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Dark Chocolate, Lead & Cadmium

By Mila McManus, MD

...tested 28 different dark chocolate bars and found 23 of them to contain potentially harmful levels of lead, cadmium, or both.

Last January, Consumer Reports urged several chocolate producers to reduce the amount of lead and cadmium found in their dark chocolate products. A corporate accountability organization called You Sow tested 28 different dark chocolate bars and found 23 of them to contain potentially harmful levels of lead, cadmium, or both. The exposures were considered concerning for those who consume one ounce or more per day.

Heavy metals, such as lead and cadmium, are especially harmful for pregnant women and children because they can negatively affect brain development and lead to lower IQ.  They have negative effects on others as well, of course. Frequent exposure to lead in adults can lead to nervous system problems, hypertension, immune system suppression, kidney damage, and reproductive issues.

Brands with the highest levels included:

High in Both Lead & Cadmium – Theo Organic Dark 70%, Trader Joe’s The Dark Chocolate Lover’s, Theo Organic Extra Dark Pure, Lily’s Extremely Dark, and Green & Blacks Organic Dark.  All of these had 120-145% lead levels and 101-229% cadmium levels.

High Lead – Tony’s Chocolony Dark, Lily’s Extra Dark, Godiva Signature Dark, Chocolove Strong Dark, Lindt Excellence Dark, Endangered Species Bold + Silky Dark, Trader Joe’s Dark, Hu Organic Simple Dark, Chocolove Extreme Dark,  and Hershey’s Special Dark Mildly Sweet. All of these had 134-265% lead levels.

High Cadmium – Beyond Good Organic Pure Dark, Equal Exchange Organic Extra Dark, Lindt Excellence Dark, Scharffen Berger Extra Dark, Alter Eco Organic Dark Blackout, Pascha Organic Very Dark Dark,  and Dove Promises Deeper Dark. Cadmium ranged from 112-253%.

While every bar had some level of lead and cadmium, those found to have the lower and safer levels when consumed in moderation are Mast Organic Dark, Taza Chocolate Organic Deliciously Dark, Ghirardelli Intense Dark, Ghirardelli Intense Dark Twilight Delight, and Valrhona Abinao Dark. In these selections, lead ranged from 14-63% and cadmium ranged from 40-73%.

Heavy metals lurk in the cocoa solids of the cacao bean and are higher in the darker, over 65% cacao by weight, chocolates. Cocoa butter is the other solid portion. The heavy metal concerns can extend to other products such as hot cocoa, brownie mixes, and cake mixes. The older a tree becomes, the more heavy metals are passed from the soil into the tree. Additionally, different countries vary in the heavy metal contents of their soils. Heavy metals also tend to increase during the drying process while beans lie on the ground or near roads in the sun.  One way to reduce the heavy metal content is to mix beans from a variety of soils.

Michael J. DiBartolomeis, PhD, a toxicologist and former official at the California Department of Public Health who has researched heavy metals in chocolate, says that while he cautions pregnant women and children from eating dark chocolate, he doesn’t tell most people to give it up, just to know the risks and not overdo it. Consider adding detoxification strategies such as exercise, sauna, proper hydration, regular bowel function promoted through a high fiber diet, and frequent rotation of a wide variety of foods. Ask your provider if heavy metal testing is right for you.



Doctor’s Data Inc., Descriptive Texts for Lead and Cadmium, 1999-1921.




By |2023-05-23T11:23:01-06:00May 24th, 2023|Articles, General|

Fructose: The Most Harmful Sugar

by Mila McManus, MD

Fructose is increasingly in the forefront as causing significant health problems and its use by the food industry has increased considerably.

All sugars are harmful for us, especially when eaten in excess. We always recommend reduction of sugar intake as far as you possibly can. Fructose is increasingly in the forefront as causing significant health problems.  

The negative effects of fructose include:

  • Fatty liver
  • High Triglycerides
  • Weight Gain
  • Leptin Resistance
  • Keeps you feeling hungry
  • Increases uric acid which contributes to Cardiovascular Disease, cognitive decline, and kidney stones to name a few
  • Causes insulin resistance

Fructose is a simple sugar found in fruit, vegetables, and some natural sweeteners, and is also added to a wide variety of processed foods and beverages. Over the last 50 years, fructose use by the food industry has increased considerably.

The body’s preferred source of fuel is glucose, the form of sugar we are “wired” to use. While fructose is a simple sugar, the process of converting it to glucose must be done by the liver.  Once converted, it will be used for energy if the blood needs glucose, or it will be stored in the liver, or in fat cells.  The process of converting fructose results in a waste product called uric acid, a key contributor to gout and heart disease.  A good analogy would be to say that glucose is a clean fuel and fructose is a dirty fuel that pollutes your body.

High fructose corn sugar is a combination of fructose and glucose and made from corn starch. It is cheaper and sweeter than cane sugar.  It is found in soft drinks, bread, juices, ice cream, canned fruit, canned soup, ketchup, sweetened dairy products, cakes, cereal bars, salad dressings, and many other manufactured foods. We recommend elimination of these foods for a multitude of health reasons notwithstanding the ones listed above.

We also recommend avoiding corn syrup, honey, and agave nectar, and limiting fruit to no more than 2 servings a day. Grapes, watermelon, jackfruit, and dried fruit like cranberries, raisins, apricots, and apples are intensified forms of fructose, so best avoided or very limited. Small fresh fruit is a better choice and offers natural fructose. Fructose in fruit isn’t what’s causing disease in most people.  Along with the fructose in a piece of fruit you’re also getting fiber, vitamins, minerals, and other micronutrients that your body needs.  Good choices include apples, apricots, berries, melon, citrus fruit, kiwi, cherries, pear, plum, and peach. A portion is about the size of a tennis ball, or ½ to 1 cup of fresh bite sized pieces.

If you need help getting fructose out of the diet, our staff nutritionist is available to guide you to healthier choices that are best for your unique body and health status.

Eat Well, Be Well.


Dr. David Perlmutter, author of Drop Acid: The Surprising New Science of Uric Acid


By |2023-05-15T15:55:34-06:00May 17th, 2023|Articles, General|

Melatonin Gummies: Label does not Equal Content

by Mila McManus, MD

The study analyzed 25 melatonin gummy products and found that 22 of them, (88%!) did not contain what the label said they did.

It always seems worth repeating – supplements are not all created equal! A recent study published by the Journal of the American Medical Association (JAMA) demonstrated, once again, the lack of quality control measure that are too common with over-the-counter supplements. Moreover, this is much more common with cheaper brands.

This investigation was for melatonin gummies for a sleep aid. The study analyzed 25 melatonin gummy products and found that 22 of them (88%!) did not contain what the label listed. One of them contained only 75% of the advertised amount on the label, while another had 347% more melatonin than the package listed. Another brand did not contain any detectable melatonin at all. Gummies are a popular delivery method for children’s supplements which makes this all the more concerning.

The same has been found to be true for many other supplements.  I have written about this before and explained a number of concerns, including the distinction between whole food supplements and synthetic supplements, and I encourage you to read that here.

We want to make sure this does not happen to our patients, families, and friends. Supplements and protein powders are not a wise place to scrimp on your budget. The quality and purity of all of the ingredients, both active and “other” ingredients on the label, and the correct dosing as promised on the package, all add up to safety and effectiveness. We are also aware of many supplements that are being counterfeited on Amazon (more than half the supplements sold on Amazon are counterfeit!); another concern resulting in our recommendation that you also not buy supplements there.  The supplements that we recommend at our facility have been vetted, so you can have peace of mind.

Be wise, be safe, and be well.





By |2023-05-09T09:27:19-06:00May 10th, 2023|Articles, General|

Kiwi: A Tasty New Option for Constipation and Gut Health

by Mila McManus, MD

Scientific studies have shown that Kiwi Fruit, has the ability to promote good digestion and to ease chronic constipation.

Many people struggle with constipation or other gastrointestinal maladies. Scientific studies have shown that Kiwi Fruit, a long valued traditional Chinese medicine, has the ability to promote good digestion and to ease chronic constipation. Most medications for chronic constipation are not very successful and have traditionally helped fewer than half of the patients. They are also associated with cramping, bloating, and diarrhea.  This makes more natural approaches appealing.

Kiwi is rich in antioxidants and high in fiber. A potent anti-inflammatory, studies show that daily consumption of kiwi fruit improves the softness and bulk of stools, thereby increasing the frequency and ease of bowel movements while reducing uncomfortable straining.  Unlike laxatives, kiwi does not cause diarrhea. In one study published in Asia Pacific Journal of Clinical Nutrition, participants diagnosed with irritable bowel syndrome consumed two green kiwi fruit a day for four weeks. The participants experienced significant increases in frequency of bowel movements, less colon transit time, and improved bowel function.[1] In another study,[2] kiwi fruit reduced straining better than psyllium fiber!

Much of Kiwi’s therapeutic power comes from actinidin, an enzyme that helps to promote digestive  motility. Kiwi also contains pectin, which adds bulk to the stool and helps to treat both diarrhea and constipation.  Actinidin and pectin are both prebiotics, providing food for your friendly gut bacteria that are essential for good gut and immune functions.  Researchers compared the effect of kiwi fruit pectin to other commercial prebiotics and found that kiwi was the most effective in reducing the intestinal adhesion (aka stickiness) of disease-causing Salmonella bacteria. Furthermore, kiwi increases the stickiness of good, favorable gut bacteria found in probiotics.[3]

Kiwi is also an excellent source of Vitamin C, E, and potassium, and has 2.1 grams of fiber for an average sized fruit. They contain antioxidant citric and gallic acids as well as vision-boosting carotenoids such as lutein. Kiwi is also rich in glutathione, the body’s most powerful antioxidant that prevents oxidative damage to cells, and recycles vitamins C and E in the body. One kiwi a day has also been shown to lower the risk of stroke, blood clots, and heart disease.

A word of caution: For individuals who are allergic to pollen, rye, avocado, or bananas, you may also find that you react to kiwi fruit.  Additionally, those who are prone to kidney stones may want to limit it since they are moderately high in oxalates.

[1] Chang, Chun-Choa et al.”Kiwi fruit improves bowel function in patients with irritable bowel syndrome with constipation.” Asia Pacific Journal of Clinical Nutrition 2010; 19(4):451-7.

[2] Bayer, Simone B, et al. Two gold kiwi fruit daily for effective treatment of constipation in adults – a randomized clinical trial. Nutrients 2022; 14(4146). https://doi.org/10.3390/nu14194146

[3] Naturalhealth365.com


By |2023-05-04T06:15:41-06:00May 4th, 2023|Articles, General|

Laundry Detergent: What’s in Yours?

by Mila McManus, MD

...recently banned laundry detergents ... after recognizing ... that 1,4-dioxane is a potential carcinogen found in laundry detergents.

Are you using Arm & Hammer Clean Burst, Tide Original, Arm & Hammer Sensitive Skin Free & Clear, or Gain Original + Aroma Boost? You may want to reconsider….

New York state recently banned laundry detergents containing more than 2 PPM of 1,4-dioxane after recognizing the health concerns that 1,4-dioxane is a potential carcinogen found in laundry detergents.

Exposure to 1,4-dioxane occurs by inhaling or ingesting contaminated air, food, or fumes from detergent, or from sheets or clothing that have been washed in the detergent. Exposure can also take place through skin contact (e.g., in lotions). Because it evaporates quickly, breathing the fumes pose the greatest risk, according to the Food and Drug Administration.

1,4-dioxane would not be included on an ingredient list because it enters detergent products through ethoxylation, a chemical processing that takes place in the manufacturing stage, and so is a byproduct of processing. It takes lab equipment to detect it.  Animal studies have flagged 1,4-dioxane as a potential carcinogen, although it is not the only harmful contaminant in laundry detergents. Skin irritation and rashes from popular laundry brands are common.

According to Lydia Jahl, PhD, a science and policy associate with Green Science Policy Institute, the best approach is to avoid detergents with ingredients like “polyethylene glycol (PEG), polysorbates, and chemicals ending in “-eth” or “oxynol” such as sodium laureth sulfate, which might suggest, though not confirm, that 1,4-dioxane is a contaminant.

The Environmental Working Group (ewg.org) has rated dozens of laundry detergents and at least twenty of them have received an “A” rating. Here are some of the cleaner, less toxic brand names:

Aspen Clean                                       Martha Stewart Clean                                    Puracy

Attitude                                              Nature’s Promise                                           Sensitive Home

Better Life                                          Dropps                                                           Seventh Generation

Common Good                                 O Organics                                                     Simple Truth Organic

Blueland                                             Earthley                                                         Whole Foods Green Mission

Dirty Labs Bio                                    Go By

365 Everyday Value                           Greenshield

9 Elements                                         Grab Green

Hello Bello                                         Presto!

Lazy Coconuts                                    PUR Home         

Be clean, Be Healthy.




By |2023-04-27T12:00:35-06:00April 27th, 2023|Articles, General|

Male Sperm Count – A Global Crisis

by Mila McManus, MD

A meta-analysis of sperm count in men on six continents shows an alarming decline that continues to accelerate.

Medscape reported in January 2023 that a meta-analysis of sperm count in men on six continents shows an alarming decline that continues to accelerate, according to an international team of researchers at Hebrew University of Jerusalem.

In South and Central America, North America, Europe, and Australia, sperm count declines have accelerated in the last 5 years. The crisis has been related to our modern environment and lifestyle with broad implications for current populations.  The decline in sperm counts is consistent with other adverse trends in other men’s health, such as testicular cancer, hormonal disruption, and genital birth defects, as well as decreased lifespan. A simultaneous set of adverse outcomes is being seen in female reproductive systems.

While Medscape expresses the concern that “without mitigation, the decline in sperm count and male reproductive health could threaten mankind’s survival”, it is interesting to note how aversive the government, insurance, pharmaceutical, food, and health industries are to supporting less pollution, less manufacturing, cleaner food, and encouraging healthier diets and lifestyles. What a difference this could make if they were less interested in profits and control, and more interested in mankind.

Own your health. Take control. Be Well.


By |2023-04-19T12:10:04-06:00April 20th, 2023|Articles, General|

Colorectal Cancer: No Longer a Disease of the Aging…

by Mila McManus, MD

Colorectal cancer is the third most commonly diagnosed cancer and the third leading cause of cancer death for both men and women

During the 2000’s, colorectal cancer declined among people aged 50 and older largely due to an increase in cancer screenings.  Colorectal cancer (of the colon and/or rectum) is the third most commonly diagnosed cancer and the third leading cause of cancer deaths for both men and women in the United States. 

The concerning and interesting change in the data is that the incidence among younger adults has doubled.  In addition, more advanced disease is being diagnosed. This means that the proportion of individuals of all ages presenting with advanced-stage colorectal cancer increased from 52% in the mid-2000’s to 60% in 2019.

We found it interesting that Medscape’s article points out the senior author, Ahmedin Jemal, DVM, PhD from the American Cancer Society reporting the new data “pointed out that more than half of all cases and deaths are associated with modifiable risk factors such as smoking, and unhealthy diet, high alcohol consumption, physical inactivity, and excess body weight”; yet the very next sentence from Medscape is that “it remains unclear why rates are rising among younger adults and diagnosed at more advanced stages”! 

Unclear? Hardly.  The current parenting generation was raised largely on the Standard American Diet (SAD) and the FDA Food Plate recommendations, both full of sugar, processed carbohydrates, and fast food. Moreover, obesity has reached epidemic proportions. COVID, along with excessive time sitting while using television, cell phones, computers, and gaming equipment, have promoted less activity. Environmental chemicals, harmful food additives, and excessive use of plastics are also contributors.  We cannot ignore the impact that stress and trauma have on health either.  While we will all die of something eventually, and we cannot promise anyone a disease free life, we do know that lifestyle choices toward good habits matter greatly. Healthy food, quality sleep, regular exercise, good relationships, stress management, and attention to spiritual matters all contribute, in powerful ways, to overall good health.  Teaching young people better health habits is long overdue and, in and of itself, would dramatically reduce the volume of death and disease.

Choose wisely for your family and yourself. Encourage a healthy lifestyle for friends and family. Demonstrate it to neighbors in your community. Let’s help each other make wiser choices. Let’s not wait until Medscape figures it out! And, oh yea, please stay up to date on your cancer screenings!

Live Well. Be Well.


Colorectal Cancer Incidence Doubled in Younger Adults – Medscape – March 2, 2023


By |2023-04-05T11:57:41-06:00April 6th, 2023|Articles, General|

Will the Fake Meat Empire Collapse?

By Mila McManus, MD

We shared our concerns about making “food” using cultured animal cells. Fake meat, like the Impossible Burger, is one good example. 

In mid-February, we shared our concerns about making “food” using cultured animal cells. And April 2022 we wrote about plant-based “meats”.  Thankfully, it appears there are signs we are not the only ones concerned.  This may be more of a fad, along with a power grab attempt, than a permanent change in the way Americans eat.  Here are some reasons to hold out hope:

  • Many consider it conspicuous that Bill Gates has become one of the largest owners of American farmland as of May 2022. He is also a proponent of proliferating fake meat products made from GMO Soy and other controversial ingredients. Is fake meat a profit pushing gig at the expense of human and environmental health?
  • Shares for Impossible Foods have dropped dramatically, and Bloomberg reports the company recently laid off 20% of its workforce.
  • One compound, soy leghemoglobin (SLH) used to make fake meat look raw and bleeding, is derived from genetically -modified yeast, and has been shown in animal models to be associated with anemia, kidney disease, and weight gain. The European Patent Office has revoked Impossible Foods’ European Union patent due to this concern as well as other flavor precursor molecules. The FDA also has questioned if arguments presented in favor of allowing Impossible Food’s products to be considered GRAS (“Generally Recognized As Safe”) establish such safety.

We continue to hold firmly to the belief that cultured animal cells and GMO soy mixed with other flavor enhancers is not real food but a highly MAN-ufactured food.  Be real. Eat real.







By |2023-03-20T10:43:55-06:00March 22nd, 2023|Articles, General|

Erythritol In the News – What it means

By Mila McManus MD and Nancy Mehlert MS

Erythritol, the zero-calorie sweetener, being found in a study to be “linked to increased cardiovascular risk”.

You may have seen several news stories recently about Erythritol, the zero-calorie sweetener, being found in a study to be “linked to increased cardiovascular risk”. The study, published by Nature Medicine, on the surface sounds concerning.  The researchers measured levels of erythritol in the blood and found that those with higher serum erythritol levels had an increased risk of stroke, heart  attack, and death. The research has been ongoing for over ten years.

When hearing news stories such as these, it is wise to take a closer look at what really occurred in the study. In fact, more often than not, the media outlet has not shared the whole story. There are at least three flaws to examine more closely in this study before we toss out the erythritol.

First, this study was not based on the intake or consumption of erythritol[1].  In fact, this study began before erythritol was approved as a sweetener, nor was it widely used as the study progressed. Serum samples from participants, therefore, reflected erythritol levels from another source. A 2017 study[2] found that humans produce erythritol endogenously ( i.e., produced inside the body) in response to the consumption of both glucose and fructose via the pentose phosphate pathway, or PPP.

Second, endogenous erythritol is a marker for a poor diet and metabolic dysfunction. Unlike erythritol, glucose and fructose are widely consumed in enormous amounts in both the U.S. and Europe, explaining why the study participants may have had high serum erythritol. This endogenous production of erythritol is correlated with cardiometabolic disease. For example, the PPP pathway is shown to modulate insulin sensitivity and obesity-induced inflammation and becomes dysregulated in people with obesity and metabolic disease. It seems likely that insulin resistance and high blood sugar are underlying causes of elevated endogenous erythritol levels.

Third, it is still unknown if high serum erythritol caused cardiovascular risk or was just associated with it. (It requires more than a suspect being at the scene of the crime to conclude that s/he was the culprit!) Nature Medicine did conduct a small experiment at the end of their study with eight human participants who were fed 30 grams of erythritol for seven days.  Their serum levels of erythritol increased significantly, but the researchers did not gather markers for blood clotting or note any adverse effects. So, we do know that high serum erythritol levels are associated with a higher risk of cardiac events and death, but again, correlation is not causation. Moreover, a study with only 8 participants, a good study, it does not make.  Sample size matters.

Studies in the past where animals were fed erythritol, the serum erythritol levels increased but no adverse effects were noted. In one study, rats were given a diet made up of 10% erythritol for two years and researchers observed positive effects on body weight with no adverse changes on numerous biomarkers related to metabolic health[3].

Chris Kresser summarized the results by saying “The study does not tell us that high serum erythritol causes cardiac events or deaths. Nor does it suggest that consuming erythritol in the diet increases the risk of cardiac events or death. In fact, given prior research, there is reason to believe that serum erythritol is simply a marker for sugar intake and or underlying metabolic dysfunction.”

We cannot be sure of either until more research is done.  In the meantime, we can offer some recommendations/reminders:

First, if you are consuming primarily packaged food bars, waters, protein powders, gummy candies, baked keto goods, and sweetening drinks with erythritol numerous times every day, err on the safe side and cut back on the excessive erythritol. 

Second, no matter what sweetener you use, be it sugar, artificial sweeteners, or more natural sweeteners like erythritol, xylitol, monk fruit, and stevia, constant use overstimulates your sweet taste buds and your pleasure centers of the brain.  This keeps you addicted to sweets, and possibly leads to overeating, or craving constantly. Moreover, this may mean that you fail to eat the meat, vegetables, nuts, seeds, and natural fruit for which humans are best suited.  So work toward less and less sweet drinks and foods, especially those that are “man”ufactured, and stick with the whole real foods and water our bodies are wired for and thrive on.  Fruit is the ideal sweet treat and, even so, should be consumed in moderation. Aim to make 80-90% or more of everything you eat real, whole, nature-made food.

[1] https://chriskresser.com/does-erythritol-increase-the-risk-of-heart-attack-and-early-death/, March 3, 2023

[2] Hootman KC, Trezzi JP, Kraemer L, Burwell LS, Dong X, Guertin KA, Jaeger C, Stover PJ, Hiller K, Cassano PA. Erythritol is a pentose-phosphate pathway metabolite and associated with adiposity gain in young adults. Proc Natl Acad Sci U S A. 2017 May 23;114(21):E4233-E4240. doi: 10.1073/pnas.1620079114. Epub 2017 May 8. PMID: 28484010; PMCID: PMC5448202.

[3] Lina BA, Bos-Kuijpers MH, Til HP, Bär A. Chronic toxicity and carcinogenicity study of erythritol in rats. Regul Toxicol Pharmacol. 1996 Oct;24(2 Pt 2):S264-79. doi: 10.1006/rtph.1996.0108. PMID: 8933643.

By |2023-03-16T09:10:19-06:00March 16th, 2023|Articles, General|

Before you flush……

by Mila McManus, MD

 the otherwise invisible spray that is sent into the air by flushing a toilet with the lid up... pathogens from human waste spread up into the air,

A group of engineers from the University of Colorado Boulder used laser lights to expose the otherwise invisible spray that is sent into the air by flushing a toilet with the lid up. It became visibly evident that pathogens from human waste spread up into the air, potentially exposing people to contagious disease.

The research was done using a typical commercial toilet, showing how the flush generates a strong upward jet of air that can rapidly carry particles up to 5 feet above the bowl within a few seconds of the start of the flush.

Respiratory diseases such as influenza are smaller particles that remain longer in the air and can be easily contracted through inhalation. Larger particles that settle faster on surfaces can spread intestinal diseases by contact with hands and mouth.

While toilet bowls generally have concentrations of pathogens even after dozens of flushes, the risk of disease transmission from toilet aerosol plumes is still unclear.

In any case, it never hurts to put the lid down before flushing :-/


*Closing the Toilet Lid Before Flushing Is Important – Medscape- Feb 14, 2023.

*Toilets spew in invisible aerosol plumes with every flush – here’s the proof, captured by high powered lasers,” published in The Conversation on December 16, 2022, theconversation.com.

By |2023-03-07T13:06:22-06:00March 8th, 2023|Articles, General|