Dietary Considerations - Carolina Total Wellness

April 11, 2019May 20, 2019

Staying Thin is Harder Than in the Past

843 weight loss harder these days

If you feel like you have a harder time staying slim than your grandparents did at your age, you are right. We are about 10 percent heavier than people in the 80s, even when we eat the same foods and exercise just as much. This may be due to changes in lifestyle and environmental factors that impact our BMI, or body mass index.

Recent research by York University’s Faculty of Health shows it’s harder to maintain the same weight at a certain age than it was for someone 20 or 30 years ago. Even if you eat exactly the same macros (protein, fat, and carbs) and do the same amount and type of exercise, you are likely to be heavier than they were at your age.

In fact, with all factors accounted for, the predicted BMI has risen 2.3 points between 1988 and 2006.

According to study author Jennifer Kuk, “Our study results suggest that if you are 40 years old now, you’d have to eat even less and exercise more than if you were a 40-year-old in 1971, to prevent gaining weight. However, it also indicates there may be other specific changes contributing to the rise in obesity beyond just diet and exercise.”

Specific factors contribute to our increased BMI

Historically we tend to look only to dietary and exercise habits when we consider our weight or BMI (body mass index).

However, weight management is much more complex than watching what you eat and how much you work out. Our BMI is affected by many factors such as:

Medication use
Environmental toxins
Genetics
Meal timing
Stress level
Gut bacteria populations
Nighttime light exposure

While the study’s authors admit we need more research to determine exactly how these factors play into the changed BMI picture, they suggest three main players:

Increased environmental toxins. Compared to 30 years ago, we are exposed to a higher level of environmental toxins such as pesticides, air pollution, heavy metals, flame retardants, plastics used for food storage, and more. These toxins put a heavy burden on the endocrine system, altering the hormonal processes that affect metabolism and weight management.

Increased use of prescription drugs. Since the 1970s our use of prescription drugs has risen dramatically. Many antidepressant drugs are linked with weight gain and are the most prescribed drugs in the US for people between 18 and 44.

Our gut microbiome has changed. The gut microbiome, or the community of good and bad bacteria that naturally inhabit the digestive tract, have changed dramatically since the 80’s.

Americans eat differently than they used to. The products we eat are more filled with antibiotics, pesticides, and other toxins; we eat more artificial sweeteners; and we eat more junk food. All of these factors may negatively affect our gut bacteria populations.

A hot topic of research, the gut microbiome is linked to more and more aspects of health and disease. We now know that some gut bacteria are linked with weight gain and obesity. In fact, doctors are even using fecal implantation — insertion of gut bacteria from a healthy slim patient into the gut of an unhealthy obese patient — to reduce chronic obesity.

Support your microbiome with SCFA

In functional medicine we consider the gut microbiome to be a foundation of health. An imbalanced gut microbiome can prevent you from healing from many health disorders, so it makes sense to do everything you can to support yours.

One important factor is oral tolerance, or the body’s ability to properly recognize food proteins. When we lose oral tolerance, the immune system mistakenly thinks more and more foods are pathogens, and we begin to have more food sensitivities, increased hormonal issues, increased autoimmunity, and imbalanced metabolism and weight gain.

You can support oral tolerance by fixing leaky gut, supporting liver function, taming histamine reactions, reducing stress, and balancing blood sugar. But one of the best ways to support it is by providing your body with plenty of short-chain fatty acids (SCFA).

Your gut bacteria not only make SCFA, they also need them as fuel to produce more SCFA. The more you eat them, the more your good gut bacteria can outweigh the bad.

Three main SCFAs include:

Butyrate
Propionate
Acetate

SCFA bind to cell receptors that control your hunger and appetite, turn off insulin resistance, and burn body fat more efficiently.

When you are low on SCFA you will:

Have a larger appetite
Be prone to insulin resistance (think pre-diabetes)
Store body fat better than you burn it

When gut diversity is ruined, SCFA can’t signal properly and you end up with what we call an “obese microbiome.”

How to support SCFA

To support healthy levels of SCFA, adopt the following habits:

Eat abundant and varied produce. Eat plenty of diverse vegetables so your gut bacteria stay adept at recognizing many different food proteins. Aim for 7 to 9 servings a day. One serving consists of a half cup of chopped vegetable or one cup of shredded greens. Go easy on high-sugar fruits to keep your blood sugar stable.

Supplement with SCFA. You may benefit from also supplementing with butyrate, the main SCFA. Start with one capsule a day and work your way up to two capsules twice a day.

Boost glutathione levels. Glutathione is the master antioxidant that helps dampen inflammation, a main factor in loss of microbiome diversity. Take absorbable glutathione such as liposomal glutathione, s-acetyl glutathione (regular glutathione isn’t absorbed well), or its precursors such as n-acetyl cysteine.

There are many other helpful ways to support a healthy microbiome. Contact our office to determine your microbiome health and how to improve it, so you can maintain a healthy weight.

March 4, 2019May 20, 2019

New Study Shows Processed Foods Shorten Your Life

838 processed foods shorten life

A new study shows regularly eating processed foods — the staple of most western diets — can shorten your life. In functional medicine, we know from the published research that a diet based on processed foods also will significantly increase your chances of suffering from chronic disease. Common chronic diseases tied to diet include diabetes, obesity, heart disease, autoimmune diseases, high blood pressure, dementia, and Alzheimer’s.

The study was conducted in France and published in the JAMA Internal Medicine journal. It tracked almost 45,000 adults, most of them in their late 50s at the start of the study. Researchers followed the health and the diet of the subjects over a period of eight years.

On average, the subjects derived about a third of their calories from processed foods. The processed foods researchers looked at included the following:

Instant noodles
Instant soups
Breakfast cereals
Energy bars and drinks
Chicken nuggets
Ready-made meals and snacks
Packaged snack foods
Any foods made using industrial processing

During the course of the study, more than 600 subjects died, primarily from cancer and cardiovascular disease.

In looking at the deaths, the researchers adjusted for general health, socioeconomic status, and influencing behaviors, and compliance with a healthy diet.

However, even after all that, they still found that every 10 percent increase in consuming processed foods was linked with a 14 percent higher chance of early death.

Why eating a lot of processed foods leads to chronic disease and earlier death

In considering the link of processed foods to risk of earlier death, the authors suggest the following possibilities:

High-temperature processing may form contaminants. High-heat food processing can alter protein structures so that the body sees them as inflammatory. In functional medicine we know that high temperatures also make industrial oils used in food processing toxic to the brain and body.

Additives may be carcinogenic. Food additives are synthetic chemicals that are foreign to the human body. Chemical food additives bind with food proteins to create new molecules that the immune system recognizes as an invader. Many synthetic chemicals are also simply difficult for the body to metabolize and eliminate, thus raising inflammation and the toxic burden. Many additives have also been linked to brain-based symptoms and disorder. Simply put, food is no place for synthetic chemicals that have little safety vetting.

Packaging of prepared foods can lead to contamination. The industrial nature of the packaging process can introduce harmful toxins into the food itself. Also, if you are gluten-free, eating packaged foods is always a crap shoot as they are most likely contaminated with gluten due to multiple foods being processed on the same equipment.

What we know about processed foods in functional medicine

Those were the concerns listed by the researchers. In functional medicine we are aware of other reasons processed foods cause chronic disease and raise the risk of an early death.

Industrial oils. The brain is made of primarily fat and the fats you eat determine the health of your brain. The oils used in food processing are industrial seed oils that are generally rancid due to their very unstable molecular structure. These oils contribute to poor neuron structure and integrity and thus cause overall brain health to suffer. They are also generally inflammatory. Additionally, processed foods that contain hydrogenated fats are especially problematic for the brain and body and linked with cognitive decline, heart disease, and inflammation.

Poor fatty acid ratio. The oils used in processed foods are very high in omega 6 fatty acids. Human health requires a ratio of omega 6 to omega 3 fatty acids (such as from nuts and cold-water fish) of at least 4:1 though 1:1 is even better. Sadly, most Americans eat a ratio of 25:1 thanks to processed foods. In other words, way too much omega 6. This puts the body in an inflammatory state that promotes obesity and chronic disease.

Too many processed carbohydrates. One of the biggest promoters of chronic disease and dementia is unstable blood sugar from eating a diet too high in processed carbohydrates. Processed and packaged foods are predominantly grain-based and/or sugary and very high in carbs. This sends blood sugar on a tail spin every time you eat them, promoting inflammation and the chronic disease process.

Gluten. Most packaged and processed foods are wheat-based and thus loaded with gluten. Many people have undiagnosed gluten sensitivity or celiac disease that keeps their body in a constant state of inflammation, thus promoting chronic disease. Gluten is linked with 55 diseases so far, most of them autoimmune.

Eating a whole foods diet with basic real-food ingredients is one of the best things you can do to turn your health around. For more advice on a whole foods diet, please contact my office.

February 26, 2019May 20, 2019

Gut Bacteria Play a Role in Anorexia and Other Eating Disorders

837 anorexia and gut microbiome

People with eating disorders such as anorexia simply do not experience hunger and satiety in the same way people who have a healthy relationship with food do. New research suggests that the composition of gut bacteria, or the gut microbiome, may play a role in the behavioral aspects of anorexia and eating disorders. For instance, previous research shows a connection between mood disorders such as depression and poor gut microbiome diversity. Less than half of people with eating disorders fully recover, showing that conventional treatments are failing untold numbers of people, the vast majority of them women.

The study showed that patients with anorexia had lower diversity of gut bacteria than healthy individuals. They also found that the less diverse the gut microbiome was the more depression and anxiety patients suffered. The researchers also found that as a patient with anorexia began eating again their gut bacteria diversity was partially restored, which in itself aided in recovery.

Alterations in the gut microbiome can affect how a person’s body functions, how they think, feel, and behave, and how they interact with others.

The gut microbiome is critical not only to regulating mood and behavior, it also plays a vital role in regulating metabolic function, appetite control, and weight.

A better understanding of the role of the gut microbiome in anorexia can help researchers forge new directions in treatment around determining target weight goals, how fast the anorexic patient should gain weight, and what type of diet the anorexic patient should follow to best support the brain’s role in eating disorder behaviors.

The researchers are now investigating whether targeted probiotics could ease the renourishment and refeeding phase of anorexia recovery — many patients struggle with gastric and abdominal distress when reintroducing foods. Customized probiotic therapy could also support the mental and emotional aspects of recovery from an eating disorder.

Gut bacteria targeted in eating disorders

Past research has also shown a link between the gut microbiome and eating disorders, which affect an estimated 5 to 10 percent of the population. A 2015 study from France showed gut bacteria plays a role in eating disorders.

The study looked at mice who had an inflammatory reaction to a protein made by gut bacteria. In essence, the mice responded to these bacteria as if it were an allergy or sensitivity. This immune response caused eating disorders in the mice.

The gut bacteria that triggered this reaction is very similar in structure to a hormone called alpha-Melanocyte-stimulating hormone (a-MSH). a-MSH is a satiety hormone that tells you when to feel full. When the immune system attacks the gut bacteria similar to a-MSH, it also attacks the a-MSH due to their structural similarity. This immune reaction can then dysregulate signals around feeding, energy usage, and anxiety.

When the immune system mistakenly attacks the body

This study is evidence of a “cross-reactive” immune reaction, in which the immune system confuses something in the body with something infectious and attacks both. This is a very common mechanism in autoimmune reactions, such as with Hashimoto’s hypothyroidism, type 1 diabetes, or multiple sclerosis.

The research suggests that some eating disorders may have an immune reaction driving the psychological disorder.

Tips on addressing eating disorders nutritionally

Although eating disorders are highly complicated and require intensive, sometimes multi-faceted therapeutic approaches, it’s still important to be mindful of nutritional strategies to support the brain and the gut microbiome:

Eliminate processed carbs and sugars as they trigger addictive tendencies metabolically.

Keep blood sugar stable to curbing cravings, food obsession, and relentless hunger. You may need to eat small, frequent meals that include protein initially.

Base your diet on plenty of vegetables and a wide, ever changing diversity of vegetables. This will increase the diversity of your gut microbiome, which promotes psychological health and stability.

Supporting your brain chemicals, or neurotransmitters. Neurotransmitters affect your mood, thoughts about yourself, behavior, energy levels, and other aspects of how you feel and function. For instance, you may need serotonin or dopamine support. Serotonin is the neurotransmitter that allows us to feel joy and stave off depression. Dopamine, on the other hand, is necessary to feel self-worth, motivation, and to not experience constant cravings. Both serotonin and dopamine have been shown to play a role in eating disorders. If you have been starving yourself, binging and purging, undereating, or affecting your diet in other ways due to an eating disorder, there is a strong possibility you may be deficient in either one or both of these important neurotransmitters.

Ask my office for more advice on how to support a healthier approach to balanced approach to recovering from eating disorders.

February 4, 2019May 20, 2019

Test for Gluten Sensitivity if You Have Hashimoto’s

834 hashimotos and gluten

Numerous studies show a strong link between gluten intolerance and Hashimoto’s disease, an autoimmune disease that attacks the thyroid gland, causing hypothyroidism. This is because gluten has a molecular structure that closely resembles thyroid tissue — gluten sensitivity triggers an attack on the thyroid gland. Gluten (technically, the correct term is gliadin), is the protein found in wheat and wheat-like grains, such as spelt, kamut, rye, barley, triticale, and oats.

One of the immune system’s primary jobs is to protect the body from foreign invaders. Sometimes it may recognize a common food as a dangerous invader. When you eat that food throughout each day this can keep your immune system engaged in constant battle, making it hyper zealous, overly sensitive, and thus prone towards food sensitivities and autoimmunity.

Some people also have celiac disease, disease in which gluten triggers an autoimmune attack against the gut, the skin, or neurological tissue. Gluten sensitivity is more common than celiac disease, however, both show up in higher numbers in people with Hashimoto’s hypothyroidism.

If you have been diagnosed with hypothyroidism you should first test for Hashimoto’s by screening for TPO and TGB antibodies — the majority of hypothyroidism cases are caused by Hashimoto’s.

You should also screen for gluten intolerance or celiac disease given how common these conditions are in patients with Hashimoto’s. Likewise, people who discover they are gluten intolerant or have celiac disease should screen for Hashimoto’s.

It’s important to give up gluten completely if you have Hashimoto’s and gluten intolerance. Cheats and little bites are not ok as they trigger an immune response that ultimately destroys thyroid tissue. Also, it’s important to avoid foods that have been contaminated by gluten. Be careful when in a kitchen where gluten is used, with restaurant food, or with questionable packaged foods.

Cyrex Labs offers testing to identify gluten intolerance. However, sometimes the immune system can be so depleted that it produces too few antibodies to produce a positive test, even though you react to gluten. You can screen for this with a total immunoglobulin test.

However, given the evidence establishing a link between gluten intolerance and Hashimoto’s disease, you may be surprised how much better you feel by simply removing gluten from your diet as a start.

Many people have to remove other foods as well, such as dairy, eggs, or other grains. Following the autoimmune paleo diet for about a month and then reintroducing restricted foods one at a time every 72 hours can help you determine which foods trigger an inflammatory reaction in you.

Many people are able to put their hypothyroid symptoms into remission simply by following a diet that eliminates gluten and other trigger foods. Although autoimmune diseases such as Hashimoto’s can be successfully managed through diet and lifestyle strategies, it’s important to understand they can’t be cured. It’s just a matter of taming the immune system.

Ask my office for ways to manage your autoimmune Hashimoto’s hypothyroid condition.

Category: Dietary Considerations