On Monday, I did my grocery shopping for my first week following the Mediterranean Diet recommendations – you can see the food and ingredients I bought in the picture below. In addition to these, we already had olive oil, canned and dried beans, dry pasta/rice, bread, fresh vegetables, and canned/frozen fruit that I expect I’ll be using.

Mediterranean Diet staples

Below is a summary of the nutrition staples I made to guide my grocery shopping throughout my time on the Mediterranean diet.

• Proteins: fish (fresh, canned, or frozen), shellfish, canned or dried beans, nuts, seeds
  • Limited chicken, pork, and beef (1-2 servings of each per week)
• Low- or non-fat dairy products: milk, yogurt, part-skim mozzarella cheese
• Vegetables: select a variety – fresh, frozen, or canned (no salt added)
• Fruit: select a variety – fresh, frozen, dried, or canned (in juice)
• Grains (preferably whole grains): pasta, rice, bread, crackers
• Beverages: tea, water, wine (if desired)
• Other: olive oil, vinegar, herbs, spices, olives

The Cost of Following a Mediterranean Diet

Originally I was concerned that the Mediterranean Diet would be particularly expensive because of its emphasis on seafood. I was pleasantly surprised that I was still able to meet our normal grocery budget of $100 per week for our family of four (check out my series on Eating Well on a Budget if you want to know about how I do that) while shopping for the Mediterranean diet.

There are probably a few reasons I was able to easily stay within budget:

• I had several Mediterranean Diet staples already in my pantry.
• My family eats the same dinners, but lunches and breakfasts are often individual, so I wasn’t necessarily buying Mediterranean diet foods for all four of us for three meals per day all week. In addition to the foods pictured above, I purchased several items for the rest of my family that I won’t be eating.
• While the Mediterranean Diet has some more expensive aspects (seafood, olive oil), it also has some lower-cost aspects (beans, pasta, rice, bread) and limits other higher-cost options like red meats. Altogether, they may balance each other out.

Since this is only the first week of shopping for a Mediterranean Diet, I’ll see in the upcoming weeks if it continues to match our normal grocery budget and keep you posted!

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You voted, and my next diet feature is the Mediterranean Diet!

The Mediterranean-style diet is often praised for its associations with improved longevity and low rates of chronic disease and certain cancers. The diet is based on the eating patterns of countries bordering the Mediterranean Sea, particularly Greece and southern Italy.¹ The exact parameters of the Mediterranean diet are not entirely clear and vary somewhat depending on who you ask.² Part of this stems from the fact that there are several different Mediterranean countries – each with their own unique culture. Their diets are distinct and therefore have different characteristics.

In general, however, there are some trends that are consistent. According to the American Heart Association and the American Journal of Clinical Nutrition, the Mediterranean Diet includes:

• high consumption of fruits, vegetables, bread and other cereals, potatoes, beans, nuts and seeds
• fresh fruit as a daily dessert
• olive oil as the prominent fat source
• dairy products, fish and poultry in low to moderate amounts
• less than 2 servings of red meat per week
• 0-4 eggs per week
• wine in low to moderate amounts^1-2

The Fundación Dieta Mediterránea developed a food guide pyramid reflecting Mediterranean Diet recommendations as well:

Starting next Monday, I will be following these recommendations for 3 weeks and detailing the experience for you! I’ll be keeping tabs on how much it costs to follow, the challenges of following it, and more. Comment below with what you’d like to know about the Mediterranean Diet!

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References

1. Willet W C, et al. Mediterranean diet pyramid: a cultural model for healthy eating. June 1995. 61:6(1402S-1406S). https://doi.org/10.1093/ajcn/61.6.1402S.

2. American Heart Association. Mediterranean Diet. Reviewed April 2018. Accessed September 2019 at https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet.

Thanks to all of those who voted in the poll for my next featured diet! Your voices have been heard – my next feature will be…

the Mediterranean diet!

This diet, touted for its benefits for longevity and cardiovascular health, is a popular diet recommended by many doctors. In the coming weeks, I will be blogging about the research behind the Mediterranean diet. I will also follow the diet myself for 3 weeks to assess how easy it is to follow, how much it costs, and other lifestyle factors.

I’ve been on a liver-friendly diet for over a month now. If you’re not sure why, you can read about it here. A few days ago, my doctor redrew my blood to check my liver enzymes and they were…*drumroll please*…normal! Thank goodness that whatever was the reason for my elevated liver enzymes has resolved at this point and is no longer an issue!

As far as following the liver-friendly diet itself, here are my observations:

The Good

Eating 5 servings of fruits and vegetables every day makes me feel so good! I have great energy, great digestion, and my skin is super clear compared to when I eat fewer servings of the good stuff. Whenever I make sure to get my plant foods in it always reinforces to me how important it is for my body.

The Bad

No raw sushi. 🙁

The Ugly

Not a whole lot…probably the toughest part of the whole month was navigating social situations where others were drinking alcohol or eating high-fat or high-salt foods and I was trying to limit those. I wrote about a few of those situations in my post about eating out on a liver-friendly diet. It wasn’t miserable, but it was a bit tough. I think the difficulty would depend on how often you normally drink alcohol, take NSAID medications, or eat high-fat foods. Since none of these are a huge part of my normal, I didn’t feel like I was missing out too much.

Thanks for following along with my liver-friendly journey! Stay tuned to find out what I’ll be up to next!

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This past weekend I had the opportunity to try out a weekend of celebration, liver-friendly style. Every year in January we go with some friends for a weekend away, this time to McMenamin’s Grand Lodge in Forest Grove, OR. Typically, this weekend consists of delicious food, a few cocktails and ciders, and a lot of board games. We always have a great time. Since I’m on a liver-friendly diet this year, I decided to do the best I could to navigate my nutritional recommendations while still having a great time with my husband and friends.

Whether it’s a whole weekend away or a single meal, my primary strategies for meeting dietary recommendations while eating out: plan and prioritize.

Planning Ahead

Check out the place you’re going to (if you haven’t been there before) and find out what kinds of food are going to be available. We have been to the Grand Lodge many times, so I already know that the lunch and dinner fare is primarily pub-type food (with amazing tater tots). Veggies, protein, grains, and dairy will be no problem, but fruits will be lacking. I’ll have to be careful with fat and sodium, for sure.

Also, I know that there is an amazing chocolate milkshake made with their Terminator Stout that I usually get that I won’t be getting this time because it’s loaded with saturated fat and sugar and contains alcohol.

To address these two anticipated issues, I brought along some mandarin oranges and a dark chocolate bar. The chocolate bar contains some saturated fat and sugar, but it will be far better for lil’ ol’ liver than that Terminator Stout milkshake, and I’ll still get some chocolate!

Prioritizing

Think about what menu item would most delight you to eat, whether it’s an entree, a side, a dessert, you name it. Even if it’s a bit high in sodium, fat, or sugar, get that thing. Enjoy it! Surround it with healthier options.

We headed out Friday afternoon and on the way down we decided to stop at a burger joint recommended to us by a friend. None of us had been to Smashburger before, but we decided to give it a go. After checking out the menu, I saw that they had some rosemary herb tater tots. I am a big tot fan, so that was going to be my priority. My main dish was going to have to be healthier. They had a black bean burger on a multigrain bun with avocado, and it sounded tasty!

It was pretty dang good, but the tots were even better. I rounded it out with a water.

Later that evening, we went to soak in the hot tub. This is when I would usually end up getting a mojito, but since alcohol is a no-go on my liver-friendly diet, I asked for a seltzer water with a lime.

Was it as delicious as a mojito? No, but it was refreshing, tasty, and certainly more hydrating! Besides, I’m really out there to relax in the soaking pool, so mission accomplished.

After soaking we settled in for some board games and snacks. The Grand Lodge has some epic Cajun-spiced tater tots. If you remember from earlier, tots are definitely a priority for me. Those had to happen. We ordered some pretzel sticks with cheese sauce, but I only ate a couple of the pretzel sticks and avoided the cheese sauce. I would rather have tots!

They were fantastic as always.

The next morning I was fortunate enough to eat one of my favorite dishes, and it just so happens to be liver-friendly! This salmon and red potato hash is made with veggies, anti-inflammatory salmon, and red potatoes. If you want to try it, check out this copycat recipe. My hubby’s breakfast came with a fruit cup but he’s not a melon fan, so he ate the rest and then I got some fruit too!

Breakfast did not disappoint.

That afternoon, my friend and I went to see Mary Poppins Returns. It was so well done! For the movie I would normally have chosen to order a hard cider. I wanted something sweeter than the lime water I had last night, so I ordered a seltzer water with lime juice and a half-shot of simple syrup. It had a couple grams of sugar, but it was a definite liver-friendly improvement.

A side benefit of these “alternative” drinks is that the bartenders wouldn’t even charge me for them since they were mostly water and a little bit of fruit juice. I spent a few dollars in tips instead of the $20-25ish I would have spent on my usual drinks throughout the weekend!

For a late lunch, we ended up at a Hawaiian fusion restaurant. Everything on the menu looked so good, but I had to go with chicken katsu curry. While it does contain veggies and lean meat, the meat is deep fried and the curry is loaded with sodium. This one may have been a little over the top, but the last time I ate katsu curry was in Japan and I about died from delicious, so I wasn’t going to pass it up. It was supposed to come with macaroni salad, but I subbed that out for the house salad. The curry was the priority!

After lunch, we were going to settle in for some more board games and snacks. The crew stopped at the grocery store to buy some junk food. My oranges and chocolate bar came to the rescue so I was satisfied with only 2 cookies instead of…however many I would otherwise have eaten…

For our final breakfast, I had been itching to find out what the chef’s “daily scone” was. I am Scottish, after all. I asked my server – it was caramel apple. Guys. I was definitely going to have that. Now, I realized that a caramel apple scone was basically breakfast dessert, so I needed some protein and ideally veggies to balance this sucker out. I ordered the veggie sausage on the side and got another cup of unappreciated melon from my husband. The whole thing was dee-licious.

Then it was time to leave relaxation for the regularity of normal life. Sigh…it was such a great weekend. While the food I ate was certainly not as low in sodium, fat, or sugar as what I would eat at home, I feel great about the balance. When you’re eating out, gauge your choices based on the foods that are your priorities. The tastiest and most wonderful should take center stage, backed up by a chorus line of nutritious extras. You’ll enjoy yourself and feel great!

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Since my foray into the realm of the feverish I was placed on a liver-friendly diet for a month before my doctor re-checks my liver enzyme levels. I always joke with my clients that liver is a very busy guy, and he has many, many jobs. Sometimes they get overwhelming. Enter this comic from The Awkward Yeti.

There are many things you can do to support liver in his work. First, let’s briefly cover some of his job responsibilities, to name a few:

• Create bile to help digest fat
• Metabolize and store carbohydrate, protein, fat, vitamins, and minerals
• Modify or eliminate toxic substances
• Create many of the compounds that help blood clot
• Prevent low blood sugar

The composition of a liver-friendly diet is, in essence, a healthy balanced diet. There are some more specific things you can do, depending on what is wrong with your liver (which in my case is pretty unclear). Read on for the typical recommendations to support liver health.

Liver-Friendly Recommendations

• Follow a diet that will help you achieve or maintain a healthy weight. If you need to lose weight, mild calorie restriction is a safe and effective method that has been shown to reduce liver damage in non-alcoholic fatty liver disease.¹
• Eat moderate (not high or low) amounts of carbohydrates, proteins, and fats. Diets high- or low- in one of these groups inevitably lead to unhealthful compensation from other groups.¹
• Antioxidants, vitamins, and minerals are very liver protective and supportive. Eat several servings daily of fruits, vegetables, nuts, and seeds to give your liver all the help he needs.^{1, 2} Hey, a rhyme!
• Avoid “megadoses” of vitamin or mineral supplements (supplements that provide significantly more than 100% of the recommended daily allowance).¹ I know someone whose doctor was convinced he was an alcoholic because of the damage his vitamins were doing to his liver. Yikes!
• Avoid foods that are high in fat, added sugar, or salt.^{1, 3}
• Avoid alcohol and over-the-counter NSAID medications, unless approved by your doctor.³
• Avoid raw or undercooked shellfish.³

Liver-Friendly Suggestions

(Not proven by research, may or not be helpful, but certainly aren’t going to hurt anything)

• Probiotic consumption may be linked to improved liver health.¹ We don’t have studies to confirm this or give a specific dosage, but upping your intake of non-alcoholic fermented foods like pickles, sauerkraut, kimchi, yogurt, or miso could benefit your liver.
• There is no proof that eating organic produce can improve liver health or protect your liver; however, one of your liver’s jobs is to remove toxins, which would include pesticides. More than 99.3% of foods test as “well below” the Environmental Protection Agency’s acceptable levels of pesticides; however, eating organic foods may take a bit of extra strain from your liver.

To summarize, I’ve been eating plenty of fruits and vegetables (organic when they fit the budget), plenty of nuts and seeds, and not so much of the super high fat, high sugar, or high salt stuff. Yes, Christmas was a tad tough but I had to do my best to find balance. Also, no alcohol, no sushi, no NSAIDs, and no vitamin or mineral supplements. My doctor plans to re-check my liver levels in a couple of weeks, so hopefully this will help it heal and all of my liver levels will be back to normal!

References

1. McCarthy, E and Rinella, M. “The Role of Diet and Nutrient Composition in Non-Alcoholic Fatty Liver Disease.” Journal of the Academy of Nutrition and Dietetics. March 2012. 112:3 (401-409). Accessed from https://jandonline.org/article/S0002-8223(11)01703-2/fulltext.
2. Cook, L, et al. “Vegetable Consumption is Linked to Decreased Visceral and Liver Fat and Improved Insulin Resistance in Overweight Latino Youth.” Journal of the Academy of Nutrition and Dietetics. November 2014. 114:11 (1776-1783). Accessed from https://jandonline.org/article/S2212-2672(14)00107-5/fulltext.
3. American Liver Foundation. “Liver Disease Diets: A Healthy Diet, a Healthier Liver, and a Healthier You.” 2017. Accessed 6 January 2019. Accessed from https://liverfoundation.org/for-patients/about-the-liver/health-wellness/nutrition/#1504047357338-1da02851-5896.

You may have noticed that my posts have been a bit absent in the last few weeks. More than likely you didn’t necessarily notice…until now. 🙂 That’s okay, it doesn’t hurt my feelings! Anyway, here’s why I’ve been MIA: Starting the Saturday after Thanksgiving, I started to feel like I was coming down with something. Fever, achy muscles, fatigue…bummer. I did my best to stay hydrated and geared up to work through a cold or flu. For several days after I continued to feel feverish, tired, and achy (including headache), but I never developed any other symptoms. No runny nose, no sore throat, no cough, no nausea/vomiting, nothing. It was strange, but not too concerning at first.

After a few days with no worsening or improvement, I decided it might be wise to go to a walk-in clinic to get checked out. During the course of that appointment, the doctor brought up some concerns of pelvic inflammatory disease and/or toxic shock syndrome, so she sent me to the emergency room to be evaluated. At the emergency room, the doctor was not very concerned about me. He was confident that I did not have toxic shock syndrome. He also figured that pelvic inflammatory disease was unlikely. He took a flu swab and a urine sample (to check for UTIs, and of course, pregnancy and STDs – standard procedure) and sent me home. All of those tests came back negative, so I figured I just had some kind of wonky virus that I just needed to wait out.

I rested, I ate soup, fruit, and Haagen-Daas sorbet (heaven!), and I took Nyquil to sleep at night.

Three days later I was steadily getting worse (a week and a half with a 101-degree fever at this point) and I was starting to get concerned that I had some kind of more serious infection. I went to another clinic and they were, thankfully, able to get me in right away. The nurse practitioner I saw was definitely concerned about the possibilities, so she ran me through a gamut of tests. She gave me a complete physical exam, took my blood, swabbed for strep, and took more urine. Because, you know, pregnancy and STDs.

Three days later, I was feeling even worse and really starting to get concerned about my continued fever with no treatment of any kind whatsoever. I called the clinic, who did not yet have my results but they told me they wanted me to have an abdominal and pelvic ultrasound to check everything out. They also told me I could take a dose of antibiotics prophylactically, so I did. The next day I felt significantly better, as I did for the next few days. I completed the ultrasound and awaited the results of all of my testing.

When all the results came in, every single thing was negative and there was no explanation for my 2-week-long fever. I was floored. At this point, we knew that I didn’t have flu, I didn’t have strep, I wasn’t pregnant, had no STD’s, and theoretically had no infection whatsoever because my white blood cells (even those that respond to bacterial or viral infections) were normal!

I was totally baffled – why did that antibiotic make me feel so much better? Placebo?

My nurse practitioner was also at a loss, and offered to put me on the schedule of the most experienced MD at their clinic. Meanwhile, I continued to feel better but still had a 101-degree fever. I was started to get very annoyed with being sick. You know, sick and tired of being sick and tired. I hadn’t worked out (or hardly worked) for 2 and a half weeks and was just getting kinda done with it. I can only lay around and watch Netflix for so long before going nuts. What was wrong with my body?

The MD tested me for mono, ran a comprehensive metabolic panel (kind of an all-systems-check), and checked my thyroid. When the results came back, everything was negative except one thing – my liver enzymes were 8 times higher than they should have been. Now, for the most part, liver enzymes belong inside your liver and not in your blood, so if the liver enzymes in your blood are high, then your liver is leaking them for some reason. Your liver is somehow damaged, and that’s typically not a good thing. Since the ultrasound of my liver had come back normal, the doctor wanted me to have a CT scan to get a clearer picture to rule out stones (and cancer…eek!).

I happen to know that Nyquil (which I hadn’t taken for about a week at this point) contains acetaminophen, which can affect your liver enzymes for a couple of weeks. I asked my doctor’s office about that, but they said that based on the dose I had taken and how long it had been since I had taken them, it was unlikely that they would affect my liver enzymes SO much.

So off I went, back to the radiology clinic for a CT scan. I was reluctant to have the CT scan (radiation and all…) but I knew I needed to have everything checked out. The CT scan itself was super easy. Five minutes tops. Then came the waiting and the trying to not think too much about every possible thing that could be wrong with me.

Fortunately, it only took a couple of days to get the results back and everything was completely normal. While the doctor still had no explanation for why my liver enzymes were so high, the good news was that my liver looked totally fine.

Since all of that testing, I have been feeling basically back to normal energy-wise. I still occasionally feel feverish, but I’m back to my normal life. I even got to go back to (light) working out in the last few days! That was such a blessing and a mood boost, for sure.

First day back in the gym!

The mystery of what was/is wrong with me continues, but here are my marching orders: as long as I continue to feel better, I need to follow a liver-friendly diet and come back to have my liver enzymes tested next month to see if my liver has healed from…whatever was wrong. So while I didn’t exactly plan on doing a diet feature right now, I figure if I have to be on a diet anyway, I might as well feature it! It is the Christmas season, so my posts may not be as frequent or thorough as they typically are during a feature, but I’ll do my best.

Stay tuned to learn more about what a liver-friendly diet is and follow along with me while I follow it for the next month!

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