Individual Nutrition assessment – an example chart note

What is health care? What is included in an individualized health care appointment?

The answer varies with the type of specialist you are seeing – and what they are allowed to do within their facilities’, or the individual’s insurance plans protocols.

My nutrition counseling experience was in prenatal/early childhood, and residential (nursing home) facilities.

Chart notes would be written for high risk clients when working in either role. Occasionally the nutrition assessment and recommendations note would be sent to the physician directly if very high risk.

As a preventive health focused prenatal/early childhood counselor, or for residential facility chart review (nutrition assessments of all nursing home residents considered high risk nutritionally, occasionally would include an in person visit with the resident to visually observe and ask further questions about their health and diet symptoms.

Patients typically do not see a chart note. They might be given the ‘Problem’ and ‘Assessment’ sections as an action list of recommendations on a simpler handout. The medical chart has a Care Plan section where recommendations for a daily change in care might be added – such as adding a high protein snack in the evening.

I would typically spend a half hour to an hour per client and writing a good note might take an additional 15 minutes. Current insurance standards have been set which limit physicians to 15 minutes per patient appointment – and only scheduling/discussing one symptom per appointment. That would make a differential diagnosis fairly impossible.

  • The entirety of a person’s symptoms – and what makes the problems worse, and what seems to improve things – is what provides clues to the underlying issues that may have led to the increased inflammation and/or decreased function.
  • Health is a balance of not too much inflammatory response -> autoimmune or allergies – or too little -> rampant infection and catching every cold.
  • Health is also a balance of enough nutrients and not too many toxins to cope with, whether from air, water, food, or touch, or from internal production of stress chemicals caused by emotional or physical stress.

Autoimmune issues are particularly challenging because many odd symptoms can occur, and more than one type of autoimmune antibody may be involved – not just one ‘autoimmune disease’ – several. Low vitamin D makes autoimmune issues more likely to occur, and low magnesium can make low vitamin D more likely – even with supplements of vitamin D.

Low magnesium also increases inflammation symptoms, pain, and anxiety, depression or anger and irritability.

A physician might look at my example note (below) and think: ‘but this is not my field‘ — exactly — please refer to the specialist – a registered dietitian or clinically trained nutritionist. Caution, there are many ‘nutrition certification’ programs online which are not equivalent to a college education, internship, and the equivalent of a lawyer’s Board Exam.

The client gave permission to share the write-up for educational purposes or maybe to help someone. Patients know that pain hurts, and that health is better. Too often I hear from physicians something like ~ ‘we don’t know what is causing this, … so the patient will probably die‘ – but it is regarding symptoms that likely involve nutrient deficiency.

Even sick patients need to eat or be fed and their nutrient needs are likely increased, or decreased, due to the illness, for a few specific nutrients affecting or being used in excess by the underlying issue. Telling a patient there is no hope is providing a nocebo – a negative expectation. Saying “I don’t know,” – when that is the true situation – would at least not be setting up a roadblock for the patient to seek further information or a second opinion.

If in reading my example chart note*, as a physician, you think, ‘but this is not my field‘ — exactly — you are correct – but it is the patient’s whole health that matters, not just symptoms that may be temporarily controllable by medications.

SOAPE note

The SOAPE chart note* below, is an extended version compared to what would be likely to be written in a patient chart. SOAPE note: Subjective, what the client said; Objective, what the clinician observed; Assessment; what the clinician believes may be underlying issues; Problem/Plan, recommendations being made by the clinician; Evaluation – an opinion statement about the likelihood of positive change, based on the overall attitude or motivation the client is presenting and social factors that may impact the client positively or negatively.

I included extra information that might be in a report to the client, with the education they might need to understand the reasoning for the recommendation, or how to proceed. Complex strategies can take several weeks of a class like setting possibly with cooking and tasting demonstrations. My web pages and posts try to provide self care guidance so a motivated learner could just try things and see if they help.

I added some additional info links for the version in this post, to pages or posts that provide some next step guidance, Gluten Free diet? what is that? The products on the market are not ideal suppliers of nutrients in my personal and professional opinion and learning how to bake gluten free can be healthier and less expensive for the nutrient value. My websites are my file cabinet of patient handouts, some of it.

While working as a public health nutrition counselor I did occasionally write a very thorough note for someone with a complicated case, and send it to the client’s physician on their or their child’s behalf.

Nutrient deficiencies can lead to death (niacin/pellagra example) – and can turn around dramatically very shortly after the nutrients and any cofactors are provided (nutrients are a team – refeed gradually and in balance).

Sometimes nutrition care is a life or death situation. Continue the nutrient deficiencies and deterioration can be rapid, and death can be the result. Niacin deficiency, pellagra, has a nickname for symptoms – the four D’s: “Pellagra defines systemic disease as resulting from a marked cellular deficiency of niacin. It is characterized by 4 “D’s”: diarrhea, dermatitis, dementia, and death.” (1) If there is severe lower leg rash and edema – suspect a B vitamin deficiency.


Nutrition assessment

Subjective:

  1. CoV like symptoms, mild, ~ early outbreak mid 2020, left a new problem, 2. swollen throat, reflux like pain/not quite reflux though, flair up of CoV symptoms again later when family had it 2021, again not too bad. 
  2. Swollen throat symptoms – has had labs showing autoimmune thyroid condition.
  3. Thyroid symptoms had improved a year or so earlier after stopping use of wheat/gluten and dairy. Recently started using ginger tea for the throat problem and it sooths. Hasn’t used long term, recent addition. 
  4. Reading about eosinophilic esophagitis did not sound like the problem. 
  5. Reading about histamine/MCAS symptoms did sound like it might be a problem. Tomato/salsa particularly, chicken causes congestion. Likes to drink orange juice.

Objective:

  1. Pale complection, may suggest magnesium deficiency/low vitamin D, low level anemia of chronic inflammation possibly.
  2. Throat visibly enlarged in pattern of enlarged thyroid gland 

Assessment: 

  1. CoV, even with mild symptoms, may have increased autoimmune antibodies, or created new types. Pale complection may suggest magnesium deficiency/low vitamin D, low level anemia of chronic inflammation possibly.
  2. Enlarged thyroid gland would be likely to cause difficulty swallowing at times, particularly if a food flair of the underlying autoimmune antibody sensitivity. (The thyroid gland presses inwards also and can narrow the throat significantly – *personal experience from also being an autoimmune thyroid patient, swallowing a large supplement can be very painful, and may feel stuck even.)
    1. Eosinophilic esophagitis might also be adding to swallowing symptoms if early stages, wouldn’t be causing as severe reflux symptoms as a more advanced case which is more likely to be what is described in articles about the problem. Food sensitivities are the most frequent cause and include gluten, dairy, eggs, and other common food sensitivity foods.
  3. Autoimmune thyroiditis can be a gluten molecular mimicry problem – the thyroid hormone chemically is similar to the gluten molecule. 
  4. Autoimmune antibodies to other food chemicals might also flair up an underlying autoimmune overactive eosinophile problem, white blood cells. Ginger contains a chemical similar to albumin and an egg sensitivity might be triggered by a sudden increase in use of ginger – or chicken – or eggs, or any animal product containing albumin. *also learned from personal experience – this can be a significant problem – I developed sensitivity to eggs and gradually realized I needed to exclude all sources of albumin or my symptoms would flair up again (non healing rash, not quite eczema – more wounds, lack of skin regrowth).
    1. An apparent ‘wheat/gluten’ sensitivity might be an albumin sensitivity, see one of my early posts with the information about plant albumin in wheat and ginger: Wheat is rich in albumin – so are ginger and egg whites.
  5. Histamine sensitivity seems a problem worth working on by decreasing trigger foods. Orange juice could be an additive problem food. The total load is part of the problem but even small amounts can set off the allergy cells that increase inflammatory cytokines and pain/inflammation signals – swollen, itchy, sore throat, dry eyes, but it can also effect mood when a more severe problem – extreme anxiety and fear, or out of control, hyper-excitable.

Problem:

  1. Elevated iron and symptoms of anemia of chronic inflammation may be a lingering CoV effect or of autoimmune conditions – it can be common to have several types of autoimmune antibodies also, and there has been cases of LongCovid where autoimmune antibodies were found. The spike lodges in a receptor and antibodies are made against the receptor, instead of against spike.. 
    1. Iron chelators may help mitigate chronic inflammation damage, restore energy level if that is a problem. The quercetin is one, continue regularly, opposite the niacin protocol if following that., or eat more of the good plant sources of a few, EGCG, pomegranate peel, green tea, oregano, olive leaf extract, there are many see the Iron chelator section of this Resources & Iron Chelators list
    2. Epsom salt soaks for a topical source of magnesium, help immune function, energy level, fluid balance. Continue if already using or start 1-3 times a week.
    3. Sunshine or Full spectrum light 20-30 minutes per day and or a moderate dose vitamin D3 ~ 600-1000 IU. 
    4. Avoid glyphosate residue. Consider supplementing with DMG, dimethylglycine, bulk powder, 1/2 spoonful once or twice a day in water or with a little juice and water. (too much juice is not really good for us).
  2. Thyroid problems in the modern world are likely related to excess fluoride and bromide and too little iodine. Cautiously increasing iodine and 200 mcg selenium may be helpful. Higher dose for one month can help the body to dump fluoride, bromide and chloride. When there is a lack of iodine the body will build molecules with the other halides, but then the thyroid hormone or other chemical won’t work right. Lab tests may show ‘normal’ levels of thyroid hormone but symptoms of hypothyroidism may still be present.
    1. In autoimmune conditions, when possible, it is essential to identify the trigger foods and strictly avoid them. It can take 6 months for antibodies to fade away, at which point symptoms should improve, but memory B cells still exist so even little tastes of the problem foods can set off a new 6 month batch of autoimmune antibodies that will attack the thyroid gland, or esophagus, or wherever else the problem point is located. 
    2. In this case eggs/chicken/ animal products/ ginger/ albumin /*hemp kernels too then/, may be part of the problem foods – 
    3. Elimination type diets that start with the least risky foods and gradually reintroduce things one at a time can be the best way to individualize what is the problem for you the individual. 
  3. Gluten was definitely identified as a part of the thyroid problem by removing, it already had helped to stop that. Dairy has a variety of allergens, and also would have albumin. Removing food triggers strictly, can help a swollen thyroid gland reduce in size – versus get more swollen when trigger foods are eaten.
    1. Gluten free baking recipes and tips for converting recipes: effectivecare.info – G8. Cookies & Bean Soup. -> and it mentions that increasing corn or corn flour instead, is not ideal either. Corn or gluten can increase zonulin which also increases leaky membranes in the gut or blood brain barrier, and more open membranes can increase risk of allergens entering undigested from the diet. See: What is Zonulin? (2)
    2. A quick mix recipe that can be used for pancakes or muffins, a post: Pancakes in a Jiffy – Quick Bread Mix.
  4. Eosinophilic esophagitis may be related to food sensitivities, so as food elimination is attempted it would also be helpful to pay attention to the swallowing symptoms to see if change occurs other than the swollen pressure feeling of the enlarged thyroid gland.
    1. Research shows a strong connection between food allergies and eosinophilic esophagitis (EOE). These six foods are most commonly associated with this allergic response: dairy, wheat, soy, eggs, nuts, and seafood/shellfish. Unfortunately, there is no accurate test to identify food allergies* connected with EOE.” (3
    2. *The food sensitivity is not the same type as tested for people who get hives to peanut butter or eggs or are allergic to bee stings. It is food sensitivity that activates white blood cells though, called eosinophils. 
    3. During normal function eosinophils fight parasites for us. So …. Maybe they are doing something in ‘autoimmune disease’ that involves their normal function too fighting an unidentified parasite – or they are responding to chemicals of the six foods listed above in an allergy-like way. 
    4. Asthma and allergies involve increased eosinophil activity, which can lead to inflammation symptoms and tissue damage: “Eosinophils can consume foreign substances. For example, they fight substances related to parasitic infection that have been flagged for destruction by your immune system. Regulating inflammation. Eosinophils help promote inflammation, which plays a beneficial role in isolating and controlling a disease site.” […] “…eosinophils play a key role in the symptoms of asthma and allergies, such as hay fever. Other immune system disorders also can contribute to ongoing (chronic) inflammation.” (4
  5. Eliminating common histamine problem foods may help anxiety and inflammatory symptoms. Orange juice, tomatoes, fermented foods, or older leftovers, cranberries, others, it is a lengthy list but can make a huge difference *personal issue for me also.
    1. More info on page MCAS/Histamine, jenniferdepew.com: MCAS/HIstamine.
    2. Summary of foods to avoid, or a few helpful in an over-reaction: Histamine Food Lists. it is a document (6)

Evaluation:

Client seems motivated and capable of making positive changes for improving health, cheerful and confident amid a complex set of problems, and has support of family.


So does my disclaimer make more sense now?

  • Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

My professional and personal expectations of individualized health care guidance does not include a 15 minute appointment limited to discussing one symptom. In seeking a health care provider I recommend searching for ‘functional health’ or possibly holistic but that is less precisely used than ‘functional’. The orthomolecular approach is also whole body and restoring function oriented.

*am I taking clients? I am working in that direction but I am still in initial stages of having a system set up.


Change is easiest by just practicing the desired habit and the more often it is remembered, practiced, then the more that brain pathway will be strengthened and the old one is gradually deactivated, becomes harder for the nerve cells to fire instead of being an automatic habit like happens without even thinking consciously – to change that ingrained of a habit takes substituting a new pattern rather than trying to ‘attack’ with ‘will power’. Work with nature and it will work with you. Attack and it tends to have an undesired ripple effect.

Pain hurts, health is better.

We all die, the question is quality of life while living – and enjoying that life while living.

Namaste – the soul in me, sees the soul in you.

We are all children, under the care of Mother Nature and Father Sun.

Where there is light there is life, and there is hope.

Reference List

  1. Hegyi J, Schwartz RA, Hegyi V. Pellagra: dermatitis, dementia, and diarrhea. Int J Dermatol. 2004 Jan;43(1):1-5. doi: 10.1111/j.1365-4632.2004.01959.x. PMID: 14693013. https://pubmed.ncbi.nlm.nih.gov/14693013/
  2. What is Zonulin? https://www.creative-diagnostics.com/blog/index.php/what-is-zonulin/
  3. 6 Food Elimination Eosinophilic Esophagitis, oregonclinic.com, https://www.oregonclinic.com/6-Food-Elimination-Eosinophilic-Esophagitis-EOE 
  4. Eosinophilia, symptoms, mayoclinic.com, https://www.mayoclinic.org/symptoms/eosinophilia/basics/causes/sym-20050752

Documents, Posts & Pages

  1. Wheat is rich in albumin – so are ginger and egg whites, post transcendingsquare.com
  2. Resources & Iron Chelators list, document https://docs.google.com/document/d/1XiwJBPoFUnUTQKcRAW_8NMriQMt8b31zjeTY4zV0wJo/edit?usp=sharing
  3. effectivecare.info – G8. Cookies & Bean Soup, webpage
  4. Pancakes in a Jiffy – Quick Bread Mix. post transcendingsquare.com
  5. MCAS/Histamine. webpage, jenniferdepew.com
  6. Histamine Food Lists. document, https://docs.google.com/document/d/17iz9lsJyGqIUUjF0p-totXp4R2GhgRi2Na4gYueisTM/edit?usp=sharing

Pre-eclampsia means pre convulsions; a life threatening prenatal condition.

Eclampsia is an old medical term for convulsions and has been a known risk with pregnancy for many centuries. (G5.1) In more recent centuries the earlier warning signs of pre-eclampsia have been recognized and include high blood pressure, protein in the urine, and edema – increased swelling in the legs, arms and face. Many women may experience increased puffiness or swelling in the lower legs during later stages of pregnancy and it can be painful to walk with swollen feet. In the more severe condition fluid is also collecting in other areas of the body on the exterior of cells instead of being collected by lymphatic or blood vessels and excreted as urine as in normal health.

Why the condition occurs is not known although some risk factors are known. It is more of a risk for very young women, (G5.3); very young women who are also overweight, (G5.4); overweight women; or women over age 40; women who are pregnant with twins, triplets, or more; women of African ethnicity;  women with a history or currently have high blood pressure; and any women who already had pre-eclampsia during previous pregnancies, or who have a family history of other women in their family (such as the pregnant woman’s sisters or her mother) having had pre-eclampsia. (G5.2) Very low calcium intake may increase risk. (G5.1)

What is known is that the condition or related high blood pressure conditions during pregnancy are a significant cause of maternal deaths, 18% of all maternal deaths in the U.S., and of neonatal/infant deaths, over 10,000 each year in the U.S.. It is also more frequently associated with preterm delivery of infants which can leave the infant more at risk for many other chronic health or development complications. (G5.1)

My health is not great, but it has been worse – I prefer better than worse. On my bucket list is to continue working on collating available research regarding the simple question – Why did simply adding raw shelled pumpkin seeds help my previous prenatal clients prevent the risk of having pre-eclampsia during their later pregnancies.

Possible answers: genetic variations in the TREK 1 potassium ion channels may leave women in some families more at risk for developing preeclampsia due to their membranes being less responsive as normal to changes in acidity or stretch – swelling. (G5.5) The preventative health solution might be too eat a more alkaline promoting diet, a more vegetable based diet rather than excess meats and dairy foods.

Very young women and women of African ethnicity may be more at risk due to less space within the abdomen and pelvic cavity. Young women may be smaller framed than more fully mature women in their twenties and the pelvic shape of women of African ethnicity is slightly narrower than that of other ethnic groups (may be a better shape for running fast though.) A hypothesis suggests a preventative health strategy that includes spending a half hour or so daily or periodically during the day in a position where the head is rested on the arms on a pillow while kneeling so the abdomen is inverted slightly and is above the heart – to help fluid movement and relieve pressure in the area around the baby. (G5.6)

The position that is recommended in the hypothesis article (G5.6) can be seen in this article, see Figure 3, Knee-Chest Position: (G5.7). It would likely help women with a family history of preeclampsia too if TREK 1 variations were involved, to relieve intra-abdominal pressure, or for any prenatal woman in the third trimester. The position can also help promote the infant remaining or moving to a head down position which is safer for delivery (preventing a breech birth delivery).

Pumpkin seeds may be particularly helpful due to being a good source of many nutrients including magnesium, (G5.13), zinc, (G5.11), and phospholipids. (G.26) Cocoa/chocolate is also a good source of magnesium and phospholipids (G.26) and women who report eating chocolate several times per week prenatally has been associated with less risk for preeclampsia. (G5.8)(G5.9) Zinc levels have been found to be significantly lower in women with preeclampsia than in pregnant women not experiencing preeclampsia. (G5.12)  Pumpkin seeds may also help due to omega 3 fatty acid content (G5.11) which has also been found to help reduce risk of preeclampsia. (G5.10Pumpkin seeds  or pumpkin seed oil may help prevent preeclampsia due to increased detoxification and removal of toxins from the body as they may cause a diuretic effect. (G5.11)

Pumpkin seeds are a good source of many minerals. Just two tablespoons provides about 25% of the daily recommendation for magnesium. (G5.13) They are also a source of manganese and other trace minerals including selenium. A larger serving of 100 grams (1/3-1/2 cup) would provide 17% of the daily recommendation for selenium and almost 200% of the recommendation for manganese. (G5.14) Supplements of 100 micrograms of selenium per day  for 6-8 weeks during later pregnancy were found beneficial for preventing pregnancy induced hypertension – high blood pressure in the later part of pregnancy is an early sign of preeclampsia. (G5.15)

Balance of nutrients is important and loss of nutrients due to increased oxidative stress may be the underlying problem rather than deficiency. Selenium, magnesium, and manganese levels were found to be comparable in women who did and did not develop preeclampsia in later pregnancy however the women who did develop the condition had elevated copper levels in early pregnancy. (G5.16) Copper and zinc levels need to be in balance with each other for optimal health.

Why should we care? The risk of complications or death for mothers and infants due to pre-eclampsia is significant and is worse in undeveloped nations. The rate of maternal death has been increasing in the U.S. and now is worse than that of other developed nations. Other developed nations range from four to nine maternal deaths per 100,000 live births while in the U.S. the rate has worsened to 26.4 maternal deaths per 100,000 live births. (G5.17) If 18% of those deaths are due to preeclampsia, (G5.1), then in 2015 when there were 3,978,497 births, (G5.18), approximately 189 families lost a mother due to the dangers of preeclampsia.

This is an introduction to the topic, a longer draft is available here: G5: Preeclampsia & TRP Channels, which does not contain some of the information in this post – yet.

Traveling is fun, I took pictures, but traveling the internet saves gasoline. Bucket list – before I kick the bucket I hope to continue working on ways to help women identify their individual risk factors that may be involved in preeclampsia and identify ways to reduce those risks. Like many problems a similar set of symptoms can have a variety of underlying causes, not just one cause, one set of symptoms. Health requires many things, not just one simple solution.

This may seem melodramatic however my health has been bad enough over the years and more recently to make me very appreciative of health and mental health. Dementia is a very real problem and one that is growing in number of people effected either as patients or as caregivers. I have improved my health but it required many changes in diet and lifestyle habits that  are ongoing, missing a day or two can send me back into negative health symptoms.

Magnesium is an important part of preeclampsia care that may also be needed for dementia. I will also post my initial draft on a magnesium  article I began working on after reading a textbook: Magnesium and the Central Nervous System, (free Magnesium ebook, adelaide.edu.au).  The short message that overlaps with this post is that to have adequate magnesium stores within the cells where it is needed for optimal health then it is likely also essential to have adequate protein intake and phospholipid intake. Something that I have found important that is not included in the text or other current medical articles on the topic is that for some people topical sources of magnesium such as Epsom salt/magnesium sulfate baths or footsoaks or magnesium chloride hand lotions or topical liquid solutions may be needed to bypass problems with intestinal absorption of magnesium.

  • Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

G.26: Arlen Frank, Chemistry of Plant Phosphorus Compounds, Elsevier, Jun 3, 2013, https://books.google.com/books/about/Chemistry_of_Plant_Phosphorus_Compounds.html?id=6btpFSV1T2YC (G.26)  

Robert Vink, Mihai Nechifor, editors, Magnesium in the Central Nervous System, University of Adelaide Press, 2011, adelaide.edu.au, free ebook pdf, https://www.adelaide.edu.au/press/titles/magnesium/magnesium-ebook.pdf 

  1. John D. MacArthur, Placental Fluorosis: Fluoride and Preeclampsia, Townsend Letter, May 2015; 382:74-79. http://www.townsendletter.com/May2015/placental0515.html (G5.1)
  2. Who is at risk of Preeclampsia?, NICHD, Eunice Kennedy Shriver National Institute of Child Health and Human Development,  https://www.nichd.nih.gov/health/topics/preeclampsia/conditioninfo/Pages/risk.aspx (G5.2)
  3. Priscila E Parra-Pingel, Luis A Quisiguiña-Avellán, Luis Hidalgo, Peter Chedraui, Faustino R Pérez-López, Pregnancy outcomes in younger and older adolescent mothers with severe preeclampsia, Adolesc Health Med Ther. 2017; 8: 81–86. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476435/ (G5.3)
  4. Mulualem Endeshaw, Fantu Abebe, Solomon Worku, Lalem Menber, Muluken Assress, Muluken Assefa, Obesity in young age is a risk factor for preeclampsia: a facility based case-control study, northwest Ethiopia. BMC Pregnancy Childbirth. 2016; 16: 237. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992278/ (G5.4)
  5. Chad L. Cowles, Yi-Ying Wu, Scott D. Barnett, Michael T. Lee, Heather R. Burkin, Iain L.O. Buxton, Alternatively Spliced Human TREK-1 Variants Alter TREK-1 Channel Function and Localization. Biol Reprod. 2015 Nov; 93(5): 122. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712007/ (G5.5)
  6. Diane J.Sawchuck, Bernd K.Wittmann, Pre-eclampsia renamed and reframed: Intra-abdominal hypertension in pregnancy, Medical Hypotheses, Vol 83, Iss 5, Nov 2014, pp 619-632 
    http://www.sciencedirect.com/science/article/pii/S0306987714002722  (G5.6)
  7. Marybeth Lore, MD, Umbilical Cord Prolapse and Other Cord Emergencies, Citation Lore, M, Glob. libr. women’s med., (ISSN: 1756-2228) 2017; DOI 10.3843/GLOWM.10136 https://www.glowm.com/section_view/heading/Umbilical%20Cord%20Prolapse%20and%20Other%20Cord%20Emergencies/item/136 (G5.7)
  8. Elizabeth W Triche, Laura M Grosso, Kathleen Belanger, Amy S Darefsky, Neal L Benowitz, Michael B Bracken. Chocolate consumption in pregnancy and reduced likelihood of preeclampsia. Epidemiology. 2008 May;19(3):459-64. PMID: 18379424 http://www.greenmedinfo.com/article/chocolate-consumption-during-pregnancy-may-reduce-likelihood-preeclampsia (G5.8)
  9. Audrey F Saftlas, Elizabeth W Triche, Hind Beydoun, Michael B Bracken. Does chocolate intake during pregnancy reduce the risks of preeclampsia and gestational hypertension? Ann Epidemiol. 2010 Aug;20(8):584-91. PMID: 20609337  http://www.greenmedinfo.com/article/chocolate-intake-during-pregnancy-may-reduce-risks-preeclampsia-and-gestationa (G5.9)
  10. M A Williams, R W Zingheim, I B King, A M Zebelman. Omega-3 fatty acids in maternal erythrocytes and risk of preeclampsia. Epidemiology. 1995 May;6(3):232-7. PMID: 7619928 http://www.greenmedinfo.com/article/omega-3-fatty-acid-consumption-may-contribute-reduction-risk-preeclampsia (G5.10)
  11. Pumpkin Seeds versus Pumpkin Seed Oil, Activation Products Blog, https://www.activationproducts.com/blog/pumpkin-seeds-vs-pumpkin-seed-oil/ (G5.11)
  12. Yue Ma, Xiaoli Shen, Dongfeng Zhang, The Relationship between Serum Zinc Level and Preeclampsia: A Meta-Analysis. Nutrients. 2015 Sep; 7(9): 7806–7820. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586561/ (G5.12)
  13. Megan Ware, RDN, LD, What are the Health Benefits of Pumpkin Seeds?  Jan. 18, 2017, MedicalNewsToday.com, https://www.medicalnewstoday.com/articles/303864.php (G5.13)
  14. Pumpkin Seeds: Nutrition Facts, nutrition-and-you.com, https://www.nutrition-and-you.com/pumpkin-seeds.html (G5.14)
  15. L Han, S M Zhou. Selenium supplement in the prevention of pregnancy induced hypertension. Chin Med J (Engl). 1994 Nov;107(11):870-1. PMID: 7867399 http://www.greenmedinfo.com/article/selenium-supplementation-may-contribute-reduction-risk-pregnancy-induced-hyper (G5.15)
  16. Hiten D. Mistry, Carolyn A. Gill, Lesia O. Kurlak, Paul T. Seed, John E. Hesketh, Catherine Méplan, Lutz Schomburg, Lucy C. Chappell, Linda Morgan, Lucilla Poston, Association between maternal micronutrient status, oxidative stress, and common genetic variants in antioxidant enzymes at 15 weeks׳ gestation in nulliparous women who subsequently develop preeclampsia. Free Radic Biol Med. 2015 Jan; 78: 147–155. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291148/ (G5.16)
  17. Nina Martin, Renee Montagne, U.S. has the Worst Rate of Maternal Deaths in the Developed World, May 12, 2017, NPR, https://www.npr.org/2017/05/12/528098789/u-s-has-the-worst-rate-of-maternal-deaths-in-the-developed-world (G5.17)
  18. Birth Data, National Vital Statistics System, CDC, https://www.cdc.gov/nchs/nvss/births.htm (G5.18)

Links on heart disease, calcium and iodine

Whether nutrient deficiencies or other metabolic imbalance is the cause is not clear or it may be a response to oxidative stress, however levels of the trace nutrients magnesium, selenium, zinc, and vitamin D3 were found to be low and the level of calcium elevated in myocardium, a type of muscle tissue in the heart. (1)

The short story – adequate nutrition is needed to support pregnancy and lactation (breast feeding) – longer duration breast feeding (6-12 months or more) is associated with less heart disease (2) and breast cancer (3risk. Increased amounts of iodine is needed for pregnancy and lactation (4) and low iodine and low selenium may be involved in breast cancer risk. (5)

A high protein diet, especially one high in dairy products is associated with more heart disease risk. (6) Background information – a high protein diet creates more work for the kidneys in order to excrete the extra nitrogen from protein that was converted into energy (ketones) (7(29) instead of being used to build muscle or other proteins.

Magnesium may help protect against calcification in heart disease in two important ways. It is needed for the kidneys to be able to excrete excess calcium. It also acts as a calcium channel blocker by providing electrical power from inside of cells or organ tissue in order to help keep excess calcium from entering the soft tissue and blood vessels through the membrane calcium channels. Medications used for hypertension include several calcium channel blockers.

Potassium is also important to protect against calcification of blood vessels by preventing increased calcium entry into the cell. The mineral is also important for preventing high blood pressure/hypertension – in addition to excess sodium/salt, too little potassium can be a problem. See excerpt with the link. (29)

Five to nine servings of vegetables or fruits per day is the recommendation for a healthy balanced diet (five) or potentially cancer preventing diet (nine). They are a good source of potassium and magnesium in addition to other trace nutrients.

Cholesterol plaque formation (atherosclerotic plaques) along vessel membrane walls may be simply acting as a coating to prevent the electrically active calcium ions from entering cells or doing other damage by plastering it in place, like plaster or spackle on dry wall. Calcium and magnesium levels in normal health are very carefully controlled by the kidneys. Lack of potassium and excess sodium may also affect the kidneys ability to excrete excess calcium.

The current understanding of atherosclerosis does not describe the role of magnesium in this way – current description: (8) and (9).

The role of potassium, magnesium and calcium in hypertension is available here: (10) and (29).

Magnesium has been found to help reduce vascular calcification (atherosclerotic plaques in blood vessels) in animal based research, (11) {and I believe in a few human research studies too but I have to find the links again. See Table 7 for a list of symptoms common to magnesium deficiency, hypertension and myocardial infarction are included: (14)} Magnesium may also help reduce prostate cancer risk or progression, (15), and low magnesium levels may be an underlying factor in the formation of cancer tumors, (18); and depression (16) can be a symptom of magnesium deficiency (14) and frequently co-occurs with other diagnoses. (17)

The short story – excess calcium may increase heart disease risk while adequate iodine, selenium, magnesium, potassium and vitamin D are all important for a healthy pregnancy, ability to lactate for a longer duration and reduce the risk of heart disease and breast cancer.

Addition, miscarriage history and history of having more than four pregnancies/four children has been associated with increased risk of heart disease for the mothers. (12) Increased losses of iodine and magnesium stores from the bones may be an underlying factor.  Premature infants born to multiparous women (women who had previous pregnancies) are more likely to have low Thyroid Stimulating Factor – which is associated with hypothyroidism which can simply be due to low iodine levels during the pregnancy. (13)

The long story is in the links below;

except for references about magnesium, potassium and vitamin D for pregnancy and breast feeding but they are also important for pregnancy and lactation. The baby may not thrive or may be fussier if the breast milk is low in essential nutrients or it may be difficult to maintain an adequate supply if the woman is malnourished.

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes. Thanks.

  1. Karl T. Weber, William B. Weglicki, Robert U. Simpson, Macro- and micronutrient dyshomeostasis in the adverse structural remodelling of myocardium, Cardiovasc Res. 2009 Feb 15; 81(3): 500–508. https://www.ncbi.nlm.nih.gov/pubmed/18835843 (1)
  2. Katherine Lindemann, Mothers who breastfeed may be less likely to suffer from heart disease and stroke later in life, an interview with Sanne A. E. Peters, University of Oxford, Research Fellow in Epidemiology, June 21, 2017, researchgate.net blog post,   https://www.researchgate.net/blog/post/breastfeeding-may-have-long-term-health-benefits-for-mothers-too  Benefits were seen/measured with six months increments in breastfeeding duration, with a large group of Chinese mothers, “Mothers who had breastfed their babies had a nine percent lower risk of heart disease and an eight percent lower risk of stroke.” (2)
  3. Loren Lipworth, L. Reness Bailey, Dimitrios Trichopoulos,

    History of Breast-Feeding in Relation to Breast Cancer Risk: a Review of the Epidemiologic Literature, JNCI: Journal of the National Cancer Institute, Volume 92, Issue 4, 16 February 2000, Pages 302–312, https://academic.oup.com/jnci/article/92/4/302/2624708 “Overall, the evidence with respect to “ever” breast-feeding remains inconclusive, with results indicating either no association or a rather weak protective effect against breast cancer. […] It appears that the protective effect, if any, of long-term breast-feeding is stronger among, or confined to, premenopausal women. It has been hypothesized that an apparently protective effect of breast-feeding may be due to elevated breast cancer risk among women who discontinue breast-feeding or who take medication to suppress lactation; however, the evidence is limited and should be interpreted with caution” (3)

  4. Angela M. Leung, MD, MSc, Elizabeth N. Pearce, MD, MSc,* and Lewis E. Braverman, MD, Iodine Nutrition in Pregnancy an Lactation, Endocrinol Metab Clin North Am. 2011 Dec; 40(4): 765–777. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266621/  Iodine needs are increased during pregnancy and lactation and in iodine replete geographic areas breast milk levels seemed adequate for the infant’s needs. 250-290 micrograms is estimated to be needed compared to the RDA of 150 micrograms. That level did not seem adequate in geographically low area of New Zealand: ” In a recent study, the iodine needs for breastfed infants in iodine-deficient New Zealand remained inadequate even when their mothers were supplemented with 150 μg/d of iodine during the first 6 postpartum months.” (4)
  5. Peter PA Smyth, The Thyroid, Iodine and Breast CancerBreast Cancer Res. 2003; 5(5): 235–238.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC314438/ Autoimmune thyroid disease and goiter is more common in patients with breast cancer. Iodine and selenium may be protective against both conditions, a review of literature rather than a study. (5)
  6. Heart Risk of High Protein Diets, June 4, 2018, The Hippocrtic Post,  https://www.hippocraticpost.com/ageing/heart-risk-of-high-protein-diets/?utm_source=website&utm_medium=webpush&utm_campaign=notifications The group of men with the highest intake of protein in percentage of total calories had increased risk of heart disease, except for protein from fish or eggs. “When they compared men who ate the most protein to those who ate the least, they found their risk of heart failure was:33 percent higher for all sources of protein;
    43 percent higher for animal protein;
    49 percent higher for dairy protein;
    17 percent higher for plant protein.” (6)
  7. Sherwin RS, Hendler RG, Felig P.,  Effect of Ketone Infusions on Amino Acid and Nitrogen Metabolism in ManJ Clin Invest. 1975 Jun;55(6):1382-90.
       https://www.ncbi.nlm.nih.gov/pubmed/1133179 (7)
  8. Isabella AlbaneseKashif KhanBianca BarrattHamood Al‐KindiAdel Schwertani, Atherosclerotic Calcification: Wnt is the Hint, Basic Science for Clinicians, February 8, 2018 Journal of the American Heart Association,  http://jaha.ahajournals.org/content/7/4/e007356 (8)
  9. The Cardiovascular System in Disease, Diseases of the Vessels, Chapter 6, Ch006-M3430.indd 4/19/2007, http://booksite.elsevier.com/samplechapters/9780723434306/9780723434306.pdf (9)
  10. Mark C. Houston MD, MS, Karen J. Harper MS, PharmD,  Potassium, Magnesium, and Calcium: Their Role in Both the Cause and Treatment of Hypertension, JCH, Vol 10, Issue 7, pp 3-11, July 2008,  https://onlinelibrary.wiley.com/doi/full/10.1111/j.1751-7176.2008.08575.x (10)
  11. Fatih Kircelli, Mirjam E. Peter, Ebru Sevinc Ok, Fatma Gul Celenk, Mumtaz Yilmaz, Sonja Steppan, Gulay Asci, Ercan Ok, Jutta Passlick-Deetjen, Magnesium reduces calcification in bovine vascular smooth muscle cells
    in a dose-dependent manner, Nephrol Dial Transplant (2012) 27: 514–521, https://watermark.silverchair.com/gfr321.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAZ0wggGZBgkqhkiG9w0BBwagggGKMIIBhgIBADCCAX8GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMbSRHWigPf17i-jCnAgEQgIIBUIkKsm3S-WvD5qd-tNiIBBwsoiqBg-FrbTXdm2oS2q2AdX0wuviR-rsM-hi6IMVKWwMEinUYTbh7DopBg7SWLxBIi4bHXaQft3IHdQqhDKr_RiB69uxkVRwW_2aHFGYjR0FzhUSfhDrmVLweVHZRTIYDVbrSkgaVgLnFq4YHvxohG08oMbAeF4C26XL026jpA7J1xbOodHz_o5MUvoQgVcxwhrIFuu7ysxD_B7bjJehfrw6SLjkrm3Q43jrsS3vS37v_hIig_lTQyFCPe5L6UhFwlQvH1mwPIKPNituSvoob5OxY5odMFjtcXNg0Wz2tqLajbKP_Cg4Rt1X0c67CLvTGMkos_d7QLKbxwiFibtfpcrPJlIfbPPEIjd4jKRI2MWFePBaQTQLnUOoC934JHOp4abLCC5jRaOAgHykzJhZPOpvgmvrgj-jJmZBtfdgW9g (11)
  12. Kashmira Gander, Having More Kids Linked to Heart Disease Risk in Mothers, According to New Study, June 4, 2018, newsweek.com, http://www.newsweek.com/kids-linked-heart-disease-risk-mothers-according-new-study-956066 (12)
  13. Kelli K Ryckman, M.S., PhD, Cassandra N Spracklen, M.S., John M Dagle, M.D., PhD., Jeffrey C Murray, M.D.Maternal Factors and Complications of Preterm Birth Associated with Neonatal Thyroid Stimulating Hormone, J Pediatr Endocrinol Metab. 2014 Sep; 27(0): 929–938. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260397/ “Maternal and neonatal thyroid levels are tightly correlated and hypothyroidism …. Multiparous women had infants with lower TSH levels (P=8×10−4) compared to …” (13)

  14. R. Swaminathan, Magnesium Metabolism and Its Disorders, Clin Biochem Rev. 2003 May; 24(2): 47–66.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1855626/ (14)
  15. Oseni, Saheed & Quiroz, Elsa & Kumi-Diaka, Jim. (2016). Chemopreventive Effects of Magnesium Chloride Supplementation on Hormone Independent Prostate Cancer Cells. Functional Foods in Health and Disease. 6. 1-15.  https://www.researchgate.net/publication/291164181_Chemopreventive_Effects_of_Magnesium_Chloride_Supplementation_on_Hormone_Independent_Prostate_Cancer_Cells (15)

  16. Eby GA, Eby KL, Rapid recovery from major depression using magnesium treatment.Med Hypotheses. 2006;67(2):362-70. Epub 2006 Mar 20. https://www.ncbi.nlm.nih.gov/pubmed/16542786 (16

  17. Hee-Ju Kang, Seon-Young Kim, Kyung-Yeol Bae, Sung-Wan Kim, Il-Seon Shin, Jin-Sang Yoon, and Jae-Min Kim, Comorbidity of Depression with Physical Disorders: Research ad Clinical ImplicationsChonnam Med J. 2015 Apr; 51(1): 8–18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406996/ (17)
  18. : Castiglioni S, Maier JAM. Magnesium and cancer: a dangerous liason. Magnes Res 2011; 24(3): S92-S100 doi:10.1684/mrh.2011.0285   http://www.mgwater.com/Magnesium%20and%20Cancer.pdf (18)
  19.  Pharmacology of Cardiac Potassium Channels, Cardiovascular Research, Volume 62, Issue 1, 1 April 2004, Pages 9–33, Oxford Academic – see Table 4, https://academic.oup.com/cardiovascres/article/62/1/9/373105 (19)
  20. Lakshman Goonetilleke, John Quayle, TREK-1 K+ Channels in the Cardiovascular System: Their Significance and Potential as a Therapeutic Target, Cardiovascular Therapeutics 30 (2012) e23–e29  https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1755-5922.2010.00227.x (20)
  21. University of Pittsburgh: Cardiovascular system during the postpartum state in women with a history of preeclampsia, Chapter 2: Cardiovascular System,  pp 190-191, Advances in Physiology Research and Application: 2012 Edition, Scholarly EditionsDec 26, 2012, ebook, https://books.google.com/books?id=3SyvNMZLBU0C&pg=PA190&lpg=PA190&dq=TREK+1+preeclampsia&source=bl&ots=2SzKQHcFJ0&sig=fGwDeK6cMIkUXhtwPDNKqio1zIQ&hl=en&sa=X&ved=0ahUKEwirhN_h6-XbAhUSbq0KHWDZCS0Q6AEIUjAF#v=onepage&q=TREK%201%20preeclampsia&f=false (21)
  22. Ma R, Seifi M, Papanikolaou M, Brown JF, Swinny JD, Lewis A.TREK-1 Channel Expression in Smooth Muscle as a Target for Regulating Murine Intestinal Contractility: Therapeutic Implications for Motility Disorders.  Front Physiol. 2018 Mar 6;9:157, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845753/ (22)
  23. Antidepressant Drugs Suppress Activity of Potassium Channels, Lawrence Berkeley National Laboratory, Feb. 8, 2011, psypost.org,  https://www.psypost.org/2011/02/antidepressant-ssri-potassium-channel-4068 (23)
  24. Nicholas J. Talley, SSRIs in IBS: Sensing a dash of disappointment. Clinical Gastroenterology and Hepatology, May 2003, Volume 1, Issue 3, Pages 155–159.  https://www.cghjournal.org/article/S1542-3565(03)70030-5/fulltext (24)
  25. Tülay Özkan Seyhan, Olgaç Bezen, Mukadder Orhan Sungur, İbrahim Kalelioğlu, Meltem Karadeniz, and Kemalettin Koltka,

    Magnesium Therapy in Pre-eclampsia Prolongs Analgesia Following Spinal Anaesthesia with Fentanyl and Bupivacaine: An Observational Study., Balkan Med J. 2014 Jun; 31(2): 143–148.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4115934/ Exerimental group needed less fluid replacement and waited longer before requesting additional pain killing medication than the women with normal (no preeclampsia) deliveries. (25)

  26. Ramanathan J, Vaddadi AK, Arheart KL. Combined spinal and epidural anesthesia with low doses of intrathecal bupivacaine in women with severe preeclampsia: a preliminary report. Reg Anesth Pain Med. 2001 Jan-Feb;26(1):46-51. https://www.ncbi.nlm.nih.gov/pubmed/11172511 (26)
  27. KCNK2 potassium two pore domain channel subfamily K member 2 [ Homo sapiens (human) ], Gene ID: 3776, updated on 23-May-2018,   https://www.ncbi.nlm.nih.gov/gene/3776 (27)

     

  28. Tayyba Y Ali, Fiona Broughton Pipkin, and Raheela N Khan, The Effect of pH and Ion Channel Modulators on Human Placental Arteries. PLoS One. 2014; 9(12): e114405. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260857/  “In vessels isolated from placentae of women with pre-eclampsia (n = 6), pH responses were attenuated.” (28) *attenuated means a weakened response, less responsive to the stimulus.
  29. Qi Qian, Dietary Influence on Body Fluid Acid-Base and Volume Balance: The Deleterious “Norm” Furthers and Cloaks Subclinical Pathophysiology, Nutrients 2018, 10(6), 778; Open Access, http://www.mdpi.com/2072-6643/10/6/778/htm “Recently, Sun et al. [53] demonstrated a causal role for dietary K+ in the regulation of osteogenic differentiation and calcification of vascular smooth muscle cells, both in vitro and in atherosclerotic animal models. Specifically, lower levels of extracellular fluid K+ induce vascular smooth muscle cell osteogenic transformation by elevating intracellular calcium. The latter activates CREB (cyclic AMP response element-binding protein) leading to an enhanced expression of osteogenic markers, e.g., RUNX-2, and simultaneously reduced smooth muscle cell markers, e.g., α-actin. Remarkably, even a slight serum K+ reduction (mean K+ level, 3.70 ± 0.21 mEq/L) in mice can trigger significant vessel calcification associated with elevated pulse-wave velocity, a reliable indicator of aortic stiffness. On the contrary, when K+ levels are raised to ~4.73 mEq/L by dietary modification, signs of osteogenic differentiation were abrogated, and vascular calcification prevented. Consistent with the notion of K+ being protective to vasculature, a high ratio of urine Na+/K+ excretion (indicative of high Na and low K+ intake) has recently been linked to the genesis of HTN [54].?” (29)
  30.  Robert Vink, Mihai Nechifor, editors, Magnesium in the Central Nervous System, University of Adelaide Press, 2011, adelaide.edu.au, free ebook pdf, https://www.adelaide.edu.au/press/titles/magnesium/magnesium-ebook.pdf  See page 20 re TRPM7 channels and different effects of oxidative stress on calcium versus magnesium being allowed through the ion channel. Magnesium helps survival while calcium can increase risk to the cell.  other notes about the book:   https://twitter.com/deNutrients/status/1012685811001806849?s=19

All are equal in Equal Opportunity Programs

“Some are more equal than others” in the book Animal Farm by George Orwell. (paraphrased)

“All animals are equal, but some animals are more equal than others.”

In the 60’s and 70’s women’s liberation and sexual liberation were somewhat connected. Being a single unwed mother was rare and was disapproved of.  That has changed for the better, women and children are accepted no matter the marital history. However the poverty support programs as they are currently written promote unwed mothers by penalizing couples -giving less support or no support help to married couples or unwed couples where the father is named.

A support net that promotes single parenting and not naming a child’s father is discriminating against the child’s right to know their father and their medical and cultural heritage. Welfare programs in larger areas even inspect for evidence of an unnamed father figure and women can lose their benefits even if the large size jeans were their own. Supporting children is a goal that benefits society and stressful situations make parenting more difficult. Rewriting policies that are more open to two parent households whether it is mom and dad, or mom and mom, or dad and dad, would be a positive goal for the sake of raising healthy and secure children who have adequate caregiving available.

Raising children is a challenge with two parents and raising them with one parent may be less stressful and the wiser choice if one parent is unreliable or abusive, so flexibility in any welfare type support net program is the wisest choice for the children’s sake. And for the future’s sake raising secure well adjusted children is most likely to lead to more well adjusted  prosocial tax paying self sufficient adults. (link elsewhere on this site.: From a previous post: Regarding potential underlying reasons for a person to resort to mass violence – typically it isn’t due to “mentally ill” people unless they were already prone to violence. An increased risk for violence is not associated with depression, anxiety or ADHD. Increased risk for mass violence is significantly associated though with being a male who had experienced child trauma and who is a binge drinker.  (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318286/ ))

Sexual liberation was openly discussed by some in the past, 60s/70s, but it wasn’t common for the average woman or household (some women were free/open to casual encounters but most others were not; and swinging/key parties were an experiment of the 70s). Now we have fifty percent (roughly) of children growing up in poverty and many of them living in poverty have single parent households. The inequality of women’s pay to men’s pay when broken down into more precise detail is actually more of a difference in mother’s pay to other’s pay. nytimes The salaries of women without children are more comparable to men’s wages.

So who is liberated now – father’s from their previous role as a head of household? Or are they liberated from being anywhere in the household? Maybe but liberated maybe not. Some are in prison as the number of prisoners has increased with the for-profit prison industry. Since 1974 the amount of prisoners has increased from a steady 100/100,000 to 500/100,000 by 2004. nap.edu

Is sexual liberation still around – or just single parenthood? It seems to be the latter, based on my experience it went away with the increase in sexually transmitted disease and the increase in AIDS/HIV that occurred in the 80s and 90s.

What about equality? Are some animals more equal than others? Yes, some do seem to have different rules than others regarding taxation and legal protection and even in television show games we have many that focus on voting who to keep and who to remove from the lineup of contenders. Some animals are more equal it seems, in our modern times.

In my world we are all equal and the animals count too. We need offshore microbes to modify the form of trace minerals found in ocean water into a form that is available in the atmosphere.

Some animals may think they are more equal than other animals but in the long run we may all be looking to microbes for help that they won’t be able to provide in an ocean that is more acidic and warmer. It is hard to predict who will be more equal than who in a greatly changed world, planning ahead now might make the transition go smoother. Stopping change is already too late, it is happening at the more severe rates that have been used in calculations of predicted events.

In the world I grew up as a child in the 70s we cared about climate and cleaning up air and water and women’s liberation included freedom to touch and be touched not just be seen in more exposed and expensive fashions. Fathers were part of the household, not just on visitation days. Was it perfect then? probably not, but is it perfect now? not really. Lack of jobs for many and lack of time for those who do have jobs is a problem in our modern society that isn’t going to change without the creation of new industries. Globalization has decreased poverty around the world but has led to fewer jobs in the U.S. that are as well paying in proportion to the type of pay that a father as head of household might have had in the 50s or 60s. It will require planned change in priorities to create a new job or basic income society. The advantage could be more stable parenting by two parent households.

Men, on average, are still expected to be a good earner in order to win a woman’s partnership as a spouse and parent. cnn.com/american-men-less-marriageable-partner Expectations may be involved in the suicide rate by males which is a problem of our modern society that was also a problem in the 50s and 60s. More men commit suicide than women on average (males ~18-21/100,000, females ~ 4-6/100,000) and both rates have been fairly consistent since the 1950s. statista.com  Social roles being demanding in different ways seems unlikely to explain that consistent of a difference, speculatively, testosterone levels are not directly associated with violence but in individuals whether male or female if prone to violence increased testosterone can increase tendency towards violence and suicide is a violent reaction against the self. (Sapolosky, Behave)

So are women liberated yet? are men? are children? Prisoners certainly aren’t. /https://mic.com/articles/86519/19-actual-statistics-about-america-s-prison-system#.RB8uGOHzW/ And are we sexually liberated yet? I read one study showed an average of less than two encounters per week for couples – we were supposed to be shocked that the use of medical marijuana was associated with a 20% increase in the rate, bumping up close to 1/week to closer to 2/week metro.co.uk/2017/10/27/weed-smokers-have-more-sex-apparently – I was shocked by both rates. It was not a large study, so maybe there’s more healthy fun going on in the world of consensual couples. Although for the busy pace of a full-time job and commute and helping with children’s homework or doing other household chores it can be difficult to find energy let alone time for extraneous activities no matter how fun. For me fun, solo, helps with better mental health and it can have pain killing benefits for a woman. Migraine relief was sometimes only a few minutes of concentration away if I had some privacy. Good and good for you.

Asexuality seems to be the new liberation. Zinc and omega 3 fatty acids and iodine and selenium may all be helpful for boosting that average for men or women. Food sources of iodine and selenium are available here: effectivecare.info/g9-iodine-&-thyroid

Some animals do seem to be more equal than others. George Orwell was right about that part.

The new site that I still need to work on is meant as ideas, not to be considered better or worse than anyone, the point of Equal Opportunity Programs is that all are treated equally, equal service offered in a variety of languages. The site has ideas, just ideas to consider and online translation services can give a rough translation, but currently the site is in English and written from the perspective of someone who worked in the U.S. in a field that was largely staffed by women, so my ideas may not convert well to a modern mixed gender working world, however the goal of Equal Opportunity Employment is that gender ratios in all of the businesses participating would be similar or not matter if they weren’t in similar ratios. Pay and benefits would be equivalent. Goals are a starting point to consider and work towards, ideas are a place to start.

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.