Sunday, July 29, 2018

Diet - 'A Way of Life'

In the U.S. we usually use the word 'diet' to mean a weight loss scheme but the original word in Greek meant 'a way of life'. The 'Standard American Diet' or SAD for short, consists of a lot of packaged food, frozen food and take-out/drive-through food laden with preservatives and chemical additives. It's no wonder our allergy rates, diabetes rates, heart disease rates and cancer rates are skyrocketing. Our 'way of life' is killing us.



Organic but not necessarily good for you.







                      Veggies but super-processed.













I don't think you can find these in nature!









I recently read this article about how an allergy to mammalian meat might develop following a tick bite and what struck me was that if the tick bite is injecting material that precipitates the allergy in certain people and this mechanism is how vaccines work then why hasn't the connection between vaccines and the rise of allergies been made? Probably because the vaccine makers don't want that data to be known - just like Big Tobacco didn't want the lung cancer data to be known.

If the whole lung cancer from smoking paradigm doesn't impress you or the fact that it took until 1996 for the U.S. to ban lead from gasoline when it was known to be toxic for hundreds of years or that it took two decades for the radioactive paint industry to be brought to justice (please read Radium Girls) then you can stop reading now and go enjoy a Big Burger Meal Deal. For the rest, I want to raise your level of awareness about your way of life.

I saw a patient this week who was brought in by her husband. She is in her mid-50s but is unable to function because she had a massive stroke. She is lucky it didn't kill her. She can't walk without assistance and is partially paralyzed in her upper body on the right side. She doesn't have all of her speech ability. She has some severe nutrient deficiencies so I had to get creative in helping her husband figure out how to improve her nutrient status so she can perhaps have better function. She can't really swallow large pills so she will have to get her vitamins and nutrients in food and in powder or liquid form.

You may recognize these veggies from my previous post. The easiest way to boost nutrient levels and antioxidant power in your body is to eat unprocessed organic foods. For my patient, if she has difficulty chewing certain foods they can be put into a smoothie. Her husband has had to learn how to cook and make smoothies and the only feedback he has is if she won't eat something, he has to assume she doesn't like it or she doesn't tolerate it. So how can he find out if a food isn't tolerated? Let's discuss.

There are two basic strategies to help determine whether a particular food is causing an immune reaction that could harm you.

The 'gold standard' to finding the foods that may trigger your immune system is the elimination diet. I frequently place my patients on an elimination diet for at least six weeks. The reason being that any immune reaction to a particular food produces antibodies that will circulate in your blood for at least 4 weeks. You want to get rid of all of the antibodies before adding that food back to your diet in order to see if that food is a problem.

For example, if I eat eggs every other day and my body doesn't like the eggs then I will constantly be producing antibodies to the eggs. I may not notice any symptoms from the increase in antibodies to eggs. I may even develop seasonal allergies or autoimmune disease and never suspect eggs as the trigger for my condition.

Then I eliminate eggs for six weeks and those antibodies all go away but the ability to make them remains because our immune system has memory. So when I add the eggs back in I notice I feel bloated and produce a lot of intestinal gas (whoopsie) and that tells me that my immune system doesn't like eggs.

I might not die from being gassy but the activation of my immune system could lead to other issues like Hashimoto's thyroiditis, Rheumatoid arthritis, Multiple Sclerosis, and more over time. I've seen patients who were developing serious nervous system disorders who completely recovered when they eliminated gluten. Yes, there are serum tests for celiac but if you eliminate gluten and your symptoms go away do you really need to run any tests?

Depending on your level of commitment, you can eliminate one food at a time for 6 weeks or you can eliminate all of the most common foods found to cause immune, gut or neurologic disorders. These include:
Gluten
Dairy
Soy
Corn
Peanuts
Nightshades (potatoes, tomatoes, peppers, eggplant, goji berries)
Eggs

If you decide to do it yourself, following an anti-inflammatory diet by avoiding packaged foods, red meat, sugar and alcohol will help your immune system and gut do a better job during the process and make it easier to determine if a food causes a problem for you.

If you've already done an elimination diet and didn't get a clear idea of if a food was an issue for you, the second way to determine if a particular food is a problem is by using a reliable reproducible food sensitivity test. Do a bit of research before you get tested because most of them will set you back at least $250 and upwards of over $1000 and some provide more useful information than others. Work with a Functional Medicine doctor to find out which test might be right for you.

So back to my patient. I'm not sure which foods may be an issue and her husband doesn't feel he can afford the testing so he can eliminate one food at a time and see if she feels better. Since she had a stroke due to hypertension (uncontrolled, not taking her blood pressure medication) and a diet mainly of eating take out and restaurant food (heavy on the salt), just eating healthy unprocessed foods is helping her gradually recover from her brain injury from the stroke.


For her nervous system to improve, omega 3 fatty acids are very important. These come from walnuts, chia, flaxseed oil, cold water fish like salmon and sardines and algae. Vitamin D3 is also very important and she can get it from cod liver oil (yum, right? - jk), salmon, mackerel, fortified orange juice, eggs from pastured hens and not so much from mushrooms or fortified milk. There are liquid vitamin D drops to help boost her levels as well.

Increasing the antioxidant levels in her food are critical to helping her heal. This means eating colorful foods like the ones in my veggie photo above. It is easy to incorporate foods with high antioxidant power (ORAC values) - I put cinnamon in all of my smoothies and try to have a blueberry smoothie at least twice a week (got to rotate with the cherries and the black raspberry powder).

For more on stroke recovery this book is fascinating.

So to all my friends, family and readers who want to avoid stroke-town and diabetes-ville and heart attack city, maybe consider that those foods that are so convenient maybe aren't so convenient in the long term. Maybe our bodies are designed to function at their best when they are nourished with the best foods, as close to their unadulterated form as possible. Maybe all those fast food ads are selling you poison disguised in glitzy packaging.

 I hadn't had fast food in years and last summer my son wanted some Sonic so I got it for him and tasted his food. I had to spit it out! All I could taste were the chemical additives and fake flavoring and preservatives. I suspect that all the added flavoring and preservatives alter your taste perception so you like the processed food taste but when your taste buds revert to their natural state they will tell you the difference. So get rid of soda and sugar-heavy snack foods, chips fried in inflammatory oils and salt-soaked take out. You may just feel twenty years younger!

And lest you think I never eat anything yummy (although the salad and roasted eggplant I had for supper last night were yum-oh) - I made this vegan gluten free Double Chocolate Zucchini Bread - yes, the same one I made last weekend - for my son to celebrate completing his last high school Summer Marching Band Camp (any excuse for chocolate):


Line a 1 pound loaf pan with parchment paper and preheat the oven to 325 degrees F.

Make a flax egg by grinding 1 T flaxseed and placing the ground flaxseed into a small glass bowl and adding 4 1/2 T filtered water and let sit for at least 10 minutes.

Meanwhile, place in a medium mixing bowl:
Either 1 cup gluten free flour mix OR
1/2 cup brown rice flour
1/2 cup sweet sorghum flour
1 T teff flour
1 tsp xanthum gum
then add:
1 tsp baking soda
1/2 tsp salt
1/2 cup organic non-gmo cocoa powder and mix all together.

Shred a medium zucchini and place roughly 2 cups of shredded zucchini in the bowl of a stand mixer or into a large mixing bowl. Add the flax egg, 1 tsp vanilla, 1/2 cup agave syrup (or maple), 1/2 cup cashew milk, non-gmo unflavored soy milk or your favorite non-dairy milk and 1/2 cup unsalted cashew butter (or almond butter or sunbutter) and mix together until well blended.

Add in the dry ingredients and mix well. Add a handful of Enjoy life dark chocolate chips and fold in. Place the batter into the loaf pan and bake about 50-60 minutes (test with toothpick for doneness). Let cool in the pan about 15 minutes then lift onto cooling rack. Enjoy with some green tea (or organic coffee).


Sunday, July 22, 2018

Supplements - what you need and why you need them.

Every day I see patients who are confused about supplements. I understand - I've gone shopping for supplements and have been confused about what to get and whether to believe the claims about their benefits. I am an IFM certified practitioner and being a Functional doctor means helping people improve the way their bodies function.

The Good Lord gave us everything we need to be at our best health but the society we live in today isn't conducive to being healthy. This shows up in our bodies as our increasingly stressful livestyles and our increasingly nutrient deficient eating habits cause our bodies to become DIS-eased. As we age this process accelerates because our bodies can't repair the damage at the pace that we are creating it inside our cells.


This is what I have in my kitchen today to eat (plus a bodacious double chocolate zucchini bread - gluten free and vegan of course). I bought a share of an organic farm and my CSA share contained all of this except the cherries that I got (organic) at Whole Foods and the avocados purchased at Sprouts.

Even if I only eat organic produce and pastured meat, the nutrient density in our food supply is deficient due to the land being over used. I'm pretty sure I'm getting more nutrients from this family-owned organic farm than from the food at the grocery store but I still take supplements.

So I'm going to cover the Top 5 supplements that I think most Americans eating a 'Standard American Diet' need to improve their health. First, many people try to cut corners and buy supplements from a club or service or even at Target or Walmart or GNC but since supplements aren't regulated, these larger merchants get their supplements from the lowest priced options which are usually sourced from China and other areas that don't screen the ingredients for purity.

Another worrisome issue is that many of these cheaper supplements don't even have the ingredients on the label! When the Attorney General in New York State chose random supplements from the above mentioned merchants, over 75% of them did not have the listed ingredients. Some were labeled gluten free and actually contained gluten! The third problem with cheap supplements is that the amount of ingredients is usually far below what you need to improve your health.

One example I can think of is when a patient proudly told me she took fish oil daily and then produced the bottle and the total omega 3 content was less than 500mg. This means the EPA and DHA (most useful omega 3s) added up to less than 300mg. I usually recommend AT LEAST 1000mg of combined EPA and DHA so she was getting less than a third of my minimum recommended dose. She was paying about half of what a quality supplement with over 1000mg would cost but she was only getting about a fourth of the benefit. Note on my bottle the 'NSF' quality seal and the listing of the actual amounts of the EPA and DHA components of the omega 3 content in the image below.


So fish oil is a very important supplement. The EPA fraction is very anti-inflammatory and can help with heart health. The DHA fraction is also anti-inflammatory and helps with brain health. The other omega 3 fatty acids are all anti-inflammatory and help with hair, skin, eyes, and all of them together have been studied and found to help with ADHD, arthritis and to inhibit certain cancers from growing. To list all their benefits is beyond the scope of this one post so I will just say that a high quality, screened for purity and sourced from reliable and sustainable sources Fish Oil supplement is usually the first supplement I recommend to patients.

Omega 3 fatty acids are found in cold water fish like salmon and sardines and anchovies but I doubt many of us eat enough of these foods regularly to see the benefits of adequate omega 3 intake. It is thought that historically humans ate a diet that was balanced with a one to one ratio of omega 3s to omega 6 fatty acids and now, due to the proliferation of processed foods containing high amounts of omega 6s, that ratio is close to 20:1 or higher in favor of omega 6s (which, by the way, can be very inflammatory). So for most people, taking a supplement is the best way to improve their ratio of omega 3 fatty acids to the omega 6s.

My second most frequently recommended supplement is a really good multivitamin. Since we see all sorts of chronic disease issues at my clinic, we have multiple options to offer patients. There are special vitamins targeted for specific patients (like prenatals) but in general, I like a vitamin with methylated folate and B12 (because a significant percent of the population has difficulty with methylation due to a polymorphism in their MTHFR gene).

The multivitamin I recommend most often is the Phytomulti but I also like the Pure O.N.E. multi. Both are produced by companies that I trust to vet their ingredients and use a third party company to screen their products for purity. I wouldn't get them off of Amazon (even though I linked to them to show what they look like) because they may come from unreliable sources and even by re-packaged with sub-standard products. You want a vitamin product that your body can actually absorb and not one that you will just pee or poop out.

I buy these products and have patients buy them directly from me but I also use a reliable supplement site called Fullscript which you need to be invited to by your provider. Many of the supplements are available at therapeutic doses so they aren't open to the general public. If you want to purchase and don't have a Functional doctor, send me an email to KarenFMillerMD@gmail.com

Thirdly, I recommend a good broad spectrum probiotic. We have many different brands for patients but in general the best are made by Master Supplements and Klaire labs. I like to see 4 or more lactobacillus strains and 4 or more bifidobacterium strains. Maybe even Sacchromyces boulardii, a beneficial yeast. Colony counts should total at least 20 billion CFU (colony forming untis) to be of any benefit. The main thing a good probiotic does is improve your gut health. If you have poor gut function you should add probiotics with the help of a Functional Medicine doctor. Gut health impacts our mental health, immune health and ability to detox which impacts the risk of developing cancer.

Fourth, I think most people in North America don't get enough sun exposure because almost everyone I test has a vitamin D3 deficiency. A good quality vitamin D3 should have at least 5000IU. Most of my patients maintain their vitamin D3 levels with 5000IU daily but sometimes patients require more because vitamin D3 is critical for immune system function and if your situation causes your immune system to be overactive then you may need a higher maintenance dose. Have your doctor check your vitamin D3 levels at least once a year. (Right before flu season is a great time to make sure it is adequate)

Last but not least, most people will benefit from a high quality curcumin product. You get curcumin from the turmeric root so you can add turmeric root to smoothies and make tea from it but for a good anti-inflammatory and antioxidant action there are products that have intensified the effects by formulating the active ingredient to be delivered in a bioavailable way. I like Thorne's Meriva product that contains a phytosome complex of curcumin released in a time-released way or Integrative Therapeutics' Theracurmin HP with enhanced bioavailability and a high percentage of curcuminoids.

I take curcumin daily as it, like Fish Oil, is a powerful anti-inflammatory and antioxidant. It has been shown to help prevent heart disease, metabolic syndrome and Alzheimer's to name a few. It also increases Brain Derived Neurotropic Factor which does just what it sounds like, it helps increase growth of neurons so it improves brain and nervous system health. Curcumin can also help prevent growth of tumor cells and has been shown to help induce the death of cancer cells, a good reason to take it daily in our increasingly toxic environment.

So this is a very superficial review of my Top Five supplements. Almost everyone can benefit from these and if you have specific chronic conditions, you may need more than just these to get to your best health. If you want to locate a Functional medicine doctor to help you figure out which supplements would be best for you, you can use the 'Find a Practitioner' link on the IFM website or come see me! (I can do some phone consultations - email me at KarenFMillerMD@gmail.com for details.)







Sunday, July 15, 2018

Nutrition, Toxins and Cancer

I'm all for progress but the more I read about how we developed into an Industrialized Nation, the more worried I become. I recently finished reading The Radium Girls about the concerted effort of the men in charge of these highly profitable companies that sold items painted with radioactive paint who systematically covered up the harm being done to their workers (many of whom died a horrible death from radioactive poisoning at a young age). I applaud those who fought and won worker protection and eventually established agencies like OSHA to protect employees from harm but I doubt we have evolved to a safer place. As long as Congress is beholden to Big Business our nation is not a safe place.

So what does this have to do with nutrition? I'm glad you asked.

Every cell in your body responds to the chemicals you feed your body when you put something in your mouth, on your skin or breathe something into your lungs. Since I became allergic to a lot of environmental chemicals and was no longer able to perform deliveries or surgeries as an OBGYN, I have had to read all labels on every medication, household product, personal care products and food before I allow it into my home or body. You might think that those government agencies that were created to protect us would be making sure that all those chemicals are safe and you would be wrong.

I'm currently reading a textbook about nutrition and cancer and one of the researchers cited was Weston Price, a dentist who travelled around the world visiting societies that still ate a traditional diet. He visited Eskimos, Peruvian Indians high in the Andes, the Maori of New Zealand, the Masai in Africa and others and examined the teeth of those who only ate the 'whole food' diets of their ancestors and compared them to the teeth of those in the same tribes who had begun to incorporate some packaged foods into their diet.

What he discovered was that those who ate a traditional diet, whether all meat, fish and fat like the Eskimos or all seafood, roots and fruits of the Polynesians, enjoyed excellent physical health and had perfectly normal teeth while those who had begun to eat packaged foods developed rampant diseases such as diabetes, heart disease and cancer and they had malformed dental arches and dental caries. He cites one physician who lived in northern Canada and took care of Eskimos and said that in 30 years of taking care of them he had never seen or heard of a case of cancer among those who ate a traditional diet.

So what's a body to do? For one thing, avoid GMO foods. Big Agribusiness developed genetically modified foods saying they were increasing yield to 'Feed the World' but that has not proven to be the case. What has happened is that the foods are genetically modified so farmers can spray tons of pesticides on crops like soybeans, sugar, corn and wheat (among others) up until harvest. Also the genetically modified seeds can't be saved so farmers have to purchase them from the companies that created the genetically modified foods. Another issue is that the soil is damaged from the overuse of pesticides and the depletion of nutrients which translates to less nutrients in the food.

I think one reason I'm seeing so many people with food sensitivities is that the combination of genetically modified foods with the pesticides is doing serious damage to our guts and immune systems (70% of your immune system is in the intestinal lining) AND we aren't getting the nutrients we need from our food to keep us healthy. So look for the NON-GMO label but also consider eliminating all packaged food and making sure your food is organic or at least on the 'SAFE' list on the EWG.org Healthy Living app.

And take good quality supplements! I promise I'll post on supplements now that I've covered why you need them.




Saturday, July 7, 2018

Pears, pears & more pears!

I was recently very generously gifted a crate of pears so I must extol their goodness while we have them available locally. As a Functional Medicine physician I see many people with chronic issues - many of which can be addressed by identifying food intolerances and removing those foods from the diet. Rarely do we have to eliminate pears! I think any food can become an issue if it is consumed too frequently but in general, when we are trying to heal the gut, pears are okay to eat.

Please get organic produce whenever possible. Check out EWG.org to look at the levels of pesticides in your foods. On the 'Dirty Dozen' list, cherries are #7 and pears are #8 (ranked 1 - 12 in levels of pesticides found in these foods). So what's so great about pears, besides that they are so tasty?

Well, for starters, whenever you want to do a detox, or get rid of all those pesky pesticides from the foods you got from a restaurant or drive through or a package because you were in a hurry, you will need to follow a specific eating plan to eliminate the inflammatory foods so your liver can work harder but you will also need to eliminate the byproducts that the liver is flushing out into your intestines. This means you will need to poop one to two times a day. Pears have lots of fiber and can help you get the job done. The gritty fiber in pears binds to cancer-causing chemicals and free radicals and helps to protect your colon from damage caused by those agents.

Pears are low in calories, a medium pear only has about 100 calories, so they are helpful when trying to lose weight. Nutritionally, they provide vitamin C, potassium, folate, some of the B vitamins along with a few minerals, including copper, iron, manganese and magnesium. Pears are also rich in antioxidants so they boost your immune function and can help prevent illnesses like the common cold (a virus which should not be treated with antibiotics). Pears contain boron which, along with the other minerals in pears, will improve your bone health. They also contain vitamin A which helps prevent the effects of aging on the skin, like wrinkles and age spots, and who wouldn't want that?

So if you don't have a generous extended family member with a pear tree, get yourself some organic pears (hopefully grown locally) and enjoy! I'm going to be canning, making preserves and freezing some pears for smoothies later and I promise to write about supplements soon!

I will just say this one thing about supplements, though, and that is this - even if you only eat whole foods straight from the garden or organic section at your grocery store, most commercially farmed soil is nutrient deficient and studies have shown that our population is lacking in many of the key vitamins and nutrients needed for normal functioning. So stay tuned for more about supplements and meanwhile, enjoy these delicious summer fruits while they are available!