Twenty years ago, most people didn't know anything about gluten. People didn't even know how to spell gluten. Now gluten-free diets have become all the rage. But are celiacs the only people who should be on a gluten-free diet?
A reader tweeted, "I lost 30 lbs on The Blood Sugar Solution program. Now, I am following the guidelines from Eat Fat, Get Thin for the next 30 days. NO sugar/carbs—all veggies, proteins, good fats—but seeing much slower weight loss this time."
Weight loss plateaus are a very common and frustrating issue. When I am working with someone who is having trouble losing weight, despite doing everything right, there are a few things I look at, to see if we can uncover why they are hitting a weight loss plateau.
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In this week's House Call, a reader asked, "If one is lactose intolerant, but has no other intolerance to dairy, (e.g. casein and whey) is it ok to consume dairy products while having Hashimoto's?"
By now, most of my readers probably know how I feel about dairy—it's nature's perfect food—but only if you're a calf. We have no biological requirement for this food, and yet, we've been told over and over again that dairy is a great source of calcium, milk makes healthy bones and we should drink it daily. I'm here to tell you that this is not true.
Did you know that 50 percent of media headlines about medical studies are dead wrong? And that many of these headlines don't accurately match the conclusions of the studies they cover? That's from a review published in the New England Journal of Medicine.
It makes me sad and furious at the same time that journalists don't do their homework and create firestorms of confusion because of their negligent work.
Scott, a 10-Day Detox participant wants to know, what are the best prebiotics and probiotics to take and how to keep his gut healthy.
The health of the trillions of bugs in our gut (which outnumber your cells 10 to 1) is one of the biggest things that impacts our wellbeing. We have to learn how to tend the flora of our internal gardens (our gut) by being selective of what we eat and how we live. We must feed the good bugs and avoid gut-busting habits—like eating too much sugar and starch or consuming too much alcohol or allowing stress to wreak havoc (yes, your gut bacteria are eavesdropping on your thoughts).
Drinking wine is like a U-shaped curve. A little bit is ok; a little more is bad news. For women, wine can be especially damaging. Why? Increased alcohol load means your liver can't metabolize estrogen well. Increased estrogen in the body can lead to breast cancer. Drinking just one glass of wine a day increases your breast cancer risk by 40 percent.
I'm often asked by my patients, "What superfoods are most important to stay healthy?"
I like to think that everything I eat is a superfood. When I walk into the grocery store, which I call the "Farmacy," I like to seek out powerful foods that are going to provide the right information for my body.
Have you heard of the concept of food as medicine? Have you ever wondered about the Blood Type Diet or the Ketogenic Diet? These are the three questions covered in this week's Housecall.
Food as Medicine
Our first question comes from Chrysanne who asked, "Is it really worth it to spend extra money on good food? Does it make a difference?"
The food industry likes to trick us into thinking that eating healthy is expensive, but this is far from the truth. My friends at the Environmental Working Group created an easy-to-use, comprehensive guide, called Good Food on a Tight Budget, to help consumers make the best food choices without breaking the bank.
When people tell me they cannot afford organic produce or healthy cuts of meat, I ask them to consider the gargantuan markup of many convenience foods. Manufacturers package them in "value-priced jumbo sized" containers and grocery stores promote them with price cuts to create the illusion that we are getting value.
Relying on inexpensive, overly processed food is tempting, given our demanding lifestyles and schedules, but the cost to our health is quite large. Feasting on the sodium, fat and sugar bombs disguised as food can lead to serious diseases that cost hundreds of dollars in doctor's visits and prescription drugs.
Food is not just calories; food is information. I've seen thousands of people transform simply by changing their diet, so why not give it a shot? You will only feel better. Here are my tips for eating well on a tight budget.
The Blood Type Diet
Our next question comes from Jenna who asked, "Eating for your blood type advocates say that those with O blood type shouldn't eat anything with coconut, but it's so good for you. What are your thoughts on this?"
I believe in the personalization of our diets. We are learning more and more about how to customize diets for every individual based on their genetics, metabolic type and more. The blood type diet was one of the first customizable diets, but it only focuses on one bit of information: your blood type.
Instead, I recommend looking at the whole picture. When I see a patient, I look at their genetics, predisposition to diabetes, food intolerances, detoxification symptoms and other factors.
My hope is that in five years or less, we will be able to customize our diets based on a simple drop of blood. But until then, my advice is to look at the whole picture instead of just one factor. You can do this by working with a Functional Medicine practitioner who can test you for food intolerances, check out the state of your gut, identify nutritional deficiencies among other factors, to give you a complete picture of the state of your body. From there, they can create a plan to customize your diet to get you back on track and optimize your nutritional intake.
Also, you know your body better than anyone else. If coconut oil works for you, use it. The smartest doctor in the whole room is your own body. Take note of how you feel after you eat certain foods. If you dig a bit deeper, you can find out what works for you and what doesn't.
The Ketogenic Diet
Our final question comes from Deanna who asked, "Is there such a thing as a vegetarian or a vegan ketogenic diet?"
I'm not going to lie to you, it is absolutely tougher to be vegan or vegetarian on a ketogenic diet, but it is possible.
You need to focus on two important groups to maintain a vegetarian ketogenic diet: proteins and fats. In fact, studies have shown that a low-carb vegan diet with higher amounts of plant-based fats and proteins has advantages over a high-carb, low-fat diet—including increased weight loss and improvement in heart disease risk factors.
Sources of vegetarian protein include:
- Tofu and tempeh
- Nuts and seeds
- Eggs (if you're not vegan)
Sources of plant-based fats:
- Organic extra-virgin olive oil
- Organic virgin coconut oil
- Macadamia nut oil
- Avocado oil
- Grass-fed ghee (if you're not vegan)
Here's an easy guide to a vegan ketogenic diet.
"My doctor wants me to take another antibiotic for this cold that won't quit, but I've read antibiotics damage the gut and even can make me fat," a patient recently asked me. "I've read mixed reviews and I know you've given them the thumbs down in the past, but really, how bad are antibiotics?"
Firstly, let's not totally dismiss antibiotics. After all, they can be life saving and in certain situations, become absolutely necessary. They've saved millions of lives. Trust me, we do not want to live without antibiotics in the twenty-first century.
That being said, antibiotics today are over-prescribed and often unnecessary. Developments to prevent and treat infectious diseases—like sanitation, early vaccines and best-use of antibiotics—have dramatically reduced deaths from infectious disease. But there is a cost.
Take sanitation ... hyper-focusing on hygiene and sterilization using hand sanitizers and overusing vaccines and antibiotics has dramatically altered our gut ecosystem, spiking autoimmune and allergic diseases and contributing to things like obesity, diabetes, heart disease, depression and autism.
While western medicine has greatly advanced with acute disease, we've failed miserably addressing chronic disease.
Louis Pasteur discovered the bug or microbe causing infections and Alexander Fleming discovered antibiotics to cure them. This simple cause-effect "cure"—single bug, single disease and single drug—might work for infection, but not so much for chronic disease.
Ever since, we have been searching for "cures" for chronic diseases (including cancer and dementia), yet we can't find them! Medicine's history has become the pursuit of a holy grail—a pill for every ill. This failed approach will continue to fail because chronic disease results from the complex interaction of our genes, lifestyle and environment. A magic pill or other "miracle cure" just isn't going to cure us. We need a well rounded, permanent lifestyle approach.
So back to the original question: Antibiotics can become detrimental because they damage your gut ecosystem, what we collectively call our microbiome, which is made up of 100 trillion bugs that live inside you and outnumber your cells an astounding 10 to 1.
True, antibiotics wipe out the bad stuff that is causing the infection; but they are like napalm—they take out everything in their path—including the good bacteria.
That becomes a real problem because while your gut has trillions of bacteria, they collectively contain at least 100 times as many genes as you do. That bacterial DNA in your gut outnumbers your own DNA by a very large margin.
That's important, because among its functions, this bacterial DNA controls immunity, regulates digestion and intestinal function, protects against infections and even produces vitamins and nutrients.
Antibiotics destroy these beneficial bacteria, which creates a wide open field for the overgrowth of bad bugs, yeast and candida, leading to numerous problems including mood disorders, food allergies, fatigue, skin issues and of course, digestive issues.
Overgrowth of bad bugs can also encourage cravings for sugary, processed junk foods, leading to weight gain and other problems that eating junk foods creates. So it is clear that antibiotics can potentially make you fat.
When a patient comes to see me, I ask if they have a history of taking antibiotics. More often than not, I've learned overuse has led to their gut issues, including leaky gut.
I recently had a patient born by C-section, who was then bottle fed and as a child suffered recurrent ear infections. Conventional doctors—doing what they felt was best—overprescribed antibiotics, eventually leading to irritable bowel syndrome during the patient's teen years and then an autoimmune disease as a young adult. I hear this story repeatedly, and much of this stems from not honoring, respecting and tending to your inner garden.
More often than not, the antibiotics children receive for viral infections, colds, sore throats and other ailments, for which they likely would have gotten better on their own, have damaged their delicate gut flora starting at an early age.
One Centers for Disease Control and Prevention (CDC) study found 71 percent of children who suffered C. diff infections (inflammation of the colon caused by a specific bacteria called clostridium difficile) received numerous courses of antibiotics for respiratory, ear and nose illnesses 12 weeks before infection.
Another study published in the American Society for Microbiology found a one-week course of antibiotics could negatively affect your microbiome for long periods of time, potentially even for a whole year.
While antibiotics can sometimes be absolutely necessary, I highly recommend conferring with a Functional Medicine practitioner to discuss alternatives (including allowing infections to heal on their own).
If you must use antibiotics, I recommend a few things before and after using them.
First, add in the good stuff. Eat a low-glycemic, whole-foods diet and take quality probiotics and prebiotics. A high-quality, multi-strain probiotic helps populate your gut with beneficial bacteria. Prebiotics, a form of soluble fiber, which also helps feed good bugs, which can be found in onions, garlic, resistant starch, sweet potatoes, dandelion greens and jicama.
Unlike regular starch, your small intestine doesn't absorb potato starch. Instead, your gut bacteria process it, creating molecules that help balance blood sugar and healthy gut flora. In other words, when you consume resistant starch, it "resists" digestion and does not spike blood sugar or insulin.
I like to supplement with my favorite resistant starch found in Bob's Red Mill Unmodified Potato Starch. I suggest adding about 1 teaspoon to a glass of water.
Then, focus on gut repair—especially after you're finished using antibiotics. Utilize gut-healing nutrients including L-glutamine, omega-3 fats, vitamin A and zinc to repair your gut lining so it can resume its normal, natural functions. The use of digestive enzymes can help you digest your food better.
That's it … pretty simple but with amazing results.
"I have been dealing with constipation for years now and I'm so tired of it. It's making me cranky, bloated and it's messing with my appetite," a social media follower recently wrote. "I feel like I'm doing everything right, but I can't poop. Help!"
Unfortunately, I see many patients who struggle with constipation and other bathroom issues. Sometimes they are too embarrassed to admit their problem until it becomes too painful to bear.
My patients aren't alone. Researchers find that roughly 12 to 19 percent of the U.S. population (about 63 million people) suffer from constipation. And while constipation might be common, it's definitely not normal and it can have disastrous consequences.
Having healthy digestion and eliminating waste every day (ideally twice—yes, twice—a day) is critical to your overall health. Remember—your liver flushes out toxins and dumps them into your intestines. If your digestive system isn't working optimally, then all those toxins and waste gets reabsorbed into your body. So, it makes sense that constipation has been linked to multiple diseases, including cancer and even Parkinson's disease, plus it actually makes you feel like crap!
Then there are the practical problems. Constipation is often uncomfortable and can lead to symptoms including bloating, irritability, lack of appetite and vomiting.
I often ask my patients if they are regular. One answered yes, but when I followed up with how often she eliminated, she replied "once a week." Trust me: That is not regular. Other patients think constipation is normal but after treating them, their whole world turns around once they eliminate normally. Again, common does not mean normal, nor does it mean it's okay.
We now know so much about how to fix your gut, how to tend your inner garden (the flora in your gut), and how to reset your system, yet many of us maintain poor ways of eating and living. Like most problems, constipation is usually fixable without pharmaceutical drugs or other invasive procedures.
The first most important thing to get things moving consistently is addressing your diet, which causes most constipation. While chronic stress and antibiotic overuse can mess up your gut, a diet that is high in processed foods and sugars does great harm and promotes constipation.
Incorporating the following simple hacks will help most people get things moving:
Eat whole, real foods in their unprocessed forms. This is the first and easiest and healthiest first step to healing.
You need lots of fiber. Back in the day, as hunter-gatherer, we humans ate 100 to 150 grams of fiber a day. Today most modern humans are lucky if they get 8 grams daily. Fiber comes from plant foods. Besides eating lots of colorful fruits and vegetables, I like "super fibers" like ground flax seed. Try adding 2 tablespoons a day to your smoothies or salads for an easy fiber boost. Nuts, seeds and beans also contain high amounts of quality fiber; however, remember that beans can cause insulin spikes—so go easy if you are prone to blood sugar imbalances. You'll also want to avoid foods that cause constipation. Dairy tops this list, and gluten is a close second. I challenge you to give those up for at least three weeks and see how your digestion and overall health improve.
And here's something that often surprises my patients: Low-fat diets can contribute greatly to constipation, despite still being touted as healthy.
A clinical study published in the European Journal of Clinical Nutrition put 11 men on a high-fat diet for two weeks and found that, when compared to a low-fat diet, a high-fat diet accelerated gastric emptying.
You'll want to incorporate lots of smart healthy fat sources include wild fatty fish like sardines and salmon, olive oil (which lubricates the digestive system) and avocados.
One of the best "laxatives" is MCT oil, which I recommend in my book Eat Fat, Get Thin. You can put it in your coffee (which, by the way, also helps you go) or use it in your smoothies and salad dressings.
Another big constipation culprit is magnesium deficiency. We don't eat enough of this underrated mineral (magnesium-rich foods include nuts, beans and greens), plus things like chronic stress, too much caffeine and sugar and toxic overload often deplete magnesium levels.
Even if you eat plenty of magnesium-rich foods, you probably need to supplement to get optimal levels. Use 200 mg to 1,000 mg of magnesium citrate daily. Gradually increase the dose until you go once or twice a day. If you take too much, you will get loose stools. If that happens, back off a bit.
Vitamin C is another great poop inducer. You can take 2,000 to 4,000 mg or more a day, along with magnesium supplementation. The same principle applies here: If you begin to get loose stools, just back off a bit.
Many patients are often deficient in healthy gut bugs, which is why I also recommend adding probiotics.
Exercise is a great laxative. So move your body everyday to help move those bowels.
And lastly don't forget water: Hydration is critical, so drink at least 6 to 8 glasses of water each day.
Simply put, to optimize bowel function:
- Eat a whole foods, high-fiber diet (check out the Pegan Diet I explain in my book Eat Fat, Get Thin).
- Add 2 tablespoons of ground flax seeds to your daily diet.
- Eat more good fats and try MCT oil.
- Supplement with magnesium, vitamin C and probiotics.
- Drink 6 to 8 glasses of water a day.
- Exercise daily.
If you're still struggling after using the above tips, then consider having your thyroid looked at. An often-overlooked culprit is a sluggish thyroid, which affects 1 in 5 women and 1 in 10 men (about half of whom are not diagnosed or not treated properly). Check out my e-book, The UltraThyroid Solution, to figure out if this is a problem for you and what to do about it.
And there could be other underlying problems that a Functional Medicine practitioner could help address.
I was visiting Google one day and I walked into a lunch area and saw everyone sitting on couches and at tables, all on their computers. I asked, "Is this the silent lunch room?" and was surprised when I was told no.
Far too often, I find myself on my phone or computer for most of my day—often missing the people and life events that are all around me. This is why it is important to do a complete "digital detox"—something I do at least a few times a year so that I can get back to just being.
More and more studies have been coming out showing the link between too much Internet usage and screen time and mental and mood disorders (like ADHD, anxiety, depression etc.). In a recent study, people who reported excessive Internet use also reported social anxiety disorders, loneliness, social isolation and lower quality of life. The study also showed that Internet addiction was associated with reduced immune function.
That's right, too much Internet and screen time can actually make you sick!
Connected Online = Disconnected from Self
How is this possible? Your addiction to your screen prevents you from the habits that make you a healthier person. People who are addicted to their screens often live very sedentary lifestyles. They don't make enough time for exercise, movement, community and play. These are important factors in achieving optimal health. People who habitually sit have as much risk of dying as people who have bad diets or smoke. Being sedentary also increases risk of cancer, heart disease and diabetes. If you think about it, sitting is the new smoking.
Also, more time in front of your screen means less time for face-to-face contact with other humans, which not only increases stress but also feelings of isolation and social anxiety. Too much FaceTime and Facebook, and not enough real face-to-face time.
Sleep Disrupting Screens
And there's more. Too much screen time, especially before bed disrupts our circadian rhythms, affecting our hormones, our sleep and our energy. This artificial light coming from our screens delays melatonin secretion (needed for sleep); and we now know, that inadequate sleep can quickly sabotage our efforts at getting healthy and losing weight. Sleep is a major cornerstone for an energetic, joyful, healthy life.
One problem that's been proven is that not getting enough sleep or getting poor-quality sleep adversely affects the hormones that make you hungry and store fat. One study found that just one partial night's sleep could create insulin resistance. Ever wonder why you get bad carb and sugar cravings after sleep deprivation? This is why!
Other studies show that poor sleep contributes to cardiovascular disease, mood disorders, poor immune function and lower life expectancy. So, banish your phone from your bedroom or at least switch it to airplane mode.
Downtime Linked to Healthier Habits
So many of us are used to slaving away in front of our computers, pushing ourselves to get more work done and be more efficient. However, a Stanford University study found that creative output increased by an average of 60 percent in people who took regular walks. In fact, the more fun we have, the more we move, the more we get out in nature and away from our devices, the more productive we become and the healthier we are.
Attention and focus are hard to come by. Psychiatrists increasingly diagnose "adult attention deficit disorder" and prescribe Ritalin for grown-ups who can't focus or pay attention. A lot of this is caused by our distraction by email and the ping of a new text message. Our bodies' break down under the onslaught of stress—insomnia, anxiety, depression and all chronic disease are made worse by the unending stress from being constantly plugged in.
In order to manage all of this stress, we need to unplug and have fun. I love to incorporate play and fun in my daily life: horseback riding, playing basketball, biking, doing yoga and decompressing with friends over a good meal. These are all things that keep me happy and allow me to recharge so I can perform well at all of my jobs—and I have a lot of them!
Play is not just for kids! It's for adults, too. Playing gives us the chance to unplug, de-stress, find joy, challenge our brain in different ways and connect with new and old friends. It also keeps our immune systems healthy and elevates our energy level.
I know it sounds impossible, but I suggest you give it a try today. Here are my tips for unplugging for a successful digital detox:
1. First, use a timer. Commit to only a certain amount of screen time per day. I like to set a timer to stay focused on the task at hand and when the timer goes off, I get up, take a walk, stretch or take a yoga break. This keeps me from being sedentary even on days where I have to do a ton of work on the computer.
2. Next, silence your cell phone. Unplugging does not mean going for a walk while scrolling through Facebook and Instagram. Put your phone and your notifications on silent so that your unplugged time isn't interrupted by noise. Carve out specific times to do emails, answer texts, do social media or surf the Internet, and leave blocks of time where your technology is turned off so you can focus, play, read or just be.
3. Next, quit TV. Try going without TV for a week. Television is a serious time suck that prevents us from doing things we actually love to do and it keeps us from accomplishing our goals. Quit TV for a week and watch how much more time you have to cook and stay active.
4. And, finally, when it comes to exercise, find something you love. When you don't feel excited about going to the gym, Netflix and that game on your smart phone become very attractive. It's important to find an activity that you love. You won't find me at the gym. I love sports and adventurous activities that challenge my body and my mind. Find what works for you. Find something that you love so much, you'd rather do it than sit in front of a screen.