Blog Posts by Dr. Ayala

  • How can “cutting added sugar” drive better health?

    The American Heart Association's (AHA) new guidelines published in late August were a refreshing point of clarity contrasting with the vagueness typical of nutrition advice designed not to offend any major food lobby.

    The new statement, published in Circulation, replaces AHA's hazier 2006 one to "minimize the intake of beverages and foods with added sugars," and provides detailed guidance by recommending an upper limit on added-sugars intake.

    Let's start with the AHA guidelines and look at the numbers:

    The upper limit for added sugars should be no more than half our discretionary calories. (Discretionary calories are at the very tip of the food pyramid, an area that's small but fun; this is what we can allow ourselves to eat once we've eaten a nutritious diet; luxuries such as solid (saturated) fats, added sugars, and alcohol fall into this category, all of which should be consumed sparingly.)

    Most American women should consume no more than 100 calories of

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  • I can't believe the summer vacation is over and kids will be going back to school this week. This summer went by way too fast!

    I was happy to get a letter from my daughter's elementary school announcing new snack policies-the school will not be giving out any more snacks, will not give food as incentives, prizes or rewards, and birthday celebrations at school will become "food free." Parents are being encouraged to send healthy snacks from home, including fresh fruit, cut-up vegetables, dry fruit and trail mix (with no candy).

    The reasons cited for this change of policy are dual-better nutrition to prevent childhood obesity and a precaution taken because many kids suffer food allergies.

    I'm greatly encouraged to see that change in the way we feed our kids is indeed coming!
    And to this hopeful note I'd like to add a few suggestions for simple steps that can add up to better health this coming school year. These steps are indeed small, certainly doable, and can have

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  • Poor nutrition driving rise in kidney stones—in adults and kids

    A recent study in the Journal of the American Society of Nephrology, found that a high intake of fruits, vegetables, nuts and legumes, low-fat dairy products, and whole grains and low intake of sodium, sweetened beverages, and red and processed meats was associated with reduced risk of kidney stones. This study, which analyzed data from more than a quarter million participants, led me to repost a piece I wrote last year. It's just one more argument to make for healthy nutrition. Enjoy the rest of your summer, Dr. Ayala

    Kidney stones are becoming more common at an alarming rate, and this is one trend you should absolutely try to avoid.

    If you've ever had one, you know they're no fun. In fact, women who've experienced both kidney stones and child labor describe the pain associated with the passage of a stone as comparable in intensity to that of labor (without an epidural), with much less satisfying rewards.

    Diet plays an important role in the development of kidney

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  • Are “functional” foods healthy foods?

    I was disturbed by a short exchange I had with my ten-year old-daughter today. I told her we would be cooking a cholesterol-free dinner tonight, because one of our guests is trying to lower her cholesterol without medication, to which my dear daughter replied, "She should eat Cheerios."

    Apparently General Mills' health claims-prominently displayed on every box-have reached my daughter, and she accepts them as fact.

    Skimming through the New York Times later in the day, I read an Associated Press article , reporting on a Pricewaterhouse Coopers research paper just released, showing that even in a struggling economy America's appetite for "functional foods" has not diminished. In fact, this category-accounting for more than $27 billion in sales a year of vitamin-, fiber-, calcium- and omega 3 fatty acids-fortified foods-is growing, and the report estimates a future growth range of from 8.5 to 20 percent per year-far more than the 1 to 4 percent forecast for the food industry

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  • User Post: A snake visits our summer garden

    I am taking a summer break for a few weeks to spend time with my family and travel. Meantime, I'm reposting some of the more popular posts I've written over the past almost two years (wow, how time flies!) so that new readers have a chance to catch up. Enjoy this post! - Dr. Ayala

    This week my kids came running into the house screaming "Snake!"

    They had been playing in the back yard and while looking for the lacrosse ball, they lifted the sled they left under the magnolia tree a week ago (what they were doing with a sled in mid-summer is another topic).


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    And there was the snake, with its beautiful checkerboard patterns, sticking out its tongue at me. I quickly took these pictures and the snake left quietly.

    I've only lived in this area for about 9 years, and this was the first snake I saw in our own garden. We get plenty of rabbits, deer and foxes, and we're happy with our animal visitors -- even when they eat up the garden -- but my kids weren't happy

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  • User post: Watermelons--A healthy taste of summer

    I am taking a summer break for a few weeks to spend time with my family and travel. Meantime, I'm reposting some of the more popular posts I've written over the past almost two years (wow, how time flies!) so that new readers have a chance to catch up. Enjoy this post! - Ayala

    One of the best things to enjoy on a warm summer day is a cold watermelon. What could be better? Sweet, crisp, refreshing, red and nutritiously healthy.

    My husband sees it as a personal failure when we open a watermelon and find a pinkish disappointment that tastes like a cucumber. He feels there must be a fool-proof way to pick the perfect fruit.

    Alas, there's no secret method, but I can offer a few tips for choosing a good watermelon:


    Tapping: Tap the watermelon with the pads of your fingers. A winning watermelon will typically have a slight hollow sound, more like the sound you get when tapping your head rather than tapping your chest.

    The yellow spot: At the bottom of the watermelon --

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  • With healthcare reform on many people's minds, and awareness of the rising and overwhelming costs of chronic disease, I want to bring to your attention two recent articles in the Journal of the American Medical Association (JAMA), both of which study the effects of lifestyle factors on two all-too-common chronic illnesses in two different populations.

    The first study by Forman et al looks at the relationship between six modifiable lifestyle factors and the lifetime risk of heart failure. Heart failure is a very serious situation in which the heart structure or function is impaired, and cannot keep up with the body's blood supply needs. The most common causes of heart failure in the U.S. are coronary artery disease and hypertension.

    The study included 20,900 physicians, all apparently healthy, and with an average age of 53.6 years at the baseline. The six healthy lifestyle factors were: Normal weight (body mass index, or BMI of 25 as the cutting point), not smoking, exercise

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  • From garden to healthy table—zucchini, potato and fresh herbs gratin

    As I've mentioned before, I'm an amateur organic gardener with many good intentions and a very modest yield.

    I give my little vegetable patch lots of love, but the veggies are very slow to grow, and although some of my friends have been boasting home-grown produce for weeks, I harvested my first few cucumbers, tomatoes and zucchini just this week.

    I love watching the plant in all its stages, and I'm especially fascinated to see how a fruit evolves from the flower. In the case of the zucchini, the beautiful golden flowers-both male and female-are edible and quite tasty, and can be eaten fresh, sprinkled into salads soups and pasta dishes, or cooked-stuffed zucchini flowers are a gorgeous delicacy.

    By the way, only the female flower results in a zucchini: A bud appears at the base of the flower and grows into a zucchini. (And yes, a zucchini is botanically a fruit and not a vegetable.)
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    One of my favorite zucchini recipies is for an easy gratin. I usually make this

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  • Can Pac-Man help kids make healthier choices?

    One-third of American kids are overweight or obese. Obesity rates among kids have tripled in the past thirty years. Many experts blame not only the food environment we live in-comprised of endless opportunities to eat foods of minimal nutritional value-but also the massive bombardment of advertising our kids are exposed to, baiting them to consume these foods.

    According to the Federal Trade Commission , the largest U.S. food and beverage companies spent about $1.6 billion (!) in 2006 marketing their products to kids-$492 million for soda ads alone-and I'm sure they wouldn't be spending this kind of money unless they saw real results.

    Most parents are aware of how abundant junk food ads are on kids' TV programming, but ads lurk in every corner. Media consumption habits have changed, and marketers are keeping up as they find new ways to get their message to kids in new outlets, including social media, product placement in TV shows and movies, sports sponsorships, mobile phones

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  • Go see Food, Inc. and improve your food and health




    The New York Times called it "one of the scariest movies of the year."

    I wouldn't know, since I generally avoid horror films, but while Robert Kenner's Food, Inc. is indeed deeply disturbing and isn't the light entertainment typically screened in the heat of summer, it's an important movie to watch, and it does offer a hopeful note and an action plan. I bet you'll be moved by this movie, and understand more than ever that there's plenty we can do to affect our own diet and the food landscape in which we all live.

    We buy our food in clean pastoral looking supermarkets. It's beautifully packaged, and marketed as the bounty of our land and the product of smiling healthy looking farmers.

    Once Kenner lifts the veil, the industrial food system looks very different and so much uglier.

    Our industrial conventional foods are controlled by a handful of very large and powerful conglomerates shown to often put profit ahead of other consideration, including consumer

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