Thursday, October 9, 2014

Delicious, Easy, Never Lumpy Turkey Gravy: GAPS, SCD, Paleo Friendly

Thanksgiving holiday is just around the corner. A great opportunity to count our blessings and to let our loved ones know how much we appreciate them. Even if we can't be together for a meal we can celebrate so many different ways.

If a turkey dinner is in your plans, you will be making it with a gravy. There are no gravy making kits that are safe. 
So how can you do this in GAPS, SCD or Paleo and be safe, without losing any deliciousness?

Here is a GAPS gravy that is easy, delicious and never lumpy. 


I experimented a lot (as I've been teaching, cooking and eating SCD/GAPS since 2005), but found my inspiration from my mother who is an excellent self taught home cook, and Elaine Gottschall and her book Breaking the Vicious Cycle, a book I still use quite often. The aim is to find flavour and thickening. The onions have flavour and they have pectin, which thickens hot fluids without lumps. The reserved vegetables that were roasted under the meat, turkey or chicken, are caramelized and very flavourful. I view the water left behind from boiled vegetables as a secret ingredient for flavour boosting, not something to throw out. The dehydrated vegetables found in "Herbamare" or "Mrs. Dash" are commonly used as a salt substitute because they give flavour without relying on salt, so the end product is lower in salt but just as delicious if not more so. (This is the way to go for those who are looking to lower their salt intake.)

And it is easy, because there are no special ingredients you don't already have in your kitchen. Except maybe the dehydrated herbs and vegetable powder which you can pick up later as an important part of your GAPS, SCD,or Paleo pantry. All you need is a stand or immersion blender. 

GAPS GRAVY
Ingredients for stock used in gravy: Start while poultry (or any meat) is roasting.
1 litre or 1 quart of homemade chicken or turkey or vegetable stock
2 large onions with or without poultry giblets

Ingredients for gravy:
Stock with soft cooked onions
Reserved roasted vegetables (onions, carrots, garlic, celery or any herbs) from under the roast 
Roasting pan drippings, reserved
Seasoning from 'Herbamare' or 'Mrs. Dash', NO SUBSTITUTION, to taste, 1-4 tsp, optional
Sea salt and pepper 
Extra filtered or pure water to make up consistency to your liking


While the poultry is roasting I make the stock by cooking the onions. I almost never have homemade turkey or chicken stock available so I try to save all the vegetable water from any veggies I cook on that day or in the few days before. This is something my mother taught me. I may have potato, or cauliflower, or green bean, or celeriac or carrot water for the stock. You need about 1 quart or 1 litre. Add 2 large onions (and giblets if available) and simmer the onions, uncovered until they are very soft, 20 minutes to 2 hours. 

The next step, the making of the gravy takes place in the roasting pan or the pot used to cook the onion, and basically you put all the gravy ingredients listed above in one pan, puree and heat, on top of the stove. 

When the roast is finished cooking it needs to be set aside about 10-15 minutes to rest. Now I loosen every last bit of pan drippings and mix them with the onion/veggie water. You could also use the pan drippings from any vegetables you have roasted as a side dish, such as brussels sprouts, or acorn squash, and put that in too. I usually pour the onion water into the roasting pan but you could pour the drippings into the pot with the onions. Then I add the vegetables that were roasted under the turkey into the same drippings pan, with 1-4 tsp of “Mrs. Dash “ or organic 'Herbamare' (both gluten and carb free) and salt and pepper to taste. You can also use fresh herbs, but I can't vouch that bottled spices are gluten free and may contain MSG without you knowing it. Then I use an immersion blender to puree. It should be smooth and thick. Add water to make the consistency to your liking. 

Heat when ready to serve, so it is hot and at its best. 
If it needs reheating it does not go lumpy or limp. 


I always get good comments on this gravy.  It is has a nice look about it, rich in colour, and thicker than “au jus” and can be almost as thick as wheat flour gravy. It goes nicely over mashed garlic cauliflower or mashed celeriac root, both always a hit around here.

For another version of gravy see Elana's Pantry for her "Herb gravy". 

Happy Thanksgiving Everyone 
To Your Health
Dr. Barbara







  

Wednesday, October 1, 2014

Nestlé Sustainability Champion: GM food Not ’Answer’ To Feeding World



My focus to help people maximize their health is to heal the bowel and grow a healthy microbiota, which, in my mind is the root of health. 
Lately I have recognized that my patients and myself included are not attaining a full recovery of a healthy bowel and microbiota in one to two years nor ever, even on a carefully planned program of GAPS, probiotics, vitamin D levels above 120 nmoles/l,proper amounts of good fats in the diet, maximization on the absorption of nutrients, good cholesterol and triglyceride levels, getting rid of chemical exposures of all kinds, detoxing with sauna and maximizing B vitamins.  

This is compared to reports of thousands of people being cured on a Specific Carbohydrate diet (SCD) (first developed in the 50's) by Dr. Haas and Elaine Gottschall) in one to two years. Not so now. 

So I have been searching for the compounding reasons why this may be so. The environment has changed greatly from the 50's.At last count we are exposed to 84,000 new chemicals since the discovery of the first 'never seen on earth' chemical was manufactured in 1854 by Perkins. And we are exposed to natural toxins like lead which has no safe level for humans. Or poorly understood or researched bio-technology products, GMOs being one of them.

Continued bowel inflammation, old, not healing or new damage can be linked to:
- use of nonsteroidal antiinflammatory drugs, NSAIDS, like ibuprofen
-use of prescription antibiotics.
-low vitamin D serum levels, below 120 nmol/l.
-cheating on gluten even once a month, even invisible amounts such as MSG in a salad dressing or soup, sometimes called natural flavouring. 
-eating oats (I have an upcoming article on why you should never eat oats, not even "gluten free" oats). 
-inhaling polluted air or smog. 
-titanium dioxide used in supplements
-ingestion of GMO containing foods including commercial meat/products causing 65 know human health risks. This link includes the American Academy of Environmental Medicine's position paper on GMO foods. 

With mounting evidence that GMO containing foods damage the bowel and cause a "celiac" like condition with massive malnutrition and sulphur deficiency  the question arises, why don't we have GMO labelling laws and why do we even grow these crops? Scientist from all over the world have been researching these crops and the link to human health for decades and because of the bans in other countries (European Union and Russia to name two jurisdictions), one must think these scientists and governing bodies must use a precautionary principle and have found evidence that does not warrant putting large numbers of people at risk.

Not just people are becoming ill, but also livestock fed GMO grains. Here’s the first paragraph of an article from Organic Connections on the effects of genetically modified feed on pigs. This is not an isolated observation.

“A new, peer-reviewed study has just been released detail­ing adverse effects of genet­i­cally engi­neered (GE) feed on pigs. Center for Food Safety has long advo­cated for more robust safety test­ing prior to intro­duc­ing GE foods into the food sup­ply. Currently, no GE safety test­ing is required in the U.S. The long-term study revealed that pigs fed a GE diet suf­fered higher rates of severe stom­ach inflam­ma­tion and had on aver­age heav­ier uteruses. The find­ings were bio­log­i­cally and sta­tis­ti­cally sig­nif­i­cant and mir­ror what many farm­ers have been report­ing anec­do­tally for years. The study was per­formed over the course of five years by inde­pen­dent researchers in Australia and the U.S.” Read More. The paper: “A long-term toxicology study on pigs fed a combined genetically modified (GM) soy and GM corn maize diet” by Dr Judy Carman, Howard Vlieger, Dr Larry Ver Steeg,Verlyn Neller, Dr Garth Robinson, Dr Kate Clinch-Jones, Dr Julie Haynes and Dr John Edwards has been published by the Journal of Organic Systems, Vol 8. No 1 (2013) and is available for free download from http://www.organic-systems.org/journal/. Or cut an paste into your browser if you are having trouble reading it.



A top Swiss GMO researcher's comments have been recently reported in "Food Navigator" :    

Nestlé sustainability champion: GM food not ’answer’ to feeding world

Genetically modified food is unnecessary to feed the world and the food industry would reap more benefits from using resources more sustainably and employing other techniques. That's the view of Hans Johr, corporate head of sustainable agriculture at Nestlé and honorary president of SAI Platform, a group of top global food and drink manufacturers working to improve supply chain sustainability. ”There are a lot of new breeding technologies today that don't use GM food. You can do a lot of things without GM. GM per se is not a golden bullet, but may be an interesting tool in the box. ”We [Nestlé] have a very simple way of looking at GM: listen to what the consumer wants. If they don't want it in products, you don't put it in them.”
Food Navigator, France: Nestlé sustainability champion: GM food not ’answer’ to feeding world

We the consumer can influence the manufacturers of our food, according to Hans Johr of giant Nestle. We have to become informed consumers and vote with our pocket books. 

Here are two examples of how the people of Germany have said they don't want GMO foods and where they have been listened to.

Firstly the German Grocery association has listened and it has demanded a return to GMO free fed poultry as of January 2015. There is enough non-GMO poultry feed available contrary to the complaints of the producers.

And Secondly, there is a movement among the German Federal states to openly be recognized as GMO free and set standards. From August 2014,GMO Free News for Germany (my bold):


GMO-free regional governments:
9 out of 16 German federal states (among them 3 city states) signed the Charta of Florence and thereby joined the European GMO-Free regions network.......

By the end of August 2014, 212 GMO-free-regions, 343 GMO-free-municipalities and 30.458 GMO-free-farmers, i.e. 1.106.156 ha (2.733.371 acres), were declared in Germany. Definitions, lists and maps can be accessed at the English section of the website GMO-free regions in Germany.

There was no commercial cultivation of GMOs in Germany since 2012 and no deliberate releases since 2013. Lastly, GM potatoes (0.3 ha) and GM sugar beets (0.5 ha) were planted for experimental purposes in 2012.

The commercial cultivation of the GM corn MON 810 has been banned on April 14th 2009. BASF’s genetically modified starch potato “Amflora”, approved on 2nd of March 2010, had its approval withdrawn December 2013 by the EU General Court due to procedural error during the approval procedure. Until then it was grown on 15 ha in 2010 and ultimately on 2 ha in 2011.

Based on German biotech law food manufacturers and –retailers can label their products GMO-free since May 2008. The GMO-free label (“ohne Gentechnik”) is for animal products (meat, eggs and dairy products) derived from animals fed without GM plants. Licensee partners and advocates for a food production without GMOs are organized in the Association Food without Genetic Engineering (VLOG).

(Updated in August 2014 information provided by Bund für Umwelt und Naturschutz Deutschland e.V. (BUND) Friends of the Earth Germany).


As I have said, we need to take responsibility over our own health and become informed about food, natural over chemical, and food supply chains. We can't do this effectively without good labels on our food or supplements informing us whether there is GMO present in the product or not. Without labelling laws we still have choices. We can grow some of our own food, buy real food and the "dirty dozen"  should be avoided or bought as organic, and make your own from scratch or belong to a community organic farm association sometimes called CSA. If it is not clear, I also contact manufacturers about the ingredients of their products (gluten or corn or soy or canola) and the sourcing of their products especially if it is from GMO or not. 

I hope this information helps you in your decision to chose your food wisely, GAPS is best, remove chemicals from your life, add probiotics for the sake of the microbiota, but also to take a look at one of the most common food sources that reverses all the good you are doing, and putting you at risk for 65 known health problems.

I don't see eating a GAPS diet alone overcoming the effects of commonly ingested drugs or chemicals  or GMO products. 

Is eating GMO meat or cheese, or soy or canola worth the risk?


To Your Health
Dr. Barbara

Monday, September 22, 2014

Available Course: Step by Step Healing With GAPS Diet

It is one thing to hear and agree to doing the grain free, sugar free way of eating called GAPS and it is another to do it. I know it is a powerful way to heal so many serious illnesses and it doesn't work if you don't follow it to the letter.

But where to start? Or if you have started you may find that you are having some difficulties. You may find out that the store bought gluten free ice-cream that you eat once a month, is adding to your risk of heart disease and or it is slowing down your recovery from depression, for example. Now what do you do!

For resources, I have recommended-
1. The book, Gut and Psychology Syndrome by Dr. Campbell-McBride. 
2. the web site www.gaps.me 
3. GAPS certified (by Dr. Campbell- McBride herself) nutrition therapists in your area, or online, . 

And you have another choice. 
The Weston A. Price Foundation " Wise Traditions" 2014 conference has finished and you can sign up to on demand access to one of four packages of lectures. All include the "Step by Step Healing with GAPS diet". They are priced at US$ 30.00  up to the full conference at US$ 89.00.

Go to this link to see your amazing choices of high quality lectures from beginner to more advanced needs:  http://www.fleetwoodonsite.com/ppSD2/catalog.php?id=14. 


To Your Health
Dr. Barbara

Monday, September 15, 2014

Gluten Sensitivity, Vitamin D, and Cavities

 Worldwide, 60–90% of school children and nearly 100% of adults have dental cavities, according to the World Health Organization. What makes this statistic so concerning is that oral health is essential to general health and quality of life. Something many are unaware about is the connection between gluten sensitivity, vitamin D, and oral health.

A study conducted in 2012, confirmed that gluten causes the body to produce an immune reaction against one of the main proteins responsible for producing enamel on the teeth. The lack of enamel causes excessive cavities, tooth wear and tear, and thus the premature destruction or loss of teeth.

Vitamin D, on the other hand, produces two proteins (cathelicidins and defensins) which have antibacterial effects to fight the bacteria that cause cavities. Vitamin D deficiency is proven to be a cause of tooth decay within clinical trials involving 3,000 children. What Dr. Hujoel found was that an increase in vitamin D levels reduced cavities to 50 percent.

Gluten sensitive people, eating a normal diet with gluten have low vitamin D from many different mechanisms, including their skin has trouble making vitamin D. Eliminating gluten from the diet stops further destruction, but does not in most cases heal. For that you need to heal the gut, and do a GAPS diet.  

In light of this information, I have a few recommendations to improve the quality, mineralization and health of your pearly whites. 

  1. Commit to a GAPS diet, which consists of eating fermented foods, probiotics, and foods high in vitamin D while eliminating grains, dairy, legumes, and sugar. A GAPs diet helps increase the absorption of nutrients, minerals, and fat soluble vitamins, such as vitamins K, D, E, and A. 
  2. Take silica supplements that can be found as liquids, powders, or tablets. 
  3. Drink green and black tea frequently (without any sweeteners, milk, or cream) as it reduces plaque buildup and suppresses bacteria levels in your mouth
  4. Brush your teeth with baking soda with or without peroxide and then rub a small amount of xylitol powder (corn free, made from birch or any hardwood tree on your teeth. Commercial toothpaste contains glycerin, which prevents the mineralization of your teeth.
  5. “Oil Pulling”, an ancient art popularized by Dr. Bruce Fife, involves rinsing your mouth with a few teaspoons of oil. I recommend coconut oil and unpasteurized butter for the oil used, for whiter and healthier teeth!
  6.  Avoid the “dirty dozen” as described by the Environmental Working Group, which include, seed oils, farmed fish, and chemical exposure of all kinds (creams, toothpaste, tap water with fluoride, ‘Raid’, baby shampoo, etc).
  7. Keep your vitamin D serum levels above 100. You will need a blood test to determine your vitamin D level.  

      To Your Health
       Dr. Barbara

Tuesday, September 9, 2014

The Implications of Low Cholesterol in Depression and Suicide- Dr. Greenblatt, MD

After fatigue, the most common symptom of celiac disease                                                            and gluten sensitivity is probably
cholesterol
depression if one were to include mild depression. Low levels of cholesterol, triglycerides and essential fatty acids (EFAs) are intimately linked to depression. Understanding the consequences of deficiencies in essential fats and cholesterol is important for the effective treatment and response of depression. Whether low cholesterol is drug induced, genetic, or the result of a leaky gut and poor digestive enzyme production or low bile production from chronic gluten ingestion in a gluten sensitive person, low cholesterol impairs optimal brain function and often prevents successful recovery.

Some gluten sensitivity researchers say that if a person has low cholesterol, low triglycerides, or low essential fatty acids on an initial assessment, then that is enough to give the person the diagnosis of gluten sensitivity. I have found 50% of people on initial assessment who end up with positive gluten sensitivity diagnosis, have low levels of each, cholesterol or triglycerides or EFAs. Fixed only when the bowel issues are fixed. (Grain free, dairy free, sugar free way of eating called GAPS (www.gaps.me) seems the only way to fix it.)



James M. Greenblatt, M.D.

For the last quarter century, we have been told that cholesterol is dangerous for our health and were advised to avoid it in order to live a healthier life. However, cholesterol is essential in maintaining good mental health. The brain is the most cholesterol-rich organ in the body, and depriving the brain of essential fatty acids and cholesterol can lead to detrimental health problems. Lower levels of cholesterol in the blood are associated with a heightened risk of developing major depressive disorder, as well as an increased risk of death from suicide. A study published in the Journal of Psychiatric Research found that depressed men with low total cholesterol levels (less than 165 milligrams per deciliter [mg/dL] or less than 4.14 nmol/l) were seven times more likely to die prematurely from unnatural causes such as suicide and accidents.

Most recently, the continued allegation that cholesterol is dangerous came under scrutiny. A meta-analysis published in the March 2014 issue of Annals of Internal Medicine found that there's not enough evidence supporting the claim that saturated fat increases the risk of heart disease. After reviewing 72 different studies, researchers did not find that people who ate higher levels of saturated fat had more heart disease than those who ate less. Researchers came to the conclusion that instead of avoiding fats, which are essential to maintaining brain health, scientists are identifying the real villains as sugar and highly processed foods.

Low Cholesterol and Depression

Several studies have linked low cholesterol levels to an increased risk of developing depression. Consider the following examples:
1. 1993 paper published in the Lancet reported, "Among men aged seventy years and older, categorically defined depression was three times more common in the group with low total plasma cholesterol . . . than in those with higher concentrations."
2. 2000 study published in Psychosomatic Medicine, researchers compared cholesterol levels to depressive symptoms in men ranging in age from forty to seventy. They found that men with long-term, low total cholesterol levels "have a higher prevalence of depressive symptoms" compared to those with higher cholesterol levels.
3. Women with low cholesterol levels are also vulnerable to depression.


Of note, the reverse seems true, that more cholesterol is protective of depression. In a 2008 meta-analysis, higher total cholesterol was associated with lower levels of depression. 

Low cholesterol has other serious health implications such as cancer, infertility and lower immune health and you can get more info here and here

If you have high cholesterol and are worried about it causing heart disease, see a balance article here describing how cholesterol levels are not the focus of "heart care'' in the recent guidelines.

If it is hard for you to introduce more saturated fats and give up the poly unsaturated fats because you believe they will lower your rate of heart attacks, then you should watch the gripping movie called Oiling of America. Everyone in your family should see it. 

To Your Health.
Dr. Barbara


Wednesday, August 6, 2014

Olive Oil Fraud “Widespread” Warns New Yorker Magazine- But You Can Get The Real Thing. Here is How!

I've been reminded by this article by Fresh Pressed Olive Oil.com   that I need to dig deeper into how people choose the olive oil they eat, if there is unremitting inflammation. The person may be consuming fake olive oil.

Extra virgin olive oil (EVOO) is probably the number one fake food out there. And the fake stuff has oils that are in the omega 6 category and I recommend reducing the omega 6's in an anti inflammatory diet. Some people may be keeping their omega 6 oil levels up without knowing it when they eat and make foods from just any old EVOO. Here is what I wrote about the evidence for the rampant adulteration of EVOO found in North American stores and some suggestions for finding the real thing. 


Scientists at UC Davis found that 69% of the imported extra virgin olive oils they tested were fake, adulterated, stale, or so subpar that they failed to meet international and USDA standards for being labeled “extra virgin.”

From freshpressedoliveoil.com:
This Is Outrageous!

This [amount of fraud] is an outrageous shame because authentic extra virgin olive oil—the real stuff—is so healthy for you. Medical science has determined that it is one of the healthiest foods you can consume. For example:

Scientific studies have shown that authentic extra-virgin olive oil lowers “bad” cholesterol and cuts your risk of heart disease and stroke. It helps protect against cancer, especially cancer of the breast, prostate, and colon. It’s a godsend for arthritis sufferers because it can cool inflammation and ease joint pain without any side effects.

It has also been shown to lower blood pressure, reduce your risk of diabetes, and may even help reduce the risk of Alzheimer’s disease. If you want to avoid osteoporosis, it’s outstanding because it enables the calcium in your food to be better absorbed into your bones. Finally, it’s loaded with some of the most powerful disease-fighting antioxidants and polyphenols known to science, which fortify your immune system and help it protect every organ of your body against disease.

Way back in the fourth century BC, Hippocrates, the father of medicine, was way ahead of his time. He loved his Greek olive oil and considered it beneficial for over 60 therapeutic uses, hailing it as “the great therapeutic.”

Read the whole article to find out how to avoid the second issue with buying EVOO and that is how to tell when it was bottled. It is best to consume the EVOO by six months of it being bottled. 


There is another three ways to buy authentic EVOO.
One is to check the Consumer Reports which has a list of EVOO products that were found to be authentic, found at the first link above.

The other is to find a source of single estate (family farm) EVOO at your local farmer's market or ethnic shop. You have to ask questions until you are satisfied it is the real thing.

And the other is to look for a bottle with the yellow and red seal symbol with the words............Denominazione D'Origine Protetta which indicates the real EVOO comes from Italy. Or the label Appellation d'origine controlee (AOC) if it comes from France.  Or Denominacion de Origen (DO) if it comes from Spain. More and more stores are carrying these products which have labels that indicate the product has passed strict quality control evaluations and have met clearly defined standards set by the EU and received this protected designation of origin. 

One last word. In the US, there appears to be only one certified label for EVOO and it is for Californian olive oil, so look for the seal with California Olive Oil Council ( COOC). 


After going to all this trouble to find the real extra virgin olive oil, treat it gently to maintain its health benefits. Please don't apply high heat to it. If you are sauteing or frying use an oil like coconut oil that withstands higher heat and does not lose its goodness, and pour some olive oil over the meat, fish, eggs or veges as you are serving it. 

To Your Health
Dr. Barbara



Wednesday, July 30, 2014

WHO- 85% of Adult Cancers are Preventable: Beyond Celiac

We are so busy every day we often forget that we are what we eat and other lifestyle habits. Simple ( but not necessarily easy) changes make a very large difference in our future health.

If you eat inflammatory foods like grains, and you have inflammatory lifestyle habits like smoking or a sedentary life, you will encourage inflammatory responses in your body which include, but is not exclusive of, cancer. 

The Cytokine Research Laboratory published an article entitled "Cancer is a preventable disease that requires major lifestyle changes" which can be summarized by saying reduce inflammation/cytokines with lifestyle changes.  

The WHO has put out a paper declaring 85% of adult cancers of preventable and known risk factors are overweight, obesity, malnutrition and infection, all of which are higher in gluten sensitive persons. Here is an excerpt. 

Cancers of the oral cavity, pharynx and oesophagus. In developed countries the main risk factors for cancers of the oral cavity, pharynx and oesophagus are alcohol and tobacco, and up to 75% of such cancers are
attributable to these two lifestyle factors (5). Overweight and obesity are established risk factors specifically for adenocarcinoma (but not squamous cell carcinoma) of the oesophagus (6--8). In developing countries, around 60% of cancers of the oral cavity, pharynx and oesophagus are thought to be a result of micronutrient deficiencies related to a restricted diet that is low in fruits and vegetables and animal products (5, 9). 


The World Health Organization (WHO) has revealed that 85 per cent of adult cancers are entirely avoidable and, of these, around half are related to nutritional deficiencies in the Western diet. A recent government report showed how nearly 70,000 premature deaths could be prevented each year by simply improving the UK's diet.
Another study carried out by Brigham Young University professor Steven Aldana, published in the Journal of the American Dietetic Association, March, 2005, found that a combination of 30 minutes of cardio exercise a day along with a switch to a healthier diet dropped the participants’ health risks for diabetes, cancer, and heart disease dramatically in just 6 weeks.

Let us all be mindful when we choose our food for the day. Planning our lunches that we take to work or making food on Sunday in preparation for the week goes a long way to being healthier.

Walking is great exercise and with a few sprints added in for the cardio and you will help keep the blood flowing rather than stagnating.

Choose your food wisely. More to come on this topic.

Besides eliminating inflammatory foods and lifestyle habits, how can reverse inflammation and encourage anti inflammation?

-Keeping our microbiota healthy by eating and drinking fermented foods (like water Kefir) and supplementing with good probiotics. 
-Eating fish three times a week, and supplementing with fish oils to keep our omega 3 levels as high as possible. 
-avoiding grains and seed oils and other sources of omega 6's, because the average persons levels are too high. 
-Keeping serum homocysteine levels below 8 with B vitamins and Betaine
-Keeping ones serum high sensitivity CRP ( a blood test ordered by your doctor) below 2. 
-flossing your teeth and seeing a biological dentist for assessment and care.
-moderate exercise, slightly more if you need to lose weight.
-keeping your waist/hip ratio below .75 for women and below 1.0 for men and 
-keeping the waist measurement below 30 inches for women and below 35 inches for men.


To Year Health
Dr. Barbara