We have been told that all it takes to lose weight is a reduction in calories and/or an increase in exercise. The theory goes that if we eat fewer calories or exercise more or both, we will lose weight.
Yet, we continue to struggle with losing weight and keeping it off. Only a small percentage of overweight and obese people maintain a weight loss of 10 percent of body weight for one year. The reason for this goes beyond the simple calories in/calories out calculation. What researchers are discovering is that a calorie is not just a calorie. Rather, it’s the quality of the diet as a whole that determines whether a person will be able to lose weight and keep it off or not.
The New Model of Obesity
A paper published in the Journal of the American Medical Association proposes a new model of obesity that better explains why and how we get fat. The current model states that the standard American diet (SAD), full of convenient, highly palatable, energy-dense foods, causes people to overeat, which increases energy intake (calories in), while a sedentary lifestyle decreases energy expenditure (calories out). As a result, circulating fuels in the bloodstream (glucose from sugar and carbs, fatty acids from fats, and ketones from proteins) are more available, which increases fat storage and leads to obesity.
The new model proposes that diet quality— especially carbohydrate amount and type—as well as genetics and lifestyle factors such as inadequate sleep and stress, all contribute to an increase of fat storage, which decreases the circulating fuels in the bloodstream (sugar, fat, and ketones), triggering hunger (calories in) and lowering metabolism (which lowers the burning of calories). The result—obesity.
This new model helps explain why a calorie is not just a calorie and supports the fact that a lowcarbohydrate diet versus a low-fat, high-carbohydrate diet of equal calories results in better weight loss, blood sugar control, and cholesterol levels. It also explains why a low- versus high-glycemic index diet (glycemic index measures the ability of a food to raise blood sugar) of equal calories decreases hunger.
Other dietary factors that decrease fat storage are a low refined sugar intake, high omega-3 and low transfat intake, adequate protein, high micronutrient and phytochemical content (in other words, plenty of fruits and vegetables), and probiotics and prebiotics.
You may think that overeating causes you to be fat, but it’s actually a poor quality of diet that causes overeating, which causes you to be fat.
How to Improve Diet Quality
Here are some tips:
Eat plenty of nonstarchy vegetables and low-sugar fruits.
Eliminate sugar and grains.
Eat healthy fats such as omega 3 (fish oil), omega 9 (olive oil), and medium-chain triglyceride saturated fat (coconut oil), and reduce your intake of unhealthy omega-6 fats (most vegetable oils).
Eat protein throughout the day.
Eat fermented foods, which contain beneficial bacteria.
In conclusion, following these dietary suggestions along with moderate caloric restriction with optimum nutrition, exercise, and stress reduction not only leads to permanent weight management, it is also the recipe for adding years to your life as well as life to your years.
If cans of tuna conjure up unpleasant memories of soggy school sandwiches, get ready to rethink the famous “chicken of the sea” and its other canned friends.
Tinned salmon, sardines, tuna, mackerel, and other varieties are not only nutritional powerhouses, they are also conveniently pre-cooked and shelf stable.
Not a bad choice when it comes to stocking the pantry for uncertain weather and other challenging life events.
Do You Eat Enough Fish?
Whether it’s because fish may not be readily available where someone lives, or whether it’s because there’s a fear of preparing it incorrectly, Americans aren’t consuming enough seafood.
Research shows about 90 percent of us don’t eat the suggested weekly amount of at least two servings of fish, one preferably being an oiler variety like salmon, sardines, trout, or mackerel.
Reasons to Eat Tinned Seafood
Here are some reasons why we should all be eating more tinned seafood.
It's Nutritious
Seafood is a good source of lean protein and offers key nutrients like omega 3s, vitamin D, and calcium.
A key part of the Mediterranean diet, fish is rich in healthy omega-3 fatty acids. This nutrient is known for being anti-inflammatory, helping to improve joint health, and offering protection against heart disease.
Canned seafood is an important and convenient source of omega 3s.
It's Budget-Friendly
Tinned seafood is a budget-friendly choice, especially when compared to other fresh and frozen varieties.
It Lasts on The Shelf or on The Go
Sealed in an airtight container, tinned fish lasts.
It can be used as a food source in emergency situations when refrigeration is an issue, or for camping, hiking, traveling, and picnicking adventures.
Cans of seafood can be stored for two to five years, depending on how the product was packaged and produced.
It's Versatile
A versatile ingredient, tinned fish can be found in many varieties:
Common:
tuna
salmon
anchovies
sardines
Specialty:
trout
mackerel
mussels
cod
clams
oysters
octopus
squid
Choosing Your Tinned Seafood
Here are some things to look out for when purchasing tinned seafood.
Labeling
For the healthiest tinned seafood, look for the following:
packed in:
water
extra-virgin olive oil
a BPA-free can
lower in:
mercury
sodium
caught:
wild-caught
safe-caught
sustainably
Sustainability
Many tinned seafood producers work with local fisheries and canneries to ensure their products follow sustainable fishing practices.
Look for the following terms on the label:
pole-caught
troll-caught
school-caught
FAD-free
If there’s no information on how the product was harvested, it could mean an unsustainable method was used.
Mercury Content
Most fish contains some amounts of mercury.
Risk Factors
For many people, the exposure risk is not too much of a concern. However, pregnant women and young children can be harmed from higher levels of this pollutant.
Limiting Mercury
To ease concerns regarding mercury contents, be aware of the different varieties.
Lower-Mercury Fish
These varieties that tend to be lower in mercury:
skipjack (a.k.a. “light” or “chunk light”)
wild Atlantic salmon
pink salmon
Atlantic mackerel
Atlantic sardines in oil
Higher-Mercury Fish
Consume these less frequently to avoid mercury:
albacore (white) tuna
yellowfin tuna
king mackerel
Sodium Content
Canned seafood can be high in sodium. So if you’re watching your intake, look for low-sodium varieties.
Water-Packed vs. Oil-Packed
Water-packed tinned seafood is typically better for you than versions packed in oil, unless the oil is extra-virgin olive.
Package Integrity
Avoid purchasing cans of seafood that have bulges, leaks, or dents. The product within may be contaminated.
How to Use Those Tins
Opening a can of seafood is easy, but what can you do with it besides making a sandwich or eating it straight from the tin?
For Charcuterie
Look to what some restaurants are doing: they’re replacing high-saturated fat items (cured meats, pâtés) on expensive charcuterie boards with high-quality tinned fish.
Try it yourself by accompanying your favorite canned seafood with an assortment of mustards, cornichons, olives, pickles, minced red onion, and capers.
As Toppings
Anchovies
Add canned anchovies to dressings, Caesar salad, or pizza.
Clams / Mussels
Tinned mussels or clams add flavorful protein to salads and pastas.
Salmon
Use canned salmon in salmon burgers and sushi rolls, or mix it into salads.
Sardines
Canned sardines are good atop crackers and in rice dishes or pasta sauces.
Trout
Try tinned trout as an ingredient blended into dips and spreads.
Tuna
Tinned tuna can, of course, be made into sandwiches (try a tuna melt!).
But it can also be added to casseroles, green salads, and pasta dishes.
Storing Opened Cans
Store opened and uneaten portions of tinned seafood in an airtight container in the fridge. Enjoy within a few days.
Sources
“5 reasons you should eat more canned fish, according to a dietitian” by Breana Lai Killeen, MPH, RD, www.EatingWell.com, 7/18/23
“Ask the doctor: is canned fish good for the heart?” Harvard Health Publishing, www.health.harvard.edu, 7/11/20
“How to pick fish high in omega-3 and low in mercury,” https://health.ClevelandClinic.org, 1/25/23
“Is canned fish healthy? The no. 1 pick to start eating . . . ” by Caroline Kee, www.Today.com, 5/9/24
“Tinned fish is having a moment, but is it actually good for you?” by Leigh Weingus, www.HuffPost.com, 4/27/23
It’s estimated that about 4 million people in the U.S. have frequent constipation, with many of these being men. Add frequent gas, belching, and bloating to this mix and there’s a good chance that the underlying problem is an imbalanced gut.
The gut, or microbiome as it’s often referred to, is essentially the gastrointestinal system, including the intestines. When it comes to symptoms like constipation, gas, belching, and bloating, it’s the intestines where everything begins.
Scientists are coming to realize that one of the most important things you can do for your health is to keep your gut in balance. What researchers have found: A healthy, balanced gut doesn’t just help us to digest food, it also keeps our immune system strong. That’s because 70 to 80 percent of our immune cells live in the gut.
A healthy gut is also important to maintaining a healthy weight. And it’s key to maintaining optimal health and longevity.
Five Steps to a Healthier Gut
Daily exercise, putting relaxation strategies in place, and getting plenty of sleep all go a long way to staying balanced overall, which can also contribute to a healthier gut—and optimal health.
Clear Out Your Gut
If you’re backed up, you need to get things moving again before you can get your gut back on track. This isn’t always easy to do on your own.
That’s why NBPure’s gut cleanse MagO7 is a bestselling constipation relief product. It works overnight to give guaranteed relief come morning.
MagO7 contains a proprietary mix of ozonated magnesium oxide compounds with the added electrolyte potassium. Magnesium oxide has been proven to work through independent research.
Eat More Whole Foods, Limit Processed Foods
Processed foods like packaged meals, fast food, and sugary treats—as well as alcohol—can contribute to gut health problems.
Whole foods, on the other hand, help to nourish a healthy, balanced gut. This includes lean protein, fresh fruits and vegetables, whole grains like brown rice, nuts and seeds, and healthy fats.
Get Enough Probiotics
Be sure you’re getting probiotics, or healthy bacteria, every day. By adding probiotics to your diet every day, you’re ensuring that there are more beneficial bacteria in your gut than unhealthy bacteria. It’s the unhealthy bacteria that can contribute to symptoms like bloating and gas and make us not feel great.
While foods like yogurt and sauerkraut have healthy bacteria in them, you may not be getting enough. That’s why adding healthy probiotics into your gut through daily supplements like our own Poobiotics can help.
Get Enough Fiber Every Day
90% of Americans—with many of these being men—don’t get enough fiber. Men need at least 38 grams of fiber every day. It’s fiber that keeps the digestive system and gut in balance, preventing constipation. Fiber is also important to maintaining healthy cholesterol and blood glucose levels.
Foods high in fiber include fruits and vegetables, whole grains like oatmeal, seeds like flaxseeds, and beans and legumes. Taking a daily fiber supplement can help you meet your daily goal.
Our Daily Multi-Fiber offers 4 grams of fiber per teaspoon (just mix well into water) plus probiotics and prebiotics (to help nourish beneficial bacteria).
Stay Hydrated
Getting enough water can help the gut stay balanced—and keep things running smoothly to prevent constipation. Men need at least 15.5 cups of water daily. Plain water helps hydrate as can herbal tea and hydrating fruits and vegetables like cucumbers, lettuce, and watermelon.
What to Eat (and Avoid) When Trying to Get Pregnant
Mark Wallace
What you eat can’t guarantee you get pregnant, but it can help!
Keep in mind that while diet and supplements can help with fertility, you should talk with your physician if an infertility work-up is necessary.
Fertility Friendly Foods
Consider the following foods to promote and support fertility.
Fruits & Veggies
Fill half the plate at each meal with fresh produce.
Kale contains nutrients that help with estrogen metabolism.
Asparagus and watermelon offer high amounts of glutathione—an important nutrient for egg quality.
Iron-Rich Food
Consider spinach, beans, tomatoes, beets, pumpkins, and whole-grain cereals. They all seem to promote fertility.
Full-Fat Dairy
Eat up to two servings a day of whole yogurt, whole milk, and other full-fat dairy products.
This is a better choice than low-fat dairy. A high intake of low-fat dairy has been shown to increase the risk of ovulatory infertility when compared to consuming higher-fat options.
Proteins
Vegetable Protein
Replace one serving of meat a day with beans, peas, or nuts.
These sources of vegetable protein may help improve fertility.
High-Quality Animal Protein
The nutrients these contain help with the development of a baby’s nervous system.
Egg yolks contain the nutrient choline, which helps with a baby’s brain development.
Eating lean chicken and omega-3-rich seafood (salmon, sardines, and canned light tuna) can help cut premature birth risk.
Whole Grains
Whole grains contain high amounts of B and E vitamins as well as fiber—nutrients that all help with fertility. Eat brown rice, quinoa, millet, and amaranth.
Healthy Fats
Avocados, olive oil, grapeseed oil, and nuts reduce body inflammation, which in turn encourages fertility and healthy ovulation.
According to integrative nutritionist and author Alisa Vitti, “Studies have shown that consuming a certain quantity of monounsaturated fats in the form of avocados during the IVF cycle increased the success rate by three and a half times, as opposed to women who don’t eat good plant-based fats during that period.”
Foods to Reduce or Avoid
Sodas
They appear to promote ovulatory infertility.
Coffee
Drinking too much coffee can cause issues. High amounts of caffeine fill the body with cortisol—a fat-storing hormone.
Artificial Sweeteners
These cause a cortisol response, which blocks ovulation. If you need to use a sweetener, try a less-processed option such as honey, maple syrup, or stevia.
Trans Fats
They harm heart and blood vessels and increase insulin resistance. Increased insulin levels cause metabolic problems that affect ovulation.
A Harvard School of Public Health study of almost 19,000 women found a higher incidence of ovulatory disorders in women who ate more trans fats and carbs.
Sugar
Overconsumption of sugar and processed foods elevates blood-sugar levels.
Salt
Too much salt heightens stress levels by increasing blood pressure.
Consider a Multivitamin
Before becoming pregnant, start supplementing with a daily multivitamin/mineral. Look for one that offers 40 to 80 milligrams of iron and 400 micrograms of folic acid.
A Harvard School of Public Health study followed women for eight years and found that those who supplemented with a daily multivitamin containing 400 micrograms of folic acid were 40 percent less likely to experience ovulatory infertility over this time period than those who did not supplement.
Sources
Clean & Lean Pregnancy Guide by James Duigan ($18.95, Kyle Books, 2015)
The Templeton List is Your Guide to Healthy Eateries
Mark Wallace
The Templeton List isn't just for people deeply dedicated to health; it's for anyone looking for healthy dining options across America.
Featured in Whole Foods Magazine and Woman's World among other publications, it provides a reliable go-to resource for finding healthy eateries across the U.S.
Discover Healthy Eating Spots Everywhere
The Templeton List, a division of The Templeton Wellness Foundation, is more than a mere list of places to eat; our dedicated team ensures each restaurant adheres to our rigorous health standards before we recommend them.
This means evaluating everything from their ingredients' freshness to their cooking techniques, so that wherever you travel in the country, there will always be delicious yet nutritive meals available to you!
Something for Everyone
New restaurants are added daily! With a growing number of dining establishments on the list ranging from cozy cafes to fine dining establishments, there's sure to be something ideal for every palate and diet.
This variety enables consumers to make informed food decisions that balance flavor with health considerations while supporting local eateries that prioritize both.
We’re always in search of the healthiest restaurants in the country – feel free to contact us if there is one you’d like to recommend. Our team will check it out.
James Templeton's Dream
Inspired by James Templeton, who overcame Stage 4 cancer over 38 years ago and has since been an advocate of alternative health practices, The Templeton List strives to make eating well part of everyday wellness.
James's experience, as recorded in his book I Used To Have Cancer, emphasizes the value of diet when it comes to staying healthy. This List serves as his way of helping others discover pleasure from eating food that's good for them!
Making Healthy Dining Simple
We understand it can be challenging to find healthy dining options, which is why the Templeton List keeps you up-to-date with the latest offerings. More than just a directory, this resource serves to foster better eating habits among you and your loved ones.
Start making healthier eating choices right now using The Templeton List, taking one step towards living a balanced life.
Soothe skin, aid digestion, and absorb more nutrients!
Mark Wallace
In partnership with Lily of the Desert
Aloe vera is a great multitasker.
Humans have been using this plant for thousands of years. Cleopatra used aloe gel as a moisturizer and people still use it to soothe sunburns.
Benefits of Aloe Vera
Consumers can drink food-grade aloe juice and gel for many benefits, including improved wrinkles and skin elasticity. Its natural compounds, especially its polysaccharides, show promise in bolstering immunity and improving digestion.
But did you know that this plant can also help increase nutrient absorption? Research shows that its polysaccharides help carry nutrients to cells, allowing for better absorption. In other words, the next time you take your supplements, wash them down with aloe vera juice instead of water!
Stop Flushing Nutrients Down the Drain
Ever notice how bright yellow your urine gets after you take your vitamins? That’s a sign that water-soluble nutrients intended to benefit your body are not being absorbed as well as they could be. Studies show that when supplements are taken with aloe vera instead of water, nutrient absorption improves by 200%.
Lily of the Desert has found a way to amplify those benefits to 2000%.
With its patent-pending process called Aloesorb, Lily of the Desert takes the heavier molecular weight polysaccharides responsible for acting like nutrient taxi cabs, isolates them, and infuses them back into its aloe products.
When Aloesorb juice was tested for nutrient absorption of vitamin C, the Lily product was found to be ten times more powerful than generic aloe, proving 2,000 times the absorption rate.
“Given the polysaccharides’ enhancement of nutrient uptake, it certainly makes sense to get full value from your daily dietary supplements by taking them with a couple ounces of aloe juice,” writes Martie Whittekin, CCN, in her book Aloe Vera: Modern Science Sheds Light on an Ancient Herbal Remedy.
Other benefits of Aloesorb include boosted immune support. Lily of the Desert products with Aloesorb have been shown in clinical trials to support an increase in white blood cell counts.
Get the Most Bang for Your Buck
ConsumerLab.com, a provider of independent test results, recently investigated how much money a consumer pays to get 25 milligrams of acemannan, one of aloe’s main bioactive polysaccharides.
Costs ranged considerably, especially because one product contained no acemannan! Lily of the Desert was rated as the top pick for drinkable aloe because it delivers 25 mg of acemannan at 20 cents. The closest competitor was 37 cents.
Sources
“Aloe juices, gels, and supplements review” by Tod Cooperman, www.ConsumerLab.com, 11/22/21
Aloe Vera: Modern Science Sheds Light on an Ancient Herbal Remedy by Martie Whittekin ($7.95, Integrated Healthcare Publishers, 2019)
“Dietary aloe vera supplementation improves facial wrinkles and elasticity . . .” by S. Cho et al., Annals of Dermatology
“Extraction, purification, structural characteristics, biological activities and pharmacological applications of acemannan . . .” by S. Liu et al., Molecules, 4/19
“A randomized placebo-controlled crossover trial of aloe vera on bioavailability of vitamins C and B(12), blood glucose, and lipid profile in healthy human subjects” by J.-M. Yun et al., Journal of Dietary Supplements, 6/10
Veganism is trending these days, and while most people don’t choose a vegan lifestyle for its cool factor, that popularity has made it easier to opt for a solely plant-based diet.
Whether you’ve decided to switch to a vegan diet to help prevent the exploitation of animals, to improve your health, to promote a green planet, or all of the above, you’ll find many resources and products to smooth the way.
Tips for Starting a Vegan Diet
Here are some strategies to start you down a vegan path.
Build on What You Know
You likely already have some vegan meals in your repertoire, along with vegetarian meals that can be “veganized.” Think bean-based chili, pasta and veggies, lentil stew, and stir fry. Start with those so you don’t need to come up with something new for every meal.
Try Jackfruit
With a texture similar to meat, this fruit can replace pork, beef, and chicken in recipes and has 3 grams of protein per serving.
Ease Into It
Start with One Meal
Committing to one plant-based meal per day is a great start. You might try breakfast—hot or cold cereal with fruit, nuts, and nondairy milk will fuel your morning. For a weekend brunch, make an egg-substitute veggie omelet, “bacon” made from tempeh or soy, and plant-based yogurt on the side.
Think in Proportion
Ease into vegan living by gradually upping the amount of plant-based foods on your plate and decreasing the amount of meat, eggs, and dairy.
Do Your Homework
Read about veganism, join online forums, talk with longtime vegans and newbies (new-vees?), and watch documentaries on living the plant-based life.
Read Labels
Find local shops and restaurants that offer vegan products and entrées. When you shop for groceries, examine the ingredients. Not all vegan products are labeled “vegan,” and some items you think will pass the test don’t—some pasta has egg in it, for instance, and some cornbread mixes contain animal fat.
Make a Supplement Plan
Vegans need to be sure to get enough of the following nutrients
vitamin B12
vitamin D
omega 3s
iodine
iron
calcium
zinc
You can address each of these separately through diet, supplementation, exposure to sun, etc., but while you’re still feeling your way into a new way of eating, consider researching multivitamin-mineral supplements designed for vegans.
Be Steadfast
Finally, don’t be daunted! You can go as fast or slow as you want in arriving at “full veganhood.”
When Daniela Djordjic brought her son in to get his shots that September day in 2000, she was understandably nervous. Just two weeks earlier, 2-month-old Jovan had been rushed to the emergency room after he turned blue during a crying fit. Doctors intubated him until he stabilized, and sent him home a few days later with a diagnosis of whooping cough.
Except Djordjic and her husband, Voya, had never noticed a cough. They kept vigil over Jovan, jumping to soothe any sign of discomfort before it could turn to tears.
At the pediatrician appointment, the crying and choking began again. Lynn Porter, MD, called code blue, and what seemed like “the whole hospital ran in,” recalled Daniela, now 49, at her home in Peabody, MA. “He almost died endless times. It was very stressful, and I was lost.”
ICU doctors at Tufts Medical Center in Boston struggled to determine the problem. Jovan, who had seemed small and quiet but normal, could no longer breathe on his own. He needed almost constant sedation with Fentanyl to keep him from ripping the intubation tubes from his mouth and nose. Each time the doctors removed him from the ventilator, Jovan could only make it a day or night on his own. So much blood was pulled for testing that he needed transfusions, but a diagnosis remained elusive.
Three months later, the 28-year-old parents, both refugees from the Bosnian War, were given two options: A tracheostomy tube could be inserted in the baby’s neck so they could stop sedating him; or they could remove him from the ventilator and do nothing. “It’s your decision,” the doctor said.
“Do we want to pull the plug?” said Daniela. “I try to block that memory. How can you say, ‘I don’t want my child to live’? We said, ‘Of course we want him to live,’ with the hope that things will change. We still didn’t even know what the condition was.”
Muscle samples taken from Jovan’s hand during the trach surgery revealed missing cells in his myelin, the protective sheath around nerves that allows the brain to communicate to muscles. Doctors predicted Jovan would remain ventilator dependent and start losing his ability to move. The Djordjics sought a second opinion. That doctor ran more tests, verified that Jovan would become paralyzed from the neck down due to polyneuropathy, the malfunction of many peripheral nerves. He ran a vocal cord test that, because one of the cords was paralyzed, meant there was a 50 to 70 percent chance a future child would have the same genetic mutation. He estimated Jovan would live a year.
Voya Djordjic holds his son, Jovan, at Franciscan Children’s Hospital in MA.
The prognosis confused Daniela. Why would Jovan die so soon if he was already on life support? The doctor explained that many infants with complex medical conditions develop pneumonia and respiratory problems they can’t survive, even on a ventilator.
Trach surgery was in early December. On New Year’s Day, 2001, Jovan was sent to Franciscan Children’s Hospital in Brighton, MA, a long-term pediatric rehabilitation facility, where his parents began learning how to care for him. A few months later, surgeons inserted a gastrostomy tube into the 9-month-old’s stomach so he could be fed nutritional formula that way. In October 2001, more than a year after his first hospitalization, Jovan finally came home.
Home Is Where the Heart Is
By then, the Djordjics were living in a tiny two-bedroom apartment in Somerville, MA. “Their apartment looked like an ICU,” said Kathleen “Kathy” Ryan, a former case manager with Home First, a program funded by the Massachusetts Department of Developmental Services to help families whose children qualified for living in pediatric nursing homes.
“At the time, there were only three pediatric nursing homes in the state,” Ryan said. “The department had finally gotten the message that people should not grow up in nursing homes. Voya and Daniela were working really hard at keeping Jovan alive and out of the hospital.”
Daniela Djordjic with her son, Jovan, in the early years.
Ryan understood the challenges of navigating medical services because of her own experience caring for a profoundly disabled son. She became a trusted resource for the overwhelmed couple, helping them obtain items they needed for Jovan's care, such as a wheelchair van. The couple had no idea they could be reimbursed for certain expenses, which added up quickly.
As predicted, Jovan began losing his ability to move. In a slow progression, he lost movement in his legs, then his fingers, then his arms, becoming a quadriplegic by age 8. In terms of what Jovan has lost, nothing has changed since then. However, what he’s gained is something of a miracle, thanks to his medical team, modern technology, the devotion of his family and caregivers, and maybe, just maybe, his mother’s homemade soup.
Getting a Diagnosis
Despite the prediction that Jovan would likely die before age 2, he turned 21 in 2021, the same year he finally received a more precise diagnosis than the earlier one of polyneuropathy. The medical mystery was solved during an appointment with a neurologist new to the family. He asked many questions about Jovan’s early life and family history. When he asked Daniela and Voya to remove their shoes, he knew he had the answer. Voya’s high arches—which run in his family—are a classic symptom of Charcot-Marie-Tooth disease, CMT, for short.
Caused by genetic mutation, Charcot-Marie-Tooth, pronounced (shar-KO mä-ré tooth), is a progressive nerve disease named for the three physicians who first described it in 1886. CMT damages the peripheral nerves that extend to the feet and hands, and interferes with the brain’s ability to communicate with muscles. Many people with CMT experience muscle pain, hand tremors, cold hands and feet, chronic fatigue, and develop trouble walking. Most have a normal lifespan, only very rarely do they have breathing problems. Jovan seems to be among the most extreme cases.
At an appointment in 2021, one of Jovan’s doctors asked Daniela, “How is he still alive?” After listening to her daily routine, which includes feeding him homemade food through his G-tube, he remarked, “I think it’s the nutritious food you’re giving him every day,” recalled Aleksandra “Aleks” Samardzic, Daniela’s older sister.
“He is the only one who eats food,” Daniela said. “He, knock on wood, has never had any bed sores. His skin is so good. And he’s been healthy.”
Beyond Canned Nutrition
When Jovan got home in 2001, Daniela fed him Peptamen Junior, the same canned nutrition the hospitals used. These formulas typically contain whey protein, fiber, medium chain triglycerides (MCT), and are fortified with vitamins and minerals.
“He did not tolerate the canned liquid food very well,” Samardzic said. “He had constant diarrhea. First, she tried to adjust the feeding times and quantities, but that didn’t help.” One day in 2002, when Jovan was 2, Aleksandra and Daniela’s mother, Javorka Vujnovic, who was living in the United States at the time, wondered aloud, “Why don’t we just give him some chicken soup?”
“I looked at her and said, ‘That’s not a bad idea,’” Daniela said. The memory still makes the sisters laugh.
This strategy of figuring things out as they went along, even without a true diagnosis, resonates with Ryan. “In the beginning, you really, really, really want to know. Then you realize your child is going to tell you who they are, and you’re just going to have to respond to their needs as they go along in life, and I think that’s what they’ve figured out. I mean, this family is so darn clever.”
Jovan’s doctor was not opposed to his eating food, only concerned it would not be nutritionally sufficient. Daniela began feeding Jovan some homemade food and a can of Peptamen Junior per day. Not only did his bowel movements stabilize, but his skin grew healthier, and he looked happier.
She began experimenting more and more with the food until she was able to wean Jovan from the Peptamen Junior.
“Mothers feeding children is extremely important,” Ryan said. “That’s why people are so resistant to G-tubes when they’re told their children have to get them. We’re wired to feed our children. Daniela’s a good cook, and she wants him to have good, healthy food. He can’t taste a thing, but it doesn’t matter to her.”
A nurse feeds Jovan one of numerous small servings of real food he receives daily via his G tube.
Over the years, Daniela perfected a food plan that met Jovan’s nutritional needs and caused no digestive discomfort. Many ventilator-dependent children struggle with digestion. Because of this, when Jovan’s G-tube was installed, the surgeon cut a muscle on the side of his stomach to move food into his small intestine faster. Unfortunately, Jovan developed a dumping syndrome, also called rapid gastric emptying, which means the food moves too quickly into the small intestine. The accelerated digestion can cause nausea, abdominal cramping, and a rapid rise of blood sugar levels that causes sweating and discomfort. To prevent these issues, Jovan is fed just a bit of food through his G-tube at regular intervals throughout the day.
The Daily Menu
Breakfast starts at 9 a.m. Earth’s Best Organic Whole Grain Oatmeal Cereal, unsweetened almond milk, and fruit (blueberries, apple, or banana) are blended to the point of near liquefaction in a heavy-duty Oster blender. The meal is put in a syringe and a small amount is placed into Jovan’s G-tube every 30 minutes.
Jovan’s diet is mostly vegan because he has issues digesting protein. For lunch, Daniela or one of Jovan’s caregivers consults the notebook kept in a kitchen drawer to see which vegetables he’s been fed recently. They chop up and simmer several new varieties, using organic produce whenever possible. Once soft, the vegetables are allowed to cool, and then put into the blender along with two tablespoons of Californian extra-virgin olive oil, some fresh garlic, and a bit of salt. One slice of whole-wheat bread (baked daily by Daniela) is torn into chunks and added to the blender along with two hard-boiled eggs and, sometimes, cooked rice. Once the blender is 75 percent full, water is added to thin the mixture, and then blended into Jovan’s “soup of the day.” About a half-cup of soup goes into the G-tube via syringe starting at 3 p.m., a process that’s repeated every half-hour until 9 p.m. Overnight, he receives Pedialyte via a feeding pump to keep him hydrated.
Even though there was concern early on that real food wouldn’t be nutritionally sufficient, it is proving to meet Jovan’s needs quite well. His blood is tested regularly, and Daniela tweaks his diet as needed. “Last time when they were doing his bloodwork when we were in the hospital, his vitamin K was a little low,” she said. “We added a few leaves of baby spinach to his diet. We make these little adjustments, but everything else seems to be fine.”
"In the more than 10 years that I've been seeing him at the house, I've marveled at the family's ability to support Jovan in his physical needs, especially with natural, well-balanced table foods," said David Casavant, MD, senior associate in Critical Care Medicine, Department of Anesthesiology, Critical Care, and Pain Management at Boston's Children Hospital and assistant professor of anesthesia at Harvard Medical School. "He's the example I think of when I explain to other patients that formula is good, but often some wholesome food can be better than something made in a factory."
Daniela doesn’t think of the cooking she does every day as anything special. When she came to this country in 1998, she was surprised at how much packaged food people ate, and confused they didn’t know how to make something as simple as yogurt. “We grew up on a mini-farm” that provided the family with eggs, milk, and meat, said Samardzic. “I don’t think our mother or grandmother ever bought any canned ingredients or ready-to-eat meals. For Daniela, switching to homemade food was just a matter of time.”
The Djordjics at the Massachusetts State House after Daniela’s speech advocating for better pay for home health nurses.
The family keeps a garden, and Daniela eats a vegan diet, always mindful of her health because so much of her son’s daily care rests upon her shoulders. She is a one-person command central who schedules the around-the-clock skilled nursing care (always challenging, and even more so during COVID), provides physical care for her son, deals with all the medical bureaucracy, and makes sure the home is stocked with medical supplies.
“She doesn’t crush,” said Samardzic. “Sometimes she’s like, ‘I don’t know if I can take this anymore physically.’ But mentally, never, never. She’s extremely, extremely strong.”
After so many years of caring for her son, Daniela knows when Jovan is in pain or something is off. “For me, after 21 years, I think it’s simple,” she said. “What you need is people. You need support in the house, of course. But you also need to know who to call and how to navigate the system. I started doing that a long time ago with the 12 doctors he has. There’s always one person I know the direct line to.”
The family prefers dealing with routine medical issues as they arise at home, resorting to hospital visits only for emergencies. Sometimes trips to the hospital can exacerbate challenges—or introduce new ones—especially if the visit occurs on a weekend when Jovan’s regular doctors are not there.
Jovan and his Aunt Aleks wear matching shirts in support of the Big Walk on Wilson’s (BIG WOW).
“He is alive because of medicine, obviously, and all the medical equipment,” said Samardzic. “But we are also spiritual beings, and we have energy, and we know ourselves the best. Sometimes we have to listen to our intuition, and that’s what she’s doing when it comes to him, too.”
"I think the truly magic ingredient, and the thing that makes it uniquely successful is love, and that is what abounds in this family," Dr. Casavant said.
A Good Life
In 2022, Jovan will graduate from the Kevin O'Grady School, which educates students with significant disabilities. Stephanie Couillard, M.Ed., an assistant program director there, said he is the only homeschool student she knew of who'd graduated from the 12th grade, the highest level offered.
Jovan exudes happiness around those he loves and has a good sense of humor. He gets a kick out of watching the movie "Bridge to Terabithia" with his nurses and PCAs, for example, because he knows the scene of Jess and Jack in the forest always makes them cry.
Voya, who, with Daniela, owns Sigma Pros, a general contractor and millwork supplier based in Wakefield, MA, installed a floor-to-ceiling pipe by Jovan's bed that has several articulating arms that can swivel in, left and right, and up and down, depending on what Jovan wants to do, which is typically a lot. One shelf holds his Tobii, an eye-tracking computer that speaks for him. Out of necessity and personality, Jovan is a direct communicator and often asks Daniela to connect him with people, including his grandparents in Bosnia, via video calls.
Another shelf holds a TV screen that he uses to watch movies, golf, and college football. He enjoys following the news, especially 60 Minutes, and his current crush, WCVB Channel 5 meteorologist Cindy Fitzgibbon, sent him a Happy Birthday video for his 21st birthday.
Jovan, sporting a fake nose ring, shares a light-hearted moment with his cousin Katarina Samardzic, one of his caregivers. She earned a B.S. in Public Health in 2022. “I don’t know who I would be if I didn’t have Jovan and Daniela in my life, and I am forever grateful."
Bath time, often reduced to sponge baths for people with severe disabilities, is a joy for Jovan. Years ago, Voya designed a special tub for him with a reclining insert that can support his body.
At bath time, which occurs several times a week, the lightweight, fiberglass tub gets placed on a waist-high folding table similar to a massage table. A long extension hose attached to the bathroom showerhead fills the tub, and then a lift device moves Jovan from his bed into the tub via netting.
During a recent bath, a nurse scrubbed Jovan’s feet while Daniela washed his hair using a shower attachment. His head was wrapped in a towel warmed in the microwave while Safa Rizvancevic, a personal care attendant from Bosnia who has been with the family so long she is considered family, ran to the basement for more warm towels straight from the dryer. The machine lifted him from the tub, and he was rinsed, dried, and moved back to bed, where his skin was moisturized and he was given a foot massage. The final touch was Daniela, long hair pulled back into a no-nonsense ponytail, touching her nose to his, joy spreading over both of their faces.
His family remains determined that Jovan enjoy as full a life as possible. Each summer, they travel to a special place, often Long Island, via a caravan of vehicles that transports family members, nurses, PCAs, and all the equipment Jovan needs, including his tub, which is used as a bed for the ride. “Everything moves,” said Samardzic. “It is a mission.”
Jovan and his loving caregivers on a van ride together.
Once at the hotel, they remove all the furniture from one room so it can be outfitted into a replica of Jovan’s room at home. With such complex medical needs, it’s important that the care routine run like clockwork.
The hotel is located on a 2-mile-long boardwalk that parallels the ocean shoreline. Syringes filled with food and water are stashed in Jovan's small backpack so he can stay on his feeding schedule. The length of the boardwalk allows everyone to walk together for an hour and 40 minutes before they need to return indoors to attend to Jovan’s medical needs. Look at any photo of Jovan at the ocean and you will see his face lit with happiness.
“I meet a lot of families who have children with serious problems,” reflected Kathy Ryan. “There are moments of worry and depression and loneliness and fear. The thing about this family that I’ve always admired is that they always were up for celebrating something. They are very loving people, and they were that way to begin with. I don’t think that was new because of Jovan. They understand that there are things in life that should be celebrated and marked, and they do that, and I love that about them.”
Aunt Aleks, personal care attendant Safa, and nurse Maria enjoy walking the boardwalk with Jovan.
Future Strategy
Pre-COVID, the Djordjics bought a neglected, but beautiful property in Topsfield, MA, not far from their home. They are renovating it with the hope it someday serves as a place for children with disabilities to spend time together, having fun and learning. Daniela hopes to teach younger families what she's learned, not just about physical care and feedings, but also about how to navigate medical systems, minimize hospital visits, and advocate for a loved one if a hospital stay becomes necessary. She wants parents to know they can trust themselves.
"Listen to your instincts. That, I learn over and over again. Most of the time, we know, but we don't listen to our gut because someone went to school," she said.
Call it mother's intuition, call it old-fashioned commonsense, call it what you like. But for Jovan "Jovi" Djordjic, the most important prescription, the one that has kept him not just alive but smiling, has always, always been love.
Our lungs came into sharp focus with COVID-19. Is there anything we can do to reinforce the health of our lungs?
Fortunately, many foods support lung health.
Foods That Support Your Lungs' Health
Here are 10 options to get you started.
Beets
Beets are rich in nitrates, magnesium, potassium, antioxidants, and vitamin C. Each of those components boost the health of human lung tissue. The nitrates relax blood vessels within the lungs and distribute oxygen more efficiently.
Red Peppers
Red peppers are an excellent source of vitamin C, a nutrient especially important to the lung function of smokers.
Apples
Apples are rich in antioxidants and vitamin C. Eating five or more apples a week can help improve lung function and reduce the risk of developing chronic obstructive pulmonary disease (COPD).
Tomatoes
Tomatoes are rich in lycopene, a carotenoid antioxidant proven to improve lung health. Substances in tomatoes can also reduce airway inflammation to help people with lung challenges such as asthma and COPD.
Green Tea
Green tea has a high concentration of EGCG— epigallocatechin gallate. Because EGCG boosts the body’s antioxidants, it also boosts anti- inflammatory properties to help heal scarred lung tissue.
Edamame
Edamame beans are rich in isoflavones. Isoflavones help guard against lung disease, including COPD. Isoflavones can also reduce shortness of breath in those with impaired lung capacity.
Oysters
Oysters are rich in zinc, selenium, copper, and B vitamins. Those nutrients improve lung function. Smokers often deplete their B vitamin stores. Oysters help return the balance.
Blueberries
Blueberries are rich in anthocyanins, pigments that help protect lungs from tissue damage. In one study, people who consumed two servings of blueberries a week slowed the progression of lung disease significantly.
Coffee
Coffee helps protect your lungs. Caffeine and antioxidants help protect against respiratory diseases including asthma and COPD by expanding blood vessels and improving the transfer of oxygen.
Turmeric
Turmeric is rich in antioxidants and anti- inflammatory agents. Its active ingredient curcumin is especially helpful for improving lung function.
