Follow your doctor’s advice by asking for one clear next step. You might ask: What is one food I can add more often to support this condition? Or, what is one food or drink I can replace with a healthier choice?

These are some of the most empowering questions you as a patient can ask. Asking questions does not mean you are challenging your doctor or being disrespectful.

Information gives you a sense of direction, and direction helps move you from worry to action. It means you are helping your medical provider understand what your real life looks like. It means becoming an active participant in your care, so you can leave with enough understanding to take the next step.

Your doctor may know your labs, diagnosis, and medications, but you know your kitchen, your budget, your family meals, and the foods you grew up with. When you ask, “What does this look like on my plate?” you are bringing those two worlds together. That is where good advice can become a plan you actually follow. It is one way we take kuleana for our health.

For doctors and other providers, this question is worth listening to because it may determine whether motivation turns into real-life action. Patients often look to you as a trusted guide, and one clear answer can help them leave the visit with hope, direction, and a next step they can follow.

They may be wondering: Can I still eat the foods I grew up with? Do I have to give up rice, poi, ‘uala, or the meals my family shares? What changes can I make without feeling overwhelmed?

Beneath these questions, they are really asking, “Can you help me understand this diagnosis in the context of my real life?” Patients do not always need a long lecture or a perfect meal plan. They need one clear, doable next step.

Instead of only saying, “eat better” or “exercise more,” say, “this week, try adding one vegetable to dinner,” “switch one sugary drink to water or unsweetened tea,” or “walk for 10 minutes after your largest meal.”

Last year, I shared about my FoodRX Assistant app, created for individuals and families who want personalized nutrition guidance, meal plans, and recipes. I recently launched FoodRX Clinical, created for health professionals, offering evidence-based nutrition protocols and culturally tailored patient handouts.

Together, these tools are meant to support both sides of the care conversation, helping patients and providers move from general advice to clearer answers to the question: “What does this look like on my plate?”

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These are everyday examples of a powerful truth: the gut and brain are constantly talking to each other.

This two-way communication is called the gut-brain axis. The brain sends signals to the gut through nerves, hormones, and stress chemicals. When we are under stress, the body releases hormones like cortisol and adrenaline. These can change digestion, slow or speed bowel movements, increase stomach sensitivity, and affect appetite. This is why stress can trigger stomach pain, bloating, diarrhea, constipation, or cravings.

The gut also talks back to the brain. Inside our intestines are trillions of bacteria called the gut microbiome. Healthy bacteria help digest food, protect the gut lining, support the immune system, and produce helpful compounds. These compounds can send messages through the bloodstream, immune system, and nervous system, including the vagus nerve, which connects the gut and brain.

A well-nourished gut supports healthy bacteria growth, helping the body feel steadier and more resilient. An irritated or poorly nourished gut may contribute to digestive stress, fatigue, brain fog, anxiety, low mood, or poor sleep. Our daily food choices can affect not only our stomach, but also how we feel, think, and handle stress.

So, what feeds a healthier gut-brain connection? Fiber is one of the most important nutrients, as it feeds beneficial gut bacteria and help them produce short-chain fatty acids, which support the gut lining and may help calm inflammation. Good choices include kalo, poi, ʻuala, ʻulu, oats, tofu, mung beans, lentils, vegetables, and fruits.

Fermented foods, such as sour poi, yogurt, kimchi, natto, miso, and tempeh, also support healthy gut bacteria growth. Avocado, banana, nuts, seeds, and green leafy vegetables provide minerals like magnesium that support the nervous system.

Natural plant compounds, such as carotenoids and polyphenols, act as antioxidants that lower inflammation, supporting the health of the gut lining and brain cells.

Carotenoids include papaya, mango, kabocha, orange ʻuala, watercress, spinach, moringa, sweet potato leaves, and cooked lūʻau leaf. Polyphenols are found in purple ʻuala and eggplant, berries, ginger, turmeric, and garlic. Fish rich in omega-3 fatty acids, such as ʻōpelu, akule, sardines, salmon, and other fatty fish, also support brain health and inflammation balance.

Diets high in sugary drinks (juice, soda, energy drinks, specialty coffee drinks) and foods, fried foods, processed meats (Vienna sausage, hot dog, spam, deli meats), and packaged snacks support unhealthy bacteria growth and inflammation.

When these foods become the norm, this pattern may gradually make the body less resilient to stress and may contribute to fatigue, brain fog, irritability, low mood, anxiety, or difficulty coping with everyday stress.

Our kūpuna may not have used the word “microbiome,” but they understood that food, ʻāina, body, and spirit are connected.

The post From ʻŌpū to Mood: The Gut-Brain Connection appeared first on Ka Wai Ola.

Like lūʻau, the leaves were commonly used to wrap foods for cooking in the imu, helping to retain moisture and flavor.

Depending on a person’s condition, different parts of the plant – leaves, flowers, or shoots – were useful medicinally as well.

Leaves were applied externally, often slightly crushed, and placed on the forehead or body to help relieve fever and headache. They were also used to cover the body or used in specific areas to reduce pain and inflammation and soothe sore muscles.

In addition, kī leaves were used as bandages to wrap injured or fractured areas. Kī flowers were traditionally eaten raw or juiced, often combined with other plants in preparations for asthma, other lung conditions, and even nasal polyps. Young leaves and shoots were used as a decongestant.

Kī was not only a remedy itself, but also a tool that supported the broader practice of healing, as leaves were also used to wrap or deliver herbal preparations, serving as a natural way to hold, carry, or apply other plant medicines.

Modern science has identified compounds within the plant that help explain its usefulness for these common ailments. One of these is shikimic acid, a compound used in the manufacture of the antiviral drug oseltamivir (more commonly known as Tamiflu), which is widely prescribed to treat influenza A and B. Shikimic acid has also been studied for its anti-inflammatory and immune-supporting effects.

Kī also contains other important plant compounds, including flavonoids and steroidal saponins. Flavonoids are widely studied for their antioxidant and anti-inflammatory effects, including asthma, congestion, and joint pain such as arthritis. Steroidal saponins, another compound found in kī, have shown antimicrobial activity, helping to limit the growth and spread of bacteria, fungi, and parasites.

Even today, there are simple ways kī can be used for everyday support. For fever or headache, fresh kī leaves can be rinsed, gently crushed or bruised to release their natural compounds, and placed across the forehead or over the head, replacing them as they dry or begin to wilt.

For congestion, young shoots can be boiled in water, and the steam carefully inhaled from a safe distance. For breathing support, kī flowers can be eaten raw or mixed into foods such as poi.

As only green kī was used in pre-Western times, it would be wise to choose these over the colorful varieties commonly seen today. As with any natural approach, these natural therapies should be seen as complementary, rather than as a replacement for medical care when needed.

Growing alongside buildings in urban areas, throughout the countryside, and used in lei, kī reminds us that some of the most familiar plants carry both practical value and deeper meaning.

And that caring for our health can begin right in our own backyard.

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For many of these individuals, the liver and pancreas are not working together the way they should. The liver may produce more glucose than the body needs. In response to this, the pancreas releases more insulin to control it. High insulin levels signal the body to slow fat burning and store more fat.

These imbalances are often linked to lifestyle factors, including diets high in added sugars and highly processed foods, too little physical activity, chronic stress, and inadequate sleep. Over time, these factors can contribute to conditions such as prediabetes, fatty liver disease, and insulin resistance, which further worsen the imbalance and create a self-reinforcing cycle.

Some researchers believe that certain populations, such as Native Hawaiians and Pacific Islanders, may have a slightly higher genetic risk for these imbalances as well. When this higher risk is combined with unhealthy lifestyle patterns, weight gain may occur more easily, and weight loss may become more difficult for some individuals.

Healthy lifestyle changes – improving diet quality, increasing physical activity, getting adequate sleep, and managing stress – can help break this cycle. In some cases, this process can be accelerated with GLP-1 medications, especially tirzepatide (also known as Zepbound or Mounjaro). While semaglutide works mainly by regulating hunger and fullness signals, tirzepatide works additionally by normalizing glucose production in the liver.

Losing just 5-10% of body weight can begin improving how the liver and pancreas function.

Many obesity researchers say that GLP-1 medications create a “behavioral window.” As patients will find it easier to develop new habits and healthier eating patterns when their appetite is controlled. If these habits are not built during treatment, weight regain becomes more likely once the medication stops.

While I do not promote unnecessary reliance on prescription medications, there are times when they can be useful tools to help people regain control of their health until lifestyle changes can take over. GLP-1 drugs are one example that can help when other approaches have not worked. However, they should never be relied on to support unhealthy habits.

Certain foods and nutrients can help the body maintain better metabolic balance when transitioning off GLP-1 medications. Eating more soluble fiber supports healthier glucose regulation in the liver and helps manage appetite. Traditional starches, kalo (taro), ʻuala (sweet potato), and ʻulu (breadfruit), as well as oats, tofu, and other beans are good sources.

These foods, along with omega-3 fatty acids from fish and limu (seaweed), to also help reduce liver fat. Adequate protein helps preserve muscle during weight loss, making weight loss easier to maintain after stopping medication. Combining these foods with healthy lifestyle changes can lead to even greater improvements.

Modern medicine can offer support, but lasting health still grows from daily habits.

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When Europeans first arrived in Hawaiʻi, they described Native Hawaiians as having strong, healthy teeth – quite a contrast to many Europeans of that era whose sugar-rich diets and long sea voyages sustained by refined flour, alcohol, and salted meats often led to scurvy and poor oral health.

Archaeological studies of precontact remains support these accounts. Researchers found normal tooth wear and some periodontal disease in adults, but no evidence of scurvy or rickets – conditions that can signal problems with gum or bone health. Only about 10% of children had cavities, and just over 2% of their teeth were affected.

Today, oral disease is far more common. About 42% of Native Hawaiian adults have lost at least one permanent tooth due to decay or gum disease, and nearly 10% have substantial tooth loss. Among low-income preschoolers, 46% of Native Hawaiian children in Head Start have untreated tooth decay.

These differences are largely due to shifts in diet, alcohol, and tobacco use. Traditional diets were rich in whole foods that provided adequate amounts of vitamin C, calcium, and other nutrients important for oral health. They also included fibrous foods that required more chewing and increased saliva flow, helping wash away food particles and neutralize acids that erode tooth enamel.

In contrast, modern diets are high in processed and sugary foods that cling more easily to teeth and fuel bacterial growth that produces acid and erodes tooth enamel. Alcohol and tobacco further damage gum tissue and promote harmful bacteria.

Traditionally, Hawaiians used wood ash rubbed directly onto the teeth or mixed with salt water for daily dental care. Ripe noni fruit and puakala (native poppy) root were used to treat gum disease and infections. ʻŌlena (turmeric) and ginger may have been used to lower inflammation and promote healing. Post-contact, young guava leaves were chewed, or the inner gel of the aloe plant, were optionally applied for toothache and gum irritations.

Simple daily habits go a long way. Brush twice daily with a soft toothbrush. Floss your teeth daily. Rinse with water after meals. Limit sugary snacks and sweetened beverages. Drink water regularly to support saliva production. Avoid tobacco and alcohol. Managing blood sugar is especially important, since diabetes increases the risk of gum disease.

Keep in mind that oral health affects the rest of the body. Gum disease is a chronic inflammatory condition that can cause bacteria and inflammatory chemicals to enter the bloodstream. Left untreated, gum disease increases the risk of heart disease and complications from diabetes. In communities where chronic diseases are already common, protecting oral health becomes even more important.

By returning to traditional lifestyle patterns and maintaining daily hygiene habits, we can protect both our smiles and overall health.

The post What Our Ancestors’ Teeth Can Teach Us appeared first on Ka Wai Ola.

For Native Hawaiians, the ocean is not only a source of sustenance, but also a place of restoration. Today, science is beginning to affirm what our kūpuna have long known: spending time by the ocean has measurable healing effects on the body and mind.

Research on “blue spaces” shows that people who spend time near the coast experience lower stress levels, improved mood, and better overall wellbeing. Studies have found that simply sitting by the sea can slow heart rate, reduce cortisol (the stress hormone), and shift the body out of fight-or-flight mode into a calmer, more restorative state.

Coastal environments have also been linked to reduced symptoms of anxiety and depression. Ocean immersion has also been used traditionally in detoxification, lowering inflammation, and cleansing of mind and spirit.

How does this work? The rhythmic sound of waves and the wide, open horizon create what researchers call “soft fascination,” allowing the brain to rest and recover from mental overload.

Ocean air carries mineral-rich sea mist that may support comfortable breathing, while moving waves generate negative ions linked to improved mood and reduced stress. Together, these effects encourage slower breathing, gentle movement, and greater emotional balance.

The ocean offers spiritual grounding as well. Sitting quietly by the shore, or in the ocean, allows space for reflection, renewed perspective, and reconnection with ancestry and ʻike kūpuna.

In a world filled with constant noise and tension, the ocean becomes a sanctuary reminding us that sometimes healing begins in the sea.

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Unuhi ʻia e Manakō Tanaka

No nā kānaka ʻōiwi, ʻaʻole ke kai he waihona o nā pono wale nō, akā he mea hoʻōla kekahi. I kēia mau lā, ʻakahi nō a hoʻomaka ka poʻe ʻepekema e ʻike i ko ko kākou mau kūpuna ʻike: he hoʻōla ka noho pili kai ʻana i ke kino a i ka noʻonoʻo kekahi, a ua hiki ke ana ʻepekema ʻia.

Wahi a ka noiʻi e pili ana i nā “wahi uliuli” ua ʻike kino nā kānaka i noho ma kahi o kahakai i ke emi ʻana o ka ʻaloʻahia, i ka piʻi ʻana o ke ʻano hauʻoli, a me ke olakino maikaʻi ma nā ʻano like ʻole. Wahi a ia mau noiʻi, mālie mai ka pana puʻuwai i ka noho wale ʻana ma kahakai, emi ka cortisol (ʻo ia hoʻi ka hōmona ʻaloʻahia), a hoʻololi i ke kūlana kino mai ke kūlana “lele o luku,” ʻo ia hoʻi ka “fight or flight,” a mālie ke kūlana hoʻōla.

He pilina pū hoʻi ko nā ao kahakai i ke emi ʻana mai o ka loʻohia a me ka luʻuluʻu. He mea ke komo ʻana i ke kai e hemo ai nā mea ʻawahia, e lapaʻau ai i ka pehu, a e hoʻōla ai i ka noʻonoʻo a me ka ʻuhane mai ka wā kahiko mai.

Pehea e holo ai? He mea ka pana o nā nalu o ke kai a me ke ʻano ākea o ka hoʻokuʻi e hana ai i ka “hoihoi palupalu” ʻo ia hoʻi ka “soft fascination,” a he mea ia e maha ai a e hoʻōla ai i ka wā loʻohia o ka noʻonoʻo. Halihali ana ka makani o ka moana i ka ʻehukai i lako i nā minerala e kākoʻo ana i ka hanu ʻoluʻolu ʻana, a hana nā nalu pae mai i nā ʻiona hōʻole i pili i ke ʻano maikaʻi o kānaka, a me ke emi ʻana mai o ka loʻohia. Ke hoʻohui ʻia kēia mau mea e ʻoi aku ana ka hanu mālie, ka ʻoni mālie, a me ke kaulike o ka naʻau.

Hoʻonā pū ke kai i ka ʻuhane. He mea ka noho pili kai, a i ʻole i loko o ke kai hoʻi, e hoʻokaʻawale ana i wahi e nanalu ai, e ʻimi ai i ke kuanaʻike hou, a e hoʻi hou i ke ao o nā kūpuna a me ko lākou ʻike.

I kēia ao i piha i nā mea kulikuli a me ka hukihuki, lilo nō hoʻi ke kai i puʻuhonua e hoʻōla ai iā kākou.

The post Ka Mana Hoʻōla o ke Kai appeared first on Ka Wai Ola.

These common cooking oils are now being blamed for everything from inflammation to chronic disease, while others argue they’re misunderstood. How did such an everyday ingredient become one of the most controversial topics in nutrition?

The debate over seed oils is rooted in a handful of concerns that deserve closer examination.

The most cited is that seed oils promote inflammation. Oils, such as soybean, corn, sunflower, and safflower, are high in omega-6 fats, a type of fat known to cause inflammatory processes in the body. This has led to the belief that seed oils automatically cause inflammation.

Studies have shown that, when used in moderation, seed oils alone do not cause inflammation. However, when eaten frequently, these oils may help sustain inflammation, especially in people with inflammatory metabolic conditions such as insulin resistance, diabetes, and heart disease.

Or they could contribute to an already inflammatory diet that is high in processed meats, added sugars, and fried foods. In other words, they are unlikely to cause inflammation on their own, but in these settings, they can help fan the flames.

The issue becomes more serious when it comes to how oils are used. When seed oils are exposed to very high heat, especially during deep frying or when used repeatedly, they break down and form harmful chemicals.

Frequent exposure to these chemicals can damage cells and contribute to inflammation, aging, and chronic disease. Using gentler cooking methods, such as steaming, baking, or light sautéing – and avoiding the reuse of cooking oils – can help reduce this risk.

Another concern relates to seed oil production. When seeds are processed to make oil, chemical solvents, like hexane, are used to extract more oil from the seed. Bleaching and deodorizing the oil is also done to make it a clearer and more neutral tasting product. In addition to removing natural antioxidants and flavors, this process may leave trace chemical residues in the final product.

For this reason, it is best to choose organic, cold-pressed, or expeller- pressed oils whenever possible. Oils labeled “organic” are made from seeds grown without synthetic pesticides, while cold-pressed and expeller-pressed oils are extracted mechanically, without chemical solvents and with less heat.

This gentler processing helps preserve natural antioxidants and reduces unwanted product breakdown. For everyday use, better choices include cold-pressed or extra-virgin olive oil for light sautéing and other low heat cooking methods. Avocado oil is best for high heat cooking, like baking and grilling.

The push to limit seed oils is not only tied to these valid considerations but also to a broader effort to reduce fried and highly processed foods and return to more whole, fresh foods.

For many people, cutting back on seed oils automatically means eating fewer foods that are processed, foods that contain added sugar, and fast foods. Instead, eat more fruits, vegetables, and minimally processed ingredients.

Those shifts matter for your health and help explain why the seed oil debate isn’t as simple as it seems.

Follow Dr. Matsuo on: Facebook (@DrJodiLeslieMatsuo), Instagram (@foodrxblueprint), and on Twitter/X (@foodrxblueprint).

The post What to Know About Cooking With Seed Oils appeared first on Ka Wai Ola.

Many people assume that Japanese and Korean people stay thin because of their genetics. However, research shows when they move to Hawaiʻi or to the U.S. continent, their rates of obesity and chronic disease rise sharply. Their genes remain the same, only their habits and environment change.

This shows that lifestyle patterns matter far more than genetics when it comes to weight and overall health.

Part of why Japanese and Koreans can enjoy rice without the weight gain has to do with their meal pattern. A typical Japanese meal includes a small bowl of rice, about 2/3 to 1 cup, along with 2-4 side dishes and a bowl of miso soup. Koreans follow a similar structure, with a broth-based soup instead and more side dishes.

Fish and tofu are common, and vegetables are abundant. Meat, if eaten, is typically in a combined vegetable dish. Both cultures also include functional foods daily – ginger, garlic, scallions, mushrooms, seaweeds, fermented vegetables and soy foods, and green or barley tea – all of which help lower inflammation.

Lifestyle habits matter as well. In Japan and Korea, people tend to walk more, use public transit, and build movement naturally into their day. Meals are eaten at regular times and more slowly, with an emphasis on stopping before feeling overly full, a common cultural approach to portion awareness without strict dieting.

Compare this to what often see in Hawaiʻi. Are our portions of white rice and other foods larger? Is meat a side dish or main dish? Are vegetables a regular part of our meals? What functional foods are included? What type of drinks do we frequent? Is physical activity part of our daily routine?

Maybe white rice is not the villain after all.

There are practical lessons we can take from the Japanese and Korean approach. First, white rice itself is not bad for you. It becomes a problem only when it replaces vegetables or is eaten in oversized portions.

We need to adopt a new, rebalanced meal pattern. One where more of the plate is filled with vegetables prepared in different ways: fresh, steamed, stir-fried, simmered, or in soups. Meals that include more fish and tofu. If we choose meat, combine it in a vegetable dish, rather than eating it alone.

Add functional foods like ginger, garlic, seaweed, fermented vegetables. Pair meals with māmaki or herbal tea, instead of sugary drinks. When these changes are combined with cultural habits of moderation, shared meals, and natural movement throughout the day, they can make a meaningful difference.

Follow Dr. Matsuo on:
Facebook (@DrJodiLeslieMatsuo),
Instagram (@foodrxblueprint)
and on Twitter/X (@foodrxblueprint).

The post Can White Rice Work for Us Too? appeared first on Ka Wai Ola.

Between 2014 to 2018, Native Hawaiian women had the highest rates of breast cancer and breast cancer deaths in Hawaiʻi – higher than Japanese, Filipino, or white women. Many cancers are still found at advanced stages, when treatment is harder and recovery slower.

Traditionally, breast cancer has been seen as a disease that mainly affects older women. Yet in recent years, doctors are seeing more cases in women under 50, with rates in younger women rising faster than in older age groups. This makes prevention and the adoption of healthy habits important early in life.

Studies worldwide show that 30-50% of breast-cancer cases could be prevented through healthy lifestyle choices. Lifestyle factors that increase cancer risk are:

• Excess body weight: Extra fat tissue raises estrogen, insulin, and inflammation, all of which increase breast cancer risk. Recent U.S. data show that excess weight accounts for about 30% of advanced-stage cases in postmenopausal women. In Hawaiʻi, 73% of Native Hawaiians are overweight or obese, the strongest modifiable risk factor women can change. For those already diagnosed, maintaining a healthy weight can help lower recurrence risk.
• High breast density: Dense breast tissue increases risk, explaining nearly 40% of advanced cases in younger women and up to 47% in Asian and Pacific Islander groups. Alcohol use and low physical activity raise density, on top of genetics.
• Alcohol intake: Every alcoholic drink per day raises breast cancer risk about 10%, with each additional drink increasing risk further. One drink equals one can of beer, ½ cup of wine, or one shot of liquor. In short, there’s no health benefit to drinking alcohol. Avoiding it is one of the simplest protective steps.

The following are lifestyle choices that lower cancer risk. Together, these everyday choices can prevent roughly one in three breast cancers:

• Physical activity: Regular exercise – about 150 minutes a week of brisk walking or equivalent – a lowers risk by 20-30% and improves hormone balance and immunity. Among those already diagnosed, it can reduce death from breast cancer by 48%. Yet about 24% of Native Hawaiians report no regular physical activity.
• Healthy diet: Eating more fruits, vegetables, soy, beans, and whole grains is linked to lower breast cancer risk. In contrast, higher intakes of red and processed meat, saturated fats, and processed foods are associated with more deaths and recurrences.
• Breastfeeding and limiting hormone therapy: Each 12 months of breastfeeding lowers risk about 4%; minimizing menopausal hormone therapy also helps.
• Regular mammograms: Screening can detect breast cancer early, often before symptoms appear, when treatment is most effective and survival rates are highest. Studies show that regular mammograms lower the chance of dying from breast cancer by 25-40%.

Lifestyle medicine isn’t a replacement for medical care, it’s a partner. Combined with timely screening and treatment, positive daily choices can protect, heal, and empower Hawaiʻi’s wāhine for generations to come.

Follow Dr. Matsuo on: Facebook (@DrJodiLeslieMatsuo), Instagram (@foodrxblueprint) and on Twitter/X (@foodrxblueprint).

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