1. 14
on the cover
STORIES BY Ann-Marie Vazzano
AND Lynne Thompson
PHOTOGRAPHY BY Jeff Downie
BEYOND
THE FOOD
PYRAMID
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6
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3
n-Marie Vazzano
hompson
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2. C
ut fat. Avoid sugar. Limit red meat. Carbs
are the enemy. There’s a lot of focus these
days on the things we shouldn’t eat. But
what about the things we should?
In 2011, the USDA retired its antiquat-
ed food pyramid. We’re all familiar with
it — the illustrated triangle encouraging
us to eat six to 11 servings of grains dai-
ly, three to five servings of vegetables, two
to three servings of meat and poultry —
and the list goes on. The problem was, Americans’ notions of what
constituted a “serving” were foggy at best. To simplify things, USDA
introduced MyPlate, a graphic representation of a round plate, with
one quarter dedicated each to protein and grains, with vegetables and
fruit making up the remaining half.
But there’s more to eating well than just enjoying your broccoli.
Doctors and nutritionists now recommend incorporating the whole
spectrum of color. “If you get a lot of different colors into your diet,
you’ll be getting a lot of different nutrients,” says Michele Hiatt, clini-
cal dietitian at St. John Medical Center. “It also helps spruce up the
plate and makes it look more appealing.”
Purple
Step away from
the pop machine
and pour yourself
a glass of purple
grape juice (no sugar
added). Research
has found that
pressing grape seeds
and skins releases
flavonoids — a heart-
healthy substance
that helps reduce
bad cholesterol.
1 // COLOR WHEEL MEALS
Colorful foods provide fiber, as well as all the essential vitamins
and minerals. “I notice when I do nutrient analyses for people that
oftentimes they don’t get enough fiber in their diet,” says Hiatt. But
rather than focus on what patients are doing wrong and what they
shouldn’t be eating, Hiatt prefers to counsel them on what they can
add to their diets. “Sometimes saying, ‘aim for five fruits and vegeta-
bles a day’ — it becomes more of a positive thing — it’s something to
add to your diet,” she says. In turn, patients often end up eliminating
some of the not-so-healthful foods because they fill up on fruits and
vegetables. “If you can say one thing to eat, sometimes that makes a
big difference to people,” says Hiatt.
In addition to adding more color to their plates, many people
are taking their diets to a whole new level. Whether they want to be
healthier, protect animals or lose weight, these diners are following
special diets that require them to be more attentive to their food
choices. Read on for popular eating regimens you might want to
investigate before stopping at the drive-thru for lunch.
Think you don’t have time to incorporate all the colors into your diet? Think again. It
just takes some small changes to your daily routine.
Red
Toss some tomatoes
into your salad.
Tomatoes contain
lycopene, which
studies have shown
to reduce the risk
of cardiovascular
disease and cancer.
Orange
Orange foods are
packed with immune
system-boosting beta
carotene and vitamin
C. Swap your regular
baked or mashed
potatoes for the sweet
variety — one large
sweet potato counts
as one cup of orange
vegetables, according
to USDA’s MyPlate.
Yellow
“Bananas kind of get
a bad rap because
they’re starchy and
higher in calories
than most fruits, but
they do contain a
lot of potassium,”
says Michelle Hiatt,
clinical dietitian at
St. John Medical
Center. “When you
have low potassium,
sometimes you
have problems like
muscle cramping.”
Plus, bananas
make a great grab-
and-go snack.
Green
Green veggies
contain antioxidants,
including folic
acid, which also
helps prevent heart
disease. As an
alternative to potato
chips, Hiatt suggests
keeping kale chips
on hand. Toss fresh
kale leaves in olive
oil with any herbs.
Spread them on a
baking sheet and
bake at 350 degrees
for about 10 minutes,
or until crisp.
Blue
Blueberries are an
antioxidant-rich
super food. Top
your morning cereal
with a handful for
added sweetness
and a healthy dose
of manganese,
which helps
process cholesterol,
protein and carbs
into energy.
1 2 3 4 5 6

3. 16 fall 2013 • circleeastmag.com
2 // THE PALEO PLUNGE
‘Caveman diet’ calls
for fresh fruits and
vegetables and ethically
raised meat, but no
dairy, legumes or grains.
TIPS FOR GOING PALEO Commit to it for 30 days. Lytle says most people can conceive of going without
current staples such as milk and bread for that short period. But it’s long enough for them to experience the benefits of life without them.
“A lot of people just honestly feel better,” she says. “They feel more energized.” • Take a multivitamin and vitamin D supplement.
“There’s some debate over what level of vitamin D in the blood is optimal,” Cimperman says. Check with your doctor to determine how
many international units you require each day. • Eat fish and chicken rather than beef and pork. Handley advises keeping portions to
3 or 4 ounces. “The more vegetables that you put on your plate, the better off you’re going to be,” she advises. • Eat a wide range of
vegetables and fruits. Doing so not only provides variety but necessary nutrients. • Two words: sweet potatoes. Lytle recommends eating
the popular veggie to get more energizing carbohydrates, particularly for those feeling a tad sluggish. • Get in the Zone. If you discover
your body just can’t function without some dairy, grains or legumes, consider trying the Zone diet, a variant of the Paleo diet that includes
foods such as oatmeal, whole milk and cheese from grass-fed cows, soy products and peanut butter. Daily food consumption is prescribed in
“blocks” of protein, carbohydrates and fat based on gender, age, activity level and body type.
For more information, log on to library.crossfit.com/free/pdf/cfjissue21_may04.pdf.
What It Is. Janine Lytle, a certified nutritionist with CrossFit Akron, refers to the Paleo (short for “Paleolithic)
diet as “the caveman diet,” one based on foods our hunter-gatherer ancestors ate before the advent of agriculture:
fresh meat and seafood, seasonal vegetables and fruits, nuts and seeds. It includes game, beef, poultry, eggs,
almond and coconut milks, sweet potatoes and oils from nuts and seeds. Off the menu are dairy, legumes (beans,
peas, peanuts, soybeans, etc.), white potatoes, grains, refined sugars, soft drinks and alcoholic beverages, along with
products made with or derived from them.
Adherents differ in how they observe the “no processed foods” rule. Some avoid cured and processed meats; make
their own almond and coconut milks; and use only raw honey as a sweetener. Others indulge in bacon, ham and deli
meats; buy almond and coconut milks at the grocery store; and sweeten with pure maple syrup, molasses and stevia.
THE BENEFITS THE DRAWBACKS
It is based on fresh, whole, “real” foods. Cutting out processed
foods (in other words, foods not in their original form) eliminates
preservatives and artificial colorings. According to Kim Handley, a
holistic nutritionist with Debi’s Personal Training based in LaGrange,
many researchers and health professionals believe these ingredients
contribute to the development of diseases such as cancer and
diabetes, perhaps because the body has difficulty processing them.
It emphasizes eating ethically raised, hormone- and antibiotic-free
animal proteins. That means pastured grass-fed beef and pork, free-
range poultry and wild-caught seafood. Lytle explains that livestock
allowed to roam at will and subsist on what Nature intended are leaner
and therefore a more healthful entrée option.
“When livestock is fed grains, that increases their fat deposits,” she
says. “So you have a fattier piece of meat.”
It is free of refined sugars. “Sugar consumption today is very high
— it seems [food manufacturers] are putting sugar in everything,”
laments Michelle Kaluzne, a registered and licensed dietician at
Summa Health System. “Those who eat more refined sugars tend to
be overweight or obese, which is a risk factor for Type 2 diabetes.”
It relies on animal proteins as a staple. For decades, doctors have
been warning their patients that red-meat consumption contributes
to developing high LDL, or “bad,” cholesterol and heart disease.
Kaluzne observes, while fresh, grass-fed beef is a more healthful
option, it still must be consumed in moderation. Some people, she
adds, see the Paleo diet as a license to consume Fred Flintstone-sized
cuts of meat.
It excludes whole grains. Lisa Cimperman, a clinical dietician at
University Hospitals Case Medical Center in Cleveland, explain whole
grains are a common source of complex carbohydrates, fiber and
B vitamins, the last of which are important in converting food into
energy. Lytle has encountered Paleo devotees who feel tired and
lethargic. “Carbs are energy,” she notes.
It cuts out dairy products. There are plant-based sources of calcium
— leafy greens such as collard greens, kale and okra, for example.
But, Cimperman says, eschewing fortified dairy products eliminates a
common source of vitamin D. The nutrient is necessary for more than
calcium absorption. She cites a recent study that showed individuals
with sub-par vitamin D levels had a higher risk of dying from all causes.

4. circle east live well • fall 2013 17
The Paleo Shopping List
INGREDIENTS:
For the spaghetti squash:
1 spaghetti squash
4 tablespoons coconut oil, divided
2 teaspoons garlic salt
1 small butternut squash,
peeled and cubed
2 cups portabella mushrooms, sliced
1 medium onion, chopped
salt and pepper to taste
4 cups kale, shredded
For hot turkey-sausage meatballs:
2 teaspoons garlic salt
1 teaspoon black pepper
2 teaspoons Italian seasoning
1 teaspoon crushed red pepper
1 teaspoon fennel seeds
1/2 pound ground white turkey meat
1/2 pound ground dark turkey meat
For the sauce:
1 cup canned pumpkin,
plain (not pie filling)
¼ cup chicken broth
1 teaspoon garlic salt
1 teaspoon crushed red pepper
2 teaspoons thyme
1 teaspoon nutmeg
2 tablespoons raw honey
¼ cup almond milk, unsweetened
INSTRUCTIONS:
1 Preheat oven to 425 degrees.
2 Cut spaghetti squash in half and
scoop out seeds. Brush flesh of
each half with 1 tablespoon coconut
oil, then sprinkle each half with 1
teaspoon garlic salt. Place spaghetti
squash halves cut-side down on a
baking sheet and roast for 20 to 25
minutes, or until rind yields to gentle
pressure. Remove from oven and set
aside.
3 For the meatballs, mix seasonings
with the ground meats. Roll into
medium-sized meatballs and place
in a foil-lined roasting pan. Reduce
oven heat to 375 degrees and bake,
uncovered, 10 to 12 minutes, or until
meatballs are lightly browned.
4 While the meatballs are baking,
heat 2 tablespoons coconut oil in a
skillet. Saute butternut squash over
medium heat for 5 to 7 minutes, or
until tender. Add mushrooms, onion,
salt and pepper and continue
cooking until tender. Remove from
heat and set aside.
5 For the sauce, whisk together
pumpkin, chicken broth, seasonings
and honey in a saucepan over low
heat. Slowly whisk in almond milk.
Continue simmering until bubbles
form.
6 Scrape spaghetti squash from
rinds with the tines of a fork and toss
with other vegetables, including the
kale. Divide on plates, ladle sauce
over vegetables, and top each
portion with 2 to 3 meatballs.
Serves 4.
TRY IT
Nutritionist Janine Lytle encourages anyone who thinks they can’t live without pasta to try her fall favorite. She replaces spaghet-
ti with spaghetti squash and traditional tomato sauce with a seasonal pumpkin counterpart.
Spaghetti Squash with Savory Pumpkin Sauce
• Vegetables (fresh and in
season if possible; plain
frozen is OK)
• Large-leaf lettuce (for
sandwich wraps)
• Spaghetti squash (to
replace pasta)
• Sweet potatoes
• Fruits (fresh and in season, if
possible; plain frozen is OK)
• Eggs (cage-free)
• Almond or coconut milk
(unsweetened)
• Almond or cashew butter (to
spread on apples, bananas,
strawberries, etc.)
• Fresh meats
• Fresh seafood
• Nuts and seeds
• Oils and seasonings (to make
salad dressings)
• Raw honey (for sweetening)
STOCKING THE PALEO KITCHEN is all about shopping the perimeter of the grocery store. Janine
Lytle, a certified nutritionist with CrossFit Akron, suggests picking up the following items.

5. Gluten-Free
Substitutes
1 / Cornstarch: works well as a
thickener for soups/sauces
2 / Amaranth: high in protein
and fiber; adds a nutty
flavor to baked goods
3 / Almond Meal Flour: made
from whole almonds ground
into powder; works well in
cookies, cakes and other
desserts (use a half a cup for
every 1 cup in recipes)
4 / Quinoa: packed with protein
and other vitamins and
minerals, it adds texture and
moisture to baked goods
5 / Coconut Flour: high in fiber
and adds sweetness and
moisture to baked goods
6 / Buckwheat: makes great
pancakes and low-cal,
gluten-free breads
6
1
2
4
5
3
2
WANT TO COOK AND BAKE
gluten-free at home? With these
substitutes, you won’t even miss your
all-purpose flour:
3
4
18 fall 2013 • circleeastmag.com

6. circle east live well • fall 2013 19
3 // GLUTEN-FREE GUIDE
Should you avoid gluten? Here’s the lowdown on this pervasive protein.
T
en years ago, you’d be hard-pressed to find a single product labeled “gluten-free” in
your local grocery store. But now, many supermarkets are catering to the increasing
number of consumers avoiding gluten, a protein substance found in wheat, rye and
barley. Stroll through your grocery store today and you’ll undoubtedly stumble
upon an entire section dedicated to gluten-free foods.
So why the sudden anti-gluten movement? Increased awareness of celiac disease
— an intolerance to gluten — created a growing demand for gluten-free products,
which in turn created a unique marketing opportunity for food manufacturers. But there’s a lot to
consider before going gluten free.
HOLD THE
GLUTEN
How do you stick to a
gluten-free diet when
out and about? Here’s a
list of helpful smartphone
apps and websites to try:
• Eating Out G-Free:
an app that offers tips
on finding gluten-free
menus, lets you create a
gluten-free shopping list
and lists foods to avoid
• Find Me Gluten Free:
this app rates restaurants
and businesses on
gluten-free friendliness,
allows you to view
gluten-free menus for
chains and fast food
restaurants and helps
you find local gluten-
free establishments
• Gluten Freed: an
app that displays a
list of nearby gluten-
free restaurants
• Gluten Free Daily: an
online guide featuring
gluten-free recipes, tips
on what to eat, a grocery
list and a daily journal
Should You Avoid
Gluten? Sharon
Minjares, registered dietitian
and Wellness Institute
director at Lake Health,
says she generally suggests
a gluten-free diet only to
patients who have been
diagnosed with celiac disease
or gluten sensitivity. “Being
diagnosed means typically
that they have to have some
blood work done by their
physician, and they also
probably need to have a
biopsy of the intestines,” she
explains. Symptoms of celiac
disease include stomach
cramps, bloating, diarrhea,
constipation, nausea,
vomiting and weight loss, but
the cause of the disease is
poorly understood.
Minjares says she has dealt
with several patients who
have not been formally diag-
nosed with the disease but
experienced gastrointestinal
distress after eating wheat
products. After eliminating
gluten, they found relief. But
she’s quick to note that foods
contain many ingredients, so
without a proper diagnosis,
it’s impossible to know if glu-
ten is to blame for gastroin-
testinal issues.
For individuals suffer-
ing from celiac disease, the
body’s immune system sees
gluten as an enemy and re-
acts accordingly, causing
damage to the lining of the
small intestine. “Most of the
nutrients in food are actually
absorbed through the small
intestine, so damage to the
small intestine is going to
mean you’re not absorbing
nutrients into the body,” Min-
jares explains. “It can lead to
some significant nutrient defi-
ciencies.”
But avoid-
ing gluten
can come
with risks,
too. “Adher-
ing to a glu-
ten-free diet
may actu-
ally result in a
diet that’s low
in carbohy-
drates, iron,
folate, niacin,
zinc and fi-
ber,” Minjar-
es says. These
vitamins and
minerals are
commonly
found in glu-
ten-rich foods. Therefore, she
recommends supplementing
with a multivitamin.
Gluten and
Weight Loss Many
people who have not been
diagnosed with celiac
disease or gluten sensitivity
are adopting gluten-free
diets to aid in weight loss.
But Minjares says there is
no evidence that a gluten-
free diet itself will promote
weight loss. What it can do,
however, is lead to decreased
carbohydrate intake. Because
gluten is found in breads,
cookies, cakes and other
baked goods that also tend
to be higher in fat and sugar,
decreased consumption of
these types of foods can lead
to weight loss and improved
health.
Where people sometimes
run into trouble, notes Min-
jares, is if they simply buy
packaged
gluten-free
products
thinking
they’re more
healthful
than their
tradition-
al counter-
parts. In fact,
a person
could ac-
tually gain
weight on a
gluten-free
diet. “If you
compare a
serving of
pretzels —
regular pret-
zels provide
approximately 108 calories
and 1 gram of fat, and glu-
ten-free pretzels contain 140
calories and 6 grams of fat,”
Minjares says. And for individ-
uals who have celiac disease,
eliminating gluten can lead to
weight gain simply because
the small intestine is now able
to absorb more nutrients.
The good news for those
avoiding gluten is that help-
ful resources for living gluten-
free are abundant. “There are
some really nice apps that
are available that people can
download on their smart-
phones,” says Minjares. “It’s a
safe place to go to learn how
to eat.”
HIDDEN GLUTEN
Gluten is found in
more than just baked
goods. Other products
that frequently contain
gluten include: broths/
soups, lunch meats and
hot dogs, chips and
candy, salad dressing,
soy sauce, gravy,
imitation seafood, dairy
substitutes, lip gloss/
lipstick, toothpaste,
medication/vitamins

7. 20 fall 2013 • circleeastmag.com
4 // GOING VEGAN
• almond milk
• beans (dried or canned)
• brown rice
• fruit (fresh or plain frozen)
• peanut butter, almond
butter or cashew butter
• vegetables (fresh or plain
frozen)
• whole-grain bread
• whole grain cereal
• whole-grain pasta
The Vegan Shopping List
REGISTERED DIETICIAN Kristin Kirkpatrick, wellness manager at the Cleveland Clinic Wellness
Institute in Lyndhurst, advises against picking up items such as tofu (soybean curd) and seitan (flavored
wheat gluten) during your first few trips to the supermarket. Instead, buy what you already know how
to work with: vegetables, fruits, whole grains and legumes.
This plant-based diet
respects animal rights and
promotes healthy living.
What it is. The vegan diet is one that excludes “anything that has a mom or a face,” according to registered
dietician Kristin Kirkpatrick, wellness manager at the Cleveland Clinic Wellness Institute in Lyndhurst. Those who adhere
to it not only eschew meat, poultry and seafood, but other animal products such as gelatin (derived by boiling specially
prepared skin, bones and connective tissue), eggs and dairy.
“If you’re a true vegan, you wouldn’t have honey, either,” she says. “Honey comes from bees.”
Kirkpatrick estimates that 50 percent of her vegan clients maintain the diet for health reasons; the other 50 percent
do so because of concerns about how animals are raised or an objection to killing them for food. Kim Handley, a holistic
nutritionist with Debi’s Personal Training based in LaGrange, points out that going vegan is often a lifestyle that eliminates
wearing leather and fur, using cosmetics tested on or containing products derived from animals, etc.

8. circle east live well • fall 2013 21
THE BENEFITS
THE DRAWBACKS
It cuts out sources of saturated
fat and cholesterol and increases
intake of fruits, vegetables and
whole grains. Studies of cultures
around the globe show that a
plant-based diet contributes
to living a longer, healthier life,
Kirkpatrick says.
It doesn’t cause discomfort in
those who have trouble digesting
meat. “Some people just don’t
have enough acid in their
stomachs to break down meat
very well,” Handley explains. “It
just makes them feel heavy.”
It is devoid of vitamin B12.
Kirpatrick notes animal products
are the only food source of
vitamin B12, a nutrient essential
to maintaining a healthy nervous
system and repairing cells.
“It doesn’t take a lot to keep
you sufficient in those levels,”
she says. “But once you have a
B12 deficiency, it’s very difficult
to reverse the process.”
It is not easy to do. The
challenges extend beyond
fighting cravings for a big, juicy
burger or a wedge of creamy,
dreamy cheese — the food
Kirkpatrick says her vegan clients
have the most trouble giving up.
She observes that maintaining a
vegan diet can require spending
more money at the grocery store
and more time planning and
preparing meals, particularly for
those who rely on the fast-food
drive-thru. When it comes to the
number of vegan restaurants and
menu selections in Northeast
Ohio, she adds, “we’re still a
little behind New York City, for
example, or the West Coast.”
Those who adopt a vegan
diet without proper education
and preparation often end up
subsisting on breads, pastas,
cereals and processed foods
(veggie burgers, soy sausages,
etc.), the last of which often
are high in calories, sodium,
preservatives, artificial colorings
and other additives.
INGREDIENTS:
2 cups broccoli florets
3 cups water
2 tablespoons vegetable base
1 tablespoon extra-virgin olive oil
1 cup onion, diced small
2 tablespoons fresh garlic, minced
1 cup red, yellow and/or orange bell
pepper, diced small
1½ cups white button mushrooms,
sliced
salt and pepper, to taste
½ cup jarred or canned roasted red
peppers, julienned
4 threads saffron, crushed
¼ teaspoon red pepper flakes
1 14.5-ounce can diced tomatoes
1 cup brown rice, uncooked
½ cup scallions, sliced thinly
½ cup frozen peas, thawed
1 cup frozen baby lima beans,
thawed
INSTRUCTIONS:
1 Preheat oven to 350 degrees.
2 In a pot, par-cook broccoli in 3
cups water. Remove broccoli and set
aside. Reserve 2 cups water; mix with
vegetable base and set aside.
3 Heat a 4-quart cook pot, add olive
oil and sauté onion until translucent.
Add garlic and cook until fragrant.
Add remaining ingredients except
for cooked broccoli, scallions, peas
and lima beans. Mix well and bring
to a simmer. Remove pot from
heat, cover and place in oven for 20
minutes.
4 Remove pot from oven and let
stand, covered, for 10 minutes
to finish cooking. Add broccoli,
scallions, peas and lima beans. Mix
well. Makes 10 1-cup servings.
TRY IT Cleveland Clinic Wellness Institute executive chef Jim Perko’s version of the
classic Spanish dish removes the meat and seafood and leaves the flavor, along with the
veggies and rice, in the pot.
Vegan Paella
TIPS FOR GOING VEGAN
Getting Started
Explore what a vegan diet might look like. Kirkpatrick asks her clients to write down a week’s worth of typical
meals and snacks. She then suggests healthful vegan alternatives where necessary. A go-to breakfast of coffee with
half-and-half, eggs and whole-grain toast, for example, might be modified by trading the half-and-half for a soy
creamer or almond milk and replacing the eggs with a slathering of all-natural peanut butter on the toast. Kirkpatrick
suggests tackling the exercise with a vegan dietician or nutrition-savvy vegan doc. He or she not only will be able to
recommend vegan alternatives but can assess your specific nutritional needs and suggest how to best meet them.
Go vegan gradually. “People tend to be more successful when they take the diet they already enjoy and start
to make some small changes,” Kirkpatrick observes. She gives the example of eliminating eggs the first month,
cutting out poultry the second month, swearing off cheese the third month and so forth. The practice allows time
to experiment with new foods and recipes, introduce them into menus over time and find new favorites. Slowly
increasing servings of vegetables, fruits and legumes also is a good idea for adults whose diets are lacking in fiber.
Eat more vegetables than fruits. Handley points out vegetables contain protein as well as vitamins, minerals and
fiber. Dark, leafy greens — spinach and kale, for example — are high in calcium. And unlike fruit, they don’t contain
large amounts of natural sugar.
Schedule extra grocery-shopping time. Some processed foods that appear to be vegan-friendly actually contain
animal products. Kirkpatrick notes, for example, that some rice cheeses contain the milk protein casein. Handley
adds that some soy, almond and coconut milks contain a lot of sugar. Therefore, scrutinizing labels is necessary.
Keeping It Going
Include a protein source or two in each meal. Michelle Kaluzne, a registered and licensed dietician at
Summa Health System, says dietary analyses indicate most of her vegan clients are consuming enough protein.
But she still suggests they eat a serving of nuts, seeds, legumes or soy milk at each sitting to keep it that way.
Pair iron- and vitamin C-rich foods when possible. Kirkpatrick points out the iron
from, say, a steak is better absorbed by the body than iron from plant sources such as lentils,
nuts, quinoa, soybeans and spinach. Vitamin C actually enhances that absorption. One tasty
idea: “Put some mandarin oranges or some strawberries on top of your spinach.”
Try blackstrap molasses as a calcium supplement. Kaluzne says one tablespoon contains 200 milligrams.
Pay attention to how you feel. “If you feel very lethargic, your body might actually need that
meat,” Handley says. “And that’s OK. If you don’t want to eat beef, add in chicken or fish.”