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The Whole View
76 minutes | Jun 18, 2021
Episode 461: Oats-M-G, Are These Actually Healthy?
The Whole View, Episode 461: Oats-M-G, Are These Actually Healthy? Welcome back to episode 461! (0:28) Stacy has mentioned in the past how great she feels when she includes some oats in her diet. She clarified that it's not something she loads up on daily. Finding high-quality, gluten-free, and non-glyphosate was a game-changer for her as well. For years, Stacy and Sarah have talked about how grains were problematic for digestion, proper absorption of nutrients, and gut health. However, it's important to revisit how we look at food with a scientific approach as often as possible. Both Stacy and Sarah's health journeys took a path through the Paleo Diet to a point where they are now very open to experimenting with foods they were not maligned to for a long time. For Sarah, that means revisiting the science of these foods to get away from the idea of grouping foods together and instead look at the pros and cons of individual foods and how they can fit into an overall healthy diet to empower others to experiment. Sarah is a self-described Thrive Market junkie, and many of the (non-sponsored) products she and Stacy will be discussing can be found on their site. They also have a great feature called subscribe and save, where you can save money on products you buy regularly! Listener Question Sarah and Stacy have received many questions on this topic. This question in particular resonated the most: First off, I ADORE you both. I feel like you are my best friends and just don't know it yet :) I want to eat raw heads of lettuce (I've done this for years!) and get angry about poorly conducted research with Sarah, and go lift heavy weights while discussing clean beauty with Stacy. I can't get enough of you guys! So, my question is related to oats. Because my diet has been restrictive for so long while I've tried to heal my digestive system after being diagnosed with celiac three years ago, I have now developed anaphylactic responses to a lot of paleo foods. I was really happy this month when I was successfully able to reintroduce rice and oats, finding them to actually feel calming on my stomach. Because my list of paleo foods that I am reacting to keeps growing longer the more I rely on them, I am finding myself turning to these other foods like legumes, rice, and oats, on a daily basis in order to simply get enough food in. While I seem to tolerate it, it makes me nervous that I may be doing long term damage. I know you have discussed briefly how rice and some beans are actually not bad for the gut, but that was still always with the caveat of them being eaten "occasionally." And I don't think I've heard you discuss oats much at all. Could you perhaps address the effect of GF oats on the microbiome, as well as the overarching effects of a diet that includes a lot of these "non paleo" foods, but in the context of an otherwise veggie and fruit rich diet with only healthy fats, high quality meat and organ meats, and no refined sugars? Thank you! I love you both and am so thankful for all you do! - Anna Dogma of Paleo and Other Rigid Diets Stacy shares how much this question resonates with her. She first started on this health journey from guilt and feeding into the dogma of paleo that glorifies some foods and demonizes others. (8:00) In fact, what qualifies as a "paleo" food will vary from person to person. It's okay to lean into foods that make you feel good even if they don't fit a diet "framework" of what good and bad for you. For example, it was easy for Sarah to lump oats in with wheat and other grains and not critically evaluate it independently. Paleo has a very rigid set of rules, and it's important to Sarah to give listeners the tools and confidence needed to find what works best for them as individuals. Even if you stray from the framework of a particular diet but still identify with the term Paleo, there's nothing wrong with that. What works today might not work two years from now. It's okay to change to something better suited for what we need in a moment. Stacy stresses that they are not here to tell you what good, bad, and qualifies under a certain label. Health Benefits of Oats Oats have been very well studied for at least 30 years and have some well-established health benefits. (16:27) Whole grain oat products have shone to positively impact coronary heart disease, diabetes, satiety/weight management, low glycemic index, and blood pressure. These characteristics are mainly attributed to the high content of oat-specific beta-glucans, which are soluble food fibers. However, some people don't do well with oats. This is likely due to gluten cross-contamination. Gluten is a prolactin that is inflammatory that increases intestinal permeability, and is linked to adiposity signals. But avenin, prolamin type lectin, may not be as bad. Oats are often grouped in with wheat and barley as problematic, but not because oats themselves are a problem. Avenins are present at a lower concentration (10%–15% of total protein content) in oat as compared to gluten in wheat (80%–85%). The avenins in the genus Avena are free of the known CD immunogenic epitopes from wheat, barley, and rye. T cells that recognize avenin-specific epitopes have been found very rarely in CD patients. In fact, avenins are highly digestible and don't come out half-digested like gluten often does. Unlike gliadin peptides, oat peptides are also sensitive to digestion by pepsin, trypsin, and chymotrypsin in the gastrointestinal tract. They are unlikely to have any clinical relevance. Some cultivars of oats are gluten cross-reactors, meaning that if your body forms antibodies against gluten. But this appears to be a fairly low-frequency cross-reactivity and even not a problem for most people with celiac. High Likelihood of Cross Contamination However, oats are often processed on the same wheat, making the potential contamination pretty high. For example, the U.S. specification for No. 1 oats allows the presence of up to 2% foreign material, which could be all wheat and barley! So yes, the biggest con of oats is that it's frequently contaminated with gluten. As we discussed on a recent show, upwards of 55% of people, have at least one gluten sensitivity gene. Stacy references Oat O's and Thrive Market (not sponsored on this show!) for reduced risk of cross-contamination and what she personally leans on. For more information, Sarah recommends: frontiersin.org/articles/10.3389/fped.2019.00384/full tandfonline.com/doi/full/10.3402/fnr.v60.30324 journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0010001 Oats Nutrient-Density Although oats fare better than other grains, they are nutritionally underwhelming per calorie. (26:50) A 100-gram (2/3 cup) serving of oats has a moderate glycemic load (37) but serves a fairly high (389) in calories. That serving of oats does provide an impressive 246% DV for manganese and 40-50% DV for vitamin B1, magnesium, and phosphorous. It also provides 20-30% DV of iron, copper, zinc. Not too shabby... but not crazy impressive either. Sarah has been calculating Nutrivore Scores, and oats are the third-highest grain after corn and buckwheat. She adds that this is neither a pro nor a con for oats but shouldn't really be considered a "foundational" part of your diet, but rather fit in for added benefits. Revisit 29:30 to figure out what Stacy is talking about with more context. Oats and the Microbiome That same 100-gram serving contains a whopping 10.6 grams of fiber, including being particularly rich in a very special soluble fiber: mixed linkage beta-glucan. (34:31) This is a highly fermentable fiber that feeds anaerobic microbes in the gut and significantly increases the production of the short-chain fatty acids butyric and propionic acids. Oats contain 3-7% beta-glucan! Studies show over and over again that beta-glucans from oats significantly increase the growth of very important probiotic strains of Bifidobacterium as well as the Lactobacillus-Enterococcus group. And oat beta-glucans seem to be better than beta-glucans from other grains. One study showed that an oat-based diet resulted in higher Bifidobacteria levels than either a barley-based or wheat-based diet supplemented with equivalent amounts of beta-glucan. In addition, these high levels of beta-glucan appear to be the "magic ingredient" behind oat's most famous properties, including their cholesterol-lowering effects. This occurs because beta-glucan increases the viscosity of the chyme in the upper GI tract, leading to increased binding and secretion of bile acids. In turn, plasma cholesterol becomes a substrate for newly formed bile, causing blood levels to decrease. Beta-glucans contribute to the maintenance of normal blood cholesterol levels. Consumption of beta-glucans from oats and barley as part of a meal (4 g/30 g carbohydrates) contributes to reducing the blood glucose rise after that meal (EU 432/2012). Oat grain fiber contributes to an increase in fecal bulk (EU 432/2012). Reducing saturated fat consumption contributes to the maintenance of normal blood cholesterol levels (EU 432/2012). Oat beta-glucan (3 g/day) has been shown to actively lower/reduce blood cholesterol. High cholesterol is a risk factor in the development of coronary heart disease (EU 1160/2011). In addition, oat fibers increase the fecal bulk, which contributes to a normal stool and positively impacts the functioning of the microbiome. Oats in particular also have high bioactive potential and relatively high lipid content relative to other grains. Their unique composition contributes some special benefits to gut health compared to other whole grains. Surprise! Oats Are Super Digestible Protein content in the oat groat is relatively high (15%–20% by weight), as is the digestibility of oat protein (90%), and the majority (85%–90%) of oat protein consists of globulins. (43:15) This is in contrast to wheat, in which the vast majority consists of gluten. Starch (about 60% of the total dry weight) is a major component of the oat grain. The amylopectin: amylose ratio is about 3, and the digestibility of oat starch is about 100%. Oat starch digests slowly, partly due to high amounts of fiber and the high oil content in whole grain oat, which retards stomach emptying and improves digestion. This results in a gradual supply of glucose to the intestine, which maintains a long feeling of satiety. As a result, whole grain oat foods have a low glycemic index (GI), which is advantageous in cases of diabetes and obesity. Compared to other cereals, oat grains have a relatively high oil content of on average 7% oil, but some varieties can have up to 18%: The three most abundant fatty acids are palmitic (C16:0; 20%), oleic (C18:1; 35%), and linoleic (C18:2; 35%) acids, which account for about 90%–95% of the total fatty acids. The largest part is thus unsaturated, but there is more omega-6 than omega-3. Alpha-linolenic acid (18:3, omega-3) is notably present in the oat germ. The high lipid content can also hurt the sensory quality of oat products because of lipid oxidation, which produces fatty acid hydroperoxides and volatile aldehydes, causing rancidity. Therefore, before further processing, oats are kilned—a high-temperature treatment to inactivate especially lipases. So, Which Oats Are Best? Sprouted is best! Sprouting happens the seed is trying to turn itself into a plant. However, they are tough to sprout at home unless you buy unkilned oat groats. (48:35) The nutritional and bioactive properties and key enzymatic activities were studied in sprouted oat powder and compared with those of oat grain powder (control). Sprouted oat powder was an excellent source of protein (10.7%), β-glucan (2.1%), thiamine (687.1 μg/100 g), riboflavin (218.4 μg/100 g), and minerals (P, K, Mg, and Ca). This presented better amino acid and fatty acid compositions and levels of γ-aminobutyric acid (54.9 mg/100 g), free phenolics (507.4 mg GA/100 g), and antioxidant capacity (1744.3 mg TE/100 g) than control. Enhanced protease and α-amylase and reduced lipase activities were observed in sprouted oat powder. Promising features to improve its nutritional, sensorial, and health-promoting properties! Since 2009 (EC 41/2009) and 2013 (FDA), oat products may be sold as gluten-free in several countries provided a gluten contamination level below 20 ppm. Note: 20ppm may still be too high for celiac or gluten allergy! Types of Oats Interestingly, when it comes to oats, the size of the flakes appears to make a difference in how the gut microbiota are affected. One study found that thick oat flakes, but not thin oat flakes, increased Bifidobacterium levels during fermentation while also producing 2.5 times more butyrate than the thin oat flakes. The authors of this study suggested the resistant starch content of the thick oat flakes may explain these differences. Steel-cut oats have a little more resistant starch, slightly higher beta-glucans, and higher total fiber than old-fashioned rolled oats. Remember, old-fashioned rolled oats are better than quick oats. One small study showed slightly higher butyrate production with steel-cut oats than old-fashioned, but it wasn't statistically significant. Sarah recommends One Degree brands for the best-sprouted oats (not sponsored! Just a Sarah-approved favorite). Personally, Stacy and Sarah have both Old Fashion and Steel Cut oats currently in their pantries. Sarah recommends using an instant pot as well! Sarah's ideal recipe is 2 cups steel cut oats, 5-6 Cups of water (depending on how thick you like your porridge), and 1/2 a teaspoon of salt (scale up or down as desires). In Instapot, cook for 4 minutes on high pressure and then let the pressure naturally decline. Add flavoring as needed, such as maple syrup to slightly sweeten. Stacy also recommends trying this pumpkin oatmeal recipe, which has always been a crowd-pleaser. How to Experiment Sarah recommends starting by utilizing a food journal to see if you're reaching your nutrient targets for the day. If you are, first cut out the food from your diet for at least two weeks, even including trace amounts. This ensures you're testing your actual reaction and not the reaction you're currently having while already consuming the food. This helps you isolate and identify. Next, pick a day to challenge when you're feeling good, slept well, not stressed, and not eating anything else out of the ordinary. If you're worried about an allergy response, make sure you go slow since they can get really big very fast. If you check for sensitivity, like mood, stomach, or skin issues, it's okay to go more all-in. If you're not sure if something was a reaction (mild reactions can be tough), give yourself a few days to reset, and then try again to see if you have the same experience. If you're thinking about experimenting with oats, Sarah recommends buying sprouted oats (which reduces anti-nutrient content) that are certified gluten-free. Be sure to follow a methodical reintroduction protocol! Also, oats are way less likely to be tolerated by people with celiac disease (and potentially other autoimmune diseases) or anyone who has tested positive for wheat/gluten or oats on a food allergy/intolerance screen in the past. Final Thoughts Sarah views oats as a "sometimes food" due to the importance of quality. (1:01:30) Stacy's philosophy is all about variety and introducing foods to develop a palate. And the more science we look at, the more we can emphasize foods we know are beneficial to our gut and health overall. It's important not to emphasize "yes" and "no" in terms of food, but instead look at each food as an individual in terms of a healthy diet overall. Identifying your triggers is very important, and knowing that not every food will work for every person. Be sure to head over to Patreon for bonus content on how Stacy and Sarah really feel about this topic and more! Your subscription supports this show and gets your questions first in line. Thank you for your great question, Anna, and thank you, listeners, for joining us! We will see you next week.
64 minutes | Jun 11, 2021
Episode 460: How to Break the Stress-Flare-Antibiotic Cycle
Welcome to episode 460 of The Whole View! This week, Sarah and Stacy look at the science behind antibiotics' impact on the gut microbiome and what we can do to break the Stress-Flare-Antibiotic Cycle as much as possible. Stacy gives insight into actions you can take outside the body, while Sarah dives deep into foods and lifestyle habits that can help from within. If you enjoy the show, please review it on iTunes! The Whole View, Episode 460: How to Break the Stress-Flare-Antibiotic Cycle Welcome back to episode 460! (0:28) This week's episode was inspired by a lister question. As always, Stacy and Sarah pick questions that really resonate with the: First off, my mother and I love your show and have been listening to the show for years. I love how you can tackle complicated topics and boil them down to easy to understand and enjoyable shows. Stacy, your journey with your son through ADHD was such a help for me when my oldest son was diagnosed. It gave me a place to go when I wasn't sure where to go next. Now to the reason I'm writing to you. I have been battling rosacea flares ever since 2010 when I had my first son. Pregnancy seemed to set everything off and I now deal with flares off and on. I know stress is a trigger. My dermatologist's answer is always to put me on antibiotics for months at a time and it's killing my gut health. I had finally gotten my gut health to a pretty good place and hadn't needed to be treated for quite some time and then Covid hit, my mother-in-law moved in, and I started remote schooling 3 extra kids in my home along with my own children. No stress here! My question is, how do I maintain my gut health when I have Rosacea and have to use antibiotics to control the flare? Thank you for all the hard work you ladies put into your shows! -Sara Sometimes, the flare itself can be additional stress and can snowball the problem. Lifestyle changes aren't going to solve the issue independently, but adding different choices in where you can certainly help manage symptoms. First, Medication Isn't Failure! In some situations, antibiotics are absolutely needed. (7:09) It's definitely smart to avoid antibiotics when they aren't really necessary (like viral flu and colds). But when it comes to certain illnesses and infections (the ones used to wipe out huge chunks of the human population!), antibiotics can prevent serious complications and even save our lives. There's no reason we should ever feel guilty or like we've "failed" just because we need to take antibiotics. While following a healthy diet and lifestyle typically supports much stronger and well-regulated immune systems, it does not (sadly) make us invisible. The necessity for antibiotics doesn't mean that you didn't "Paleo/AIP/Nutrivore hard enough," so don't be hard on yourself. While it's always a good idea to reflect on ways to improve the quality and consistency of our diet and lifestyle choices, what's most important while recovering from illness is making science-based, informed choices that give us the best chance of getting healthy efficiently! Preventative Skincare Stacy refers listeners back to the episode on Dry Winter Skin because of the information on the moisture barrier in that show. (12:15) She also recommends checking out Science of the Skin Barrier. Beauty counter has a great Safe SPF Stacy loves! She cautions listeners to be wary of the ingredients in their products when shopping for sunscreen. Studies have shown that many modern SPF on the market (chemical and mineral) have large amounts of Benzine contaminants, a known carcinogen. There are prescription topical medications to help with issues such as Rosacea. That is another option to talk to your doctor about. Another known thing to irritate Rosacea is using hot water and dairy consumption. Sarah adds that red light therapy is another interesting avenue to look into to add to your preventative care. Self Care and Stress vs. Sleep Stress is a huge trigger for Sarah, and despite being proactive at preventing stress, it's not 100%. (18:01) Sarah and Stacy have talked about the stress, work-life balance, and stress-sleep cycle on quite a few recent shows: 458: Collective Trauma and Re-Entry Anxiety 447: Basic Needs Don't Count as Self-Care 446: Nutrient Deficiencies Caused by Stress 409: Let's Talk About Magnesium 397: Practical Tips for the Sleep Stress Cycle 351: Stress on Health Sarah explains that her biggest obstacle is her perfectionist tendencies. It's critical to put self-care on our busy to-do lists! Self-care doesn't have to mean a mani-pedi. It can be as easy as giving yourself time to do something you enjoy. Resilience activities like going for a walk, meditating, or cuddling with a pet are great ways to give yourself some time away. Stacy reminds listeners that they are allowed to let go and say no. Focusing on sleep when we can't control stress is another great way to help your body as much as possible. Antibiotics vs. Gut Health The word literally means "against life" from its Greek roots. (27:10) Antibiotics stop or slow down the growth of microscopic organisms (bacteria, fungi, and some parasites), in turn, treating potentially dangerous infections. Antibiotics can also destroy beneficial bacteria and yeast that mediate an incredible array of processes in our body. This can include gut barrier integrity, tuning the immune system, and increasing the bioavailability of nutrients from our food! So, whenever we embark on antibiotic therapy, the goal should be to protect, preserve, and restore these beneficial organisms as soon as possible. Antibiotics, by design, are very destructive to the gut microbiome, which is why so many gastrointestinal side effects are reported. Taking Probiotics While on Antibiotics It's a myth that we should wait until we've finished a course of antibiotics before trying to rebuild our gut flora with probiotics. (29:52) In reality, taking probiotics during antibiotic therapy is one of the most helpful things we can do to maintain gut health! Even if the probiotics we ingest during antibiotic therapy don't take up permanent residence yet, they can still help keep pathogens at bay and prevent crazy microflora imbalances. Several studies have examined the effects of probiotics on antibiotic-induced side effects, and the results have been impressive! Probiotics can go a long way to reduce unpleasant symptoms, especially gastrointestinal distress like diarrhea. This can occur when antibiotics wipe out the competitors for pathogenic bacteria and allow diarrhea-inducing strains to flourish. One meta-analysis looked at 63 trials on probiotics to prevent antibiotic-associated diarrhea and found a major reduction in diarrhea when people took Lactobacillus-based probiotics. Other meta-analyses found that Saccharomyces boulardii and Lactobacillus rhamnos, in particular, were very helpful for reducing antibiotic-associated diarrhea. And, additional studies have found various probiotic strains (especially Lactobacillus) can help reduce nausea, taste disturbance, headaches, hypersensitivity, and other symptoms when taken during a round of antibiotics! One study tested the effects of starting probiotics (Lactobacillus acidophilus and Bifidobacterium bifidum) after antibiotic therapy versus during antibiotic therapy. The group that started taking probiotics while still on antibiotics had more stable microflora levels and less gut dysbiosis throughout the experiment! Taking Action Against the Stress-Flare-Antibiotic Cycle Sarah recommends loading up on fermented foods teeming with natural probiotics. These include raw, unpasteurized sauerkraut, kimchi, fermented carrots, fermented beets, pickles, fermented fruits (chutneys, jams, pickled jackfruit, green papaya), kombucha, beet kvass, coconut milk kefir, coconut milk yogurt, and raw condiments. For people who aren't sensitive to dairy or soy, unpasteurized yogurt and kefir, natto, miso, tempeh, and tamari sauce are also great options. For the best results, eat these foods 2 to 4 hours after an antibiotic dose. Sarah also recommends taking probiotic supplements, especially if you're yeast or histamine sensitive or otherwise don't do well with fermented foods. For preventing antibiotic-associated diarrhea and other side effects, an intake of at least 5 billion CFU/day for children or 10 billion CFU/day per adult is recommended. Several existing trials show that Lactobacilli, Bifidobacteria, and Saccharomyces boulardii are the most effective types for reducing antibiotic side effects. All probiotics should be consumed with food, and bacterial strains should be taken at least 2 to 4 hours after each antibiotic dose so that they don't get inhibited by the antibiotic itself. Saccharomyces boulardii is actually a form of probiotic yeast, making it particularly useful while taking bacteria-killing antibiotics. Don't forget to consume plenty of gut barrier nutrients! What to Do After Taking Antibiotics Stacy adds that reintroducing known trigger foods should only happen when your flare is over to prevent the stress-flare-antibotic cycle. (39:02) Once we've completed antibiotic therapy, it's time to seriously buckle down and get our gut microbiome back in shape. Chances are, the antibiotics caused a major loss in microbial diversity, wiped out many beneficial species, and may have allowed pathogenic strains to flourish. So, the goal is to rebalance the microbiome and restore as much (good) diversity as possible! There's a really immense amount of information in The Gut Health Guidebook, but it all boils down to 20 keys to gut health. A healthy gut microbiome eats a nutrient-dense and varied diet that is moderate-fat and moderate-carb to best support a healthy gut microbiome. That includes plenty of veggies, fruit, mushrooms, and seafood, rounded out with nuts, seeds, grass-fed meats, fermented foods, and phytochemical-rich foods like herbs, tea, coffee, cacao extra virgin olive oil. 437: Intro To Nutrivore 424: 30 Fruits and Vegetables a Week?! 373: How Many Vegetables (Part 4) Powdered Veggies 304: What's Better: Raw or Cooked Vegetables? 335: How Many Vegetables Part 3: Souping vs Smoothies 281: How Many Vegetables?! 413: The Gut Health Benefits of Nuts 415: Fish oil, Healthy or not? 414: Best Cooking Fats for Gut Health Lifestyle Choices that Help Fight the Stress-Flare-Antibiotic Cycle Be sure you're hydrating without alkaline water. Lifestyle factors are also essential, like getting enough sleep on a consistent schedule, entrenching a solid circadian rhythm, eating distinct meals instead of grazing, fasting overnight (12-14 hours, not IFing), living an active lifestyle managing stress. It's also super important to optimize vitamin D levels. For more info, see Episode 354: Everything Vitamin D. A handful of traditionally excluded foods on the Paleo diet is a boon to our gut microbiomes. This includes A2 dairy like goat, sheep, or camel), most legumes (not soy or peanuts), pseudo-grains, corn, rice, and gluten-free oats. However, none of these latter foods are fundamental for a healthy gut microbiome in the same way that mushrooms, seafood, and individual families of vegetables and fruit are. Continue eating plenty of raw, unpasteurized, fermented foods throughout the day. These typically contain a huge spectrum of probiotic species and offer greater microbial diversity than most probiotic supplements. Lacto-fermented fruits, vegetables, and beverages tend to be high in Lactobacillus and Bifidobacteria, while kefir and kombucha are great sources of Saccharomyces boulardii. Eat from as many fermented foods as possible to get a variety of awesome microbes, both bacterial and yeast! For more information, see Episode 329: The Link Between Carb Intolerance & Gut Health and Episode 457: The Problem with a Low-FODMAP Diet. Studies have shown that SBOs like Just Thrive helps Lactobacillus grow and can help restore the gut microbiome after antibiotics. Just Thrive is not sponsoring this episode, but you can still use TWV link for discounts on their products and get 15% off with the code THEWHOLEVIEW at checkout! Stacy and Sarah recommend two probiotics from Smidge: Yeastbiotic and Probiotic. Final Thoughts The most important thing to do when managing the stress-flare-antibiotic cycle is to give your body what it needs to perform optimally. (50:50) This is also why modern diet-culture is such an issue. Our goal is health, and when we focus on it, we see a lot of the claims made by diet culture aren't scientifically supported to optimize health. The idea of weight loss is often enough to justify choices that make us feel sluggish or sick, and it takes rerouting our mindset toward health to see through it. There's no one-size-fits-all recipe for feeling good. It's about listening to your body and finding out what makes you feel your best. It's not about how much you weigh. Stacy reminds listeners interested in Beautycounter safer skincare to use the code CLEANFORALL20 for 20% off their purchase. Be sure to hop over to Patreon for Stacy and Sarah's unfiltered thoughts for more on this topic. Your subscription helps support this podcast and gets you front-line access to the Whole View. Thanks for listening and we will see you next week! Want more info on our Real Life? Never miss a post with our Real Everything newsletter (and get our best selling book, Eat Like a Dinosaur, as a welcome gift). Join here Wanna be Healthy Inside & Out? 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87 minutes | Jun 4, 2021
Episode 459: Gluten-Free Baking, Our Best Tips and Tricks.
The Whole View, Episode 459: Gluten-Free Baking, Our Best Tips and Tricks. Welcome back to episode 459! (0:28) Today, Sarah and Stacy will discuss baking and sharing their tips and recommendations for gluten-free baking. They've received quite a number of questions regarding this topic. Stacy recently revised a Lactation Cookie recipe from several years ago and realized just how much her mindset has changed since then. Sarah and Stacy started from a one-sided Paleo approach but gradually moved toward a nutrivore, nutrient-dense mindset. Sarah mentions she's currently working on a new website dedicated to Nutrivore! So listeners should keep an eye out for updates. It's important to get away from this dogmatic approach to food to ensure you're giving your body enough variation for it to heal. Heritage Wheat for Gluten-Free Baking Actually, the gluten content of heritage wheat is about the same as modern wheat, so from a celiac perspective, they're both problematic. (13:30) Stacy adds that gluten-sensitive vs. celiac is where you might notice a difference. As someone with Celiac Disease, even trace amounts of gluten will cause her issues. It's often thought that ancient wheat has less gluten, which is simply not true. Estimates as much as 55% of the population have gluten sensitivity genes. However, if you aren't wheat or gluten-sensitive, ancient/heritage wheat is definitely a better choice than modern wheat. Studies do show that ancient wheat has an overall anti-inflammatory profile, whereas modern wheat has a pro-inflammatory profile. Sarah recommends this great review article for more information. Scientists have a hard time pinpointing exactly why. Still, it seems to be a collection of small nutritional differences, slightly more digestible gluten, slightly more polyphenols, more carotenoids (lutein), and a slightly better effect on the microbiome. Benefits of Almond Flour Sarah has had a pretty long journey with almond flour. She used to use it all the time, then not at all, and it eventually started to creep back in. (19:40) There are definitely health benefits to an ounce or two of nuts per day, which translates to ⅓ to ⅔ cups. Almond flour is one of the more nutrient-dense flour alternatives, meaning it has more essential nutrients per calorie. And, like we covered in episode 413, it's good for the gut! But, when we're talking about a treat, we're accepting that it's not going to be super nutrient-dense, generally. Sarah prefers the chemistry of cassava flour for most applications. But, she also still uses almond flour. She adds she does have some other more obscure flours in her pantry but rarely uses them (plantain, tigernut, sunflower, coconut, sweet potato, chestnut). Stacy makes it less about what the flour is but rather what will work better for what you're making. Some flours are heavier or denser than others, so the nature of the flour means it sometimes won't rise. Stacy keeps tapioca, oats, arrowroot, and rice flours in her pantry as well. Cassava Flour for Gluten-Free Baking Cassava does contain some cyanogenic glycosides (other foods that do include almonds, apple seeds, stone fruit pits, bamboo, flaxseed, lima beans) (32:50) You can find the Legit Mixes here. The sweet cassava that is available as an imported vegetable in Western countries has only about a tenth of the cyanogenic glycosides of the bitter cassava grown in South America and Africa, which makes it pretty low on the cyanide scale to start with. And the even better news is that these compounds can be completely removed with proper preparation, which the major manufacturers of cassava flour, like Otto's do. And, when cooking with whole cassava, you can too! That's why my recipe for cassava fries includes a boiling step before roasting. Gluten-Free Baking on AIP For questions regarding AIP baking at altitudes, Sarah and Stacy recommend checking out Elana Amsterdam! (39:05) She does live at altitude, and she has great information available. She also has MS, which is autoimmune, and she's been doing grain-free recipe blogging for a very long time. Jovial has an AIP cassava-based pasta that's so good! Typical AIP substitutions for eggs are gelatin eggs, apple sauce, canned pumpkin, tapioca starch, mashed root veggies (especially cassava and taro, thanks to the mucilage fiber they contain). Sarah also recommends trying fresh, mashed cassava (tapioca) in your recipes. Sugar on Paleo and AIP Sugar is about dose rather than being on a yes list or no list. (45:45) Table sugar (cane sugar or beet sugar) is predominantly sucrose, a disaccharide made of one glucose and one fructose molecule. Sucrose is digested and absorbed quickly, and the glucose it contains has a rapid impact on blood sugar levels and insulin secretion. Consumption of glucose increases the production of oxygen radicals and markers of inflammation, even in healthy people. However, it is exaggerated in people who are obese or have type 2 diabetes, high cholesterol, or metabolic syndrome. High sugar consumption can also lead to nutrient deficiencies. Sarah covers this in-depth in How Does Sugar Fit into a Healthy Diet and 5 Nutrients You're Deficient In… If You Eat Too Much Sugar. High fructose consumption (the other half of the sucrose molecule) has been linked to obesity, insulin resistance, hypertension, fatty liver disease, type 2 diabetes, cardiovascular disease, metabolic syndrome, and increased cancer risk. In fact, the biological effects of too much fructose are likely the driving force behind the association between high sugar intake and chronic diseases. This is particularly important because of the rise of high-fructose corn syrup and because many sweet treats marketed to diabetics use fructose-based sweeteners. These are additives like agave syrup. Just because they don't cause a rise in blood sugars doesn't mean they're harmless! In fact, the evidence points to fructose-based sweeteners being even worse: Is Fructose a Key Player in the Rise of Chronic Health Problems? Fructose and Vitamin D Deficiency: The Perfect Storm? Why is High Fructose Corn Syrup Bad For Us? Is It Paleo? Fructose and Fructose-Based Sweeteners (I'm looking at you, Agave!) Natural Sugars It's important to note that there is evidence that fructose from whole fruits is not the same as fructose-based sweeteners. One recent study compared the metabolic effects of consuming 100 grams of fructose from high-fructose corn syrup versus fresh fruit. While both showed some problematic effects, it was much worse in the HFCS group. Studies also show that eating 300 grams of fruit daily (about 4 servings and up to about 45 grams of fructose) causes the biggest decrease in all-cause mortality (a general marker of health and longevity), so eating fruit is good! One piece of good news is that we don't need to count fresh fruit towards sugar intake. The cusp for the negative effects of high-sugar intake really is around 10% of total calories from added sugars. So, we don't have to give up all sweet foods to be healthy, but rather choose our sugars wisely and moderate our intake! The most important sugars to limit are refined ones, which don't offer any redeeming nutritional qualities. Find Sara's lists here: How To Avoid Added and Refined Sugars How Does Sugar Fit into a Healthy Diet? The sweet taste of sugar is highly addictive, so it can be tough to reduce our intake or give it up. Sarah and Stacy covered this more in episodes 323: Cheat or Treat, Let's Talk Sweets! and 300: How Do You Handle Sugar and Salt Cravings? Other Sweeteners Sadly, we can't cheat sweets! Sweet substances that are not sugars are called sweeteners. (58:40) They are artificial or natural substances that taste sweet but don't contain caloric sugar molecules like glucose and fructose. You won't be surprised to learn that the artificial sweetener aspartame causes even more health problems than sugar. But you might not know that other nonnutritive sweeteners like sorbitol, mannitol, xylitol, and erythritol cause gut dysbiosis and increased intestinal permeability. Sarah and Stacy discuss this more in, Is It Paleo? Splenda, Erythritol, Stevia, and other low-calorie sweeteners and Episode 309: Aspartame Is Evil Even the two "natural" sweeteners predominantly used in products marketed to health-conscious communities — stevia and monk fruit — are problematic. Just because something is "natural" doesn't mean you should eat it. There is a health trade-off to everything. And just because it won't raise blood sugar levels in diabetics doesn't mean it's safe to eat in large quantities. There are now high-quality studies proving that stevia is an endocrine disruptor and problematic for the gut microbiome. This applies to the stevia plant and whole leaf stevia, too! And monk fruit extract isn't even approved as a food additive due to toxicity concerns and is only approved for supplements. For more information on this, see The Trouble with Stevia and What's the Next Superfood Sweetener? Allulose is the molecular mirror image of fructose. While it hasn't been extensively studied, it's brought into the body by the same receptor (GLUT5). So we know that it can biologically behave similar to fructose, and we'd therefore expect similar problems. What Do Sarah and Stacy Suggest? Sarah thinks it's important to focus on the best way to enjoy a sweet treat - real, natural sugars, in moderation. (1:10:20) The best choices are unrefined sugars that offer some nutritional value, like unrefined organic cane sugar, molasses, maple syrup, and honey. Blackstrap molasses is so nutrient-dense that it contains 1.5 times more calcium per calorie than cheese and 5 times more iron per calorie than steak! Plus, it's rich in copper, selenium, manganese, magnesium, potassium, and vitamins B2, B3, and B6. Just one tablespoon contains 20% of the DV of calcium, iron, copper, and manganese, for only 42 calories. Honey Honey has known antioxidant and antimicrobial properties and may promote tissue health. Even though it's natural sugar, there's evidence that honey can help regulate blood sugar levels in diabetics and improve the efficacy of metformin! It's also been shown to be therapeutic in both chronic constipation and chronic diarrhea because it acts as a selective prebiotic for Lactobacillus and Bifidobacterium. It also inhibits the growth of undesirable microorganisms that can act as pathogens. There's even some evidence showing that eating honey can reduce cardiovascular disease risk factors and cancer risk. Plus, honey contains calcium, potassium, magnesium, phosphorus, selenium, copper, iron, manganese, chromium, zinc, and vitamins B1, B2, B3, B5, B6, B9, C, and K. When we examine all of the health problems associated with high-sugar intake, honey seems to reduce risk. All this to say that there really isn't a way to cheat sweet, but we also don't need to if we're conscientious about how often and how much sweet treats we're indulging in. Natural sugars in moderation absolutely can fit into a healthy diet. Final Thoughts Stacy and Sarah are not here to demonize the choices you make and why you make them. They want to empower you to make those decisions for yourself and not be influenced by this idea of being afraid. (1:21:45) You can never give up everything in life. It's about making things sustainable for you and giving you the knowledge to make informed health decisions to help you live your life to the fullest. Stacy encourages listeners to have freedom from the pressure and dogma that the entire culture has created around being afraid of certain foods. Sarah adds that we need to be aware of how these marketing campaigns aren't only about buying that product but make you feel bad about your alternate choice. And it's not always grounded in scientific evidence. You can join Sarah and Stacy over on Patreon for their unfiltered thoughts on this episode. If you've not joined the Patreon family yet, joining gets you access to bonus content and is first in line with any questions. Thanks for listening, and we will see you next week!
76 minutes | May 27, 2021
Episode 458: Collective Trauma and Re-Entry Anxiety
The Whole View, Episode 458: Collective Trauma and Re-Entry Anxiety Welcome back to episode 458! (0:28) With the decline of covid-19 cases, hospitalizations, and deaths, many places around the United States are starting to open again. Stacy has realized this last year was trauma, as much as that might sound like an exaggeration. Trauma is very individual, but we've all experienced a collective trauma as a group, and now we're recovering it as we're re-entering into the new world. This resonates especially with Stacy due to her experience with the effects of trauma with her foster kids. She adds that this is not a dig at or to minimize anyone with different types of trauma or medical conditions regarding mental health. But we need to be willing to acknowledge that this is something people out in the world are going through and ways to support each other. Sarah is also experiencing quite a lot of re-entry anxiety. She finds the world feels very different, and it's particularly challenging to reintegrate with people. Why Are We Experiencing Re-Entry Anxiety? We've made some very different choices during the last 15 months. Even now, we're making different risk analyses on masks and social distance. Sarah adds that she's vaccinated, but her entire family has not been yet, so she's still choosing to wear a mask. She's already been mask shamed the same way she was as an early-adopter of masks earlier in the pandemic. This is a lot of change. Going back to normal after so long of isolation, virtual work, or school, and our old routines is a lot like establishing them. Sarah manages by giving herself a lot of grace and just introducing one thing at a time. It's helpful to put those emotions into the mindset of trauma to better understand it. We want our listeners to know that many people are going through the same thing as you. Society has gone through a collective trauma. Stacy wants to underline the idea that "group trauma" is very real despite it being something we don't really think of trauma as a collective and gives the example of a community experiencing a hurricane or other natural disasters. Increases In Mental Health Issues Scientists studying the aftermath of the global pandemic look at it from a very umbrella view, looking at increases of anxiety, substance abuse to cope, signs of PTSD, and even suicidal ideation. (10:30) Last summer, a study reported that the biggest increase in trauma symptoms was in the first few months of the pandemic when things were changing quickly. Anxiety disorder showed approximately three times more reported in the second quarter of 2019 (25.5% versus 8.1%), Depressive disorder showed approximately four times what was reported in the second quarter of 2019 (24.3% versus 6.5%) (2). Suicidal ideation was also elevated; approximately twice as many respondents reported serious consideration of suicide in the previous 30 days than did adults in the United States in 2018, referring to the previous 12 months (10.7% versus 4.3%). During August 19–31, 2020, through December 9–21, 2020, scientists observed significant increases in the percentages of adults who reported experiencing symptoms of an anxiety disorder (from 31.4% to 36.9%), depressive disorder (from 24.5% to 30.2%), and at least one of these disorders (from 36.4% to 42.4%). More adults (22.4% to 25%) reported taking prescription medications or receiving mental health counseling during that time. More adults said they needed but did not receive counseling (9.2% to 12.4%). While the researchers found an increase in symptoms among all demographic groups, the trend was highest among individuals aged 18 to 29 and those with less than high school education. This additional study showed similar results. Mental Health Issues Before Covid-19 Stacy shares that she had high-functioning anxiety before Covid-19, which impacts how she dealt with the stress of the pandemic. Sarah shares that she has 20+ years of experience with panic attacks, which are better or worse during specific times of her life. So while we might have this collective trauma, our experiences within that trauma might be very different. There's no one way to experience depression, anxiety, etc. Stacy and Sarah want to acknowledge this collective trauma and discuss how behavior is driven by emotion, which means we need to support emotion rather than address bad behavior. Stacy adds that she and Sarah are not medical professionals, and it's incredibly important to talk to your primary care doctor. Medication, therapy, and/or asking for help is not a failure! Stacy and Sarah have done many shows on mental health that can act as a foundation for what they'll be talking about in the episode: 319: Abundance Mindset (PTSD, Emotional Freedom Technique, EMDR, and mindfulness) 383: Anxiety (amygdala vs. cortex in generalized anxiety disorder, mindfulness, diet and lifestyle for mental health) 303: Are Certain Foods Causing My Anxiety? 446: Nutrient Deficiencies Caused by Stress (big focus on vitamin C) 409: Let's Talk About Magnesium 397: Practical Tips for the Sleep Stress Cycle 351: Stress on Health 408: Insomnia? (the link between insomnia and mental health) 382: Social Media (impact of social media on mental health) 251, Transitioning Out of Depression 204, Stacy's Physical and Mental Recovery How Does Trauma Affect the Brain? Some common symptoms of PTSD include nightmares, flashbacks, panic attacks, startle response, and preoccupation with the traumatic event. (26:00) Memories are stored through fragments of visual images, smells, sounds, tastes, or touch within our brains. The brain can easily be triggered by sensory input. Those with PTSD have more severe reactions to specific inputs that remind them of that trauma. We might not even realize we're responding in the way that we are, like assuming the worst of others. In terms of collective trauma from the recent global pandemic, we've been conditioned to be wary of things like large crowds or people not wearing masks. Finding yourself in those situations now can trigger re-entry anxiety symptoms similar to how the brain triggers responses for PTSD patients. Source: https://www.cell.com/trends/neurosciences/fulltext/S0166-2236(11)00103-2 The American Psychiatric Association defines trauma as "an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of self or others." Such events can include military combat, natural or human-made disasters, torture, and/or violent personal attacks. Traumatic experiences induce physical and psychological symptoms that affect aspects of life. It can involve significant distress and impairment in social, occupational, and other more. These experiences can also lead to structural, functional, emotional, and cognitive function and processing. Behavior vs. Emotion What all this means is it's normal to see people behave on a range of spectrums, from scared, passive, and fearful to enraged, aggressive, and impulsive. Stacy highlights that all these emotions, regardless of where they come from, will change your behavior. This is something she'd noticed significantly from her experiences at home. It's not so much about correcting the behavior because the behavior is triggered by an emotion the person is feeling inside. Unless we understand where that emotion is coming from and how to deal with experiencing it, correcting just the behavior isn't helping anything. Understanding that everyone is re-adjusting to "life as normal" puts a lot of perspective on your own re-entry anxiety. That's it's not just you, and they're not treating you a specific way because of something you've done. Stacy and Sarah also talked about this in the context of Generalized Anxiety Disorder in TPV Podcast Episode 383: Anxiety. You can learn some things you can do to help people when you see this happening. However, simply pointing it out isn't actually helpful to someone whose amygdala is in protective mode. Brain Food, Lifestyle Activities, and Re-entry Anxiety There are many ways that PTSD and other mental health issues also have a profound effect on our physical health. (43:01) Stacy and Sarah talked about nutrition and lifestyle for mental health in detail in: 383: Anxiety 303: Are Certain Foods Causing My Anxiety? 446: Nutrient Deficiencies Caused by Stress 409: Let's Talk About Magnesium 397: Practical Tips for the Sleep Stress Cycle It's crucial to take advantage of experts, whether a psychologist, psychiatrist, primary care, specialized physician, or all of the above. Sarah also acknowledges that certain diets and lifestyles can increase susceptibility to PTSD. However, this does not mean it's to blame for it. But can looked at as an action step toward helping yourself through your experience. Studies have shown an association between post-traumatic stress disorder, lack of exercise, poor diet, obesity, and co-occurring smoking. Meta-analysis revealed that PTSD sufferers were 5% less likely to have healthy diets, 9% less likely to engage in physical activity, 31% more likely to be obese, and 22% more likely to be current smokers. An additional study looked at post-traumatic stress disorder (PTSD) in mid-age and older adults. They wanted to know if PTSD differs by immigrant status and ethnicity, nutrition, and other determinants of health in the Canadian Longitudinal Study on Aging (CLSA). Ways to Support Your Mental Health & Re-Entry Anxiety Science has linked nutrient deficiencies to increased depression/anxiety, and that supplementation helps. A variety of RCTs show exercise interventions reduce symptoms. However, there's not enough data to have an optimal "walk 30 minutes per day" or "cardio 4X per week." Data also shows that therapy and mindfulness (meditation) reduces symptoms more effectively than stress management education. Helpful stress management techniques are fresh air, sunlight and nature, walking (low-intensity activity), getting enough sleep on a consistent schedule, and social connection. Final Thoughts If your sleep is being impacted by anxiety or depression, it's more difficult for these health techniques to stick. (1:04:11) Sarah reminds listeners that sleep regulates our bodies and stress hormones, which can impact our health in various ways. Social connections are crucial to feeling better, and depression can cause us to isolate and further the problem. Lifestyle and relationships can be toxic and also impacting your health. Stacy reminds listeners that there's nothing wrong with setting boundaries with others, self-care, and creating a healthier connection. Sarah adds that there is nothing wrong with asking for help and that we're all in this together. Be sure to check Sarah and Stacy out on Patreon if you've not already joined the family. It gets you bonus access to what they really feel about the topics they talk about on The Whole View. Thank you for listening, and we will see you next week!
63 minutes | May 20, 2021
Episode 457: The Problem with a Low-FODMAP Diet
The Whole View, Episode 457: The Problem with a Low-FODMAP Diet Welcome back to episode 457! (0:28) Sarah and Stacy last covered FODMAPs in detail in TPV Podcast Episode 238, What's a FODMAP and Why Do Some People Avoid Them? The science on them has definitely evolved, so it's time to revisit what FODMAPs are and why there can be a problem with a low-FODMAP diet! This show is sponsored by Stacy and Sarah's favorite probiotic company, Just Thrive! Formulated by microbiologists, Just Thrive Probiotic includes four science-backed, clinically proven, super-beneficial Bacillus species. It is free of wheat, gluten, Dairy, nuts, soy, salt, sugar, artificial colors or flavors, binders, fillers, allergens, and GMO's. Stacy and Sarah only invite brands they love to be a part of this show and never endorse something they don't use themselves. Just Thrive is offering 15% off with code THEWHOLEVIEW at checkout, or follow this link! Quick Review of FODMAPs The term FODMAP is an acronym for Fermentable Oligosaccharides, Monosaccharides, Disaccharides, and Polyols. (4:10) FODMAPs are sugar alcohols and short-chain carbohydrates rich in fructose molecules. These molecules are inefficiently absorbed in the small intestine but are highly fermentable by our gut bacteria in the large intestine. Many dietary carbohydrates that have prebiotic actions are members of the FODMAP group of carbohydrates: Fructo-oligosaccharides (FOS), galactooligosaccharides (GOS), xylooligosaccharides (XOS), polyols, and fructose. These FODMAPs selectively stimulate the growth of super beneficial specific types of bacteria. They include Bifidobacteria, Lactobacillus, Akkermansia municiphila, Faecalibacterium prausnitzii, Roseburia intestinalis, Eubacterium rectale, and Anaerostipes caccae. When FODMAPs enter the large intestine full of those wonderful beneficial bacteria, they increase the metabolic activity of our gut bacteria. This increases the production of SCFAs and gasses. Because of the increase in production, we might notice even if we eat a ton of FODMAPs all at once is an increase in flatus frequency. Sarah adds that this is perfectly normal. FODMAP Intolerance Where it flips into FODMAP intolerance is when it becomes uncomfortable. (10:34) Typical symptoms of FODMAPs include bloating, gas, cramps, diarrhea, constipation, indigestion, and sometimes excessive belching. This is why a typical diagnosis is Irritable Bowel Syndrome. Some researchers even believe that 100% of IBS is caused by FODMAP intolerance. So, what causes FODMAP intolerance? There's three potentially overlapping, causes Gluten and/or Dairy sensitivity Fructose malabsorption Gut dysbiosis Gluten Sensitivity The biggest source of FODMAPs in the Standard American Diet is wheat. This is because wheat is consumed in large quantities, not because it is a concentrated source of FODMAPs. Additionally, up to 55% of the population (in North America) has gluten sensitivity genes! Symptoms of non-celiac gluten sensitivity include IBS bloating, gas, cramps, diarrhea, constipation, indigestion, and belching. PLUS extra-intestinal symptoms, such as brain fog, fatigue, lethargy, skin rash (including eczema), headaches, fibromyalgia-like symptoms (joint and/or muscle pain), carpal tunnel and peripheral neuropathy-like symptoms, depression, anxiety, and anemia 2012 double-blind elimination and challenge study showed 30% of IBS was wheat sensitivity. Stacy and Sarah discussed these genes in detail in TPV Podcast, Episode 293: Do I Have to Be Gluten-Free Forever? Dairy Sensitivity And lactose is a FODMAP! Lactose intolerance is caused a deficiency in the enzyme lactase. Rates of intolerance vary widely based on ethnicity, ranging from 5% among Northern Europeans to over 90% of the population in some Asian and African countries. In fact, in the US alone, somewhere between 30 and 50 million people are lactose intolerant! Also, epidemiological reports of cow's milk allergy (IgE antibody reactions to cow's milk proteins) range from between 1 and 17.5% in preschoolers, 1 and 13.5% in children ages 5 to 16 years, and 1 to 4% in adults. The prevalence of cow's milk sensitivities (IgA and IgG antibody reactions to cow's milk proteins) in the general population is unknown. But one study in patients with Irritable Bowel Syndrome showed that a whopping 84% of participants tested positive for IgG antibodies against milk proteins. Other Food Sensitivities Soy is also a high-FODMAP food. The rate of soy IgG intolerance in IBS is about 23%. IBS is strongly linked to food sensitivity. And up to 65% of people have symptoms resolved if they do IgG testing and eliminate all the positives. Some people eliminate FODMAPs, and their symptoms go away. So they think it's FODMAP intolerance, but it's really gluten, Dairy, soy, or other sensitivity. So, they're eliminating a ton of healthy fruits and veggies needlessly! Sarah and Stacy will get into why that's important. Fructose Malabsorption After digestion, monosaccharides are absorbed into the bloodstream by being transported through the cells that line the small intestine, the enterocytes. (20:54) Enterocytes have specialized transporters, or carriers, embedded into the membrane that faces the inside of the gut. FODMAP intolerance may be due to insufficient carbohydrate carriers, specifically GLUT5, which is the specific carbohydrate carrier for fructose. This can happen, for example, in celiac disease, where you have intestinal villous atrophy. Fructose uptake rate by GLUT5 is also significantly affected by diabetes mellitus, hypertension, obesity, and inflammation. This uptake rate is also influenced by diet! The simultaneous presence of glucose can inhibit uptake, which is why whole fruit might be tolerated where something like agave might not. Additionally, the simultaneous presence of sorbitol can inhibit this. It's important to note that while fructose malabsorption causes symptoms extremely similar to IBS, it's considered a separate diagnosis. However, due to the similarity in symptoms, patients with fructose malabsorption often fit the profile of those with irritable bowel syndrome. Stacy adds that she and Sarah are not medical professionals. If you are struggling with symptoms like those listed, it's best to arm yourself with this knowledge and seek trained professionals to help narrow down your diagnosis. Gut Dysbiosis The most likely cause of symptoms is actually Gut Dysbiosis. If there's an imbalanced gut microbiome, such as the right species for cross-feeding (or a high consumption of FODMAPs all at once), this causes a variety of digestive symptoms, For example, it has been shown that consuming fructans increases the production of butyrate. But the two main types of bacteria that ferment fructans (Bifidobacteria and Lactobacilli) are lactic acid-producing bacteria. Many other bacteria (including Eubacterium, Roseburia, and Faecalibacterium) account for this bump in butyrate production. Acetate serves as an essential co-factor and metabolite for key bacteria like Faecalibacterium prausnitzii, which requires acetate to grow. The Most Likely Culprit Studies confirmed that gut dysbiosis is the most likely culprit in IBS. This study compared participants with IBS to healthy controls. Another study detected dysbiosis in 73% of IBS patients vs. 16% of healthy individuals. This basically captures all the people with IBS symptoms that don't have food sensitivities (with some overlap) And studies confirm more gas production from FODMAP consumption in people with IBS. This study aimed to compare the patterns of breath hydrogen and methane and symptoms produced in response to diets that differed only in FODMAP content. They concluded dietary FODMAPs induce prolonged hydrogen production in the intestine that is greater in IBS. Sarah has taken part in several different breath tests in her lifetime and always finds them interesting. The problem with a low-FODMAP Diet A huge number of studies show that when people with IBS follow a low-FODMAP diet see about 75% of symptom alleviation. (32:15) But can it make the problem worse by increasing dysbiosis? Important gut health superfoods are high-FODMAP: Vegetables include: Asparagus, Brussels sprouts, cauliflower, cabbage, chicory leaves, globe and Jerusalem artichokes, garlic, onions, leeks, mushrooms, and snow peas Fruits include: Apples, apricots, cherries, figs, mangoes, nectarines, peaches, pears, plums, and watermelon Legumes and pulses include: Baked beans, black-eyed peas, broad beans, butter beans, chickpeas, kidney beans, lentils, and split peas All these foods are great for the gut microbiome! See Sarah's Gut Health Guidebook and Gut Health Cookbook for a deep dive on all of these. Because many FODMAPs have prebiotic actions, there is concern that their dietary restriction leads to dysbiosis with health consequences!. Studies do show that low-FODMAP diets both in healthy individuals and in IBS cause dysbiosis! This study randomly allocated twenty-seven IBS and six healthy subjects into one of two 21-day provided diets, differing only in FODMAP content. And then crossed them over to the other diet with ≥21-day washout period. Fecal indices were similar in IBS and healthy subjects during habitual diets. It concluded that diets differing in FODMAP content have marked effects on gut microbiota composition. And the low FODMAP diet should not be recommended for asymptomatic populations. This study associated a low-FODMAP diet with changes in the microbiota and reduction in breath hydrogen but not colonic volume in healthy subjects—the low FODMAP diet associated the reduction in Bifidobacterium and breath hydrogen in healthy volunteers. Another study in IBD shows a low FODMAP diet helped symptoms but had a significantly lower abundance of Bifidobacterium adolescentis, Bifidobacterium longum, and Faecalibacterium prausnitzii. High FODMAP & Prebiotic Supplementation Diets Interestingly, there have been studies looking at high-FODMAPs and prebiotic supplementation diets for IBS. (35:50) Studies consistently demonstrate the clinical effectiveness of the low FODMAP diet in patients with IBS. However, the impact on the microbiotaone is an unintentional consequence of this dietary intervention. This leads to an interesting paradox! Increasing luminal Bifidobacteria through probiotic supplementation is associated with a reduction in IBS symptoms. However, the low FODMAP diet has clinical efficacy but markedly reduces luminal Bifidobacteria concentration. Similarly, another study found no differences in severity of abdominal pain, bloating and flatulence, and QoL scores between prebiotics and placebo. Conclusions Food intolerance can cause IBS. In this case, identifying exact triggers through elimination and challenge is important. That way, you aren't cutting out important foods. Dysbiosis causes the vast majority of the rest. Low-FODMAP may help alleviate symptoms, but it also perpetuates gut dysbiosis. This means every time you eat a FODMAP, you'll get symptoms. They may even worsen over time. Stacy adds that we tend to focus more on what we can take away than add. We need to focus on both sides to ensure our solution to symptom relief isn't furthering the problem causing those symptoms. What to Do: The Problem of a Low-FODMAP Diet Support gut health and go slow! (42:30) Be sure to keep FODMAP consumption low enough that symptoms are tolerable while supporting gut health. Consume lots of veggies, fruits and mushrooms (Episodes 281, 286, 304, 307, 335, 346, 373, 392, 424, & 435). Eat nuts and seeds in moderation (Episodes 413 & 452). Use EVOO as your go-to fat (Episodes 326 and 414). Be sure you're consuming lots of fish, shellfish, or a fish oil supplement (Episodes 366, 415, & 451) Avoid prebiotic-enhanced foods, inulin, and overdoing one type of fiber. It's best to get fiber from whole-food sources. Be sure you're getting enough sleep, activity and are effectively managing stress. A good Bacillus-based probiotic like Just Thrive can help immensely! Plus fermented foods (not the same probiotic species, so both are important). Bacillus species (like what are in Just Thrive) are keystone species known to create a gut environment conducive to the growth of Lactobacillus and Bifidobacterium. It's also important to gradually increase high-FODMAP foods but go slow. Final Thoughts Stacy really appreciates their ability to revisit these topics and the science as it changes. (50:45) This show is all about facts, not opinions, and sometimes those facts can change. Stacy loves the idea of dieting in terms of what we can add to it to better ourselves, rather than focus solely on what we could take away. Sarah highly recommends her books, The Gut Health Guidebook and The Gut Health Cookbook, for even more information about the gut microbiome and combating the problem with a low-FODMAP diet. This show was sponsored by Just Thrive, which Stacy and Sarah both use and love! Remember, use code THEWHOLEVIEW at checkout for 15% off. Be sure to head over to Patreon for even more from Stacy and Sarah! It's a great way to connect with them and get first in line for answers to whatever questions you might have!
95 minutes | May 14, 2021
Episode 456: Foster Care and Mental Health Awareness
The Whole View, Episode 456: Foster Care and Mental Health Awareness Welcome back to episode 456! (0:28) It's foster care awareness month, and this topic is something very important to Stacy. She hopes that in talking about foster care, she can dispel some of the system's myths and miseducation. And let listeners know how they might be able to get involved even without becoming an official foster parent. Here's a list of some famous people who were once in foster care: Eddie Murphy Colin Kaepernick Steve Jobs John Lennon Marilyn Monroe James Dean Willie Nelson Ice T Louis Armstrong Cher Alonzo Mourning Source: Famous Foster Children Who Have Been Through Foster Care | EHSD Stacy wants listeners to understand that neither foster nor biological parents with children in foster care don't need to be demonized or stereotyped negatively. The goal of foster care is always reunification first, meaning the idea of having the child return to their biological family. Stacy adds that this doesn't always mean parent, but sometimes caregiver or guardian. Sometimes this is by the parent's choice for what is better for the child. Types of Foster Families There are many different types of foster families. (5:15) Many children go through the state directly. Stacy had a friend who just adopted her foster daughter this way. Others go through agencies that provide administrative and emotional support to foster families. States have many different foster care laws, so agencies will look a little different depending on where you're located. There is also Therapeutic Foster Care through an agency. This is what Stacy and her family do. They are uniquely approved to foster and adopt children and teenagers who are working to overcome trauma, abuse, or struggle with emotional, behavioral, and/or medical challenges. It involves extensive training to be licensed (not just as foster parents but also as a therapeutic foster resource family) and receives comprehensive, ongoing support. As a foster parent, you undergo investigation from extensive background checks to validating your financial independence. There is an extensive interview process families go through that involves friends and neighbors as well. And it's much more difficult than it's portrayed in movies to just "get foster kids for the money." The Goal of Reunification in Foster Care The length of time kids spend in foster care varies, but the goal is no longer than 18 months, and there are always "goals" written by the state that both sides need to abide by. In Stacy's experience, the state goes above and beyond to reunify the kids with their families. This includes support services to the biological parents. Fostering to adopt really varies from state to state. Where Stacy lives, it's only possible to be approved for both through an agency. Stacy and her family aren't wholly looking to adopt at this time. However, they wanted that flexibility if it makes sense for kiddo to stay, which is why they chose an agency that did both. The kiddo currently staying with Stacy is estimated to be with them for about a year. This is to allow proper time to evaluate the child's situation and ensure that they receive the held and care they need. Need for Foster Care The more kids in the system, the longer the process is. Stacy mentions that in her state, the need for foster care is at an all-time high. (16:01) An estimated 437,283 children were in foster care on September 30, 2018. For perspective, that's one chilling entering care every 2 minutes. On September 30, 2018, nearly one-third of these children (32%) were in relative homes, and nearly half (46%) were in non-relative foster family homes. Over half (56%) had a case goal of reunification with their parents or primary caretakers. About half (49%) of the children who left foster care in 2018 were discharged to be reunited with their parents or primary caretakers, and close to half (43%) who left foster care in 2018 were in care for less than 1 year. Stacy adds that the estimated 437,283 children in foster care on September 30, 2018, were in the following types of placements: 46% in non-relative foster family homes 32% in relative foster family homes 6% in institutions (such as juvenile detention centers as holding spots) 5% on trial home visits (State retains supervision of the child) 4% in group homes 4% in pre-adoptive homes 2% in supervised independent living 1% had run away (that's over 4k kids!) The Importance of Trust and Support Even before covid, Stacy was shocked to learn that foster kids in her state are often placed in Juvenile detention centers, not for having committed no crime but because they have no place to go. This often puts those kids on a path they would otherwise have been able to avoid in a safe, stable environment. Stacy explains that of these kids that run away, a lot of it comes down to trust. They've seen and experienced so much that they don't trust others to take care of them. So they'd prefer to take their chances on the streets. However, Stacy shares success stories where the families can establish that trust and bring the kids back in. Of those 437,283 children: 56% had a goal of reunification with parent(s) or principal caretaker(s). 27% had a goal of adoption. 5% had not yet had a case plan goal established. 4% had a goal of emancipation. 4% had a goal of guardianship. 3% had a goal of living with other relatives. 2% had a goal of long-term foster care. And of those same 437,283 children: 49% were reunited with parent(s) or primary caretaker(s).** 25% were adopted. 11% went to live with a guardian. 7% were emancipated. 7% went to live with another relative. 1% had other outcomes. Re-entry Into The System Stacy notes that kids who are returned but then later re-enter the system are a different statistic. (26:45) Re-entry in child welfare is traditionally viewed as a child exiting to permanency and then re-entering the child welfare system. Using this approach is effective for understanding child welfare practice from a single-system lens. However, it gives an incomplete picture of how children may move between related child-serving systems. The present study expands the definition of re-entry by examining re-entry for 2259 children who either return to the child welfare system or move into the juvenile justice system after reunification from foster care. When measuring a broader concept of re-entry (into either system), the rate of re-entry went from 18% to 25% (a 33% increase!) Sarah asks about statistics on why there is so much re-entry. A lot of children end up needing care due to the epidemic of drug use. Relapse is a very real problem in recovering addicts and can easily result in children once more needing care. The amount of support given to families while the kids are in the system is fantastic. However, once the kids go home, the families are once more on their own. Stacy believes better transitional programs would help. Stacy also notes that a child entering foster care will likely live in more than four homes during the first year of care. If things don't go "as planned," it's common for children who grow up in foster care to move more than 15 times. Each move can mean falling further behind in school and having to make new friends. Parental Rights And Outcomes Stacy has 4 foster kids in her home in the last 18 months. 3 had a goal of reunification: 2 are still on that path while 1's parent chose to terminate parental rights. (30:10) If parents are unable or unwilling to meet the goals established when the child enters the system, either the state or the parents can choose to terminate parental rights. This can be voluntary or involuntary. For teenaged children also have significant input in the decision. The state tries to support parents as much as possible to reunify with addiction treatment, therapeutic services for abuse, helping them get financial support, etc. Stacy reminds listeners that terminating parental rights isn't something to be demonized. Sometimes, having the biological parent act as the primary caregiver isn't what's best. In this case, terminating rights gives the child a chance at getting adequate care and support to flourish. And it doesn't mean the parent relinquishes any and all relationship with their child. The 4th child that stayed with Stacy had a goal of adoption. However, it was not their outcome. They had been in the system for 4 years (in multiple institutions, group homes, and over a dozen foster homes), and sometimes trauma from consistent rejection and abandonment can be too much. Every case is different. Outcomes can be influenced by many different, complex reasons, including the child no longer wanting to be with that family anymore. Respite Families as a Way to Help Everyone needs to be happy with the placement, including the parents and the child. This is why many agencies have "short-term placements" while finding the best fit for the child's situation. Respite is also a program for families, biological or like Stacy's, who just need a week or so for a break to breathe. Stacy has both used respite and been a Respite family. Respite isn't like a "time out" or a failure. Stacy has fostered the same kids repeatedly while acting as a respite for another family because you get to know these kids, and having them come stay with you for another week is exciting. Maslow's Hierarchy of Needs Maslow's Hierarchy of Needs is based around this idea that there's a broad hierarchy of basic human needs that are universal. (36:50) Sarah adds that this concept has received some criticism over the years of its existence because many cultural and biological things can impact needs. However, it's commonly excepted as a general umbrella of human needs. Maslow's theory states you can't move up to the next stage without meeting all the levels below it first. And you have to address all the base needs before reaching your best self. Foster kids, statically, struggle with school. Stacy explains that it's hard to occupy yourself with math when safety needs aren't being met. Attachment, food, safety, and shelter are things that come up again and again as something these kids have had ripped away from them. So even though you know you're providing it to them, it's difficult for them to let their guard down. Foster Care Support For Families Each child entering into the system have a team of people to help them and their families throughout the process. (44:50) CASA is a volunteer position and is perfect for people who want to be involved and help but cannot serve as a foster family. They advocate for what the child wants. GAL is a legal advisor to act as a judge for what that child wants. The child and the biological family each have their own court-appointed lawyers to help see them through the legal side of the process. A DSS worker is a legal guardian for kiddo while they're in care. They sign school forms, medically advocate for the child, and take on other roles usually held by a legal guardian. They have medical service providers and treatment providers, such as wrap-around services, to prevent foster care, intensive in-home therapeutic services, and therapy for both the child, biological parent and foster family. Stacy also has a 'therapeutic foster care worker' and a team of supervisors who support her as a foster resource parent and family because it's a lot! Over Medication of Youths In 2010, the Tufts Clinical and Translational Science Institute estimated that the rate of psychotropic medication use for youths in foster care is anywhere from 13 to 52%. This is compared to about 4% for youth in the general population. A 2014 Government Accountability Office (GAO) report found that at least 18% of children in foster care were taking at least one psychotropic medication. Some of the medications have not even been approved as safe and effective for children by the FDA. Children with one consistent caseworker have a 75% of permanent placement while those with 2 drops drastically to 17%. Those with 3 or more have a .1% chance of being placed! She wished tons of things differently, but Stacy genuinely sees kids' best interests at play. Covid And Foster Care Stacy notes that Covid has had a significant impact, and the system is so overwhelmed it cannot provide adequate safety for many. (59:15) They are expecting a significant increase from the 2018 numbers in 2020 due to the pandemic. Sarah shares these news articles she's found on Covid on the foster care system: N.Y. Times The Nation The Impact of Covid-19 on Youth in Foster Care | Forbes www.acf.hhs.gov Coronavirus Throws Foster Care System into Crisis | The Marshall Project Issues can stem from families not wanting to foster anymore because they're afraid it might bring covid into the home. Others can be from families now overwhelmed with the kids being home and unable to provide adequate care or put the kids in dangerous situations. Systematic Child Welfare Stacy is privileged to live in an area with the funding for all the roles and programs offered to these kids. (1:05:30) In fact, white families are more likely to prevent foster treatment than black or brown parents. A seminal 2017 study found that a shocking 53% of Black children in the U.S. will be investigated as potential victims of child abuse by age 18. That's 16% higher than the rate for all children! Despite studies showing no relationship between race and child maltreatment, Sarah points out that systemic racism could fuel it. Once in the system, black children also are more likely to stay in foster care, less likely to be reunified with their families, more likely to be placed in group care, age out in greater numbers, and become involved in the criminal justice system. The pipeline that feeds youth in foster care into the adult criminal system has an especially harmful impact. As of 2015, black youths were 5x as likely as white youths to be detained or committed to juvenile justice facilities. In 2019, The Kansas City Star surveyed nearly 6,000 incarcerated people in 12 states, and 1 in 4 responded that they had been in foster care. Black children are separated from their families and placed in foster care at a far higher rate than white children, often repeatedly. In 2019, Black children accounted for 23% of the children in foster care, although they make up only 14% of the country's children age 18 or younger. They are also more likely to be placed in a group home where they face additional trauma and abuse. Notable Cases In a devastating tragedy earlier this year, staff members restrained and killed a 16-year old black boy, Cornelius Frederick, while being held in a for-profit foster care group home facility. (Source) Another example is Ma'Kai Bryant, a black foster teen fatally shot earlier this year. Stacy is confident Ma'Kai's situation would have ended differently had she had the treatment team Stacy's kiddos were fortunate enough to have in their corner. They can call a social worker for concerns, process, or cope, rather than having to wait until a physical altercation to call the police. Stacy breaks down the following are the races and ethnicities of the estimated 437,283 children in foster care on September 30, 2018: 44 percent were White 23 percent were Black or African-American 21 percent were Hispanic (of any race) 10 percent were other races or multiracial 1 percent were unknown or unable to be determined The percentage of Black or African American children in care on September 30 decreased between 2008 and 2018, while the percentages of White children, Hispanic children, and children of other races or multiracial children increased. Aging Out of the Foster Care System There is a huge lack of support for children as they turn 18 and age out of the foster care system. (1:15:00) Within four years of aging out, 70% will be on government assistance, and about half will not complete high school. Only 3% of youth in foster care graduate from college, and 25% are incarcerated within 2 years. (Source) Children and adolescents with foster care experience are diagnosed with PTSD at twice the rate of U.S. war veterans. Within four years of aging out, 50% have no earnings and those who do make an average annual income of $7,500. After foster youth ages out, homelessness and unemployment become a huge issue linked to increased risk of drug addiction, unwanted pregnancy, and human trafficking. Trafficking Risk In the U.S., 60 percent of domestic child trafficking victims have a history in the child welfare system. Traffickers target youth in foster care because of their increased vulnerability due to a lack of family and emotional relationships and support. 74% of child trafficking cases involved sex trafficking, and the majority of those involved pimp-controlled prostitution. According to the National Center for Missing and Exploited Children, the average age of child sex trafficking victims is 15, according to the numbers of children reported missing. Source: Child Sex Trafficking - Children's Rights The overwhelming majority of missing children reported are endangered runaways. The statistics tell us that 91 percent of missing kids reported missing were children running away from home or foster care last year. The second highest rates of missing children were abducted by a family member who did not have custody. Less than one percent were non-family (stranger) abductions. For more info, see Child Sex Trafficking (missingkids.org) This is why foster care families, support, and funding are so important for these kids. We need ongoing support after they age out or reunify with their families. LGBTQ+ A 2019 study found 30.4% of youth in foster care identify as LGBTQ+ and 5% as transgender, compared to 11.2% and 1.17% of youth not in foster care. The Williams Institute also found that around 40% of unhoused youth identify as LGBTQ+. LGBTQ+ unhoused youths are roughly 7.4x more likely to suffer acts of sexual violence than heterosexual unhoused youths who have been in foster care. Without safe foster care placements and without the vital support of caseworkers and other child welfare professionals, LGBTQ+ youths often flee abuse in foster care only to face homelessness and exploitation. What Can We Do? One of the best things you can do is volunteer and donate time, money, or goods. (1:24:45) There's a huge need for foster parents, but it's not always feasible. Other ways you can help are through respite, becoming a CASA, or providing resources for agencies or families. Talk openly and honestly about what foster care is and what it isn't. There are so many misconceptions from T.V. and film, and people often assume the worst. You can donate a "birthday box" through Together We Rise, a non-profit organization that will ensure a kid with the same birthday gets a pre-packaged birthday box to their social worker. You can support kiddos aging out of foster care through the Dreammaker's Project Shop, where kiddos' creations are available for purchase. Stacy has personally bought the spices and artwork cards! Dreammaker's Project allows you to sponsor kids aging out who need basic needs to survive. This helps provide things like bus money to get to their job or for a computer to finish school. You can also donate or sign-up for a children's rights membership at Children's Rights (convio.net) Stacy's specific Agency, UMFS, is always looking for support. Or you can find one in your local area by donating goods (like suitcases and car seats) they may need, your own time, or money. This month, Stacy will be donating 20% of all her proceeds from Beautycounter to these organizations. Last month, she raised $2500 for Children's Rights, which fights for systemic change. Just $1 donated is equal to $100 into the system because of the broad impact it makes. Final Thoughts These kids don't have access to that next-level diet and lifestyle that's so often talked about on this show because they're struggling with basic needs. (1:30:00) There's so much room to nurture these kids by showing that support and avocation to the foster care system. How can you be worried about health from non-toxic living if your life is in danger and aren't safe and stable? The Whole View has always advocated for health, wellness, and safety for all, and while we talk about our personal wellness, there's a lot more going on out in the world. Being a foster parent is not easy, but it's so rewarding. Stacy has learned so much from these kids, and they deserve to be just as well, healthy, and safe as everyone else. Thank you so much for joining us this week! For more behind the scenes on this topic, be sure to join us on Patreon for exclusive content.
93 minutes | May 7, 2021
Episode 455: Covid-19 Vaccines - Real World Data and Updated Vaccine Studies
Welcome to episode 455 of The Whole View! This week, Stacy and Sarah discuss the data from updated vaccine studies in terms of what we knew in previous episodes. If you enjoy the show, please review it on iTunes! The Whole View, Episode 455: Covid-19 Vaccines - Real World Data and Updated Vaccine Studies Welcome back to episode 455! (0:28) This is the next part in a series of shows where Sarah and Stacy discuss the science behind the Covid-19 vaccines. Sarah and Stacy will be discussing updated vaccine studies from previous episodes. So be sure to check those out before jumping right in: In episode #440, we examined the history of vaccines, the very real statistics on vaccine-induced injury, and the advances that led to mRNA vaccine technology, along with the inherent advantages of this platform. Episode #441 looked at the safety and efficacy data from the phase 2/3 clinical trials for both the Pfizer/BioNTech and the Moderna covid-19 vaccines, including subgroup analysis. In episodes #443 & #444, we answered listener FAQ, including concerns about adverse events including autoimmune disease, fertility, antibody-enhanced infection, the current state of evidence regarding safety concerns for pregnancy and children. We addressed common myths circulating on the internet. And last week, on episode 454, we looked at how adenovirus vaccines work and the safety and efficacy data from the phase 2/3 clinical trials for both the Johnson & Johnson & Janssen and the AstraZeneca/Oxford University vaccines, including a deep dive into immune thrombotic thrombocytopenia (what the news is reporting as a rare type of blood clot). All five episodes took a data-driven approach, presenting the science and facts with context, detail, nuance, integrity, compassion, and as objectively as possible. Stacy reminds listeners that she and Sarah are not medical professionals or here to tell anyone what to do. Their only goal is to pass along the science to allow you to make an informed decision that works best for you. Personal Experiences with Covid & Vaccination Sarah and Stacy first share their personal experiences with Covid-19. (7:01) As many may remember, Stacy got Covid in April of last year and is one of the estimated 10% that end up with "long hauler" Covid. She shares how that's impacted her life for the last year and techniques she's utilized to cope with it, such as focusing on nutrient density and getting enough sleep. Stacy also took the first vaccine appointment she gets, which was for Moderna. She talks a bit about the mild side effects she experienced. And how the vaccine has actually shown treatment benefits to people, like Stacy, that have developed long-hauler symptoms. Sarah, on the other hand, was lucky enough to avoid getting infected with Covid. She and her family have lived relatively isolated for the past year. And she is looking very forward to seeing people outside of her immediate family again. She managed to book a vaccine appointment that was a cancellation. So she had about 3 hours' notice to get there and had no idea which vaccine she was getting. Although, she would have taken whichever they had available. She shares what side effects she experienced after vaccination, which were a little more on the moderate side than many. Stacy notes that one of the things she appreciates in previous Covid shows was that Sarah looked into the possibility of adverse side effects. She notes, however, that if the audience doesn't hear about any of those adverse effects in this show, Stacy and Sarah aren't ignoring them. It's because they covered them in other shows. Updated Vaccine Studies on mRNA Vaccines Last week, Sarah talked about how the mRNA vaccines slightly altered the spike protein to maintain its prefusion conformation. (24:35) She erroneously said postfusion. And, this makes sense since we want the immune system to neutralize the coronavirus before it binds to our cells. Pregnancy & Lactation There's a lot more data available for how the vaccine impacts pregnant women than when Sarah previously covered it. (25:55) V-safe is the community monitoring program for the vaccine. Sarah recommends every sign-up for it regardless of if you're pregnant because it's where a lot of this data comes from. It even allowed for this study on pregnancy outcomes. A total of 35,691 v-safe participants 16 to 54 years of age identified as pregnant received either mRNA vaccine. Authors conclude: "preliminary findings did not show obvious safety signals among pregnant persons who received mRNA Covid-19 vaccines. However, more longitudinal follow-up, including follow-up of large numbers of women vaccinated earlier in pregnancy, is necessary to inform maternal, pregnancy, and infant outcomes." This prospective study in pregnancy & lactation study included 131 participants pregnant and lactating women. No differences were noted in reactogenicity across the groups. Vaccine-induced immune responses were significantly greater than the response to natural infection. And immune transfer to neonates occurred via placenta and breastmilk. Another lactation study in Israel took breastmilk samples from 84 women for 6 weeks starting 2 weeks after 1st shot. Sarah explains that this indicates getting the vaccine while pregnant or breastfeeding is protective for the fetus and/or baby. All studies showed zero increased concern for pregnant women as compared to nonpregnant women. Sarah does note, however, that pregnancy puts you at greater risk for a more severe infection of covid-19, as well as a greater risk of mortality. Real-World Data & Breakthrough Infections Sarah reminds listeners of the roughly 95% effectiveness shown in the phase 2/3 clinical trials for both mRNA vaccines. And that studies defined infection as 1 or 2 symptoms plus positive test. (36:01) We now have studies showing effectiveness against asymptomatic infections too! A study of providers tested 3,950 healthcare personnel, first responders, and frontline workers with no documented SARS-CoV-2 infection in six states between Dec. 14, 2020, and Mar. 13, 2021. They were tested every week, meaning this study captured asymptomatic and symptomatic infection. Under real-world conditions, mRNA vaccine effectiveness of full immunization was 90% against SARS-CoV-2 infections regardless of symptom status. And Vaccine effectiveness of partial immunization was 80%. A study of pre-procedural screening at Mayo Clinic looked at 39,000+ asymptomatic adult patients screened before procedures that mainly required general anesthetic. 1 dose prevented 72% of asymptomatic infection, and 2 doses prevented 80% of asymptomatic infection. Sarah generalizes a: 10% to 20% breakthrough infection rate, ½ to ¾ of which are asymptomatic, and the vast majority of the remaining are mild to moderate cases after vaccination. This is amazing news - it means the vaccines prevent even most asymptomatic infections and stop 80% to 90% of people from passing along the virus. This is great news for herd immunity! Here is even more real-world breakthrough infection data. Updated Vaccine Studies for the Second Dose An analysis of cases the week of April 12-18 showed ~21,000 of the roughly 470,000 people who tested positive for covid-19 had received their first dose only. Most of this happened within the first two weeks before hitting that 70-80% effectiveness. (43:45) The second dose not only increases your individual protection but it's also designed to make your immunity last longer. Approximately 8% (that's about 5 million people) have skipped their second dose. This is due to vaccine distribution centers not having the same kind or running out, people getting scared by the side effects of the first dose, or think they only need one dose because they had covid-19 already. Even if you have a breakthrough case, you may not be as contagious as if you weren't vaccinated. That is not to say you aren't contagious! Israeli researchers found that people who had been vaccinated with the Pfizer-BioNTech vaccine and later contracted an infection had lower viral loads than unvaccinated people who contracted an infection (source here and source here) The higher the viral load, the more virus is shedding, which means you're more contagious. This is great for herd immunity! But it's also why it's still prudent to wear a mask indoors or in crowded outdoor areas, socially distant when possible, and wash hands properly and prudently even after getting vaccinated. How long? Until infections are at a low enough level that we can go back to contact tracing every infection. Variants of Concern Coverage by Vaccines Sarah reminds listeners that Covid-19 is a very slow mutating virus. (52:25) However, due to its high rate of transmission and infection, it has had many opportunities to mutate. And this is where we're getting the different variants reported around the world. However, these variants are still not different from the original virus to be considered different strains. Recent research from Pfizer looked at 44,000 people worldwide and found that the vaccine remained 100% effective against severe disease and death. This included people in South Africa who were predominantly exposed to the B.1.351 variant. Real-world data also shows that the Pfizer vaccine held up against the B.1.1.7 variant, which was first detected in the United Kingdom. Even in an area where B.1.1.7 was the dominant strain, the vaccine was 97% effective against symptomatic COVID-19, hospitalizations, and death. Pfizer and Moderna are both testing the 3rd shot that we could get as early as this fall. Both will be a booster to prolong immunity. However, they will offer more complete coverage for the variants of concern, including B.1.351, B.1.1.7, and P1. Monoclonal Antibodies for COVID-19 There are also some interesting antivirals being tested. These would be similar to Tamiflu but for covid and hopefully with better efficacy. (1:01:30) There are some promising therapies, too, including monoclonal antibody therapies. They need to be infused (IV) but are highly efficacious. This is especially true when given early in the disease course. Eli Lilly's Bamlamnivimab is also a cool treatment for exposed people but not necessarily infected yet. Regeneron's Casirivimab and Imdevimab are other notable treatments being studied. Sarah adds that some drugs are still used to prevent or treat Covid when there's no science for it. Hydroxychloroquine is still used in some circles and shown to potentially worsen outcomes. And now we see Ivermectin, which is an anti-parasitic mainly used for animals. Neither are safe or studied! There is no natural remedy for fight Covid-19. There are things you can do better your health to better prepare or to take precautions. But without science, this isn't something that's going to naturally go away. Data from updated vaccine studies show a very low chance of catching covid-19 from surfaces (about 1 in 10,000). It's still prudent if someone in the house has been exposed or has it, for example. But we can stop disinfecting groceries. You can skip wearing a mask outdoors if you can socially distance but should still wear one in crowded outdoor spaces, especially if already vaccinated. Wearing a mask indoors is still super important. 6 feet is not enough indoors without a mask, and, depending on airflow, 30 feet is what science suggests. With everyone wearing a mask, studies of kids in schools show 3 feet is a safe distance. The best prevention is vaccination combined with masks, distance, and hygiene. Notable Updated Vaccine Studies Menstruation irregularities should be added to the vaccine side effects list. (1:09:30) This is finally being studied, but we don't currently have an estimated frequency like other side effects. One thing researchers are doing is to look at the frequency data after the HPV vaccine. The vaccine was associated with increased age-adjusted odds of hospital visits for an abnormal amount of menstrual bleeding, irregular menstruation, and severe headaches. Sarah explains this is due to cortisol which increases during infection. This increase is directly related to disease severity. There is a large cross-talk between the HPA axis, thyroid, sex hormones, and immune system. Menstrual irregularities are caused by dysregulated cortisol and can also happen after infection. It's a normal side effect of the flu, for example. Illnesses can sometimes pause ovulation and delay your period. Stress from the flu can lead to changes in your periods or even amenorrhea. This was studied in a clinical trial in influenza vaccine as well! There is no information supporting permanent fertility issues. Pfizer has asked for its EAU to be extended to 12 to 15-year-olds. We'll have that detailed data to pour over soon, but what we know so far: 2,260 younger adolescents ages 12-15 100% efficacy against symptomatic infection This study used the same two-shot regimen that is being used in adults. The study also found that younger adolescents who received the vaccine produced more coronavirus antibodies than 16- to 25-year-olds in an earlier study. Vaccine side effects were similar to what was seen in this older age group. Stacy reminds listeners that kids can be asymptomatic carriers, and we don't know what this could do to children's health long-term. Sarah also explains that different variants can affect the younger age groups differently than the original virus. For example, outbreaks could cause more severe infections in children and young adults. Final Thoughts Stacy loves how inquisitive this audience is and how dedicated you are to science. (1:28:01) Did you hear about what Spain is doing?! If you have any additional questions or concerns regarding these covid shows, Stacy and Sarah encourage you to reach out on Patreon. If you haven't joined the Patreon family yet, your subscription goes directly to supporting this podcast. You'll also gain access to bonus content, including what Sarah and Stacy really feel about the topics they discuss. Plus, any questions or comments submitted through Patreon take precedence! We appreciate you! Thank you so much for listening, and we will see you next week!
85 minutes | Apr 30, 2021
Episode 454: J&J and AstraZeneca Covid-19 Vaccines
The Whole View, Episode 454: J&J and AstraZeneca Covid-19 Vaccines Welcome back to episode 454! (0:28) This is the next part in a series of shows where Sarah and Stacy discuss the science behind the Covid-19 vaccines. They strive to present you with all the information available to make an informed decision about whether receiving the vaccine is right for you. Sarah plans to go through the show with the assumption that listeners have background/base knowledge about vaccines and how they work. So if you have not yet listened to the previous shows in this series, Sarah highly recommends you do before listening to this episode. Previous Covid-19 Shows In episode #440, Sarah and Stacy examined the history of vaccines and the very real statistics on vaccine-induced injury. They also looked at the advances that led to mRNA vaccine technology and the inherent advantages of this platform. Episode #441 explored the safety and efficacy data from the phase 2/3 clinical trials for both the Pfizer/BioNTech and the Moderna covid-19 vaccines. In episodes #443 & #444, Sarah and Stacy answered listener FAQ. This included concerns about adverse events, including autoimmune disease, fertility, and antibody-enhanced infection. They also examined safety concerns for pregnancy and children and addressed common myths circulating on the internet. Stacy and Sarah took a data-driven approach for all four episodes, presenting the science and facts with context, detail, nuance, integrity, compassion, and as objectively as possible. Fact vs. Opinion on The Whole View Stacy underlines that they are not here to convince you of a certain mindset or push a vaccine agenda in this show. Although Stacy and Sarah may share their personal opinions on vaccines, they remind the audience that their opinions are just that - opinions. And what's right for them might not be right for you. They strive to take this same scientific approach today and next week with the J&J and AstraZeneca Covid-19 vaccines. (Yes! You're getting two more vaccine shows!) Stacy also reminds listeners of Sarah's credentials and that she had a Ph.D. in research science. Like the other shows, they will address the rumors, concerns, and myths. It's critical to walk through the facts first. And remember- facts don't have opinions. Stacy and Sarah's primary agenda is to give the data for you to interpret for yourself. Adenovirus Vector Vaccines J&J and AstraZeneca Covid-19 vaccines are both DNA vaccines that use an adenovirus vector. The concept is similar to the mRNA vaccines but not wholly the same. (5:20) Sarah reminds the audience that to make proteins, DNA is first transcribed into mRNA, which is then translated into protein. So, both J&J and AstraZeneca vaccines deliver instructions to make the full-length covid-19 spike protein. Only slightly different from the instructions for the mRNA vaccines, which have a couple of mutations to stabilize the tertiary structure into what's called the postfusion conformation and the transmembrane anchor added Both adenovirus vaccines encode full-length spike protein without the postfusion conformation stabilization mutations (say that 5 times fast!) but still add the membrane anchor. Sarah recommends this source for more information. So, these work similarly to the Pfizer/BioNTech and Moderna mRNA vaccines. However, J&J and AstraZeneca Covid-19 vaccines require two steps to make the spike protein instead of one. They also require a special delivery agent to get into the cell nucleus. That's where adenoviruses kick in! Adenovirus Vectors Research There are about 50 years of research on adenovirus vectors as DNA delivery vectors. (8:48) Adenoviruses are basically common cold viruses that can cause illnesses ranging from cold-like symptoms to bronchitis, gastroenteritis, and conjunctivitis. They are non-enveloped DNA viruses that can't alter our DNA because (unlike retroviruses such as HIV or lentiviruses) wild-type adenoviruses do not carry the enzymatic machinery necessary for integration into the host cell's DNA. Basically, they do not enter our cell's DNA. Adenoviruses deliver DNA that can enter the cell nucleus, are transcribed into mRNA, leaves the nucleus, and then translated into protein. That's exactly what makes them good vaccine platforms for infectious diseases. I used adenovirus vectors (Ad 5, the same used in the Russian sputnik V and China's CanSino covid-19 vaccines) for gene therapy research during my Ph.D. and even have a patent using them! Different Adenovirus Serotypes There are at least 88 human adenovirus types. Most serotypes cause mild illness, although data links adenovirus serotype 7 with more severe illness. (12:25) When used for gene therapy research or vaccines, research engineers them to be incapable of replicating and causing disease. There are adenovirus vector vaccines already in use. The rabies vaccine our pets get and the Ebola vaccine. One problem with using adenoviruses in vaccines is that people may already have antibodies to them, overwhelming them before they can do their assigned work. Researchers get around that issue by using adenoviruses that humans are unlikely to have encountered before. The AstraZeneca/Oxford vaccine uses the ChAdOx1 platform based on a modified version of a chimpanzee adenovirus (causes colds in chimps and nothing in humans). The Johnson & Johnson & Janssen (J&J) vaccine uses a proprietary AdVac platform made up of recombinant human adenovirus (adv26). It's the same platform used in the company's Ebola virus vaccine (approved in Europe) and its investigational Zika, RSV, and HIV vaccines. Adjuvants in J&J and AstraZeneca Covid-19 Vaccines Like the mRNA vaccines, J&J and AstraZeneca Covid-19 vaccines don't require an adjuvant. (14:40) Stacy and Sarah talked about adjuvants in-depth in previous episodes. The viral vector itself helps to prime the immune system in a specific way to fight a virus- not generally the way aluminum-based adjuvants do. Then the real stimulant is the spike protein our cells make. The interesting thing about viral vector DNA vaccines is that our bodies react to it the same way as if we were actually sick with the illness. Therefore, we get the same immune benefits as natural illness, minus the coronavirus's ability to manipulate the immune system and even more robust and durable immunity. Stacy shares that she was very surprised at how clean they were when she reviewed the vaccine ingredients. Sarah confirms this, saying newer vaccines (such as the recent ones for Covid) are missing many ingredients from early vaccines that cause many people to be hesitant about getting vaccinated. Ingredients in J&J: Recombinant, replication-incompetent adenovirus type 26 expressing the SARS-CoV-2 spike protein Citric acid monohydrate and trisodium citrate dihydrate - pH buffering, both naturally found in citrus fruit Ethanol 2-hydroxypropyl-β-cyclodextrin (HBCD), cyclic oligosaccharide containing seven D-(+)-glucopyranose units that are widely used to improve the aqueous solubility of various compounds, especially those containing a phenyl group, toxicology studies show very safe Polysorbate-80, emulsifier, pretty safe option Sodium chloride (aka salt) Source for Reference Both AstraZeneca and J&J Covid-19 vaccines have reported that their vaccines were well tolerated with no serious safety concerns. However, there have been recent reports of blood clot issues, which Sarah and Stacy will cover. J&J and AstraZeneca Covid-19 Vaccines Clinical Trial Results Like the mRNA vaccines, scientists could develop them quickly because of the decades of research scientists built from. (22:50) It's the same technology used in rabies vaccines for our pets and the Ebola vaccine (the only widespread vaccine used in humans). Johnson & Johnson One-shot (they are testing a 2-shot version test for efficacy increase) Stable at normal refrigerator temperatures, so cold-chain requirements are easier J&J Vaccine Fact Sheet FDA Fact Sheet for J&J Safety and Efficacy of Single Dose Efficacy against symptomatic disease 66.9% Vaccine efficacy was higher against severe–critical Covid-19 (76.7% and 85.4%) Prevented 100% of deaths from covid-19 No observable differences in vaccine efficacy according to sex, race, or ethnic group Similar to mRNA vaccines, no red flags from a safety perspective came up -- The incidence of serious adverse events balanced between the vaccine group and placebo. AstraZeneca Two shots 62% effective against symptomatic disease 100% against severe disease, hospitalization, and death Again, no red flag from a safety perspective Source for Reference What About Adverse Side Effects? Stacy points out that the media always leads with the lowest number of something potentially problematic instead of leading with the bigger number, such as preventing 100% of deaths. (24:50) Sarah adds that the risk of developing a treatable reaction isn't the worst thing if the same treatment is keeping you from something way more serious - such as death. Stacy shares that it's not just the death toll, it's the risk of future complications and the way the symptoms can linger for months- two things she has personally experienced after having Covid last spring. She hates how the media is so ready to focus on the drama of the vaccine but completely skips over how much it's actually doing to protect us despite those few risks. AstraZeneca Not Approved In US Sarah explains that AstraZeneca's US trial is still ongoing and not yet approved for use. (34:00) However, she points out that no "red flags" were presented during the clinical trials for either of these vaccines. That's important to put into context since both have shown complications when used in the community (which researchers expected, and Sarah explains why). The delay in the AstraZeneca trial lasted nearly seven weeks in the fall due to an adverse reaction in a UK participant. This was later determined as unrelated to the vaccine. The initial trial results in November puzzled many experts from all around the world: The company combined data from its Brazil and UK groups, even though they had different sample sizes and demographics. It also averaged the results of two different dosing regimens (one administered by mistake). Just 12% of participants in AstraZeneca's UK and Brazil trials were over 55 (but one quarter will be in US trial) Now, scientists hope that results from AstraZeneca's US trial will clear up much of the world's confusion. According to a press release, key interim results of the trial, which included more than thirty thousand participants, and the data looked excellent. The vaccine appeared to be 79% effective at preventing "symptomatic COVID-19." The press release said that no one given the vaccine in the trial became severely ill, hospitalized, or died due to COVID-19. Also, the study did not turn up any serious safety concerns. They'll likely apply for an EAU in the states in the next month or two. Why The Pauses Were Important The pause allowed the collection of more data to see how prevalent this adverse effect is. This way, they can find more cases, and the total was 15 out of about 8 million doses had this effect. The pause gives researchers time to educate patients on what to look out for and doctors on what to test for and how to treat. Sarah stresses that this is so important! Here's some perspective: For one million J&J shots, researchers expect about 2 cases of TTP This contrasts with over 2,000 fewer deaths and 6,000 fewer Covid-related hospitalizations It's important to know that the agencies tasked with community monitoring are actually doing their job. This is how it's supposed to work! New stories have called this pause a bad thing, which has increased vaccine hesitancy. The media then inflamed the issue in an inaccurate and unhelpful way. Yes, plenty of people way they want Moderna or Pfizer instead of J&J right now. However, it takes time to educate people. Journalists need to focus on how the system works the right way to protect us instead of increasing fear. Just because AstraZeneca isn't approved yet doesn't mean it's unsafe. It means researchers want to devote enough time to understand the data as much as possible. Moderna, Pfizer, J&J and AstraZeneca Covid- 19 Vaccines Sarah explains that it's impossible to make an accurate comparison of efficacy between these trials. (47:10) Tests performed at different times, in different countries, with some variants may have impacted results. For example, the USA tested Moderna first, and now we see it undergoing testing elsewhere. The USA and Germany originally tested Pfizer (before B.1.1.7 became dominant). It is now undergoing testing elsewhere. Argentina, Brazil, Chile, Colombia, Mexico, Peru, South Africa, and the United States tested the J&J vaccines. Brazil, South Africa, and the UK tested AstraZeneca initially. It is now running trials in the US, Japan, Russia, Kenya, and Latin America. Also, many areas define "symptomatic reactions" often vary. Sarah explains that to actually and accurately compare, we'd need a head-to-head trial with far fewer variables. What About the Blood Clots? Stacy decides now is the time to talk about the elephant in the room: the reported risk of blood clots from the J&J vaccine. (52:45) Sarah explains that this is nowhere near clot risk from birth control pills (some many women take regularly), which is 1:1000. Also, it isn't a good comparison. "Run-of-the-mill" embolisms or thrombosis are easily treated. However, large ischemic stroke or myocardial infarctions, pulmonary embolism are more serious. The rates of these types of blood clots after the vaccines are about what you'd expect in the population normally. However, this rare adverse event following J&J and AstraZeneca Covid-19 vaccines is NOT run-of-the-mill. https://www.bmj.com/content/372/bmj.n774 Cerebral venous thrombosis and portal vein thrombosis risk is 10x higher after covid-19 than after AstraZeneca vaccine https://www.bmj.com/content/373/bmj.n931 Immune Thrombotic Thrombocytopenia (ITT) Sarah underlines that calling this side effect "blood clots" isn't entirely accurate. What's actually happening ITT- an autoimmune response. Immune Thrombotic Thrombocytopenia (ITT) is blood clotting at the same time as low platelets. However, if treated properly and promptly, ITT is very treatable! This is so important because the normal way you treat blood clots (blood thinners like heparin) can cause death by hemorrhage. With ITT, mortality is high (~90%) if untreated. The median age of onset 40 years and, like most autoimmune diseases, has a 3:1 female-to-male ratio. Stacy also reminds listeners that autoimmune diseases cannot be "caused" by something. Immune diseases are latent in the system until triggered, which is bound to happen at some point regardless. Autoimmune suffers aren't necessarily at higher risk. Some HLA risk alleles for other autoimmune diseases protect against TTP, and many don't increase risk at all. GREAT REVIEW PAPER https://www.nejm.org/doi/full/10.1056/NEJMe2106315 https://www.nejm.org/doi/full/10.1056/NEJMoa2104882 Importance of J&J and AstraZeneca Covid- 19 Vaccines First, it's cheaper to make, ship, and store. So, they can get to places that are really tough to get the mRNA vaccines to, like rural America and developing nations. (1:12:10) Stacy and Sarah remind the audience that the pandemic isn't over until the whole world is protected. The high infection rates lead to the variants of concern, which we'll talk a bit more about next week. This virus mutates slowly, but it has so many opportunities to mutate because of high infection rates, including in the USA. J&J is great for people who dislike needles, unhoused people, and people with schedules that make getting the second shot hard (e.g., truckers or flight attendants who travel a lot). More References for J&J and AstraZeneca Covid-19 Vaccines Watanabe, Y. et al. (2021) Native-like SARS-CoV-2 Spike Glycoprotein Expressed by ChAdOx1 nCoV-19/AZD1222 Vaccine. ACS Central Science, See source here https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31604-4/fulltext Final Thoughts These vaccines are just more tools in our toolbox to get through this pandemic. (1:15:10) Stacy and Sarah have dedicated the last 8 years to do this podcast to focus on everyone's health, safety, and wellness. Stacy adds that we often get so caught up in our own health, wellness, and safety that we forget part of what a vaccine does is protect others. It's easy to be fearful and hesitant because there's so much to the science that an average person might not easily understand. And the more the media talks about it from a negative perspective, the less confident people get to go and get something that might be lifesaving- not just for themselves but others around them. Stacy takes a minute to talk about the difference between one mild/moderate complication right after the vaccine (heavier period) compared to more long-term complications from "long hauler syndrome" (brain fog, i.e., brain damage). Stacy reminds listeners that Patreon is a great way to connect. So if you haven't joined the family yet, be sure to pop over for bonus content like how Stacy and Sarah really feel about the topics they discuss. Thanks so much for listening, and we'll see you next week!
77 minutes | Apr 23, 2021
Episode 453: Should We Eat Breakfast Before 8:30am?
The Whole View, Episode 453: Should We Eat Breakfast Before 8:30am? Welcome back to episode 453! (0:28) Stacy reminds listeners that science is an evolutionary process and, like life, things are constantly changing and growing. The Whole View has years of shows that may contain outdated science. Both Stacy and Sarah feel it's important to bring some of these episodes back to the forefront and re-examine how science has changed. So in honor of revisiting some of our favorite shows with the updated science, Sarah decided to start with re-examining the science behind eating (or not eating) breakfast before 8:30am. See Episode 381: Is Breakfast the Most Important Meal of the Day? for more notes from the last episode! Updates Stacy reminds listeners that when you go through long periods of not eating (intermittently fasting), it signals to your body that it's time to rest. This can mess with your circadian rhythm. (58:26) Studies link eating breakfast can lower stress levels, help manage mental health, and improve physical health. Stacy also reminds listeners that coffee doesn't count as breakfast and can actually inflame stomach issues. You can also spread out breakfast throughout the morning "breakfast" window by eating a series of small things. Endocrinology Conference: Breakfast Before 8:30am The study was designed to look at restricted feeding, comparing shorter windows to loger windows. (1:04:20) Previous studies have found that time-restricted eating, which consolidates eating to a shortened time frame each day, has consistently demonstrated improved metabolic health. But research shows that an early time-restricted feeding window is better: TPV Podcast Episode 386: Intermittent Fasting Intermittent Fasting: Secret to Weight Loss or Dangerous Fad? Researchers analyzed data from 10,575 adults who participated in the National Health and Nutrition Examination Survey. They divided participants into three groups depending on the total duration of food intake: less than 10 hours, 10-13 hours, and more than 13 hours per day. Then, they created six subgroups based on eating duration start time (before or after 8:30 am). They analyzed this data to determine if eating duration and timing were associated with fasting blood sugar levels and estimated insulin resistance. Fasting blood sugar levels did not differ significantly among eating interval groups. Insulin resistance was higher with shorter eating interval duration but lower across all groups with an eating start time before 8:30am. What they discovered instead was that eating breakfast early reduced insulin resistance, and feeding window didn't matter. Is Breakfast the Most Important Meal of the Day? Is Breakfast The Most Important Meal of the Day? New Science Has Answers! People who start eating before 8:30 am had lower blood sugar levels and less insulin resistance. This could reduce the risk of developing type 2 diabetes. Sarah surmises that it makes sense from a cortisol vs. insulin perspective! Breakfast & Cortisol Stress, breakfast cereal consumption, and cortisol: recent research has shown that regular breakfast cereal consumption is associated with lower stress levels and reports of better physical and mental health. The present study examined this issue using an objective indicator of stress, salivary cortisol. Results showed that stress was associated with higher cortisol levels, and daily consumption of breakfast cereal was associated with lower cortisol levels. Meal Timing Regulates the Human Circadian System and affects glucose tolerance, substrate oxidation and circadian-related variables: A randomized, crossover trial. Another study showed female breakfast-skippers display a disrupted cortisol rhythm and elevated blood pressure. Not to mention, chronic stress is associated with indicators of diet quality in habitual breakfast skippers. New Science About Breakfast Before 8:30am Skipping breakfast is also associated with cancer-related and all-cause mortality in a national cohort of United States adults. Data associates habitual nightly fasting duration, eating timing, and eating frequency with cardiometabolic risk in women. Association between Breakfast Consumption and Depressive Symptoms among Chinese College Students: A Cross-Sectional and Prospective Cohort Study. The ORs (95% CI) for depressive symptoms with decreasing breakfast consumption frequency were 1.00 (reference) for ≥6 times/week, 2.045 (1.198, 3.491) for 2-5 times/week, and 2.722 (0.941, 7.872) for ≤1 time/week (p for trend: 0.005). Final Thoughts Changing any sort of habit can be difficult, and Stacy reminds the audience that it won't be the easiest fix if you're not a breakfast person. (1:13:50) She tries planning ahead by hard boiling eggs to grab and go in the morning. Stacy also makes a lot of smoothies in the morning using whole fruit. If you haven't joined Patreon yet, now is a great time! It supports this show and gives you behind-the-scenes content, including how Sarah and Stacy really feel about these revisiting episodes. Thanks so much for listening, and we will see you next week!
52 minutes | Apr 15, 2021
Episode 452: New Science on Soaking or Activating Nuts
Welcome to episode 452 of The Whole View! This week, Stacy and Sarah look back at soaking or activating nuts and reflect on how data has impacted previous science. If you enjoy the show, please review it on iTunes! The Whole View, Episode 452: New Science on Soaking or Activating Nuts Welcome back to episode 452! (0:28) Facts are facts; science is science, and no matter how we felt about it before might change if we are open to hearing new information. Sarah adds that there was science available in previous shows that allowed us to infer some of these things. As more data has become available in the past year, we see that it's actually not the case. Episode 188, Paleo-Friendly Bread: Episode 413: The Gut Health Benefits of Nuts Stacy reminds listeners that this isn't a one-size-fits-all concept. To make sure the science on this show, which is specific to soaking or activating nuts, isn't extrapolated into different areas. We have a question from listener Vanessa: I'm interested in getting nuts and seeds back into my diet but am wary due to my autoimmunity. I've read all the articles I can find on the subject on your website (even your dehydrator article) and ran a search. Still, there is no mention of soaking (and dehydrating) nuts and seeds to break down the enzyme inhibitors that cause digestive issues. Some nuts give me a stomach ache and bloating (I've experimented here and there with low Fodmap nuts), and I have also purchased activated nuts (that have already been soaked and dehydrated). I seem to get on fine with the activated nuts, but if you don't mention this process in your articles, is this not something you advocate? Thanks - Vanessa Summarization of Nut Benefits 20 grams of tree nuts per day shows substantially reduced risk (think 20-70%) of cardiovascular disease, cancer, neurodegenerative disease, kidney disease, diabetes, infections, and mortality from respiratory disease. (3:05) Even three 1-ounce servings per week can lower all-cause mortality risk by a whopping 39%. This means that eating nuts regularly improves health, but they can potentially extend lifespan. Nut consumption is also known to decrease inflammation markers, including some endothelial markers (called adhesion molecules). There's emerging evidence of beneficial effects on oxidative stress, vascular reactivity, and hypertension. Numerous studies show that people who regularly eat nuts tend to have more favorable blood lipid profiles. One meta-analysis of 25 clinical studies showed that nut consumption had a dose-response cholesterol-lowering effect. Interventional studies consistently show that increasing nut intake has a cholesterol-lowering effect, even in the context of healthy diets. Plenty of research suggests that, despite their energy density, nuts and seeds don't contribute to weight gain, and they may even protect against obesity and diabetes. The health benefits of nut and seed consumption can be attributed to their nutritional content, rich in antioxidant vitamins, essential minerals, dietary fiber. They also include L-arginine, polyphenols, and some nuts that contain high levels of heart-healthy monounsaturated fats and the omega-3 fatty acid α-linolenic acid. We went into detail in Episode 413: The Gut Health Benefits of Nuts. The Health benefits of nut consumption do not continue to increase beyond about 20 grams per day. And there's some evidence that consuming large amounts of nuts daily can increase disease risk (at least for stroke). That means we get benefits with about a palmful of nuts and seeds per day, but that eating more than that won't do us any favors (and may potentially undermine our health). Why Aren't They AIP? Tree nuts are among the most allergenic foods, with true allergies (meaning the body produces IgE antibodies against proteins in nuts) estimated at about 1% of the total population. (9:00) Some preliminary scientific studies show that nut intolerance may affect a whopping 20 to 50% of us. People with autoimmune disease are more likely to test positive on food intolerance panels than healthy people. One 2018 study evaluated the level of IgG antibody production in autoimmune disease sufferers. This is compared to healthy controls and found that autoimmune disease sufferers produce double and up to 10X more IgG antibodies against foods than healthy people. The most common food intolerances in people with autoimmune disease are the foods already eliminated on the AIP. This is because they are inflammatory, disrupt hormones, or negatively impact gut barrier health, including grains, dairy, egg whites, and legumes. See How Gluten (and other Prolamins) Damage the Gut, Worse than Gluten: The Agglutinin Class of Lectins, 3 Myths About Legumes — Busted!, The WHYs behind the Autoimmune Protocol: Eggs). The other foods that test positive with high frequency are nuts and seeds. Another 2015 study compared the frequency of IgG food intolerance in Inflammatory Bowel Disease sufferers compared to healthy controls. What The Data Shows Nut and seed intolerance was very common, especially in Crohn's disease sufferers. (13:30) This is also something that won't improve over time with exposure. Mouth and lip-tingling is a pre-anaphylaxis sign. Nuts & Seeds % Crohn’s patients with IgG Ab % healthy controls with IgG Ab Almond 16 0 Pecan 38 0 Sesame 7 0 Sunflower seed 11 0 Walnut 7 0 In a 2004 study of people with unexplained gastrointestinal symptoms, cashews are among the most common nut intolerances and affect upwards of 50% of study participants. Compared to intolerance to almonds, about 28%, Brazil nuts were 23%, and walnuts were 3%. Food % IBS Patients with IgG Ab Almond 28 Brazil nut 22.7 Cashew nut 49.3 Walnut 2.7 In yet another 2016 study of people with unexplained allergy symptoms, also common among autoimmune disease sufferers, pistachios were among the most common nut intolerances, affecting upwards of 60% of study participants. Does Soaking or Activating Nuts Reduce Risk? New Science Says don't bother soaking. (16:49) We're going to talk about 4 new studies, two from 2020, one from 2019, and one from December 2018. All consistent with each other and point to no benefit from soaking nuts. Sarah mentions that this is actually quite surprising. There's lots of evidence, especially in legumes, that soaking, sprouting, and fermenting reduce agglutinins and phytates. The amount of deactivation of antinutrients in legumes depends on the specific legume and how it is prepared. For example, soaking pigeon peas for 6 to 18 hours reduces the problematic lectin content by 38 to 50%, and soaking kidney beans for 12 hours reduces the lectin content by nearly 49%. New Data to Study Likewise, one study found that for white beans, broad beans, lentils, chickpeas, and soybeans, soaking for 12 hours at 78°F reduced phytate levels by between 8 and 20%. Additional research shows that longer soak times in warmer water result in the greatest phytate decrease. Lastly, fermentation—which occurs after extended periods of soaking—can reduce phytates and lectins even further. One study found that fermentation reduced phytates by 85% in kidney beans, 77% in soybeans, and 69% in mung beans, particularly to the bacteria Lactobacillus bulgaricus. Many of us assumed that nuts would be similar, but this hasn't been evaluated in the scientific literature until just the last year! In fact, when Sarah wrote The Paleo Approach (published in 2014), she said: "It is commonly postulated that soaking nuts in salted water and then drying them improves digestibility, reduces enzyme-inhibitor activity, and decreases phytic acid. This has not been documented in the scientific literature. Still, anecdotal accounts suggest that many people can tolerate nuts that have been soaked and dried even if they do not tolerate raw or roasted nuts." Plus, she never actually included a recommendation to soak nuts on her website or in her books. This is because there hasn't been science to say yay or nay… until very recently! Sarah's References: Soaking or Activating Nuts Sarah references and explains findings from these studies: (25:30) Lee LY, Mitchell AE. Determination of d-myo-inositol phosphates in 'activated' raw almonds using anion-exchange chromatography coupled with tandem mass spectrometry. J Sci Food Agric. 2019 Jan 15;99(1):117-123. doi: 10.1002/jsfa.9151. Epub 2018 Jul 15. PMID: 29808577. Taylor H, Webster K, Gray AR, Tey SL, Chisholm A, Bailey K, Kumari S, Brown RC. The effects of 'activating' almonds on consumer acceptance and gastrointestinal tolerance. Eur J Nutr. 2018 Dec;57(8):2771-2783. doi: 10.1007/s00394-017-1543-7. Feng Y, Lieberman VM, Jung J, Harris LJ. Growth and Survival of Foodborne Pathogens during Soaking and Drying of Almond (Prunus dulcis) Kernels. J Food Prot. 2020 Dec 1;83(12):2122-2133. doi: 10.4315/JFP-20-169. Why Would This Be? My hypothesis is that this is due to the botanical difference. A legume is typically a pod with multiple seeds that will start to open on its own as it becomes ready for harvesting. Dried beans are those seeds. A nut is typified by a hard outer shell protecting a single seed that we would call the "nut" and does not open on its own. Certain temperatures and moisture for very long times, etc., needed to get a nut to sprout, which point the shell splits. See for example https://www.wikihow.com/Plant-a-Walnut-Tree A drupe is basically a nut with a pulpy fruit around it. If you wanted to plant a nut to grow a tree, you'd plant the whole nut with the shell and husk around it. If you wanted to plan a legume to grow a plant, you'd plant just the seed outside of the pod. Legumes will sprout (and you could plant those sprouts) on your kitchen counter, but nuts won't. What About Making Nut Milks, Yogurt, "Cream Cheese"? The difference in minerals and phytates is small, +/- ~10%, so if you have to soak for a recipe, don't worry about it. (41:10) BUT, soak at a cooler temperature (like 15C, better yet soak in the fridge) to make sure that if your nuts have E-Coli on them, that you don't' create an environment where they can grow After doing this research, I'm actually amending some recipes to have the nut soaking occur in the fridge. Final Thoughts Nuts are a healthy food in moderation and great for the gut microbiome. It's better to eat raw or roasted and not bother soaking, sprouting, or activating. Sarah adds that none of these studies were performed on seeds, so we're still unsure how this affects seeds. Big shout out to Georgia Grinders, which offers slow-roasted nuts that Stacy and Sarah love- completely unsponsored. Be sure to pop over on Patreon to hear what Stacy and Sarah really feel about soaking or activating nuts.
101 minutes | Apr 9, 2021
Episode 451: ConspiraSEA: Is Sustainable Seafood Impossible?
Welcome to episode 451 of The Whole View! This week, Stacy and Sarah address the health benefits, the question of sustainable seafood and Seaspiracy as a whole. If you enjoy the show, please review it on iTunes! The Whole View, Episode 451: ConspiraSEA: Is Sustainable Seafood Impossible? Welcome back to episode 451! (0:28) Stacy and Sarah have received many questions on Netflix new documentary, Seaspiracy. Stacy took almost eight pages of notes, while Sarah has also prepared many sea-related puns for you. First off, the name ConspiraSEA was right there, and she totally feels they missed the boat (ha!) on that one. Stacy also mentions they gathered thirteen pages between them to ensure you are provided with as much information as possible and not just Stacy and Sarah's opinions. The message the show tries to deliver is the opposite of this show's top recommendations. Stacy could tell within minutes that the filmmakers had an agenda. She and Sarah plan to review the science-based facts from the claims made in the film. The goal is to help listeners navigate safe, sustainable seafood because despite what the film attempts to present, seaweed and plant-based options do not compare to the health benefits. So Stacy and Sarah want to dive right in. (Get it?) Benefits of Seafood It's important to emphasize what we'd be missing out on if the premise that sustainable fishing is impossible is true. (4: 01) Eating more seafood can reduce cardiovascular disease and prevent obesity and diabetes. High amounts of vitamins, minerals, carotenoids, fats, and protein all contribute to these benefits. (Intro to Nutrivore) Fish is a great source of vitamins B1, B2, B3, B6, B9, B12 and E, zinc, phosphorus, magnesium, iron, copper, potassium and selenium. Oily, cold-water fish provide substantial amounts of vitamin A and vitamin D as well. Fish with bones remaining (such as canned salmon and sardines) are the best dietary sources of calcium in the food supply. Marine fish are an excellent dietary source of iodine. High Selenium Content protect against some cancers, enhance bone health, maintain thyroid health, reduce the risk of infection, assist in DNA production, and protect the body from free radical damage Omega-3 Fats EPA and DHA reduce inflammation, lower blood pressure, protect against some cancers (including breast), increase insulin sensitivity, and improve endothelial function Improves gut microbiome composition Salmon Or any fish with a similar salmon-pink or orange color also contains the antioxidant carotenoid astaxanthin. helps reduce LDL oxidation boosts HDL levels, and protects against skin damage. Fish protein is the BEST! Also supports a healthy, diverse gut microbiome (in addition to omega-3s) - better than any other protein source: beef, pork, chicken, soy, casein, and pea. (11:20) Many fish benefits are mediated via protein, and fish protein is easy to digest. In a meta-analysis of five prospective cohort studies, lean whitefish's high consumption reduced the risk of stroke by 19% (which was even more than fatty fish intake, which reduced stroke risk by 12%). A study of Swedish women shows that three servings of lean fish per week reduced the risk of stroke by 33% compared to zero servings per week. In Norwegian men, weekly lean fish consumption (including whitefish) was associated with a lower risk of metabolic syndrome, lower triglyceride levels, and higher HDL cholesterol. Likewise, a randomized crossover trial found that simply adding 100 grams per day of whitefish (Namibia hake) to the diet significantly lowered waist circumference, diastolic blood pressure, and LDL levels! And another trial found that eating 150 grams of cod per week caused significantly greater weight loss in young overweight adults than a same-calorie diet without seafood. Seaspiracy "Documentary" Sarah poses the question: what if eating fish and shellfish is destroying the ocean ecosystem and is actually full of toxins? (17:30) This is what Seaspiracy claims, so let's talk about this propaganda. Stacy reminds us documentaries are a filming style, and the information contained within is not regulated. They can be amazing ways to learn about history or science. They can also be manipulative propaganda. So just because it's in documentary format does not mean it's news or that it's true. This documentary was made by the same people who made What the Health and Cowspiracy. What the Health… is Wrong With This Documentary?! Handling Critics, Conflicts and Vegans We don't want to get into a point-by-point discussion but let's bust the two biggest myths purported by this documentary: Sustainable Seafood Claims The "movie" claims that there's no such thing as sustainable seafood what so ever. Commercial fishing is destroying the oceans. They claim fisheries aren't regulated, and fish farms are even worse. Also, the proportion of fish sold in the U.S. is caught illegally, and the ""sustainably caught label is meaningless. The second claim is that we should all be vegan. Seafood is full of toxins (like mercury and PCBs) and microplastics. It's destroying the oceans, and we can get the same nutrients from algae. What is Sustainable Fishing? Sarah adds that her first research job in college was research for the Canadian Department of Fisheries and Oceans. (22:01) It entailed actually doing research for sustainable salmon fishing. They even published a paper based on her research! The United States is recognized as a global leader in sustainable seafood because we rely on strong science, responsive management, and enforced compliance. Fish, shellfish, and marine algae are renewable resources because they reproduce and replenish their populations naturally. That means we can sustainably harvest fish within certain limits without depleting their populations. Sustainability has two basic steps: Scientists perform a stock assessment to recommend how much fish should be harvested. Fishery managers and regulators follow and enforce that recommendation. Fishery management uses science to determine these limits and entails catching some fish while leaving some to reproduce and replace the fish that are caught. What It Means For Sustainability The United States is actually a global leader in seafood sustainability in general. Interesting enough, Stacy notes the "documentary" left this detail out entirely. (25:03) The argument centers around that our global population are rising, but our global abundance of wild fish is not. Food and Agriculture Organization of the U.N. (FAO) estimates that 66% of fisheries are sustainable, contributing 78.7% of consumed seafood. This means there's room for improvement since 20% of the fish eaten in the world are from overfishing. However, this doesn't mean give up on fish. It means you need to be an informed consumer! One of the amazing things about our oceans is that fish stocks can recover and replenish if they are managed carefully for the long term. Some stocks that have come back from the brink include the Patagonian toothfish in the Southern Oceans. Other examples include the recovery of Namibian hake, after years of overfishing by foreign fleets, or the increase in some of our major tuna stocks globally. Research shows that fish stocks that are well-managed and sustainable are also more productive in the long term. This means there is more seafood for our growing global population. Outlying Scientific Data on Sustainable Seafood In 2006, a study predicted a global collapse of fish species and empty oceans by 2048. However, it was later busted here: https://sustainablefisheries-uw.org/fisheries-2048/ Stacy adds that while watching the "documentary," she noted all the studies referenced were at least 5 years old. Sarah mentions that when she comes across studies considered "outliers" and goes against most other data, she looked a bit closer at the details. Nowadays, we're seeing many of these "outlier" articles being overly weighted and fueling pseudoscience claims on the internet. She notes that it doesn't mean that they are necessarily wrong. We just need to look a bit more critically at the science to figure out what exactly is happening. Commercial Fishing is Highly Regulated Stacy notes one important aspect she learned from the "documentary" is that people can be bribed anywhere. (38:06) She adds that given details in contrast to the "documentary" agenda can be cut out to strengthen the case. Because bribery exists, the "documentary" claims you can't believe anything anyone in the industry says. However, they fail to provide any instances of this so-called bribery. Commercial fishing is not equivalent to CAFO's or industrial farming. All it means is catching fish to sell. It can be done large scale, but the industry is highly regulated. In fact, U.S. fishermen abide by some of the most rigorous environmental measures in the world. Both large and small scale fishing boats are regularly inspected to ensure fisheries are protected, and we're abiding by sustainable seafood guidelines. Fishery management in the United States is guided by several laws, including the Magnuson-Stevens Act, Marine Mammal Protection Act, and Endangered Species Act. 10 national standards of sustainability manage U.S. fisheries. These standards aim to prevent overfishing, protect other species and habitat, and minimize bycatch on non-target species. It is the case that some fish sold in the U.S. were caught elsewhere. If you're looking to uphold sustainability, ensure you shop local or see where the fish was caught, or the fishery is located. It's important to note that the main economy of Pacific island nations is fishing. So outlawing the sustainable seafood industry would result in their economy's collapse. Farm Fishing Isn't Evil Stacy notes one claim the "documentary" makes is that fish farms have a "organic waste" (aka the fish poop in the water). (51:35) Fish poop is not a toxic substance and used as food for organisms like algae. Aquaculture, or farming in water, plays a critical role in ensuring that our need for seafood is met sustainably. It's also a resource-efficient way of increasing and diversifying U.S. seafood production. The future of sustainable seafood must include both farm-raised and wild-capture seafood! Increasingly, seafood farming (if done responsibly as it is in the United States) is recognized as one of the most environmentally sustainable ways to produce food and protein. We discussed antibiotics use and "coloring" in farmed fish in Episode 366: Seafood Safety Concerns. Sarah notes there's a mandatory withdrawal period for each type of antibiotic fed to fish before the fish can be slaughtered. So, there is ample time to make sure there's no residuals in the meat by the time we eat them. Additionally, the dye used is actually astaxanthin: the same red carotenoid pigment found in red algae makes wild fish flesh that distinctive color. It's an important antioxidant and makes them healthier! Because of feed ingredients, the nutrient profile of farmed fish usually isn't as good as wild. But, it's still a great choice! Marine Stewardship Council Certification At Whole Foods, the seafood counter displays blue labels from the Marine Stewardship Council (MSC), an international, nonprofit organization. (58:52) The MSC is a prime example of an economic trend: private groups, not the government, tell consumers what is good or bad for the environment. The MSC says its label guarantees that the wild seafood was caught using methods that do not deplete the natural supply. It also guarantees that fishing companies do not cause serious harm to other life in the sea, from coral to dolphins. Unilever and the World Wildlife Fund joined hands in 1997 to establish MSC as an independent not-for-profit, more than 20 years ago over concerns about overfishing, This certification process is not carried out by the MSC. It is independent and carried out by expert assessment bodies. Also, it's an entirely transparent process, and NGOs and others have multiple opportunities to provide input. All the assessments can be viewed online at Track a Fishery. Only fisheries that meet the rigorous requirements of Standard get certified. Check out their rebuttal to Seaspiracy here! Other labels to look for: The Monterey Bay Aquarium labels products like a traffic light — green, yellow or red — to urge shoppers to buy or avoid a particular fish. The Blue Ocean Institute has a similar system. The Tuna Tracking and Verification Program (TTVP), established under the Dolphin Protection Consumer Information Act, is how NOAA Fisheries monitors compliance with dolphin-safe tuna labeling. (Reference) What about the BAP cert for responsibly farmed fish? This topic is very important to Sarah and Stacy, and they want to make sure they're supporting the right companies and share this with listeners for their own knowledge. Conspiracies The "documentary" claims that sustainably sourced labels are lies and all dishonest. (1:12:20) It was organized in a very manipulative way where it starts with a fact but shows footage as a representative that isn't a fact. Stacy shares these examples: Fact: enough single-line is used daily to wrap around the world 500x. This does not mean that much line is discarded into the ocean daily- just used. It's phrased as though it's being dumped in the ocean every day, which it's not. In fact, single line fishing is a good thing! Fact: 250,000 sea turtles are "captured, injured, or killed" in U.S. annually from fishing vessels. When fact-checked, you realize that that number includes the ones returned to the ocean after capture or healing from injury. This species is protected now, so many are rescued and returned. However, the "documentary" conveniently leaves that out to manipulate the impact of the number. Sarah adds that we are biologically herbivores (solely plants) or carnivores (solely meat) but omnivores. This means our body is designed to gain nutrients from a combination plant and meat diet. Fish Toxins Can't we just eat algae? No- it's not the same as seafood. By this logic, we'd get the same nutrients eating grass that we do from eating beef. Stacy and Sarah did a whole episode on it: TPV Podcast Episode 366: Seafood Safety Concerns. There have been a few European studies showing a U-shaped response curve to fish consumption. Moderate fish consumption reduces all-cause mortality and cardiovascular disease risk. However, higher fish consumption increases the risk of all-cause mortality. The studies have postulated that this may be due to increased exposure to some of the toxins that can accumulate in fish. These toxins include methylmercury, dioxins, and polychlorinated biphenyls (PCBs) However, this isn't seen in North American or Asian cohorts studies where fish is equally as likely to contain these toxins. The authors of a rigorous 2017 meta-analysis proposed an alternate explanation for a U-shaped curve in Europe. Traditional preparations of fish in many parts of Europe include deep-frying, pickling, or salting. This high-salt and/or trans-fatty acid intake may be to blame for the higher all-cause mortality seen with higher fish consumption. What about microplastics? We've talked about single-use plastics on the show before in TPV Podcast Episode 352: Sustainability & Mother Earth. Also, Sarah has written about it here: https://www.thepaleomom.com/my-journey-towards-zero-waste/ Plastic pollution is a problem! They did get that right. For more information on this, see articles here and here. But solving this problem doesn't include avoiding seafood (buy sustainably caught). Look to lower your carbon footprint, reduce the use of single-use plastics, avoid cycling, recycle properly, and look to reusable bags and containers. There are better ways to learn about how to protect our oceans: Planet Earth documentary Blue Planet Nova National Geographic Scientific American magazine Where Do Stacy and Sarah Get Fish? My favorite source is ButcherBox https://www.butcherbox.com/thepaleoview Stacy has a local fishmonger at farmer's market, plus Costco, Trader Joe's - tons of vendors now sell Alaskan and/or certified sustainable seafood Farmed shrimp, Alaskan / farmer's market salmon, dolphin-safe line-caught tuna, local shellfish Great Resources https://sustainablefisheries-uw.org/start-here/ https://www.fisheries.noaa.gov/feature-story/5-things-you-should-know-about-sustainable-seafood https://www.msc.org/media-centre/news-opinion/news/2021/03/26/response-to-netflix-seaspiracy-film https://pubmed.ncbi.nlm.nih.gov/31932439/ https://oceanservice.noaa.gov/facts/microplastics.html Final Thoughts Sarah reminds listeners that documentaries are not grounded in scientific fact and can be skewed. (1:31:40) The truth is the oceans are in trouble and need help, just not wholly in the ways stressed in the "documentary" Seacpiracy. We need to look at this practice to find an action we can walk away with feeling good about. If you haven't joined the Patreon family yet, joining supports this podcast and provides you with bonus content on what Stacy and Sarah really feel. Thank you so much for listening, and we'll see you next week!
79 minutes | Apr 1, 2021
Episode 450: Spices on the AIP? What’s In, What's Out, and Why.
The Whole View, Episode 450: Spices on the AIP? What’s In, What's Out, and Why. Welcome back to episode 450! (0:28) Stacy and Sarah both have sensitivities to nightshades due to inflammation-driven health issues. Nightshades are common trigger foods and can be super problematic to autoimmune diseases and chronic illnesses as well. This is because the immune system is already in overdrive. Adding an immune stimulant (such as nightshades) to the equation can cause symptom flare-ups. The logic that goes into the autoimmune protocol requires a little bit of reasoning about how best to apply it to your day-to-day choices. When writing her book on AIP, Sarah's research really focused on how the immune system works and how it intersects with nutrients, lifestyle, hormones, etc. Understanding how foods can be problematic for some people is never irrelevant. Even if you're perfectly healthy, the science behind AIP can be applied to optimize diet and troubleshoot any future health issues. In this episode, Stacy and Sarah plan to do a deep dive into what herbs and spices are awesome when on AIP, which are considered early reintroductions, and which ones are best avoided until the very end of the healing process. For more references, please see: When Do We Re-Do the Elimination Phase of the AIP? Can Food Intolerances Be Fixed? Food Allergy, Sensitivity, and Intolerance: What’s the Difference? What Do I Do After a Bad Reaction? Listener Question This episode was inspired by this listener question from Jeff. (10:30) Hello, I'm a chef of 20 years and as most of us in the hospitality industry have experienced, things are not good. During my temporary retirement I've decided to help out a family who has started an AIP diet. I haven't cooked specifically for a person who has said they are specifically AIP, but I have had plenty of experience with similar dietary needs. It will no doubt be a challenge, but it will be a fantastic learning experience and chance to change a persons experience while on their path to recovery. In my journey I'm looking for ways to infuse the flavors which I like to use in ways that will be in line with the protocol. My inquiry has to do mainly with flavor infusion. Take for example a brine for pork. I use products like whole black peppercorn, whole coriander seed, mustard seed, etc. to add layers of flavor to the brine. Is the main issue with these spices the pieces of the seeds? Are the extracted oils also off limits? My main concern is around spices. I would venture to believe that nightshade oils are the problem (i.e. dried chilies, capsicum, etc). - Jeff Stacy reflects on how much she enjoy's Jeff looking at it from a chemistry perspective in the cooking. Alternatively, people who find out they can't eat raw tomatoes might discover they can have cooked ones as they reintroduce foods back into their diet. It's very bioindivideal, meaning Stacy and Sarah can't answer what foods will affect you and why. AIP is a way to isolate triggers for you personally to optimize your health. Overall Philosophy Spices on the AIP Sarah believes the most helpful place to start is taking a step back and looking at herbs and spices in general. (13:30) The autoimmune protocol first tries to flood the body with nutrients- both essential and nonessential. Sarah references this show for more information on nutrient toxicity. Another thing AIP tries to do is remove inflammatory properties from the diet. Herbs are derived from the leaves of fragrant plants and sometimes flowers. They are safe to use whole, fresh or dried. It's actually very beneficial to include them since the same phytonutrients that provide the flavor tend to be awesome antioxidants and anti-inflammatory. Other properties they often have are anti-cancer, liver protective, neuroprotective, and more. See our Essential Oil show for more on extracts, though. These can be more complex and don't get an automatic pass. TPV Podcast, Episode 272: What's the Deal with Essential Oils? Spices often derive from non-reproductive plant parts like barks, roots, styles, and arils, but it's not always the case. Herbs don't generally need to be ground before using in a recipe, whereas spices often need to be ground before using. Why Spices on the AIP Are Eliminated They are eliminated on AIP if they derive from seeds, berries, fruit, or the nightshade family. (21:20) This is due to their unusually high food allergy and intolerance rates. Seed spices should be avoided at first, even though many seed-based spices haven't been specifically studied. Spices that derive from berries and fruits of plants typically contain more seed than fruit. You are still consuming the ground seed. Depending on your individual autoimmune challenges, some people tolerate the very small doses of seed-based spices used in cooking. This happens during Phase 1 Reintroductions. As a result, seeds are often early reintroductions because they aren't something that necessarily will show up on an allergy test. However, something can cause inflammation or stomach issues without being an actual allergy. In that case, passing a test doesn't mean you're in the clear to eat it without complications. Proteins that are unique to seeds as a reproductive part of the plant cause complications. Also, the nightshade family causes problems for most people with autoimmune disease. Nightshades are restricted on the Autoimmune Protocol due to high glycoalkaloid content and agglutinin content. They increase gut permeability and act as an adjuvant, exaggerating immune responses. Spices from the nightshade family (mainly peppers) also contain capsaicin (one of the chemicals that give them heat), a mucus membrane and gut irritant. Safe Herbs and Spices on the AIP There are plenty of safe spices to have while on the AIP. (29:35) However, extracts are not an automatic pass because you're not necessarily getting everything from a plant. Some compounds might be concentrated and or skewed into being unbalanced. When Sarah talks about "safe spices" she's talking about the whole leaf, flower, root, or bark: Balm (lemon balm): Leaf of Melissa officinalis L. Basil Leaves (Sweet): Leaf of Ocimum basilicum Bay Leaves (Laurel): Leaf of Laurus nobilis Chamomile: Flower of Anthemisnobilis L. or Matricaria chamomilla L. Chervil : Leaf of Anthriscus cerefolium Chives: Leaf of Allium schoenoprasum Cilantro (Coriander): Leaf of Coriandrum sativum Cinnamon/Cassia: Bark of Cinnamomum spp. Cloves: Bud of Syzygium aromaticum Dill Weed: Leaf of Anethum graveolens/Anethum sowa Garlic: Bulb of Allium sativum Ginger: Root of Zingiber officinale Horseradish: Root of Armoracialapathfolia Gilib. *(Read ingredients for horseradish sauce!) Lavender: Flower of Lavandula officinalis Chaix. Mace: Aril of Myristica fragrans Marjoram Leaves: Leaf of Majorana hortensis Moench Onion Powder: Bulb of Allium cepa Oregano Leaves: Leaf of Origanum vulgare/Lippia spp. Parsley: Leaf of Petroselinum crispum Peppermint: Leaf of Mentha piperita Rosemary: Leaf of Rosmarinusofficinalis Saffron: Stigma of Crocus sativus Sage: Leaf of Salvia officinalis/Salvia triloba Salt: Mineral - moderation is important! Savory Leaves: Leaf of Satureia montana/Satureia hortensis Spearmint: Leaf of Menthaspicata Tarragon: Leaf of Artemisia dracunculus Thyme: Leaf of Thymus vulgaris/Thymus serpyllum/Thymus satureioides Turmeric: Root of Curcuma longa Vanilla Bean*: Fruit of Vanilla planifolia/Vanilla tahitensis Moore *Vanilla gets a pass because the seeds are so small that they are intact when you consume them, putting vanilla bean (which is not a legume) in the same category as berries. Moreover, Vanilla and vanilla extract is also okay, provided it's certified gluten-free (often grain alcohol is used). If it's not a nightshade and comes from bark, root, leaf, or flower, you're good to go! What to Avoid There is also a list of spices to avoid altogether, and some you should reintroduce at different stages in the AIP. (59:03) Early Reintroduction Spices (Berries & Fruit) Allspice: Berry of Pimenta officinalis Star Anise: Fruit of Illicium verum Hook Caraway: Fruit or Carum carvi Maton. Cardamom: Fruit of Elettariacardamomum Juniper: Berry of Juniperus communis Black Pepper: Berry of Piper nigrum White Pepper: Berry of Piper nigrum Green Peppercorns: Berry of Piper nigrum Pink Peppercorns: Berry of Schinus terebinthifolius Early Reintroduction Spices (Seeds) Anise Seed: Seed of Pimpinella anisum Annatto Seed: Seed of Bixa orellana Black Caraway (Russian Caraway, Black Cumin): Seed of Nigella sativa Celery Seed: Seed of Apium graveolens Coriander Seed: Seed of Coriandrum sativum Cumin Seed: Seed of Cuminum cyminum Dill Seed: Seed of Anethum graveolens/Anethum sowa Fennel Seed: Seed of Foeniculum vulgare Fenugreek: Seed of Trigonellafoenum-graecum Mustard Seed: Seed of Brassica juncea/B. hirta/B. nigra Nutmeg: Seed of Myristica fragrans Poppy Seed: Seed of Papaver somniferum Sesame Seed: Seed of Sesamum indicum Avoid (Nightshades) Capsicums: Seed of Capsicum spp. Cayenne: Fruit of Capsicum annuum Chili Pepper Flakes: Many Varieties, fruit of Capsicum genus Chili Powder: Blend of fruit of Capsicum genus Curry: A spice mixture typically containing coriander, cumin, fenugreek, and red pepper. Paprika: Fruit of Capsicum spp. Red Pepper: Fruit of Capsicum Common Spice Blends To Watch Out For In general, Sarah doesn't recommend against using any spice blends because the ingredients list often doesn't actually say everything in it. Sarah has no idea where it became okay to say "spices" or "natural flavors" on the labels. But, here are some common spice blends you might have in your kitchen with components to worry about: Curry Powder: Mixture typically containing coriander, cumin, fenugreek, and red pepper. Chinese 5-Spice: Contains Star Anise, Peppercorns, and Fennel Seed Garam Masala: Contains peppercorns, cumin seeds and cardamom pods Poultry Seasoning: Often contains pepper, nutmeg Steak Seasoning: Usually contains pepper, chili, cumin, and cayenne What About Brines, Broths and Oils? For brines, broths, and oils, it really comes down to why we're eliminating this food. And is the thing we're eliminating fat or water-soluble. (1:08:05) Proteins are water-soluble, so yes, you can get this in broth or brine. For seed and berry/fruit-based spices, the concern is common food intolerance. However, you can use these in flavored oils because little to no protein is imparted. Also, with nightshades, avoid brines, broths, and oils. Glycoalkaloids have a detergent structure and help water and oil mix. Final Thoughts When it comes to nightshades, Sarah has not met very many people who have gone all the way through AIP and have successfully reintroduced all nightshades. (1:11:35) Stacy has met a lot of people who are in denial that nightshades are an issue for them. She adds that she was at the stage where, like Sarah, she could have a little nightshade spice every so often. Then she got Covid and is a long-hauler. That, mixed with the stress of a pandemic and virtual school, she's been very strict with avoiding nightshades. She doesn't want to risk undoing all the work she's done by consuming nightshades when her body isn't operating optimally due to her current stress. But just because nightshades might be an issue for you, that doesn't mean you can never have them ever again. If eating your mother's curry is an act of self-love and comfort, go ahead and eat it if that's what you want to do. Just know and prepare yourself for a possible flare-up. If you want to hear what Stacy and Sarah really think about today's show, be sure to join the family on Patreon for some bonus behind the scenes content. Thanks so much for listening, and we'll see you next week!
55 minutes | Mar 25, 2021
Episode 449: Navigating Shift Work in a Healthy Way
The Whole View, Episode 449: Navigating Shift Work in a Healthy Way Welcome back to episode 449! (0:28) There are many people throughout the US and the world with careers that involve working on alternate shifts. This constant fluctuation in waking and sleeping hours can make navigating shift work difficult since your circadian rhythm never gets the opportunity to fully stabilize. However, if you work regular shifts like Stacy and Sarah, you can still utilize the techniques in this show for things like jet lag and daylight savings. Sarah explains that there aren't many differences between jet lag and working alternate shifts because they impact circadian rhythms. This show was inspired by this listener question: I have been dialing in my nutrition, activities and sleep and feel so much better for it. But due to my work schedule everytime I come off a rotation of night shifts it takes me 3 days to recover back to my new normal again. I started working 12 hour shifts (7am to 7pm for 4 days then 2 days off. Then 7pm to 7am for 4 nights, then 6 days off to rest). It's like having jetlag every 16 days! Is there anything I can do to help and support my body through this? Many thanks, Sophie This is a common issue for many over the last year- specifically front-line workers through the pandemic. Many thanks to front-line workers and medical staff for their flexibility to be there when we've needed them. Sarah remembers when this alternation between day shift and night shift was introduced. Before it, people would work days or nights and stick with that one shift all the time. Balance and fairness are important in the workforce, yes. However, Sarah feels it's important to talk about why having a consistent night shift would be better than going back and forth. Ideal Circadian Rhythm Entrenchment Forcing our circadian clock to adapt is harder on our bodies than living out of sync with the sun. (6:40) Things like bright lights indoors in the evening, not spending enough time outside, eat at weird times or too late, and even over air condition our house during the day can mess with that entrenchment even if we work during the day. Working a shift that's out of sync with the sun requires us to "overwhelm" the signal we get from the sun. We can do this by ensuring our sleeping environment is very dark, challenging if we're sleeping during the day. Double layered blackout curtains can help block out the sun from windows. Sarah also recommends covering anything with LED lights (especially blue and green) with duct or masking tape. Temperature shifts are also big signalers to our circadian rhythms. Ensuring our sleeping environment is cold when we're sleeping and warmer can help make navigating shift work easier. Bright lights can inhibit our body's melatonin production, which signals that it's time for sleep. Amber-tinted glasses block blue light and can help support sleep. Even when you're not asleep during your "night," turning off lights, keeping the blinds closed, programable LED lightbulbs and avoiding screens an hour before bed can help you trick your body into thinking it's nighttime. Stacy and Sarah have talked in past shows about how melatonin is sometimes used for sleep disorders. It also works great for jet lag and shift workers. Manage stress since dysregulated cortisol can hinder circadian rhythm entrenchment. Make sure you're not vitamin D deficient since vitamin D is vital for biorhythms, and if you sleep during the day, you may not be getting enough sunlight. Navigating Shift Work On Nights Off Staying on one schedule isn't always practical when you work nights because most of the world operates on daylight hours. (18:45) Seeing friends and family members and running errands are all things you'd probably do during the day on days off. Sarah recommends shopping at the end or beginning of your day, right when the store opens at 7am or before it closes at 7pm. Meet your friends for your breakfast and dinner, or vice versa, to keep a generally similar schedule to your workdays. It is also possible to shift your day partially, say 2-3 hours instead of a full 12 hours. This frees up more time for family activities but not so jarring for your body. Shift work is often associated as a cause of insomnia due to the constant changing of when we're awake. Adequate sleep is also tied to insulin production, metabolism, and immune system function! Shift work impacts sleep quality through disruption of the circadian clock. If we don't find ways to healthy manage it, it impacts insulin production, metabolism, immune system function, and more. Navigating Shift Work That Alternates Sarah turns her focus toward Sophie's situation of constantly switching from days to nights through her workweek. (24:20) She adds that experiencing 3 days of jet lag for a 12-hour time shift is actually pretty normal-whether it's through changing time zones or work change. A lot of the studies done on this topic use jet lag as a model. However, it is well understood in the science community that the two are basically the same thing and affect the body in the same way. You can help your body adjust to the new time is by going outside and have that light signal to jumpstart resetting your clock. If you're flying, you can do this by reorienting your time to the time of your destination as soon as you get on the plane. You can also use melatonin (higher dose, up around 1mg) for those first few nights. Make sure you're managing stress! Cortisol has to shift, too, and having dysregulated cortisol, to begin with, makes the transition harder. Vitamin C, omega-3s, and magnesium super helpful here. If you're going to be shifting back and forth, having a lightbox to use at the breakfast table, no matter what time of the day it is, is an ideal setup. It doesn't matter when you exercise, but rather that it's on its own predictable schedule. If you like going to the gym before work, do it before work no matter when your shift starts. So if you work out in the morning, keep doing that whenever your "morning" is (aka 6am on day shift days, 6pm on night shift days) Basically, keep your schedule the same but shift it to 12 hours. Meal timing is crucial to shifting, so don't skip breakfast on "jet lag" days. You might feel hungry, but make sure you keep habits and patterns. Eat similar size breakfast, lunch, and dinner whichever "time zone" you're in and your same "fasting periods" over at least 12 hours. Nutrients That Help Because Sophie has tackled some big nutrition changes, it's essential to look at what roles nutrition can play in navigating shift work in healthy ways. (33:15) Vitamin D is important for biorhythms, so always take it during your "morning." Vitamin C, magnesium, and omega-3s all support healthy stress responses, including cortisol rhythms. Extra vitamin C may be helpful due to the increased oxidant formation during jet lag. Avoid low-carb, low-fat, and low-protein because studies show it can make jet lag worse! Another study suggests that a balanced diet containing carbohydrates, protein, lipids, and vitamins/minerals may be effective for inducing phase shifts in the peripheral circadian clock. It also indicates simple diets such as 100% sugar, 100% protein, and 100% oil are inadequate for inducing entrainment signals. The gut microbiome also has biorhythms, and 12-14 hours of fasting while you're sleeping are important to regulate it. We work on things like muscle repair when we're sleeping and less on digestion. This means if we eat too close to bedtime, digesting that food can actually interfere with our ability to enter deep REM. This means you shouldn't "graze" to keep yourself awake. Stacy adds that they speak of a "low carb" diet they speak in terms of very low-carb, not what you'd normally get from recommended amounts of fruits and veggies. When you're sleep-deprived, one of the first things your body craves is those refined carbohydrates. Filling that craving with fruits and veggies can balance hormones and get you back into a healthy rhythm. Symptom Management It's important to recognize that a few days of that jet lag feel will be pretty normal regardless. (43:35) Some caffeine in your "morning" is okay. However, be careful not to overdo it or to take it too late in the day. There's many studies showing how great power naps are for improving cognitive performance and energy without taking away from nighttime sleep. These are naps between 10 to 30 minutes long naps to stay in Stage 1 and Stage 2 sleep. You need at least 3 minutes of stage 2 sleep for them to work. If you get into Stage 3, you'll know it by feeling groggy when you wake. Make sure not to rely on sugar or snacking as a crutch to stay awake as they will prolong the feeling of jet lag long-term. Activity can keep up energy levels, so make sure you're getting enough regular exercise. Just be sure that the first day's activity doesn't require great judgment since you might be tired. Final Thoughts Stacy revisits the importance of breakfast and how eating shortly after we wake up can signal our bodies that it's time to wake up. (47:45) Sarah references these two shows: Intermittent Fasting and Is Breakfast the Most Important Meal of the Day? Instead of taking energy shots or drinking a lot of caffeine, add daylight and liver pills to your regimen. Anything that happens inside our bodies uses energy, so ensuring we give our bodies things they can use to make that energy is crucial to optimally functioning. Supplements are great, but getting nutrients from whole foods is better (i.e., liver pills). If you've yet to join the Patreon family, pop over for more behind the scenes. Patreon gives you access to how Sarah and Stacy really feel about these topics and supports shows like this one that aren't sponsored. Thanks so much for listening, and we will see you next week!
60 minutes | Mar 18, 2021
Episode 448: Marijuana and Gut Health
The Whole View, Episode 448: Marijuana and Gut Health Welcome back to episode 448! (0:28) Sarah and Stacy have done shows on the topic of marijuana and wellness, including CBD, CBD for pets, and pain management. This show is sponsored by One Farm, both Sarah and Stacy's favorite CBD brands. One Farm's goal is to create the highest quality hemp extract on the market. Their products are made with the best hemp, grown organically in the perfect climate, extracted without toxic solvents, and mixed with quality ingredients. One Farm and their handling/processing facility are USDA Organic, which very few companies have. By controlling everything from seed to shelf, One Farm gives you the assurance that everything they make is from our USDA Certified Organic hemp, lovingly raised, cultivated, and processed 100% by One Farm in Colorado. Stacy notes that they also 3rd party test every batch that comes out of their USDA Certified lab. Use the code WHOLEVIEW at checkout to receive 15% off your order! Listener Question on Marijuana and Gut Health: Today's question about Marijuana and gut health comes from Dana (6:15): "I love focusing on gut health. I've read your books plus Dr. Terry Wahls books. I rely on cannabis to help me manage some of the residual MS symptoms I have while I work on healing my body. I am greatly aware of the risk of developing CHS as it has been on the rise in the Medical marijuana community here in Portland. It's terrifying to know that something that helps us so much, can harm us too. My question: How does THC affect the gut and gut motility? How can we prevent CHS medical users who use regularly and sometimes heavily to help manage our diseases? There isn't a lot of research I've found surrounding the effects of thc on the gut. I know it can slow down gut motility, but how much is too much and is there a way to counteract this effect? Does CBD have the same effect as thc on the gut or is it different? Can they work together in the gut to create a safer gut effect versus using a higher thc ratio? Ratios are big in the medical world. We rely heavily on the science we are presented in regards to the best ratios for our specific disease. There needs to be more talk on the potential risks of cannabis and how to lower our chances of developing something like CHS since so many of us meet the criteria of being at high risk of developing it. Would love to hear your thoughts on this. Seriously. Thank you." CHS: Cannabinoid Hyperemesis Syndrome As Sarah explains, CHS is a very rare syndrome that occurs in long-term, heavy users of THC-rich cannabis. (7:50) It was only first reported in medical literature in 2004. The reported symptoms include nausea, vomiting, and abdominal pain. Also, they are episodic, lasting for 24 to 48 hours, and not returning for several weeks or months. More than 90% of cannabis users who experience these symptoms also have a compulsion to bathe in hot water during the episode. This is often what helps doctors and patients determine CHS as the cause. Sarah adds that vomiting can be severe and can leave CHS patients extremely dehydrated, acidosis, decreased serum bicarbonate, acute renal failure, and damage to the esophagus. Because cannabis is usually known to help keep nausea and vomiting at bay, these users may end up using cannabis to keep the CHS symptoms at bay. Hyperemesis symptoms are very resistant, and typical antiemetics, such as ondansetron and promethazine, don't work. The treatment of choice is abstinence for a prolonged period. The only other effective treatment currently is IM injection with Haloperidol (normally used to treat schizophrenia, schizoaffective disorders, and Tourette syndrome) or Olanzapine (normally used to treat schizophrenia and bipolar disorder). Because of the use of antipsychotics, this suggests it's not working through the "normal" ways that induce vomiting. That it's something more related to the central nervous system and not the GI tract. The Difference Between THC and CBD Sarah believes it's critical to look at the differences between THC and CBD to see why CHS is rising. (13:15) Both THC and CBD are plant chemicals that interact with the endocannabinoid system, an ancient lipid signaling system. It mediates between our emotional and physical reactions to pain. THC is the most abundant chemical in cannabis. It's also the cannabinoid responsible for the sense of euphoria or "high" that comes from using the plant. CBD is the second most abundant chemical and doesn't have the same psychoactive effects as THC. The difference comes down to how each chemical binds with different receptors in our bodies and activates them. CBD binds but doesn't activate, which is why you don't get the same sense of euphoria as THC. Instead, it appears to modulate or adjust how the receptors respond to stimulation from other compounds. THC creates mental status changes, motor function, memory, and body temperature by interacting with CB1 and CB2 receptors. This can manifest as euphoria accompanied by increased heart rate, anxiety, hunger, and eventually sleepiness. CBD CBD does not have psychoactive effects for most people or very weak effects on sensitive people. (17:30) Instead is associated with: Neuroprotective Anti-inflammatory Antioxidant Analgesic Antipsychotic Anti-anxiety & antidepressant As we talked about in TWV Podcast Episode 420: CBD for Pain Management, both THC and CBD have been shown to reduce pain. Both CBD and THC also have strong antiemetic effects. Also, THC increases appetite and can have a sedating effect useful for insomnia. Because of the combo of increasing appetite and decreasing nausea, cannabis is often used by cancer patients when they're undergoing chemotherapy. High-THC Marijuana And Gut Health Stacy adds that the drug industry has actually altered these plants and bred them to yield higher THC concentrations. (20:01) The decreasing levels of CBD are an unintended consequence of that practice. In the old days of finding wild marijuana, THC and CBD's typical levels would be about 50/50. In the 1990s, typical "joints" contained 1–3 mg of THC. The typical joint in Colorado now contains 18 mg of THC or more. Also, Emergency room patients have self-reported smoking up to 2,000 mg or more of THC in a day. Higher potency products are associated with an increased risk for CHS and an increased risk for psychosis and other types of weed sickness, such as Cannabis Use Disorder. However, CHS is still considered a pretty care complication. What Are the Chances of Developing CHS? About 75% of CHS cases report daily or more than daily cannabis users, most of the remaining use at least weekly, very few cases are less often than that. (25:50) Sarah adds that there aren't many good epidemiological studies out there right now. But there are a lot of case reports and series to look at for data. About ⅔ of patients diagnosed with CHS have been using cannabis for at least 2 years before symptom onset. So far, CHS cases' demographics reflect the demographics of cannabis users, so it doesn't look like any particular population is at greater risk. So, this increase likely reflects increased use. A study that investigated trends of marijuana use between 2002 and 2014 indicated that prevalence is increasing among both men and women. Data from the US national survey on drug use and health show that 12.4 million men and 7.7 million women used marijuana in 2002. This number increased to 18.4 million men and 11.7 million women in 2014. Sarah notes that we're not quite sure why some people who use cannabis daily develop the condition and others don't. Current estimates are that 12% of Americans are active cannabis users. Another study showed that CHS sufferers had to seek medical attention an average of 7 times before getting diagnosed. Sarah does this quick math: This would place CHS risk for near-daily to daily users of cannabis anywhere between about 0.2% and 1%. (1 in 100 to 1 in 500) The risk for more casual users would be much, much, much lower, using the same back of the envelope math, about 0.003% (1 in 30,000) A similar study in Colorado showed the incidence of CHS about doubled after legalization of cannabis. What Does It Mean? Medical marijuana is on the ride in many areas. Stacy wonders about the implications this could have on health. Sarah reminds listeners that this is very rough data. She did very rough math to give everyone a general idea of how common this complication. She also dug deep, looking for similar health issues caused by high-CBD use, and found one paper so far with very little data listed. Sarah found a narrative article that mentions it can very rarely be seen with high CBD use, but not a single published case study to look at. So, it's unclear if the claim is actually true. In fact, there's a postulation that increasing CBD could protect against CHS. The combination of high THC and low CBD in high-potency cannabis is driving whatever maladaptation is behind CHS. The Mechanisms Behind CHS Sarah explains that, so far, no good quality data pointing to exactly what is causing CHS. Cannabinoids may bind to CB-1 receptors in the gastrointestinal tract and decrease GI motility and gastric emptying. This may override brainstem-mediated antiemetic effects and precipitate hyperemesis. [9, 92, 95, 132] Chronic cannabis use leads to desensitization and downregulation of CB1 receptors that ordinarily have peripheral antiemetic effects. This causes rebound vomiting and spasmodic pain that abates with abstinence and corresponding recovery of CB-1 receptor activity. [98, 136, 185] In chronic cannabis users, cannabinoid metabolites may accumulate in the brain and fatty tissues, inducing a toxic effect. [90, 94] Patients susceptible to developing CHS may have a genetic variation in their metabolic enzymes resulting in toxic levels of cannabinoid metabolites  THC may act as a partial agonist on CB1 receptors and thus relatively antagonize the effects of full endogenous agonists on these receptors. This would precipitate sudden withdrawal and hyperemesis in sensitive patients. [97, 105] THC causes dilation of splanchnic vasculature, resulting in CHS. Hot bathing leads to peripheral vasodilation and shunts blood away from the splanchnic bed, resulting in symptom improvement. [102, 137] Marijuana and Gut Health Stacy adds that if you live in an area where marijuana is legal, people who work in the shops that sell it are educated on the topics and can point you to what will work best for your needs. (46:30) Sarah underlines that she doesn't want this show to scare away anyone from using CBD that might benefit CBD. Results show normalization of overall appetite and increased/decreases in some circumstances. It also shows a reduction preference for fatty foods- especially polyunsaturated fats. It's also believed to relieve diarrhea and abdominal pain, improve appetite in IBD, reduce inflammation and histamine in the gut, prevent mast cells from releasing histamine, and reduce intestinal inflammation in various models and humans. Data also suggests that THC and CBD's use improves gut barrier health and reduces intestinal permeability in a variety of models. The Gut Microbiome The blocking endocannabinoid system causes gut dysbiosis and endotoxemia. A 2015 mouse study showed THC reduced weight gain, fat mass gain, and energy intake in Diet-Induced Obese but not lean mice. This 2019 mouse study showed THC and CBD could improve experimental MS (reducing inflammation and clinical signs of paralysis) with effects at least partly mediated via improvements to the gut microbiome, preventing dysbiosis normally associated with MS. Another 2020 study used CBD plus fish oil in the mouse model of colitis and showed that CBD and fish oil had small benefits. However, both had additive benefits when used together, including reducing inflammation, reducing intestinal permeability, and improving the gut microbiome. More of Sarah's Citations: Epidemiology of cannabis use: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719106/ https://www.cdc.gov/mmwr/volumes/65/ss/ss6511a1.htm Basics: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915118/ CHS Review articles: 2011 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576702/ 2017 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5330965/ 2019 https://digitalcommons.chapman.edu/physician_assistant_articles/6/ 2020 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6194425/ 2020 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7599351/ https://pubmed.ncbi.nlm.nih.gov/33208685/ 2021 https://pubmed.ncbi.nlm.nih.gov/32673642/ Seems to be due to THC to CBD ratio: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6690288/ CBD and Gut Health https://pubmed.ncbi.nlm.nih.gov/31803950/ https://pubmed.ncbi.nlm.nih.gov/33162890/ Inflammation https://pubmed.ncbi.nlm.nih.gov/31764093/ Cannabis https://pubmed.ncbi.nlm.nih.gov/27792038/ THC https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4669115/ Endocannabinoids https://pubmed.ncbi.nlm.nih.gov/27792038/ Gut barrier https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5333598/ Final Thoughts When Sarah looks at all this data together, she definitely feels it's worth having a conversation with your healthcare provider if you're planning to use marijuana for medial purposes. (57:22) Sarah and Stacy are big fans of CBD for its diverse benefits. And that it doesn’t have the problems associated with chronic cannabis use. Thank you to One Farm for not only sponsoring this show but having a trustworthy and high-quality product. Stacy adds that she's so appreciative of their third-party testing because that's not a practice that's regulated. If you've not yet joined the Patreon family and want to know how Stacy and Sarah really feel about this topic, hop over for more bonus content and stories. Thank you for listening!
71 minutes | Mar 12, 2021
Episode 447: Basic Needs Don’t Count as Self-Care
Welcome to episode 447 of The Whole View! This week, Stacy and Sarah If you enjoy the show, please review it on iTunes! The Whole View, Episode 447: Basic Needs Don’t Count as Self-Care Welcome back to episode 447! (0:28) Stacy kicks off this show by speaking about this article about women's tendencies (especially moms) to put others' needs above their own. This often takes the form of attributing "self-care" status to activities that fill a bare-minimum, basic need. Taking a hot shower or going on a quiet trip to the store without the kids isn't going to fill your cup and allow you to pour more into others. Sarah laughs that a part of her wants to clap her hands over her ears and not listen. If any listeners feel similar ways, like if you don't call the bare minimum stuff self-care, then can't call anything you do self-care, Sarah wants you to know you are not alone. Stacy adds that in Sarah's defense, there is a lot of things that she does she might not realize count as self-care. For example, Sarah spends a lot of time with her dog, going for walks and training, That's something Sarah does out of pure enjoyment that recharges her. Stacy explains that what self-care looks like is different for all of us. It's not just facials and massages. It's what makes you feel full and refreshed. If you can't love yourself, how are you going to love somebody else? -Ru Paul If you don't take time to fill your cup up and love yourself, how can you love and take care of someone else? Stacy knows she's am a better mother, wife, and friend to other people when she's taken care of herself and not at the precipice of losing her patience. Doing something that's not draining is different than doing something restorative. Types of Self-Care Stacy breaks down self-care into four different types, and that they don't have to be the cliche versions to count as self-care. (12:01) Stacy challenges listeners to really think about what outcome has them feeling lighter and better? It might not necessarily feel like something that's self-care upfront. Maybe it makes you feel a little uncomfortable at the moment. But it also might be something fully restorative to you. Mind: Emotional Self-Care Stress is incredibly inflammatory and can negatively impact your health if you're not effectively managing it. (20:13) Mental health is so important. It's often one of the most overlooked ways of giving yourself love because of the stigmas attached to them. Stacy asks the audience to remember that even the healthiest of minds need a break and help. If you're a frequent listener, you probably know how much Stacy struggles with the idea of meditation. However, science shows meditation can rewire the connectivity between different brain areas, limit the overactive flight-or-fight response, and help regulate our hormones. If guided mediation just isn't your thing, there are alternatives you can try. Sarah shares that she's much more comfortable with breathing exercises than she is with gratitude meditation. It's not one size fits all, and there are many different shades and colors of it! In Episode 432: Giving Thanks, Stacy and Sarah dig deeper into meditation's science and practice. It can seem a little ridiculous, but it really is a great way to reflect on mindset while focusing on wellness! If you haven't already, you should check out Stacy's favorite show, Episode 421: Body Image. Stacy's said it before, and she repeats it now: there is nothing wrong with asking for help. Talk therapy is a great way to decompress the everyday stresses of life. It allows us to target and work on any toxic traits we're harboring that can sabotage our self-care efforts. If you're unsure where to start, Stacy explains one avenue is to get a referral from your primary care physician. There are also many online counselors and apps specifically designed to help! Self-acceptance is vital to good self-care. Stacy shares how difficult it can be to accept your body when you feel like it's failing you due to autoimmune issues. But beating yourself up about things you can't control won't help you feel any better. Body: Loving Your Physical Self Move your body! Health is so much more than BMI or the number on the scale. (36:15) Science has shown that BMI is actually more inaccurate than it is correct. Many thin people have health issues, and many overweight people do not! Moving your body is an act of self-love because it's good for you – but also because it makes you feel good. Stacy reminds listeners that what we put inside our bodies is just as important as what we put on the outside. Sarah advises listeners to do it because they like it and they like doing it. There are foods that nourish our bodies, and there are foods that nourish our souls. Respecting yourself enough to prioritize both is self-care. A great place to start is gut-healing with a broad range of macronutrients from a nutrivore approach! Getting enough sleep is crucial to taking care of yourself. Do what you need to fully relax your mind and enjoy deep restorative sleep. It is when your cells replenish themselves. Those with poor sleep patterns are at high risk for a myriad of health conditions – so, taking a nap and going to be early is the ultimate act of self-love! Interpersonal: Your Relationship with Other This is the one both Stacy and Sarah struggle with the m0st, which is your connection with others. (43:01) Stacy shares her personal experiences with Zoom fatigue and trying to turn off her phone to disconnect. Working on interpersonal health means occasionally unplugging from a screen whenever you can, but not unplugging from people. Voxer or Marco Polo are free apps where you can leave short or long voice and video messages for an individual or a group. It's the perfect way to let out a vent of frustration or a primal scream to a trusted friend. You aren't uninterrupted, and the friend gets to listen when it is convenient for them. Stacy uses it for both personal and work purposes. Take intentional screen breaks. Playing games, baking, watering the plants, and working on re-arranging the house are ways to disconnect online and connect with people in our lives. Sarah also unplugs from 8am-8pm, so she has 12 hours of uninterrupted time. She doesn't use her phone on her morning hikes and uses that as a time to unplug. Also, it's important to take time this week to schedule your annual appointments. It's so easy for those in a primary caregiver role to put their own wellness aside, but so important to keep upon. Setting boundaries is critical to self-care. No one can read your mind. If you aren't telling people what you need, you can't expect them to give it to you. Sarah adds that it is often even helpful for the other people in our lives when we make boundaries. When you set that expectation, they don't need to worry about how to act. Personal: The Things That Bring Joy If you're an extrovert, this part could have been hit hard by quarantine if your hobbies involved going out in public and doing things. (58:01) But there are small ways that you can bring that deeper connection to your soul through intentional practices! Personal self-care means doing things that you enjoy just because they bring you joy. Plus, hobbies are great ways to cope with stress and trauma in life. Stacy shares She also decided to get back into houseplants during the quarantine. It's one way she can intentionally focus positive energy on something. It gives her an avenue when she needs a pick-me-up. Stacy and Sarah both love playing with their pets and have talked at length in the past about how great pets can be for mental health. Final Thoughts Self-care is something that's been really hard for scientists to define. (1:03:14) Science defines it most in terms of the stress response and how that response impacts our overall health. In its essence, self-care is reversing that stress response to reign it in and turn it off. Having a regulated stress response positively impacts the body in terms of hormones, gut health, tension, and more! Self-care allows us to regain mental space for the important things in life. Stacy reminds listeners that self-care is suggestive, and a restorative activity for one person might not be restorative for you. Be sure to pop over to Patreon for some bonus content about this episode! And to hear how Sarah really feels about all this.
73 minutes | Mar 5, 2021
Episode 446: Nutrient Deficiencies Caused by Stress
The Whole View, Episode 446: Nutrient Deficiencies Caused by Stress Welcome back to episode 446! (0:28) This show is a direct follow-up to last week, where Stacy and Sarah talked about supplementing while on AIP and the philosophies that couple different strategies together. In that episode, Sarah mentioned certain nutrients, such as Magnesium and Vitamin C, which depleted during times of chronic stress. Paleovalley also has a great Central C Complex, a great source of Vitamin C, and they agreed to sponsor this show! Stacy shares that she uses many products from Paleovalley and highly recommends this brand because they make their products from Whole Foods. Studies have shown that supplementing with Vitamin C can support a healthy stress response, which in turn can help improve sleep, regulate appetite, improve immune function, lower cardiovascular disease risk, improve depressive and anxiety symptoms, and even reduce migraine headaches! Nearly half of Americans aren't getting enough daily! Plus, infection, inflammation, and stress all increase our vitamin C needs. Why PaleoValley? Sarah and Stacy both love and regularly use Paleovalley products. (7:35) Paleovalley's complex uses three food-based vitamin C sources: unripe acerola cherry, camu camu berry, and amla berry. This means you get the full spectrum of nutrients, minerals, and bioflavonoids from Whole Foods. Food-based vitamin C has concurrent phytonutrients that make this type of vitamin C up to 2.5X more bioavailable. Even though it's bioidentical to non-synthetic Vitamin C, many people with sensitivities to corn aren't able to take synthetic vitamin C. Paleovalley uses no synthetic (GMO corn-derived) vitamin C in their complex! Plus, there are no wonky fillers, and it uses a simple gelatin capsule. Review of the Stress Response Stacy expresses how excited she is for Sarah to get into what exactly she's been putting her body through all these years! (8:04) Sarah and Stacy did a deep dive into how chronic stress impacts health in TPV Podcast Episode 351: Stress on Health. A stressor is a chemical or biological agent, environmental condition, external stimulus, or event that activates the hypothalamic-pituitary-adrenal axis (HPA axis) and releases stress hormones. Stressors: Physical (e.g., injury, a vigorous workout, sitting for prolonged periods, not getting enough sleep, extreme environmental temperatures) Sensory (e.g., loud noises, too-bright lights, overcrowding) Chemical (e.g., tobacco, alcohol, drugs, allergens) Psychological (e.g., deadlines, traffic, bills, societal and family demands) This is responsible for our fight-or-flight response caused by complex communication between three organs: The hypothalamus: The part of the brain located just above the brain stem. It's responsible for the autonomic nervous system, such as regulating body temperature, hunger, thirst, fatigue, sleep, and circadian rhythms. The pituitary gland: A pea-shaped gland located below the hypothalamus. It secretes hormones, such as thyroid-stimulating hormone, human growth hormone, and adrenocorticotropic hormone. The adrenal glands: Small, conical organs on top of the kidneys. It secretes hormones, such as cortisol, epinephrine (also known as adrenaline), norepinephrine, and androgens. This response helped our early ancestors pay closer attention, run away faster, or jumpstart healing in times of crisis. It also reduces the effectiveness of bodily functions the body aren't crucial to survival in that moment, such as our digestive or reproduction systems. Nutrient Deficiencies Caused by Stress in the Modern Era Sarah explains that the body doesn't differentiate between types of stress. So when we experience acute stress over long periods, such as at our jobs or physical stress, our body is constantly shutting down those "non-necessary" functions because it's in chronic survival mode. In modern life, when we never have a break from stress where our bodies can return to baseline, we suffer from what's called "chronic stress." The brain borrows hormones from other functions to make things we need in a crisis. All of that together is why chronic stress is so problematic to lifelong health. If we're chronically stressed, we're constantly using up key nutrients we need to perform their normal jobs in our body. Lifestyle factors are very important to managing chronic stress and nutrient replenishment, and getting enough sleep. Anxiety is a consequence of chronic stress. Chronic stress can also increase the risk of depression, cardiovascular disease, obesity, diabetes, autoimmune diseases, chronic headaches, memory problems, digestive problems, infections, and poor wound healing. Plus, chronic stress influences other behaviors, influencing our food choices (due to cravings for energy-dense foods and increased appetite). This can make us more vulnerable to addiction. Sarah references these shows for more information on anxiety: Episode 383: Anxiety Episode 303: Are Certain Foods Causing My Anxiety? Nutrient Deficiencies Caused by Stress When Sarah talks about nutrient deficiencies caused by stress, she means normal, run-of-the-mill chronic stress, not the mental health challenges that can arise from chronic stress. (19:30) She also recommends this review paper for more information on the effects of stress on the body: https://pubmed.ncbi.nlm.nih.gov/31504084/ Sarah decides to start with the nutrients with the most evidence of depletion by the stress response. Magnesium More than three hundred different enzymes in your cells need magnesium to work. This includes every enzyme that uses or synthesizes ATP and including enzymes that synthesize DNA and RNA. It is also a constituent of bones and teeth, is important for neuromuscular contractions, and is necessary for testosterone and progesterone production. It is important for the metabolism of phosphorus, calcium, potassium, sodium, B-complex vitamins, and vitamins C and E. Magnesium is also a cofactor in methylation and is necessary for detoxification functions. Numerous animal studies showed that serum reduced magnesium concentration and increased urinary magnesium excretion in animals exposed to acute and chronic stress. Studies in humans show the same thing. A 2006 study reported increased urinary magnesium excretion in university students during their examination period compared with the beginning of their academic term, correlating with self-reported anxiety. Another study conducted in 2000 showed significant decreases in plasma ionized magnesium and total magnesium concentrations in young volunteers exposed to chronic stress or subchronic stress. In a 2015 study designed to simulate a Mars mission, a 6-man crew was kept in isolation. The study recorded numbers of all magnesium measures with the biggest effect between days 0 and 30. Similar studies have shown magnesium reduction in response to sleep deprivation stress, physical stress (marathons), and environmental stress (loud noise for 4 hours). Sarah sums up that magnesium depletion shows the same results no matter what kind of stressor is triggering it. If you're looking for more information about magnesium, Stacy and Sarah did a whole show on it! Vitamin C Vitamin C is mainly an antioxidant and an enzyme cofactor. (28:00) As an antioxidant, vitamin C is essential in protecting proteins, lipids, carbohydrates, nucleic acids, and more from damage by free radicals and reactive oxygen species. Vitamin C is also used as an enzyme cofactor to generate critical compounds for joint and bone health, such as collagen. Plus, it helps to generate neurotransmitters like dopamine and serotonin! Vitamin C's role as an enzyme cofactor is likely why it's so important for the stress response due to cortisol and catecholamines production. The main catecholamines are epinephrine (adrenaline), norepinephrine (noradrenaline), and dopamine. Adrenal glands store A LOT of vitamin C. (source) An important 2007 study in humans showed that ACTH causes adrenal glands to secrete vitamin C and cortisol. It's thought that this release of vitamin C helps protect the brain from the behavioral effects of stress by preventing maladaptations (like anxiety and depression). Zinc Zinc is the second most abundant metal in the body. It has many important roles, including nearly every cellular function. (37:07) It is essential for the "reading" of the DNA map to make proteins. And it controls gene expression and communication within cells and the production of proteins. It is important for the absorption and activity of B vitamins, required for muscle contraction, and needed in insulin and testosterone production. Collagen formation, a healthy immune system, and the body's ability to heal from wounds also depend on zinc. It also plays a role in skin health and maintaining sensory organs (which links zinc deficiency with loss of smell and taste) and is a vital nutrient for immune system function. Several animal studies show that chronic stress decreases serum zinc concentrations and some tissue-specific zinc stores. Sarah adds that there aren't many human studies, but general data shows similar findings. A 1991 study measured plasma zinc concentrations before and after 5 days of sustained stress in Navy SEAL trainees ("Hell Week"). Plasma zinc levels decreased by 33% at the end of the 5 days but returned to baseline 7 days later. There have been similar decreases in zinc measured in released POWs. There is an even larger body of evidence with physical stress, like endurance sports. Iron Iron is a critical component of hemoglobin. This is a protein in red blood cells responsible for carrying oxygen from the lungs to cells in the body. (44:20) Heme is a critical component of a family of proteins involved in protection from oxidative damage. Iron is also needed to metabolize B vitamins, is a necessary cofactor for various enzymes, and is important in protein metabolism. Animal studies show chronic stress can decrease serum iron concentrations, ferritin, whole blood iron concentration, and hemoglobin. Sarah adds there are limited studies in humans. In that same Navy Seal study, iron concentrations decreased by 44%. Ferritin concentrations increased by 59% after 5 days of Hell Week. And a 2018 study of maternal perceived stress during pregnancy showed an increased risk for low neonatal iron at delivery and storage iron depletion at one year. In physical stress, a 1990 study showed decreased ferritin. However, studies in trained athletes don't show this. This indicates that there's some sort of adaptation to increased physical fitness. Calcium In addition to forming bone, calcium is essential to many processes, including neurotransmitter release and muscle contraction. (48:15) Calcium also helps to regulate the constriction/relaxation of blood vessels, nerve impulses, muscle contraction, and secretion of hormones like insulin. Sarah reminds listeners that bones are remodeled continuously throughout our lives. A hormone called parathyroid hormone (PTH) closely regulates the amount of calcium in our blood. It does this by occasionally "borrowing" calcium from bones that will hopefully get deposited back if there is enough calcium intake. In this case, there are more robust human data than animal studies. Previously mentioned 2000 study of young volunteers exposed to chronic stress showed significant decreases in plasma calcium concentrations. In the previously mentioned Mars simulation study, total serum calcium concentrations decreased by 16% from baseline after 30 days of isolation. It then stabilized at these lower concentrations during the remaining 75 days. Niacin (B3) Vitamin B3 is a water-soluble B complex vitamin and used in all cellular metabolism within our mitochondria. (53:30) We need it to produce energy from any macronutrient (fat, protein, or carbohydrate). Specifically, vitamin B3 is necessary for oxidation-reduction reactions, which involves transferring electrons across a membrane in the mitochondria. Plus, B3 is used to produce many molecules important for health (like cholesterol and L-carnitine), which is important for lipid metabolism specifically. Vitamin B3 helps improve circulation, aids the body in manufacturing various stress and sex hormones, and suppresses inflammation. One study identified the effects of cold exposure, calculation exercise, and dark exposure on niacin metabolism in female adults. Cold exposure significantly increased the urinary excretory output of niacin metabolites, although no change in urinary niacin concentrations was found after exposure to mental or emotional stress. Nutrient Deficiencies that Magnify Stress Sarah moves away from nutrient deficiencies caused by stress for a moment to talk about deficiencies that can actually magnify stress. (56:56) If you don't have these to start with and are then exposed to stress, results show it can make stress worse. Omega-3 A 2018 study associated HPA-axis dysregulation with lower n-3 PUFA, especially DHA, plasma levels. Another separate 2017 study confirms this is specific to DHA, not EPA, and EPA supplementation did not reduce stress levels. A 2004 study showed DHA supplement has an adaptogenic effect on stress. A significant reduction in perceived stress is supplemented with 6 g of fish oil containing 1.5 g per day DHA, while the placebo group is supplemented with olive oil. Stacy and Sarah have talked about omega-3 supplementation specifically in episode TWV Podcast Episode 415: Fish oil, Healthy or not? Vitamin C Sarah explains that the link between vitamin C and stress is a two-way street. (59:35) Guinea pigs made deficient in vitamin C hyper-secrete cortisol (source). Another study in rats showed vitamin C (equivalent to 2-3 grams in people) blunted cortisol secretion in response to stress (source). Supplementation of ascorbic acid in humans is associated with a decreased cortisol response after a psychological or physical stressor (source). Also, Vitamin C deficiency is widely associated with stress-related diseases! (source) Several reports have suggested a relationship between behavior under stress and ascorbic acid. A 2015 study in high-school students with anxiety, given 500mg vitamin C daily or placebo, showed a reduction in perceived stress and heart rate. Sarah briefly covers several more studies referenced here: 1. https://www.sciencedirect.com/science/article/pii/0009898175902508 2. https://europepmc.org/article/med/1963054 3. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02730-w 4. https://pubmed.ncbi.nlm.nih.gov/31001107/ Sarah adds that higher vitamin C levels increase cognition, and it doesn't matter if it's by food or supplement! Vitamin C is on Both Sides of the Equation! Vitamin C is so important because it both regulates the stress response and is depleted by stress. So low Vitamin C can become a snowball of badness. Also, nearly half of Americans aren't getting enough daily! Plus, infection, inflammation, and stress all increase our vitamin C needs. Although synthetic and food-derived vitamin C is chemically identical, fruit and vegetables are rich in numerous nutrients and phytochemicals, which may influence its bioavailability. Sarah briefly covers several other studies referenced here for more information: 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847730/ 2. www.researchgate.net/profile/Joe-Vinson-3/publication/242087621 3. https://pubmed.ncbi.nlm.nih.gov/18915110/ 4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847730/#B68-nutrients-05-04284 Final Thoughts Stacy tells listeners that there will be more bonus content on this topic over on their Patreon channel. (1:05:01) So for anyone curious as to what Stacy and Sarah really think about nutrient deficiencies caused by stress, it's definitely worth checking out on Patreon. She also thanks Paleovalley for sponsoring this week's show. Be sure to check out their vitamin C complex and bone broth proteins - both of which are Stacy's and Sarah's favorites. Stacy reminds the audience that many vitamin C products use corn-sourced products. She is sensitive to that, and finding Paleovalley's supplements was a blessing. She and Sarah only partner with brands that they love, use, and are confident in recommending. Stacy adds they she loves their organ complex and meat sticks as well!
66 minutes | Feb 26, 2021
Episode 445: What Supplements to Take on the AIP?
The Whole View, Episode 445: What Supplements to Take on the AIP? Welcome back to episode 445! (0:28) This week is all about supporting your health from the perspective of what you can control. And what you can work with medical professionals on to optimize your own health as much as possible. Specifically, Stacy and Sarah will be discussing supplements on the autoimmune protocol (AIP) or have been previously and are now in more of a maintenance mode. Stacy remembers when she first encountered coming across this topic while struggling with digestive issues. She was not absorbing anything from the food she was ingesting. This caused her to have to re-nourish herself through the use of supplements. She reminds listeners that what they go over in this show is not har-and-fast. As situations, health, and age change, your needs will change as well. Both Stacy and Sarah are not medical professionals. So be sure to touch base with your doctor when taking your health into your own hands. Sarah shares a comment from a member of the Patreon family that she feels sums up the approach she and Stacy takes toward this show. Today's Sponsor One of Stacy and Sarah's favorite supplement brands, Just Thrive, agreed to sponsor today's show! (2:30) They are currently offering Whole View listeners 15% off their order using code THEWHOLEVIEW or you can follow the link above. Bacillus bacteria are particularly important for gut health, even creating an environment where other probiotic species (like the Lactobacillus in sauerkraut) can thrive. Historically, we were exposed to Bacillus in dirt, but in our modern, sterile environments, Just Thrive probiotic has got us covered (no eating dirt necessary!). Not only is Just Thrive a potent probiotic, but it also contains a novel strain, Bacillus indicus (HU36), that produces antioxidants and vitamins right inside of the intestines, including lycopene, lutein, astaxanthin, zeaxanthin, beta-carotene, B vitamins, and vitamin K2! It can help people with IBS symptoms, digestion, infection, healthy gut, cholesterol, and so much more. The individual Bacillus strains delivered by Just Thrive have been extensively studied; plus, the good folks behind Just Thrive have published a human clinical trial showing these strains can reduce leaky gut. They have 11 other human clinical trials ongoing, which is incredible to see in the supplement industry. Other shows sponsored by Just Thrive worth checking out: 346: Can You Have A Healthy Gut If You Don't Eat Paleo 417: Vitamin K2 - Hype or Essential Other shows on supplements: 61: Supplements 234: Will I Have To Supplement Forever? Listener Question: A follow-up question from a previous show on Vitamin D inspired the topic of today's show. (12:42). Listener Sarah says: I am wondering what vitamin D supplement you recommend? When starting aip I was still taking my regular one but realized it had soy in it. I just listened to the vitamin D episode and realize how important it is for skin health. I need to get a new one and wanted to see what you recommend. I'm already doing Vital Proteins collagen, zinc, and fermented cod liver oil supplements. Anything else you recommend? I'm 3 weeks in and feel a lot better!! But I do miss eggs, chocolate, and rice cooked with homemade broth the most!! I love your podcast so much and get to listen to podcasts while I sew for my job all day!! You girls really made the day go by fast with your puns and science! Thanks for all the knowledge! Sarah adds that she believes puns to be the highest form of humor and is glad that (listener) Sarah also enjoys them. First, it's worth mentioning that Stacy and Sarah no longer endorse or recommend Vital Proteins collagen. (See Episode 430 for the details.) Stacy mentions that the formula change in Vital Proteins, depending on listener Sarah's situation, might negatively affect her if she's trying to eliminate gluten contaminants from her diet. Stacy also recommends a broth alternative that might help scratch that broth and rice itch! Sarah starts off by letting listeners know that there are many soy-free Vitamin D supplements out on the market. She wants to take Sarah's question and really talk about supplements on the AIP because it's gets asked a very common question. Taking Supplements While On AIP Sarah breaks supplements while on AIP into four different categories. (18:25) She reiterates Stacy's point at the beginning of the show that there's no one-size-fits-all approach to this or any specific list you should be taking while on AIP. It all comes down to you and your body as an individual. 1. Missing From Modern Food Supply This category is all about providing things that are really hard to get from our modern-day food supply. (19:00) Sarah explains that our modern food supply is actually quite depleted of vitamins and minerals than at other parts in history. Produce we get from grocery stores could have half the amount of minerals than what we would have bought 50 or so years ago. This she attributes to the depletion of soil over time. A lot of this can be remedied by buying high-quality, organic if you can afford to. Or even buying locally grown. The better quality dirt produce is grown in and the better quality food the animals consume all play into how much nutrients end up in the products we buy from the store. Also, our food is washed so thoroughly before it makes it to the shelves. Natural sources for many nutrients, such as bacillus bacteria, are from dirt! Historically, this is something we would have gotten much more easily due to smaller industries and more home-grown dependencies. Just Thrive probiotics are things we would have been exposed to originally that we just aren't getting from our modern food supply. 2. Food-Based Supplements For Nutrient-Dense Superfoods These are nutrients from superfoods that some might have barriers against getting enough of. (23:10) Stacy and Sarah have talked extensively about bone broth in the past as something that people are not getting enough of. Sarah poses the question of what options you have if you don't like the idea of consuming bone broth or organ meat to get those nutrients. Paleovalley is another trusted resource of Stacy and Sarah. They make a great Bone Broth Protein and Organ Complex for consumers looking to supplement those nutrients rather than directly to the source. Smidge Liver Pills is another organ supplement that Sarah highly recommends. Sarah has noticed it's been a lot more difficult to get organ meat during the pandemic. She has relied on supplements much more this last year. Stacy also notes that she switched to Paleovalley organ complex a few months ago. She likes how diverse the supplement was. Sarah and Stacy talked in depth about the benefit of seafood from a nutrient stand-point in Episode 415: Fish oil, Healthy or not? Some people, however, don't like or can't eat seafood. For them, Sarah recommends OysterZinc or Cod Liver Oil. In Episode 373: How Many Vegetables (Part 4) Powdered Veggies, Stacy and Sarah talked a lot about the power of freeze-dried veggies. Episode 392: Are Mushrooms Really Magic? Part 2 is another great resource for nutrients that often met with barriers. Real Mushrooms offer a great supplement to fill that gap! Fermented foods are another hurdle that can be bridged by a probiotic like the ones provided by Just Thrive. Stacy adds to watch out for juices and pulps because you're not getting the whole form of the fruit and/or vegetable, so you may be missing out on some key nutrients. She personally leans into smoothies as a way to "juice" without juicing. 3. Targeting For Severe Deficiencies This doesn't necessarily mean targeted synthetic. It could easily mean targeting one of the prior mentioned categories to meet that shortfall. (43:02) This is where you get into Sarah's "Test Don't Guess" mindset. Here is where you should work with a professional medical expert who can run tests to tell you exactly where your deficiencies are. Vitamin D is one of the most common deficiencies doctors see. If your Vitamin D levels are already low, it's very hard to meet that deficiency without supplement help. Iron and vitamin B12 deficiencies are also among the most common. Sarah notes, however, your body could be deficient in something completely different due to genetic issues that put you at a disadvantage for absorbing it. Listeners might still supplement with food-based supplements, like taking Real Mushrooms D2 for vitamin D insufficiency. Stacy and Sarah talked in the past about Vitamin K2 and whether it's hype or Essential. Listeners might want to add Just Thrive K2 here too. Sarah also notes that it often takes more than just changing your diet to get to the appropriate levels with severe deficiencies. Stacy has personal experience with B12 struggles and Vitamin K2. She shares a little bit about her journey and what she's learned from it. None of this stuff is something you would take without testing and monitoring from a doctor. Because this is the type of stuff you'd only do with a medical professional, Sarah thinks it's best to go over what types of things it would involve. 4. Targeting For Other Purposes The "lowest hanging fruit" is digestive support supplements. Here you'd work with a practitioner to assess digestion efficacy through stool testing. (45:00) This looks for undigested fats and proteins that would otherwise not be there if your digestive system was working optimally. It's important because you can eat all the nutrient-dense food you want, but your body isn't breaking them down properly for absorption, they're not providing you with the things you think they are. Adaptogens, vitamin C, and magnesium are used to treat adrenal fatigue and chronic stress. Sarah adds that adaptogens always need to be adjusted over time which is why store-bought supplements for stress management aren't as effective as you hope/think they will. Probiotics might be called for severe gut dysbiosis. Just Thrive is in this category! However, a medical professional will test for this and help figure out the path that's suitable for you. CBD for pain and inflammation. Stacy and Sarah talked in-depth about the benefits of CBD in Ep 420 CBD for Pain Management. DIM or high crucifer intake for hormone imbalances, glutamine for leaky gut, and melatonin for sleep (Ep 314 Is Melatonin Safe) are great avenues a doctor can test for. Stacy adds that you might not need all of this, or you might be someone who would benefit from it. She and Sarah have talked at length about why some supplements they've given priority over others. For example, CBD and melatonin are often lower on their priority list. Notes for Just Thrive Probiotic Bacillus is spore-based bacteria naturally found in dirt that are particularly important for gut health. They produce at least 795 different selective antibiotic molecules that inhibit pathogenic bacteria, fungi, and protozoan parasites, helping maintain a healthy gut ecosystem. But, among the over 200 different Bacillus species currently identified, not all are equally beneficial, and some may even have pathogenic potential. That's why it's so important to choose a probiotic supplement using only well-studied beneficial strains, like the four strains delivered by Just Thrive Probiotic. Bacillus subtilis drives restoration of microbial diversity during infection, stabilizing the microbiome. They increase the growth of well-known probiotic species, including Lactobacillus reuteri and Lactobacillus acidophilus. It supports gut health by producing essential enzymes to aid digestive function, producing amino acids, synthesizing vitamins, degrading cholesterol, and even contributing to intestinal homeostasis maintenance. Bacillus subtilis can help antibiotic-induced diarrhea, ulcerative colitis, bacterial vaginosis, urinary tract infection, and candida vaginal infections. This probiotic species improves gut health by protecting against genotoxic agents and regulating cell growth, differentiation, and signaling. Sarah loves that Just Thrive Probiotic is free of wheat, gluten, dairy, nuts, soy, salt, sugar, artificial colors or flavors, binders, fillers, allergens, and GMO's. One of her priorities is taking Just Thrive Probiotic daily! Historically, we were exposed to these awesome Bacillus species in dirt (for example, eating unwashed organic veggies from a local farm, compared to other probiotics that we can get from fermented foods). But in our modern, sterile environments, Just Thrive has got us covered — no eating dirt necessary! Sarah also always takes Just Thrive Probiotic with a meal, usually dinner. Bacillus species are among those known to exhibit circadian rhythm in their relative abundance in healthy conditions (and lose circadian rhythm in metabolic syndrome), peaking after meals and ebbing between meals. Final Thoughts About Supplements While On AIP Stacy reminds listeners that AIP is an umbrella term. (1:01:20) She feels it's important to keep nutrient density in mind, but it's crucial to make sure you don't stress yourself out about it either. It's about balance. While this is a lot of information to a really simple question, Sarah jokes that a short answer would've have made a very good show. So they dug in deeper than most people would normally need to go. Take this information about supplements while on AIP as a base knowledge for what might be beneficial to you in certain circumstances. It's also critical to find a good practitioner to work with for any next-level stuff. Also, don't forget to check out Just Thrive and their probiotics and other products. Thank you, Just Thrive, for sponsoring today's show. And thank you, listeners, for hanging in. If you want more of the Whole View and hear how Stacy and Sarah really feel, hop on over to Patreon for bonus unfiltered content. See you next week!
66 minutes | Feb 18, 2021
Episode 444: Covid-19 Vaccine Myths and FAQ Part 5
The Whole View, Episode 444: Covid-19 Vaccine Myths and FAQ Part 5 Welcome back to episode 444 of the Whole View! This is the surprise second part of last week's Covid-19 FAQ and Myth show, which turned into a mammoth episode. You haven't yet listened to can find the first part of the show here. Stacy reminds listeners that she and Sarah are not medical professionals and consult your primary care doctor before making any decisions. Myths Surrounding Enhanced Infection First, Sarah has one more frequently asked question to cover before she gets into the real big myths. (2:04) There has been a lot of misinformation circulating within the scientific community regarding the mRNA vaccine and the whether or not the possibility of "enhanced infection" is possible. Hematopoietic cells originate in the bone marrow and are responsible for replenishing all types of blood cells for our entire lives. As a result, they are very important cells in combating infection and are very plugged in to the immune system. Sarah explains how stem cells work in the body to support and control our immune system and fight off illness. She also adds that there is zero evidence of any vaccine, including the mRNA vaccine, jeopardizing these cells. Sarah lists articles here and here for more information. Just in case, Sarah runs through a hypothetical of what it would look like if these claims were possible. Pfizer tracked 21 different types of severe infections. And they found no statistical difference between the vaccine and placebo group within 2 months of the second shot. In Moderna, there were 521 infections or infestations (of any kind) post-vaccine and 621 post-placebo (which is no statistical difference as well). Finally, Sarah goes over a handful of cases found in both the test and placebo group and the situations surrounding those patients to put perspective into why they might have occurred. Antibody-Enhanced Infection In Episode 425, Sarah and Stacy talked about the antibody-enhanced infection in Dengue Fever cases. (8:19) Sarah gives a brief recap of how this antibody-enhancement works. It's important to point out that SARS-CoV-2 (as well as other coronaviruses) have not been shown to have the ability to infect macrophages. Sarah adds that if this were a real medical concern, it would be the same for all vaccines across the board, not just mRNA vaccines. This misconception grew from cell cultures reacting during the early vaccine research for SARS (not SARS-CoV-2 aka Covid-19). While it is a Covid-19 vaccine myth, it did grow from a small grain of truth that we've since learned from because these experiments showed researchers needed to adjust the target. Sarah reminds listeners that building upon past scientific discoveries is what we owe to these vaccines' speedy development. Sarah recommends this paper for more information on the history of coronavirus vaccines. If ADE is possible with Covid, we'll see it with natural infection first, which we have not yet seen. She shares that scaring people with these myths, not looking at early research study as something to grow from, and using it to spread misinformation upsets her. We are over 2.3 million deaths globally and over 470k in the USA from Covid-19. Doing Your Own Research Is Important! In part 2, Sarah explained that the risk of developing some of these vaccine-induced injuries is 1 in a million. However, no one wants to be that one person. That's why it's so important to know your own health, potential risk factors, work with your doctor to use all the information available. That way, you make a choice that works better for you as an individual. And building herd immunity in the low-risk populous will protect those who aren't well enough to get the vaccine themselves. Sarah adds that with the way research works, there is the possibility that future data may change the landscape of this vaccine. And that's why research and education is so important. Corporate Myths And Theories Sarah mentions many of the "questions" she received regarding this topic weren't earnest questions from typical readers looking for information. But rather, people looking to stir up trouble. (21:20) She wants to include them in this show because listeners may have family members or friends who have heard them. And she wants to arm listeners with facts. Stacy adds that if it comes from genuine ignorance and you're looking to educate yourself, there is nothing wrong with asking these types of questions! However, when others leave inflammatory comments around these topics, she's noticed how obvious it can be that they didn't listen to the show beforehand. They're just not interested in truth- they are only interested in their own opinion. In those cases, it's not your responsibility to engage with them if you don't want to for the sake of your own sanity. If they're interested in knowing more, they will do their research. If not- it's not your job to fix other people. Covid-19 Vaccine Myths: For-Profit Argument Sarah reminds listeners that it's not in a company's best interest for their products to hurt their customers. It's not a good business model. (25:05) Also, most of these vaccines are industry-academic partnerships. And the base science tends to be academic (source). The studies themselves are peer-reviewed (meaning by third-party researchers in the same field), and the FDA review process is independent of scientists. This means there has been a TON of non-biassed eyeballs on this data. While money may be made to some degree, all of the research done on these vaccines was done by academics (not businesses). Covid-19 Vaccine Myths: mRNA vs. DNA Sarah takes a minute to underline that RNA is not the same thing as DNA (27:21). She and Stacy went in-depth in Part 1 about what role RNA plays in the body and how it does not enter the cell's nucleus (where the DNA is housed). That's what makes mRNA technology so cool! Stacy adds how glad she is just to be aware of the "line" it won't cross. There's a whole nuclear envelope acting as a barrier. Covid-19 Vaccine Myths: Traces of Controversial Tissue Cells Sarah explains that neither the Pfizer nor the Moderna vaccine uses cell lines in this form or from this origin any stage of design, development, or production of these vaccines. (29:06) She also explains what "immortalized" means, where these cells come from, and the roles (and have played) in scientific research. There are hundreds of different types of these cells- not just the controversial source commonly associated with them. Sarah adds the ethics in place now are different than the ethics of the 60s and 70s when this first started. And no sample would ever be taken unless consent was given first. Some of the COVID-19 vaccines currently being studied in clinical trials have used these "historical" cell lines. But the Pfizer and Moderna vaccines are not one of them. Sarah provides a list of potential vaccines to look closer into before getting if this is an issue you feel strongly about. There is a great effort in medical research to be ethically uncontroversial, and these cloned cells are only used if alternative ones cannot be. Covid-19 Vaccine Myths: Hidden Foreign Bodies Sarah looked into the needles' diameter used with the coronavirus vaccines and how small something would need to be injected into the skin. (37:24) Anything small enough to hide in a needle would not be able to be read from something as far away as outer space. Sarah goes through how big these foreign objects would need to be to transmit various distances. Basically, with the way currents move and physics laws, it's an impossible technology and would burn out pretty quickly. Covid-19 Vaccine Myths: Bribing Dr. Sarah's Sarah has received comments regarding her integrity regarding these topics and whether she's been bought off. (41:03) The answer to that is no. Stacy adds that both she and Sarah genuinely care about the health of their listeners. They've dedicated their careers to health and wellness. She adds how thankful she is for the "big brain" audience she and Sarah have and the mutual interest in facts and science. Sarah has applied the same rigorous research to this show as she does every other show. All she and Stacy aim to do is help people expand their knowledge base to make everyday decisions without guilt, pressure, or lack of understanding challenges. Everything they do is present science in the most balanced way possible. Sarah adds that she's a scientist. She's a nerd. All she's really interested in is the facts. Roll-Out Priorities & Challenges The rate at which the vaccine can be produced is the reason behind roll-out priority for who gets the vaccine. (47:20) Basically, they haven't made enough vaccines yet for everyone to get one and focus on people who need it the most while they ramp up production. Priorities are healthcare professionals and the people who are more likely to get a severe disease and die. There are different ways to define these populations, and some states are doing it differently. Here are the Phases the CDC recommends: 1a - healthcare personnel, long-term care facility residents 1b - frontline essential workers, persons aged 75+ 1c - persons aged 65-74, persons aged 16-64 with high-risk conditions, essential workers not recommended in Phase 1b 2 - everybody else There have been racial inequities in vaccine distribution which is very upsetting to Sarah because the black community is 1.4X more likely to get Covid and 2.5X more likely to die from Covid. She attributes this to the compounding of different things, including systemic racism and the prevalence of that community in frontline positions. Less than half of the states keep track of demographic data for vaccine distribution, but we know so far that there are big inequities in distribution (source). This is a problem that public health officials need to solve. And there are some really good ideas being considered- like mobile sites, door-to-door. You can donate to advocacy agencies to help and not participate in vaccine tourism! Who Should Wait to Get a Vaccine? Children 15 and younger because clinical trials for that age group have not been approved yet. Pregnant/lactating women, immunocompromised individuals, anyone on immune-suppressing drugs (even prednisone), and people with multiple severe/anaphylactic allergies should all talk to their doctor. Anyone with a known allergy to PEG (found in some other vaccines, medications, and laxatives) should also wait. It's also not recommended for the terminally ill or all elderly. Sarah also explains a bit about why some governments throughout the world are holding back and why. She attributes this to trying to get the best out of a limited number of vaccines. Vaccine Aftercare Sarah takes another listener question on whether taking Advil or Tylenol after being vaccinated impacts how well it works. (58:25) She explains that something like Advil is anti-inflammatory will suppress some of the immune response, which is counterproductive to the goal. She adds that this is actually true for all vaccines! Instead, you should do the same thing as if you were recovering from a cold or flu: rest, fluids, and nutrient-density focus. It's also noteworthy that adults don't take very many 2-shot vaccinations. DTap booster every 10 years and maybe annual flu vaccine are both 1-shots. The flu-like symptoms come from the second shot (which we're not used to getting). And it's important to rest and recover! Further Citations & Scientific Literature Summary of mRNA vaccine technology https://www.nature.com/articles/nrd.2017.243 https://www.frontiersin.org/articles/10.3389/fimmu.2019.00594/full https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439223/ https://www.nature.com/articles/s41541-020-0159-8 https://www.nature.com/articles/nrd4278 Covid Immunity, relevance to all vaccines in development https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32137-1/fulltext Moderna mRNA-1273: FDA Briefing Document (54 pages) Published Phase 1 trial result Published Phase 2/3 trial results Pfizer BNT162b2: FDA Briefing Document (92 pages) Published Phase 1 trial results Published Phase 2/3 trial results Final Thoughts Stacy thanks any and all listeners for hanging with them through everything! (1:03:01) She invites anyone who hasn't already joined their Patreon family to consider doing so. Patreon listeners get bonus content on what Sarah and Stacy really feel about these topics. Also, Stacy encourages anyone willing to leave a review about the Whole View to do so. Due to vaccines being such a sensitive topic, your review would help balance negative ones left by those who disagree but don't bother listening to the show. Thank you so much for listening. Be safe. Be healthy. And we will see you next week!
74 minutes | Feb 12, 2021
Episode 443: Covid-19 Vaccines Part 3 - Myths and FAQ’s
The Whole View, Episode 443: Covid-19 Vaccines Part 3 - Myths and FAQ’s Welcome back to episode 443 of the Whole View. (0:27) Stacy explains that this is part 3 of the Covid Vaccine Shows: you can find Part 1 here and Part 2 here. She thanks every listener for all their positivity and understanding. The point of these shows is to give the information needed to make an informed decision for yourself. She also extends a bit thanks to Sarah, who has logged a ridiculous amount of hours doing extensive research to arm listeners with all the information she can. Sarah explains that this show may be on the long side. But she hopes to answer some questions followers have and dispel or shed light on common myths around these vaccines. Stacy adds that this show is all about the facts. Nothing they say is meant to be opinion based not backed up by science. She also reminds listeners that she and Sarah are not medical professionals. They are not qualified to give medical advice on whether you should get the vaccine or not. The best practice is to consult your primary care physician. Stacy hopes that all this information can help listeners make an informed decision they are happy with. Listener FAQ: Covid-19 Vaccines Myths Sarah goes through several positive comments left by viewers, expressing their appreciation of the science included in previous shows and arming them with as much research as Sarah did. (7:45) She takes a moment to emphasize that the FDA reports and all of the peer-reviewed papers on these clinical trials are full public access. They will be included in these show notes so listeners can go to the source for more information and formulate their own opinions based on the science. Stacy jokes that will be a theme of the show today: science and information. The first question Sarah takes comes from a listener on Patreon. Sarah reminds listeners that Patreon is the best platform to reach them and was the first place they went when pulling questions. If you've not joined the Patreon family, she invites you to for bonus content and extra episodes! Herd Immunity The first question Sarah takes is about herd immunity and why wearing masks is still encouraged after vaccination. (13:30) Sarah explains the there are multiple positive outcomes that we hope to get from the vaccines: Prevent disability and death Ease the burden on the healthcare system to ensure patients get the necessary attention Ease the burden on the economy so we can open schools, etc. back up Achieve herd immunity, so we don't have to live with covid forever She adds that even if we can achieve the first three without the fourth, that's a huge win, and we don't necessarily need herd immunity for the vaccine to be a success. The benefit of herd immunity (why it's ideal) is it limits the spread to pockets that more easily die out because they don't have as many places to go. Sarah explains that we don't have all the information yet to determine how long immunity from vaccination will last. There is still a lot of tests needing to be done to accurately calculate those numbers. Sarah does say that the preliminary data (early outlooks) looks promising for reducing asymptomatic cases. That's why it's still important to wear a mask in the meantime. We need to keep the disease spread as low as possible to give researchers time to figure out what the future will look like for herd immunity. Sarah adds that this is actually very exciting early data. She explains data for the newer Oxford/Astrazeneca vaccine maybe 59 percent effective at stopping asymptomatic infection. However, Sarah emphasizes that we definitely need more data before saying people with the vaccine can go without masks and social distancing. Long-Term Effects of Asymptomatic Cases Sarah jumps to another listener's question on whether those asymptomatic or mild cases carry the risks of long covid or other long-term damage. (22:32) Sarah recaps long-covid, which she and Stacy talked about long covid and tissue damage on our previous covid shows. She does a quick recap on what long-term effects are known to be associated with Covid-19 infections, such as the tissue damage seen in long-Covid. There's no evidence from the clinical trials about possible long-term damage comparable to mild cases. Myocarditis is shown to occur in between 15-35% of covid patients and even 15% in young college athletes with mild or asymptomatic cases. Sarah reminds listeners that not everyone who gets covid will suffer permanent heart damage. She does agree it's a concern but doesn't want to scare anyone. While this hasn't been methodically studied yet, the early data points to the only likely long-term effect of getting vaccinated being immunity to covid-19. Stacy adds that many people involved in the clinical trials actually reached out to her and Sarah. They spoke of the attentiveness they experienced and how closely monitored they were. Stacy thanks those followers for sharing their crucial experiences! Stacy also shares her experiences with long-covid and does not wish it on anyone. Both vaccines were thoroughly tested for anything and everything that could possibly go wrong. Pregnant Women Another listener asks if the Covid-19 vaccines are safe for pregnant women and children yet, due to it being super unclear in the media. (37:20) Pregnant women were excluded from trials, but some became pregnant after enrolling. Those women were followed closely for monitoring. There is very limited human testing in this area. However, WHO recently said pregnant women can get the covid vaccine due to the few cases. No issues with pregnancy were detected in animal studies of vaccines. Sarah mentions that pregnant women are considered high-risk, and that's definitely something to keep in mind when deciding if vaccination is right for you. Pregnant women are overall 3-3.5x more likely to require ventilation. And 70% more likely to die from covid than their age and risk factor-matched controls. It's even worse for AMA, pregnant women aged 35–44 years with COVID-19: nearly four times as likely to require invasive ventilation twice as likely to die than were non-pregnant women of the same age Sarah recommends reviewing this article for more information. She also mentions that despite being considered "high-risk," the absolute risk is still low. This is why even though data is preliminary for vaccines, some organizations recommend it. CDC recommends pregnant women have a conversation with their doctors. Another listener asks for recommendations for breastfeeding. Sarah says that nothing is saying that breastfeeding could be problematic. But it does warrant a conversation with your doctor. Stacy adds that what's in your blood is different from what's in your milk. Children Pfizer already tested in 16-18-year-olds. It showed good safety, efficacy consistent with adult data and already has EUA to 16+. (40:41) Pfizer is currently testing in 12-15-year-olds, fully enrolled, and expect data in the summer. Moderna is currently testing 12 to 18-year-olds, still enrolling, and hoping to have approval in time for 2021/2022 school year. Sarah actually enrolled her daughter because they are having issues filling slots for those studies. She and her family are waiting to find out if she'll be in the trial. Then they'll move into younger and younger children (6-11 then 1-5). They go slow, start with a lower dose to be extra cautious, and so these trials take longer. Moderna doesn't expect to have data in children 1 to 11 until well into 2022, so we just have to wait for now. Young Women and Future Pregnancy Sarah addresses a question from a listener regarding information she heard about the possibility of hurting the lining of their placenta when they want to have children. What is the premise of this? (49:50) She explains that this is one of those myths based on a kernel of truth but took on a life of its own on the internet. Sarah goes in-depth about the spike protein and how antibodies affect them. She adds that the same thing has a chance of happening in natural infection. And even then, the numbers are very slim. Sarah summarizes that it's not impossible but highly improbable, and we have no examples to point to. Autoimmune Diseases In More Detail Sarah covers another question on whether a vaccine could cause something with no history of autoimmune conditions to trigger a response for a lifelong autoimmune condition. (53:02) She goes in-depth, looking at numerous case reports indicating that vaccines could potentially worsen autoimmune disease activity and increase measurable autoantibody levels. This is most likely attributed to the adjuvants in vaccines. However, several large-scale prospective studies indicate no link between vaccines and autoimmune disease or autoantibody formation. Sarah explores several different studies that looked at this research topic and breaks down what the data shows. In fact, early data shows vaccines could potentially reduce autoimmune diseases by preventing environmental triggers for it. However, this still needs to be studied in a lot more detail before we can say for sure. Sarah adds that for the covid mRNA vaccines, clinical trials included autoimmune sufferers (even those on DMARDS) and tracked autoimmune disease as possible adverse events. Sarah revisits vaccine injury, which they discussed in the Covid first show, and the timeframe. She adds EAU will transition to full regulatory approval once there are 6 months of follow-up data and we're actually nearly there. Clinical trial participants will also be followed for 24 months. Final Thoughts Stacy reflects on how much it blows her mind the comparison between the study group and the placebo. (1:07:14) When out of 30,000 people, you have one person in the study group and one placebo group both have an immune response, it sounds way better to Stacy than if that's the same one person was extrapolated from the data, and the rest left out. Sarah reiterates that this is the point of these shows: to provide listeners with the big picture and all the data. Not facts that may or may not have been taken out of context. Stacy mentions that she and Sarah didn't want to skimp on any information. For this reason, decided to cut this two-hour show into two parts. Join us again next week for more Covid-19 vaccine myths dispelled! And be sure to pop over and join Sarah and Stacy on Patreon.
70 minutes | Feb 5, 2021
Episode 442: How Do I Know What Dietary Protocol to Start With?
The Whole View, Episode 442: How Do I Know what Dietary Protocol to Start with? Welcome back to episode 442 of the Whole View. (0:27) Stacy welcomes listeners to the show! She hopes everyone has had a great start to the year so far, but if not, it's a new month. Today's topic is dietary protocol. And Stacy hopes listeners have been seeing fewer advertisements and pressure to conform to a dietary standard that could end up making them not feel right. She and Sarah, as always, will approach this topic from the perspective of addressing the difference in the dietary protocols that are focused on health. Stacy also takes a moment to remind listeners that all the information in this show comes from a place of optimizing health. They are not here to tell you to lose weight and fit into your jeans, but rather help you feel better, inside and out. This is a safe place to learn and not to feel pressured. Listener Question Sarah reflects on how much this show has documented her and Stacy's individual health journeys and the ups and downs that they've experienced. (4:03) They are not the type of people to hide their challenges to paint a rosy picture or endorse that approach. Their main goal is to endorse a solution-oriented mindset about health, doable, approachable, and sustainable. Sherly asks: Hello Dr. Sarah and Stacy! I was so happy to find your podcast during these strange times and have found all your Covid shows so helpful. I understand that neither of you strictly follow any of the diets you talk about on the show (AIP, Sarah’s Gut Health Diet and Paleo) but rather used them to find out what worked best for you over time. For those of us just starting out how do we go about picking a diet to start from? Is there a hierarchy here? And where does being a “nutrivore” fit into all of this? Apologies if you have already covered this, but I am slowly working my way through your shows. I have come to trust your recommendations and I would like to re-do my own way of eating, I just don't know where to start. Thanks in advance for your help! The Quick Answer Stacy explains that, in brief, the autoimmune protocol is an additional step beyond the paleo diet. Its driving strategy is to eliminate potentially inflammatory foods out of the diet still included in paleo (including nightshades). Nutrivore is more concerned with nutrient-density and taking care of your gut microbiome health. Sarah jokes and congratulates Stacy for pulling off a great elevator pitch! Though, Stacy urges listeners to stick around a bit longer because there is a lot more to the science behind these protocols. Sarah explains that the lines between each dietary protocol are pretty blurry. She attributes that blurriness to how these lines are used to hone in on a personalized optimal diet. She and Stacy have both used these protocols to target their individual triggers and build a diet that works for them. Sarah and Stacy do not do on this show are rigid rules, "perfection-or-bust," or one-side-fits-all. Instead, they encourage the understanding of universal truths and bio-individuality. The Dietary Protocol Hierarchy Stacy reminds listeners that there is such a thing as taking too big of an initial jump. (13:16) It's essential to listen to your body and tell you what you need or crave. Top Level: Nutrivore The idea of nutrivore is to eat all the nutrients available, both essential and non-essential, that we need to thrive. This includes nutrients to support a healthy gut microbiome and is very similar to the gut health diet. The gut health diet provides just a little extra focus above and beyond nutrient sufficiency. Sarah references Episode 437: Intro To Nutrivore as a great reference if you're looking to focus on a nutrient-dense diet. She thinks of this as a diet modifier, meaning you can apply nutrivore to any other diet template, including the other protocols on this list. However, the exception to the "umbrella" of nutrivore is extreme diets, such as raw vegan, carnivore, or some keto variants, which cut out all food sources of specific nutrients. Sarah explains the benefit of nutrivore is the ability to give the body all the "building blocks" it needs to do its job on a cellular level. Paleo Plus or 80/20 Paleo Sarah explains there are many different versions of the Paleo diet. (18:50) This is a version that adds a few nutrient-dense, gut microbiome superfoods to provide some extra flexibility. The most common additions are grass-fed (hopefully A2) dairy, traditionally-prepared legumes, sprouted pseudo-grains, and rice. “Strict” Paleo Ideally, this would be implemented with the guiding principles of a nutrivore approach. (20:01) But it also eliminates empty calorie foods that are often allergy triggers or anything that wouldn't have been available to our primitive ancestors. The foods eliminated (processed/refined foods, grains, legumes, and dairy) most commonly drive inflammation while not contributing meaningfully in terms of nutrients. Paleo should still include an elimination and challenge aspect. This is where you do "strict" Paleo for a few weeks to months and then test your individual tolerance to non-Paleo foods to see how you react. AIP AIP is the strictest dietary protocol. (23:56) Nutrivore is the core of this protocol but with the addition of eliminating a larger collection of foods known to cause inflammation. On top of processed and refined foods, grains, legumes, and dairy, AIP also eliminates eggs, nightshades, nuts, seeds, alcohol. This dietary protocol includes an equal focus on lifestyle, such as sleep, stress, activity, nature, and connection. It involves three phases: Elimination, Reintroduction, Maintenance. Sarah explains that AIP is not meant to be a long-term solution. But rather, the hope is to empower you through self-discovery and set you on a dietary path that works best for you as an individual Lastly, Sarah recommends visiting the AIP Coach Directory if you're interested in receiving more AIP information. Dietary Protocol: Where To Start? Stacy explains that everyone is different, and there is a lot of wiggle room to make sure they are working optimally for you. (27:30) Moreover, many of them, especially FODMAP diets, aren't meant to be upheld long-term. In those cases, they are more designed for symptom maintenance. Sarah explains that anything layer to think about is food sensitivities. There is an extra challenge when you have a hyperactive immune system and an unhealthy gut that you can develop allergies, intolerances, or sensitivities to foods that are always super healthy and otherwise something you wouldn't eliminate. Part of the self-discovery stage could include working with a specialist to target what could be triggering your individual symptoms. Because we are all different, Sarah explains that deciding where to start depends on few different factors. Health Challenges And Goals This is the first side of the coins, Sarah explains. (33:47) AIP is usually recommended for autoimmune disease or chronic disease. Paleo or Paleo Plus is great for symptoms without a diagnosis, and using a food journal to target other potential food sensitivities. Nutrivore or Paleo Plus works well for age-related health challenges. And if you have no health challenges, in particular, Sarah recommends starting top-tier with Nutrivore. Mitigating or managing autoimmune or chronic disease, AIP is a good strategy to use. If you're looking for a healthy weight loss (see our show on weight stigma!), Paleo or Paleo Plus might work best for you. Unless your weight gain is related to autoimmune diseases, like hypothyroidism. Nutrivore or Paleo Plus is great for people looking for a performance diet or healthy aging. And for general health, nutrivore is always a great protocol to implement. Barriers Sarah explains to listeners that you don't want to make it so challenging day-to-day that you can't stick with it. The idea is to set yourself up for success, see results, and improve your health. We often justify actions centered on the idea of weight loss and claim that it's for health. Stacy reminds listeners that diet culture is so pervasive that we don't even realize we're swimming in it. And that we must look at whether or not we feel good. Especially when it comes to inflammation and autoimmune. It's very important for Stacy that her joint pain is manageable as she ages. Stacy also shares that at one point, she was using dietary protocols and "getting healthy" as an excuse for losing weight. She really wants to encourage everyone to ask those questions and challenge themselves and the reasons behind their choices. You can want to be the best version of yourself while loving and respecting who you are today, without all the ugliness that comes with the culture around it. Stacy also underlines the importance of emotional and lifestyle aspects and that you can't just diet your way into being healthy. A few solutions to overcoming barriers are education, coaching, support network, flexibility, and lifestyle before diet. Maybe you're just not used to shopping/cooking/eating this way. It could be your budget, time management, energy, or symptoms getting in the way. Maybe your family isn't on board (temptation, no support, cooking for 2+ different diets). History of yo-yo diet, on-again-off-again, and bad relationships with food can also get in the way. Final Thoughts Sarah explains that sometimes the best place to start isn't diet at all. (48:03) Often, when she gets this question, she asks whether or not the person is getting enough sleep. This way, we can set up for success before we even get started on changing our diet. Sarah references this show for any listeners looking for a reference on the Science Of Habits. She reminds listeners that this is a journey! There is no one way to do it, and any steps you take on that journey is a great way to do it. This really comes down to who you are as a person and how you're able to best perform a task- whether incrementally. It needs to be an individual choice and a choice you're willing to re-evaluate as you go. Sarah underlines that the most important thing about starting a health journey is to start it. Stacy adds that it's not so much what step to take to get you started but what steps will be sustainable. Stacy talks about how this played into the inspiration behind their third book, Real Life Paleo. She reminds listeners that messing up isn't a failure. It's about continuing to try. Sarah agrees, adding not to let perfection be the enemy of the good. It's all about our choices, and we should never feel guilt or shame about them. The key part of this journey is learning about our bodies well enough to know what we'll be able to come back from and what we never want to repeat again (like the last time Sarah ate gluten). Stacy encourages listeners to look at healthy choices as an act of self-love for themselves and their bodies. Thank you so much for listening! Stacy and Sarah are so thankful to have such a fantastic community.
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