In the United States, at least 30 percent of adults and as much as 10 percent of children older than 2 have NAFLD. With obesity as a common comorbidity, the prevalence of NAFLD has doubled in the last two decades and may soon surpass hepatitis C infection as the leading cause for liver transplantation in the U.S.

The Disease Spectrum

NAFLD is a non-specific title describing several variations of the disease with differing levels of severity. In simple NAFLD, there are no symptoms, only steatosis, which is an excess of triglycerides in the liver. As many as 30 percent of people with NAFLD will progress to non-alcoholic steatohepatitis, or NASH, a severe form of fatty liver characterized by inflammation. There often are no symptoms related to NASH, though some sufferers complain of fatigue or discomfort in the upper right abdomen. Many people with NASH go on to develop fibrosis or scarring of the liver. As fibrosis progresses, cirrhosis develops, which can lead to progressive chronic liver failure, liver cancer and death.

Risk Factors and Causes

NAFLD is more common in people who have obesity or Type 2 diabetes. At least half of people with Type 2 diabetes and approximately 90 percent of people with body mass indices of 35 or higher have some form of NAFLD. Insulin resistance is common among these conditions and often is expressed as metabolic syndrome.

NAFLD is widely considered the liver manifestation of metabolic syndrome. Insulin resistance leads to excess free fatty acids in the blood stream and increased fat deposition in the liver. Furthermore, metabolic abnormalities spur the liver to produce and store high amounts of fatty acids. Most people with NAFLD have at least one feature of metabolic syndrome, and about one-third have all five features: elevated blood sugar levels, high blood pressure, low HDL cholesterol levels, elevated triglyceride levels and increased waist circumference.

Additional risk factors for NAFLD include high cholesterol levels, polycystic ovary syndrome, sleep apnea and underactive thyroid. These conditions share risk factors and complications such as weight gain, inactivity, diabetes and poor diet.

Less common causes of NAFLD include medications, infections, genetic disorders affecting metabolism, malnutrition and rapid weight loss.

NAFLD Progression and Cardiovascular Complications

Progression of patients throughout the spectrum of NAFLD is not well-defined. Continued or worsening insulin resistance likely plays a role in the advancement of liver abnormalities, as do oxidative stress and inflammation. Zachary Henry, MD, assistant professor of gastroenterology and hepatology at the University of Virginia, notes that for most of his patients, as metabolic syndrome worsens, so does NAFLD. To make matters worse, the progression to NASH may cause a vicious cycle of increased insulin resistance and faster progression through the NAFLD spectrum.

Not all patients progress in a typical fashion. “There are subsets of patients that likely have a genetic predisposition to progress regardless of metabolic syndrome,” Henry says.

Heart disease is the top killer among people with NAFLD, especially for those who have progressed to NASH. It is unclear if this is an association related to metabolic disturbances or if liver abnormalities cause heart complications. Research suggests NAFLD may lead to heart disease by contributing to blood vessel dysfunction, systemic inflammation, oxidative stress, and worsening cholesterol and triglyceride levels.

Screening for and Diagnosing NAFLD

Screening starts with a blood test to measure liver enzymes, but diagnosis requires imaging of the liver, typically by ultrasound. Health care providers frequently order imaging tests for patients with elevated liver enzymes in the presence of high-risk conditions such as Type 2 diabetes, metabolic syndrome, obstructive sleep apnea and a BMI of 35 or higher. However, the disorder likely is under-diagnosed because many patients with NAFLD have normal liver enzyme levels. Henry favors imaging everyone at high risk, but because this puts a heavy burden on the health care system, many providers order diagnostic procedures only when liver enzymes are elevated.

A liver biopsy is necessary to learn if a patient has simple steatosis or if the disease has progressed to NASH, fibrosis or cirrhosis. Under a microscope, the sampled liver tissue looks identical whether the patient has fatty liver from alcohol consumption, insulin resistance or some other reason. The diagnosis of NAFLD is made by ruling out excessive alcohol intake.

Treatment of NAFLD

There currently are no FDA-approved medications for treating NAFLD. The treatment trifecta is weight loss, healthful eating and physical activity — the same lifestyle interventions that treat other conditions associated with insulin resistance.

Inspiring difficult lifestyle changes for a condition without symptoms is challenging, but early intervention can prevent progression and even reverse NAFLD, says Kristin Kirkpatrick, MS, RD, LD, manager of Wellness Nutrition Services at Cleveland Clinic and author of Skinny Liver (Da Capo Press 2017). The key, she says, is to learn what motivates each individual and to focus on comorbid conditions such as elevated blood sugar levels.

WEIGHT LOSS. As with other conditions related to insulin resistance, even moderate weight loss improves NAFLD. At the University of Virginia Health System, Mary Lou Perry, MS, RDN, CDE, works with a multidisciplinary team to encourage healthful lifestyle habits and weight loss of 7 percent to 10 percent of starting weight. Perry notes that the degree of improvement is proportional to the amount of weight lost. However, rapid weight loss of more than 3.5 pounds weekly, with its greater flux of fatty acids to the liver, may worsen inflammation in NASH and accelerate disease progression.

HEALTHFUL EATING. Research has not identified an ideal diet or macronutrient distribution for the treatment of NAFLD. Thus, following recommendations of the 2015-2020 Dietary Guidelines for Americans is reasonable. One option gaining traction among health professionals is a Mediterranean-style diet. In a small crossover study, a Mediterranean-style diet produced greater reversal of both insulin resistance and liver fat content compared to a low-fat, high-carbohydrate diet even without a change in weight.

The following food items deserve special attention because they affect the progression of the disease or because patients frequently ask about them:

Alcohol: Moderate alcohol intake is associated with less heart disease and greater insulin sensitivity. However, it is unknown if these benefits extend to patients with NAFLD or if small amounts of alcohol are harmful. The American Liver Foundation and some physicians advise people with NAFLD to completely avoid alcohol. In the absence of clear guidelines, patients with NAFLD should adhere to the American Heart Association’s defined daily limits of one drink for women and two drinks for men.

Coffee: Limited data suggests coffee consumption may reduce the severity of NAFLD through anti-inflammatory and antioxidant properties.

Green tea: With its rich polyphenol content, researchers propose that drinking green tea may improve NAFLD. However, there have been no randomized controlled studies in humans.

Sugar-sweetened beverages: Research suggests drinking sugary beverages is associated with greater risk of NAFLD.

Dietary supplements: There is little evidence for the use of dietary supplements in treating NAFLD. Vitamin E shows some promise, but other studies link vitamin E supplements to increased mortality. Although some people may try unproven therapies such as milk thistle and green tea extract, unsupervised dietary and herbal supplements cause 20 percent of liver toxicity cases.

PHYSICAL ACTIVITY. Both cardiovascular exercise and strength training improve insulin resistance and NAFLD. Without clear exercise guidelines for this condition, it is prudent to work toward federal recommendations of achieving at least 150 minutes of moderate-intensity aerobic activity and two full-body strength training sessions weekly.

This vegan dessert omits ingredients that were rationed during World War I: butter, milk and eggs.

Servings: 16
Serving size: 1 2-by-2-inch square (50 grams)
Prep time: 15 minutes
Cooking time: 40 minutes

Ingredients

• 1 cup all-purpose flour
• ½ cup whole-wheat flour
• ¼ cup unsweetened cocoa powder
• ½ teaspoon salt
• 1 cup granulated sugar
• 1 teaspoon baking soda
• 1 tablespoon (15 milliliters) apple cider vinegar
• 1 cup (240 milliliters) water
• 1 teaspoon (5 milliliters) pure vanilla extract
• ⅓ cup (80 milliliters) canola oil
• ⅓ cup dark chocolate chips

Instructions

1. Preheat oven to 350°F (177°C).
2. In a large bowl, whisk together all-purpose and whole-wheat flours, cocoa powder, salt, sugar and baking soda.
3. In a separate small bowl, stir together apple cider vinegar and water.
4. Make a well in the center of the dry ingredients and pour in vanilla extract and oil.
5. Drizzle the vinegar-water mixture over the dry ingredients and stir to form a smooth batter.
6. Add chocolate chips and stir to combine.
7. Pour batter into an oiled 8-by-8-inch baking dish. Bake for 35 to 40 minutes, until cake is set and a toothpick inserted in the center comes out clean.
8. Transfer the baking dish to a wire rack and allow the cake to cool.
9. Slice into 16 squares and serve.

Nutrition per serving: CALORIES 151; TOTAL FAT 6g; SAT. FAT 1g; CHOL. 0mg; SODIUM 159mg; CARB. 24g; FIBER 1g; SUGARS 13g; PROTEIN 2g; POTASSIUM N/A; PHOSPHORUS N/A

Note: Nutrition information for potassium and phosphorus in dark chocolate chips not available.

Known in France as “poor man’s asparagus,” leeks have a classic role as a stock and soup enhancer but also can add flair as a garnish and star as a featured ingredient. Leeks have a unique flavor, texture and gelling quality that can be central to the success of a dish, making them preferable to onions, shallots or scallions in certain applications.

Available year-round, leeks have seasonal peaks in summer and winter. Wild leeks, or ramps, are available primarily in April and have an intense, garlicky flavor, but they are a different species than cultivated leeks. When purchasing leeks, look for a white base, firm stalk and supple, smooth green leaves. Large leeks with more dense fibers require more time to cook, so select similar-sized leeks for consistent cooking.

Leeks in the Kitchen

While leeks cook quickly, like many leafy green vegetables, they require some effort to clean. Leeks are known as “dirty” vegetables due to trenching, a technique for piling soil around the base of the stalk to blanch it white, which then traps grit between layers as the stalk grows.

To clean a leek, remove roots and tough outer leaves, then cut the stalk in half lengthwise and run water through the layers or swish the halves in a bowl of water.

Heat quickly turns leeks silky, making them ideal in gratins, frittatas and soups such as vichyssoise (see recipe). Gently sauté leeks in butter for a fondu (French for “melted”) texture for side dishes or poultry and fish toppings. Leeks are a must in French dishes such as pot-au-feu soup, flamiche (leek pie) or poireaux vinaigrette (leeks with a warm vinaigrette).

Stews, soups or stocks thicken when leeks are added as an ingredient or as a bouquet garni flavor bundle (leek leaves wrapped around thyme, parsley and bay leaves.) When cooked, leeks develop a slippery texture that gels when cooled, adding body to liquids.

Other ways to cook leeks include slicing them into strips to pan fry or sauté for a crispy garnish on soup, pizza or fish; charring or grilling whole leeks to serve halved and stuffed; or braising them for tender centers with crispy edges.

Mince the tender white base of leeks to make a sweeter and more subtle replacement for shallots in a vinaigrette. Cabbage-like flavors may be perceived in the greener sections and inner stalk where the strongest flavors are concentrated. Like onions, leeks have sulphur-containing amino acids that contribute “meaty,” savory flavors to dishes.

Leeks in the Clinic

Leeks often are used more for their tender, sweeter white sections than for their leafy greens. Despite its white-green appearance, choosemyplate.gov categorizes the leek as a dark green vegetable. The greener sheaths contain a more concentrated amount of diverse flavonoids such as kaempferol. Some epidemiological studies link kaempferol with reduced risks of developing multiple cardiovascular diseases and cancer.

A one-cup serving of raw leeks is an excellent source of vitamins K and A, and a good source of folate, iron, and vitamins B6 and C. Like other green vegetables, leeks contain carotenoids including lutein, which is linked to healthy eyesight and protecting the macula and cells from free radicals.

Leeks in Quantity

Cleaned, cut and frozen leeks are available for foodservice use, but freezing compromises flavor and textures. While frozen leeks are not ideal for cooked dishes or garnishes, they do work well for making stock.

Unlike onions and garlic, leeks require refrigeration for storage. Untrimmed and unwashed leeks can be stored in the refrigerator for up to two weeks; cooked leeks should be eaten within a couple of days.

More than 8,000 varieties of apples are grown worldwide, with about 2,500 cultivated in the United States and 100 of those grown on a commercial scale. Almost all apple trees today don’t actually come from seeds, but rather from a process called grafting, since most seeds will not produce the same apples from which they came.

When it comes to nutrition, there is some truth in the saying “an apple a day keeps the doctor away.” An unpeeled apple, that is. With the majority of its nutrients found in the skin, an apple is a good source of dietary fiber and vitamin C.

Typically in peak season from late August to October, apples are available year-round across the country. When purchasing apples, look for a smooth skin free of bruises, with a bright color and shine. Prolong shelf life by storing fresh apples in a plastic bag in the refrigerator or in a cool, dark place. Apples left on a countertop or table will ripen faster and should be consumed within a few days.

Because apples produce the natural gas ethylene, they can cause other fruits to ripen faster. Place a ripe apple with unripe fruits or vegetables in a brown paper bag and seal it. After a day or two, open the bag to see if the fruit or vegetables have ripened.

Every variety of apple has a distinct taste, color and texture. While some are considered “all-purpose” apples, good for snacking or cooking, others may be better suited for different culinary applications.

Red Delicious

Originally known as the Hawk Eye, the Red Delicious hails from Iowa and is known for its deep red color and tall stature. It has a mild sweetness with a crisp, juicy texture and tough skin. The Red Delicious is best eaten on its own or chopped in salads.

Braeburn

Originally from New Zealand, the Braeburn is undeniably crisp with a balance of sweet and tart flavor. Its skin is pale green with red and orange streaks. Braeburns can be eaten fresh, baked whole or used in tarts or applesauce.

Granny Smith

This Australian-born variety gets its name from Maria Ann “Granny” Smith, who discovered it in 1868. The Granny Smith has a thick and shiny green exterior, with a puckering sour taste. Its firm, crisp and juicy texture is ideal for baking into pies and sauces.

Gala

This New Zealand variety has quickly become the second most popular apple in the United States. Gala has a waxy reddish-yellow skin and golden flesh, with a snappy, tart flavor. Gala is an all-purpose apple, making it a good choice for eating and cooking.

Pink Lady

Also known as Cripps Pink, the Pink Lady is from Australia. Its pink exterior is speckled with white freckles and has a sweet-tart and almost tropical flavor. Resistant to browning when cut, Pink Lady apples are great for salads or cooking.

Honeycrisp

Originally from Minnesota, this variety is pink-red in color with juicy flesh. With a mild, sweet flavor and an undeniable crunch, Honeycrisp apples are best when eaten fresh or dried and often are used in baking.

McIntosh

Although it originated in Canada, the McIntosh has become the quintessential New England apple. Its texture is crisp and juicy at its peak, but it quickly softens. With skin that is bright red mixed with varying amounts of green depending on ripeness, McIntosh apples can be eaten fresh from the tree or used to make cider and sauces.

Fuji

This barrel-shaped apple originated in Japan but is now enjoyed worldwide, especially for snacking. It has a yellowish-red skin striped with pink accents, a crisp and juicy texture, and a sweet, fruity flavor.

Jonathan

Hailing from New York, the Jonathan apple has a ruby-red exterior with gold spots, a spicy scent and a sweet-tart taste. Jonathan apples hold up well in baking, making them perfect for pies.

Golden Delicious

The Golden Delicious apple has soft, yellow skin speckled with brown spots. It has a mostly sweet, almost melon-like flavor and crisp texture. The Golden Delicious is an all-purpose apple, ideal for snacking or cooking.

Empire

Named for its home state of New York, the Empire is a cross between the McIntosh and the Red Delicious. Its shiny, red skin and sweet taste make it one of the top picks in the U.S. Best eaten fresh, Empire apples’ crunchy texture fades fast with prolonged storage.

Instead of drawing water and nutrients from soil, hydroponic produce is grown with the roots submerged in nutrient-fortified water. Aeroponics is a related method in which the roots hang in the air and are regularly misted with water and nutrients.

One benefit of hydroponic farming is that it allows large amounts of produce to be grown on a relatively small piece of land and in places where traditional farming would be untenable, such as urban centers, or limited by geography and weather, such as in Alaska.

Hydroponic growers help satisfy demand for local produce in areas that are not well-suited for traditional farming. But even in farm-friendly regions where rain and sun are plentiful, storms, heat waves and unexpected freezes can cause unpredictable and costly crop losses, to which indoor farmers are largely immune.

Hydroponic crops also are less susceptible to weeds, insects and other pests, which means the plants can be produced without herbicides and pesticides.

All this has made hydroponics one of the fastest growing sectors of the agriculture industry, with more traditional growers investing in hydroponics as a supplement to existing operations or switching over entirely.

Another potential advantage of hydroponic farming is the degree of control the grower has over the conditions to which plants are exposed and the ability to precisely replicate those which produce better results.

However, not every plant does equally well in hydroponic growing conditions, at least with current technology. Lettuce and other leafy greens, herbs, tomatoes, peppers, cucumbers and strawberries are the most commonly grown hydroponics.

Hydroponic operations, which often use sophisticated water recycling systems, may use up to 90 percent less water than traditional farming, depending on the location. While traditional farms in water-stressed areas rely heavily on irrigation and use far more water than hydroponics, other areas get most of their water from rain.

Some hydroponic growers also rely on electric grow-lights instead of the sun. This allows growers to artificially extend the length of the day and manipulate light wavelengths to increase yield and productivity year-round.

Not having to till and plow fields can reduce the amount of greenhouse gasses associated with crop production. However, the overall carbon footprint of a food depends on additional factors, such as the distance it is transported after harvest, which complicates comparisons of environmental impact between hydroponically and soil-grown crops.

How Do Hydroponics Compare Nutritionally?

Comparing the nutritional content of hydroponic and soil-grown produce is challenging, and research involving direct comparisons is limited. Both traditional and hydroponic farmers can influence the nutritional content of produce by adding nutrients to the soil or growing medium. But the nutritional composition of a fruit or vegetable also depends on the particular cultivar or variety, the degree of ripeness when harvested and the storage period after harvest.

With hydroponics, there is no danger of plants absorbing heavy metals that may be in the soil. On the other hand, growing vegetables in soil may yield benefits that we don’t yet fully understand. Raw produce can be a source of beneficial probiotic soil-based bacteria, for example. Although it’s not yet clear to what extent this can be replicated indoors, commercial hydroponic growers are experimenting with techniques that foster a healthy and diverse microbiome.

What about Flavor?

Although you may think sun and soil are essential for good flavor, the factors that influence flavor — including air temperature, humidity, the amount and color spectrum of light-nutrient availability and moisture — can be precisely controlled and more reliably replicated in a hydroponic environment.

As with nutrient content, the flavor of produce depends on the variety and freshness, as well as growing conditions. “We can breed for flavor, texture and nutrition instead of mold resistance, pest resistance or shelf life,” says Alina Zolotareva, RDN, marketing manager for AeroFarms, an aeroponic grower of salad greens in Newark, N.J. “And because hydroponics can move the farms to the people, it can give people access to fresher produce.”

But the hydroponic produce at a local grocer isn’t necessarily grown locally. Although hydroponics make it possible to grow fruits and vegetables anywhere, the largest hydroponic growers in the U.S., accounting for about half of hydroponic sales, are clustered in Pennsylvania, California, New York, Vermont and Wisconsin.

The Organic Debate

Because hydroponically grown fruits and vegetables can be produced without the use of pesticides or herbicides, many hydroponic growers are pursuing organic certification, which allows produce to be sold at a higher price point. But many traditional organic farmers are crying foul.

“[Hydroponics] is a really efficient model of production,” says Mark Kastel, co-founder of The Cornucopia Institute, a public interest group supporting sustainable and organic agriculture. “If unchecked, hydroponics could squeeze out traditional organic farmers to the extent that consumers wouldn’t really have the option to buy soil-grown organic produce.”

“Allowing hydroponic produce to be certified as organic is completely contrary to the values of the organic movement,” Kastel says. “Improving and maintaining the health and biodiversity of soil is one of the core principles of organic growing. How can you be stewarding the soil if there is no soil?”

Proponents of organic hydroponics argue that hydroponic systems are aligned with the principles of stewardship, conservation and environmental harmony outlined in the Organic Foods Production Act of 1990. They also view new technology, such as hydroponics, as essential to meeting the demand for organics.

In 2010, the National Organic Standards Board, or NOSB, a federal advisory board, petitioned the United States Department of Agriculture to make hydroponically grown vegetables ineligible for organic certification, a recommendation that the USDA has so far declined to adopt.

“The USDA has made it clear that hydroponics will be allowed to be certified organic,” says Nate Lewis, farm policy director for the Organic Trade Association. “At the very least, we’d like to see a rule that requires hydroponically grown vegetables to be labeled as such.”

In April 2017, the NOSB convened and discussed potential recommendations it would provide the USDA for organic certification of hydroponic systems. No decisions were made, and the Crops Subcommittee will be developing a proposal on this topic for a meeting in the fall.

The classic deviled egg gets a flavor makeover with sun-dried tomatoes, basil and a crunchy breadcrumb topping.

Servings: 6
Serving size: 2 egg halves (75 grams)
Prep time: 20 minutes
Cooking time: 25 minutes

Ingredients

• 4 cups (950 milliliters) water
• 6 large eggs
• ⅓ cup nonfat plain Greek yogurt
• 2½ tablespoons chopped smoked sun-dried tomatoes (not in oil), divided
• 1 teaspoon Dijon mustard
• 1½ tablespoons chopped fresh basil leaves, divided
• ¼ teaspoon fine table salt
• ⅛ teaspoon freshly ground black pepper
• ½ teaspoon extra-virgin olive oil
• 2 tablespoons seasoned breadcrumbs

Instructions

1. In a large saucepan, add water and eggs and bring to a boil over high heat.
2. Remove saucepan from heat, cover and let stand for 15 minutes (add 2 minutes if the eggs were not room temperature).
3. Rinse eggs under cold water and peel off shells.
4. Cut each egg in half, separate the whites from the yolks and place each white on a plate and all yolks in a small bowl.
5. To the bowl of yolks, add yogurt, 2 tablespoons sun-dried tomatoes, mustard, 1 tablespoon basil, salt and pepper. Stir until creamy.
6. In a small skillet over medium heat, add oil and breadcrumbs. Stir until breadcrumbs are lightly browned and toasted.
7. Remove from heat and set aside.
8. Fill each egg with approximately 1½ tablespoons of yolk mixture.
9. Garnish with a small piece of sun-dried tomato and sprinkle with basil and toasted breadcrumbs.

Note: This recipe can be made up to 24 hours in advance, but do not add garnish and breadcrumbs until ready to serve.

Nutrition per serving: CALORIES 92; TOTAL FAT 5g; SAT. FAT 1g; CHOL. 164mg; SODIUM 265mg; CARB. 4g; FIBER 1g; SUGARS 2g; PROTEIN 8g; POTASSIUM N/A; PHOSPHORUS N/A

Note: Nutrition information for potassium and phosphorus in Dijon mustard not available.

According to the American Psychological Association’s 2017 Stress in America survey, 80 percent of Americans experienced at least one physical or emotional symptom of stress within the previous month, such as headache (34 percent), feeling overwhelmed (33 percent), nervousness or anxiety (33 percent) and depression (32 percent).

However, adults also are significantly more likely to recognize the connection between stress and physical and mental health than in previous years — and 36 percent identify stress reduction as a personal priority.

Among myriad anti-anxiety treatments, including behavioral therapy, medication and other therapies, is one of the current darlings in wellness circles: adaptogens.

The use of herbs for maintaining balance in the midst of a variety of stressors has been a healthy lifestyle tenet in Eastern Chinese medicine and Ayurveda for centuries. However, the notion that some herbal plants may help alleviate chronic stress has existed in Western medicine for about 60 years, when midcentury researchers defined adaptogens as nontoxic compounds with many mechanisms of action and pharmacological effects related to adaptability and survival.

The theory is that adaptogenic compounds affect several key mediators of the adaptive stress response both inside and outside cells, thus having a broader spectrum of action than traditional medications that target one symptom or disease.

For instance, adaptogens are characterized as eustressors, or “good stressors,” that induce stress-protective responses. By stimulating the expression and release of mediators of the adaptive stress response, adaptogens may help increase the body’s tolerance to stress.

With chronic stress being linked to adverse health effects such as cognitive, emotional and behavioral dysfunctions, as well as increased inflammation in the body potentially leading to cardiovascular disease, diabetes, cancer, autoimmune syndromes and mental illnesses, alleviating or limiting ongoing stress is vital for overall, long-term health.

This is where adaptogenic plants may play a therapeutic role, as they have been found to normalize chronically increased cortisol and corticosterone — stress hormones that have been linked to anxiety, depression, digestive troubles and other chronic stress issues.

However, the National Institutes of Health National Center for Complementary and Integrative Health emphasizes caution with using herbal remedies due to limited scientific evidence.

Currently, there are about 70 herbal plants cited in literature with adaptogenic properties, including ginseng, Rhodiola Rosea and maca root. Two of the most popular adaptogens are tulsi and Ashwagandha root.

Also called “holy basil,” tulsi is revered in Ayurvedic medicine as the “elixir of life.” This peppery-tasting herb sometimes is called “hot basil” and is used in stir-fry dishes and spicy soups. Tulsi is used as a treatment for a range of conditions including anxiety, asthma, diarrhea, fever, arthritis, eye diseases and indigestion.

In vitro, animal and human studies reveal tulsi may have therapeutic actions, including adaptogenic, antimicrobial, anti-inflammatory, cardio-protective and immunomodulatory effects. A 2017 review in the journal Evidence-Based Complementary and Alternative Medicine examined 24 studies to assess the clinical efficacy and safety of tulsi and found positive clinical outcomes with no adverse effects. Although these results reinforced the efficacy of tulsi for treating diabetes, metabolic syndrome and psychological stress, further studies are needed to determine its mechanism of action, dosage and dose form, as well as populations that may benefit from it.

The Natural Medicines Comprehensive Database lists holy basil as “possibly safe when used orally, short-term.” The database notes some preliminary research on its effectiveness in reducing anxiety, blood sugar control and decreased symptoms of stress, but more evidence is needed in these areas. There is some evidence that holy basil extract can be used safely for up to six weeks; however, the database advises against use during pregnancy and lactation due to lack of reliable information.

Commonly called “Indian Ginseng” or “Winter Cherry,” the adaptogenic herb Ashwagandha root is named for its odor. This herb emits the smell of horse — which is the literal translation of “Ashwagandha”— and consuming its extracts is said to give people strength and vitality similar to that of a horse.

Known as the “royal herb” in Eastern medicine, Ashwagandha is the most commonly used and studied adaptogen, although human studies are limited and Ashwagandha is not listed in the Natural Medicines Comprehensive Database.

In a 2012 study on the safety and efficacy of Ashwagandha root for reducing stress and anxiety in adults, participants who took 300 milligrams of a high-concentration, full-spectrum extract of Ashwagandha root twice daily for 60 days experienced a significant reduction in stress and cortisol levels. No serious side effects were reported, and researchers concluded Ashwagandha root safely and effectively improved study participants’ resistance toward stress and improved self-assessed quality of life. However, further longterm research using a larger population with varying degrees of physical and psychological stress is needed to determine the effects of Ashwagandha root on stress resistance.

Although the available human research on adaptogens shows potential for alleviating symptoms associated with stress, more studies are needed to determine their efficacy and the range of interactions between adaptogens and stress response pathways in preventing chronic stress and age-related disease — as well as their role in exercise recovery.

As always, a thorough health and nutrition assessment by a physician and registered dietitian nutritionist is necessary, along with supporting evidence, for individualized nutrition recommendations involving botanicals or herbal remedies.

Also called food or cooking thermometers, kitchen thermometers are available in analog and digital varieties for meat, candy and a variety of other foods. Newer Wi-Fi enabled “smart” versions, which send a notification via phone when food is ready, can cost $200 or more. For a less expensive option, get a simple analog meat thermometer for about $10 or an all-purpose “instant read” digital thermometer for $30 to $100.

When selecting a kitchen thermometer, consider the foods you cook most often. A “dial” meat thermometer does not require batteries and has markings to indicate safe internal cooking temperatures for beef, poultry and pork. Most meat thermometers can be placed into raw food and left until done cooking. Meat thermometers also can be used for re-heating soups, stews and casseroles to ensure they have reached a safe temperature.

To use a meat thermometer, place the probe in the thickest portion of the food and stay away from bones, fat and gristle. For irregular-shaped foods such as egg dishes and casseroles, check the temperature in several locations to ensure consistent overall heating.

Candy thermometers, which do not have a metal probe, are a necessity for candy makers and for home cooks who do a lot of deep-frying. Clip a candy thermometer to the side of a pot or pan before heating food. This is especially important with a glass thermometer, as extreme temperature shock may cause it to break. Make sure the bulb does not come in contact with the bottom of the pan, which will result in a false temperature reading.

If you want only one thermometer, an “all-purpose” digital instant read or thermocouple thermometer is the best choice. Look for three key features: length (the longer the better), grip (choose one that feels secure in your hands) and visibility (opt for a large display with a screen on the side, rather than on the top, for better readability from different angles).

Deluxe thermocouple thermometers with a fast read time of 2 to 5 seconds sell for about $70 to $100, while less expensive yet highly rated versions with read times of fewer than 10 seconds sell for about $30. A disadvantage of thermocouple thermometers is that they cannot be left in food while cooking.

No matter the type, kitchen thermometers should be calibrated regularly using ice water or boiling water to ensure accuracy. To clean a kitchen thermometer, wash it with hot, soapy water after each use and store it in a case so no one gets poked when rummaging through the kitchen drawer.

Enjoyed in the early 20th century, this egg-and-potato-based breakfast met challenges of wartime conservation efforts while repurposing the waffle iron.

Servings: 2
Serving size: 2 4-inch square waffles
Prep time: 35 minutes
Cooking time: 10 minutes

Ingredients

• 2 extra-large eggs
• ⅓ cup part-skim ricotta cheese
• 1 tablespoon finely diced shallots
• ½ teaspoon minced garlic
• 2 teaspoons finely chopped fresh parsley
• ⅛ teaspoon salt
• ½ cup peeled and shredded white potato
• ½ cup finely diced Red Delicious apple with skin

Instructions

1. Break eggs into a small bowl and beat with a whisk.
2. Add ricotta and incorporate with the whisk, followed by shallots, garlic, parsley and salt. Whisk well.
3. Lightly oil an 8-inch square waffle maker with cooking spray. Preheat waffle maker (use medium-high setting, if available).
4. Stir potatoes and apples into egg mixture.
5. Pour mixture onto preheated waffle maker, spreading evenly to the edges.
6. Close lid and bake until eggs are set and golden brown, about 10 minutes. Serve immediately.

Nutrition per serving: CALORIES 180; TOTAL FAT 8g; SAT. FAT 4g; CHOL. 196mg; SODIUM 249mg; CARB. 15g; FIBER 2g; SUGARS 4g; PROTEIN 12g; POTASSIUM 296mg; PHOSPHORUS 195mg

Although garlic is delicious and full of health-promoting nutrients, its lasting, pungent odor can make it a pain in the kitchen. When garlic is crushed or chopped, its essential oils are released and can be tough to wash off hands. These oils also permeate lung tissue, which is why garlic breath and sweat can last hours after eating.

Buying peeled or pre-minced garlic is one way to avoid garlicky hands, but why spend extra money and sacrifice flavor? Instead, use these tips:

Standard method: Cut the end of the clove and peel with your fingers from the cut part, starting at the woody ends (not the tapered tip). Often you can roll the skin right off without too much mess. Best if peeling only one clove.

Knife method: Place a garlic clove on a flat surface, then gently press (or smash, if minced garlic is your end goal) with the broad side of a knife. This should “crack” the woody exterior and make it easy to peel with your fingers. Best for peeling one or two cloves, as finger-peeling will eventually get messy.

Microwave method: By far the easiest and cleanest method, place any number of bulbs in the microwave and heat for 10 to 20 seconds. Carefully remove, since they will be hot, and the bulbs will slip right out of the skins. Best for recipes calling for multiple cloves.

Gadget method #1 – a silicone garlic peeler: Place a clove inside the tube, roll on a flat surface to gently loosen the peel, then tilt the tube to release the bald clove. The peel stays stuck to the inside of the peeler, which you can simply rinse away. Requires practice, as some cloves come out half-skinned. Best for peeling one or two cloves.

Gadget method #2 – a garlic press: You don’t always need to peel the garlic first. Simply take a clove of garlic and press it to mince. The garlic juices and flesh push through, but the skin is left behind. Best to use if crushing is your end goal. Some garlic presses are not well-suited for this method.

There’s no easy trick to stop garlic pieces from sticking to the side of the knife when chopping. To keep the mess at a minimum, chop, slide garlic off, then chop some more until pieces are the desired size.

Want more ways to use garlic in the kitchen? Check out “Healthy Kitchen Hacks: Garlicky Goodness”

To see the entire Healthy Kitchen Hacks series, click here. 

Definition

Color additives, including food dyes and pigments, are substances derived from both synthetic and plant, animal or mineral sources that add color to food. The objective is to enhance natural colors, add color to otherwise colorless foods, compensate for natural color variations and help identify flavors (such as yellow for lemon).

Functions, Names and Labeling

Synthetic color additives were developed to maintain hue and depth of color regardless of pH, temperature or presence of other ingredients. Synthetic colors are classified as “certifiable colors,” as they require U.S. Food and Drug Administration testing and certification each time a new color batch is used. Certifiable color additives are man-made and derived primarily from petroleum.

The nine FDA-approved “certifiable colors” include:

FD&C (FDA approved for Food, Drugs & Cosmetics) Blue No. 1, Blue No. 2, Green No. 3, Red No. 3, Red No. 40, Yellow No. 5 and Yellow No. 6; Orange B (only for use in hot dog and sausage casings) and Citrus Red No. 2 (only for use to color orange peels).

Other color additives derived from sources such as fruits, vegetables, insects and minerals are “exempt” from batch testing and certification, but they still must adhere to safety standards and regulatory requirements. Examples include grape skin extract, saffron, and fruit and vegetable juices. Some people may call these color additives “natural.” However, the term “natural” is not regulated or defined by the FDA, and the FDA objects to the term’s use in products containing added color, whether from certifiable or plant- or mineral-derived colorants.

Certifiable colors must be declared on food labels by the name of the additive, with at least the color and number (such as “Blue 2”). Other color additives may be declared as “Artificial Color,” “Artificial Color Added” or “Color Added,” or by an equally informative term such as “Colored with Fruit Juice” or “Vegetable Juice Color.” Carmine and cochineal extract color additives must be declared on labels because some people are allergic to these substances.

The ability to replace synthetic with plant- or mineral-derived colorant compounds depends on and varies with the pH and temperature of the food or beverage. Certifiable colorants may be preferable when the color needs to be vibrant, stable for long periods of time or when a specific color cannot be achieved with plant- or mineral-derived options.

Oversight

The FDA oversees all color additives, which must be approved for use in food, dietary supplements, drugs and cosmetics, and includes ongoing review of scientific evidence on the safety of their use. In addition, the FDA sets specifications and limitations for types of foods to which each color additive may be added, maximum amounts allowed in foods and how they must be identified on labels.

Color additives are regulated a little differently than other additives. “Because of the potential to deceive consumers about quality or safety of food, color additives require proof of safety during the authorization procedure and cannot be registered as ‘generally recognized as safe,’ exempt from FDA approval,” says Kantha Shelke, PhD, CFS, principal at Corvus Blue, LLC, and adjunct faculty in food safety regulations at Johns Hopkins University.

Safety

Despite additional layers of oversight, some consumers are concerned about the safety of food dyes. The FDA asserts color additives are thoroughly evaluated prior to approval and safe when used in accordance with regulations. However, over the years, many colors — including yellows 1, 2, 3 and 4 — have been banned due to adverse health effects. Color additives that have been found to cause cancer in animals or humans may not be used in FDA-regulated products marketed in the U.S.

Scientists have examined the relationship between food coloring and hyperactive behavior in children with mixed results.

“The FDA has reviewed and will continue to examine the effects of food dyes on children’s behavior,” says Andrew Zajac, PhD, director of the Division of Petition Review in FDA’s Office of Food Additive Safety. “The totality of scientific evidence indicates that most children have no adverse effects when consuming color additives, but some evidence suggests that certain children may be sensitive to them.”

Adverse reactions to color additives are estimated to be quite rare overall, even among people with allergies. Research is limited in this area, and there is no scientific evidence to support a link between exposure to artificial coloring and allergies.

That said, some experts think color additives are completely unnecessary. “It’s better to color food with colorants from food sources or add no color at all than to use synthetic color additives without the benefit of long-term safety studies,” says Virginia Tech food science professor Sean F. O’Keefe, PhD.

Whether in response to mounting evidence or ongoing consumer concern, many companies around the world have begun eliminating food dyes from some or all of their products. The British government now requires warning labels on most foods containing color additives, which has led to the reformulation of many products.

Final Thoughts

There is a growing trend to replace synthetic colors with plant- or mineral-derived compounds. These are assumed to be safer, but without regulation of the term “natural” and without being batch tested or certified, plant- and mineral-derived color additives are not a panacea.

“It is essential that all colorants be tested with the same rigor, something not always done with ingredients such as fruit extracts that bestow a false sense of safety because they are derived from familiar plants and foods,” Shelke says.

Color additives, which confer no health or nutritional benefit, are unlikely to be dangerous for most people. For those wishing to avoid color additives, helpful strategies include reading food labels and eating more foods that are minimally processed.

Synopsis of the App

Yoga Wake Up lets you wake up to the sound of yoga or meditation with gentle routines that can be performed from the comfort of the bedroom or even in bed.

Platform and Price

Free, in-app purchases. Apple only.

RDN Score:

5 out of 5

 Pros

• Colorful and calming design that’s easy to navigate.
• Sync with the Apple Health app to share mindful movements, yoga practice time and sleep information.
• Select meditations and yoga sessions to wake up to.
• Variety of instructors to reduce monotony and an increased chance of finding a good-fit personality.
• Learn more about the instructors by clicking the link on each session or from the homepage.
• Search for wake-ups by category including ”from bed,” “for kids,” “meditations,” and “popular.”
• Active community sharing recipes and other wellness content.
• Track your progress including total yoga time, wake ups and day streaks for the month.
• Save favorites for easy recall.
• Includes mindful exercises and programming for kids and adults.
• Set reminders for bed times and wake-ups.

 Cons

• Must download “wake ups” (about 15 MB each) to your phone to use the “wake up to this” option feature.

Bottom Line:

Yoga Wake Up helps you break up with the alarm clock to start the day with calming yoga audio sequences. It’s ideal for adults and kids alike.

A favorite in the early 1900s, Crab Louis Salad traditionally was made with iceberg lettuce, crabmeat and Thousand Island dressing. This version is lighter yet hearty for a balanced meal.

Servings: 2
Serving size: 2½ cups
Prep time: 30 minutes
Cooking time: 8 minutes

Ingredients

Dressing:

• 4 tablespoons plain Greek yogurt
• 1 tablespoon mayonnaise
• 2 tablespoons ketchup
• 1 tablespoon sweet relish
• 1 tablespoon minced red onion
• ½ teaspoon lemon zest
• 1 tablespoon (15 milliliters) fresh lemon juice
• ¼ teaspoon Sriracha sauce
• 1 tablespoon minced fresh parsley

Salad:

• 2 ears corn on the cob, husks removed, grilled
• 10 thin asparagus spears, trimmed to 6 inches, grilled
• 4 cups mixed baby greens
• 1 cup halved grape tomatoes
• 4 ounces jumbo lump crabmeat, drained well (about ¾ cup)
• 1 large egg, boiled, peeled and chopped
• 2 tablespoons roasted, unsalted sunflower seeds

Instructions

1. In a medium mixing bowl, combine all dressing ingredients and stir to combine. Set aside.
2. Cut corn from the cobs (will yield about 1 cup corn) and slice asparagus into 1½-inch pieces.
3. In a large mixing bowl, combine corn, asparagus, baby greens, tomatoes, crabmeat and egg.
4. Pour in dressing and toss gently to combine, being careful to leave crabmeat in chunks.
5. Sprinkle sunflower seeds on top.
6. Portion salad into 2 servings and serve immediately.

Nutrition per serving: CALORIES 306; TOTAL FAT 14g; SAT. FAT 3g; CHOL. 170mg; SODIUM 642mg; CARB. 23g; FIBER 4g; SUGARS 14g; PROTEIN 23g; POTASSIUM 770mg; PHOSPHORUS 426mg

Synopsis of the App

Simple Habit provides daily meditations for busy people in just five minutes a day to reduce stress, improve focus and promote better sleep in a Spotify-style platform.

Platform and Price

Free trial, then $7.99/month. Apple and Android.

RDN Score:

5 out of 5

Pros

• Simple, user-friendly design.
• Get unlimited access to more than 1,000 meditations.
• Applies a streaming Spotify-style model to the meditation app space. You can create a playlist and choose from and follow more than 50 teachers for new content.
• Variety of voices keeps the content feeling fresh and new.
• Access your account on mobile devices and the web.
• Use the “on the go” feature to explore 10 meditation categories based on what you’re doing — including sleep, commuting and waiting, walking, tough day after work and SOS among others.
• Search for meditations based on length of time or topics like stress reduction, letting go, joy and resilience.
• Participate in meditations with or without background sounds.
• Set up reminders to meditate daily via phone or calendar.
• Select meditations based on the amount of time you have from five, 10 or 20 minutes. Download meditations to listen offline.
• Follow and message your favorite meditation teachers so you don’t miss a session.
• Connect the app to Facebook or allow access to your contacts to create a community.
• Participate in challenges to manage a streak or those like “Meditate Daily in October.”
• Sign up with email or quickly with Facebook.
• Create your own playlist for easy access to your favorite meditations.
• Track your meditation history and daily mindful minutes.
• Offers a free trial option, thereafter plans start at $7.99/month

 Cons

• The price is among the highest in this market space and may be a turnoff for some users.

Bottom Line:

Simple Habit makes meditation easy for novice and experienced meditators. One of the more comprehensive and well-designed meditation apps, Simple Habit helps encourage mindfulness throughout the day no matter what you’re doing.

Synopsis of the App

The Talk-to-Track Diet and Fitness Calorie Counter app lets you set weight goals, choose a diet plan and track food and activities by simply speaking the details into the app.

Platform and Price

Free. Android and Apple.

 RDN Score:

4 out of 5

Pros

• Easy to use.
• Immediately walks you through the goal-setting process to manage weight and choose a plan with target dates.
• Speak to track food and activity details and the app does the rest.
• Ability to choose macronutrient ratios CHO:PRO:FAT from low-fat and balanced to very low carb (10:45:45) and the “USDA Food Guide” set at 53% carbohydrate.
• Prominently displays calories burned and eaten and percent macros used on the homepage, making it easy to adjust meal intake through the day.
• Accept or override the allotted calories for the day to adjust to your individual needs.
• Clearly displays user status in a user-friendly design.
• Click through for complete nutrient data like cholesterol, saturated fat and sodium.

 Cons

• Requires a username and sign on before accessing the app.
• No expert guidance on appropriate macronutrient ratios.
• Does not include a fitness plan or resources.

Bottom Line:

Best for those who already know what they need, the Talk-to-Track Diet and Fitness Calorie Counter app is ideal for those counting macros. It’s especially useful for conveniently tracking food and macros and activity by speaking versus typing in every entry.

Synopsis of the App

Billed as “your body’s dashboard,” Record by Under Armour (UA Record^TM) lets you seamlessly track sleep, fitness, nutrition and other key statistics from the app.

Platform and Price

Free. Android and Apple.

RDN Score:

5 out of 5

Pros

• Well designed, user-friendly interface with a motivating color scheme.
• Track steps, nutrition, sleep and real-time workout stats like heart rate, pace, distance and calories burned.
• Use the app alone or with the UA HealthBox^TM.
• Users start by selecting and setting goals. Choose to improve the basics, lose weight, tone up or bulk up, sleep better or eat better, improve performance and stress less among others.
• Limits goals to three for a manageable journey.
• Option to track steps, sleep and workouts by allowing the app to access your phone’s motion sensors.
• Delivers a UA Game Plan after taking some basic goal and biometric data. Includes provisions for sleep, fitness, activity and nutrition (calories) targets.
• No calorie counting required in its simple nutrition style – can simply input light, medium or heavy days for calorie intake.
• Easily enter how you feel on a scale from 1 to 10 and a place to add notes.
• Keeps weight and goal progress graphs and numbers in view from the home page.
• Uses active and encouraging language like “Let’s Do This!” instead of “agree” or “next.”
• Get competitive and create challenges and invite friends. Includes most steps, most calories burned, most distance or most workout time over a variety of days.
• Connect other UA devices like the scale, heart rate monitor and wristband trackers, as well as Fitbit and Jawbone trackers and with apps like MyFitnessPal and MapMyFitness.
• Register with email or a Facebook account.
• Select interests and follow athletes and pages to inspire you.
• Includes an active community to connect with for activity and to learn about local fitness opportunities.

Cons

• The app has a bit of a bit masculine tone with tips from Tom Brady and other popular athletes.
• Limited without the UA Band since you are not able to get full fitness activity/steps tracking and sleep details.
• Includes advertisements at the bottom of the main pages.
• Must load contacts for challenges – giving access to contacts versus being able to invite them by directly adding email addresses.

Bottom Line:

UA Record^TM is a comprehensive body tracker. You can possibly delete the other trackers as this one seems to have it all.

Rub for bread. To make simple yet flavorful garlic bread, rub the cut side of a clove over bread slices or a baguette cut lengthwise. Drizzle with olive oil, sprinkle with grated Parmesan cheese and broil until toasted.

Roast a bulb. Without peeling, cut off one-quarter of the top of the garlic bulb, exposing the cloves. Wrap bulb loosely in foil and bake at 400 degrees Fahrenheit for 45 to 50 minutes, until cloves are mushy. Cool slightly and squeeze the roasted cloves into sauces, soups or dressings, or use it as a sandwich spread.

Go for the green. In late spring, look for garlic scapes, the curly, green stalks of the garlic plant that are harvested for only a few weeks each year. Garlic scapes are tender and milder in flavor compared to cloves. Mince and use them like chives as a raw topper for salads, soups and vegetables or puree them into pesto and hummus.

Neutralize the smell. Get rid of garlicky odor lingering on your hands with some kitchen metal. Wash your hands with soap and water, then rub them on a stainless steel faucet for about 10 seconds. Rinse and repeat until the smell is gone. If there is no stainless steel in your kitchen, purchase a soap bar-shaped piece of stainless steel designed for deodorizing hands after cooking.

Find more garlic hacks: “Peeling and Dealing with Fresh Garlic”

To see the entire Healthy Kitchen Hacks series, click here. 

Synopsis of the App

Photoshop Fix puts professional editing tools in a mobile app to let you repair and refine any image from anywhere, then share it across multiple platforms.

Platform and Price

Free. Android and Apple.

RDN Score:

5 out of 5

Pros

• User-friendly mobile interface.
• Repair and restore photos.
• Adjust face features using the Face Point nodes to significantly change symmetry and other characteristics of the face (size, tilt, width and shape). This could be a con – obviously.
• Remove blemishes or a stray crumb or smear in an otherwise perfect photo with the spot healing and patch tools.
• Paint and brush on color with ease.
• Full range of editing tools to flatten, crop, adjust, liquefy, heal, smooth, paint and defocus as well as add a vignette and adjust light, contrast, saturation, warmth and color for photos.
• Send and share projects to the full Photoshop Creative Cloud with separate and editable layers.
• Enable automatic backup to automatically sync projects to your Creative Cloud account
• Import images from and share images to the camera roll, Lightroom, the Creative Cloud, Google photos, Facebook and Dropbox.
• Includes tutorials for key features.

 Cons

• Steep learning curve for those without significant photo editing experience.
• You’ll need to set up and remember your Adobe ID to access the app but this is a small price for admission.

Bottom Line:

Best for those with some editing experience, Photoshop Fix puts many of the powerful editing tools features of Photoshop right in the palm of your hands and at no cost.

Servings: 9
Serving size: 1 cup (230 grams)
Prep time: 30 minutes
Cooking time: 35 minutes

Ingredients

• 8 small russet potatoes
• 6 leeks, white and light green parts only
• 4 cups (950 milliliters) unsalted chicken stock
• 1 dried whole bay leaf
• 2½ tablespoons grated Parmesan cheese
• 1 cup (240 milliliters) half-and-half
• ¼ teaspoon ground sage
• ½ teaspoon fine salt

Instructions

1. Wash and peel potatoes.
2. Make 2 cross-sectional cuts lengthwise down the leeks, then wash them.
3. Dice leeks into 1-inch pieces and add them with potatoes, chicken stock and bay leaf to a large pot.
4. Bring to a boil, then reduce heat to simmer and cover. Let simmer for 30 to 35 minutes, until potatoes are very tender.
5. Remove pot from heat and let sit for 3 to 5 minutes.
6. Working in batches, use a high-powered blender or immersion blender to blend ingredients.
7. Return blended ingredients to pot, add cheese, half-and-half, sage and salt.
8. Stir to combine and serve warm.

Nutrition per serving: CALORIES 202; TOTAL FAT 4g; SAT. FAT 2g; CHOL. 11mg; SODIUM 227mg; CARB. 37g; FIBER 3g; SUGARS 5g; PROTEIN 7g; POTASSIUM 649mg; PHOSPHORUS 140mg

Synopsis of the App

MyRA is designed to help those with rheumatoid arthritis track progress and monitor symptoms and take control of the condition.

Platform and Price

Free. Android and Apple.

RDN Score:

5 out of 5

Pros

• User-friendly interface.
• Track and monitor symptoms directly from the app’s home screen.
• Prompts to track morning stiffness, joint pain, fatigue, daily functionality and “big picture” feelings.
• Monitor daily functionality activities from bathing to commuting and lifting a full cup to mouth and prompts for quality of life like reading, typing and volunteering.
• Add medication with notes (includes an extensive list of medications to choose from).
• Enter content and notes by typing, speaking or snapping a photo, which makes it easier for those who might have difficulty typing responses.
• Track labs including C-reactive protein and erythrocyte sedimentation rate, or ESR.
• Easily scroll and click through the different features.
• View a summary of each area to share with the doctor and track progress.
• Set reminders and monitor your tracking streak.
• Access links to a variety of resources like Rheumatoid Patient Foundation and the Arthritis Foundation.
• Save a PDF to share customized summary reports covering one to 90 days.

Cons

• App is sponsored by a disease activity testing company but it doesn’t seem to negatively impact the content or appear salesy.

Bottom Line:

MyRA makes it easy to track RA symptoms in one place from anywhere. The prompts and reporting options make it easy to get a comprehensive view of what’s going on and share it with a healthcare team.