Fitness Resources

Month: April 2016

Vitamin D for Major Depressive Disorder




ACE Professional Resources ProSource: May 2016


Everyone feels sad sometimes. For some people, however, sadness can grow into a debilitating medical condition known as depression, or major depressive disorder (MDD). MDD is quite prevalent, affecting approximately 20 percent of people at some point in their lifetime, and has been linked to other physiological complications, such as increased risk of cardiovascular disease, dyslipidemia, diabetes and hypertension. Increase in oxidative stress in MDD patients has also been reported. Overall, MDD patients have been shown to have decreased lifespan and quality of life.

Vitamin D is a fat-soluble secosteroid (a steroid with an “open” ring) that enhances absorption of essential elements, such as magnesium, iron, calcium, phosphate, and zinc. Traditionally, the majority of vitamin D has been obtained from exposure to sunlight. It is also available through dietary consumption, mostly through fortified foods like milk and cereal. Vitamin D obtained from sunlight or diet requires hydroxylation (addition of a hydroxyl “–OH” group) in the liver to become biologically active.

There are two major forms of vitamin D: D2 (ergocalciferol, obtained from foods) and D3 (cholecalciferol, synthesized following exposure to sunlight). Collectively, both isoforms are termed calciferol. Calciferol is converted into calcidiol, a parahormone, in the liver, and subsequently converted into the biologically active form calcitriol in the kidneys. Calcitriol binds the nuclear vitamin D receptor, which is ubiquitously expressed, inducing transcription of various target genes. Vitamin D plays an important role in proper bone formation and maintenance of bone density, along with a possible role in the immune system. Vitamin D deficiency has been associated with a variety of diseases, including osteoporosis, neurodegenerative diseases, cardiovascular disease, and complications during pregnancy.

Serum vitamin D levels have also been negatively correlated with depressive symptoms. Recent meta-analyses have shown a connection between higher serum vitamin D levels and improved depressive symptoms in people with MDD. There are also a number of studies on the effects of various levels of vitamin D supplementation in MDD patients. Some studies suggest no benefits of vitamin D to mood symptoms of MDD; however, a meta-analysis of existing studies concluded that vitamin D supplementation of 800IU per day or more in vitamin D deficient patients has a positive impact on MDD mood symptoms.

In addition to a positive effect on mood, vitamin D supplementation has been shown to have a positive effect on glucose and cholesterol levels in pregnant women with gestational diabetes (high blood sugar during pregnancy). Recent meta-analyses have indicated that type 2 diabetes is significantly more common in MDD patients, and markers of oxidative stress are elevated in MDD patients. Since the researchers behind the current study have recently shown that high-dose vitamin D supplementation improves glucose levels, oxidative stress and inflammation in type 2 diabetes patients, in this study they wanted to investigate the effect of vitamin D supplementation on oxidative stress and blood glucose in MDD patients, as well as the effect on mood change.

Vitamin D supplementation has been shown to be beneficial in studies on depression and metabolic disorders; however, no studies have investigated effects of vitamin D supplementation on both mood and metabolic markers in a population of MDD patients. This study was designed to investigate the benefits of high-dose 8-week vitamin D supplementation in MDD patients.

Who and What was Studied?

Researchers conducted a randomized, placebo-controlled, double-blind study on MDD patients 18–65 years of age living in Kashan, Iran. They used the Hamilton Depression Rating Scale (HDRS) to measure participants’ level of depression at study recruitment. Those with a score of at least 15 on the standard HDRS, which corresponds to at least mild depression, were included in the current study. Patients were excluded if they had a history of liver and cardiac diseases, were pregnant or lactating women, were smokers or substance abuses, or took dietary supplements during the last two months.

Figure 1 summarizes the study design. Participants were then randomly assigned to take either a capsule of 50 kIU (50,000 IU) of vitamin D or a placebo pill once a week for eight weeks. Both the experimental and the control groups consisted of 17 women and one man each.

Figure 1


To measure changes in biochemical parameters, fasting blood samples were collected from participants at the beginning and end of the study. They measured plasma levels of 25-hydroxyvitamin D levels (a measure of stored vitamin D) and insulin as well as C-reactive protein (hs-CRP, a marker of inflammation) using enzyme-linked immunosorbent assay (ELISA). Other measurements included glucose, triglycerides, calcium, cholesterol, lipoproteins, and antioxidant capacity.

Homeostatic model of insulin resistance (HOMA-IR) and beta cell function (HOMA-B), as well as quantitative insulin sensitivity check index (QUICKI), were estimated using measured values for fasting serum glucose and fasting insulin according to published formulas. The HOMA formulas were developed from physiological data on glucose and insulin levels, and are often used in diabetes research to determine the relative degree of impairment in insulin resistance or beta cell function. The QUICKI is a simplified version of the HOMA that was designed to be implemented in large-scale studies.

What is ELISA?

ELISA is used to measure the concentration of one or more proteins in a sample. Its basic steps are outlined in Figure 2.

Figure 2


There are three main types of ELISA assays, which vary based on detection method: direct, indirect and sandwich. During direct ELISA, the simplest form of the assay, the protein of interest is immobilized onto a microwell plate. The plate is incubated with solution(s) containing antibody that will bind to the protein of interest. The antibody is conjugated to an enzyme (such as horseradish peroxidase (HRP)), and substrate for this enzyme is added to the wells.

The enzyme cleaves the substrate, producing a visible color signal that can be detected in a microplate reader. The amount of signal is proportional to the amount of protein present in the well. Direct ELISA uses a single antibody for the protein, whereas indirect and sandwich ELISAs use an antibody for the protein followed by a secondary antibody to amplify the signal. Known amounts of protein are incubated alongside unknown samples to build a standard curve from which the amounts of protein are calculated.

To assess changes in participants’ MDD symptoms, researchers used the Beck Depression Inventory (BDI). Like HDRS, BDI is a questionnaire composed of 21 questions that measure a variety of depressive symptoms, such as mood, suicidal ideations, and changes in weight. The answer to each question is rated on a scale from zero to three, with the higher value indicating more severe symptoms. Therefore, an increase in BDI score would indicate worsening MDD symptoms.

Iranian men and women who were 18-65 years old and diagnosed with moderate MDD were given 50,000 IU Vitamin D or placebo for 8 weeks. Researchers measured changes in markers of insulin functioning and redox status by collecting plasma from the participants. Researchers also assessed nutritional intake and exercise throughout the study through self-reported questionnaires. Lastly, researchers also tracked changes in participants’ mood using a self-reported depressive inventory.


What Were the Findings?

Both experimental and control groups were deficient in vitamin D at baseline, and serum levels of 25-hydroxyvitamin D (vitamin D) were significantly higher in the experimental group  (13.6ug/L) compared to placebo group (9.2 ug/L) at beginning of the study. In order to control for any effects of the elevated vitamin D levels at baseline, researchers controlled for baseline values, age and baseline BMI.

Figure 3 shows the main study results. Vitamin D supplementation increased circulating 25-hydroxyvitamin D by 250 percent in the experimental group only. Researchers noted improved BDI scores in the vitamin D group. BDI scores in the vitamin D group decreased by 32 percent (indicating improvement in depressive symptoms), whereas only a slight decrease was noted in the control group. The difference in the decrease between the two groups was not quite statistically significant (p=0.06), although it became significant when researchers corrected for baseline 25-hydroxyvitamin D levels, as well as baseline BMI and age (p=0.04).

Figure 3


There were also significant differences in the changes in metabolic parameters between the two groups. Serum insulin concentrations significantly improved by 28 percent in the vitamin D group compared to no change in control group. The homeostatic model assessment of insulin resistance (HOMA-IR) significantly decreased by 36 percent in the experimental group, while slightly worsening in the placebo group. This indicates that, at least using mathematical modeling, MDD patients supplemented with vitamin D have decreased insulin resistance. The redox profile also improved in the vitamin D group compared to placebo controls. Total antioxidant capacity significantly improved, although only by 7 percent, compared to a lesser, insignificant improvement of 3 percent in the control group. Glutathione concentrations significantly increased in the vitamin D group by 24 percent, but decreased by 28 percent in the control group.

Eight weeks of high-dose vitamin D supplementation in MDD patients may improve their depressive symptoms. It also improved a variety of metabolic measures, decreased their fasting serum insulin levels, improving insulin resistance and beta cell function, increasing their antioxidant capacity and elevating serum glutathione levels.


What Does the Study Really Tell Us?

This study adds to growing evidence showing that vitamin D supplementation improves depressive symptoms in MDD patients. Serum levels of 25-hydroxyvitamin D have been shown to negatively correlate with depressive symptoms in MDD patients. In the current study, eight weeks of supplementation with 50,000IU vitamin D per week resulted in possibly improved (decreased) BDI score, ameliorating participants’ depression diagnosis from moderate to mild depression. The dose in this study amounts to 7,143 IU vitamin D per day.

The researchers interpreted their data to indicate that vitamin D supplementation improves patients’ depressive mood. However, the differences seen in the vitamin D group did not become significantly different until researchers controlled for a variety of variables (baseline 25-hydroxyvitamin D levels, BMI and age). As researchers reported no difference in baseline BMI or age between the experimental and control groups, it is unclear why controlling for these parameters would alter significance of changes in BDI scores. Therefore, study conclusions regarding impact of vitamin D supplementation on mood symptoms in MDD should be taken with a grain of salt. Moreover, the BDI does not determine whether reported symptoms are due to MDD or other illnesses. So theoretically, vitamin D supplementation may have improved energy levels in MDD patients independent of improving mood per se; however, this would be measured as improved MDD symptom on the BDI measures.

In this study, researchers used two different measures of MDD symptoms, the HDRS (at the recruitment stage) and BDI (to measure changes in depressive symptoms throughout the study). It is unclear as to why the researchers switched to a different measuring tool in the study. Some argue that the two scales measure different aspects of MDD treatment, with HDRS measuring medication effects and BDI assessing psychotherapy outcomes. Since researchers measured the effects of medication on depressive symptoms, they might have benefited from using HDRS for the entire study.

MDD has been linked with diabetes and insulin resistance. In this study, vitamin D supplementation improved insulin levels along with predicted insulin resistance and beta cell function. It is unclear exactly how vitamin D affects insulin metabolism specifically. Insulin is secreted into the blood to help promote glucose absorption. Vitamin D has been shown to increase levels of the glucose transporter GLUT4 and improve glucose metabolism in cultured adipocytes (fat cells), and GLUT3 expression in diabetic rats. This may increase glucose absorption and consequently decrease blood insulin levels. Vitamin D could exert other effects on insulin metabolism that have yet to be discovered.

This study does not clarify whether positive effects of vitamin D occur once patients reach a threshold value (threshold model), or whether positive effects of vitamin D supplementation are proportional to vitamin D levels post-threshold (dose-dependent model).

In this study, vitamin D appeared to improve mood, which may be due to increased neurotransmitter synthesis. Vitamin D also appears to improve insulin functioning, though the exact mechanism is unknown.

The big picture

MDD is a debilitating disease that affects many people worldwide. It is associated with decreased life expectancy and poor quality of life. Improved treatments for this condition are needed. There has been an accumulation of evidence for the beneficial role of vitamin D in MDD. This study shows that high-dose vitamin D supplementation possibly promotes improvement in depressive symptoms.

However, high doses of vitamin D may have harmful side effects. A study in seniors showed an increase in falls in the groups that received 24,000 IU or 40,000 IU once a month. This suggests that it may be wise to accurately assess vitamin D side effects in MDD patients as well, especially in trials using large doses of vitamin D.

This study highlights the need to correct an existing vitamin D deficiency if there is one, as the patient population was largely vitamin D deficient at baseline. Insulin and mood benefits were only observed when participants reached sufficient serum vitamin D levels. Further studies of vitamin D effects on MDD in other patient populations, including those with replete serum vitamin D levels, are needed before vitamin D can be used as a reliable treatment for MDD.

The molecular mechanism by which vitamin D could influence mood is unclear. Vitamin D supplementation has been shown to increase expression of receptors for dopamine and norepinephrine in diabetic rats, which might contribute to elevated mood through increased neurotransmitter signaling. Vitamin D has also been shown to increase levels of tyrosine hydroxylase, an enzyme responsible for the synthesis of dopamine and other catecholamine neurotransmitters. However, vitamin D may exert beneficial effects on mood through other mechanisms as well.

Frequently Asked Questions

Are there any dangers to taking vitamin D supplements?

As vitamin D deficiency is very prevalent, it is generally a good idea to take a vitamin D supplement if you’re unable to get enough sunlight. However, beware of high-dose vitamin D supplementation, as high serum levels of vitamin D can cause a dangerous rise in blood calcium levels (hypercalcemia). Taking vitamin K2 alongside vitamin D may help prevent calcium spikes. And given the aforementioned potential of high dose vitamin D to cause increased falls in the elderly, it may be best to avoid weekly/monthly/yearly high doses if more regular smaller doses are feasible.

Should I pop vitamin pills, or go for the sunshine route?

First of all, these options are not mutually exclusive. Opting for supplementation in the winter and sunshine in other seasons is a common strategy. Second, it’s been suggested by several studies in different populations that sunshine has a greater effect on mood than does vitamin D alone. That makes intuitive sense, as you get vitamin D benefits in addition to other benefits such as increased endorphin production.

What Should I Know?

MDD has been linked with increased insulin resistance, and vitamin D has been shown to improve insulin resistance parameters. In this study, researchers administered high doses of vitamin D to patients with moderately severe MDD weekly for eight weeks, and found an improvement in insulin resistance parameters and possible depressive mood scores. This study highlights the need to further investigate vitamin D as a potential therapeutic for people with MDD, with a focus on dose needed to achieve an effect as well as potential side effects in this specific population.

Source: Vitamin D Supplementation Affects the Beck Depression Inventory, Insulin Resistance, and Biomarkers of Oxidative Stress in Patients with Major Depressive Disorder: A Randomized, Controlled Clinical Trial

Reproduced with permission from All rights reserved.

Fit Life / What You Need to Know About Eating Organic

April 5, 2016

Organic food has become very popular, with more and more organic foods available every month. But is eating organic food healthier? How do you identify organic produce and which ones are a must when choosing organic? Do pesticides cause cancer and other diseases? Here is a quick guide to eating organic to help you navigate the aisles of your grocery store.

What Does “Organic” Mean?

Organic refers to foods that are grown without pesticides, synthetic fertilizers, antibiotics or artificial growth hormones. Organic farming procedures reduce pollution and encourage soil and water conservation by using crop rotation and natural fertilizers.

According to the United States Department of Agriculture (USDA), for a food to be labeled “organic,” the ingredients must be at least 95 percent organic. The next level down is the “Made with Organic Ingredients” label, in which at least 70 percent of the ingredients are organic. Foods containing less than 70 percent organic ingredients cannot use the organic seal or the word “organic” anywhere on the label. One hundred percent organic meat, poultry, dairy and eggs are free of antibiotics and artificial growth hormones. Fish is not included in the organic monitoring of animal proteins, as it is not governed by the USDA. Instead, look for “wild” caught fish rather than “farmed” fish, in most cases. Your best reference bet for choosing the healthiest and safest fish is to consult the Seafood Watch guide from the Monterey Bay Aquarium.

Which Foods Should Be Organic?

Every year, the Environmental Working Group ( puts out a list of the 12 fruits and vegetables with the highest levels of pesticides—what they call the Dirty Dozen. While we await the release of the 2016 list, the 2015 list includes: apples, nectarines, peaches, strawberries, grapes, celery, spinach, sweet bell peppers, cucumbers, cherry tomatoes, imported snap peas and potatoes. They also listed two additional items: hot peppers and kale/collard greens. The EWG advises that consumers should choose organic versions of items on the dirty dozen list. All produce bears a sticker with its identifying number, so look for a “9” at the beginning of the number, as this signifies an organic item. The EWG also puts out its Clean Fifteen list so that consumers can feel safe about which conventionally grown items they can purchase.

Are Organic Foods Healthier?

Organic foods provide a number of health benefits. Studies have shown that organic produce is higher in antioxidants than conventionally grown produce, which can reduce the risk of heart disease and certain cancers. In addition:

  • Organic food is free of pesticides, which include herbicides and fungicides. Pesticides, such as organophosphates, have been linked to impaired child brain development. In 2012, the American Academy of Pediatrics issued a report that said that children have “unique susceptibilities to [pesticide residues] potential toxicity.” They cited research linking early exposure to pesticides to “pediatric cancers, decreased cognitive function and behavioral problems.” They also urge parents to consult reputable sources of information on the pesticide content of food.
  • Organic food from your local farmer’s market ensures that you are getting product that was just picked from the garden, so it maintains higher levels of freshness and nutrients. The longer a fruit or vegetable sits on the shelf, the more nutrients it loses.
  • Organic food is GMO-free. Genetically modified organisms (GMOs) are a hot topic in health due to the concern over the creation of “Frankenfoods” or the increase in food allergies. Some believe these may be due to the fact that creating GMOs involves splicing in the DNA of one species of animal into a plant to help it grow larger, heartier and more resistant to damage from insects. Despite growing consumer protests against GMO foods, GMO foods do not require identifying labels, as legislation mandating GMO labels has not passed in many states. The crops grown in the United States that are primarily genetically modified include soy, corn and wheat. It is recommended that you purchase organic versions of these foods.
  • Organic meat and dairy is richer in certain nutrients, such as omega-3 fatty acids. Grass-fed, organic cows have a better fatty-acid profile than do cows raised on a grain-based diet.
  • Organically raised animals are given NO growth hormones, antibiotics or animal byproducts. Conversely, conventionally grown cows are given recombinant bovine growth hormone (rBGH), a synthetic hormone that increases milk production. Plus, organically raised animals are given more room to roam, which gives them a higher lean-to-fat ratio.

How to Shop for Organic foods on a Budget

Buying organic foods can really increase your food budget, as you are paying a little more for the benefits that organic offer, as well as the packaging. To help cut costs when shopping, consider shopping at your local farmer’s market. By taking the middle man out of the equation, you can save quite a few dollars. Plus, making friends with your local organic farmers allows you to taste before you buy. You’ll also benefit from eating local and seasonal ingredients. Buy just what you think you will need for the week, as certain fruits and vegetables are quicker to spoil.

At the traditional grocery store or health food store, buy items such as rice, cereal, pasta and dried fruit in the bulk bins. The organic sections of traditional grocery stores, as well as stores like Target, Wal-Mart and Costco, have increased in size and are projected to continue to expand. You’ll likely save a few dollars if you buy packaged organic items (yogurt, cereal, eggs) from discount stores.

The Bottom Line

It’s your choice to purchase organic foods and products. There’s a growing sentiment that these foods are healthier due to their lack of pesticides, hormones and GMOs. There’s no reason you can’t buy organic and save some money by shopping smarter. Stay educated about the great organic debate so you can make the best choices for yourself and your family.

U Rock Girl!U Rock Girl! ContributorTiffani Bachus, R.D.N., and Erin Macdonald, R.D.N., are the co-founders of U Rock Girl!, a website designed to nourish the mind, body and spirit of women of all ages and stages of life. They have just authored the rockin’ breakfast cookbook, No Excuses! 50 Healthy Ways to ROCK Breakfast! available at

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3 Healthy Snack Swaps to Add Variety to Your Diet

ACE/Fit Life


February 17, 2016

Are you stuck in a nutritional rut, eating the same foods every day because it’s easy and efficient? Although this may not sound so bad if you eat a healthy diet, the downside is that you may be exposing yourself to the same nutrients, processing methods, pesticides (even in healthy, organic foods) every day, while also missing out on an array of nutrients.

If you’re trying to up your nutritional game without sacrificing efficiency when in a time crunch, making dietary swaps at snack time is a good place to start because these foods don’t require the investment of creating a whole new meal. The following three foods may be slightly off your radar, but they are fun, healthy and easy to add into your dietary repertoire.


Here’s why: You may order edamame at a Japanese restaurant, but it’s not likely one of your staple snack foods. Edamame is the young soybean that’s been harvested before the beans have a chance to harden. It makes a great snack because it contains fiber and protein, both of which are key for satiety. If you worry that green plant foods will leave you hungry, this one won’t.
Bonus: Research has linked soy foods like edamame to improved heart health, reduced risk of osteoporosis and cancer.

  • You can buy edamame shelled or in the pod, fresh or frozen.
  • Edamame comes in its own wrapper (the pod) so it isn’t processed like most snack foods and it may just have the crunch you’re looking for.
  • A serving is one-half cup shelled or a little more than one cup in its pod. You’ll get 120 calories, 11 grams of protein and 9 grams fiber.
  • Buy edamame and eat as a snack as is, or make these easy, satisfying edamame dishes to keep on hand for snacks:
    • Super easy, sweet and crunchy Corn & Edamame Salad (188 Calories, 15 g protein, 7 g fiber)
    • Edamame Hummus for veggie dipping (115 Calories, 7 g protein; 3 g fiber)
    • Edamame Cranberry Feta Salad (183 Calories, 12 g Protein, 4 g Fiber)

Figs (or Dates) and Low-fat Cheese

Here’s why: You likely snack on a banana or apple, but aren’t going for sweet and delicious figs. Dried figs contain up to 50 times the polyphenol content of most other fruits. Phenolic antioxidants are powerful when it comes to defending the body from damage. Figs (and dates, too) make a great snack because they’re portable and can handle a hit to your bag without bruising. They’re also packed with fiber to keep you satiated and regular. Plus, figs are both sweet and fibrous, which means you can’t devour them quickly.

  • Paired with protein-rich, savory cheese, figs make for a filling, phytonutrient-packed, indulgent treat.
  • Enjoy three small figs and one small, light 30- to 35-calorie cheese round (one-half cup of fresh figs contains about 74 calories, so this light snack has approximately 125 calories).
  • Figs are rich in potassium and contain very little sodium, so they help to keep your blood pressure levels low.
  • Dried figs can add up in calories quickly, so keep portions to about one-half cup and round them out with cheese for protein.

Grab a few figs and a low-fat organic string cheese, or try this delicious alternative: Goat Cheese Walnut Stuffed Dates (To increase the protein content, swap the goat cheese for low-fat feta and use more feta.)

Crunchy Cucumber Sandwiches and DIY Veggie Chips

Here’s why: We all know we need more veggies, but most people aren’t opting for crudité and dip to meet their quota at snack time. Give yourself some enticing flavors and textures (like the ones below) to motivate you to get the powerful phytonutrients that help to fend off chronic illnesses. What’s better than a crunchy sandwich that contains just 50 calories and more protein than most yogurts? If that doesn’t call your name, what about chips that just happen to offer the fiber and phytonutrients that you’d get in a salad?
Try any of the options below. You can take them to the office or with you in the car. Plus, they all contain plenty of protein. Eat the “chips” and “fries” with one-half cup of nonfat Greek yogurt, cottage cheese or with a hard-cooked egg, one-half cup edamame or with two tablespoons of hummus.

Skinny Cucumber Sandwiches (You can make these in minutes; choose either the cottage cheese or cheese varieties with tomato and they contain just 50 calories and 9 g protein.)

Skinny Egg Salad Sandwiches (Eat a few of these creamy numbers on crunchy cucumber “bread” and you’ll easily forget about the vending machine.)

Paprika Zucchini Chips (Snack on these with a Greek yogurt or a wedge of low-fat cheese—or some edamame.

Guilt-Free Kale Chips (These chips have just 36 calories, plus contain cancer-fighting nutrients.)

Spicy Carrot Fries (At just 71 calories and with 5 g of fiber, these fries pack a nutrient punch without the grease of other fries. Dip them in hummus or have a hard-cooked egg with them for protein.)

Sweet Potato Chips with Sea Salt & Dark Chocolate Drizzle (Pair these with some yogurt or another protein.)



Goat Cheese & Walnut Stuffed Dates

These treats are perfect to serve as an appetizer at a party or a mid-day snack! With walnuts and goat cheese “wrapped up” in a date, topped off with a sprinkle of cinnamon; this is a flavor combination your taste buds will adore! We love the sweet, savory and salty combination of flavors with the gooey, smooth and crunchy textures. Enjoy!

Yields: 1 serving

Serving Size: 1 date


1 pitted date (or you can pit the date yourself by cutting the date down the middle)

½ tsp goat cheese

1 shelled walnut

Sprinkle of cinnamon


Slice the date partially down the middle so that you can see the inside but so that the bottom is still attached.

Take a ½ tsp of goat cheese and use a knife to place it in the date, then stick the walnut inside and partially close the date to avoid the ingredients from falling out.

Sprinkle a dash of cinnamon on top, but be careful not to add too much as its’ strong flavor may take away from the rest of the bite.

Nutrition Facts

Calories: 43

Carbohydrates: 5 g

Fat: 2 g

Protein: 1 g

Saturated Fat: 0 g

Cholesterol: 0 g

Sodium: 9 mg

Fiber: 0 g

Sugar: 4 g
Goat Cheese & Walnut Stuffed Dates

1 pitted date (or you can pit the date yourself by cutting the date down the middle)
½ tsp goat cheese
1 shelled walnut
Sprinkle of cinnamon




The Nutrition TwinsThe Nutrition Twins ContributorTammy Lakatos Shames and Elysse (“Lyssie”) Lakatos, The Nutrition Twins®, share a passion to teach people how to eat healthfully and exercise so they’ll have energy to live happy lives. The twins have been featured as nutrition experts on Good Morning America, Discovery Health, Fox News, NBC, Bravo, CBS, The Learning Channel, FitTV, Oxygen Network, and Fox & Friends. They co-wrote The Nutrition Twins Veggie Cure: Expert Advice and Tantalizing Recipes for Health, Energy and Beauty, The Secret to Skinny: How Salt Makes You Fat and the 4-Week Plan to Drop A Size & Get Healthier with Simple Low Sodium Swaps. The twins are both ACE Certified Personal Trainers, and members of the American Dietetic Association and several Dietetic Practice Groups.