2022 - Functional Health Solutions

November 30, 2022

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Nutrient Density – a key to thriving

The diet wars are filled with dogma. People defend their specific nutrition regimen with religious fervor. I get it. We all want to believe we are doing the right thing and honestly, nutrition research is a train wreck. I prefer to think about it in terms of nutrient density and what foods are going to give my body everything that it needs to function at a cellular level.

Let start with some definitions. Macronutrients are the main constituents of the diet: protein, carbs, and fat. Micronutrients are the vitamins, minerals, and amino acids that every cell in our body needs to function at a high level. Nutrient density is essentially the concentration of micronutrients in a given food amount.

It is interesting when you look at what the different groups identify as nutrient dense foods. Traditional/conventional groups will recommend foods that are high in nutrients compared to the calories they provide. This means looking for foods with the lowest fat content like vegetables, grains, legumes, lean meat, and low-fat dairy. However, this doesn’t take into account bioavailability and it excludes foods that are high in fat, particularly saturated fat. This is the pattern that we have followed for the last 50 years and where has it got us? Fat and chronically ill.

Now, when more ancesteral health minded groups analyze foods and don’t demonize them for their fat content, dramatically different results are discovered. All the sudden the foods that we have prized for millions of years, more specifically, organs, red meat, and full fat dairy, rise up and show how how amazing they are. I have found that the more these foods are included in the diet, the healthier you become. Labs typically agree with this. I have patients come to me all the time taking handfuls of synthetic supplements and are following “my plate” advice perfectly, but have abnormal nutrition, inflammation, and cardio-metabolic markers. Once we start giving the body what it needs and removing what it doesn’t, their conditions and markers start to normalize.

Essential nutrients aren’t just important for us to eat, but are essential for us to survive and thrive. We can’t make them and thus must get them from our food. If these nutrients are bound up to anti-nutrients in plant foods then we can’t absorb or utilize them.

To corroborate what I have seen over the years, a recent study came out that looked at different foods and their micronutrients to assess their nutrient density. This study was unique in that it not only looked at the nutrients, but also took into account how bioavailable they are to the human body. This study looked at many essential nutrients (zinc, iron, folate, vitamin A, calcium, and vitamin B12) and how much of a given food we would need to get 1/3 of the recommended intake. Guess what food came out the most nutritious? Liver… and it wasn’t close. You need 11 calories of liver to get these nutrients. Compare this with dark leafy greens at 72 calories and beta-carotene rich fruits/vegetables at 297. This means that liver is almost seven-fold more nutritious that the leafy greens we have been told are all the rage. Further, 17 of the top 20 foods were all animal foods and included many organs, fish, beef, eggs, and milk. These are the foods that should be the base of the food pyramid.

I often tell my patients that if you give your body what it needs and remove what it doesn’t, the body is capable of amazing things and can heal from almost anything. The “giving it what it needs” part refers to providing plentiful meat/fish, organs, eggs, and raw dairy. This will give you all the amino acids, minerals, and vitamins that your body needs to thrive. Do this and you have won half the battle. Combine this with removing what is bothering your system and magical things can happen.

Sources: https://www.frontiersin.org/articles/10.3389/fnut.2022.806566/full

November 23, 2022

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Thanksgiving Without the Bloat

I have had several patients very concerned about how they are going to maintain their diet on Thanksgiving, so I thought I would write a blog post on the topic.

Thanksgiving is one of my top 3 favorite times of the year, but knowing how to navigate the food around this holiday can be tricky. The good news is that all the foods at Thanksgiving can be made in a way that are still conducive to you having good health. However, it does take some intention around your food choices and some time in the kitchen.

Turkey and all the organs that come with it make the base of the Thanksgiving meal. As long as you eat the organs and you find a turkey that has not been fed corn or soy, you can’t go wrong. This does mean that you have to ask the butcher or the store if they know what the turkey was fed. This is often easier to accomplish at a butcher shop. If the turkey was pasture raised and fed a diet free of corn and soy then eat to your heart’s content.

Pumpkin is technically a fruit and, as fruits are the part of the plant that wants to be eaten, they are typically very well tolerated. My wife makes a great pumpkin pie with raw milk and honey. Yeah, I don’t get to enjoy a flaky crust, but that is 95% of the good part without any of the post-meal hangover. Squash and cranberry sauce are other classic Thanksgiving day meals that are also a fruit! You can also get creative with different apple dishes. If the biggest “cheat” that you do is cinnamon with some of these dishes, then that will be a success in my book.

Raw dairy is also another great addition to a Thanksgiving Day meal. With our pumpkin pie this year, we are going to enjoy some vanilla ice cream made by yours truly. You could also have sour cream (fermented cream) and add it to pretty much anything because what doesn’t go with sour cream?

Yes, I get that I have left some classic Thanksgiving Day dishes off my list like stuffing and gravy, but I am sure there is away that you could incorporate animal foods and some “low toxic” plant foods in order to make something passible as stuffing and gravy. View it as an opportunity to mess around in the kitchen with your loved ones. I would encourage everyone to reframe the purpose of Thanksgiving. It isn’t one of my favorite times of the year because of the food, but actually because my whole family is together inside a warm house laughing, playing games, and making long lasting memories. If you begin to appreciate it for this reason then the food becomes just an added bonus, but either way the holiday remains special.

November 9, 2022

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All About Autoimmune Disease and How to Fix It

Autoimmune disease is all around us. An autoimmune condition affects approximately 8% of the US population, 78% of whom are women. Autoimmune diseases happen when your immune system gets confused resulting in your immune system attacking your own body. The 3 most common autoimmune conditions are rheumatoid arthritis (immune system attacks your joints), Hashimoto’s thyroiditis (immune system attacks your thyroid), and celiac disease (immune system attacks the small intestine).

The cause of autoimmune disease is classically ascribed to some viral illness, which seems to be the thing that western medicine pins on most things that they don’t understand. I think this is one potential mechanism, but I think there are other things contributing that are much more common. Molecular mimicry and non-protein amino acids are two of the major mechanisms that make the most sense to me.

Molecular mimicry is when you are exposed to some foreign protein, your immune system reacts to it, and there is a protein in your system that looks similar. This sets the groundwork for your immune system to then attack yourself. This is most commonly believed to occur when someone has intestinal permeability leading your immune system to attack many proteins that look foreign in your gut. Some of these proteins may look molecularly similar to proteins in your body and this results in your body mistakenly attacking itself. The key to fixing this problem is to fix the intestinal permeability. The most common offender of causing this is gluten, but other lectins from plants can induce this as well. A very interesting study found that antibodies that react with wheat germ agglutinin also have high reactivity to thyroid peroxidase. So if you have a leaky gut caused by lectin induced permeability and this results in your immune system reacting to wheat germ agglutinin in the bread products you eat, there is potential for you to develop an autoimmune response directed at your thyroid.

Non-protein amino acids are amino acids of plant origin that have no function in the human body other than messing things up. They can get accidentally incorporated into proteins, which can confuse our immune system into attacking these proteins, as they look foreign. Our immune system is designed to attack foreign things! If we have foreign looking amino acids being incorporated into our own proteins, then our immune system is just doing its job and accidentally hurting us in the process.

Viruses inducing inflammation and ultimately an autoimmune response isn’t really something within our control and I think if we are healthy a process like this should be short lived as our immune system will eventually figure it out.Ultimately, if we give our body what it needs and remove what it doesn’t, then our immune system will function at a high enough level and things like this will be a major contributor to autoimmune processes long term. Control what you can control. Unfortunately, viruses you come into contact with isn’t something you can control.

Now that we have learned the major mechanisms of autoimmune disease, how do we treat it? The most obvious way is to avoid the plant parts that are high in plant defense chemicals (roots, stems, nuts, seeds, and leaves) or at the very least, process them so these compounds are mostly broken down. I personally feel better without those parts of the plant in my diet, so I avoid them. However, some will not be able to make that transition right away and finding ways to process them like fermenting, pressure cooking, soaking, sprouting, etc. can decrease their toxic burden and likely improve symptoms. The most efficient way to reverse an autoimmune disease that I have seen is a carnivore diet. It’s pretty simple: eat meat, salt, and water. The next step up from this is an animal based diet where you combine Weston A. Price, GAPS, carnivore, and Terry Whals’ diet principles and hope that you are limiting enough of these compounds that your system can handle it. Do one of these for 6 weeks and see where you end up. In my experience, it will be in a much better spot than when you started!

I will say something briefly about other treatment modalities. Of course you want to replace thyroid hormone with Hashimoto’s, but I also think that low dose naltrexone can be very beneficial for people with an autoimmune disease. Obviously this requires a functional medicine provider or an open minded rheumatologist, but this treatment is successful for many people to varying degrees. I think ultimately it comes down to nutrition, but treatments like this can make symptoms more bearable while we are treating the root cause.

If you have an autoimmune disease and are trying to resolve it, give the above a try and let me know how it goes!

October 27, 2022

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Nutrition for a Better Thyroid

A very common complaint you see, especially in functional medicine, is concerns about thyroid function. Interestingly, women are 5-8 times more likely to develop thyroid dysfunction than men with the lifetime risk of thyroid issues in women at about 12%.¹ The most common cause of thyroid issues is an autoimmune disease called Hashimoto’s Thyroiditis. Like all autoimmune diseases, this is reversible. Another common thyroid issue is inadequate conversion of hormones in the periphery. We will focus on these two forms of thyroid disease.

Before getting started, I realized in the middle of writing this that thyroid issues are too complex to get through in one blog and therefore will become a three part series as well.

First, the thyroid is a powerful organ that is responsible for regulating the metabolism of every single cell in our body. If it doesn’t work, then you gain weight and experience things like brain fog, constipation, hair issues, and chronic fatigue. Because of its importance, we want to take good care of it and this starts with a deeply nourishing diet.

In order for your thyroid to function properly there are several nutrients that you need to ensure are in your diet at the proper levels. These include iron, selenium, iodine, selenium, zinc, tyrosine, vitamin A, Vitamin Bs (B2, B3, B6), and vitamin D. I will focus the major ones.

Selenium is involved in activating the enzymes that are naturally part of our body’s antioxidant systems. This helps protect a highly active thyroid from things like oxidative stress (too much work). Think of oxidative stress as long days at work and selenium as whatever you do to decompress from the long day. You want to shoot for 120 mcg/day. Plant food is an inconsistent source of selenium and would require you to eat 20 brazil nuts per day to meet your needs. In animal foods, we can get plenty from 1/2 oz of liver, 4 egg yolks, and 16 oz of lamb. This would give me 156 mcg and easily attainable for me.^2,3

Zinc is involved in the production of essentially everything in the body, including thyroid hormones. It also aids in proper conversion of hormones. In order to get enough, we again need to go to animal foods as this form is 5 times more absorbable. The best sources are in oysters and red meat, so if you focus on getting at least one of these foods in your diet daily then you are likely to get enough zinc on a daily basis. I prefer people get red meat in at least twice a day to get enough protein as well. ^2,3

Iron is well known for its role in blood formation, but also plays important roles in thyroid hormone production and deficiency can lead to hypothyroidism. This is a big reason that I often check iron levels on all patients, especially females. Heme iron is the form we want and again is only found in animal foods. This form is more absorbable and therefore usable by our bodies. Meat and organs are the two foods with large amounts of this vital nutrient.^2,3

Iodine is the classic thyroid nutrient and is the major nutrient in thyroid hormone, hence its importance. However, it is also considered a “goldilocks” nutrient as too much can be as harmful as too little. Plant foods are again not a consistent source as foods grown in one area vs another can have 100 fold different levels of iodine because of variation in soil quality. Focusing on milk, cheese, and fish/shellfish are the first places I have people focus on and then go from there. If you are very deficient, short term use of kelp can be beneficial, but work with someone that knows what they are doing if you are worried. Additionally, iodine deficiency is associated with fibrocystic breasts, so focusing on this nutrient can help with this as well.^2,3

Vitamin A is another big player with thyroid health as it aids in both production and conversion at a nuclear level. This is again another food where focusing on animal foods is ideal. Retinol is the animal form and what is used by all the cells of our body. Beta-carotene is the plant version and requires an enzyme called BCMO1. If you have a dysfunctional variant (up to 65% of people have some level of dysfunction) then you will have a 60% reduction in retinol production from beta-carotene, making it a suboptimal nutrient form of vitamin A for most people. Again, this means focus on eggs and liver for your vitamin A.^2,3

Lastly, vitamin D plays big roles in thyroid health through immune system function. Having optimal vitamin D means you are more likely to have optimal immune function, which means less likely to have autoimmune thyroid disease. During the summer, I recommend getting this from the sun (no, I don’t recommend sunscreen, but that sounds like another good blog post topic!), but during the winter I rely on high vitamin cod liver oil. Depending on the brand, you will need up to 3 tsp to get adequate vitamin D, but this is the best way I can come up with to get vitamin D from diet during less sunny months.^2,3

I hope you noticed a trend when discussing nutrients for thyroid: focus on animal foods. This is where the bulk of everyone’s nutrition should come from if they want to function optimally. I always go back to ancestral wisdom when I have burning questions about nutrition and this tells me that meat and organs were the center of the diet. This means we evolved this way and because of that we typically thrive with more animal foods in our diet.

October 19, 2022

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Hippocrates Was Dead On

Hippocrates, thousands of years ago, said that “all disease begins in the gut.” The more that I get into human optimization and functional medicine, the more I realize that this quote is true. The gut is our biggest interaction with the outside world and it is exposed to things regularly throughout the day. If we continually expose it to things that cause inflammation and dysfunction, then our gut will erode and with it will go nutrient absorption and proper immune function. If we can eliminate the things causing inflammation and give our gut what it needs to heal, then our body is capable of healing amazing things.

The microbiome in our intestine is a collection of trillions of bacteria, viruses, and fungi. When we are healthy, there is a symbiotic relationship with all of these bugs where we get immune system training and improved nutrition (i.e. B vitamin production by the bacteria) and they get a home. If we aren’t healthy, then they are capable of taking over, causing inflammation that eventually results in disease throughout the body.

The first step in healing your gut is eliminating the foods high in plant lectins, plant pesticides, oxalates, fiber, and other plant compounds that can be difficult for your gut to digest. This is mostly found in the roots, stems, nuts, seeds, and leaves of the plant. This is the part of the plant that doesn’t want to be eaten and thus has the highest quantity of compounds to deter you from eating it. Plants have no way of defending themselves other than producing chemicals that interfere with our hormones, gut function, and immune system and thus eliminating the parts of the plant high in these chemicals can be immensely beneficial, at least in the short term. Notice that I didn’t say fruit as this is the part of the plant that wants to be eaten and thus has the lowest levels of these compounds.

Another big aspect of gut health is glyphosate exposure. Glyphosate has been shown to have antibiotic properties, essentially wiping out much of our healthy flora as well as having a paralytic effect on the gut, linking it to constipation. If you look at the prevalence of inflammatory bowel disease and death from intestinal infections, it has increased in lockstep with glyphosate exposure. It has also been shown that glyphosate up regulates a protein called zonulin. This protein is involved in gut barrier and when production is increased your gut is more leaky. This allows your immune system to interact with everything you eat in ways that wouldn’t normally happen and can lead to the development of autoimmune disease. Finally, it raises the intestinal pH, which decreases the amount of butyrate and other short chain fatty acids, which supply our intestine with energy. In essence, eating organic food free from glyphosate and other pesticides is a big step in the right direction as far as our gut health is concerned.

Third, we need to add in beneficial bacteria. This is can be in the form of being outside in the dirt, eating food with dirt on it, eating yogurt or other fermented foods, and probiotic supplements. I am a big fan of the first 3 and only use supplements in certain circumstances. Yogurt is my personal favorite way of doing this and I use Lactobacillus reuteri, Lactobacillus gasseri, Bacillus coagulans, and Bifidobacteria infantis to make my yogurt. L. reuteri has been shown to make smoother skin, accelerate healing, and improve muscle. L. gasseri has been shown to improve IBS, reduce oxalates, and protect against SIBO. B. coagulans reduces symptoms of IBS and also accelerates recovery. B. inantis is essential for a healthy developing gut and should be included in a yogurt for anyone pregnant. This combination promotes overall gut health and is something I try to get in twice per day. If I use a probiotic, I will recommend Megaspore by Microbiome Labs and/or Seed probiotic. However, I always prefer to get these from food if possible.

How do you know if these interventions have worked? There really isn’t great testing for the gut so we rely on symptoms. Are you having well formed bowel movements without having to wipe much? Are you having minimal gas and bloating? Are your autoimmune, metabolic, neurologic, etc. symptoms improving? If yes to the above, then its likely your gut is getting better.

Now go out and try some of the above interventions and see how you do!

October 13, 2022

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Infant Nutrition – How to Build a Whole Foods Diet for Your Little One

Transitioning your baby to food is an important step in raising a healthy child. Not only is it critical for ensuring that your baby undergoes proper physical and mental development, but is also important in establishing healthy eating habits for the rest of their life.

First, I think the key with adding in foods is to make sure that your baby enjoys whole foods. Limiting processed foods, including many baby foods, is essential in this process. My bias is obviously a nutrient dense, animal based diet, but regardless of diet preference, whole foods is key.

The transition of Hank to normal food was quite a bit easier than I thought it would be as he essentially eats the exact same as I do. This approach is called baby led weaning and there are many great resources out there on how to do this properly. It started out with mostly sucking on the foods and spitting them out, but this is just fine as this means his primary source of nutrients is breast milk, which is optimal for a growing baby.

The first foods that Hank was given were meat from beef or lamb, liver, heart, bone broth, eggs, yogurt, fruit, and white rice. As you can see, the predominant foods on this list are animal foods and that is intentional. They are by far the most nutrient dense options for babies, are very easy on their digestion, and are least likely to trigger an immune response. Babies have limited enzyme production and it takes up to 28 months for all of this to ramp up properly, which can make it difficult for them to break down lots of complex carbohydrates.¹ They do have the ability to break down protein and fat as these are the predominant nutrients in the mother’s milk, hence animal foods being the perfect option. Hunter-gatherers often feed liver as one of the preferred first foods and I can attest that if you give it to babies at a young age, they love it.

Cereal and grain based foods are the worst thing that you can introduce at this point. First, they are processed and the last thing you want is your baby hooked on processed food from a young age. Second, they have been associated with low nutrient status in infants as they are nutrient devoid and have phytates and other plant defense chemicals that reduce absorption of key nutrients.²They are full of lectins and can stimulate the immune system inappropriately, especially with their underdeveloped gut.

The three big foods that I think are essential are egg yolks, liver, and muscle meat. If they get these three things then you will be off and running in the right direction.

Egg yolks in particular are rich in choline, cholesterol, healthy fats, and B-vitamins. They really are “nature’s multivitamin.” They house all the nutrients to grow a healthy baby and in the exact forms that you want. There is some concern that the white of the egg is the more allergenic component and could cause issues, but its also a great source of protein and we decided to give Hank the whole egg.

Meat will provide a great source of many b-vitamins as well as heme iron. Multiple studies have shown that good iron status is important for the baby’s brain development and subsequent intelligence. Heme iron is the most bioavailable form for humans and thus meat is an essential component of a baby’s diet. Don’t fear the animal fat as well! It has many of the fat soluble vitamins needed for immune system, skeletal, and many other aspects of development.

Liver is the most nutrient dense food on the face of the planet. Liver is an amazing source of b-vitamins, choline, minerals (like selenium, zinc, iron, etc.), vitamin A, and many more nutrients. It really is a power house. Anyone who thinks kale is a super food should take a look at the nutritional profile of liver compared to kale! This will give your baby the nutrients it needs to form all the cells and chemical messengers his body needs to grow and thrive.

As for plant foods, we have mostly stuck with sweet fruit, as it is easy to digest . Remember, fruit is the part of the plant that wants to be eaten and thus is best tolerated by our digestive tracts. Avocados, melons, mangoes, and strawberries have been Hank’s favorites so far. As far as vegetables go, he hasn’t had many. I am sure that we will probably expose him to some eventually, likely starting with fermented ones, but as of now we are happy with his diet.

https://www.westonaprice.org/health-topics/childrens-health/nourishing-a-growing-baby/#gsc.tab=0
Are weaning foods causing impaired iron and zinc status in 1-year-old Swedish infants? A cohort study.

October 4, 2022

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Prenatal Nutrition – First Step Towards a Healthy Baby

The second I found out Suz was pregnant I became a little obsessed with how to grow the strongest and healthiest baby possible. Through my functional medicine training I knew that much of a person’s future health was determined by the quality of nutrition while in the womb and in the first two years of life. This forms the base of your life’s pyramid and if you want a pyramid that lasts, you can’t have cracks in the foundation. I wanted to pour as good of a foundation for my baby as possible so that when setbacks come he can lean on the excellent foundation we poured for him.

This started with Suz’s nutrition through pregnancy. The sources of information I leaned heavily on included an amazing book called Real Food for Pregnancy by Lily Nichols, the Weston A. Price Foundation (WAPF), and the primary research cited by these two sources. The WAPF puts out amazing information that every parent should read to raise a healthy child.

The nutrients that we paid special attention to were the fat soluble vitamins (vitamins A, E, D, K), EPA/DHA, biotin, folate, B12, and choline.

The fat soluble vitamins play essential roles in skeletal formation, immune system development, and brain development. Vitamin E is needed for proper placenta formation and is a potent antioxidant. This is the least studied fat soluble vitamin with pregnancy, but nonetheless important to mention.

Vitamin A is a crucial vitamin for proper development of every organ in our bodies and was written about extensively by Weston A. Price in his book Nutrition and Physical Degeneration. Vitamin A deficiency in laboratory animals has shown to cause spontaneous abortion, prolonged labor with death of the mother, eye defects, defects of the snout and dental arch, displacement of internal organs (kidneys, ovaries, testes), and deafness. There is controversy about how much as there was one study that used synthetic vitamin A and found above 10,000 units caused birth defects. Every other study on vitamin A has essentially shown that higher doses, up to 40,000 units, cut the risk of birth defects. I believe it comes down to whole foods vs synthetic vitamins. The WAPF recommends 10,000-20,000 units per day from whole foods and I think this is a reasonable goal, but if people are getting it from whole foods I suspect they will be around 10,000 units per day. I believe this will get you all the benefits and none of the risks. Note: beta carotene isn’t a replacement or equivalent to retinol. You need to get vitamin A in its active form as this is the only form used by our bodies and most people don’t have the cellular machinery to convert beta-carotene at a high enough rate to make it useful. Retinol only comes from animal foods, so focus on these as your source of vitamin A.

Vitamin D is more well known to most people and plays big roles in skeletal development. It also plays roles in lung maturation and immune system development. This is especially true when derived from a food source. The WAPF recommends cod liver oil as the source of vitamin D and I tend to agree with them. There was a study out of Finland that looked prospectively at 12,058 children and found that children supplemented with vitamin D at 2000 units essentially had no risk of type 1 diabetes compared to those that didn’t supplement.² To me, this shows the immense role that it plays in proper immune system development. Having a properly formed skeleton is no small matter so everyone should focus on getting enough of this vital nutrient from food sources (i.e. cod liver oil).

Vitamin K2 is the vitamin made famous by Weston A. Price (initially called activator X) and then more recently by Chris Masterjohn Phd. Vitamin K tells your body where to put calcium (i.e. your bones) and where to keep it out of (i.e. your organs). It is essential in forming every solid structure in your body. It also plays roles in hormone production and signaling as well as protects our genes. MK-4 is form of vitamin K2 that you get from food and is essential for healthy baby development. Weston A. Price believed this was the missing nutrient from our modern diet and with it we could eliminate much of western disease. He found that it was in high concentrations in the butterfat of milk of mammals, eggs, and organs/fats of animals. Traditional cultures have cherished these foods for pregnant women because they know the vital importance of this nutrient in developing healthy children, even if they don’t have the “science” to prove it.³

In order to get these fat soluble vitamins in Suz’s diet during pregnancy, we did an ounce of liver per day (in the form of 6 capsules), 4-5 egg yolks, 1.5 tsp of a fermented cod liver oil, and lots of whole milk, hard cheese, and other dairy products. As of now, if I could do it over again, I would have added a fermented butter oil to increase the vitamin K2 content of her diet.

EPA and DHA are major fats in the brain and are thus tied to cognitive development. A fetus uses massive amounts of DHA during development, at a rate ten times that which it can synthesized by the growing baby. This means we must get much of it from our diet in order to feed our growing baby’s brain. The best sources of this are cod liver oil, egg yolks, fatty fish, and to a lesser extent, grass fed meat. Eggs from chickens that are not fed corn and soy are a great source with as much as 350 mg per egg. This was a big source for us as well as the 1-2 Tbsp of cod liver oil that she consumed daily.

Biotin is another B vitamin that is essential for pregnancy. In animals, it has been shown that even a marginal deficiency can cause problems in the offspring, especially in limb and palate development. This hasn’t been studied in humans, but I still took this nutrient very seriously during Suz’s pregnancy. It is mostly found in liver and egg yolks and she was consuming these foods everyday. Please note that egg white, and especially raw egg white, has something called avidin that will bind biotin and make it unavailable to our bodies, so just consuming the yoke or cooking your whole eggs is needed to absorb a good portion of the biotin.

Folate is the nutrient that everyone relates to pregnancy. This is because it is very important for proper neurologic development. You need 600 mcg of folate during pregnancy in order to prevent birth defects. Most will take a prenatal vitamin, which should always be methylated folate as that is the active form your body needs. However, if you are ambitious and make intentional food choices you can do it without a prenatal vitamin. Using an app like cronometer can be great as you can log your food and they tell you the exact amount that you are getting. With Suz, we did a combination of prenatals and food. If she hit the targets for the day then we skipped it, but if she didn’t she took enough prenatal to cover her needs.

Choline is the last of our specific nutrients that I will address. This nutrient is essential for proper brain development. Rats fed large amounts during pregnancy give birth to offspring with increased visuospatial memory, better cognitive function with aging, better ability to concentrate, and are more resilient to neurotoxic insults in our environment. Obviously this is something we want lots of. I may sound like a broken record, but this is mostly found in egg yolks, high quality dairy, and liver. Thus, these foods should be staples in every pregnant woman’s diet.

Pregnancy is a very exciting time and when you take the time to learn and implement the changes above it can be very empowering. However, obsessing over this is not beneficial and it takes time and effort in order to incorporate all this properly. Its often best to work with someone that knows this information and can help you implement it, but you can also learn it on your own if you read and are intentional about what you put in your body. Good luck!

https://www.westonaprice.org/health-topics/childrens-health/vitamins-for-fetal-development-conception-to-birth/#e
https://www.sciencedirect.com/science/article/abs/pii/S0140673601065801
https://www.westonaprice.org/health-topics/in-defense-of-vitamin-k2-mk-4-dr-prices-activator-x/#gsc.tab=0
Vitamins and Minerals 101 by Chris Masterjohn

September 28, 2022

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Optimal Nutrition for Breastfeeding

Optimal nutrition for a growing baby has been on my mind a lot the last 9 months. Ever since my wife became pregnant 18 months ago, I have been thinking about how to optimize both my wife’s and my son’s nutrition to give him the best chance at at reaching his potential as a human. To cover all we have done over the last 18 months would take an entire book, so I am going to focus this article on what we did while breastfeeding. Sequels to this article will be about what we did before he was born and how we introduced food.

Breastfeeding is the best way to nourish a baby for the first 2 years of life. Breastfeeding is associated with lower risks of asthma, allergies, reduced rates of respiratory illnesses and ear infections, and more robust children.¹ However, breast milk is what breast milk researchers call a “conditionally perfect” food. This means that what the mother eats is able to shift breast milk in a health giving direction if she eats a nutrient dense diet. If mom eats a nutrient depleted diet (standard American diet), then it can actually be nutrient deficient.

Several nutrients that mom eats affect the breast milk. For example, fat intake, both quantity and quality, affect the fat content of breast milk. Fat forms all of the cell membranes of our bodies and cell membrane health is very important for overall health.² If you want your baby to have healthy cell membranes, then eating healthy fat while breastfeeding is vital. B vitamins in breast milk are also sensitive to maternal nutrition. For example, if mom’s diet is deficient in B12, then the baby only gets 16% of its B12 requirement.⁴ B12 is very essential for brain development and allows all of the nerves of our body to develop normally. B12 deficiency in babies can lead to irreversible neurologic damage. Other important nutrients that are dependent on maternal intake are choline, vitamin A, vitamin B2, vitamin B1, selenium, iodine, and vitamin D.⁴

In order to make breast milk the healthiest food possible for our babies, we must pick foods that contain the above nutrients in high quantities. There are several reports of babies dying of malnutrition when fed breast milk of vegan mothers, likely related to the above nutrients.³ These mothers had the best of intentions, but these nutrients are vital for life and mostly come from animal foods. This means we must focus on eggs (high in choline and B12), liver (high in everything good for you), dairy, tallow, meat, etc. If these foods make the bulk of your diet then you will have milk that nourishes your baby on a deep level.

For our family, we start the day off with a blast of nutrients. Suz has 4 eggs with some raw cheese and a smoothie with raw milk, raw yogurt, blueberries, collagen, and 2 ounces of organs (we blend 12 capsules of organ pills as she doesn’t enjoy eating organs fresh). Lunch and dinner are nearly as potent for nutrients. She will typically have 6 oz of some kind of protein (beef or fish) with a couple of ounces of raw cheese and some vegetables and fruit. Cod liver oil is really the only supplement we use, which gives us 2,000 units of vitamin D as well as several more thousand units of vitamin A. I actually think of cod liver oil as more of a food than a supplement. In totality, this provides nearly 10,000 units of vitamin A, plenty of healthy fats, and all the B-vitamins that our son needs to be healthy.

I should also mention that a nutrient dense diet is not only beneficial for breast milk. It also helps the mom heal from pregnancy. Developing a baby and giving birth are certainly taxing on your nutrient stores and your mammary glands are going to suck as much nutrients to put in the milk as possible. This can deplete your brain and body of vital nutrients that you need to stay healthy. If you replenish these stores daily, not only are you going to give baby everything they need, but also improve your own health along the way. The nutrients that stay constant in milk, no matter intake, include folate, calcium, iron, copper, and zinc. However, this means that if mom doesn’t consume them then she becomes depleted her self. These vitamins and minerals are needed for thousands of processes in the body and mom will develop health problems because of it.⁴

Our goal as parents is to allow our children the opportunity for the best lives possible. We should all want them to have better lives than we did. Being successful at life is a lot easier when you give your body the nutrients it needs to function properly. Having the healthiest breast milk possible is part of that equation.

https://www.westonaprice.org/health-topics/childrens-health/nourishing-a-growing-baby/#gsc.tab=0
https://lilynicholsrdn.com/can-we-boost-the-nutrient-levels-breast-milk/
https://www.theguardian.com/world/2011/mar/29/vegans-trial-death-baby-breast-milk
B Vitamins in Breast Milk: Relative Importance ofMaternal Status and Intake, and Effects on InfantStatus and Function1

September 21, 2022

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The Origins of Functional Health Solutions

In residency you are part of a massive medical system. You interact with doctors and other health professionals, getting to know pretty much every area of medicine. From this experience, I can honestly say that almost all the health professionals I have interacted with are in this for the right reasons. They want to help people. The tool kit they are given to help is seriously lacking, but that is a blog post for a different day. The same can’t be said for the institutions. The medical institutions are all about their bottom line. They are businesses trying to make a profit so that their board members are happy. They are involved in a power struggle with insurance companies that decide how much they get paid and for what. This drives the systems to do whatever pays the best, not what is best for the patients.

At the end of my first year of residency I had an attending leave our medical system for something called direct primary care. I went and observed his practice and others in the area and what I found was the form of medical care that I thought I was getting into when I started medical school. This form of primary care allows patients and doctors to develop deep relationships so that the doctor treats more than just the ailment in front of him or her. He treats the whole. This is why it is great for patients.

Since my junior year of college I have been very interested in human optimization. I stumbled upon functional medicine the year between college and medical school and knew this is what I was meant to do. Functional medicine is really just medicine that focuses on fixing the root cause of someones health issue so that their body can heal. It focuses on health and not treating disease. It made innate sense to me that the preferred state of the body is being healthy and vibrant. When the body isn’t in that state, there is a reason and its the job of the doctor and patient to work together to figure out what is holding the body back. I spent as much time as I could manage with functional medicine practitioners and as good as some of them were I kept coming back to this stumbling block: they see the patient once or twice, try to educate them on their health, and change a couple of things, but then the patient is lost to the ether.

My last year of residency, it dawned on me that I could combine both direct primary care and functional medicine. This would allow patients to have continued access to high quality medicine that allows them to live the healthiest, longest life possible. Now that was something I could get on board with and hence the dream of Functional Health Solutions was born.

Now this dream has come to light and I couldn’t be more excited. If this form of medicine excites you as much as it does me, then please join us. I want to build a community of like minded individuals that want more from their lives and health.

September 14, 2022

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Protein Optimization – The Secret to Better Body Composition

Ninety-nine percent of people that I have worked with or those that are in my practice currently have had a diet deficient of protein. If someone comes to me and they are having difficult time maintaining optimal body composition, I can pretty much guarantee that they are eating a diet deficient in protein. Its not their fault! I think that people have received bad advice, ranging from the food pyramid recommending most of your diet coming from grains and processed food to the recent craze about fasting and caloric restriction (I was there once too!).

Dietary protein has so many important roles in the body ranging from modulation of appetite (ie. makes you full faster) and providing building blocks for neurotransmitters to muscle protein synthesis so that you are not only stronger, but also more metabolically healthy. Don’t forget that not only is muscle very metabolically active (burn more energy), but it also serves as a glucose sync so that the carbohydrates you eat used and not converted to fat.¹

How much to protein should you eat? As one of my favorite professors used to say, it depends. It depends on your activity level, body weight, and fitness goals. To answer this question, I have read many articles and papers by two of the best researches in the protein field, Stuart Philips and Don Laymen. First of all, shooting for the RDA is way too low. The .8g/kg of body weight will essentially prevent symptoms of deficiency in 97% of people, but will be woefully inadequate if you care about performing at a high level. Not to mention that at that level 3% of people will actually have signs of deficiency! For example, the RDA for one specific amino acid, leucine, is 42 mg/kg, but in order to get muscle protein synthesis stimulated and to optimize metabolic health you need somewhere around 100-110 mg/kg.²

If you are an active person participating in resistance exercise then you need 1 gram of protein per pound of body weight per day. This should ideally be split into 3-4 meals that are 3-5 hours apart. This will lead to maximal protein stimulus through the day, leading to more muscle, and better overall health. You can tinker with this amount and go up to 1.1-1.2, but most people aren’t active enough to require this much.

Are you trying to lose weight? You likely also want to preserve muscle, so increasing the protein even more can be helpful. Eating between 1 and 1.4 grams of protein per lb of body weight will help with satiety and preserve lean body mass while you are losing weight.¹ However, I wouldn’t maintain protein levels this high for too long because if you are getting >35% of your calories from protein it can affect your hormones.³ I learned that one the hard way.

If you are inactive, but want to preserve muscle mass and want to improve your physique, then a more modest approach is appropriate. I wouldn’t recommend this, however, as resistance training and zone 2 cardio are probably the biggest levers we have in improving health and lifespan. Going as low .8 grams of protein per lb of body weight can work here, but increasing resistance training and increasing protein would be a more optimal approach.

This is a lot of protein I am talking about. For me personally, being a 190-195 lb man that is quite active, I shoot for about 1.1 grams of protein per pound of ideal body weight per day. For me this is around 210 grams of protein and in practice this looks like 8 oz of some kind of red meat three times per day, 3 oz of hard cheese, 1.5 cups of yogurt and 1 cup of raw milk after working out.

As for overall macros, I think there are a couple of ways to think about this. For fat, I typically recommend around .8 to 1 grams per lb of body weight and for carbs I recommend between .7 to 1.2 grams per lb of body weight. Where you fall on the spectrum depends on your body composition and goals. If you are trying to lose weight then I think going on the low end is appropriate for both and if you are very active then going on the high end for both makes sense. This is more something you have to tinker with and is much more of an art than a science. For example, if someone is very overweight, I will sometimes go as low as 50-75 grams of carbohydrate for a while and not restrict the fat. Once they lose some weight this way, I will often adjust the carbs up slightly and then hone in on the fat consumption. Every single person is different, which I find is the fun part!

A couple of things I think are worth reiterating about protein optimization in the diet. First, this needs to be evenly distributed between 3 meals to maintain muscle protein synthesis. Spacing protein consumption 3-5 hours apart will allow your body to continue to grow and repair through the day. If you add resistance training somewhere in there with an appropriate post-exercise feed, then you are really going to be up regulating these cellular mechanisms. Then you have a 12-14 hour fasting window where you aren’t getting the growth signals, but instead are doing cellular repair and housekeeping through autophagy. If you combine this with enough glycine (found in collagen and tougher cuts of meat) then you will get all the muscle growth and repair benefits of eating meat without any of the excessive growth signal risks (i.e. theoretically cancer). Second, protein quality matters. We get protein quality by looking at the the combination of essential amino acids and the digestibility of the protein. Animal proteins far outcompete plant proteins when they are evaluated by these criteria and this is the reason that I really want my patients to focus on getting their protein from animal foods.

Now go out and eat a steak!

Sources:

1. Optimzing protein during catabolic conditions

2. Recent Perspectives Regarding the Role of DietaryProtein for the Promotion of Muscle Hypertrophy with Resistance Exercise Training

3. Low-carbohydrate diets and men’s cortisol and testosterone: Systematic review and meta-analysis