Who doesn’t love brunch? Just because you are eating healthy doesn’t mean you have to skip your weekly brunch with friends! It’s all about making the right choices so that you can enjoy a meal outside of your kitchen once and a while.
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Here are the best choices for brunch that you should be able to find one or more of on any brunch menu:


Appetizer

Bowl of fruit - Go for the melon and/or berries which have the lowest sugar. Fruits with the greatest amount of sugar include tropical fruits such as banana, pineapple, mango - go easy on these tropical fruits.


Main Course

Eggs benedict - Request for some greens to serve as the “bun” for the eggs and skip the english muffin. Also ask for hollandaise on the side - restaurants typically smother your eggs in so much hollandaise that you can't even taste the rest of the meal. Take back the control and ask for this on the side.

Egg omelette - With lots of veggies. Again skip the breakfast potatoes or toast. If you are extra hungry then add some more fat in the form of avocado, guacamole, or cheese, or consider adding another protein like ground turkey if this is an option.

Egg white omelette - If you are not feeling egg yolks, this is also a great option. Ask to have it made with lots of veggies and hold the breakfast potatoes. Egg whites have zero fat so consider bulking them up with healthy fat such as avocado, guacamole, or cheese (if you can tolerate).

Scrambled eggs - With lots of veggies. Depending how hungry you are, you could consider adding avocado, guacamole, or cheese for some extra fat or another serving of protein such as turkey. Note: be weary of sausage or bacon which are processed meats and may also have had sugar added to them.

Eggs - When in doubt, order a side of 3-4 eggs. Poached is best because the eggs are cooked in water without any added oil.

Oatmeal - PLAIN. No added raisins/maple syrup/brown sugar/honey/agave etc. Berries are ok. This is your choice only if you are really craving something carb heavy or sweet, and if you are between this and ordering the stack of pancakes. Add some cinnamon on top to blunt the blood sugar increase that comes with eating carbs.


Drink

Prosecco - Mimosas are over-rated. Why waste any of that tiny flute space on some high sugar syrupy, over-processed orange juice? Prosecco has enough sweetness in itself, but if you must, ask for just a splash of OJ.

Dry white wine - “dry” is code for low sugar. Under all circumstances go for the drier wines such as sauvignon blanc and chardonnay. Stay away from riesling or white zinfandel tend to basically be grape juice.

Dry rose - Rose in general is pretty sweet. so a dry rose may be hard to find, but still worth asking if the restaurant has one available.


About the author: Sarah-Kate Rems is an Ivy-league trained Board-Certified Family Nurse Practitioner licensed in California and New York State with an expertise in preventative healthcare. She considers nutrition and exercise to be the basis of well-being and is a strong advocate for daily physical activity and maintaining a healthy diet. Sarah-Kate is also a co-founder of The Mindful Tech Lab

Have you ever heard of a ketogenic diet? A ketogenic diet means your body is using ketones for energy production rather than sugar. Ketones are an alternative fuel source for the body, and are produced when eating a high fat and low carbohydrate diet. This type of diet is called "ketogenic" because your body is in a state of "ketosis" meaning fueled by ketones rather than sugar (aka glucose).

Here are 9 reasons why you want your body to be fueled by ketones instead of sugar:

1. You literally burn your own fat for energy
Your body can run on either glucose or ketones. Which would you choose? Well, when you look at what this actually means: Glucose is produced from the breakdown of glycogen (strings of glucose), this means you are burning glycogen to produce fuel for your body. Ketones on the other hand are produced from the breakdown of fat (fatty acids), this means you are literally burning your own fat stores to produce energy. You can make ketones from eating very low carb (sub 50 net carbs), fasting, or consuming a product that can induce or supply the production of ketones (such as MCT oil).


2. No more “Hangry”
You know that feeling when are so starving that every little thing is irritating, and you need to eat right. NOW? Terrible feeling right? Blame the carbs! After a blood sugar spike from eating carbs, this will trigger insulin whose job is to get that sugar out of your blood as fast as it can (because sugar in your blood is toxic and inflammatory), resulting in an even lower blood sugar than you started with. Low blood sugar (aka hypoglycemia) is that terrible anxiousness you are feeling. No bueno! And how do you make that feeling go away the fastest? Eating sugar. And the vicious cycle continues.

Fat is the only macronutrient that won't raise blood sugar, and therefore won't spike insulin. Yes, that means protein can also raise blood sugar when eaten in excess. That is why a ketogenic diet favors a higher fat and moderate protein intake.


3. Ketones favor less mental stress
The presence of ketones increases the production of the primary calm inducing neurotransmitter, GABA, while at the same time decreasing the primary stress inducing neurotransmitter, Glutamate. Ketones do this by assisting in the conversion of glutamate to GABA in the brain, thereby favoring a more calming state. Increasing the activity of GABA is essentially what most anti-anxiety medications aim to do as well - pretty cool you can get the same effects by just changing your diet!


4. Ketones favor a more focused state
For the same reason ketones favor calmed brain activity, they also favor a more alert and focused state. As stated above, more GABA compared to glutamate in the brain favors a less stressed state, meaning there is less “noise” in the brain, allowing for greater focus and mental clarity.  This is why medium chain triglycerides (MCT) are marketed as a product that can increase focus and cognition - because they give the body ketones that can be used for fuel without having to be in actual ketosis from eating low carb.


5. Ketones are a more efficient source of energy
Ketones and glucose are both used as fuel by mitochondria to produce energy (aka ATP) - mitochondria are the part of a cell that takes fuel (either glucose or ketones) and manufactures energy from it. When comparing the output of energy produced from the use of ketones vs. glucose, more energy is produced when using ketones, thereby making it a more efficient fuel source. The presence of ketones also up-regulates the amount of mitochondria in cells, so more mitochondria means more energy produced. This is another reason for the improved focus and mental clarity seen with a ketogenic diet. 


6. Ketones act as antioxidants
Research has found that ketones act as antioxidants because they protect against oxidative damage from free radicals. When ketones are used to produce energy (by mitochondria) this process does not cause the release of free radicals, as does glucose when it is used to produce energy. Free radicals aka oxidative damage cause damage to cells and aid in the development of chronic disease, cancer, cognitive decline and other brain diseases, and aging. 


7. Ketones may prevent cancer growth
Compared to normal cells, cancer cells metabolize a much greater amount of glucose meaning they need more glucose to thrive. Cancer cells may preferentially use sugar to fuel their growth and proliferation, and research has shown that they may not be able to use ketones as fuel. Research has also shown greater response to chemotherapy when in a fasting state inducing ketosis. There is more research needed in this area, but ketones as a preventative measure for cancer is looking very promising! 


8. Greater absorption of nutrients
Major vitamin, antioxidants, and other nutrients need to be taken with fat to be able to be absorbed. This includes Vitamin D, Vitamin E, lycopene and beta-carotene such as in tomatoes, and the B vitamins.  Making sure you are taking in plenty of fats will ensure you are getting the most out of your food and supplements.  

9. Ketones are neuro-protective
Fueling the brain with ketones has shown to help with brain disorders such as seizures, brain cancer, Parkinson's Disease,  traumatic brain injury (TBI), and Alzheimer's Disease. There is a widely cited case of a physician who put her husband on a ketogenic diet as treatment of Alzheimer's disease and he improved within a couple of months. More research is needed on the direct effect of ketones for the prevention of diseases that affect the brain, but so far its looking very optimistic!

Side note: Ketones can supply up to 70% of the energy needed by the brain. It is true that your brain requires some glucose to function, but glucose can come from protein, it does not have to come from carbohydrates. It is a misconception that carbohydrates are necessary in your diet - they are not. Protein and fat are the two macronutrients your body definitely needs to manufacture all of the necessary components of the body.

All works cited can be found in the hyperlinks 

About the author: Sarah-Kate Rems is an Ivy-league trained Board-Certified Family Nurse Practitioner licensed in California and New York State with an expertise in preventative healthcare. She considers nutrition and exercise to be the basis of well-being and is a strong advocate for daily physical activity and maintaining a healthy diet. Sarah-Kate is also a co-founder of The Mindful Tech Lab

Herbs and spices are a great way to bring out the flavors in a dish without adding unwanted sugar or carbs. They are also great way to enhance the antioxidant, vitamin, and mineral profile of your meal. To get the greatest benefits, always use high quality, organic, fresh or dried herbs and spices and avoid storing in a hot or damp place.

Here is a list of my top 10 favorite herbs and spices:

1. Turmeric
This spice has strong anti-inflammatory and antioxidant power, and is best served with savory dishes such as with vegetables, fats, and proteins.

2. Paprika
This spice is rich in antioxidants and vitamins and is best served with savory dishes such as with vegetables, fats, and proteins.

3. Pink Himalayan Salt
Unlike common table salt which is heavily processed and devoid of nutrients, this type of salt is very low processed and also contains up to 84 different trace minerals. This can be used to bring out flavors in both sweet and savory dishes.

4. Cayenne
Capsaicin is the active ingredient that gives this spice its spiceness and is best served with savory dishes such as with vegetables or protein.

5. Cinnamon
This spice helps to keep blood sugar normal and can even blunt blood sugar spikes when added to carbohydrate meals. For this reason, this spice is great for preventing Type 2 Diabetes or for those with Type 2 Diabetes. Cinnamon can be used with both sweet and savory dishes.

6. Dried red pepper flakes
This spice contains polyphenols which are antioxidants that combat cellular damage and in effect may lower your risk of certain cancers. The “hotness” of this spice may help rev your metabolism. This spice is best used with savory dishes such as with vegetables, fats, and proteins.

7. Stevia
Stevia is an herb that comes from the leaves of a plant and is a natural (or near natural) sweetener. This is the only sweetener that I recommend because it has been studied extensively and so far has shown to have no ill effects to the body. It has also shown to not cause blood sugar spike after eating - which happens after eating sugar or certain other sweeteners. Check the label before buying and make sure there are no added ingredients or processing steps listed.

8. Basil
This herb has anti-inflammatory, antioxidant, and antibacterial properties. It is quite versatile and is well paired with savory dishes as well as fruits such as berries, melon, and tomato.

9. Rosemary
This herb is anti-inflammatory and may boost alertness and improve memory. It is best used with savory dishes such as with fish and poultry.

10. Oregano ​
This herb has both strong antibacterial and anti-inflammatory properties, and has shown to be possibly helpful for menstrual cramps, bloating, and preventing or treating mild respiratory infections. 

Sarah-Kate Rems, NP
Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here
Note: all references are cited within the hyperlinks 

I get questions from patients all the time about how to eat at a restaurant without derailing their diet. Of course cooking your own food is best because you can control everything that goes into it (not to mention you save a lot of money!) but when you want to be social and go to dinner that’s ok too!

​Here is what you should order when eating at a Mexican restaurant:

Appetizer:

• Guacamole - Carve out 2-3 spoon fulls onto your plate and dig in or add some salsa on top. Guacamole is full of healthy fats with zero carbs and will keep you much better satisfied than a basket of chips.
• Ceviche - This consists of raw fish (normally sushi grade) in citrus with maybe some diced tomatoes - you can’t get much healthier than that! This is a light, tasty, and low carb way to start your meal.

Main Course:

• Fajitas - With lots of grilled vegetables, pico de gallo, and salsa as a topping to add flavor. Skip the rice and tortillas and see if they can substitute in extra veggies instead. If you are going to keep the beans go for black beans rather than refried because they have gone through less processing and contain more fiber. If you are low carb, skip the beans and ask for a side of avocado or guacamole instead.
• Grilled chicken - With lots of vegetables. Skip the rice here as well, instead add add a side of avocado or black beans.
• Grilled fish - With lots of vegetables. Skip the rice here as well. Top with salsa or consider adding a side of avocado or black beans.

​Drink:

• Tequila on the rocks - A shot of tequila has around 70 calories and will take a longer time to sip.
• Skinny margarita - Tequila w/ soda and lime is great because you get the bubbles from the soda water and a hint of lime to pair with the tequila. This will also be easier to sip rather than a sugar bomb of a margarita - a margarita can have a whole days worth of sugar and calories! 
• Light beer - If you can’t see yourself not ordering a Mexican beer with your Mexican food, then go for a light version such as corona light.

Sarah-Kate Rems, NP
Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here

1. Get your dressing on the side
Most dressings are high in fat, sugar, and salt for very little servings sizes (think size of a ping pong ball). Get more bang for your buck with dressings that are great in flavor and have a better nutritional profile such as hummus, hot sauce, soy sauce, or balsamic vinegar. Always ask for dressing to be on the side, you are more likely to use less of it.

2. More vegetables
Vegetables fill you up due to their high fiber and high water content. The body cannot digest fiber and so it takes longer for high fiber foods to pass through your system, thus keeping you fuller longer while at the same time causing your body to absorb fewer calories. Fiber also keeps your cholesterol  in check by binding to cholesterol and literally expelling it from your body with each trip to the bathroom.

3. Ask for the bread or bun to be non-toasted.
Toasted means buttered, in most cases. The majority of restaurants will default to toasting your bread while also adding butter, resulting in more calories and fat added to your meal without you even realizing it.

4. Go open face on your sandwich 
You will not miss the top piece of bread from your sandwich. Most breads from restaurants are low in fiber, high in empty carbs and won’t do anything to help you stay full. Instead, pile on the protein and vegetables, these will fill you up more than an empty calorie extra piece of bread will.

5. Poach the eggs. 
Poached means eggs are cooked in water without anything else added to them. Rest assured your poached eggs will not have vegetable oils added them.

6. If you go omelet, ask how it's made.
Make sure to ask how the omelets are made. Restaurants may other inflammatories such as milk that may be problematic for you. And of course always add vegetables!

​Sarah-Kate Rems, NP
Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here

One of the most frequent questions I have in practice is about wheat/gluten-free and my take on how it effects the body and mind. I started doing more research on the topic and I found more than enough reasons to cut out wheat completely from my own diet. Here are the top 8 to get you started:
 
1. Not the original wheat
First of all, wheat is not what it was thousands of years ago, or even fifty years ago. Wheat today is produced by countless hybridiazations making for thousands of different potentially harmfull proteins and other compounds  We now have “wheat” that was grown in synthetic soil, saturated in chemicals, made to survive the worst environmental conditions and cultivated so that no pest would eat it – and we’re wondering if this could make us sick? Currently there is no requirement for crops that have undergone hybridization to be tested on animals or humans. Read more about this here and here.
 
2. Increases blood sugar higher than table sugar
Wheat’s main carbohydrate is Amylopectin A and raises your blood sugar higher and faster than any other carbohydrate including table sugar! When there is a large amount of sugar in your blood all at once, this signals a large amount of insulin to remove this sugar as quickly as possible and deliver this preferentially to your fat cells (why we call insulin the fat storage hormone). This is why you feel hungry an hour or two after eating a wheat product – all the sugar has been removed from your bloodstream by then and your cells are still hungry because your fat cells are hogging all of the energy. 
 
3. Addictive
Wheat contains a unique protein called gliadin which, when broken down in the body into polypeptides, crosses the blood-brain barrier and binds the morphine receptor in the brain (i.e. euphoric center). These particular polypeptides are termed “exorphins” (exogenous morphine like compounds) because of how like other opiates, you feel a mini-high after ingesting and a slump short while after. In short, these exorphins stimulate the addictive, pleasure seeking part of your brain, stimulating your appetite making you want more and more. Just as other drugs that bind the morphin receptor (think heroin, morphin), this repeated exposure distorts the brain causing mental fog, sluggishness, fatigue and makes one more susceptible to depression and other psychological disorders down the road.
 
Interesting note - there are now drugs that contain naloxone to treat obesity. Naloxone is formerly known as a drug used to treat narcotic overdose, most notably heroin. It works for weight loss because it blocks the morphine receptor, exorphins are unable to bind, and thus prevents appetite from being stimulated.

4. Blocks your brain from understanding you are full
Digested wheat proteins have been found to block the leptin receptor. This is bad because leptin functions to tell our brain that we are full - if this is being blocked, you are more likely to be hungrier regardless of how much you may have just eaten.
 
5. Increased risk for diabetes and obesity
This goes along with it’s addictive like quality, stimulating your appetite, increasing blood sugar rapidly, and blocking the mechanism that tells you that you are full. This is a recipe for you to overeat (overeat carbohydrates in particular because of their addictive quality), which leads to obesity and diabetes from too much carbohydrate ingestion aka chronic high blood sugar. I hear all the time from slender patients not understanding how they can be at risk for diabetes with a normal weight and eating healthy “whole grains.” It doesn’t matter if you are thin or overweight, if you are consuming a high carbohydrate diet (which is easiest to do with consuming too many wheat products) your blood sugar will be chronically elevated unless you start making changes.
 
6. Worsening ADHD 
This is still a controversial topic and more studies need to be done to look at this, but there have been many studies showing the improvement of ADHD in children and adults when cutting out the wheat products. You can read more about this here.
 
7. Inflammation to your gut
Gluten is the main protein of wheat, and it is made up of two proteins gliadin and glutenins. Gliadin is the primary group that triggers the immune response (i.e. infallmation) in celiac diease. But even beyond gluten and celiac diease, there are a wide range of other proteins present in wheat, more than could ever be accounted for due to the countless transformations via countless cross-breeding of strains as discussed above. These modified proteins as well as gluten have been shown to be associated with irritable bowel syndrome in non-celiac disease individuals, and accounts for digestive issues in individuals without full-blown celiac diease. This is why individuals who cut out wheat tend to have less stomach issues. 

 
8. Joint inflammation
As discussed above, wheat products raise your blood sugar more than nearly all foods. The more your blood sugar rises, the more glycation occurs. Glycation is when a sugar binds to protein causing irrversible changes, and thereby modifies proteins in the blood stream, body tissues, and joints. Glycation is particularly damaging to cartilage, and when cartilage proteins become glycated they become stiff. Overtime, glycation makes the cartilage brittle, stiff, and crumbling resulting in more pain and destruction in your joints.
 
I know it sounds hard to cut back on wheat (because wheat is in virtually all processed foods), but replace with filling full fat foods – avocado, eggs, olive oil, cheese, etc. Healthy non-processed fats should be the bulk of your diet, as the low-fat craze has brought upon the increased obesity, diabetes, and heart diease rate since it was instituted in the 1970s - more on this for another post. If you want to read more about the effects of wheat I highly recommend the book Wheat Belly by cardiologist William Davis, MD. 

​Sarah-Kate Rems, NP
Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here

This is a short list of some of the most common foods marketed as healthy, when more often than not they are no better than eating dessert. Always read the nutrition label and the ingredients list before purchasing a food. You have to watch out for sugar because it triggers insulin (fat storage hormone) to be released,  whose job is to get sugar out of your blood as quickly as possible and store it somewhere for later use (think your thighs). Unless you are training for something like a marathon or ironman where your muscles will be the first to receive the sugar, try to keep your daily sugar to a minimum - like under 25 grams per day.

 1. Skim Milk
Non-fat or “skim milk” has a surprisingly high amount of sugar. Most brands  have about 12 grams per cup – this is almost half the amount of total sugar that is recommended you ingest each day! To put this into perspective, this is the same amount of sugar as eating three Original Chips Ahoy! Cookies or three Milano Original Cookies. I am not a huge fan of cow’s milk (for many other reasons), and I recommend trying unsweetened almond, cashew, or coconut milk as an alternative.

 2. Protein/Nutrition Bars
In general,  I recommend staying away from all “high protein,” “high fiber,” “gluten free,” or however else the given bar has been marked as healthy. Strip back all of the fancy advertising and look at the nutrition label and you will find that most of these "health" bars are no better than a candy bar. For example, compare a Snickers Bar to a Clif Bar: a Snickers Bar has 27 grams of sugar and 4 grams of protein. A Clif bar can have up to 25 grams of sugar and 9 grams of protein…is there really that much of a difference between the two?? – Others popular bars to avoid include Balance bars, Luna Bars, Pure Bars, Lara Bars, and even Kind Bars which can be high in sugar. Rule of thumb, stay away from any bar with 10 grams of sugar or more. The only protein bars I recommend are Quest bars because they are high in protein and fiber, low in sugar and in overall ingredients, and Think Thin Bars which are also a healthier alternative.

3. Yogurt
Yogurt can be very healthy because it is generally high in protein and low in fat. However, you have to be careful with choosing yogurt because most have a ton of added sugar, be especially cognizant of the the non-fat versions because the fat is replaced with sugar to make it taste better. Always check the nutrition label, more than 7g of sugar per serving and you have a dessert not a healthy snack. My favorite is Plain Greek Yogurt Trader Joe's brand which has 22 grams of protein and 6 grams sugar per cup.

 4. Granola
Be very picky with granola, the vast majority are heavy in sugar and calories, and low in fiber. Granola is meant to be eaten in a small serving size, usually like a ¼ or ½ cup, meaning you could easily be eating 4 servings in one sitting. And just because the packaging says “made with honey” or “made with all natural ingredients” or some other deceiving marketing claim, this doesn’t make the food any healthier, sugar is sugar. I don’t really recommend granola in general, but if you are going to eat it I recommend eating it plain and would avoid eating it with anything else sugary such as yogurt and/or fruit.

5. Cereal
Cereal is generally not a great choice. Almost all cereals are loaded with sugar, low in fiber, and low in protein. And why is everyone eating Raisen Bran??!! It seems like just about every other patient I see is eating this. Raisen Bran has 18 grams of sugar per serving, 18 grams! This is almost the total amount of sugar that you should have in an entire day. Then add some skim milk on there and this puts you over the edge. Forget the raisens and just get plain bran cereal, you can always add your own raisens on top if necessary. The only cereals I recommend are Fiber One Original Cereal (14 grams of fiber per ½ cup!) or Trader Joe’s High Fiber cereal (9 grams of fiber per 2/3 cup) because both are low in sugar and high in fiber.

6. Sports Drinks
Everyone knows that soda is a diet-don't, but most sports drinks are just as bad. For example, a 12 fl oz bottle of Coca-Cola Coke has around 33 grams of sugar. A bottle of Gatorade has almost 50 grams of sugar (due to having 2.5 servings per bottle). And watch out for those bottled teas because they can have over 20 grams of sugar per serving and can have multiple servings within one bottle. Alternatives to these super sweet drinks are G2 which is a lower calorie version of Gatorade, Vitamin Water Zero, and PowerAid Zero.

Sarah-Kate Rems, NP
Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here