found that Anopheles arabiensis, one of the predominant species transmitting malaria in sub-Saharan Africa, avoids chickens when looking for hosts to feed on. This indicates that, unlike humans, cattle, goats and sheep, chickens are a non-host species for An. arabiensis and that the mosquitoes have developed ways of distinguishing them from host species.

Rickard Ignell, the corresponding author, said: “We were surprised to find that malaria mosquitoes are repelled by the odors emitted by chickens. This study shows for the first time that malaria mosquitoes actively avoid feeding on certain animal species, and that this behavior is regulated through odor cues.”

To find out which species the mosquitoes prefer, the research team collected data on the population of human and domestic animals in three Ethiopian villages. They also collected blood-fed mosquitoes to test for the source of the blood that the mosquitoes had fed on. People living in the areas in which the research was conducted share their living quarters with their livestock. The researchers found that while An. arabiensis strongly prefers human over animal blood when seeking hosts indoors, it randomly feeds on cattle, goats and sheep when outdoors, but avoids chickens in both settings, despite their relatively high abundance.

Since mosquitoes select and discriminate between their hosts mainly based on their sense of smell, the researchers collected hair, wool and feathers from potential host and non-host species to analyze the odor compounds present in them. Identifying certain compounds that were only present in chicken feathers, the researchers used these and other compounds obtained from all species to test their ability to repel mosquitoes from mosquito traps. The traps were set up in 11 thatched houses in one of the villages for a total of 11 days. In each of the houses, a single volunteer aged between 27 and 36 years slept under an untreated bed net.

The researchers found that significantly fewer mosquitoes were caught in traps baited with chicken compounds than in control traps. Suspending a living chicken in a cage next to a trap had a similar repellent effect.

Because it feeds indoors and outdoors on various host species, An. arabiensis is difficult to control with existing methods, according to previous research. The results of this study suggest that, in combination with established control methods, the odors emitted by chickens and other non-host species could prove useful in controlling An. arabiensis.

Rickard Ignell said: “People in sub-Saharan Africa have suffered considerably under the burden of malaria over an extended period of time and mosquitoes are becoming increasingly physiologically resistant to pesticides, while also changing their feeding habits for example by moving from indoors to outdoors. For this reason there is a need to develop novel control methods. In our study, we have been able to identify a number of natural odour compounds which could repel host-seeking malaria mosquitoes and prevent them from getting in contact with people.”



10 Things I Wish the Entertainment Industry Understood About Autism

Movie camera and film on wooden table.

It’s been almost 30 years since the 1988 movie “Rain Man” came out, featuring Dustin Hoffman as a character who was on the autism spectrum. At the time, it was one of the few depictions of autism in film. Since then more films, plays and television shows have been featuring the stories of fictional and non-fictional people with autism.

My fascination with this topic began when my parents started getting me involved in theatre to help me build on my communication skills after I was diagnosed with autism at age 4. Now as an adult, I’ve taken a role in helping bring a realistic portrayal of autism to these projects.

Here are 10 things I hope the entertainment industry knows when they are looking to feature autism.

10. Our autism spectrum has more dimensions than Rain Man. Growing up I was often asked questions such as “Do you share any similarities to Rain Man?” Many see Rain Man as the one-size-fits-all of autism. Today our spectrum varies; we have a variety of characteristics and abilities.

9.  We need to highlight girls on the autism spectrum, too. Many people still think of autism as a boy’s disorder and that couldn’t be farther from the truth. Boys are diagnosed with autism 5 times more
often than girls in the U.S., but that doesn’t mean their stories shouldn’t be highlighted. A great example of a film that looks at the life of a woman with autism is HBO’s “Temple Grandin.”

8.  Look at issues those with autism are facing today. Growing up I faced more than communication and social delays. While autism is characterized as a social and communication disorder, it can also include sensory, cognitive and motor challenges. There are issues about trying to find money to pay for supports at home and school, young adults with autism having difficulties finding employment, and trying to find a relationship.

7. Ask experts in the field of autism. Most importantly, ask people with autism to lend their support! Ask them about their stories, and even consider featuring their story in your project if you don’t have a central idea yet for what you want to do. Many people both on and off the spectrum would like to help. I’ve helped with four films focused on autism.

6. Understand that autism is a lifelong disorder. Consider featuring both children and adults equally. 50,000 children with autism reach adulthood every year. Showing the obstacles and successes they face throughout their lifespan is essential. Everything from early intervention to later adulthood services matters.

5. Nonverbal people with autism should be included in these conversations. A great example of someone who would be worthy of featuring is Carly Fleischmann, a 21-year-old woman who is completely nonverbal but communicates via her iPad.

4. Don’t try to push a character with autism into a project if it doesn’t fit into the storyline. As much as we want recognition, we also don’t want to step into a project that wouldn’t be an appropriate fit. Autism is one of the hot topics in the entertainment industry today, but coming into any project with sensitivity is important.

A few years ago I had an extreme fascination with the character of Sheldon Cooper from the CBS hit show “The Big Bang Theory,” based on many people’s beliefs that Sheldon falls somewhere on the autism spectrum. I wrote a blog titled “Why Our Autism Community Loves Sheldon Cooper.” Even though he’s not on the autism spectrum, because it may not fit into the storyline of the show, he’s still very relatable for our community.

3. Once your project is completed, consider the needs of audience members who have autism and may want to come out and see it. Countless groups are doing sensory-friendly events for movie theaters, Broadway plays, etc. Check out websites such as AMC Theatres Sensory-Friendly Initiative and Theatre Development Fund’s Autism Theater Initiative to learn more.

2. Educate if you can! What can the audience learn about autism by watching your project? One of my favorite teachers of all time said, “Think with the end in mind.” What do you hope people take away from your project as part of the overall story? If you can educate about autism and include organizations that are helping those with autism, like Autism Speaks, that’s even better!

1. Having more projects focused on a realistic portrayal of autism will help educate our communities.This is the most important thing I wish you knew. Ignorance is just a lack of awareness. With your support of our community, we can foster diverse education and acceptance for all with autism. You can make a world of difference. Never forget that.



Are You Making One of These Two Low-Carb Diet Mistakes?

A low-carb diet is an effective, but highly restrictive, weight-loss plan. It works well when you follow the rules. If you waltz into the room thinking you can do your own thing without having read and studied any of the weight-loss plans, you’ll probably find yourself asking, “Am I doing low carb right?” A dead giveaway that you aren’t.


However, if you’ve been carefully following one of the low-carb programs, and weight loss has slowed, or stopped, you might want to check and see if you’ve been making one of these low-carb mistakes.

Where Are Your Carbs Coming From?

Most individuals enter the Induction phase on a diet-high. Motivation is strong. The weight loss you experience from losing the glycogen needed to get you into ketosis keeps you pumped. Motivated by the new lack in cravings and sense of well-being, low-carb diet mistakes are few. You stick to the rules, start experimenting with new foods and recipes, and make the decision that this low carb stuff is going to be a lifestyle change – not just another diet.

But lifestyle changes don’t come that easy. Like anything else, even with a rock-solid foundation, we can reach a point where we start to slip back into our old ways of doing things. For some, that means giving ourselves permission to cheat once in a while. But for others, the tendency surfaces by trying to recreate the diet that got us fat in the first place – but from a low-carb perspective.

While there’s nothing wrong with attempting to low carb a favorite recipe or holiday treat, it’s easy to slip away from Dr. Atkins’ caution when moving into the Ongoing Weight Loss phase. “If you have decided to move to phase two, I want to remind you not to regard it as a time to cut loose and undo all of the good work you have just completed,” Atkins writes. Pretty much common sense. But then he adds that phase two is “very similar to Induction in that you will continue to derive the majority of your carbohydrates from vegetables low in carbs.”

While the carbohydrate ladder allows later additions of nuts and berries, phase two doesn’t lift most of the restrictions given for Induction. These daily limits are:

  • cheese (3-4 oz)
  • heavy cream (2-3 tbsp)
  • sugar substitutes (2-3 servings, counted as 1 gram of carbohydrate each)
  • salad dressings (without sugar, and no more than 2 grams of carbohydrate per 1 tbsp serving)
  • spices (without added sugar)
  • lemon juice (2-3 tbsp per day)
  • olives (20)
  • sour cream (1 oz – that’s 2 tbsp)
  • avocado (1/2)


Dr. Atkins also cautioned against using too many low-carb products. While he did mention that convenience foods were an option for when “you are unable to find appropriate food, can’t take time for a meal or need a quick snack,” he also warned to watch out for carbohydrate counts. Far too many products today, like low-carb breads, tortillas, and pastas, or low-carb shakes and bars have hidden carbs or digest exactly like the high-carb products they replace.

In addition, if you have wheat sensitivities, be extra careful with what you spend your carbs on, because most low-carb products are loaded with wheat protein. The same is true for many favorites like soy sauce. Also, keep in mind that some whole grains like soy flour and uncertified gluten-free oatmeal (which many low-carb bakers grind into flour) are also highly contaminated with wheat.

Are You Counting Your Carbohydrates?

Following a low-carb diet, rather than a traditional low-fat low-calorie plan, doesn’t get you out of having to play the numbers game. Do you know what your Critical Carbohydrate Level for Losing (CCLL) is? According to Dr. Atkins, knowing that number and “counting grams of carbohydrate is truly your responsibility. If you don’t count you could get into trouble.”

The idea behind the Atkins diet, or Protein Power, or any number of other low-carb plans is that your rate of fat loss is in direct proportion to the amount of carbs you eat. Knowing your CCLL, and staying at or below that number (or whatever level of carbs and protein The Protein Power Lifeplan assigns you) is like a safety net. That’s a little less than the amount of starch your body can deal with on a daily basis without having to store it as glycogen, or body fat if glycogen stores are full. Go above that number, and your weight loss will stall.

That’s pretty much what the carb ladder is all about too. Helping you make the best choice for whatever condition your current metabolism is in.

But too many times, we think we know better and we do something that sits outside the rules. Sometimes we get away with it, like eating low-carb tortillas, pasta, and bread way before step nine on the ladder. Or we stick to eating just allowable foods without actually counting the amount of carbs we are eating each day. If we’re lucky, we will continue to lose weight just fine. But sometimes we don’t. Sometimes those little inconsistencies and mistakes catch up with us, and our weight loss stalls.

Get Back on Track

When that happens, step one is always to get back to counting carbohydrates. After which it’s a good idea to examine closely where those carbs are coming from. It’s easy to get lax and stop reading labels, allowing a little sugar or high fructose corn syrup to slip into our diet through a store-purchased salad dressing. It’s also easy to forget what level of the carb ladder we’re on – when see others eating low-carb pasta and continuing to lose weight. And it’s even easier to devote ourselves to low-carb foods and ingredients than it is to drag out the measuring spoons and cups to find out exactly how many carbs we’re eating.

That’s because, when it comes to fat loss and staying on plan, most of the time, we are our own worst enemy. However, if we want to reach our weight-loss goals, we have to be willing to take a good look at ourselves, our current lifestyle, and weed out any low-carb diet mistakes that might be standing in our way. That certainly isn’t easy; it’s where I’ve been slipping down the slippery slope of fat gain lately. Not much – I weighed it at just three pounds over my current temporary weight maintenance goal – but three pounds is where I’ve personally chosen to draw the line.

So it’s back to lower carbs for me, for awhile.



Women With Agoraphobia Pens Powerful Post After Being Harassed for Taking a Selfie

Selfie of the author outside Trader Joe's

For people living with mental illness, selfies can be a powerful way to document victories against their disorder. Brenna Mae, a woman living with agoraphobia – a disorder that causes anxiety in places and situations where escape may be difficult – chose a selfie to celebrate a rare moment of relief from her disorder. What she didn’t choose was to be berated in the street for taking one.

According to her post on Twitter, Mae woke up one morning with a “flash of strange courage,” so she went out to a Trader Joe’s for groceries. “For once, I didn’t wait around to see if it would stay… [going outside] felt powerful. I felt free,” she wrote.

While taking a selfie outside of the store, Mae was harassed by a person driving by for taking a photograph of herself. According to Mae, the person yelled “Nobody cares that you’re going to the f**cking grocery store,” right as she finished taking the picture.

Mae’s powerful statement brings some much-needed visibility to agoraphobia. Mae also makes an important point about how shortsighted harassment is, as people living with mental illness face twice the amount of harassment as the general population.

You can read her full post below:

Dear driver who yelled at me for taking a selfie on the sidewalk outside Trader Joe’s, I know what you thought you were seeing, just a self-absorbed, shallow millennial, documenting a mundane task for no reason. ‘Stupid kid,’ you might have thought, ‘not every little thing has to be documented. Put your phone away and get on with your life.’ But here’s the thing. I also know what you were unable to see: I am agoraphobic.

For the past 3+ years, I haven’t gone into public by myself. I haven’t left the front door of my home without a friend or family member (except, on brave days, to get the mail). Even when going in public with loved ones, I become wracked with anxiety, crippled by panic attacks where I could barely breathe or talk. My husband has had to practically carry me out of movie theaters becasue I started panicking so hard. We’ve lost who knows how much money on non-refundable tickets. Before we got married, we couldn’t go on dates because it was too hard for me to leave the house. I have endured 3+ years of my body and mind revolting against my desire to be independent.

This morning, alone in my apartment, I experienced a flash of strange courage. For once, I didn’t wait around to see if it would stay. I didn’t worry that the courage would abandon me halfway through my trip. I just seized it. I grabbed a beanie and my messenger bag and walked out the door. I crossed two streets, by myself, while cars rushed by, and I didn’t panic. I smiled up at the blue sky and sun, for the first time in year enjoying it on my own. I felt whole. I felt powerful. I felt free.

You and I were the sole witnesses of a moment 3+ years in the making. All I wanted was one photo — not even from a flattering angle, not even well-composed. Just one photo, to prove I did it, to look at when I’m low again, that it’s possible to defeat the demons and win. To show myself that it can be done again. To send to my husband so he can be proud of me too.

When you saw me, yes, I was a woman standing outside a Trader Joe’s, acting like my shopping trip was important enough to document. Because it was.

I’m sorry that you’ll never know.

I’m sorry you see my generation documenting our lives as something to be scorned.

I’m sorry you don’t hear the stories we have to tell.

I’m sorry that I can’t tell you mine.



BioMarin Provides Positive Proof-of-Concept Data for BMN 270 Gene Therapy in Hemophilia

SAN RAFAEL, Calif., July 27, 2016 (GLOBE NEWSWIRE) — BioMarin Pharmaceutical Inc. (NASDAQ:BMRN) announced today positive interim results of an open-label Phase 1/2 study of BMN 270, an investigational gene therapy treatment for severe hemophilia A at the XXXII International Congress of the World Federation of Hemophilia (WFH).  The data was presented in the Late Breaking Gene Therapy session by John Pasi, Professor of Haemostasis and Thrombosis, Barts and the London School of Medicine, Honorary Consultant Haematologist, The Royal London Hospital, and a lead investigator of the study.  The data presented at the congress is an update since the Company reported initial results on this same study on April 20, 2016.  To access the data presented at the Congress, .

A total of nine patients with severe hemophilia A received a single dose of BMN 270, seven of whom have been treated at the highest dose of 6 x 1013 vg/kg. As of the July 6 data cut off, post-treatment follow-up ranges from 12 to 28 weeks.  For the seven patients treated with the high dose, as of each patients’ most recent reading, six of seven patients had Factor VIII levels above 50%, as a percentage calculated based on the numbers of International Units per deciliter of plasma (IU/dL), and the seventh was above 10%.  In addition, four patients who have been followed the longest had a mean Factor VIII level of 146% at their 20 week visit.  Two patients with Factor VIII levels above 200% had no unexpected events or need for medical intervention. For the seven patients at the high dose, the median annualized bleeding rate measured from day of gene transfer to data cut of observation period fell to 5 from 20.

No clinically relevant sustained rises in ALT levels or other markers of liver toxicity have been observed.  The maximum ALT levels were between 23 and 82 U/L (less than two times the upper limit of normal, which is 43 U/L for the central laboratory in this study) approximately 12 weeks after gene delivery and generally declined over the next few weeks. ALT rises have not been associated with any decrease in Factor VIII levels.  A steroid regimen administered to all high dose patients has been well-tolerated.  Patients are successfully tapering off of steroids with two subjects off steroid therapy for up to 2.5 weeks with no adverse impact on Factor VIII expression or ALT levels.  Study medication was generally well tolerated.  No serious adverse events were observed, and most common adverse events were mild in severity.

“These data provide strong proof of concept evidence that restoration of clotting function may be achieved by gene therapy,” said John Pasi, Ph.D. F.R.C.P, Professor of Haemostasis and Thrombosis at Barts and the London School of Medicine and Dentistry and primary investigator for the BMN 270 Phase 1/2 clinical trial.  “For the first time, patients have reason to hope to avoid bleeding and the opportunity to live a normal life.”

“We look forward to collaborating with experts and health authorities to design the next phase of investigation,” said Hank Fuchs, M.D., Chief Medical Officer at BioMarin.  “Beginning in mid-2017, a Phase 2b study will seek to evaluate the optimal dose of BMN 270 using Factor VIII expression as the primary endpoint with material from the to-be-commercialized manufacturing process.  If successful, this study could support an accelerated approval given the severe unmet need, the substantial effect and tolerability of the treatment.”

Phase 1/2 Study Design

The current Phase 1/2 study is evaluating the safety and efficacy of BMN 270 gene therapy in up to 12 patients with severe hemophilia A, as defined by the WFH as less than 1% of blood clotting factor. The primary endpoints are to assess the safety of a single intravenous administration of a recombinant AAV vector coding for human-coagulation factor VIII and to determine the change from baseline of factor VIII expression level at 16 weeks after infusion. The kinetics, duration and magnitude of AAV-mediated factor VIII activity in individuals with hemophilia A will be determined and correlated to an appropriate BMN 270 dose.

This is a dose escalation study with the goal of observing an increase in factor VIII levels. Secondary endpoints include assessing the impact of BMN 270 on the frequency of factor VIII replacement therapy, the number of bleeding episodes requiring treatment and any potential immune responses. Patients will be monitored for safety and durability of effect for five years.

About Hemophilia A

Hemophilia A, also called factor VIII (FVIII) deficiency or classic hemophilia, is a genetic disorder caused by missing or defective factor VIII, a clotting protein. Although it is passed down from parents to children, about 1/3 of cases are caused by a spontaneous mutation, a new mutation that was not inherited.1 As an X-linked disorder, hemophilia A mostly affects males, occurring in approximately 1 in 5,000 male births.2 People living with the disease are not able to form blood clots efficiently and are at risk for excessive bleeding from modest injuries, potentially endangering their life. People with severe hemophilia often bleed spontaneously into their muscles or joints. The standard of care for the 43% of hemophilia A patients who are severely affected, is a prophylactic regimen of factor VIII infusions three times per week.3 Even with prophylactic regimens, many patients still experience microbleeds and spontaneous bleeding events that result in progressive joint damage.

About Gene Therapy

Gene therapy is a treatment designed to alter a genetic problem by adding a corrected copy of the defective gene. The functional gene is inserted into a vector — containing a DNA sequence coding for a specific protein — that acts as a delivery mechanism, providing the ability to deliver the functional gene to cells. The cells can then use the information to build the functional protein that the body needs, potentially reducing or eliminating the cause of the disease. Currently, gene therapy for the treatment of hemophilia A is available only as part of a clinical trial.  The AAV approach to gene therapy has been advanced at the University College London (UCL) in the treatment of Hemophilia B. At UCL, this technology has shown evidence to be both safe and effective, correcting bleeding for greater than four years in a continuing clinical trial.


Forward-Looking Statement

This press release contains forward-looking statements about the business prospects of BioMarin Pharmaceutical Inc., including, without limitation, statements about the development of BioMarin’s BMN 270 program generally and the timing and results of the clinical trial of BMN 270. These forward-looking statements are predictions and involve risks and uncertainties such that actual results may differ materially from these statements. These risks and uncertainties include, among others: results and timing of current and planned preclinical studies and clinical trials of BMN 270, including final analysis of the above interim data; any potential adverse events observed in the continuing monitoring of the patients in the Phase 1/2 trial; the content and timing of decisions by the U.S. Food and Drug Administration, the European Commission and other regulatory authorities; our ability to successfully manufacture the product candidate for the preclinical and clinical trials; and those factors detailed in BioMarin’s filings with the Securities and Exchange Commission, including, without limitation, the factors contained under the caption “Risk Factors” in BioMarin’s 2015 Annual Report on Form 10-K, and the factors contained in BioMarin’s reports on Form 10-Q. Stockholders are urged not to place undue reliance on forward-looking statements, which speak only as of the date hereof. BioMarin is under no obligation, and expressly disclaims any obligation to update or alter any forward-looking statement, whether as a result of new information, future events or otherwise.



Cream brings new hope for eczema children

A new cream that may help thousands of children suffering from eczema could soon be widely available.

The treatment has shown promising results in early clinical trials and is the first non-steroidal medication for the condition.

Developed by the pharmaceutical company Novartis, the cream has shown no indication of one of the main side-effects most commonly seen with steroids: skin thinning.

Eczema in children is a significant public health problem. According to a major study, the International Study of Asthma and Allergies in Childhood, carried out in 1992, between five per cent and 20 per cent of children aged six to 14 years are affected, and the worldwide prevalence of the condition has increased by at least 30 per cent in the past 30 years.

One parent who knows about the effects of the condition on a child is Sandra Ashby, from Nottingham. Her six-year-old daughter, Charlotte, developed the disease when she was six months old.

‘She was born with dry skin, and at first I used baby oil on her. When her skin became blotchy, I went to see my GP and he prescribed hydrocortisone cream,’ says Ms Ashby.

‘The atopic dermatitis can affect her whole body, and it tends to flare up at times and then subside for a while. At one stage it was affecting Charlotte’s fingers very badly and so my GP prescribed a stronger steroidal cream, Fucibet. However, I am very wary of using these because they are supposed to lead to thinning of the skin.

‘For a child, it can be a very traumatic condition because there is a continuous urge to scratch, and the grease from the steroidal creams can make the itching worse. Charlotte has also had a few really bad infections on her skin.

‘At school Charlotte has to take her cream with her in case she needs it during the day. She is very keen on sport, although she has to be very careful about falling over.’ Like other parents in the same position, Ms Ashby does not know what sparked the condition – her eight-year-old son Bradley does not suffer from it.

Researchers are still puzzled about the reasons for the increase, but factors which have been linked to the rise include diet, increased pollution and greater genetic predisposition.

Atopic dermatitis is a non-contagious, chronic hereditary condition which makes the skin dry, itchy, inflamed and swollen. It largely appears in infancy – around 60 per cent of patients develop it before the age of six months.

There seems to be a trigger which sets it off and if we could only identify that, then we would know a lot more about eczema,’ says Dr Roger Allen, a consultant dermatologist at Queen’s Medical Centre in Nottingham.

Research has identified the prevalence of the disease as being higher in western industrialised countries, and higher among immigrants to western countries.



What a Dance Trophy Means to My Child With Sensory Processing Disorder

Group of girls in dance class

Yesterday, my sensational girl participated in her fifth dance recital. She was just a little over 2 years old when she showed an interest in dance. It was also a time when the words — sensory processing disorder(SPD) — were not yet a part of our vocabulary, but the behaviors and meltdowns were at their peak.

After two failed attempts at dance class, I gave up. Whatever was causing challenges for this little girl clearly overruled her ability to conduct herself in a dance class the way the teachers expected. And although her dance experience was far from successful, she kept asking to go back. So a friend of mine suggested I try a third studio. She heard amazing things about the teacher. Fast forward five years and this amazing teacher has turned my overstimulated little toddler into a confident, successful and happy dancer.

So here we are now, replaying all the great moments from yesterday’s show, which included my youngest child’s first-ever turn on the stage where she, like her sister before her, danced her tiny little heart out.

My daughter will also soon be rewarded with an eagerly anticipated Five-Year Dance Trophy. My now 7-year-old girl has talked about this trophy all year long. She’s counting the days until that shiny token of achievement will be placed in her happy little hands.

However, no one is more excited for her to receive this trophy than me. You see, this trophy does not only mark a major accomplishment in her life as a dancer, but it also marks many major accomplishments in her life with SPD — three letters that are now as familiar to us as our own names.

So as I sit here and write, I can’t help but reminisce about the other milestones this trophy represents because this year has been by far my girl’s most successful year to date since we started this journey five years ago.

This year, my girl took her first plane trip where she talked herself through the first few frightening minutes of takeoff before I even had the chance to comfort her.

This year, she took her first trip to Disney World, experiencing the magic with wide-eyed excitement as any other child would.

This year, she attended the Halloween dance at school, looking forward to dancing the night away with friends. Last year, she cried until we got there and clung to me until the end when she had finally gotten acclimated to the noise and chaos.

This year, she has been declassified from special education, not because she no longer has any issues, but because those issues no longer interfere in her life as a student in a significant way. 

This year, she went on her first amusement park ride, skated at her first roller rink, attended her first local fair, went to her first non-sensory movie or show, took her first shower where she actually stood under the water and the list goes on and on.

Five years ago, this little girl embarked on her journey as a dancer, but it was also the year she embarked on her journey of self-awareness as a person living with SPD. So many people are always giving me the credit for her success, but when I look back, I feel I really had very little to do with it. She’s the one who completed five years of therapies, doctor’s visits and evaluations. She’s the one who used the tools and coping strategies she learned and implemented them when needed. She’s been able to push herself past the point of discomfort more than any person I know, and even when pushed too far, she has gotten back up and started over again. She has learned to vocalize when she needs to bow out, regardless of what anyone around her may think.

This amazing girl was born with passion, determination, empathy and compassion for others. These are qualities that cannot be taught. In exchange, she had to learn how to train her brain to get used to the environment around her — something most others are born being able to do. 

She may not know it yet, but she was the one who was determined not to let SPD get the better of her, and she has not only succeeded, she excelled. The reason for most of her success in life comes from those innate qualities I had nothing to do with.

So, while I may have been who took her to therapy sessions, she’s the one who internalized everything she was taught, and she still applies it on a daily basis.

Dance is something my girl does from the heart. You can see it when you watch her. It’s the reason she has stuck with it for five years, even when she faced challenges with overstimulation. She will always be someone who leads with her heart. It will be her greatest asset.

Five years ago, I didn’t know what the future had in store for us, and I worried about the kind of life my child would have because of a disorder we knew nothing about. Five years ago, our story had just begun. Now, I look forward to what the next five years bring — and the next five after that.

But no matter where our girl takes us, I do know one thing for sure: My girl will continue to approach life with the same determination and passion that has driven her to overcome anything life has thrown at her. She will fall, and before I can stumble over to help her, she will already be on her feet back at it again.

So, just as those 99 tokens still sit in our house as a daily reminder of SPD, this Five-Year Trophy will sit right next to it — standing taller and overshadowing that tiny plastic cup that symbolizes my girl’s greatest challenge just as my girl’s greatest qualities now outshine any difficulties brought on by having SPD.