Orange and chocolate does the body good

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For those of you who have been reading my posts lately, I realize you may think I am starting to sound like Charlie Brown’s teacher (“whah whah whah, whah,”) since I talk about skin cancer so much ( I am a dermatologist after all), but orange and chocolate are really a great combination for your skin so hopefully you will indulge me. May is skin cancer awareness month and to kick off the month, today is known as “Melanoma Monday.”  Dermatologists across the country will be wearing orange to bring attention to a campaign headed up by the American Academy of Dermatology to promote skin cancer awareness and skin cancer screenings.  We dedicate today to raising awareness about melanoma, because although it accounts for less than 5% of skin cancer cases, it is the cause of the majority of skin cancer deaths. 

Here are top 10 facts you should know about melanoma*: 

  • 1 in 50 men and women in the U.S. will be diagnosed with melanoma of the skin during their lifetime.
     
  • Melanoma is the fifth most common cancer among men and the seventh most common cancer in women in the US and it is the only cancer whose incidence continues to rise nearly 2% annually. 
  •  In 2009, there were approximately 876,344 men and women alive in the U.S. with a history of melanoma. This number continues to rise.
     
  • Approximately 86 percent of melanomas can be attributed to exposure to ultraviolet (UV) radiation from the sun.
     
  • Melanoma is one of only three cancers with an increasing mortality rate for men, in addition to liver and esophageal cancers.
     
  • Survivors of melanoma are about nine times as likely as the general population to develop a new melanoma.
     
  • The vast majority of mutations found in melanoma are caused by ultraviolet radiation.
     
  • Melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for young people 15-29 years old.
     
     
  • A person’s risk for melanoma doubles if he or she has had more than five sunburns at any age.
     
  • One or more blistering sunburns in childhood or adolescence more than double a person’s chances of developing melanoma later in life.

So if you see someone wearing orange today, hopefully it will prompt you to check your skin for any new or changing spots. As dermatologists we look for “the ugly duckling” on your skin; the spot that stands out from your “crowd” of spots and the sore that isn’t healing in a timely fashion. This month, and today in particular, is a time we encourage you to do the same with your skin. If you have any concerns or questions regarding your “spots”, it’s always best to seek consultation with a dermatologist in case a biopsy needs to be performed.

Ok, so now that your brain is full of facts that admittedly are a bit frightening and overwhelming, I am here to cheer you up with chocolate! That’s right chocolately deliciousness to bring you back to your comfort zone. The key ingredient in chocolate is cocoa, which is rich in anti-oxidants, richer in fact than red wine or green tea. Recent research* highlighted the group of anti-oxidants known as flavanols (a group of compounds that can be particularly rich in cocoa) and that have been previously reported to improve blood flow and vessel function. The study revealed the potential benefits of consuming flavanol-rich cocoa and how it might actually benefit the appearance of skin from the inside out including: increasing hydration, decreasing skin roughness and scaling, and helping to support the skin’s defense against UV damage.  Good news right? Chocolate without guilt, what could be better?

So to celebrate “Melanoma monday”, put on your orange clothes, check your skin and get in the kitchen to eat some flavanols and cocoa with this chocolate chocolate chip cookie recipe that is kid tested and approved (and I have some pretty picky eaters around here!)
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2 1/4 c unsifted flour (can use brown rice flour for gluten free option)

1 tsp baking soda

1/2 tsp salt

3/4 c fair trade raw cane sugar (or whatever you got in the cupboard)

3/4 c organic light brown sugar, packed

2 tsp vanilla extract

2 eggs 

1/2 c butter

1/2 c pumpkin puree

1/4 c cacao powder

10 oz  chocolate chips ( I used Ghiradelli 60% Cacao bittersweet chips)

Preheat oven to 375F. Combine flour, baking soda, salt and cacao and set aside. Beat butter, pumpkin, sugar and eggs at medium speed until creamy. Add vanilla and eggs, one at a time, mixing on low speed until well blended.

Add your dry ingredients into creamed mixture gradually and then add your chocolate chips. On a cookie sheet drop your preferred size cookie (tablespoon or bigger/smaller) and bake for 9-11 minutes or until golden brown. Depending on cookie size makes about 4 dozen.

Voila! Comfort food that has the potential to be good for your skin and for your soul!

These cookies are a bit more cakey due to the pumpkin. You can use a full cup of butter if you don’t like the consistency. Enjoy!

*References:

1. Skincancer.org

2. Heinrich U, Neukam K, Tronnier H, Sies H, Stahl W. Long-term ingestion of high flavanol cocoa provides photo protection against UV-induced erythema and improves skin condition in women. J Nutr. 2006 Jun; 136(6):1565-9.

 

Just the facts ma’am….

just-the-facts-ma'am

Sgt Joe Friday (Jack Webb)

I was recently asked by a new acquaintance if I had been diagnosed with ADHD. My initial response was surprise. Me? Attention problem? As someone who has sat in the same spot for hours on end reading textbooks cover to cover, studying for medical boards and looking at hundreds of slides (one of my favorite parts of dermatology and why I became a dermatopathologist) without getting up to eat, drink or use the loo (that just sounds better than “potty” don’t you think?), it hadn’t occurred to me that I might have a problem staying focused.  I know I have my idiosyncrasies and nuances, and that certain” je ne sais quoi” that I like to think of as part of my charm (aka: a New Yorker without a filter=inappropriate and sometimes vulgar to which I credit  my father: love you Dad ), but I didn’t think attention or focus was a problem. But as I thought about her comment some more, I came to the realization that my issue is not an inability to stay focused when tasked, it’s more that I am perpetually interested in lots of things and often more interested in something other than what I am doing at that moment. Which brings me to the whole point of this post.

I had originally intended to post topics that only had “dermatology” titles: topics relating to the health of your skin, how to manage issues with your skin, and how to protect it, as my passion is educating people about skin cancer and melanoma, but somehow I keep getting side-tracked. Like I said, I am interested in a lot of things, especially eating. Learning new ways to cook (or just learning to cook for that matter) has opened a whole new world for me and I am having fun experimenting and I want to share that with you.

You see, your skin is a window to the overall health of your body. There are many systemic diseases which manifest characteristic skin findings. Therefore, examination of the skin can be key to making diagnoses as well as prompting a more extensive evaluation to pursue the possibility of internal organ involvement. Though not common, skin findings can be the first clue to metastasis of internal malignancy leading to diagnosis, work-up and subsequent management.

So what I am getting at is that what you eat can have a big impact on your skin. For example, those of you with Celiac disease may have experience with dermatitis herpetiformis (DH). DH is a chronic, intensely itchy, blistering skin manifestation of gluten-sensitive enteropathy (Celiac disease) which affects 15 to 25 percent of people with the disease and is found mainly in adults (more common in men and people of northern European descent). A strict gluten-free diet is the only treatment for the underlying disease, though some people may require temporary use of oral medication in order to get relief from their skin symptoms as they transition their diets.

So even though my plan was just to stick to the “derm facts”, there are so many facets of our lives that are intimately linked to the health of our skin: food, fitness, travel (bed bugs, myasis and leishmaniasis, oh my) that you may find my attention wandering in different directions. Feel free to reign me in if you have questions, or jump on board and enjoy the ride it should be interesting!

Chocolate Almond goodness

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These little nuggets of goodness are made from a recipe adapted from an inspiring and beautiful blog I have come across (thank you Caitlin-roostblog.com)  It was originally made as a dinner biscuit, but I tweeked it make it an after dinner treat. Depending on which of my adaptations you try, you can make it more like a biscuit(less sweet) or more like a true dessert….a girls got to have her chocolate right?

Over the last few months, as I have jumped, I mean seriously, like off the high dive right into the deep end of a pool (and I’m afraid of heights mind you…another wonderful bonus of getting older, but I digress) into the gluten-free realm, I have tried to nudge my family, especially the kids into the “shallow water” of gluten-free eating. So when my son, the pickiest eater of us all gives something a thumbs up, believe me, I am going to shout the recipe out to anyone willing to listen. (just turn down the volume if I’m being too loud).

I have now made this 3 ways, using either butter or coconut oil for variety. Choose whichever one sounds good to you!

Chocolate Almond Goodness: Subtle sweetness for a mini-biscuit

  • 2 1/2 cups almond flour
  • 1/2 tsp salt
  • 1/2 tsp baking soda
  • 2 eggs
  • 1/4 cup melted organic coconut oil or butter (Note: coconut oil will impart a somewhat “tropical” flavor and butter will provide a true biscuit flavoring)
  • 1/4 cup brown rice syrup
    3 Tb organic cacao powder

Preheat oven to 350F. Line a baking sheet with parchment paper or a silpat (or whatever you’ve got so things don’t stick to pan).

In a large bowl, combine the almond flour, salt, cacao and baking soda. In a medium bowl, whisk together the coconut oil, brown rice syrup and eggs. Stir the wet ingredients into the flour mixture until thoroughly combined. With a spoon or if you are willing to get dirty (which is more fun in my opinion) scoop up some dough in your hands and make small/medium blobs (very technical term) probably equivalent to 2 teaspoons or tablespoon size depending on your blob preference.

Bake for 15 minutes (give or take depending on your oven) so that a toothpick inserted into the center of a biscuit comes out clean. Let cool briefly on the baking sheet. Serve warm. ( I have also frozen the leftovers and they keep well!)

Makes about 25-28

The one below is the sweet treat version and my favorite one so far. Not too sweet, but just enough to satisfy my cravings…and hopefully yours too!

Chocolate Almond Goodness: my version of an “Almond Joy”

  • 2 1/2 cups almond flour
  • 1/2 tsp salt
  • 1/2 tsp baking soda
  • 2 eggs
  • 1/4 c organic melted organic coconut oil
  • 1/2 c organic light brown sugar
    1/4 c organic cacao powder

The mixing and cooking directions are the same as above but instead of brown rice syrup use the brown sugar and add it to your dry ingredients. Enjoy!

Gluten-free waffles

kid tested, kid approved

gluten-free waffles

We were running late in our morning routine for school as usual. I swear I try to be on time, but somehow with kids I am in a time warp where no matter what I do I am always late. At one point in my life, pre-kids that is, I was early and being on time was considered late for me. Now with kids, my timing consists of either being late (truly late), later and you know what….we better call it a day because this isn’t gonna happen. But, despite running behind schedule my son was in the mood for waffles and insisted that I had “time” to make them for him. Of course, how can I resist those big blue eyes pleading with me, so I caved and threw caution to the wind. What’s another tardy at school right? These kids need good nutrition.
So here was my experiment this morning. To my surprise the kids gave it raves reviews! Now, of course I take this with a grain of salt. I am new to this cooking thing, and I think the kids don’t want to discourage me (I really do love them!) so hopefully you will enjoy them too. But don’t worry, I won’t be insulted if they aren’t your thing. But feel free to add comments/suggestions. I can use all the help I can get.

1 cup almond flour
1 cup quinoa flour
3 tablespoons baking powder
1/2 teaspoon salt
Mixed these dry ingredients all together in a bowl and set aside

2 eggs
1 1/3 cups milk
4 tablespoons organic pumpkin
1 1/2 tablespoons vanilla ( I like vanilla but you can use less)
organic cinnamon (I forgot to measure)
1 tablespoon brown rice syrup
1 teaspoon light brown sugar (organic fair trade)
Whisk these together, then add to your dry ingredients
Grease waffle iron with either melted butter or coconut oil (for added flavor)
Voila! Enjoy!

The sunny side of rainy days

We recently moved from Northern California to the Pacific Northwest. Days of endless sunshine have been replaced by gray skies punctuated by rain showers with only glimpses of the sun. The weather folk on tv call these “sun breaks”.  It is an odd concept to wrap my head around, but I am getting used to it. At least I keep telling myself that.

I admit that seeing the sun peek out from the clouds at the end of long wet day, feels like being greeted by a warm smile when you enter an unfamiliar room. It immediately lifts my spirits. I know sunshine has this effect on many people. It’s the reason why so many of us travel to warm, sunny and tropical places in the winter to experience that instantaneous mood elevation. (Of course, that’s also why I am marred by sun damage and saw so many patients in my office with skin cancers, but that’s a downer, so let’s focus on mood elevation!) The good news, is that I have recently found the sunny side of rainy days. Who knew there was one right? But there is….just look in the mirror, it’s you.

Spending more time indoors, I have spent more time getting to know me. It sounds strange, that after all these years of being me, I never spent much time really listening to my inner voice: what she likes, dislikes and is curious about learning. She talks a lot by the way, so for the longest time I just shut her up because I had work to do, or kids to chase around, or frankly (and most truly) I was afraid of what she might be saying. But this recent move has provided me with an opportunity to spend more time indoors and by default more time with me, so I have indulged her (speaking about myself in the third person is odd, I know, but bear with me).

She wanted to cook. Now for those of you who know me, know that this is outrageous because the stove and I had never really bonded. There was always the occasional flirting with brownies and chocolate chip cookie baking, but real cooking… not a chance. My sweet husband had indulged my culinary incompetence for the last 18 years (I know, he is a saint) and whipped up delicious meals for the kids and I.  Until now.  At the beginning of the new year I started critically reading food labels and realizing that despite my umpteen years of schooling and learning the crazy terms and acronyms that lend themselves to dermatology, I couldn’t pronounce or understand 90% of what was on the ingredient lists of most packaged food. I knew I didn’t need to have gone to medical school to know that this was not a good thing.

So what next? I got schooled. I recruited the help of a nutrition counselor (love her!) and delved into the realm of whole foods. Now I know this is not a new concept. But while the rest of the gang was getting wise to the ways of nutrition, I had my nose in the derm books and remaining blissfully ignorant to all the additives and preservatives that filled the boxes in my pantry.  Long story short (sort of…I told you “she” had a lot to say), empowered with my new knowledge and abundance of rainy days, I put on my figurative big girl pants and dove into cooking. I have  roasted vegetables. That’s right rutabaga, you don’t scare me anymore. I have made soups, stews, gluten-free and dairy-free entrees, desserts, sides and salads… it has been life altering. For me. For the kids. For my my husband.

Yes, the warmth and vision of the sun is uplifting emotionally, there is no doubt. But you may find that if you step into the shade, whether literally or figuratively, and listen to your inner voice, she/he may have something interesting to say and lead you to a new type of “shaded bliss.”