Let’s Get a Hold of Ourselves

Alvin H. Danenberg, DDS Nutritional Periodontist
January 15, 2018 [printfriendly]



Get a Hold of OurselvesSeveral weeks ago, I read that a well-known author in the Paleo community and a well-known author in the Vegan community were posting back and forth like mortal enemies. This tirade was more than harsh disagreements. The words developed into mean and hateful comments. The Vegan blogger went as far as to write that the Paleo blogger should die. This is crazy. This is wrong. What’s going on in our world? We need to get a hold of ourselves!


Several years ago, an author, who stated that milk and animal fat were healthy foods, got into an argument on the Internet with another author, who stated that all milk should be removed from the diet and the only meat to eat was lean meat. The “milk and fat lover” wrote on her blog that the “milk hater” and all those followers will live to regret their decisions. The arguments went on and on. The comments deteriorated further with profanity being used during the written discourse.


Where have we arrived in our civilized society when one group of people wishes another group of people harm because of the way they eat? I thought the whole idea of eating healthier was to improve the quality of our life.


Standard American Diet

The fact is, the far majority of people in Westernized societies eat a Standard American Diet. This way of eating is unhealthy. There are many definitions of a Standard American Diet, but basically it is made up of a large percentage of refined grains, unhealthy fats, starchy foods, added sugars, excessive salt, unhealthy protein sources, and processed food products. It is deficient in fruits, vegetables, nuts, seeds, and healthy fats. In addition, many of the foods in the Standard American Diet have been contaminated with pesticides, herbicides, hormones, antibiotics, preservatives, emulsifiers, and other chemicals.


Eating a Standard American Diet has led to metabolic syndrome, which leads to many degenerative chronic diseases. Those who try to improve their diet by switching off the Standard American Diet and embracing a healthier way of eating should be commended and not lambasted. There are positives and negatives to almost anything. A person who attempts to improve their nutrition and lifestyle should never be made to feel inferior. That person should be encouraged as he or she evolves into a better way of life.


My Personal Experience

Recently, I posted a comment on a website that was read by a person who did not agree with my stated position on processed grain products. In my post, I wrote about the medical complications from gluten on the gut lining. I cited several peer-reviewed articles that supported my statements. The response from that reader was fast and furious. The reader clamored that my references to PubMed were “cherry picked” and that the authors of the research I quoted were known to be unhealthy themselves. The back and forth comments from other readers on that site continued to demonstrate visceral opinions on both sides with little interest in a discussion of the facts.


I’m thinking, “Where did those comments come from? Why is there so much hatred? Is there no place for an intelligent conversation anymore?”


Get a Hold of Ourselves

Is this the way those who are trying to eat healthy and live a fulfilling lifestyle should conduct themselves? Is this the way intelligent and educated people should present their points to the general public?


It is human nature to have convictions, and it is human nature to defend one’s beliefs. Fortunately, we live in a country where freedom of speech is allowed and uncensored. However, an element of kindness and open-mindedness needs to be emphasized rather than what we put into our mouths.


We need to cool down, take a breath, and think about what is going on. We need to get a hold of ourselves.



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Do All My Patients Follow Paleo?

      Alvin H. Danenberg, DDS     Nutritional Periodontist
      May 26, 2016   [printfriendly]

paleo dietNo!


Only about 5% of my patients are interested in my Paleo diet and lifestyle protocol. But, I keep pressing on.


My patients who follow my nutrient-dense diet and lifestyle recommendations usually are self-motivated because of other medical issues. For example, a few have recovered from a serious medical incident, and they have decided to make a change. Others have been diagnosed with a serious medical condition, and they want to get their general health back. Some patients have been following a “healthy way of living” for a while, and now I have shown them an evidence-based method, of which they have never heard, that makes sense to them.


Many people, with whom I come into contact, feel that a Paleo-type diet is too restrictive or stringent. My 30-Day Reset Plan is not difficult. It describes all the foods you could eat as much as you wanted and as frequently as you wanted until you were comfortably satisfied. However, it removes foods that most people eat daily and are used to eating even though those foods are inflammatory. After about 3 weeks on this program, cravings (especially for refined carbs and sugars) disappear or become greatly reduced. The overall benefits of an eating lifestyle like this are far reaching – well beyond a healthier mouth. My own personal story is impressive, and I share it with anyone who is interested.


While I am passionate in what I believe, it’s impossible for me to motivate anybody. You, as an individual, must motivate yourself based on your personal and innermost beliefs and goals. For example, about 30 years ago, I had a patient who had lung cancer as a result of smoking for decades. He was fortunate. Medicine at that time was able to save his life by removing his diseased lung while retaining his healthy lung. Yet, he still smoked cigarettes! How could I possibly motivate a person like that when the threat of his own mortality was not enough for him to stop smoking?


I can tell my patients how I have done what I have done personally. I can call attention to their selfish needs to have a beautiful smile. I can speak to my patients’ intellect by showing them the science-based health facts for embracing a nutrient-dense, anti-inflammatory diet and lifestyle. I can explain how healthy eating can improve their oral health as well as their overall health. I can suggest to my patients that staying on their present course may be like standing on the train tracks of an oncoming train. I can emotionally appeal to their inner selves to want to live long enough to see their children and their children’s children grow into beautiful people. But, I cannot make them do what I think they should do. They must make their own decision to act or not to act.


So, to answer the original question, most of my patients do not follow a Paleo-type diet and lifestyle. But, I won’t reduce my efforts or desire to educate my patients if they show an interest in my way of thinking. I have been accused of being a fanatic when it comes to primal nutrition and lifestyle. I stand guilty as charged. My goal is to help self-motivate all patients that are interested in getting onboard a Paleo-type diet and lifestyle. I have written about this over and over again.


I am always available to help. Send me an email with your questions.


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Battling Swollen Gums with Super Foods

        Alvin H. Danenberg, DDS       December 9, 2015


Super Foods
Can you battle swollen gums with super foods? Have you even thought about it? Here’s my professional opinion based on science and 41 years of experience treating gum disease.


Swollen gums are frequently a result of some irritant (like dental plaque or tartar) in and around the gum tissue. These irritants need to be removed. But is that all there is?


No! More importantly, swollen gums are a result of (1) eating an abundance of bad stuff like processed foods, unhealthy fats, and refined sugars and (2) not eating necessary nutrients.


Here is a paper that suggests some of the science behind this. It was published in 2009, and the results surprised the investigators.


Before the experiment began, the mouths of 10 participants were examined for various signs of gum disease. These individuals then were placed in a primal environment in Switzerland where they had to gather and fish for their own food for 30 days. To start, they only were given some basic, raw foods. They had no processed foods, no unhealthy fats, and no refined sugars to eat. In addition, during the 30-day experiment, these individuals were not allowed to brush or floss their teeth.


At the end of this experiment, their mouths were reexamined for existing gum infection. The investigators were amazed with the results:

  • The amount of bacteria around the gum margins was significantly increased.
  • The infectious-types of bacteria actually decreased.
  • The participants had healthier gum tissues than they had before the 30-day experiment.


Even though those in the study could not brush or floss for 30 days, they all had less gum infection after the experiment. How could that be?


The answers lie in the healthy changes in the gut and the mouth as a result of the primal foods these 10 people ate for 30 days. These foods were Super Foods .


My interpretation of super foods is straightforward. I am all about (1) eating what makes our individual cells and overall bodies healthy and (2) removing whatever makes our bodies unhealthy. Our mouths are the happy recipients of this healthy lifestyle.


We have 10 trillion human cells that make us who we are, but we have 100 trillion bacterial cells that live within us! Each human and bacterial cell needs its nourishment. Each cell affects every other cell in some way. Therefore, I view super foods as those that are nutrient-dense and anti-inflammatory for each cell.


If you took care of your car’s engine, your car would run more smoothly; if you took care of your body’s engine, your body would be healthier. Give your body what it needs, and your mouth will benefit also.


So what are the super foods?

These are the foods with high levels of nutrients per calorie of food. These are the foods that are grown with no chemical additives that could leach into the food and damage the powerful nutrients contained within. These are the foods that have NOT been genetically altered to create something that our body cannot recognize or use effectively. These foods give you the greatest bang for your buck.


Super foods are the pastured and wild caught animals including their organs and healthy fats. Super foods are the organically grown fruits, vegetables, nuts and seeds. Super foods are NOT the processed foods, unhealthy fats (like commercially prepared vegetable oils or man-made trans fats), or refined sugar products that are abundantly available in the average grocery store. Super foods are those that make up a Paleo lifestyle.


My recommendation: Consume a Paleo Diet, and you will consume super foods. These foods are the nutrient-dense, anti-inflammatory nourishment that will help keep you healthy and help keep you from having swollen gums and gum disease. Super foods will battle swollen gums.


8 Truths I’ve Learned After My Paleo Transition

        Alvin H. Danenberg, DDS       December 4, 2015


Healthy Lifestyle ElementsFor the first 66 years of my life, I was not a healthy guy. You can read my story here. However, for the last 3 years or so, I have become a new person, and I have incorporated my newfound knowledge and lifestyle in the way I educate my patients. Here are 8 truths I have learned after my Paleo transition. They’re listed in no special order; they’re just my thoughts:


  1. Too much conflicting information from respected medical institutions about health and diet has made the average Mary and Joe spin in circles. A Paleolithic-type diet has been around for 2.5 million years of our species’ evolution, and it has well served humankind throughout the world. It’s not a fad; it’s the way it was meant to be.
  2. Chronic emotional stress is difficult to control. The damage to the healthy gut bacteria and the immune system plays havoc on the entire body including the gum tissues in the mouth. One of the pillars of health is control of stress. There is no pill you can take to make stress go away.
  3. When I am evaluating a patient in my periodontal practice, there is no way I can do a thorough mouth examination that includes a discussion about their gut and immune system in less than an hour. The 10-15 minute exams that many of my contemporaries perform for their patients are inadequate and a disservice to the patient, in my opinion.
  4. Nutrient-dense, anti-inflammatory foods that are the basis of a Paleo diet provide the body with essential nourishment for every cell to survive and thrive. These foods make up another of the pillars of health.
  5. Although genetics play a role in gum disease and many chronic diseases, an individual’s diet and lifestyle are more important than his or her genes.
  6. A third great pillar of health is restorative sleep. The human body is based on a circadian rhythm and generally requires about 8 hours of sleep each night.
  7. The Standard American Diet (consisting of unhealthy fats, refined sugars, conventionally raised animal products, processed grains, and a host of chemicals) is a major culprit for today’s chronic disease epidemic. Period!
  8. The fourth pillar of health is an efficient exercise program. That does not mean over-exercising aerobically an hour a day, 5 days a week.


I am still learning. At almost 69 years of age, this is exciting for me. I have transformed my life and my health through the knowledge of evolutionary lifestyle. If only I knew then what I know now!!!


I will leave you with this one question: If you knew a train was coming at you, would you get off the tracks?

You Can Lead a Horse to Water, But …

        Alvin H. Danenberg, DDS       September 1, 2015    


evolution rA cliché, no doubt, but with important meaning. I cannot motivate anyone. You cannot motivate anyone. Only an individual can motivate himself or herself. You can lead a horse to water, but you can’t make it drink. I can present information that may be factual and convincing, but the individual must take the leap of faith and become self-motivated. Facts don’t move a person to action as much as emotions and social interactions do.


In my practice of treating mouth diseases, I help patients understand the importance of healthy food and lifestyle choices. Many get the message and jump in with both feet. But, even those that become self-motivated could lose their way if other factors were not in place.


A Paleo diet and lifestyle are perfect examples. My belief is that this way of eating and living has been effective for 2.5 million years of evolution, and I don’t doubt its teachings. Results are very clear to me. Science also is now proving many of the anecdotal stories from the past are indeed factual.


A few of my patients that had embraced a Paleo-type diet and lifestyle have quit. The reasons usually were not a loss of faith of the facts; the reasons were lack of support at home or an apparent lack of recipe variety.


The number one reason in my experience that several of my patients quit Paleo was no support at home. Even if a person had understood all the health benefits of at least avoiding grains and sugars and had become motivated to make it happen, one critical factor was lacking. His or her significant other was not on the same page. Success was doomed. The emotional and social aspects of eating with a person’s significant other were too strong. If one wanted to go to places that were not Paleo-friendly or if one insisted on eating pizza and cake at home, then the other who was trying to be Paleo unfortunately could lose interest.


The second reason I have encountered was boredom. Most people don’t realize there are abundant choices in Paleo meals. Some people need to have variety all of the time. These people need to know that there are hundreds of recipes that can be made in minimal time to create delicious and unusual Paleo menus at home. There is a wealth of Paleo recipes in books and on the Internet from which to choose to keep meals exciting. Without variety, one could get bored after eating leafy greens all day with a piece of bacon or an over-easy egg without changing it up.


These two reasons for quitting Paleo could be overcome, but they are compelling. In my experience, these were the major two reasons why some of my patients quit Paleo.

What You Don’t Know Could Harm You

evolution rHave you ever…

  • kissed a person with gum disease? Then you know how it tastes.
  • spoken to a person with gum disease? Then you know how it smells.
  • seen a person smile who has red or swollen gums? Then you know how it looks.

Surprising as it may sound, many people with gum disease frequently do not know they have it until the late stages of destruction. Even when it comes to general infection and inflammation in the body, the majority of people don’t know they have them.
Let’s talk specifically about the mouth. The sad part is that the majority of individuals only realize they have a problem after their workplace buddies, or friends, or partners start to avoid being close to them. Others only may know that they have a problem after their teeth start to get loose and fall out. Damage that occurs on a cellular level anywhere in the body also affects the entire human complexity, of which the mouth is an intricate part. The mouth is often viewed by the general public as remote from the inner workings of the human body. Yet, the mouth may be the first area where systemic and chronic diseases manifest.
As a periodontist for 41 years, the mouth has been my professional area of expertise. The mouth is the portal to the entire human body and all of its inner workings.
Obviously, our primal ancestors did not have toothbrushes and did not see a dentist every 6 months, but they had relatively healthy mouths. They hardly ever had gum disease or tooth decay. Today, many people see a dentist every 6 months and also brush and floss daily, but some still have gum disease. Could it be that what we have learned to believe may not be so? Mark Twain put it so clearly: “It ain’t so much the things we don’t know that get us into trouble. It’s the things we know that just ain’t so.”
Oral health, as well as overall health, is critically dependent on four basic concepts or pillars. If any one of these is not functioning properly, then our body can become jeopardized. Unfortunately, we may not be aware if one of these pillars is out of kilter. The pillars of health include:

  • A nutrient-dense diet feeding our cells and promoting healthy gut bacteria
  • Efficient exercise
  • Restorative sleep
  • Reduction in all forms of stresses and toxins on and in our body

A study published in 2012 showed that 47.2% of the adult population over the age of 30 in the United States had periodontitis (which translated to 64.7 million Americans), and an astounding 70.1% of those over the age of 65 had this disease.
Periodontitis is more serious than gingivitis, which is inflammation only in the gum tissue. Periodontitis is an advanced stage of gum disease where the gums are infected and the bone surrounding the roots of the teeth are breaking down. This disease leads to bad breath, loose teeth, loss of teeth, sensitive teeth, pain, gum recession, and even spread of infection to other parts of the body.
“This is the most accurate picture of periodontal disease in the U.S. adult population we have ever had,” said Pamela McClain, DDS, and President of the American Academy of Periodontology at the time of the paper’s publication. “For the first time, we now have a precise measure of the prevalence of periodontal disease, and can better understand the true severity and extent of periodontal disease in our country.”
So, if you have gum disease, you are not alone. If you have this infection in your mouth, you most likely have chronic inflammation in other areas of your body. Whatever happens on a cellular level anywhere in the body frequently will manifest in other organ systems as chronic disease. Gum disease is another type of chronic disease related to the nourishment we provide our bodies and the lifestyle we lead.
The CDC (Centers for Disease Control and Prevention) has made specific statements of the prevalence of other forms of chronic disease in the US today.

  • As of 2012, about half of all adults—117 million people—have one or more chronic health conditions. One of four adults has two or more chronic health conditions.
  • Seven of the top 10 causes of death in 2010 were chronic diseases. Two of these chronic diseases—heart disease and cancer—together accounted for nearly 48% of all deaths.
  • Obesity is a serious health concern. During 2009–2010, more than one-third of adults, or about 78 million people, were obese (defined as body mass index [BMI] ≥30 kg/m2). Nearly one of five youths aged 2–19 years was obese (BMI ≥95th percentile).
  • Arthritis is the most common cause of disability.
  • Diabetes is the leading cause of kidney failure, lower limb amputations other than those caused by injury, and new cases of blindness among adults.

As I suggested, gum disease is a chronic disease. Embracing a healthy eating lifestyle is congruent with adopting a Primal or Paleo Lifestyle. Eating a nutrient-dense diet, which is one of my four pillars of health, will support a healthy mouth as well as a healthy body. A recently published article confirms that this way of eating can also reverse the risks of metabolic syndrome (high blood pressure, low levels of HDL cholesterol, high levels of triglycerides, and increased fat tissue around the waist), which leads to various life-threatening diseases. Here   Here  and Here
So, what should you do if you think you may have gum disease?

  • You should see your dentist or a periodontist to have a thorough periodontal examination to determine if you have a condition that requires treatment.

Much of what you do personally to clean your mouth properly and to eat healthy will assist in preventing gum disease as well as other chronic diseases in the future.

What’s Up With Gums, Gut, and Paleo?

evolution rThe soft tissues in your mouth are an extension of your gastrointestinal tract. Your mouth is like the first tee in a golf game; like the coming attractions before the movie starts in the theater; like the entrance to Disney World. It’s where it all begins.
As a periodontist, I have been treating gum disease for 41 years. The traditional methods of treating gum disease have rarely included the concepts of healthy nutrition based on our evolutionary requirements. For my patients, I include the methods of assisting all the body’s cells to reach their peak nutritional performance along with my treatment of gum disease through patient-friendly techniques.
There is a relationship between the gums, the gut, and Paleo. Let me describe this correlation.
Your gastrointestinal tract is a tube about 25 feet long. The tissues lining the entire length of this tube from the mouth to the anus can and will respond in their own way to whatever occurs along this path.
Once you take the first bite of food, digestion begins. Assisting digestion are the teeth that chew the food, the muscles that move the food along, the enzymes and chemicals that are produced to breakdown the food, the friendly bacteria that further digest food particles and produce necessary biochemicals, and the absorption processes that allow the dissolved nutrients to migrate into the bloodstream to nourish every cell of the body. Whatever is left over from this digestion process is excreted.
If there were irritants to the gut from the foods we ate, damage to the lining of the gut and increase in unhealthy bacteria could occur. The result could be unhealthy particles of food and bacteria entering the bloodstream creating chronic inflammation. This inflammation and increase in unhealthy gut bacteria affect the entire body as well as the health of the gum tissues. Their pathways increase the potential for gum disease as well as increase unhealthy bacteria in the mouth. Unhealthy bacteria in the mouth and further insult from ingestion of unhealthy carbohydrates will cause gum disease.
Paleo is a lifestyle. A Paleo way of eating may go under various titles. It is sometimes called a primal diet, or an ancestral diet, or a caveman diet.  There are no specific foods that make up a Paleo diet. The common denominator is that all these diets DO NOT include processed foods or processed sugars or conventionally fed and farmed animal products or processed fats and oils. A Paleo diet avoids these unhealthy foods, which often lead to damage in the gut, increase in unhealthy gut bacteria, and eventually damage in the gum tissues.
To come full circle, a Paleo diet, which excludes all these bad foods, can maintain a healthy gut in addition to healing a damaged gut. A Paleo diet can help maintain gum health.
So the importance of Paleo is that its nutrient-dense foods will allow the gut to function properly. A healthy gut will allow nutrients to be absorbed properly and will maintain a healthy community of gut bacteria. All this assists the gum tissues in remaining healthy.

My Favorite Paleo Recipes:
French Onion Soup – Almost

evolution rThe first time I had French Onion Soup was when my wife and I were in Montreal in the 1970s. What a delight! (That’s when we had our first Crepe Suzettes – definitely way before my Primal education.) After returning from our vacation in Canada, we searched for the best French Onion Soup recipe. We found it in Julia Child’s cookbook (1). When I look at the ingredients now, they are not completely Paleo. So, I have tweaked the recipe and added some new stuff that I present below. Unfortunately, if you were looking for croutons, they aren’t there.
2 Lbs. sweet onions, thinly sliced
4 Tbs. butter or ghee
1 Tsp. salt
1 Tsp. turmeric
3 Tbs. arrowroot powder
6 Cups bone broth
1/2 Cup dry white wine
Optional: raw mozzarella cheese as topping if you are eating raw dairy

  • Slice onions thinly (I use a mandolin with the protection shield!)
  • Heat butter or ghee in large covered skillet on medium-low heat
  • Add onions and cook covered until onions have softened (about 15-20 minutes)
  • Uncover, add salt and turmeric (turmeric stains everything!) and increase heat to medium-high and continue to cook until most of the liquid evaporates and the onions begin to brown slightly, which will take 45-60 minutes. Stir frequently.
  • Add arrowroot powder stirring continuously to mix thoroughly
  • Remove from heat and place onions in Dutch oven
  • Deglaze skillet with white wine and add to Dutch oven
  • Add bone broth to Dutch oven and bring to boil
  • Simmer for 30-40 minutes
  • Salt and pepper to taste
  • Add raw mozzarella cheese when serving if you are eating raw dairy

1. Child, J; Bertholle, L; Beck, S. Mastering the art of French cooking. Alfred A. Knopf, Inc., New York, 1961, p 43.

My Favorite Paleo Recipes:
Thai Shrimp and Coconut Soup

evolution rI enjoy the flavor of coconut – not to mention shrimp. Thai inspired coconut soup hits the spot for me especially in the winter months. But for me, soup is good anytime – especially when the base is homemade bone broth.
For coconut soup, I like it to have a thicker consistency rather than a thin consistency. One way to accomplish this is to use only the cream in the coconut milk as I describe below. Also, you could continue to boil the liquid before adding the raw shrimp to reduce the liquid and thicken the soup further. I substitute the typical ingredient of fish sauce with a homemade concoction of mashed anchovies in coconut aminos.
1 pound wild caught shrimp
Coconut cream from 1 can (15.5 ounces) full-fat coconut milk
1 Tablespoon raw coconut aminos
1 2-oz can of anchovy fillets (drain oil)
2 cups bone broth
1 inch piece of ginger, peeled and grated
1 cup sliced shitake mushrooms
2 Tablespoons lime juice
Salt and pepper to taste
Cilantro for garnish (optional)

  • Prepare the shrimp by peeling and deveining if not already done prior to purchase; dry shrimp with paper towel.
  • Place can of coconut milk in freezer for 5 minutes for cream to solidify and separate from the rest of the liquid; open can and remove cream to use for soup and discard remaining liquid.
  • Chop up anchovies and mix into coconut aminos in separate small mixing bowl.
  • In a pot over medium heat, combine anchovies mixed with aminos, coconut cream, bone broth, ginger, mushrooms, lime juice.
  • Bring to a boil (let boil for several minutes to reduce liquid if desired).
  • Salt and pepper to taste.
  • Add shrimp, and cook until tender which will only be additional 1-2 minutes (do not overcook shrimp).
  • Top with fresh chopped cilantro for garnish.

My Favorite Paleo Recipes:
Sardines for Sardine-Haters

evolution rSardines are so healthy. One 4.375-ounce can of wild caught sardines with skin and bones contains about 310mg of EPA and 685mg of DHA omega-3 fatty acids. Also, a can contains ample amounts of vitamins B12 and D as well as selenium and coenzyme Q10. Ounce for ounce sardines contain more calcium and phosphorus than milk, more iron than spinach, more potassium than bananas, and as much protein as steak. But, most of my contemporaries say they don’t eat sardines. Here is a simple way to serve sardines. Many sardine-haters would agree they aren’t so bad when served this way. Try it. Who knows, you may become a sardine-lover.
In the picture, I have used cashews and thawed black cherries.
1 4.375-ounce can of wild caught pacific sardines with skin and bones (ex. Wild Planet, which is BPA free. They also package white anchovies, which have 4 times the amount of EPA that is in its can of sardines.)
1 large bell pepper, cut in half with seeds removed
1/2 fresh lime
About 1/4 cup of fresh or thawed fruit (ex: blueberries, dark cherries, or strawberries)
About 1/4 cup chopped nuts (ex: cashews, pistachios, almonds, or macadamia)
Sprinkle of kelp granules for taste as well as trace minerals (ex: Maine Coast Sea Seasonings)
Salt and pepper to taste

  • Place both halves of a bell pepper on a plate
  • Open the sardine can and drain liquid
  • Place sardines into the open cavity of each pepper
  • Squeeze fresh lime juice over sardines
  • Top with fruit and nuts
  • Sprinkle with kelp granules
  • Add salt and pepper to taste
  • Eat with your fingers or with knife and fork (more dainty)