September 2022 - Functional Health Solutions

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