You already know about grains that are staples in our diet: wheat, corn, and rice. But what about the one that's highest in protein, gluten-free, and contains as much calcium as milk? It's an important addition to any heart-healthy diet. Both the grain and its oil lower dangerous LDL and total cholesterol.

Don't believe all the recent bad publicity surrounding grains. Whole grains have been a significant component of a healthy diet for thousands of years. They are filled with vitamins, minerals, fiber, and beneficial fats. Whole grains turn into energy slowly and give a feeling of satiety. When you add grains to a meal, you can eat less and still feel satisfied. They'll even help you lose weight if you don't overeat them.

The grain I'm talking about today is higher in many nutrients than any other grain. The grain is amaranth, and it's actually the seed of a tall shrub with stunning magenta flowers. The Aztecs cultivated amaranth and used it as a staple in their diet for more than 7,000 years. But it's relatively new to us.

In fact, until recently you could only buy it in bulk as a grain to use like rice, or find it in prepared cereals and baked goods, such as cookies. Now more amaranth products are showing up on the shelves of natural food stores, like amaranth oil, cooked amaranth cereal, and amaranth side dishes. Here are just a few reasons to consider incorporating this tasty grain into your diet.

High protein: Amaranth contains more protein than other grains. Half a cup of cooked amaranth contains a whopping 14 grams. The same amount of brown rice has only 2.5 grams; a slice of bread has 3 grams. Amaranth's naturally high protein content makes it an ideal choice for a breakfast cereal or as a side dish.

No grains contain all essential amino acids needed to make a complete protein. Amaranth is no exception. It's low in leucine, an essential amino acid found in most other grains. So mix it with rice, oats, or wheat, or just eat another grain some time that same day.

Gluten-free: Some people can't digest gluten, a sticky substance found in most grains. They have a condition called celiac disease that causes extreme digestive distress when they eat gluten. Other people have digestive problems, such as bloating and gas, when they eat too much wheat — a high-gluten grain. If you have digestive problems and tend to eat wheat or oats, try switching to amaranth for a week or two. It's gluten-free. If you can't find foods with amaranth easily, look in the gluten-free section of your supermarket or natural food store.

Calcium and other minerals: Amaranth is higher in calcium, magnesium, and potassium than other grains. Half a cup of amaranth contains 149 mg of calcium — the same amount as half a cup of milk. But milk is low in magnesium, a mineral I consider to be even more important than calcium. More women are deficient in magnesium than calcium. The ideal ratio is either to get equal amounts of calcium and magnesium, or more magnesium than calcium. Amaranth has more magnesium than calcium — 259 mg in half a cup of the grain. It also contains 357 mg of potassium. These three minerals are important nutrients to include in a heart-healthy diet.

Amaranth oil: This oil is now starting to appear on the shelves in natural food stores. It's high in linoleic acid — an important beneficial omega-3 fat — as well as squalene and vitamin E tocotrienols. The nutrients in amaranth oil reduce total cholesterol, harmful LDL cholesterol, and triglycerides. These benefits may be due to the interaction of its ingredients or to any one of them. We don't know yet. But we do know that several good scientific studies found amaranth oil protects the heart. Use it in place of other oils for cooking and salad dressings.

Make sure that any amaranth oil you buy is extracted without chemicals. Many companies that use the oil for cosmetics extract the oil using hexane, a chemical similar to acetone. Hexane can be toxic and is linked to several cancers. I wouldn't use it internally or topically. Nu-World Foods is one company that uses no hexane or other toxins in its extraction in any of its organic amaranth products. Call them at 630-369-6819, or check their website, www.nuworldfoods.com to locate stores near you that carry their products. You may need to acquire a taste for their hot cereal/side dish, but their cold cereals are pretty good and don't get soggy.

Berger, A., et al. "Cholesterol-lowering properties of amaranth grain and oil in hamsters," Int J Vitam Nutr Res, February 2003.

Martirosyan, D.M., et al. "Amaranth oil application for coronary heart disease and hypertension," lipids Health Dis, January 2007.

Are You Protecting Your Knees From Osteoarthritis? These Tips Can Keep You Pain-Free

At least 300,000 people in this country have knee replacement surgery each year. Most people need this operation because their joints deteriorate from osteoarthritis. And women are twice as likely to have osteoarthritis in their knees as men. But did you know that most of them could have avoided surgery if they made a few changes in their daily routine?

That's right. Once you understand the causes and solutions to osteoarthritis in the knees, you can make a few changes and possibly avoid the pain and suffering that lead to a need for these surgeries.

There's a very good reason women have more knee problems than men – and it starts with our feet.

Your shoes may be the culprit

How often do you see men wearing high-heeled shoes? Never! But women wear them often. Are they part of the problem? Absolutely!

You may be able to wear shoes with high heels occasionally without consequences. But if you wear them consistently — or if you have in the past — you may be setting yourself up for painful knees. High heels put stress on the knees that can lead to arthritis. And they don't have to be exceptionally high, either.

A recent study found that heels that are just 1½ inches high increase the force on your knees enough to lead to permanent foot, ankle, knee, hip, or back problems. This pressure can lead to inflammation. And chronic inflammation causes a breakdown of cartilage in your knees, which is osteoarthritis. Measure your shoes today and buy at least one or two pair with heels that are one inch or lower to wear regularly.

You may think that narrow-heeled shoes are more likely to cause knee problems than wider heels. If you do, you're wrong. Wide heels are as hard on your knees as stiletto heels. They're just more comfortable and stable.

Shoes aren't the only problem

High heels are not the only reason women get so much osteoarthritis. Flat shoes can also cause strain on your knees if you slouch or if your body isn't in alignment when you walk. And poor alignment is a major cause of knee arthritis.

Your foot contains 26 bones and 33 joints. If movement in any of the joints is impaired, the result is increased force somewhere in the foot. This leads to stress from your feet to your knees, hips, back, and even your neck. So the idea is to align your body to reduce any stress on the joints in your feet.

Researchers say we should not block our foot's natural movements by wearing arch supports. Instead, they suggest lateral-wedge insoles — an insole that's thin at the instep and gradually increases to 5 degrees at the outside. This type of insole reduces twisting in your knees that can lead to inflammation and progress to arthritis. Talk with a good podiatrist to see if this is a possible solution for you.

The issue is alignment

Reducing pressure on your knees has everything to do with alignment. When your body is in proper alignment your feet are striking the ground in a way that reduces force on your knees. Your shoulders should be directly above your hips and ankles, rather than in front of them. When you walk with your shoulders forward, it puts additional pressure on your knees. It also throws you off balance.

When one or both of your feet turn in or out when you walk, this puts extra pressure on your knees. When your abdominal muscles lack tone, or if you slouch, your knees must handle increased force. If you're overweight, your knees are handling the extra weight.

I used to think that alignment meant standing up straight with my shoulders thrust back and my chest forward. If only it were that simple! Alignment includes flexibility, muscle strength, core stability (strong abdominal muscles), balance, and body awareness.

A physical therapist or a knowledgeable trainer at your local gym may be able to put you on a program that covers all of these areas. One or two types of classes or series of exercises are not enough to change your posture and align your body. You need them all. But if you can avoid the pain of arthritis every time you take a step, or keep your pain from progressing, you'll improve the quality of the rest of your life tremendously. Here are the steps you need to take.

Flexibility: Stretching your muscles regularly increases your range of motion. The greater your range of motion, the more likely you are to be able to stand, walk, and sit with the least amount of stress on any joints. But exercises to increase flexibility need to be tailored to your age and physical condition. Take a stretch class or do some stretching exercises regularly. I take a one-hour stretch class three days a week, and do exercises at home daily.

Muscle strength: Working out at a gym where you spend 30 seconds on each machine won't give you the results you want. You're better off using a book or DVD on weight training. Be sure to work all muscle groups. Look for a local YWCA, gym, or senior center with classes that use one- to five-pound weights and meets regularly. Your muscles need to be strong enough to hold your body in place with minimal effort. When you build muscle, you also burn more calories.

Core stability: Pilates is all the rage. It's a system of exercises that includes focus, breathing, and strengthening your abdominal muscles – your core. Exercises that strengthen your core should be done slowly and with control. They can be done on a mat, in a chair, on a machine called a Reformer, or with a giant inflatable ball.

Specific pilates exercises can help prevent knee problems. When the front of your thighs, your quadriceps, are weak, they put increased force on your knees and contribute to arthritis. Strengthening your quads can reduce this arthritis.

You can find more information on pilates in my article, "My Favorite Way to Prevent Falls," which appeared in the January 2006 issue. It's available on my website to all subscribers. Do only what's comfortable for you and get the best teacher you can find. I go to a number of classes each week that include pilates exercises.

Balance: Pilates helps your balance and alignment. So does Tai Chi and dance. Before I incorporated so many aspects of exercise into my weekly program, I pitched forward when I walked. Now I walk upright effortlessly. Part of my routine includes balancing exercises. They're included in my pilates classes. But I'm thinking of adding one Tai Chi class a week.

Body awareness: Your posture indicates how you approach life. If it's difficult for you to make decisions or meet people, your posture is likely to be caved in and your shoulders rounded. The ways in which you perceive relationships or situations affect the ways in which you move, how you walk, sit, and breathe. To change your posture — and enhance your life — the key is to release strain in joints and muscles. Breathing into these tight areas, or tightening and then releasing them, are several techniques you can use. Often, this information is included in stretch, yoga, Tai Chi, and other classes. If you can't find them in your area, look for a DVD that incorporates breathing work with exercising.

I go to my gym a lot: four days a week. Most people I know don't work out as much. But I've improved my posture and strengthened my abdominal muscles and the muscles in my legs gradually over the past three years. My alignment is better than ever. While my posture is not perfect, it's definitely improved. I'm no longer as round-shouldered as my mother. And it feels more natural to tighten my abdominal muscles and keep my shoulder blades down (not back), whether I'm sitting, standing, or walking.

The steps to take to avoid arthritis in your knees involve the input from other people. These can include a good podiatrist, exercise physiologist, or gym trainer. Invest your time and money in the best people you can find. I joined a local gym with a fantastic trainer and pay a small monthly fee for as many classes as I want to take. Look around. You may be able to find something similar.

If not, pick up Mary Bond's excellent new book, The New Rules of Posture (Healing Arts Press, 2007). It contains all the information you need to begin an effective anti-arthritis program.

Arch Phys Med Rehabil, 2002;83:889-893.

Godfrey, J.R., MS, RD. "Toward optimal health: D Casey Kerrigan, MD, discusses the impact of footwear on the progression of osteoarthritis in women," Journal of Women's Health, October 2006.

The Care and Feeding of Friendly Bacteria

If you've been reading this newsletter for very long, you know that probiotics are the friendly bacteria that live in your intestines and control your colonies of bad (pathogenic) bacteria. Probiotics support your immune system, help you fight bacterial infections, and improve your digestion. They've even been shown to increase the absorption of calcium and magnesium — minerals essential to bone and heart health.

Like me, you may be taking such probiotics as acidophilus and bifidus to enhance your gut health. But are you feeding them? If not, they may not be working optimally.

Like all other living things, probiotics need food. Their primary food, called prebiotics, consists of non-digestible sugar molecules called oligosaccharides. These sugars feed bifidobacteria in your large intestines without feeding pathogenic bacteria. There are a number of different kinds of oligosaccharides, but the primary ones found in this country are fructo-oligosaccharides and inulin.

Fructo-oligosaccharides (FOS) is the most well-known prebiotic. It's found naturally in fruits and vegetables, but they don't contain all you need. So many probiotic manufacturers add it to their formulas. But experts disagree about how much prebiotic is enough. Many say there's not enough in a probiotic supplement to do much good. Here's why:

As we age, our immune system weakens. This system protects us from colds and flu that can lead to respiratory infections, as well as cancer and other health problems. One of the most significant steps you can take to protect your health — at any age — is to strengthen your immune system. We know from scientific studies that FOS supports immunity, but you have to take one to two grams to get the support you need. That's a lot to fit into a pill with other ingredients. And research suggests it works best as a separate product.

Researchers in Chile took 60 healthy people aged 70 or more and gave them supplements including vitamins, probiotics, and FOS. What was different about these supplements were the probiotics and prebiotics. And they worked wonders.

All of the study participants were vaccinated against the flu and pneumonia. Then, over a period of a full year, the researchers measured their antibodies to these illnesses. The people who took all of the supplements had more antibodies — stronger immunity — than those who didn't take them. By the way, the vitamins they took were less potent than Vitality Plus, the formula I take and recommend.

While FOS is a good product, it's not my favorite. Much of the FOS on the market today, either added to probiotics or taken as a supplement, is made from sucrose, so many diabetics can't take it. And there are better, more natural, options, such as inulin.

Inulin is a naturally occurring oligosaccharide that feeds bifidobacteria in the large intestine. It's only one-third to one-fourth as sweet as sugar, which is why it's found in some prepared foods that are safe enough for diabetics to eat. You may even find it in some brands of yogurt. Inulin is used in foods to increase fiber and lower fats and sugars. In addition, it feeds friendly bacteria.

You can find inulin naturally in jicama, onions, Jerusalem artichokes, garlic, leeks, agave, bananas, and chicory root. You may want to add some of these inulin-rich foods to your diet to provide food for your healthy bacteria. But begin by eating small amounts to avoid intestinal gas.

If you prefer, you can use a prebiotic supplement. Inulin powder made from chicory root is available from NOW Foods in most natural food stores. You can add up to one teaspoonful to your foods or beverages.

Other oligosaccharides are used in Japan and Europe but haven't been approved for sale in this country as of yet. Soy oligosaccharides, isomalto-oligosaccharides, and lactosucrose are three forms of undigested sugar molecules sold in Japan as prebiotic supplements. I'll let you know when they become available here.

Some probiotics are stronger than others. A good probiotic needs to survive digestion in the small intestines and make its way into the colon where it attaches itself to the intestinal walls and colonizes. Prebiotics feed friendly bacteria in your large intestines and support your overall health.

Refined sugar feeds pathogenic bacteria. The more sugar you eat, the more prebiotics you need. Antibiotics, environmental toxins, and highly processed foods upset the balance of friendly bacteria. Avoid them as much as possible.

Take good quality probiotics. I've helped formulate and recommend a great probiotic from Advanced Bionutritionals. You can order it by calling 800-728-2288. You can read about other brands I found most effective on my website and in my new book, The Health Detective's 456 Most Powerful Healing Secrets. Don't forget to feed your friendly bacteria by taking a prebiotic supplement and by eating foods that contain them regularly. For best results, take one to two grams of a prebiotic supplement, such as inulin powder. The amount found in probiotic supplements is so small that it can't significantly support your friendly bacteria.

Bunout, D., et al. "Effects of a nutritional supplement on the immune response and cytokine production in free-living Chilean elderly," JPEN, September/October 2004.

Health Detective

I May Have Found the Ultimate Digestive Formula And You're the First to Hear About It

If you take supplements to improve your digestion, some of them probably are digestive enzymes. This makes sense, because digestive enzymes help break down protein, fats, and starches. As we get older, our bodies produce fewer enzymes. So it makes sense to take additional digestive enzymes if you have gas, bloating, or acid reflux. It's certainly better than taking antacids. Enzyme therapy is the Western approach to improving digestion. But there's more you can do.

Last November, I talked about using warming spices to gently encourage your body to make more digestive enzymes and stomach acids. This is an Eastern approach. It uses aromatic spices to improve digestion and help repair the digestive tract. Eventually, you may not need to take anything at all. I couldn't imagine a better approach. But my friend, Dr. Isaac Eliaz, could.

After we talked about the best possible digestive formula, he designed one that includes both Eastern and Western concepts. The result is Integrative Digestive Formula. This is a mixture of digestive herbs, minerals that reduce sugar cravings, digestive enzymes and medicinal mushrooms to strengthen the digestive tract, and botanicals that enhance the proper downward movement of digestive energy. If you have acid reflux, or if food just "sits" in your stomach too long, you know how important it is to get things moving.

Warming herbs can certainly be helpful at first. But over time they can create congestion and heat symptoms, such as acid reflux, constipation, and a burning in your stomach. Integrative Digestive Formula promotes healthy digestion throughout the entire digestive tract without the risk of future congestion. This means you can take it as long as you need it with only positive results.

I don't have the space here to give you all of the details about Integrative Digestive Formula. I will make sure that you get them shortly. But if you'd like to be one of the first people to try it, please call Advanced Bionutritionals at 800-728-2288.

What Should You Put on Your Potato?

Eating a salad with non-fat salad dressing and a baked potato may sound like a healthy meal, but it's not. Potatoes are high on the glycemic index — 76 out of 100 — which means that they turn into sugar quickly. When you eat foods with a GI under 50, you are more likely to have even energy and blood sugar, and avoid insomnia.

Fortunately, you can add one of many toppings to your potato that will drop its GI way down to 39. The fats and proteins in cheese, chili, baked beans, and tuna, when added to high GI foods like potatoes, pasta, and toast, all slow down their conversion from starch to sugar. This makes them safer to eat.

These toppings lower the GI of many carbohydrates because they are high in protein, fat, or both. So if you want to lower your risk for diabetes, or get to sleep more quickly, be sure to add a fat or protein to your high-carb meal.

Henry, C.J., et al. "The impact of the addition of toppings/fillings on the glycemic response to commonly consumed carbohydrate foods," Eur J Clin Nutr, June 2006.

Ask Dr. Nan

Q: I heard about a product called RESPeRATE that is supposed to considerably lower blood pressure. It's a device, cleared by the FDA, that teaches you to slow your breathing and relax constricted blood vessels. The exercise takes 15 minutes. Is it worth the $200 or so they're asking? And if it works like they say it does, can't you get the same results without the device? — D.McD, e-mail

A: The device you describe does seem to work according to a number of good studies published in hypertension journals over the past six years. The manufacturer built the device based on the theory that you can lower your blood pressure if you breathe slowly and regularly for short periods of time.

Many people find it easier to do these exercises with the help of a tool that guides them and gives them feedback. This particular device works by first analyzing your breathing rate and pattern. Then it creates a melody from two tones — one for inhaling and one for exhaling. It gradually increases the time between each tone, helping you breathe at fewer than 10 breaths a minute. This is the best therapeutic range.

Could you do this on your own? Probably. Will you do it every day? Maybe, if you're motivated and want to save the $299 (not $200) it costs. But if you can afford RESPeRATE, would use it daily, and want to lower your blood pressure by using something that has no side effects, give it a try. You can order it by calling 877-988-9388.

Grossman, E., A. Grossman, M.H. Schein, R. Zimlichman, and B. Gavish. "Breathing-control lowers blood pressure," Journal of Human Hypertension, 2001.

Q: I'm a healthy 69-year-old woman who has been taking bio-identical hormones for 13 years. I've had a thickened uterus for the past nine months. My gynecologist prescribed progesterone. It helped, but it caused four periods and the need for a D&C. Since I stopped hormones four months ago, the uterus lining is thickening again. Do you have any suggestions? — F.W., e-mail

A: I spoke with Dr. Cheri Quincy, a brilliant doctor of integrative medicine who specializes in bio-identical hormones. Her input may help you, and other women, find a solution. The problem with a thickening in the lining of the uterus is that it can lead to endometrial cancer.

First, begin by having your doctor look at your estradiol level. The hormones you're taking, while natural, may be too high for the progesterone to work. This thickening is more likely to occur with oral estrogen than with a topical product. If that's what happened, topical progesterone may not be strong enough.

If you want to continue taking hormones, you might consider having an endometrial ablation. This is a procedure where the doctor inserts a balloon-like device into the uterus. Then he or she fills the balloon with very hot water. The heat from the water cauterizes the endometrial layer. This means that estrogen can't stimulate the lining of your uterus. This procedure eliminates the endometrium without surgery. If you have no endometrium you can't get endometrial cancer.

Bio-identical hormones make sense for many women. But it's important to understand that we still don't have 20 or 30 years of data on any of its side effects. We don't even have 10 years of information. Take hormones only when nothing else will do the job. And please be monitored closely by a knowledgeable doctor.