Category: Information

March Research Round-Up: All things CBD

A little disclosure to begin: Please remember that I am not a medical doctor and am not offering medical advice. Whether or not you choose to try a CBD product should be discussed with your personal doctor(s). My intent here is to present unbiased information so that you will be armed with facts.

You likely have a CBD store on a corner (or two) somewhere in your town and have heard about it’s potentially miraculous health benefits. Let’s dive in and see what the science currently tells us.

CBD Basics

CBD is an abbreviation for the phytochemical cannabidiol, a non-psychoactive component of hemp and marijuana, two varieties of the Cannabis sativa plantNon-psychoactive means that it does not create a high and in fact does not have any effects on personality apart from potentially being calming or relaxing. The psychoactive effects of Cannabis come from THC (tetrahydrocannabinol), not CBD. THC is found only in marijuana, not hemp. In fact, CBD actually counteracts the psychedelic effects of THC.

Another difference between THC and CBD: With THC, you need to take more over time because you develop a resistance. With CBD, you’re able to take less over time, as the body becomes sensitized.

CBD, like all vitamins and supplements, is not subject to government oversight for safety or efficacy in the US.

CBD in the Body

CBD works by interacting with the endocannabinoid system. The endocannabinoid system has receptors in every system of the human body: Nervous, digestive, skeletal, dermal, reproductive, cardiovascular, respiratory, etc.

The primary function of the endocannabinoid system is to maintain balance for the body’s systems. If one system goes out of balance, the endocannabinoid system deploys cannabinoids to bring that system back into harmony. Of note is that this is part of our bodies as God designed them. It’s not as if the endocannabinoid system doesn’t exist unless you are taking CBD, smoking marijuna or ingesting THC in some other form. Our bodies naturally produce chemicals that are very similar to CBD. 

The endocannabinoid system is one of the key endogenous systems in the body responsible for regulating pain sensation. It is also part of all physiological systems that modulate healing. This is also the same system in the body that might make you feel physical pain when you feel intense emotional pain. Chronic pain itself can have so many subsequent effects such as anxiety, irritability, low self-esteem, decreased productivity, depression, insomnia, increased suicide risk and more. The endocannabinoid system is also involved in modulation of inflammation and subsequently, there is a lot of research currently pointing to the endocannabinoid system playing a fundamental role with inflammatory diseases, many of which are related to lifestyle.

“Pain, inflammation, and oxidative stress are symptoms of every chronic, modern, inflammatory disease—from headaches to migraines to Crohn’s disease to ulcerative colitis to arthritis to cardiovascular disease, and to depression, which is now considered to be an inflammatory condition” – Chris Kresser

Because of the way CBD works and how integrated the endocannabinoid system is within the body, CBD has the potential (and has been shown in short-term studies) to be beneficial for:

  • Inflammatory bowel diseases and GI issues
  • Mood disorders and anxiety
  • Pain
  • Chronic inflammatory conditions, such as rheumatoid arthritis
  • Autoimmune conditions
  • Nausea
  • Alzheimer’s disease and dementia

Let’s talk a little bit about CBD’s potential ability to protect the brain and, more specifically, to protect the brain from diseases like Alzheimer’s, Parkinson’s and dementia. The statistics on Alzheimer’s disease are staggering, and many experts have started referring to the disease as Type 3 Diabetes because it’s so closely related to lifestyle factors like diet, exercise, and sleep hygiene. Studies have demonstrated CBD’s ability to prevent free radical damage, reduce inflammation, and protect brain cells. Other studies have also demonstrated the role of the endocannabinoid system in simulating neurogenesis, which simply means growing new brain cells. One study showed that CBD modulates the expression of Alzheimer’s disease-related genes, meaning it might play a role in whether or not you actually develop the disease that you are predisposed to. For those who are already experiencing a neurological disease, there is some hope from ongoing studies, one of which demonstrated that CBD was able to improve the quality of life for Parkinson’s patients.

Is CBD legal?

One outcome of the Agriculture Improvement Act of 2018 was the Hemp Farming Act of 2018. This bill removed hemp (and cannabis containing less than 0.3% THC) from the list of Schedule I controlled substances. This bill effectively made CBD legal in all 50 states, as long as it contains less than the 0.3% of THC. This is significant because it affects medical research, or the lack thereof. Because of it’s previous Schedule I classification until just recently, there are few long-term studies on CBD and its effects. It was simply too difficult for medical centers to obtain CBD for use in clinical trials. That has all changed and there are currently many studies underway with many being published on a regular basis.

A few of the legal highlights regarding CBD:

  • CBD is legal in all 50 states at the federal level
  • The Farm Bill stipulates that states cannot block the intrastate transport of hemp and its derivatives, including cannabinoids such as CBD
  • The TSA states that it’s 100% legal to travel with CBD oil
  • In the U.S., cannabis plants with a THC content <0.3 percent are not considered psychoactive, and are therefore legally classified as “hemp”
    • Certain countries in Europe have THC thresholds of 1 percent

Which form of CBD is best? 

A lot of CBD products come in the fat-soluble form because it seems that fat enhances the bioavailability, meaning how well your body can use the CBD. This might be in the form of a tincture that you swallow directly or place under your tongue or may be in the form of a gel capsule. There are also gummies and other edibles available. If you asked me, I would stick to a tincture or capsule. I certainly would not recommend purchasing or consuming any sort of CBD product that is not sealed and labeled (brownies and other baked goods come to mind). You need to know what you are putting in your body.

CBD can also be used topically in the form of gels or lotions. I have also seen it in the form of an antimicrobial for certain skin conditions such as psoriasis. I have only used one CBD lotion product for arthritis pain on my feet and other than a cooling sensation from the eucalyptus and mint essential oils, I didn’t notice any great effect. I did not use it long-term though, I simply had a free sample to try.

Are there dosing recommendation for CBD?

Most of the human studies use dosages anywhere between 20 and 1,500 milligrams (mg) per day. Yes, that’s quite a large range!

The amount of CBD you should take depends on a range of factors, including:

  • your body weight
  • the condition you’re treating
  • your individual body chemistry
  • the concentration of CBD in each pill, capsule, drop, or gummy

In other words, there are a lot of variables that go into deciding how much CBD to take. Before trying CBD, be sure to talk to your doctor about an appropriate dosage and any potential risks. If your doctor tells you how much to use, stick to their recommendation.

If your doctor doesn’t provide a recommendation, or you simply choose to try something on your own, it’s best to start with a smaller dosage and gradually increase it. This could mean starting with 20 to 40 mg a day. After a week, increase this amount by 5 mg. Continue this until you feel that it’s effectively treating your symptoms.

Keep track of how much CBD you’re taking and whether your symptoms are getting better. Write it down on paper or in a notes app on your phone.

Using CBD in the form of a lotion or other topical is naturally much harder to keep track of dose than a form you would take internally.

Is is possible to take too much CBD?

A 2011 review on the safety and side effects of CBD found that continuous use of CBD, even in high doses like 1,500 mg a day, is tolerated well by humans.

A 2017 update to this review also confirmed those same results. However, a 2019 mouse study did raise some safety concerns about CBD’s potential for liver damage and its interactions with other medications.

If you’re currently taking medication and would like to try CBD, it’s essential to discuss this with your doctor.

There are very few known side effects of CBD. When side effects do occur, however, they may include diarrhea, appetite changes, and fatigue.

Final Thoughts

Some people take CBD as a preventative for chronic illnesses, such as autoimmune conditions, arthritis and dementia. Alternatively, CBD can be taken “as needed” for immune boosting or to treat acute inflammation. Personal story: Because good quality CBD is so expensive and not covered by my insurance, I do not take it as a preventative for my autoimmune condition, but I do take it as needed for headaches, other pain such as toothaches or extreme muscle soreness and during times of extreme stress. It has helped me tremendously during these times. I personally take the Cannabomega from Designs for Health because of it’s combination with omega-3s which are beneficial on their own, but also help the body better utilize the CBD. (I believe you have to set up an account through your health care provider to purchase this specific product).

This is the brand of CBD oil recommended by Chris Kresser and even though I haven’t tried it myself, I do trust his recommendations.

If you are going to embark upon trying CBD to see how it can help your health, pay attention to how it makes you feel. Just like all other things functional medicine related, there is a lot of personal experimentation involved. So far anyway, CBD appears to be extraordinarily safe and potentially very beneficial. All of the functional medicine and mainstream medical experts I researched, agree on CBD’s safety and potential efficacy.

We currently understand a lot of the mechanisms surrounding CBD, we have preliminary data showing benefits in a lot of different chronic disease states, however we do not yet have dose-response studies, meaning researchers do not currently know how much CBD should be taken, how often and in what form for maximum benefit for each disease state. There is much that is still unknown.

There are also possible drug interactions that you must be careful with, which is why you need to involve your doctor in this process.

All of the current research suggests that cannabinoid-based therapies could be extremely beneficial in the prevention and/or maintenance of some very debilitating conditions. Because of its antioxidant, anti-inflammatory and neuroprotective properties, CBD could be a healthy addition to your wellness routine, but I would caution you to purchase only from a trusted source and not one of the many hemp or CBD stores that are popping up all over the place! 

References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085542/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4543605/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297661/
https://www.ncbi.nlm.nih.gov/pubmed/25237116
https://www.ncbi.nlm.nih.gov/pubmed/30627539
https://www.ncbi.nlm.nih.gov/pubmed/32149543
mindbodygreen.com
thepaleomom.com
chriskresser.com

What to do When You’re Already Doing Everything Right

I see this a lot, people who say they are “doing everything right” and are still not feeling as well as they would like. Remember, I’m not your doctor, but I can be your health coach and part of what health coaches do is trouble-shoot, so that’s what we’re going to do today.

First of all, if you told me you were sticking to your squeaky clean paleo diet and still not feeling well, I would believe you. Many doctors think their sick or overweight patients are not being honest about their lifestyle choices, but a coach is always on your side.

If you came to an appointment with me and told me that you were doing everything right and not seeing improvement, here’s what I’d say:

Tell me what you mean by “doing everything right?”

Many people are simply referring to diet when they say they’re on track. Believe me when I say that diet is critical, but it’s not everything.

Functional medicine has six main pillars: diet, movement, stress management, sleep health, environmental toxins and community/relationships. That’s a lot to tackle and most people can’t have all those categories dialed in all at once.

Just because your diet is super clean, let’s just say Paleo for the sake of this example, that doesn’t mean that one of those other areas might be way out of alignment for what your body needs.

There is a lot to tweak and with some careful exploration, we can start to pinpoint areas you might want to address. Here are some ideas in each of the areas of Functional Medicine. This is by no means an exhaustive list of areas of exploration. Consider this a jumping off point. Carefully consider each category because at first blush, you may think stress isn’t an issue for you, but as you really consider, you might begin to see otherwise.

Movement

  • Are you moving your body on a regular basis? This means every day. No, you don’t have to train for a marathon or lift heavy weights three times a week, but you need to be more active than sedentary and ideally, get your heart rate a little elevated more days than not.
  • Are you over-training? Maybe you are training for a marathon and it’s simply too much stress for your body at this time. Chronic over-exercising causes chronically high cortisol levels (that’s the stress hormone) and that can wreak havoc on the rest of your body. High cortisol can mean high insulin, which means weight gain and possibly insulin resistance, it means higher than normal levels of inflammation in your body, it can mean poor sleep and on and on. Those who tend to be over-exercisers can have a very difficult time dialing that back. As your coach, I’d ask you to be honest with yourself and really assess the pros and cons of continuing your rigorous routine and perhaps adjusting it a bit for a time.

Stress

  • Are you highly stressed – at work, at home, with family responsibilities, by your illness…and not handling it well?
    • What do you do to relieve stress?
    • What has worked for you in the past?
    • What is your favorite way to relieve stress?
    • How can you work that into your daily life?
    • Do you need to take some time off of work?
    • Do you need to hire a babysitter so you can have an hour of quiet? 

Sleep

  • How is your sleep? How many hours are you sleeping per night? Maybe you’re one of those people who says you can get by just fine on 5 or 6 hours of sleep, but the science tells us otherwise. Most adults need 8 or 9 hours of quality sleep to be in their best state of health.
  • What can you do to improve your sleep? Do you need to unplug from electronics earlier in the evening? Experts suggest at least one hour before bed.
  • Do you need to curtail the alcohol consumption? I know it can make you sleepy and make falling asleep easier, but more likely than not it will disrupt your sleep later in the night.

Environmental Toxins

  • Have you switched your personal care products to safe brands? What you put on your skin absolutely soaks through and is absorbed by the body. Remember the study that came out last summer (2019) showing that the chemicals in sunscreen were found in high levels in the blood stream? At the very least, don’t bury your head in the sand in this regard. Full disclosure: I sell Beautycounter because I feel it is the safest and highest performing brand. There are other safe brands – I have used many of them, but none perform nearly as well as Beautycounter – for me. Start with what covers most of your body or what you use the most of and switch to a clean brand of that product. Then keep going!
  • Something as simple as a water filter can make a huge difference especially if your water supply contains high levels of fluoride or chlorine, among other compounds. I have the Zero water filter shown here and have been very happy with it for many years. Each filter lasts me about three months (and I drink the entire contents of this container in about a day and a half). Ideally, I would have a whole house filter, but that costs thousands of dollars and this costs less than $50. It’s a great, effective, inexpensive option.

Relationships/Community

  • Supportive relationships (or the lack thereof) can make or break your health. Really. This can come about in so many ways, but here are a couple examples:
    • You are working very hard to stick to your Paleo diet to get your autoimmune symptoms under control, but your spouse is not supportive. He or she wants to eat their “normal” foods and simply won’t budge. The result: you cook two meals and have lots of junk in your home that you know you shouldn’t eat. And you know what they say about the flesh being weak. It’s just hard to resist when the offending foods are right in your face. Especially if you are having to prepare them. Nobody has time to cook two meals. And you shouldn’t have to.
    • You go out to dinner with friends once a month and as much as you love these friends, they give you a hard time about your health choices and so when you’re together, you always give in and eat the foods and drink the drinks that you know derail your health. (Did you know that gluten can exert it’s negative effects in your body for up to 6 months? So that one little exposure isn’t really little.)
  • I’m not suggesting you get a new family or new friends, but consider how you might make some adjustments to these relationships so they’re working for you, not against you.

Diet

  • We do have to come back to diet for a bit even though you probably have this area well in hand. More often than not, when working with a client, the conversation about diet begins like this:
    • Client: “My diet is really great. I’m totally paleo.”
    • Coach: “Wow! That’s amazing. Staying 100% paleo can be a challenge for many people.”
    • Client: “Well, I’m 100% paleo except when I go out to dinner on Friday nights. We usually eat French fries and have a few beers. It’s my one indulgence.”
    • Coach: “How do you typically feel after that night out?”
    • Client: “Not my best, honestly, but I think it’s fine.”
    • Coach: “Have you ever tried gluten free beer or hard cider?”
    • Client: “No, because I don’t think that little bit of gluten is affecting me. Besides, it’s fermented so that makes it less bad.”
    • Coach: “How have you been feeling lately – overall? Not just after that night out? Are your symptoms totally under control?”
    • Client: “Well…no.”
  • When we’re really honest with ourselves and our health care team, most, if not all, of us will see that there is room for improvement in our diet. If you really are 100% paleo except for once a week when you eat the inflammatory oils (in the fries) and gluten (in the beer), then you’re not 100% paleo.  How about trying a week without those two foods? Maybe order a special coffee instead of the alcohol? Maybe you get a really nice steak instead of the fries? Is there some change you could make that would keep you from feeling completely deprived and allow you to see if that weekly indulgence is impacting your health? 
  • This is just one example. Every single person’s experience is different. My objective here is simply to get you thinking about your own situation and how you might make a change.

Final thoughts: You have to be honest with yourself. Remember, this is not a diet, it’s a lifestyle change. If you have an autoimmune disease or another chronic health condition such as Type 2 Diabetes, managing your health with functional medicine is not a part-time endeavor. It’s full time and it’s forever. That’s why it’s hard. Let’s just say you really have most things in proper alignment for your body, but you just can’t make yourself stop going out for beer on Friday night. And don’t forget – you don’t feel well. That’s why you’re here. You have to make a decision – no one else can make this decision for you – do you want to be well or do you want whatever it is that you’re getting from that particular beverage? Could you substitute anything else for that beer and see if that makes a difference? What are you willing to try? How much is it worth to you?

If this article has stirred up some questions for you or better yet, some motivation to finally make the changes you know you’ve been meaning to make, I’d love to help! You might benefit from some one-on-one health coaching. You can check out all my package options here and even sign up for a free consult. No string attached. I promise! My whole goal is to help as many people be well as possible. I’ve found freedom from my autoimmune disease and I want others to experience that freedom as well.

 

5 Tips for Sticking to your Diet while Traveling

I love to travel. It’s one of my most favorite things to do. When I’m not traveling (which is most of the time) I’m busy planning the next trip. I often plan for trips that I am very unlikely to take anytime soon. It’s just fun to see what’s out there, explore new places virtually. Of course, I do hope that I’ll get to really visit all of those dream locations some day.

For me, one of the highlights of travel is trying new foods. In case you haven’t figured this out already, I love to eat. I like to say it’s one of my favorite hobbies. 🙂 What I don’t like is being sick. I don’t like feeling ill and I don’t like worrying that my pleasurable eating experience is going to turn sour a couple hours later. Thankfully, there are some easy to implement strategies that can help you enjoy your travels, eat well and be well. Here they are, in no particular order:

1. Take your own food – We are very fortunate to be living in a day with many, many healthy packaged food options.

    • beef jerky
    • protein bars
    • already portioned and packaged fruits and vegetables
    • packets of nut butters
    • packets of olive oil
    • packets of coconut oil
    • just add water gluten free grain bowls

I could keep going on and on with this list. If you want to take healthy foods with you, you can. They’re available to us now. We really have no excuses for choosing unhealthy options on the road.

Then there is the option of taking fresh foods with you. Hard boiled eggs travel very well. Granted, your fellow plane travelers may not enjoy the smell, but you know what, you can’t please every body all the time so I say you eat what’s healthy and just apologize if someone complains. Most people will be fine with it and frankly, they’ll probably think you’re a genius for bringing along such an easy, filling and nutritious food.

We almost always travel by car and often leave in the late afternoon, so everyone packs their own dinner for the road. Sometimes we’ll pull over and eat at picnic tables at rest areas and other times we just keep driving and eat as we go.

Justin’s Classic Almond Butter packets are my favorite. Just be sure to squeeze for a good minute before opening to mix the oil and solids together.

See these earlier articles I wrote that are full of ideas for taking food on the road with you. Paleo Travel plus Virginia Creeper Review and Paleo Travel and Easter Recipes

When it comes time to plan where to stay, I recommend looking for a place with a kitchen or at the very least, a fridge, microwave and coffee maker. That’s pretty standard these days and not hard to find. If you can at least eat breakfast at “home” that will set you up for a successful day of eating. A fridge allows you to bring along a lot of healthy options. Just make sure to bring a cooler so you can tote those foods with you throughout your day. When my family travels, we always eat breakfast at our rental, we pack a simple lunch and generally eat at a restaurant I’ve found and researched online ahead of time, which leads me to point number 2…

Before I get to point number 2 I want to say something else about packing your lunch. When traveling, it is very likely that you will not know exactly what is available for dining in every location. And who likes to be bothered with stopping the fun just because someone wants to eat? For these reasons, we almost always pack our lunch when we’re on the road so that we can be out in the middle of nowhere exploring, hiking, biking, whatever, and then stop and have lunch whenever and wherever we want. Not only does this keep us from eating unhealthy foods, but it is the ultimate in convenience. Now, on to number 2…

2. Do your research ahead of time. One of my favorite sayings is, “If you fail to plan, you plan to fail.” This applies to just about every single situation. Of course, I am a planner by nature so sayings like this actually make me excited. Way back when my kids were little, we learned that the anticipation of the trip was half the fun for them. As we’ve planned bigger and more interesting trips, I’ve really learned to embrace the planning because it gets me excited for the trip and builds my own anticipation. And of course, part of what I’m planning is the food. We simply don’t have the luxury of just winging it and eating what and when we can. With my husband’s Type I Diabetes and my Crohn’s disease, which is managed entirely with diet and lifestyle, we have to be careful. In fact, a couple years ago when we traveled across the country to visit a lot of the National Parks, we had planned to stop in some pretty remote locations because of something unique in that locale, but had to change our plans because of lack of grocery stores or safe restaurants.

My favorite sources for food planning are:

  • The findmeglutenfree.com website and the associated app. I have found many great restaurants that way. I wish it were more heavily used, but there is still great information there. I always try to leave reviews myself with as much detail as possible.
  • I’ve also found great information from travel blogs. I love Alexisgfadventures.com. I originally found her when I was planning our first gluten free trip to Disney World, but her family actually travels pretty extensively, so I’ve found lots of dining recommendations for various locations through her website. I also like glutenfreeglobetrotter.com.
  • Just google gluten free restaurant recommendations and then the city you plan to visit. Look for private blogs because those are not likely to be sponsored and are more likely to give you honest, detailed information.
  • Don’t forget to write down or create a digital file of the information you find, including restaurant name, address, hours of operation and look for coupons!

3. Plan your indulgences

We eat paleo or primal (paleo + grass-fed dairy) at home, but on the road, if we’re not eating our own food, we stick to gluten free as our single requirement. It’s fairly easy to find gluten free options these days and gluten is the primary food trigger for my family so if we can stay away from that, we’ll be in good shape. That being said, there are certain gluten free treats in which we indulge when we travel. Fried foods (hard to find so very easy to limit this one), pastries, ice cream, alcohol. Decide what you want your indulgences to be and plan them, ideally not every day. Make it good and make it special. Don’t eat the gluten free donut just because you can if you’re really not enjoying it. Case in point, on our cross-country trip, we spent a day in Chicago on the way home. I knew Chicago had a great food scene and had researched restaurants for just about every meal because there were so many great options. We really reined in our indulgences on the rest of the trip because we knew this was coming. We found a place that was part restaurant, part food hall, part gourmet market called Eately. They had a dessert bar that contained mostly gluten free options. I believe we chose four options for the four of us to share. They were AMAZING. Each one seemed to be better than the last. So what did we do? We went back and got a few more! They were small and each of us got a bite or two of each so we weren’t stuffing ourselves, but here’s my point: we had great gluten free options, they were delicious and extravagant and special, so we really lived it up.

While in Yellowstone, we discovered this special brand of ice cream made in Montana and only available in that part of the country.  It was the best ice cream we’ve ever had. Huckleberry! Heath bar coffee! I dream about that ice cream. We got big servings and we enjoyed every single bit.

4. Intermittent Fasting (IF)

This may be the least popular suggestion here, but please hear me out. I am not suggesting that you all of a sudden begin intermittent fasting when you embark on a vacation. What I am suggesting is that if this is already a part of your healthy lifestyle, it will make travel so much easier – at least for those in your party who are fasting. In my case, I’m the only one who practices IF in my family. This means that I have to plan for and procure or cook the food for my family members for three meals a day (plus snacks – teenagers!), but I don’t have to eat all those times myself. Frankly, I’m the one with the strictest dietary requirements, so this works well. I typically just have black coffee in the morning, lots of water through the early part of the day, break my fast around 3 with a snack (this is perfect for travel because I like beef jerky, almond butter, hard boiled eggs, etc. just typical paleo travel convenience foods) and then eat dinner with the family. Whether I’m cooking it myself or eating in a restaurant, only having to worry about one meal is pretty darn convenient. The caveat here is to not be rigid about sticking to your IF plan and thereby miss out on the food adventures that await when you travel. Just know that if fasting is a part of your regular routine, there’s no reason you can’t and shouldn’t continue that while you’re on the road. It’s the ultimate in convenience and money saving strategies!

5. Be prepared with supplements and medications just in case*

  • Gluten Flam or Gluten Digest – I take one of these supplements every time I eat out – unless it’s at an exclusively gluten free restaurant. I’ve actually only ever been to two such places, so that means I take these enzymes just about every time I eat out. It’s my insurance policy against cross-contamination.
  • Digestive Enzymes – helpful with any heavy meals, especially if you don’t have a gall bladder
  • Activated Charcoal Capsules – for cases of food poisoning or gluten exposure, taking activated charcoal is extremely effective. Just be sure not to take it within 3 hours of other medications.
  • Magnesium Malate – charcoal will be constipating, so taking some magnesium before bed the day you take the charcoal can help to keep everything working properly

*I am not a doctor and am not prescribing any medications or supplements, but I am telling you what I have taken successfully in the past and what I always carry with me in my traveling medicine cabinet. On our trip out west, I found a mostly paleo restaurant. It was gourmet, it was expensive and it was delicious. They had so many amazing desserts, I had a hart time choosing. In the end I chose a cookie for my family to share and after eating it, we all realized that this particular cookie was VEGAN, not PALEO like all of the others. Our waiter knew we were all paleo. Why he served us that cookie, I will never understand. BUT, my point here is that I was horrified and extremely worried about what I had just done to my health. Since going gluten free in an effort to manage my disease, I had and have never to this day chosen to “cheat” and eat gluten. And to my knowledge, I have never been served a full gluten containing food by accident – except this once. I immediately took four charcoal capsules and before bed I took five magnesium capsules. I usually take three magnesium so I chose to take extra to combat the constipating effects of the charcoal. I had zero symptoms or negative consequences from that gluten exposure. I was prepared and I acted quickly.

In conclusion, I encourage you to travel as far as your imagination and finances will take you. We live in a beautiful world and I think we should get out and enjoy it. I recognize that traveling with food restrictions can be difficult and sometimes scary, but it can be managed successfully. Take into consideration the recommendations laid out here in this document and plan accordingly. And by all means, if you have tips and tricks for eating safely on the road, please leave a comment for all of us to learn. Happy traveling!

February Research Round-up: Intermittent Fasting, Part 2

Since last month’s review of Intermittent Fasting, I feel like I’ve been bombarded with this topic everywhere I look. So much more information has come to my attention, I’ve been reading books, listening to podcasts, searching more scientific articles, etc. etc. so I thought I’d use the February round-up to provide a little more information and clarification. If you have specific questions not covered in this report or the last one, please leave a comment and I’ll see what I can find out. There are very few published, well-designed studies on humans regarding intermittent fasting, there is a lot of “bad science” out there and even medical doctors don’t often agree on topics like this, so getting accurate information can be tricky. And ultimately, there is a great deal of experimentation involved in figuring out if Intermittent Fasting (IF) is right for you and if so, in what form.

Why should you even care about intermittent fasting? It has been shown to promote health in so many areas: immune system health, weight/fat loss (which has many positive side-effects), treatment of cancer, Alzheimer’s disease, ALS and on and on. This seems to be a powerful tool with basically no downside. And it’s easy in terms of food prep, which is the biggest deterrent for many people when it comes to changing their eating habits. If you’re the kind of person who says it’s easier for you to eat ZERO cookies rather than have just ONE, fasting is definitely something you should consider.

Let’s dive in:

Understanding Fasting:

Some of this is a repeat of the last article, but as I’ve done more research, I found additional information and ways of explaining these concepts that I think brings clarity.

A person is considered to be in the fasted state once their body has digested and stored their last meal, usually 3-5 hours after eating. Here’s what happens: You eat a meal, your body produces and releases insulin, that insulin causes your cells to store the food that was just consumed. Now it’s just sitting there waiting for your body to use it – it’s in a sort of short-term storage (in the liver). Most people eat again about the time that last meal has been used up. So the body produces more insulin, the most recent meal is stored and used until the next meal. Do you see why this is a problem for someone who wants to lose body fat? Body fat is stored fuel that your body wants to be able to use, but it’s locked away in long-term storage. If you are constantly feeding it another meal that it can put in short-term storage, it can’t ever get to that long-term storage. Even if you reduce your calorie intake while eating multiple small meals per day, you will lose weight initially, but your body quickly adapts to the reduced amount of fuel and begins to burn less each time it is fed. And if you are constantly feeding, your body will not get into that state of autophagy that I talked about in the last article. Autophagy is the body “cleaning house,” getting rid of all the cellular junk. More on that below.

Insulin is 100% the key to fat storage and fat loss, so it bears driving this home a bit: During the time that you eat, your insulin goes up. There are other hormones involved; other things that are happening, but the most impactful is that insulin goes up. And that insulin gives your body the instruction to store food energy. You store it in two different ways; as sugar, which is glycogen in your liver. And when that’s full, then you store body fat. That’s all that happens. When you don’t eat; when you fast, then your insulin levels fall, and the falling insulin levels, send information to the body that nothing is coming in. We need to start pulling out those calories that we stored away.

And that’s why you don’t die in your sleep every single night. Because your body stores it and brings it back. Kind of like your wallet. You put some money in your wallet, you take it out. It goes in, it goes out. And every day, there’s a sort of balance to that. So it’s about time, letting your body have a period of time where your insulin levels fall. To let your body digest the food and start to use it. That’s the real metabolic advantage. – Dr. Jason Fung

Back to autophagy for a bit: autophagy is the breakdown of sub-cellular proteins that are old and junky. If your body senses that you’re not eating, this is what it does. There’s a period of time where it burns through the sugar, but then there’s a period of time; somewhere, 16 to 36 hours in where it actually starts to break down some protein to produce glucose. People think this is a bad thing, but it’s actually good. Because when you break down the protein, you’re taking old, sort of defective, junky old proteins and breaking them down for energy, but at the same time your growth hormone levels go up so that when you feed again, you’re going to rebuild that protein. So you are, in fact, rejuvenating yourself. You’re actually reversing a lot of the processes that can lead to disease. Certain diseases are caused by the build-up of all this cellular junk in your body.

Alzheimer’s disease, for example, is a buildup of excess protein in the brain. Same with cancer – build-up of excess proteins. This is all very interesting, but not proven, but perhaps this knowledge will lead to the prevention of Alzheimer’s disease.  Maybe your body will be able to prevent the development of cancerous growths because they’ll just get fed into the fire to get burned. And then when you rebuild them, you’ll rebuild normal cells.

So to greatly simplify, fasting turns on two important processes in the body: fat burning (lipolysis) and autophagy and these two processes have many subsequent positive side-effects.

Clean vs. dirty fasting

Clean fasting means zero calories consumed during the fasting window and dirty fasting means you are consuming a few calories or even zero calories but including some artificial sweetener.

By fasting, you are not releasing insulin. That is a fact and it is what you want. Your body releases insulin in response to the stimulus of food or beverage consumption. Even a calorie free sweetener can cause an insulin release. Published studies have shown clearly that a sweet taste, even without the consumption of any calories, can cause the body to release insulin. One rat study demonstrated this clearly when the researchers cut the nerve that connected the taste buds to the brain. With that nerve intact, the rats were fed a sweet substance and their body released insulin in response. The nerve was then cut, the rats were fed the same calorie free, sweet substance and there was no insulin release. A similar study conducted on humans produced the same results. These study participants were given a sweet liquid to swish around in their mouths, but not swallow. Even just tasting the sweetness caused insulin to be released.

Some people will say you can consume fat only, protein only, calorie-free drinks, bone broths, etc. etc. during a fast and still stay in the fasted state. Remembering that every body is different and some personal experimentation is necessary, the data and most anecdotal evidence suggest that a clean fast is the most beneficial.

Remember, a clean fast means zero calories consumed and excludes calorie-free sweeteners.

Allowing your body to keep on going during the fasted state is key to burning body fat and turning on autophagy. When you feel a pang of hunger, just wait. Drink some water. The hungry feeling will pass fairly quickly. If you fixate on food, it will be much harder to continue to fast. Try to keep busy. If you have stored body fat, your body will start to use that for it’s fuel source. Think of the hunger pangs as your body saying, “I’m just about to start working really well. Please don’t feed me yet.” I think just about everyone has experienced being so busy that they either forgot or simply didn’t have time to eat and you survived just fine. The hunger pangs went away, eating was the furthest thing from your mind and you went about your business. It’s because your body is designed to work this way. If we were designed to need to eat every 2 hours on the hour around the clock, we would never have survived as a species! Food just wasn’t always that readily available.

If you decide to give Intermittent Fasting a try – with a clean fast and a long fasting window – you may experience some unpleasant symptoms at first – headaches, dizziness, lightheadedness, weakness, but that will pass within a few weeks as your body learns that you are not going to be feeding it constantly and it has to tap into that stored fuel. This is called becoming fat adapted or metabolically flexible. Not everyone experiences negative effects at all. Each body is different.

What you are more likely to notice is a lot of positive effects, especially a sense of clear-headedness and lots of energy. How many of us would like to have more energy and not feel that we’re in a fog? There’s a scientific reason for this: when you are fasted and your body is running on it’s stored fuel, that fat is turned into ketones, which is a highly efficient energy source for the body and happens to be the brain’s preferred energy source. That is why you so often hear people talk about how fasting got them out of their brain fog!

Please note, if you have tried fasting and were consuming artificial sweeteners in any form and felt a “crash” and therefore decided fasting wasn’t for you, you may want to try a clean fast. That sweet taste, even if it didn’t come with calorie consumption, most likely caused your body to produce insulin, which in turn caused your blood sugar to tank because there were no calories on which the insulin could work.

If you’re someone who enjoys coffee or tea in the morning, it is fine to continue to consume those beverages as long as you don’t add anything to them. And be careful with teas, because many of them now have stevia or other sweeteners added. Even an orange or lemon flavor can be sensed by the brain as sweet and cause an insulin response.

Optimal fasting window

I touched on this in the last research round-up, but again, I’ve been studying it in more detail since that time. If you have tried intermittent fasting and found it appealing for some reason – maybe simply for the convenience – but are not seeing actual health benefits you desire, you might need to extend your fasting window/shorten your eating window. A 16:8 plan (fast 16 hours: eat 8 hours) is fairly common, but has been shown to be less effective for most women. Yes, men have an easier time seeing benefit from a shorter fasting window than women. Most women need to get to a fasting window of 18-20 hours. The length of fasting window necessary to see optimal results varies by person, however, anecdotal evidence suggests that a fasting window of at least 18 hours is most beneficial, both for fat loss and for autophagy to kick in.

Sparing Muscle

One argument against fasting that I see frequently is the concern over muscle wasting during fasting, meaning you lose weight but that it is coming from muscle rather than fat. In fact, this has been studied and that argument is completely without merit. Fasting is actually considered a protein sparing diet, which means that the physiological processes that occur during fasting, shuttle the “burning” away from muscle and to other tissues. In fact, people who lose a lot of weight through fasting typically don’t have the excess skin issue that people have from other weight loss methods because the body slowly “digests” that extra skin. I know that sounds gross, but it’s actually a very good thing.

If you’re interested in the physiology of how this is possible, here are some details: During fasting, when the body begins burning fat for fuel, the actual fuel being produced and used are ketones. These ketones are transported into cells with high metabolic activity (muscle cells and neurons/brain cells primarily), where they are eventually metabolized into ATP – our body’s energy source. What’s happening through these processes is that the ketones are sustaining the function of muscle and brain cells during fasting and extended periods of physical exertion/exercise. Thus, it appears that when the metabolic switch is flipped, when someone becomes fat adapted, the primary energy source for the body shifts from glucose to free fatty acids derived from adipose tissue breakdown and ketones, which serve to preserve muscle. Retention of lean mass is increased following IF regimens for weight loss, as compared with continuous calorie restriction regimens in humans. Additionally, in mice, the decline in muscle mass that occurs during normal aging is prevented by time‐restricted feeding involving 40% caloric restriction.

Fasting early or late

In the previous report, I told you about the study that showed fasting later in the day is better for insulin resistance, inflammation and other health markers (meaning eat breakfast and lunch, but skip dinner). That study has really bothered me. A few years ago, I was diagnosed with *almost* insulin resistance (you can read all about that here) and that was a huge wake-up call for me. In brief, those test results came at the end of an indulgent holiday season and everything was back to normal a few months later, but even still, it was a shocking diagnosis to accept. There is a lot of Type 2 Diabetes in my family and I know the dangers. If my fasting early and eating later was possibly putting me at risk for Diabetes and more inflammation in general, that study was something I was going to have to seriously consider.

So I went back to that study and really dissected it carefully. This is what I found: One problem with this study is that it lasted only 4 days. Clearly, that is not long enough to make significant conclusions. Another issue with this study with relation to our question of which is better, fasting early or fasting late, is that this is not what the study authors were comparing. They compared fasting late to a normal eating window of 8 am – 8 pm. This is huge! To my knowledge, there is no long-term study of intermittent fasting in humans comparing those who fast early, those who fast late and those who do not fast at all (like their normal eating window group). This is the study that needs to be conducted in order to say unequivocally that one is better than the other.

Tips for getting started:

A natural, easy progression might look like this:

  1. Drink black coffee or tea upon waking
  2. Take a walk or do some sort of light, non-strenuous exercise
  3. Drink a big glass of water
  4. Hold off on breakfast until around 10. Assuming you finished dinner by 8 PM, you will have fasted for 14 hours. That’s a great start and very doable for many people.

Then slowly add something in – either a more intense workout before eating or extend your fasting window by 15 minutes at a time.

Then continue to slowly increase your fasting window until you reach the point where you are comfortable and seeing the results you desire.

One other technique for getting started if you experience too many unpleasant side effects of fasting, is to have a small, high fat, low or no carb breakfast and lunch (eg. just eggs, heavy cream in your coffee, bacon). The lack of carbohydrates will keep your body from producing much insulin and help you become fat adapted while still putting food in your stomach.

My personal experience with Intermittent Fasting – apparently the wrong way

When my functional medicine doctor first told me to try intermittent fasting, he suggested I still have my morning coffee, with the addition of MCT oil, collagen and butter, AKA Bulletproof coffee. The average bulletproof coffee contains 300 calories. This would not constitute fasting in any sense. While I was following his instructions, I didn’t notice any positive benefits to my “fasting” other than the convenience of not having to cook breakfast. Although, I did still have to get out my blender to make the coffee, which was a hassle. I quit doing it for that reason alone.

After a couple months of my Bulletproof fast, I switched to just some Nutpods (dairy free creamer), collagen and stevia in my coffee. This was easier, felt lighter, was much more convenient, but still didn’t really provide any benefits to me other than the convenience. I had been told that as long as you keep your calorie intake below 100, your body would still be in a fasted state.

I’ve continued with this version of “fasting” for years because I feel fine and as I’ve said, it’s convenient and works well for my lifestyle. However, my goal is to build more muscle and lose some body fat and of course, be as healthy as possible. My BMI is in the normal range, but based on body fat analysis, I do have too much fat and frankly, I can feel it in my clothes and I can see it in the mirror. I have felt, prior to now, that it was just a losing battle – me vs. my genetics, my age and the state of my hormones. I’m more active than ever, my diet is very clean, I’m not actually gaining weight, but things aren’t changing for the positive. I think IF can help me here, but I need to change some things from what I had been doing. If it’s not working, time to make a change!

So it seems that my Nutpods and collagen coffee was actually “dirty fasting.” Or some experts would say that it is not even fasting at all. Period. There is clean fasting and there is not fasting. So perhaps that is why I was not feeling all the magical benefits of fasting that I kept hearing about. I certainly didn’t have boundless energy and that is something I would LOVE! Wouldn’t we all!

In the for what it’s worth category: I have been “clean” fasting for at least an 18 hour window most days for the past two weeks. During that time, both of my children had some sort of cold virus and then my husband caught it. I never got it. I took vitamin C and was diligent about sanitizing the house and washing my own hands, but you all know how hard it is to avoid catching something when it’s in your house – and in your bed!

I chalk this up to the immune-boosting effects of my fasting. I obviously have no way of proving that, but I do think it goes in the interesting category.

In my last Research Round-up I mentioned that I was getting a body fat analysis scale (I have this one and recommend it). I’ve had it for two weeks and this is what I’ve seen:

  • weight down 2.2 lbs.
  • BMI down .5
  • body fat down .7%
  • body water up .3%
  • skeletal muscle mass up .5%

*Based on my last “advanced” body composition analysis at my doctor’s office, this at home machine is accurate and I can trust it’s readings.

All of those changes are very positive. The problem with many “diets” is that people end up losing water and muscle more than fat. My goal is definitely to gain muscle and lose fat. Fasting has long been considered a protein sparing type of diet, meaning it does preserve muscle and I have seen that myself, albeit in a very small way so far.

I honestly wouldn’t believe it if I were not seeing the numbers for myself. It’s way too early to notice any significant changes in how I feel or even how my clothes are fitting, but I love seeing the numbers all move in the right direction.

I should note that I am not restricting myself during my eating window. I eat the same things I always ate (a paleo type diet). I tend to consume most of my calories at my earlier meal and eat a lighter dinner because I’m generally not very hungry by dinner, but I’m still eating balanced meals and some of my more indulgent paleo food like biscuits and some treats.

I have also not changed my workouts, my sleep habits or anything else. All I’ve changed is when I eat. I feel like this is as controlled of a study as I can conduct on myself.

One book I recommend you read for a good overview of fasting in a very easy to understand format is Delay, Don’t Deny. One of my favorite parts of the book is that the author references many published studies and other reliable resources so if you want to dig in further, you can. I particularly love the title of this book and think it sums up this version of IF really well. I’m not denying myself any particular foods and I can eat as much as I want during my eating window, I’m just delaying when I start eating each day.

My husband and I recently went away for a quick day trip and I wondered how I would feel not eating breakfast with him and how he would handle eating a late lunch (he has Type I diabetes and just doesn’t have the same level of flexibility with his meals that I do) and it was totally fine. I stuck to my 18 hour fast and we had a great and indulgent meal around 1:30.

The only negative for me so far is that I’m pretty hungry all morning. I still get up early, drink black coffee, work out first thing, but I used to eat when I finished working out and now I don’t. I am drinking a lot more water, but I’m not eating anything. A lot of my work revolves around food: I’m researching recipes, writing up recipes, practicing recipes, videoing myself cooking, etc. etc. so it is hard for me to simply not think about food. Once I get to 1:00 I’m generally feeling fine and could in fact fast longer. But I really want to eat by that point and I’m usually done with my 18 hour fast so I go ahead and break my fast. I just want to eat; I don’t necessarily need to eat. I’d like to try extending my fast a bit – to maybe 20 hours, but haven’t done it yet. One of my favorite hobbies is eating so long-term fasting may be too hard for me. 🙂

So I get it – if you are wanting to give this lifestyle a try, but have hesitations or doubts about your ability to do it.

All I can suggest is that you try it. If you are currently not fasting at all (other than while you sleep) consider dipping your toe in.

I will say that unequivocally, I do love the convenience of a longer, clean fast. Black coffee – easy. Plain water – easy. Something else – I used to read to my kids while they ate lunch. When they were little and we were just in the weeds over here, I would eat separately from them so I could have a little peace and quiet. We all loved the reading time together and I got a peaceful lunch. It was a win win. Well, the way I had been doing my fasting, I would often eat with them, thus no more reading. So now that I’m back to not eating while they eat, I can read to them again. I’m always looking for the upside!

Final thoughts:

One argument against the paleo or autoimmune paleo diets that I hear frequently is that it’s not sustainable because it’s SOOOO much cooking and SOOOO expensive. Well, fasting is a great way to combat both of those issues! Instead of cooking three meals a day, you’re only cooking one or two. This saves both time and money.

Fasting is such a complex topic and we still have so much to learn. What is pretty clear now is that fasting seems to be a very effective strategy for fast loss, while preserving muscle mass, and for health in general, including strengthening the immune system.

As with most things in the functional medicine world, you will need to try this for yourself and see how you feel. If your diet is dialed in, you are getting regular exercise, your stress is under control, you’ve removed as many environmental toxins from your life as you can and you are sleeping like a baby and yet you still don’t feel as well as you would like, intermittent fasting might be worth trying.

I still have a couple unanswered questions that I’m continuing to research so look for another brief follow-up to come. One of those big questions is how IF might help someone who is already lean but has health concerns that could be helped with IF. I’m thinking of a friend who is fighting cancer, but is very lean and is dealing with nausea that is often settled by eating. How might IF work for her? I’ll let you know what I find out.

References (in case you’re interested in doing some research yourself):

https://onlinelibrary.wiley.com/doi/full/10.1002/oby.22065

https://www.mdpi.com/2072-6643/11/6/1234

https://www.cell.com/cell-metabolism/pdfExtended/S1550-4131(19)30429-2

https://www.ncbi.nlm.nih.gov/pubmed/?term=intermittent+fasting+and+insulin

The Intermittent Fasting Podcast – listen wherever you find your podcasts

The Balanced Bites Podcast – episode with Dr. Jason Fung

Delay, Don’t Deny by Gin Stephens

The Obesity Code by Dr. Jason Fung

Setting up your Pantry for Paleo Success

Have you heard the saying, “If you fail to plan, you plan to fail”? This is certainly true in many life circumstances, but when you’re talking about drastically changing the way you eat in order to manage your health, this is truer than ever.

If you would like to keep a chronic health condition under control with functional medicine principles (diet, exercise, stress management, sleep, supportive relationships) then you need to know going in that it is a life-long commitment. This doesn’t mean you have to start at 100% and go full steam ahead all the time. There are ways to ease into this lifestyle, and ways to take little breaks, but one thing I would heartily recommend doing sooner rather than later is cleaning all the junk out of your fridge and pantry and stocking it full of acceptable foods and ingredients.

You are, after all, going to need to continue to eat and if the food you’re eating is’t very tasty or satisfying, your likelihood of sticking with the plan long term is greatly reduced. And if you have foods readily available that aren’t serving you and your health goals, then you’ll be much more likely to eat them!

Let’s get right to the nitty gritty of what to toss and what to acquire.

Tips for cleaning out: If you have unopened products that can be donated, set those aside in a separate pile. Anything else -just feed to your garbage can. Try not to worry about being wasteful. You are saving your health and money in the long run on medical costs.

We’re working within the Paleo framework, so that eliminates all grains, all dairy, all legumes, inflammatory oils and refined sugars. That’s a very short list, but the detailed list is long. You will need to read your ingredient labels and be ruthless. Besides the paleo basics, don’t forget to look for nitrates, nitrites, carrageenan, xanthan gum, MSG and other words you don’t recognize. Paleo is a whole foods diet. Ideally, nothing would even have an ingredient label, but we are living in the real world and I recognize that some convenience foods are a must for most busy families. In my chart below you will see options for some compromises.

Some specifics to look for as you’re cleaning out:

  • anything with gluten: think packaged crackers, cookies, pasta, baking mixes, flour, candy (Twizzlers, I’m looking at you with your unexpected wheat), when in doubt, throw it out – getting rid of gluten is your top priority here. If you feel like you can’t make a clean sweep of all grains all at once, start with gluten.
  • processed sugar: the granular and powdered stuff you used to bake with, artificial sweeteners besides stevia and monk fruit (and only use these sparingly), jams, jellies, sugary sauces, candy, ice cream, soda, most juices
  • highly processed vegetable oils: canola, sunflower, vegetable, corn, peanut, vegetable shortening
  • all grains – yes, corn is a grain, not a vegetable. Corn is generally very high is pesticides and is generally a genetically modified food, and very inflammatory to many people so it’s a good idea to eliminate it initially. I do list white rice as a “bonus” pantry staple below because many people tolerate this one particular grain very well, but strict Paleo says no grains at all.

Please note that these are not complete lists. When in doubt, throw it out. Or snap a picture, send me an email and ask! elizabeth@autoimmunefreecookingclub.com I’m happy to help!

I know that at the beginning of my paleo journey, I felt like I couldn’t eat anything. In reality, I couldn’t eat much of anything in a package, but I could eat lots and lots of other things. It was eye-opening to someone who thought they had a healthy diet before to realize how many packaged and highly processed foods I was actually consuming.

I started by eating lots of simple meats and vegetables. Lots of salads. Lots of fresh fruit and nuts for snacks. But that got boring pretty fast.

So I got creative with recipe development and that’s how I have hundreds of paleo recipes now on this website. Everything from pizza dishes to chicken pot pie, soups, stews and fried chicken. We can eat really, really well and leave all those junk ingredients in the dust! It may not seem like it in the beginning, but trust me, you have lots of choices and your food does not need to be boring, but you do need to set yourself up for success.

Now, for what to add to your pantry, fridge and freezer….having these ingredients and foods available will give you the raw materials necessary to make satisfying, healthy meals and snacks. Under the heading “necessary” you will find the foods I would not be able to cook regularly without. Under the “bonus” heading you will find additional foods and ingredients that are nice to have around for variety, but not absolutely necessary. Of course, this is highly subjective, but I have been cooking this way for many years and I know what my must-haves are. When I get a craving for chocolate chip cookies, I want to make my paleo version, but if I have to run to the store to get all the ingredients, I’m much more likely to opt for a packaged version instead that will be high in refined sugar, gluten free grains and gums. I’m not suggesting that we have chocolate chip cookie emergencies very often, but it does happen on occasion and I like to be prepared – and I want you to be prepared too. 😉

Setting up your kitchen

Category

Necessary

Bonus

Flours

almond flour, coconut flour and arrowroot

tapioca starch, tiger nut flour, cassava flour

Canned and Boxed Goods

coconut milk, organic tomato products, wild caught fish (tuna, salmon, sardines), pumpkin puree, salsa (check ingredients), bone broths (I prefer Pacific brand)

canned fruits and vegetables, all fruit preserves, gluten free pasta, white rice

Oils and Fats

olive oil, avocado oil, ghee, palm shortening, coconut oil, reserved fat from good quality bacon

sesame oil, nut oils, lard

Vinegars, Spices and Seasonings

Balsamic vinegar, apple cider vinegar (raw with the mother), herbs and spices you like best (fresh and or dried)

Spice blends: Primal Palate brand or Balanced Bites are both very good. I have a few recipes on my website as well: Cajun Blend and Ranch Blend; additional vinegars such as rice wine, champagne, red wine, etc.

Sweeteners

honey, maple syrup, coconut sugar, pitted dates

coconut nectar, stevia, blackstrap molasses, date paste, monk fruit

Snacks (I know we all like snacks, but the truth is that if you are eating nourishing meals, you shouldn’t need to snack often so this list can be short.)

raw nuts, dried fruit, beef jerky (I like Chomps sticks. There are many good brands, but be sure to read the label for unwanted additives.), nut butters, plantain chips if you need something crunchy/salty, avocados

paleo granola bars (Good brands: Purely Elizabeth, That’s it fruit bars, some flavors of Lara Bars, Thunderbird)

Staples for your fridge

lots of fresh fruits and vegetables (the more variety the better),  grass-fed, pastured meats, wild caught fish and shellfish, eggs (pastured are best) coconut aminos, fish sauce, mayonnaise made from good oils (see my recipe)  mustards, Frank’s Red Hot sauce, pickles, sauerkraut, almond milk, high quality bacon

dairy free yogurts, preservative free deli meats, grass-fed aged cheeses if you tolerate dairy (cheddar and Parmesan are particularly well tolerated)

Baking Staples, other than flours

cocoa powder, coconut flakes, dates, aluminum free baking soda, baking powder, sea salt, pure vanilla extract, essential oils such as peppermint, lemon and orange

good quality dark chocolate (my favorite for baking is Enjoy Life)

Freezer Foods

Vegetables: my favorites are cauliflower rice, broccoli florets, and cut okra; bone broth (homemade is best); gluten free convenience foods: Bell and Evans chicken nuggets and tenders, Dr. Praegers Gluten free fish sticks, Cappello’s Gluten free pizzas

There are so many gluten free frozen convenience foods, but most are full of refined, inflammatory oils and other junk so just read your labels carefully and make an informed decision that you are going to go “off plan” occasionally. Remember, there is good, better and best. You don’t always have to fall into the best category with your food choices.

And there you have it! What I consider to be the necessary foods and ingredients for successful Paleo cooking and eating.

For lots of recipe inspiration, check out my What is Paleo post where I recommend specific authors and bloggers I trust for good recipes and accurate information. I also have around 20 or so free recipes on this website. You can subscribe FOR FREE for access. Or if you want access to all of my tried and true recipes, hundreds of them, you can subscribe to my recipes only membership.

5 Paleo Recipes your Family will Love!

In honor of Valentine’s Day, I’m offering you five LOVABLE recipes! These are among my family’s absolute favorites and all are totally paleo. And no, it’s not hot-dogs and French fries. These are real food recipes, made with wholesome ingredients that just so happen to taste great and feel really indulgent, but are actually good for you!

If you’re staying in with your family or even just your sweetie for Valentine’s Day, consider making them one of these dishes.

You can find all of these recipes in the FREE RECIPE section of the website. If you’re not yet a member, you can sign up now.

Beef Stroganoff – I love to serve this with mashed cauliflower and green beans

It’s not the prettiest dish, but it sure is tasty!

Pizza Popover – just add a tossed salad or roasted veggies and you’re good to go (this is what we’re having for Valentine’s dinner)

Just like pizza, but upside down. So full of flavor, you won’t miss the cheese.

Chicken Pot Pie – a one pot meal with so many veggies inside you don’t need to worry about a side dish. Want to make it faster? Make the Instant Pot version.

This is my comfort food. I could eat it every single day!

Jambalaya – so full of flavor and such simple ingredients. This is my son’s absolute favorite. He would eat it every day. Could be a one pot dish, but my family enjoys it over rice. I prefer cauliflower rice.

Citrus chicken thighs -and not to leave my daughter out – this is her favorite meal. We serve it with broccoli and rice or cauliflower rice.

So crispy and flavorful. You better make extra because everyone will want seconds!

Busy Night Survival Guide

Imagine with me: your day is non-stop from the time you crawl out of bed until you finish homeschooling or pick your kids up from school around 4. And then you have a little driving all over town to do for extra-curricular activities. Somehow, you forgot to plan a meal for tonight and things have been so crazy you haven’t even had a chance to think about dinner until one of your kids asks their favorite question, “What’s for dinner?” Then panic sets in because you have no idea what’s for dinner.

Here are your criteria:

  • inexpensive
  • easy
  • fast
  • crowd-pleaser
  • paleo (or whatever other diet you’re following)
  • if it can be made with on-hand ingredients, even better

Seems like a tall order, maybe impossible. But it’s not!

Maybe you’re like me and this, unfortunately, is not such an imaginary scenario.

As much as I preach meal planning and generally do a very good job with this task, I do sometimes fall into that “imaginary” scenario described above. (Not tooting my own horn here – there are many things I am very BAD at, but meal planning just happens to be something I can do well – usually.)

Today, for example. As I write this post, which you will see in a couple of days, I’ve turned to today in my planner and see that the dinner line is blank. What? I’ve planned all the other days. Why did I not plan tonight? Did the pages stick together? I honestly have no idea what happened, but the bottom line is that I do not have a plan for dinner tonight. There is food in my house and I can make something. I may not want to, but I can. It would be very rare in our modern society that your cupboards would actually be bare, meaning that you can find something to prepare. Remember:

  • It doesn’t have to be gourmet
  • It doesn’t have to even go together (eggs + hot dogs + apple slices + celery sticks = weird, but edible)
  • It doesn’t have to be hot
  • It doesn’t have to be typical dinner food
Pizza hash: sausage, pepperoni, vegetables, Italian spices and tomato sauce = tastes just like pizza

Here are some general guidelines:

  • Find a protein source – anything! Meat, eggs, canned tuna, you name it (to keep it paleo, I wouldn’t recommend a soy based food, but if that’s what you eat then go for it).
  • Add some plants – mostly vegetables is preferred, but if you only have fruit, that’s fine. Just get some plants. Canned fruits, vegetables, those little packets of applesauce, frozen fruits and veggies, got dandelions in your yard? Pick those greens! Ok, so maybe that’s a stretch, but there are many edible plants that are likely growing around your house if you want to really think outside the box.
  • Add something flavorful. Scour the spice cabinet to flavor it up. Got any sauces in your fridge? Mustard, mayonnaise, coconut aminos, hot sauce, pickle relish, you get my point.

Meal ideas:

  • Hash: heat up your big skillet and add in ground beef, pork, chicken, turkey, sausage, etc. and add in whatever vegetables you have on hand, season it up.
  • Scramble: real similar to a hash, but the base protein is eggs. In this case, cook the vegetables first, then add in eggs at the end.
  • Soup: You know how I always suggest you have some broth in your freezer? This is when that comes in real handy. Melt your broth, add in your meat, vegetables, potatoes, rice, cauliflower rice, etc. Again, season as desired.
  • Simple things can actually make a nutritious meal: think tuna salad, hard-boiled eggs (can you make them deviled with mayo, mustard and relish for something slightly fancy?), celery with almond butter
  • Sheet pan supper: Roast meat and vegetables together at 400 degrees. Just google it – recipes abound!
  • Charcuterie board: This can be anything! Nuts, dried fruit, fresh fruit, raw veggies, deli meat, cheeses (if you do dairy), olives, dips, etc. Kids typically LOVE this!

Is your brain full of ideas? I hope so! Many of us have been known to say, “We have nothing for dinner,” when in reality, we probably have lots of things for dinner if we just think outside the box a little bit.

A little checklist for those super crazy, hectic days:

  1. Stop, don’t panic and know it’s going to be ok
  2. Take a few deep, cleansing breaths: in through your nose, hold for a second or two, then out through your mouth. If you can, hold your tongue to the roof of your mouth during the inhale which activates the vagus nerve and aids in the relaxation response.
  3. Think: how much time do you have? What protein do you have on hand? Which fruits or vegetables?
  4. What would you eat if you were eating out? Pizza? Can you add Italian spices to some ground beef, zucchini and mushrooms and make it taste like pizza? Chinese? Stir-fry some chicken and vegetables in coconut oil and add coconut aminos for a quick sauce.

And if all else fails, you can go out to eat. Just do your best to stick to your eating plan. And don’t beat yourself up. The rise in stress from feeling guilty about this one dinner out is far worse than the possibility of receiving a poor quality meal every once in a while. Just know, you likely can make something at home if you are committed to doing so. But choosing to go out every once in a while doesn’t make you a failure in any way. It’s just a choice! Own it!

January Research Round-up: Intermittent Fasting

What’s your experience with intermittent fasting? Have you heard of it? Tried it? Think it’s all just a bunch of hype?

I first heard of intermittent fasting from my functional medicine doctor who recommended it as a possible aid in fat loss. My weight is in the normal range, but according to his diabolical body fat analysis tool, I do have some fat that needs to go (and I need to add more muscle too).

So that was my first introduction to intermittent fasting (IF) and what he recommended is probably the most common version: a shortened feeding window, otherwise known as Time-Restricted Feeding. There are all sorts of variations on this version of IF, but most involve 6-8 hours of eating and then 16-18 hours of fasting. Considering that you have time after dinner and before bed, then sleeping time, fasting for 16 hours isn’t as difficult as it might seem at first blush.

I enjoy exercising first thing in the morning (well, after coffee) and on an empty stomach so this version of fasting has worked very well for me for many years. Occasionally, I wake up and just want to eat something. Maybe I have some yummy biscuits or scones lying around and so I’ll have one with my coffee simply because it looks good – but I always regret it. Seems my body very much likes my coffee-only breakfast and I’m happy with it from a practical standpoint because it’s one less meal for me to prepare and clean up. Or maybe I’ve just become used to it? BUT – it has done nothing to change my body composition. I like this version of IF because it’s convenient to only prepare two meals a day and I feel good following this plan. However, I don’t know that it’s doing anything positive for my health.

In the years since first learning of intermittent fasting from my doctor, IF has really gone mainstream and there are lots of recommendations, opinions and philosophies surrounding this way of eating. This post will by no means be a comprehensive look at IF, nor is it a recommendation, but I do hope to provide you with a basic outline of intermittent fasting, how it might help you and give you a little scientific evidence to its effectiveness.

Let’s start with the different versions of IF:

  1. Alternate Day Fasting – this is just like it sounds – you eat one day and fast the next. There are versions of this that include eating for two days, fasting for three, eating for two, fasting for three and so on. There is also a version that involves eating normally for two days, fasting for one day, then eating very restricted calories for the remainder of the week. That last one sounds way too complicated to me! Part of the beauty of IF is that it can simplify your life.
  2. Time Restricted Feeding (which might be referred to as the 18:6 method or 19:5 or even 12:12) – the bottom line here is that you fast for the majority of the day and eat within a restricted window. Within Time Restricted Feeding, there are two variations:
    1. Skipping Breakfast – this is undeniably the most popular version of intermittent fasting and involves not eating until around lunch time. Some people enjoy coffee with a little cream or collagen, keeping the calorie count under 50. Others just drink water or herbal tea. Either way, you don’t enjoy your first real meal of the day until somewhere around 11-1.
    2. Skipping Dinner – this version was new to me, has some compelling evidence behind it and is, in my opinion, the most difficult version of fasting if you have a family. More on this below.
  3. Fasting-Mimicking Diets – introduced by Dr. Valter Longo and used to treat serious diseases, including Alzheimers, Epilepsy, Parkinson’s and Cancer. You can buy kits that contain all your food, you can buy meal plans, or you can simply follow his outline with regard to calorie counts and specific macro- and micro-nutritients to consume each day. You are never fasting completely for an entire day, but the calories are restricted and it’s a very specific eating plan designed to make the body think it is fasting. I have heard great success stories around this plan and am considering trying it this summer when all of my family will be away at camp and I only have to worry about food for me. I think if I were cooking for my family and watching them eat, I would have a hard time with this because I just like eating.

I’ll spend the majority of the space here talking about Time Restricted Feeding because it is the most common and arguably the easiest form of IF to implement.

What the research says:

There is currently a lot of research being conducted on intermittent fasting – in mice and rats. There is some research being done in humans, but not nearly enough to draw any solid, statistically-significant conclusions. We learn a lot from mice, but it’s important to remember that mice are not the same as humans.

A variety of beneficial health effects have been seen in these animal models:

  • Fasting can counteract disease processes and improve functional outcomes in a wide range of age-related disorders including diabetes, cardiovascular disease, cancers and neurological disorders such as Alzheimer’s disease, Parkinson’s disease and stroke.
  • One of the beneficial process we see happening inside the body during intermittent fasting is called autophagy, which sounds scary, but it’s actually a good thing and something a healthy body does normally. Autophagy is a process by which the cell (the building blocks of the body) becomes more efficient, getting rid of old, poorly-functioning parts. This is an important process for boosting immunity, protecting against autoimmunity and reducing inflammation. During IF, autophagy can be enhanced and therein lies the benefit. The good news is that autophagy can be enhanced by regular exercise and good, healthy sleep without any fasting required.

Human studies have been much less frequent than mice studies and the results are not as encouraging. The most prevalent positive effect of IF in humans is weight loss, though this has been attributed almost entirely to the reduced calorie intake that generally happens with IF. There are other health benefits, but they can all be tied to the weight loss: improved insulin sensitivity and reduced cardiovascular risk factors. Don’t get me wrong – these are good things for sure, but IF is not the only way to achieve these same results. Keep in mind that these are the documented positive results from actual scientific studies. There are many more benefits that have been reported by functional medicine practitioners and anecdotally by people actually practicing IF.

Some potential positive effects of IF (not scientifically proven):

  • Balanced hormones – primarily we’re talking about insulin sensitivity going up (which is good), and balancing of grehlin and leptin (the so-called fullness and hunger hormones).
  • Increased secretion of growth hormone which promotes fat loss. Chronically high cortisol causes the opposite effect – an increase in inflammation, which causes lean muscle breakdown and fat storage
  • Extended fasting, like alternate day fasting, has been shown to help with the elimination of type 2 diabetes, metabolic syndrome and obesity
  • Reduces gut inflammation, primarily by helping to balance the microbiome

I want to note that these potential benefits are HUGE and should not be discounted simply because they have not been proven in large, peer-reviewed scientific studies. It is very difficult to conduct such a study because there are so many complicating factors. Correlation doesn’t equal causation. Meaning, just because people following an intermittent fasting protocol see a reduction in inflammation and increase in insulin sensitivity (for instance), doesn’t mean that the fasting caused those results. But it might have. It’s very hard to know. You would have to control for so many different factors and count on the study participants being 100% compliant, which is just about nearly impossible.

Let’s loop back around to the different types of intermittent fasting for a moment. Remember, I talked about Time-Restricted Feeding being the most popular form of fasting? Most of us who practice IF extend our bedtime fast through the morning hours and begin eating mid-day. It turns out that the opposite of what most of us do, Circadian Feeding or Early Time-Restricted Feeding (skipping dinner) may show more promise with regards to real health benefits. It’s just harder to implement for some.

Eating to match the natural rise and fall of your cortisol levels has been shown to be very beneficial to the microbiome, increases fat burning and helps to reset the circadian rhythms, which is particularly beneficial if you have trouble sleeping. For most people, our cortisol rises with the sun, around 7 AM and begins to drop around 3 PM. So to match your feeding window to this rhythm, you would begin eating upon waking, eat most of your calories early in the day, say by noon, and have a light dinner around 3 or 4 PM. The old adage, “Eat breakfast like a king, lunch like a prince and dinner like a pauper” follows this line of research.

The question is: Does that sound practical or sustainable to you? Perhaps if you are someone who does shift work or if you are single and only responsible for feeding yourself, or have a very flexible family, you could make this work. Remember that there is often a big difference between ideal and practical.

What the research says about early time-restricted feeding (skipping dinner):

  • A study published in 2017 showed some very negative effects of intermittent fasting when the feeding window began late in the morning (skipping breakfast): increased insulin resistance, higher blood sugar and insulin levels after eating that first meal of the day, an increase in risk of Type 2 Diabetes and cardiovascular disease. Not good!
  • With other studies that looked at a time-restricted feeding window that began shortly after waking up, these results were reversed. However, there have been many studies conducted on the health benefits of sleep, exercise and stress management and the positive effects of eating from early morning until mid-afternoon and then fasting until the next morning, were far less significant than the positive effects of these other healthy lifestyle behaviors.
  • There are studies showing metabolic benefits of eating breakfast as well as eating in time with your circadian rhythms. Both of these strategies should be easier to follow than some of the intermittent fasting protocols.
So where does this leave us? As with most things lifestyle intervention related, I suggest you think carefully about what works for your lifestyle and family needs and then if you want to give IF a try, give it a try for a short time (about two weeks). You may like IF on days you exercise early, as I do. And on days when you have to head off to work early or otherwise get started with the busy-ness of your day, you may choose to have a hearty breakfast. As I said earlier, I continue with IF, the skipping breakfast version, because it’s convenient and I feel well. I will be having blood work done soon to check my insulin and inflammation levels and if I find they are less than ideal, I’ll make a change.
If you have tried IF and either didn’t feel well, generally didn’t like it or found it way too difficult for your busy life, then I hope this information encourages you that there are other ways to achieve the same health benefits that might come from IF – regular exercise (preferably outside), good stress management techniques and good sleep habits.
If I could make it work with my family life, I would happily give skipping dinner a try. It does seem that the evidence suggests that form of IF to be the most beneficial.
When I was a kid, I lived in Ohio near my grandparents. I LOVED spending time on their farm and managed to invite myself over just as often as I possibly could. My parents owned a busy restaurant, so in the summer, my brother and I were at the farm A LOT. My grandparents always ate breakfast and then their big meal at noon and just something “snacky” at dinner time. This was a typical menu:
Breakfast: coffee with cream, eggs and toast
Lunch: meat, several vegetables and dessert (meat was local and grass-fed beef mostly, vegetables were from the garden, everything was cooked in lard or bacon fat or butter, desserts were full of butter and sugar)
Dinner: small sandwich or dish of ice cream
Now in today’s healthy eating age, most would cringe at that daily feast, but my grandparents followed a lot of the guidance listed in this review: they rose with the sun and went to bed early, they spent a lot of time outdoors, rarely sat down, ate locally and minimally processed foods, consumed the bulk of their calories early in the day and were generally stress free. My grandfather smoked for many years and dealt with some consequences of that, but both of them lived long, healthy lives.
Unfortunately, I’m not a farmer and neither is my husband. I’m self-employed, but he is not, and I know this is the case for most people in our modern society. So it simply isn’t practical for most people to eat their big meal in the middle of the day. But is there a way to implement some of these principles into our busy lives? Perhaps. If you’re like me and do well with skipping breakfast, but would like to give the Circadian rhythm fasting a try, here are some ideas:
  • Add extra collagen and cream (almond, coconut, etc.) to your coffee. You could also make bulletproof coffee with butter and MCT oil. Those recipes usually yield about 300 calories.
  • Eat a hearty lunch that is easy to prepare: eggs over a great big salad with nuts, avocado, healthy dressing and lots of veggies would provide plenty of nutrition and calories.
  • Make dinner as usual for your family and just keep your portion small.
  • Stop eating right after dinner. No snacking. At most, have herbal tea.
After reading from and listening to a lot of experts in this field, I’ve realized that to achieve maximum benefits from IF, most people need to extend their fasting window beyond the 16:8 that is so standard. Seems that a lot of us can manage 16:8 (fasting 16 hours and eating within an 8 hour window), but the real benefits kick in when you can fast for 18 hours and only eat within a 6 hour window. I’ve been trying this and it’s pretty challenging honestly. You wouldn’t think two hours would make that big of a difference, but it does, for me anyway. This past weekend, my husband and I had a date and we didn’t finish dinner until 8:00. That put my first meal the next day at 2:00 PM. I was getting a little hangry by then. A hangry mama isn’t good for anybody!
I’ve downloaded an app called Zero that easily helps me track my fasting window. I just click a button when I start my fast and click it again when I end my fast. I like this because I don’t have to remember what time I last ate. There are lots of similar apps and I recommend you try one if you want to really give IF a go.
A couple additional tips:
Breaking the fast: Start with something small at first and see how you feel. Some people report not feeling well after their first post-fast meal and it’s usually when they eat a huge meal because they’re so hungry. It may take some self-restraint, but go easy – at least initially. If you feel like IF is working for you and you want to continue, you will eventually get to the point where you are not ravenous at the end of your fast and it will be easier to consume a modest meal. How long will it take to get to that non-ravenous point? It depends on your body, but generally not very long, like 5-7 days. Our bodies are quite remarkable and they adapt quickly.
If you do not have any fat to lose, but want to try fasting for other health reasons, following the fasting-mimicking plan might be a good place to start.
As always, consult your personal physician (not Dr. Google) for advice specific to your body. Everything in this post is intended to be general information and not medical advice.

Citations

Aksungar FB, et al.  “Comparison of Intermittent Fasting Versus Caloric Restriction in Obese Subjects: A Two Year Follow-Up.” J Nutr Health Aging. 2017;21(6):681-685. doi: 10.1007/s12603-016-0786-y.

Ballon A, et al. “Breakfast Skipping Is Associated with Increased Risk of Type 2 Diabetes among Adults: A Systematic Review and Meta-Analysis of Prospective Cohort Studies.” J Nutr. 2019 Jan 1;149(1):106-113. doi: 10.1093/jn/nxy194.

Farshchi HR, et al. “Deleterious effects of omitting breakfast on insulin sensitivity and fasting lipid profiles in healthy lean women.” Am J Clin Nutr. 2005 Feb;81(2):388-96.

Hatori M, et al. “Time-restricted feeding without reducing caloric intake prevents metabolic diseases in mice fed a high-fat diet.” Cell Metab. 2012 Jun 6;15(6):848-60. doi: 10.1016/j.cmet.2012.04.019. Epub 2012 May 17.

Horne BD, et al. “Health effects of intermittent fasting: hormesis or harm? A systematic review.Am J Clin Nutr. 2015 Aug;102(2):464-70. doi: 10.3945/ajcn.115.109553.

Jakubowicz D, et al. “Effects of caloric intake timing on insulin resistance and hyperandrogenism in lean women with polycystic ovary syndrome.” Clin Sci (Lond). 2013 Nov;125(9):423-32. doi: 10.1042/CS20130071.

Jakubowicz D, et al. “Fasting until noon triggers increased postprandial hyperglycemia and impaired insulin response after lunch and dinner in individuals with type 2 diabetes: a randomized clinical trial.” Diabetes Care. 2015 Oct;38(10):1820-6. doi: 10.2337/dc15-0761. Epub 2015 Jul 28.

Jakubowicz D, et al. “High caloric intake at breakfast vs. dinner differentially influences weight loss of overweight and obese women.” Obesity (Silver Spring). 2013 Dec;21(12):2504-12. doi: 10.1002/oby.20460. Epub 2013 Jul 2.

Jamshed H, et al. “Early Time-Restricted Feeding Improves 24-Hour Glucose Levels and Affects Markers of the Circadian Clock, Aging, and Autophagy in Humans.” Nutrients. 2019 May 30;11(6). pii: E1234. doi: 10.3390/nu11061234.

Ofori-Asenso R, et al. “Skipping Breakfast and the Risk of Cardiovascular Disease and Death: A Systematic Review of Prospective Cohort Studies in Primary Prevention Settings.” J Cardiovasc Dev Dis. 2019 Aug 22;6(3). pii: E30. doi: 10.3390/jcdd6030030.

Melkani GC and Panda S. “Time-restricted feeding for prevention and treatment of cardiometabolic disorders.” J Physiol. 2017 Jun 15;595(12):3691-3700. doi: 10.1113/JP273094. Epub 2017 Apr 25.

Moro T, et al.”Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males.” J Transl Med. 2016 Oct 13;14(1):290.

Nas A, et al. “Impact of breakfast skipping compared with dinner skipping on regulation of energy balance and metabolic risk.” Am J Clin Nutr. 2017 Jun;105(6):1351-1361. doi: 10.3945/ajcn.116.151332. Epub 2017 May 10.

Patterson, RE, et al. “Intermittent Fasting and Human Metabolic Health“. J Acad Nutr Diet. 2015 Aug; 115(8): 1203–1212. Published online 2015 Apr 6. doi: 10.1016/j.jand.2015.02.018

Ravussin E, et al. “Early Time-Restricted Feeding Reduces Appetite and Increases Fat Oxidation But Does Not Affect Energy Expenditure in Humans.” Obesity (Silver Spring). 2019 Aug;27(8):1244-1254. doi: 10.1002/oby.22518.

Sutton EF, et al. “Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes.” Cell Metab. 2018 Jun 5;27(6):1212-1221.e3. doi: 10.1016/j.cmet.2018.04.010. Epub 2018 May 10.

Zarrinpar A, et al. “Diet and feeding pattern affect the diurnal dynamics of the gut microbiome.” Cell Metab. 2014 Dec 2;20(6):1006-17. doi: 10.1016/j.cmet.2014.11.008.

Autoimmune Protocol Refresher

When I started this blog in 2015, I created a post called “What is the Autoimmune Protocol?” and one called “What is Paleo?”. I’ve reviewed those posts annually and made very slight changes, mostly to the recommended resources or a little wording here and there because the basic principles still stand.

There are so many people who are new to this way of life that I thought it would be valuable to write up a little refresher on AIP as there is now actual scientific data proving it’s effectiveness at treating disease and there is a new protocol/diet in town that is also proving effective that I want to make sure you’re aware of.

If you haven’t already, please read What is Paleo before jumping into this autoimmune paleo article. One builds upon the other so it’s important to understand paleo first.

Sometimes you will see this diet referred to as an anti-inflammatory diet, autoimmune paleo diet, autoimmune protocol, AIP or an elimination diet. You need to read the details of each in whatever source you’re using, but generally they all mean basically the same thing.

What you can eat on an autoimmune paleo diet:

  • healthy meat, same rules apply as for the standard paleo diet: pastured, no hormones, no antibiotics administered, humanely raised (basically, you want to buy the very best quality you can afford)
  • some vegetables (see exclusions below)
  • fruits
  • healthy fats (from healthy animals), olive oil, avocado oil, coconut oil

What you cannot eat on an autoimmune paleo diet:

  • first, take out everything that is eliminated on the paleo diet (see list here)
  • nuts
  • seeds (this includes coffee and chocolate – it’s ok to cry)
  • nightshade vegetables (tomatoes, eggplant, peppers, white potatoes)
  • refined or non-nutritive sweeteners
  • eggs
  • alcohol
  • seed-based spices

I highly recommend you read this book by Chris Kresser which contains very understandable information about how to go through an elimination diet with the goal of figuring out what works best for your body.

When you look at that short list of foods you can eat, this can feel extremely limiting. Please remember a couple of things:

1. You should not have to exclude all these foods forever. The whole point of an elimination diet is to learn what you can safely add back in. This too shall pass, though admittedly, it may not feel like it at times.

2. I am here to help you! It’s ok to complain because it does stink to have a disease and have to live with limitations. My goal is to give you really creative recipes that make you forget your “safe” food list is so short. If you need lots of help, consider private health coaching.

3. You are not alone! There are so many of us out here trying to heal our bodies from autoimmune disease through diet and lifestyle changes. This may not be mainstream yet, but there is lots of support out there. If you haven’t already, check out a few of my favorite blogs, which are great sources of reputable information and recipes:

Each of these sites has been valuable to me in one way or another and I still read them regularly today. If you ever want to know the why behind something paleo or autoimmune, I recommend you visit their sites for all the in-depth science details, particularly Chris Kresser and The Paleo Mom.

Current Research:

AIP diet in Hashimoto’s thyroiditis 

This study, published in April of 2019, followed 17 women diagnosed with Hashimoto’s thyroiditis (autoimmune thyroid disease) for 10 weeks. The study authors were trying to determine if they could improve quality of life and reduce symptoms while on the AIP diet. They used the SAD to AIP in Six program. Results were as follows:

  • statistically significant improvements were seen in physical and emotional health, pain reduction and vitality
  • six of the participants were able to reduce their thyroid medications
  • the community aspect of the study played a significant role in the success of the program
  • antibodies didn’t change significantly, but the symptom improvements were dramatic
  • hsCRP, a marker of inflammation in the body, was reduced significantly

Takeaways:

  • Everyone’s timeline is different. Some people saw rapid improvement, others more gradual, but everyone’s symptoms improved.
  • The doctor running the study suggested that everyone try a dietary intervention such as AIP for 6-8 weeks prior to even seeing a functional medicine provider. Major improvements can be made in that time and then you can see the doctor and let him or her deal with the more stubborn aspects of your disease.
  • Changing your diet may not be enough. For some people it is and for some it isn’t. When diet alone isn’t providing the relief you want or need, it’s time to dig deeper into the other facets of functional medicine: stress management, sleep health, toxin exposure, emotional/community support.

AIP diet in Inflammatory Bowel Disease

This study, published in November of 2017, followed 15 adult patients with either active Crohn’s disease or Ulcerative Colitis (9 with Crohn’s and 6 with UC) who followed an AIP diet for a 6-week elimination followed by 5-week maintenance phase. The study authors were primarily interested in determining how many, if any, of the study participants would achieve clinical remission by the completion fo the study (11 weeks later).

Results:

  • clinical remission was achieved at week 6 by 11/15 (73%) study participants (6 CD and 5 UC), and all 11 maintained clinical remission during the maintenance phase of the study.
  • dietary modification focused on the elimination of immunogenic or intolerant food groups and showed that dietary change can be an important adjunct to IBD therapy not only to achieve remission but perhaps improve the durability of response and remission
  • researchers saw reduction in fecal calprotectin, an inflammatory marker in IBD, and improvements in the mucosal appearance in most patients undergoing follow-up endoscopy

Takeaways:

  • for a subset of patients, dietary and lifestyle modification alone may be sufficient to control underlying disease
  • patients wishing to incorporate dietary therapy should be counseled how to manage micronutrient deficiencies and monitored routinely
  • integrating and coordinating care with health coaches and registered dieticians can allow for effective education and implementation of dietary modification over time, in accordance with unique patient goals as well
  • larger randomized trials are needed to validate these findings and examine the long-term course of patients during reintroduction
These studies and their results should be very encouraging. Anecdotal evidence of the effectiveness of dietary changes on autoimmune disease abound, but having well-designed, peer-reviewed studies showing the efficacy is highly valuable. Perhaps some day, these types of studies will lead to insurance coverage for functional medicine testing and care.

The University of Massachusetts Medical School’s Center for Applied Nutrition has created a diet that is proving to be very effective at treating autoimmune disease. It’s call the anti-inflammatory diet for IBD (inflammatory bowel disease) or IBD-AID. Please note that whereas this diet was designed specifically for IBD, there is significant anecdotal evidence of its effectiveness in other autoimmune conditions.

Please go to the AID website for all the details on the diet, but here is a quick summary. If you have active IBD and are anxious to get started healing naturally, I highly recommend you look into this diet. One of the great things about it is that it offers specific recommendations for various levels of disease.

The IBD-AID was derived from the Specific Carbohydrate Diet (SCD) and modified with current research on the human microbiome. Research has shown that IBD patients have an imbalance of gut bacteria, which contributes to inflammation.  This diet helps to restore balance between helpful and harmful bacteria while promoting good nutrition. The IBD-AID has three phases to treat flares and progress to the ultimate goal of maintaining remission.  Every day incorporate the four fundamental components on the IBD-AID:

  1. Probiotics: These are fermented foods that have live bacteria within them, such as plain yogurt, kefir, kimchi, miso, and fermented veggies like sauerkraut.
  2. Prebiotics: Foods that feed and maintain the good intestinal bacteria.
  3. Avoidance: The IBD-AID diet emphasizes avoidance of certain carbohydrates that are pro-inflammatory which may be disturbing the normal gut flora. Foods that contain lactose, wheat, refined sugar (sucrose), and corn are avoided in all phases of the diet.
  4. Good nutrition: Eat a variety of fruit and vegetables, lean proteins and healthy fats. (legumes, nuts, olive oil, avocado, ground flaxseed, fish, eggs, probiotic yogurt and kefir), limit intake of saturated fat, increase intake of good fats from nuts, avocado, olive oil, etc.

The IBD-AID diet focuses on three phases of disease:

Phase 1 – Active Flare, symptoms present

Phase 2 – intermittent symptoms

Phase 3 – maintenance/remission

This chart is a few pages long, but very detailed and very helpful if you’d like to know exactly what to eat based on your level of disease (according to the AID authors). This chart lists what you CAN eat, which I find much more helpful than a list of what you can’t eat. Even the psychology of this is important – looking at such a long list of allowable foods is encouraging!

Please note that this list is far more inclusive than AIP so if, for example, you know that oats are problematic for you, don’t eat them, even though they are allowed on this diet. Knowing yourself is important. However, if you’ve looked into AIP and found it to be so restrictive that you didn’t even want to give it a try, consider the AID first and see how you feel. You can always make the switch to AIP later.

I hope you found this helpful and encouraging! I’m just glad to know that there are doctors out there running studies on functional medicine principles – and that they are proving, in a statistically significant way, to be effective!

As always, I wish you good health! Don’t hesitate to reach out if you have questions about these studies, the AID diet or functional medicine in general.