This is unfortunate because the most critical time for bone health is when many of us think we are invincible: our teenage years.

What exactly is bone?

While it is easy to picture bone as a solid structure, it contains an inner “spongy matrix” that resembles honeycomb, surrounded by a hard outer shell.

Nearly half of bone is made of protein (specifically collagen) in addition to minerals such as calcium and phosphorus.

Unlike hair and nails, bone is alive and constantly being remodeled, meaning it is in a constant state of being broken down and built back up. An estimated 10% of your skeleton is being turned over in this fashion every year!

Bone provides the obvious structure and foundation for movement, but also plays an essential role in mineral storage and blood cell production.

Bone Throughout the Lifespan

The rate of bone remodeling depends on several factors, one of the most important being the stage of life:

• Infancy and childhood: Bones are rapidly being built as part of the growth process.

• Adolescence: Nearly 40% of total bone mass is accumulated during this window.

• Early to late 20s: Peak bone mass is achieved.

• Around age 30: Most people begin losing 0.5–1.0% of bone per year.

• Menopause transition: For women, bone loss accelerates to 2–3% per year, as estrogen plays a protective role in bone health.

• 50s and beyond: Gradual bone loss continues, accompanied by an increased risk of fracture.

Why Peak Bone Mass Matters

Given the somewhat inevitable decline in bone mass over time, reaching maximum bone density in your 20s is a critical piece of lifelong bone health:

The challenge is that this bone-building window comes at a time when long-term health is rarely top of mind. Some of my most challenging nutrition conversations are with teenage audiences, as I try to find compelling ways to convince them that calcium-rich foods really are important.

It’s Not Too Late

While most of you reading this are likely beyond your peak bone-building years, there is still plenty you can do to slow bone density decline, and that’s exactly what we’ll dig into in my next post.

In Part 2, we’ll explore bone metabolism and the essential nutrients needed to support your bones.

In the meantime, I’d love to hear your questions about bone health so I can make sure to address them throughout this series.

Leave a comment

Thanks for being here,

~Allison

Remember that this information is meant to educate and inspire, but is not medical advice. Please consult your healthcare team to determine what is most appropriate for you.

In Part 1, I reviewed what cognitive health is and the most common causes of cognitive decline (Alzheimer’s disease tops the list).

In Part 2, I explained the non-modifiable risk factors for Alzheimer’s disease (age, genetics, and biological sex).

In Part 3, I explored the 14 modifiable risk factors that contribute to up to 45% of all dementia cases, which are things you and your healthcare team can monitor for and address.

Today, I’ll dive into what we know about brain-healthy eating and how dietary patterns can work for, or against, your cognitive health.

Until about a decade ago, we had a hunch that the Mediterranean diet was good for the brain, but we didn’t have much good evidence to be sure.

That changed in 2015, when research on the MIND diet first made headlines1. (Note: I prefer “approach” because I’m not a fan of the 4-letter “D” word).

What is the MIND “diet”?

MIND is an acronym (which, it turns out, encompasses another acronym “DASH” which stands for Dietary Approaches to Stop Hypertension):

Mediterranean-DASH

Intervention for

Neurodegenerative

Delay

In short, the MIND intervention combines the cognitive and cardiovascular benefits of Mediterranean eating with the cardiovascular benefits of the DASH plan.

Results of the 2015 study showed that after following 960 people for almost 5 years, those who consumed the recommended MIND foods most of the time showed slower cognitive decline.

In fact, these “most of the time” folks had cognitive function equivalent to being 7.5 years younger in age than those who ate MIND foods the least.

Importantly, perfection was NOT required to see benefit.

This is good news for all of us.

If you can incorporate the MIND foods into your routine a moderate 70-80% of the time, your brain gets the benefits.

Plus, the research doesn’t suggest that you have to give up the foods that you love.

Research from around the world has continued to support the MIND intervention for reducing the risk of dementia:2

MIND Foods

The MIND approach first focuses on foods to consume more regularly (a refreshing change from “diets” that start with what to avoid):

• Green leafy vegetables — daily

• Other types of vegetables — daily

• Berries — 2+ per week

• Nuts & Seeds — 5+ per week

• Olive oil — daily

• Whole grains — daily

• Fish — 1+ per week

• Beans — 3+ per week

• Poultry — 2+ per week

While participants in the MIND studies were also encouraged to decrease intake of butter, cheese, red meat, fried foods, and sweets, the focus on what to consume more of is likely the most important part.

“Neuro” Nutrition:

As you can see, the brain-healthy MIND foods are largely plant-based, meaning that they are rich sources of fiber, vitamins, minerals, and phytochemicals.

These components, along with ones we likely haven’t discovered yet, promote brain health by:

• Improving cardiovascular health — blood pressure & cholesterol

• Supporting metabolic health — blood sugar & inflammation

• Increases micronutrient intake — vitamins and minerals (including B-vitamins, choline, zinc, iron, magnesium, and more)

• Supporting neurotransmitter (brain cell) function — healthy proteins

• Supporting brain structure — healthy fats

• Providing reliable energy for the brain — healthy carbohydrates

• Fueling the microbiome — fiber

A note on alcohol

While a glass of wine daily was originally seen as a positive dietary addition in the 2015 MIND publication, we now believe there is no safe level of alcohol consumption for brain health.3

Brain Healthy Eating = Healthy Eating

I often get new patients who come to me in a panic that they need a diet for their diabetes, high blood pressure, and cognitive health.

How will they manage it all!?!

The reassuring news is that brain-healthy eating is healthy eating. The MIND foods aren’t just good for your brain; they are good for your heart, your blood sugar, inflammation, cancer risk, and more.

Once again, the research points us to more plants, including fruits, vegetables, nuts, seeds, and grains.

No magic. Just real food.

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Thanks for being here,

~Allison

Remember that this information is meant to educate and inspire, but is not medical advice. Please consult your healthcare team to determine what is most appropriate for you.

Not long ago, an Alzheimer's diagnosis came with little more than advice to "get your affairs in order."

Those worried about their own risk had little guidance and even fewer concrete steps they could take to prevent the onset or progression of the disease.

I don’t blame science or medicine for this.

The brain is so complex. If back then we were in the infancy of understanding its complexities, then today we are mere adolescents.

We’ve come a long way, and we still have a way to go.

I have been lucky to have had a front-row seat to how far our understanding of Alzheimer's disease has come.

Back in 2016, while working at Sonoma Valley Hospital, I was asked to join a team with the Buck Institute to develop a program built around the emerging evidence that nutrition and lifestyle could play a meaningful role in preventing and slowing the progression of Alzheimer's disease.

I was a baby dietitian back then. I didn’t appreciate what a gift this opportunity was.

Nevertheless, I jumped headfirst into getting myself up to speed on Alzheimer’s disease research and haven’t slowed down since.

Over the years, I have learned that there is so much we can do to protect our brain health.

In fact, a 2024 Lancet Commission report estimated that 45% of all dementia diagnoses are due to modifiable causes, meaning things that you can monitor and address with your healthcare team.

This is huge!

In Part 1 of this series, I provided background about what cognitive health is and the most common causes of dementia (with Alzheimer’s disease leading the pack).

In Part 2, I explored the non-modifiable risk factors (age, genetics, and biological sex) and how these factors can work as motivators to understand and act on the many modifiable risk factors.

Today’s post is all about the modifiable risk factors. Oh, and by the way, these factors aren’t just good for your brain, they are good for your whole body:

Modifiable Risk Factors:

1. Level of education — While most research refers specifically to formal higher education, being a lifelong learner in any sense of the word can only help support your cognitive health. Take a class, join a book club, learn a language, pick up an instrument. Curiosity counts.

2. Traumatic brain injury (TBI) — Falls, car accidents, and sports are the leading causes of concussion and brain injury. While we can’t go back and change any history of brain injury, we can stay off of ladders, put handrails and anti-slip mats in the shower, and always wear seatbelts.

3. Elevated LDL-cholesterol — The adage “What is good for your heart is good for your brain” continues to hold true. It includes monitoring for and managing plaque-forming cholesterol. Talk with your doctor about whether the more aggressive LDL targets published recently apply to you.

4. High blood pressure (hypertension) — Working with your doctor to keep your blood pressure in a healthy range won’t just make them happy; it will protect your heart and brain.

5. Smoking — While smoking increases the risk of dementia, long-term cessation significantly lowers it. In fact, quitting in middle age or later and staying smoke-free may reduce dementia risk to that of a non-smoker after 8–10 years. It is never too late to quit.

6. Diabetes — Chronically high blood sugar damages the brain and may increase Alzheimer’s Disease-related pathology over time. Monitoring for and managing high blood sugar, prediabetes, and diabetes goes a long way in protecting your brain.

7. Excessive alcohol intake — "Excessive" is currently defined as more than 21 units of alcohol per week, compared to fewer than 14 units, with a 4–5oz glass of wine, 12oz beer, and 1–1.5oz of liquor each counting as one unit. That said, some research suggests there is "no safe level of alcohol consumption for dementia," especially for women and those carrying the high-risk APOE-4 gene.

8. Obesity — The number on the scale is my least favorite health metric, for it is often more harmful (to mental health) than helpful. That said, excess body weight, particularly around the midsection, is associated with increased risk for several chronic diseases, including dementia. If this applies to you, focusing on the lifestyle and medical strategies covered here is a more meaningful and comprehensive place to start.

9. Physical inactivity — Any movement is better than no movement (and it isn’t too late to start!) was a primary takeaway from the Women’s Health Symposium I attended yesterday. In fact, physical activity may be the most important factor in protecting your cognitive health, with regular movement being the key.

10. Depression — Appropriately treating depression and other mental health challenges, especially in midlife, is an important step in protecting long-term brain health. Seek support, whether through therapy, medication, lifestyle changes, or a combination. Your brain health is worth it.

11. Social isolation — Humans are wired for connection, and the brain thrives on meaningful social engagement. Chronic loneliness and isolation have been shown to accelerate cognitive decline. Prioritize your relationships, stay involved in your community, and don't underestimate the powerful protective effect of simply spending time with people you care about.

12. Hearing loss — Sensory input is essential for keeping the brain active and for maintaining and forming new brain cell connections. Untreated hearing loss not only reduces a critical sensory channel, but it is also often socially isolating, compounding the risk even further. Wear those hearing aids if you need them!

13. Vision loss — Untreated vision impairment can be socially isolating and may reduce engagement in cognitively stimulating activities such as reading, writing, and art. Stay current with regular eye exams, and let this be extra motivation to manage your blood sugar and blood pressure, both of which can also affect your vision.

14. Air Pollution — This risk factor is often considered a "social determinant of health," meaning that people of lower socioeconomic status are more likely to work and live in communities with higher levels of air pollution. Relocating away from polluted areas is not a realistic option for most, but it is worth acknowledging that chronic exposure to this environmental factor does play a role in long-term brain health.

Next week, I’ll share what we know about how dietary intake affects many of these risk factors, as well as the risk of cognitive decline.

In the meantime, I’d be honored if you shared this with someone you care about.

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As always, thanks for being here,

~Allison

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Please remember that this information is meant to educate and inspire, but is not medical advice. Please consult your healthcare team to determine what is most appropriate for you.

1

Confession: While I was looking forward to the speakers and mingling at the Women’s Health Symposium, I wasn’t sure what to expect with the boxed lunch that was included. Let’s just say that I couldn’t have planned the offerings better. No, it wasn’t a sandwich and a cookie. It was an array of healthy, hearty salads. Socks. Blown. Off.

The vast majority of people choose the latter without much thought.

As I introduced last week in Cognitive Health - Part 1, cognitive function is so much more than memory.

It is identity.

It is independence.

Until recently, it seemed that the risk of cognitive decline and dementia (now more commonly called “neurocognitive decline”) was left to fate.

We are lucky to live in a time where we know more and can be proactive about understanding our risk.

Alzheimer's disease accounts for an estimated 60–80% of diagnosed dementias, making it by far the most studied and the primary focus of research on cognitive decline prevention.1

Alzheimer’s Disease risk is due to both non-modifiable and modifiable risk factors.

Let’s start with the risks you can’t change.

Non-Modifiable Risk Factors:

• Age — risk of chronic diseases, including Alzheimer’s disease, goes up with age.

• Biological sex2 — Women represent approximately two-thirds of all Alzheimer's cases, which we are still trying to understand.

  • This difference is not fully explained by longer lifespan, and research is actively exploring the roles of estrogen/menopause, depression, reproductive history, and historically lower access to education and cognitively stimulating work.

• The vast majority of Alzheimer’s genetic research has focused on the APOE gene3, which accounts for an estimated 20–25% of population-level risk. Importantly, APOE risk is not deterministic, meaning even the highest-risk combination does not guarantee developing the disease.

  • The APOE gene comes in three forms:

    • APOE-2 — associated with decreased risk of Alzheimer’s disease

    • APOE-3 — associated with neutral risk (neither increased nor decreased)

    • APOE-4 — associated with increased risk of Alzheimer’s disease

  • Since we each inherit two copies of the gene (one from each biological parent), the six possible combinations are:

    • APOE 2/2, 2/3, 3/3, 2/4, 3/4, 4/4

      • APOE 3/3 is the most common combination

      • APOE 3/4 increases risk approximately 2–3x compared to APOE 3/3

      • APOE 4/4 increases risk approximately 8–12x compared to APOE 3/3

Ok, I know that went deep into the science for a moment. So let’s take a step back and put everything into perspective.

The vast majority of Alzheimer’s Disease and other dementias are related to both non-modifiable and modifiable risk factors.

Understanding each risk factor is important information as you figure out where you are and what you need to do to influence what happens going forward.

When it comes to genetic risk, I know it can be scary, and some people would rather not know. That’s ok.

For me, I choose to look at genetic risk as a motivator. I want to know all the cards on the table so I can make my next move.

Even if my genetic risk is high, remember it is not guaranteed that the disease will develop.

This is an important distinction.

Next week, for Cognitive Health — Part 3, we will dive into the important topic of modifiable risk factors. These are the risk factors that put you in the driver’s seat to decrease your risk of dementia and other chronic diseases.

Now that is inspiring and motivating.

As always, thanks for being here,

~Allison

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Please remember that this information is meant to educate and inspire, but is not medical advice — please consult your healthcare team to determine what is most appropriate for you.

I remember when my grandma’s memory started to falter. I was in grad school.

She would tell me the same stories.

She would ask me the same questions.

She knew something was off.

But, like her doctor at the time, I brushed it off:

“Grandma,” I said, “you need to focus so you don’t forget.”

Now, I feel awful about saying that.

Placing blame on her probably did more harm than good.

It wasn’t a matter of focus at all. It was the first sign of Alzheimer’s disease.

Fast forward 8 years, and, because of one of those situations of being in the right place at the right time, I had the opportunity to work with a program for the Buck Institute for Research on Aging, which is just over the hill from where I live.

At the time, research was emerging that suggested that much of one’s risk for Alzheimer’s Disease is modifiable.

So I dove into the literature, and sure enough, there was hope after all.

I had the honor of developing a nutrition education curriculum and working one-on-one with patients and providers to use lifestyle (including nutrition) approaches to support their cognitive function.

The research and the hope have continued to grow. Alzheimer’s disease isn’t inevitable. Modifiable risk factors (meaning, things you can do something about) make up an estimated 45% of the risk for developing Alzheimer’s disease.

That isn’t a small number.

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What is cognitive health?

Cognitive health is the ability to think clearly, learn, remember, and make decisions that support independent daily life and overall well-being. It encompasses several interconnected domains of brain function, including:

Yes, cognitive health includes memory, but it is waaaaaay more than memory.

It is identity.

It is independence.

Is Cognitive Decline Inevitable?

For the most part, no.

A little slowing of processing speed — recalling a name, following fast conversations, for example — may be part of the brain aging process. But this certainly doesn’t impede identity or independence.

Anything more than mild processing speed changes is cause for investigation because it suggests there may be some pathology in the brain, disrupting how it functions.

Pathology is a complex word that I’m going to over simplify as something in the brain that isn’t supposed to be there. In the case of Alzheimer’s disease, the pathology is accumulation amyloid-beta and tau-tangle proteins.

Understanding the basics of the pathology of cognitive decline can provide you with the information and inspiration you need to decrease the risk that the pathology accumulates in the first place.

The list of factors that can decrease pathology accumulation is growing. A 2024 publication in The Lancet included 14 well-researched factors to consider, and that list is expected to grow.

More on that next week in Part 2.

As always, thanks for being here,

~Allison

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Please remember that this information is meant to educate and inspire but is not medical advise — please consult your healthcare team to determine what is most appropriate for you.

Today, we are diving into the world of micronutrients, understanding why I included many of the foods in my meal-planning template in Part 2, and the growing evidence that “whole” foods provide much more than their isolated parts.

Micronutrients

Micronutrients are underappreciated and misunderstood.

If macronutrients (protein, carbs, and fat) provide the raw materials for the body to function, repair, and build, then micronutrients are the cofactors, aka “workers”, that get stuff done.

The energy from carbohydrates, for example, doesn’t just jump to work as soon as you swallow. After a complicated process of digestion (breaking the carb down into its smallest units) and absorption (the smallest units moving to the bloodstream), an even more complicated metabolic process turns it into energy for the cells:

Don’t worry, I won’t test you later. This dizzying diagram demonstrates that Vitamins B1, B2, B3, & B5 (in brown), as well as minerals iron & magnesium (in purple), are essential for carbohydrate metabolism.

Now, consider that this is only one part of carbohydrate metabolism!

Without enough of vitamin and mineral cofactors in this, or any other of the numerous processes that occur throughout the body, your health, energy, and function are impaired.

Inadequate Vitamin B1, for example, can cause a condition called beriberi (very rare in the US), which may cause fatigue, weakness, numbness, heart failure, fluid retention, memory impairment, confusion, irritability, and more.

This condition can be avoided by regularly consuming whole or enriched grains, nuts & seeds, and soy, and avoiding chronic alcohol abuse, which is the main risk factor for this deficiency in the US.

Below are two charts I put together for a recent class. I was trying to show why I included each group of foods on the macronutrient chart shared and discussed in Part 2.1

I don’t want you to just take my word for it that eggs are a good protein source, for example. I hope that the charts below speak for themselves2.

You won’t be tested on these charts, either. Full disclosure, I would probably fail the test, too.

The point is to demonstrate all the good and important factors in each of the included foods.

After looking at this, I hope you can see that nuts & seeds, for example, are more than just trail mix. They are a secret source of more than half of the vitamins and minerals that your body needs to work at its best.

Well, there you have it. This is the end of my 3-part series, where I did my best to sum up the big take-home messages about the field of nutrition.

What was your top takeaway?

Leave a comment

Thanks for being here,

~Allison

Please remember that this information is meant to inform and inspire and is not personal health or medical advice. Please speak with your healthcare team about what is right for you.

1

Today, we are diving into the world of macronutrients (or “macros” as the world knows them now): Protein, Carbohydrates, and Fat.

Nutrition Trends

Each macro has had its time in the spotlight:

• The 1980’s and 90’s were the low-fat days

• The 2000’s brought around the stubborn low-carb craze

• We are currently in the midst of high-protein everything

The tricky thing about these fads is that each is based on what I call “a nugget of truth.” A nugget that, unfortunately, gets blown out of proportion, overgeneralized, and loses its nuance.

So what are the nuggets of truth for each of these macro fads?

• Low-Fat:

  • Eating too much of some kinds of fat may increase your risk of heart disease, obesity, and other chronic diseases.

    • This doesn’t apply to all fats. Sure, not overdoing it on the butter, bacon, cheese, etc. is generally a good approach. Unfortunately, the low-fat trend also pulled down unsaturated fats like those found in fatty fish, nuts, seeds, avocados, and olive oil, etc., which may decrease risk of heart disease, some cancers, Alzheimer’s disease, and more.

• Low-Carb:

  • Frequently consuming food and drinks high in added sugars & highly processed flours (which replaced much of the fat in the low-fat days) is linked to increased weight, blood sugar, and other metabolic-associated diseases.

    • This doesn’t apply to all carbs (sound familiar?). High-quality, minimally processed carbs such as fruits, beans, and sweet potatoes have no business being associated with sodas, chips, or cookies.

• High-Protein:

  • I’ve been convinced that the RDA (Recommended Daily Allowance) for protein greatly underestimates how much protein most of us need, especially in midlife and beyond. Adequate protein can help maintain muscle mass (which decreases with age), promote satiety (feeling satisfied between meals), and manage blood sugar.

    • But, this doesn’t mean that eating high-protein chips, ice cream, and popcorn (yes, these are all real products) is the answer to our health goals.

Meal Planning Principles

I don’t make meal plans for people, despite being asked for them all the time.

I’ve learned that even if I create what I think is the most amazing, delicious, and healthy meal plan, it is too subjective of a task for me to get it right for someone else (“oh, I don’t like avocado,” “I don’t know how to cook that,” “ugh, I can’t stand cottage cheese!”).

Instead, I’ve found that by teaching the principles I use to make a meal plan, not the meal plan itself, people are empowered and can make healthy eating their own.

Some overarching principles to keep in mind:

1. Meal planning needs to be realistic, sustainable, and enjoyable. If you love to spend 3 hours on a Sunday cooking meals for the week, great, go for it. If Sunday rolls around and meal prep is hovering over you like a black cloud of obligation, that’s probably not the right approach for you.

2. Use mostly “whole” foods and keep it simple. You don’t need to have gone to culinary school (I didn’t) or spend hours in the kitchen to eat healthy-ish, delicious meals. Simple is the key to making healthy eating realistic & sustainable. We’ve got lives to live, after all.

3. Put your food to work! By understanding how different macronutrients work in your body, you can manipulate how those macronutrients work to better meet your goals:

   1. Protein: Makes the meal more satisfying, promotes balanced blood sugar, and provides the building blocks for muscle growth & maintenance.

   2. Carbohydrates: Provide the energy you need to power your brain, heart, lungs, muscles, and more. “Single-ingredient” carbohydrates (see chart below) provide a slow, steady drip of energy between meals to help keep you alert and focused.

   3. Fats: Improve absorption of Vitamins A, D, E, and K, provide essential brain structure, and act as a secondary energy source.

   4. Fiber: While not really a macronutrient, the fiber found in veggies, beans, lentils, fruit, avocado, and nuts & seeds supports bowel function, blood sugar and cholesterol levels, and more.

Make it Your Own

If it sounds simple, it is. I’ve just walked you through the framework that I use with most of my patients. Understand what different macros do in your body, and then, depending on your needs and preferences, experiment with how changing the types, amounts, and pairings of different macros.

Use this simple chart to get you started. For most people, including a protein and a carb with each meal and snack is a good place to start, and if you can get a healthy fat and/or a starchy veggie in there too, awesome.

Thanks for being here,

~Allison

Be on the lookout for Part 3 coming up next week. Subscribe below to get it straight in your inbox:

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Please remember that this information is meant to inform and inspire and is not personal health or medical advice. Please speak with your healthcare team about what is right for you.

It is a challenge for me to distill the world of nutrition into just one post, or even just one month. So, I’ll be putting out a series of posts highlighting what I think are the big take-home messages and hopefully pass on a little awe about the human body while I’m at it.

So what is nutrition anyway? It is one of those terms that is thrown around without really grasping what it is referring to. My favorite definition is:

There’s a lot there. Way more than just eating your broccoli, that’s for sure.

Over the next several publications, I’ll do my best to break it down for you in a way that allows you to make better-informed choices about how you use nutrition to work toward your health goals.

Science

Nutrition is a science. Principles that I share are based on well-designed scientific studies. But science changes. When we learn better, we pivot, often leaving a generation of frustrated people in our wake. I get it. But I’d much rather admit when I got it wrong than dig my heels in the sand.

Nutrition is not a diet, a fad, a headline, or a supplement. Nor is it about perfection, restriction, or guilt. There is no one-size-fits-all here.

Nutrients

Much more about nutrients in the following posts. For now, know that nutrients include energy (Calories), macronutrients (protein, carbohydrate, fat), and micronutrients (vitamins, minerals, & phytonutrients). Stay tuned and subscribe to receive future posts, if you aren’t already.

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Digestion & Absorption

Cue the awe. Our bodies are amazing. When you take a moment to appreciate everything going on “behind the curtain,” it is remarkable and humbling to admire the orchestra that keeps us alive.

Digestion is the process of breaking down food using mechanical and chemical processes so that it can be absorbed. This occurs in the mouth, continues in the stomach, and really gets to business in the small intestines.

Absorption is the process of nutrients passing from the digestive tract into the bloodstream on their journey to provide energy and building blocks for growth, maintenance, and repair. Most absorption happens in the small intestine, with some further down in the large intestine.*

Metabolism

Metabolism is about so much more than body weight. It is all of the processes and reactions within your body (the “orchestra”) that keep you alive.

Metabolism powers your heart, lungs, brain, muscles, & more. (Fun fact: The brain makes up ~2% of body weight but uses about 20% of energy at rest).

Metabolism builds, maintains, & breaks down muscle, bone, body fat, hormones, enzymes, & immune cells.

Metabolism helps manage blood sugar, facilitate nerve signaling, fluid & electrolyte balance, inflammation, body temperature, and cell, tissue, & organ repair.

Metabolism keeps you alive.

Thanks, body, for being so remarkable.

That’s all for today. Next time, we will dive into the “macros” and how to build a meal that lasts.

Thanks for being here,

~Allison

Please remember that this information is meant to inform and inspire and is not personal health or medical advice. Please speak with your healthcare team about what is right for you.

*I recently gave a class where I went (probably too) deep into my fascination with digestion. Here is the visual I shared. Even if you can’t make sense of it, hopefully you can appreciate the beautiful complexity:

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This is the third and final installment in my “Matters of the Heart” series. Part 1 introduced the basics of cardiovascular health, Part 2 explored how to evaluate your risk of cardiovascular disease, and today is an overview of how nutrition contributes to heart disease risk1:

More Oat Recipes to Try:

• Savory Breakfast Oatmeal

• Dinnertime Baked Oats

• Creamy Protein Oatmeal

• Overnight Oats Starter Recipe

While I was preparing the above oat-based recipes in a recent class, I fielded some great questions about food, nutrition, & heart health. Here is a sneak peek at what we discussed:

• “What can I do to lower my triglycerides?”

  • Triglycerides are a type of fat affected by much more than dietary fat intake. If you are trying to lower your triglyceride levels, here is a checklist to get you started:

    1. Limit or avoid alcohol.

    2. Limit highly processed carbohydrates, including:

       1. Beverages that contain carbohydrates/sugars — even “natural” beverages such as fruit juices.

       2. Added sugars, including refined sugars as well as “natural” options (see below). You can now find “added sugars” on the nutrition facts label. I typically recommend consuming no more than 25g of added sugar per day.

    3. Limit saturated fats:

       1. Saturated fats are fats primarily found in animal-based products. This includes fatty meats, poultry skin, butter, cheese, cream, etc.

          1. Exception #1: Fat coming from most fish is low in saturated fat.

          2. Exception #2: Fat from tropical oils (coconut, palm) also contains saturated fat, despite being plant-based.

• “Is honey better than sugar?”

  • Not really. Honey, maple syrup, agave, coconut sugar, and similar sweeteners are often marketed as “healthier,” but they raise blood sugar and triglycerides much like refined sugar.

    One advantage of honey or maple syrup is that their stronger flavor may allow you to use less, which can help reduce overall sugar intake. However, they should still be used in moderation.

• “Is bread a highly processed carb?”

  • It depends. All grain-based flours are made by grinding the whole grain, which breaks it down and makes the carbohydrate easier for your body to digest and absorb.

    If the flour is refined (like white flour), the fiber-rich bran and nutrient-dense germ are removed, leaving mostly the carbohydrate-rich center. This makes refined bread more processed and typically faster to raise blood sugar.

    So yes, most breads are processed to some degree. However, that doesn’t mean they can’t fit into a healthy diet. Whether and how they fit in depends on your overall eating pattern, metabolic health, activity level, and personal goals.

• “Does gluten-free mean low carb?”

  • Not necessarily. Gluten is a protein found in wheat, rye, and barley. When products are labeled gluten-free, they typically replace those grains with ingredients like rice flour, tapioca starch, potato starch, or cornstarch.

    While these alternatives are gluten-free, they are still carbohydrate-dense and can raise blood sugar, sometimes even more quickly than whole-grain, gluten-containing options. Gluten-free does not automatically mean lower in carbs or healthier overall.

Thanks for being here,

~Allison

I’m pleased to announce that the American Heart Association (AHA) & American College of Cardiology (ACC) have updated cholesterol guidelines in effort to increase early testing and intervention to reduce risk of cardiovascular disease!

Learn more HERE!

Before we get started today, I’m excited to share that I have a new website! I like to think of it as the hub where you can find everything I’m up to (my writing, radio show, upcoming events, etc.). You can find it at allisonmckeany.com!

Check out my new homepage!

This is the second of three installments in my “Matters of the Heart” series. Part 1 introduced the basics of cardiovascular health. Today’s post is all about evaluating your current and future risk of cardiovascular disease.

Evaluating Your Risk

Knowing where you stand on each of these objective markers of cardiovascular health can help you prioritize lifestyle changes, monitor if interventions are effective, and help guide discussions with your healthcare team about the need for any medical management of your risk1.

1. Goal Blood Pressure (BP): <120/80 mmHg — Chronically elevated blood pressure damages blood vessels throughout your body (heart, brain, kidneys, eyes, etc.).

   1. Follow these tips to ensure you are getting an accurate blood pressure reading at home or in the doctor’s office.

2. Goal Resting Heart Rate (RHR): <80 bpm — A higher resting heart rate strains the heart muscle over time, increasing blood pressure and increasing risk of cardiovascular disease.

   1. Here is a step-by-step guide to measuring your resting heart rate.

3. Cholesterol is carried through the blood by lipoproteins (such as LDL and HDL). It is essential for building cell membranes and hormones, but elevated levels of certain types of lipoproteins can contribute to plaque buildup in arteries.

   1. While Total Cholesterol was initially thought to be a good marker for cardiovascular disease risk, we now know that different types of cholesterol provide a more nuanced assessment:

      1. Goal Fasting LDL-Cholesterol: <70 mg/dL2

      2. Goal Fasting Non-HDL-Cholesterol: <100 mg/dL3

      3. Goal Fasting HDL-Cholesterol: >60 mg/dL4

4. Goal Fasting Apolipoprotein B (ApoB): <40 mg/dL5 — ApoB is a protein found on all plaque-forming lipoproteins, providing a better indicator of cardiovascular disease risk than LDL-C alone.

5. Goal Lipoprotein(a) (Lp(a)): <50 nmol/L6 — Lp(a) is a genetically-determined type of LDL with an extra protein attached that is an independent risk factor for cardiovascular disease.

6. Goal Fasting Triglycerides (TG): <100 mg/dL — Elevated triglycerides contribute to plaque formation.

   

7. Goal Fasting Blood Glucose (FBG): <90 mg/dL — Chronically high blood glucose (aka “blood sugar”) damages the lining of blood vessels, resulting in inflammation that supports plaque formation and accumulation.

8. Goal Hemoglobin A1c (HgA1c): <5.2 % — A marker of long-term (~3 months) blood sugar levels.

9. Goal Fasting Insulin: <5 µIU/mL — Released by the pancreas in response to rising blood sugar levels, high fasting insulin is an early marker of poor blood sugar management, even if blood sugar levels are at goal.

10. Goal Homocysteine (Hcy): <9-10 µmol/L (age dependent) — Elevated levels damage blood vessels and increase risk for plaque formation and blood clots.

11. Body Composition — Excess body fat, especially in the midsection (visceral fat), increases blood pressure, cholesterol, blood sugar, and inflammation.

    1. Although total body weight and Body Mass Index (BMI) reflect overall body weight, they do not account for the distribution of fat throughout the body.

    2. Assessment of visceral fat provides a more accurate indicator of cardiovascular disease risk:

       1. Goal Waist Circumference: Men <40”, Women <35”

          1. Use this guide to accurately measure your waist circumference at home.

       2. Goal Waist-to-Hip Ratio: Men <0.90, Women <0.85

          1. Here’s a handy ratio calculator.

Navigating today’s medical system requires self-advocacy. If your doctor isn’t yet aware of the updated guidelines, here are a few resources to share:

American Heart Association

JAMA Learning Network - What’s new in the updated lipid guidelines? (March 27, 2026)

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Thanks for being here,

~Allison

Significance

February is American Heart Month, a time when we celebrate love and (hopefully) the amazing organ that is our heart.

Surprisingly, heart disease continues to be the leading cause of death for both men and women in the US,1 even though we’ve learned so much about risk factors and both lifestyle and pharmaceutical management.

Heart disease, or more broadly, cardiovascular disease, encompasses several conditions that affect the heart muscle and/or the blood vessels that circulate blood throughout the body.

Blood delivers oxygen, nutrients, and immune cells and removes waste products that would otherwise be toxic.

Every cell in your body depends on adequate blood flow to survive.

In that sense, taking care of your cardiovascular health is taking care of your whole body health.

Definitions:

The most common cardiovascular diseases include:

• Heart Attack: Sudden blockage of blood flow to the heart muscle.

• Stroke: A blocked or ruptured blood vessel in the brain.

• Coronary Artery Disease (CAD): Narrowing of arteries caused by the buildup of plaque (atherosclerosis).

• Heart Failure: Weakened heart muscle, which includes symptoms such as fluid accumulation (edema), fatigue, & shortness of breath.

• Peripheral artery disease (PAD): Narrowing of arteries and decreased circulation in the arms and legs.

• Arrhythmias: The heart beats too fast, slow, or irregular; Atrial Fibrillation (AFib) is the most common.

Risk Factors:

Cardiovascular disease risk factors include both non-modifiable and modifiable.

Non-Modifiable Risk Factors (Things we can’t change, but are important to be aware of):

• Age — Risk increases with age.

• Sex at birth — Men are at an increased risk earlier in life, and women are at increased risk postmenopause.

• Genetics / Family history — Especially for early heart disease in close relatives.

Modifiable Risk Factors (Things we can change):

• Smoking — Injures blood vessels, increases blood pressure, & increases risk of atherosclerosis.

• Nutrient intake — Excess salt, sugar, & unhealthy fats increase blood pressure, cholesterol, & inflammation that promotes atherosclerosis.

• Alcohol — Excessive intake raises blood pressure.

• Inactivity — Reduces blood circulation & weakens the heart muscle.

• Sleep — Poor sleep quantity & quality increases blood pressure, blood sugar, & inflammation.

• Stress — Chronic stress increases blood pressure & inflammation.

This is a lot of information, I know, which is why I am going to end here for today. I will follow this up with a piece about the objective markers that you can use to evaluate your cardiovascular health now and ongoing (blood pressure, labs, etc.). Subscribe to stay tuned!

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Thanks for being here,

~Allison

Please remember that this information is meant to educate and inspire, but is not medical advice. Please consult your healthcare team to determine what is most appropriate for you.

Thanks for being here,

~Allison

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P.S. - Photo credit goes to Uncle Mark, who was the lucky recipient of my last batch of muffins.

In a post a couple of weeks ago, I teased my take on supplements:

When it comes to supplements, I have so much to say that it deserves a post all its own. The short version: I’m not “pro” or “anti” supplements. I’m all about targeted supplementation — first figuring out if you truly need a supplement, and if you do, regularly monitoring the dose and duration.

While I still owe you an in-depth piece about supplements, a question I was asked at a recent in-person event allows me to address one supplement in particular: biotin.

The question was about the “hair, skin, and nails” supplements that are all the rage right now. Countless formulations fit into this category, but the main nutrient these supplements lean on is biotin.

If I had to guess, biotin-containing supplements for the purpose of supporting hair, skin, and nail growth are near the top (if not at the top) of the list of the most common supplements my patients report taking.

So what is biotin? Does it work? And is it safe?

First, a bit of info about biotin (also known as vitamin B7):

• Like other members of the B-vitamin family, biotin helps convert food into energy by acting as a coenzyme (“helper”) in several metabolic processes.

• Biotin deficiency is rare because it is found in so many common foods: eggs, nuts & seeds, beans & lentils, whole grains, fish, meat, dairy, sweet potatoes, & avocados.

• Most adults need ~30 mcg biotin per day.

Most hair, skin, and nail supplements contain up to 10,000 mcg biotin per dose, which is over 300 times the estimated need.

So my question is: Do these extra-high doses actually work?

My go-to resource for unbiased evidence-supported information on supplements is examine.com. While the platform recently added a paid option, basic safety and effectiveness information continues to be free.

The information on examine.com about biotin confirms what I have read in the past — there has been little research done about biotin and hair, skin, and nail health in humans.

While some human research shows that biotin improves hair, skin, or nail quality, this is primarily in people with biotin deficiency or conditions like brittle nail syndrome.

The good news is that biotin doesn’t appear to be harmful at the mega-doses found in common hair, skin, and nail supplements.

The biggest concern is that biotin-based supplements can interfere with blood tests, potentially leading to falsely high or low results, or to missed or misdiagnosed conditions.

This is because some testing technology uses biotin as an “ingredient” in the testing process, and excess biotin in the test sample can disrupt how these tests work. This most commonly affects thyroid, hormone, and cardiac marker tests.

Takeaways

• It is unclear if the common hair, skin, & nails supplements actually work for already healthy people.

• I recommend starting with food first to meet your biotin and other needs.

• If you are concerned about hair loss, brittle nails, or other symptoms, check with your healthcare provider to test for a possible biotin deficiency or other underlying causes.

• If you decide to try or continue biotin, consider a standard multivitamin, which typically contains the daily recommended needs for biotin.

• If you take a high-dose biotin supplement, always let your healthcare provider know and stop taking it for at least one week prior to getting any labwork done.

Thank you for the great questions. Please keep them coming!

Leave a comment

Thanks for being here,

~Allison

Check out my upcoming in-person events!

Vintage House Sonoma - February 12, 2026

Sonoma Community Center - February 21, 2026

Brannan Center Calistoga - February 28, 2026

This information is meant to inform and inspire—but it’s not medical advice. Be sure to check in with your own healthcare provider before making any changes to your routine.

This week wrapped up the first Insight into Health Series of 2026 at Vintage House Sonoma, where the theme was Longevity & Healthspan.

We started by exploring what longevity means for you, and then had a “book club” discussion (I did the reading for you!) where I shared my big takeaways from Outlive by Peter Attia, MD.

This week, I demo’d two recipes incorporating the ingredient of the month — avocado — while answering questions and sharing some of my favorite recipe books and websites.

(Full disclosure here, I have done a ton of food demos for friends and family and cooking classes for kids, but this was my first EVER for an adult class!).

Serendipitously, one of my favorite podcasts about food history and science, Gastropod, published an episode this week all about avocados. I learned that the average American eats 70 pounds of avocado each year, 12% of which is consumed on Superbowl Sunday! Take a listen.

While avocados are best known in savory dishes, I took a risk and demo’d a use for them that’s both savory and sweet — chocolate avocado pudding.

If you attended any of the Vintage House Sonoma Insight into Health classes this month, please send your feedback to: allison.mckeanyrd@gmail.com. I’m always looking for ways to improve my classes and would love to hear from you.

I look forward to kicking off the next Insight into Health series at Vintage House Sonoma on February 12th, with the theme Matters of the Heart — a month dedicated to understanding heart health. Register for each class below:

February 12 — Lecture: Understanding Heart Health & Risk

February 19 — Book Club Discussion: Highlights from Brené Brown’s “Atlas of the Heart”

February 26 — Cooking Demo & Taste Test: Heart-Smart Eating

Thank you for being here,

~Allison

This week, the Insight into Health series at Vintage House Sonoma featured my very first book club. And the best part? I did the reading for you!

You will usually find me reading at least two books at a time: one fiction (often historical) and one nonfiction. While fiction is purely for pleasure, my nonfiction books tend to be filled with sticky notes, which I later summarize in a notebook so I don’t forget my favorite takeaways.

This was the inspiration for the Insight into Health book club — to allow me to put those notes to use. January’s book is Outlive by Peter Attia, MD.

Peter Attia, MD, is a Stanford-trained physician who transitioned into preventive medicine after seeing how traditional healthcare often treats disease too late. He now focuses on translating medical research into strategies to reduce the risk of chronic disease and extend healthspan.

I have been listening to Peter Attia’s deep-dive podcast, The Drive, for years1. While I love the detail and complexity he and his guests get into, I was thrilled when I learned that he was publishing a book. A book that I hoped would be more accessible to everyone than his highly technical podcast.

I’m glad to report that Outlive lived up to my expectations.

If you have read any of my posts about defining health2 or listened to my weekly radio program, you will quickly understand how much Peter Attia’s work influences my approach.

Below are my takeaways from the book, which can be further summed up as this:

Many of the leading causes of chronic disease, disability, and death share common risk factors. We can often reduce those factors by advocating for more intensive preventive monitoring, proactive intervention, and active participation in our own health.

To further illustrate this point, when the leading causes of death in the U.S. are compared by their shared risk factors, the overlap is striking:

If I have your attention now, you may be wondering, “Where do I start?”

Peter Attia recommends beginning with an honest evaluation of your current health, including comprehensive lab testing and preventive screenings to help you and your provider identify and address risk factors.

An important distinction between the labs included in a standard annual physical and Peter Attia’s recommendations is the expanded testing and the way results are interpreted, as illustrated in Section 1 below.

First, here’s a brief explanation of each test and why it’s recommended:

• Blood pressure (BP): Chronic elevation overstresses arteries and the heart.

• Resting heart rate (RHR): Lower usually reflects improved heart function.

• Low-Density Lipoprotein Cholesterol (LDL-C): The main type of cholesterol that can build up on artery walls.

• Non-High-Density Lipoprotein Cholesterol (non-HDL-C): All types of cholesterol that can build up on artery walls (includes LDL-C).

• Apolipoprotein B (ApoB): The specific number of artery-clogging particles, which can better predict heart disease risk than LDL-C alone.

• Lipoprotein(a) (Lp(a)): A genetically inherited cholesterol particle that increases heart disease risk.

• Fasting glucose: A marker of short-term blood sugar regulation.

• Fasting insulin: Indicates how hard the body has to work to manage blood sugar; higher levels suggest insulin resistance, even before fasting glucose increases.

• Hemoglobin A1c (HbA1c or “A1c”): Average blood sugar over months; indicates long-term blood sugar levels.

• Uric Acid: A marker of metabolic stress and cardiovascular risk.

• Aspartate Aminotransferase (AST): A marker of liver health, elevations suggest fat accumulation or liver damage.

• Alanine Aminotransferase (ALT): A marker of liver health, elevations suggest fat accumulation or liver damage.

• Thyroid-Stimulating Hormone (TSH): Reflects thyroid function, which affects metabolism and energy.

• Estimated Glomerular Filtration Rate (eGFR): An indicator of kidney function.

• Vitamin D: Supports bone, immune, and cardiovascular health.

• Vitamin B12: Essential for energy metabolism, nerve, and blood health.

• Homocysteine (Hcy): Elevated levels signal B-vitamin insufficiency and cardiovascular risk.

It’s a mystery to me why all of these tests aren’t standard, especially the ones that can provide earlier indicators of chronic disease risk (like fasting insulin) — all the more reason to be your own advocate for true disease prevention.

Now, let’s see how to make sense of these results.

As you would expect, Peter Attia doesn’t settle for results that are merely “fine,” or “within normal limits” (WNL) in medical jargon.

He wants your results to be as optimal as possible, which means you can’t always rely on what your lab report — or your doctor — says about your results.

While his guidelines for markers such as blood pressure and LDL-C align with standard recommendations, many of his targets are more ambitious, reflecting a goal of minimizing disease risk as much as possible.3

One example is hemoglobin A1c, a test often used to identify prediabetes (above 5.7%) and diabetes (above 6.5%).

What if your A1c comes back at 5.6%? You may be told that everything is normal. But that is like standing on the edge of a cliff and saying you're fine because you haven’t fallen. Yet.

Whew, I know this is a lot to take in. We didn’t even get this far in the book club group. Luckily, we can continue next week while I try my hand at my first cooking demos.

There’s just one more thing I want to share before we wrap up. The order of the longevity checklist is very intentional. It starts with testing and assessment (and later, reassessment) to guide your next steps, whether that means lifestyle changes, medications, or supplements.

This way, if and when you and your doctor decide to add a medication, you can do so with confidence, knowing you remain an active participant in your own health.

When it comes to supplements, I have so much to say that it deserves a post all its own. The short version: I’m not “pro” or “anti” supplements. I’m all about targeted supplementation — first figuring out if you truly need a supplement, and if you do, regularly monitoring the dose and duration.

Thanks for being here,

~Allison

I will use this platform to provide a summary of each class for those who were able to attend in person and for anyone unable to make it.

In true Allison style, I proposed a bigger and better Insight into Health offering at Vintage House (read about my first go-round in November of last year here).

Here’s what I have in the works for 2026:

• Each month will center around a theme

  • January: Longevity

  • February: Matters of the Heart

  • March: Navigating Nutrition

• Each weekly session will explore the theme in different ways:

  • Lecture & discussion

  • Book club (reading the book not required!)

  • Cooking demos

  • More! (I would love to offer grocery store tours, field trips to the farmers market, and bring in guest lecturers)

Here’s the class synopsis for January 15, 2026:

What Longevity Means for You

Health is so much more than a number on the scale, a test result from your doctor, or any other objective data point.

Only you can define what health means for you, now and into the future.

First, I encourage you to think about different types of health:

• Physical: How you feel and how well you take care of your body

• Functional: Your body’s ability to do what you want it to do

• Cognitive: Ease of thinking, focusing, and remembering

• Emotional: Being able to experience and manage a range of emotions

Evaluating and addressing each of these areas is the first step to better understand where you are in this moment and to take the steps to get where you want to be.

Finding the motivation for making sustained changes is so much more difficult if we don’t understand the “why” behind them.

I call this the “so what” factor.

Here is an exercise we explored in class. I encourage you to take a moment to rate yourself on where you stand right now on each area of health. There are no wrong answers — if you find that you aren’t where you want to be, great! This is the first step to taking charge of your health, no matter where you are starting:

This activity brought up a lot of great questions and discussion. I heard many brave and vulnerable shares, such as…

I can’t do what I used to be able to do.

I’m in denial about aging.

I just had surgery so there is a lot I can’t do.

While I am still thinking about how to best respond to these comments, I hope that these two ideas came through during the class:

1. Experiencing a range of emotions is what emotional health is all about. It isn’t just about positive emotions. So feel the sadness, feel the grief. Your body will tell you when you are ready to take those feelings and use them as motivation for action.

2. There is some inevitability to a decline in most areas of health as you age. The rate of decline, however, is largely modifiable. How you take care of your body today can inform whether your physical health declines sharply or smoothly.

I’m curious what you all think. Please share by reaching out to me directly at allison.mckeanyrd@gmail.com or commenting below:

Leave a comment

After inviting class participants to evaluate their health now, I then encouraged them to think about what is important to their health in the future.

While some ideas on the list below tend to be universal goals to remaining independent, others are very individualized and are (in my opinion) the most important and the most motivating.

Being able to do crosswords for the rest of my life, for example, is not on my longevity wish list. I don’t enjoy crosswords now, and I don’t have any desire to enjoy crosswords in the future.

But being able to play card games? That is definitely on my cognitive health wish list as it brings me joy, connection, and a dash of nostalgia.

What’s on your list? We will use these as jumping points to dig into the choices you make each day that can support your longevity wish list, no matter what it holds.

I look forward to the first Insight into Health book club, where I will review my highlights and “take-home messages” from Dr. Peter Attia’s book, Outlive. Remember, reading the book beforehand is not required!

Thanks for being here,

~Allison

A quick reminder that you will hear me live on air Mondays at 7 pm on Sonoma Valley’s KSVY radio, 91.3, or stream anywhere from ksvy.org. Can’t tune in live? No problem! I post show notes and the recordings every Tuesday at insightintohealth.substack.com.

If you are interested in working with me as a private patient, you can email me at allison.mckeanyrd@gmail.com, and we’ll see if I’m the right fit for you and your health goals.

Register Here!

I have never been a fan of New Year’s resolutions.

Even when growing up, I was aware that all too often, they quickly led to failure. I would avoid setting my own to avoid becoming a failure, too.

New Year’s resolutions, though, come with the territory of being a dietitian. I often joke that I am the most popular person in January. And then my fifteen minutes of fame fade just as quickly as they started.

I’ve never liked this type of popularity. It bums me out that health and nutrition are linked with this performative tradition. I’d so much rather that my area of passion and expertise be associated with intrigue, optimism, and intention.

Here’s the problem with New Year’s resolutions: they are famously about correcting a personal deficiency.

I’m going to exercise more

I’m going to spend less

I’m going to be more organized

I’m going to eat better (whatever that means)

Each of these popular resolutions suggests that there is something wrong that needs to be fixed. I didn’t even include the ever-popular, “I’m going to lose weight,” on this list.

Don’t get me wrong, I believe that we are all works in progress and will be for the rest of our lives. This is part of what makes us human — always striving to improve.

It’s the idea that January is the time that we are supposed to guilt and shame ourselves into behaving that doesn’t sit well with me.

Last year was the first year I recall ever setting a New Year’s resolution, and it was made more in the spirit of fun when someone asked me what my resolution was.

Instead of launching into my pessimism around New Year’s resolutions, I thought about something I’ve always wanted to do and resolved that in 2025, I would take a dance class.

Dancing is something I’ve wanted to do since I was a little girl, but (believe it or not), I was far too shy to put myself out there. I was too caught up in the whole “I don’t want to be a failure” to risk trying something so new.

It turned out that simply setting and stating my New Year’s resolution out loud opened doors to more dance class opportunities than I realized were available.

All told, I took several dance classes over the course of the year:

• Swing, Waltz, and Rumba lessons with my husband, Lyle

• Swing dance class (x2!) with neighbors after I shared my New Year’s resolution

• Tap dance class taught by the one and only, TJ Carter, at our community center

Better yet, I plan to continue seeking out these and other dance classes into 2026 — something most can’t say about their New Year’s resolutions.

But why is that?

Why is it that New Year’s resolutions seem to be synonymous with failure?

I have a theory: framing New Year’s resolutions around correcting a personal failure is something that’s difficult to face every single day. And as January bleeds into February, it’s no surprise that an estimated 80% of New Year’s resolutions are abandoned by the end of January.

As a new dietitian, I approach this time of year armed with SMART goals. I work with patients and classes and at health fairs to take the normal New Year’s resolutions and put them into the SMART framework: Specific, Measurable, Achievable, Realistic, & Time-based.

The idea was that simply saying, “I’m going to eat better,” was too vague to be able to implement, evaluate, and determine if the resolution was “met.” So instead, I would help people craft more specific statements, such as, “I’m going to eat at least one vegetable every day for the next 90 days.” A statement that meets all of the SMART goal criteria.

The problem was that even SMART goals became overly focused on “fixing” something wrong.

While I’m no psychology expert, I know enough to respect that positivity works better than negativity with others, as well as ourselves.

What if we approached this arbitrary time of “new beginnings” with positivity? Joy seeking? Joy spreading? I think it is worth a try.

I encourage you all to rethink your New Year’s resolution. Instead of finding something wrong that you want to fix, what is something that you could do to bring a little more joy to yourself or others?

Go to a concert?

Volunteer at the animal shelter?

Take a (dance, art, music…) class?

Have lunch with a different friend each month?

As for me, my New Year’s resolution this year is to go skiing. I’ve wanted to get back on skis for the last three years, but time, money, and lack of planning have gotten in the way.

By making my resolution known to family, friends, and all of you this year, I hope that many open doors and opportunities will follow.

What is your joy-seeking and/or joy-spreading resolution for 2026? Feel free to comment or email me directly at insightintohealth@gmail.com.

Leave a comment

Thanks for being here,

~Allison

A quick reminder that you will hear me live on air Mondays at 7 pm on Sonoma Valley’s own KSVY radio, 91.3, or stream anywhere from ksvy.org. Can’t tune in live? No problem! The show notes and the recordings are posted every Tuesday at insightintohealth.substack.com.

If you are interested in working with me as a patient (to move beyond New Year’s resolutions!), my schedule is now available.

The sweet smell of ginger and molasses. The crunch of gingerbread crumbs under my feet. Patches of dried royal icing on my countertops. It must be Christmas!

I appreciate a simple holiday. I’ve never been a fan of the chore of decorating, especially the part where you have to undo it all.

But homemade gingerbread houses? I will gladly pour hours into the prep and cleanup for the joy it brings me this time of year.

The tradition began before I was born. In 1979, to be exact (my mom remembers these things).

This is the year she took a class on making gingerbread houses from scratch. She and my grandma then made and decorated dozens of houses for gifts that year. We use the same typewriter-written recipe to this day.

As far back as I can remember, these gingerbread houses have been a sign of the holidays. In fact, decorating gingerbread houses was often my December birthday party activity of choice.

Many of my childhood friends fondly remember coming over to join in on the fun, as do college roommates who would visit during the holiday break. Clearly, I haven’t outgrown the tradition.

When my now-teenage daughter was a toddler, I was excited to do gingerbread houses with her for the first time. It quickly became a group activity as friends started to join — and look forward to — gingerbread house time at our house.

I have pictures of her annual gingerbread house creations. Each one captures a sense of her personality at the time:

Shopping for Gingerbread Extravaganza is an event: I fill my cart with boxes upon boxes of brown and powdered sugar, all the molasses I can find, and oh so much candy.

I always brace myself to run into a patient or someone who knows me professionally. The surprised look on their face as they peer into my cart is priceless. Hazard of the job, I suppose1.

Gingerbread Extravaganza seems to grow every year. Not that I’m complaining. It brings me joy to share this with friends old and new, my youngest’s class, and my teenager’s friends.

This year, I made a whopping 34 houses2 throughout the month, which included enough for two decorating parties at my house, one in my daughter’s classroom, and a few extra for special deliveries.

On my radio show on KSVY earlier this week, my husband, Lyle, joined me to talk about our gingerbread tradition. His favorite part of this tradition has nothing to do with baking or decorating — it is feasting on the crispy, gingerbread edges that are leftover at the end of the day.

I also have to give him credit for learning to expect and accept the mess that Gingerbread Extravaganza brings into our home. We will be finding remnants for weeks to come. To be honest, those remnants make me smile. And he knows how much joy it brings me. I’m a lucky gal.

I wish you all a wonderful holiday. May you embrace what brings you joy this season and let go of what doesn’t.

Thanks for being here,

~Allison

Persimmons bring to mind fall, my grandma, and a left-handed cookbook.

I’ll explain. First, persimmons.

Persimmons are a lesser-known fall fruit. Persimmon season in my area of Northern California runs from late October through the end of the year.

I can attest to this, as our Sonoma Valley glean team has harvested our sixth persimmon tree of the season this week!

We have been gleaning the two most common types of persimmons: Fuyu and Hachiya.

Growing up, I was only familiar with the Hachiya variety. My grandparents had a beautiful tree in their Petaluma backyard that would produce prolific, deep-orange, ornament-like fruits come November.

Hachiya persimmons are acorn-shaped and need to be fully ripe — their flesh has the consistency of applesauce — before consuming. The hard, unripe flesh is unappetizingly astringent, similar to biting into an underripe banana.

Because of this, Hachiya persimmons are often ignored. I ate a few off my grandparents’ tree every year, but mostly recall them stacked high in decorative bowls, providing a touch of holiday flair.

My grandma was the neighborhood persimmon pusher. She would walk up and down her rural road giving them to anyone she could find. I imagine that neighbors would see her coming with persimmons and pretend they weren’t home.

It wasn’t until I was in college that I discovered there was a more approachable persimmon variety: Fuyu.

Fuyu persimmons are round and squat and can be eaten when still hard, like crunching into an apple. They are delicious as a snack, sliced into salads, or made into any number of fall desserts.

I have been known to pay top dollar at farmers’ markets for the few weeks of fall when I can get my hands on this very seasonal fruit.

Hachiya persimmons, though, will always hold a special place in my heart, which brings me to the left-handed cookbook.

My great-grandfather, Grandad, was an icon. His robust figure and ability to captivate a room with his stories awed me as a child.

Grandad wasn’t about to let the right-handed world box him in. So he made a left-handed cookbook. It starts at the back page and works backward (er, forward? Clearly I’m a righty):

Grandad’s left-handed cookbook also contains the minestrone recipe that we make at every family reunion, which is always pitted against my great-grandmother’s recipe.

At these annual minestrone duels, some stay loyal to Grandad’s ground turkey and spaghetti noodle version. Others take the side of my great-grandmother’s cabbage and smoked pork specialty (turkey when it is my turn to make it, shhhh).

There are always undecided voters who mix the two soups so they don’t have to play favorites.

Back to Hachiyas. I have to admit that I have never made my grandad’s steamed persimmon pudding. It doesn’t really sound good. Raisins? Not a fan. I’m not known for having rum around the house. Plus so much butter, sugar…

I’ll make it one day, though. When my mom decides I am responsible enough to take good care of the left-handed cookbook. I’ll even buy rum to do it.

In the meantime, here is what I plan to do with Hachiya persimmons this year:

• Arrange them in a big bowl on my counter and wait for them to slowly ripen to jelly-like perfection.

• Eat at least one scooped directly out of the skin like pudding, just like my grandma used to do.

• Freeze some of the fully ripe ones to be enjoyed later as persimmon sorbet.

• Try this fruit leather.

• Attempt the famous Hoshigaki persimmon — a massaged persimmon Japanese delicacy. Yes, massaged. I have to try it.

I would love any persimmon memories, recipes, or wisdom that you may have to share:

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Thanks for being here,

~Allison