Dr. Kyle: Diet Do’s and Don’ts for 2019

 

Looking to start a new diet in 2019? Here are a few tips on what to avoid and what to incorporate into your nutritional regime this year.

FATS ARE GOOD

The human body is designed to process and burn fats as one of its primary energy sources. Fat enhances food digestion and nutrient absorption. Accompany sides of vegetables with a fat source to increase nutrient bioavailability.

Try cooking with animal fats, organic grass-fed butter and coconut oil. Avoid trans fats and poly-unsaturated vegetable oils like canola oil.

Add some wild-caught salmon into your diet to balance out the ratio of omega-3’s to omega-6’s. The typical western diet has an abundance of omega-6’s so eating salmon 1-2 per week will boost your levels of anti-inflammatory omega-3’s.

DON’T SHY AWAY FROM CHOLESTEROL

Cholesterol is vital for the synthesis of hormones and vitamin D. It also helps form cell membranes and other structural components.

Eat whole foods and at least 1 yolk with your egg whites. This will give you a better nutrient profile and a healthy dose of cholesterol.

RED MEATS

Red meats have almost everything you need to not only survive but thrive. They are one of the most micronutrient dense fuel sources on the planet. Red meats are high in b-vitamins, iron, zinc, magnesium, and creatine.

Red meat also includes Lamb! It is an excellent source of heme-iron as well.

GET YOUR PROTEIN

It is most commonly recommended that daily intake should be 1g of protein per pound. Older athletes will need more due to less efficient protein absorption.

Keep in mind that dietary needs will fluctuate based on physical demands and training goals. Athletes trying to put on mass should eat 40g before bed to maintain protein synthesis throughout the night.

20g per meal will provide 90% of muscle protein synthesis. 40g will provide 100%.

Carbohydrates

Some carbs are better then other! So, we want to pick the right ones.

Avoid refined sugars (obviously). Include variation and eat 2 forms of carbs at a time for faster absorption. I recommend sweet potatoes, spinach, red peppers and carrots. These foods have plenty of micronutrients and produce low levels of gas.

Add a side of white rice to your meat and vegetable dish. White rice is easy to digest, and can help supplement your macronutrient intake. Oats on the other hand can be hard to digest – soak them in warm water overnight or add yogurt.

Remember, carbohydrates are used to fuel workouts! Getting adequate carbs to sustain your athletic performance will protect against muscle tissue breakdown.

As always, ask a healthcare professional for dietary recommendations that best suit you. Some foods that work well for others may not sit well for you. Listen to your body.

Stay healthy and good luck achieving all your health and wellness goals for 2019!

Dr. Laura: How does your thyroid function?

Feeling tired, loosing hair, bring fog, brittle nails, constipated,  periods heavy and cholesterol rising? Perhaps your thyroid is to blame.

What does thyroid hormone do?

Thyroid hormone keeps:

  • our metabolism humming
  • hair and skin smooth and silky
  • muscles and tendons well lubricated
  • mood bright
  • digestion moving along
  • brain firing on al cylinders
  • LDL cholesterol at healthy levels

How do you measure thyroid function?

General practitioners assess Thyroid Stimulating Hormone (TSH), and if it is out of range, T4 and T3 is measured. Sometimes an ultrasound is done to visualize the size and health of the gland, to assess nodules or help diagnose thyroid cancer.  Naturopathic doctors, functional medicine doctors and endocrinologists will be more likely the ones to run a full thyroid panel (freeT4, freeT3, TSH, TPO, Anti-Thyroglobulin and reverse T3).

How does the body naturally balance thyroid hormone?

T3 is the active hormone in the body and is made from T4. Although the T4 is made in the thyroid, conversion to T3 happens mostly in the liver and the gastrointestinal tract.   A normal functioning thyroid gland works with the hypothalamus in the brain using a negative feedback system to indicate when there is enough active thyroid hormone in the system.

How does the medical doctor balance thyroid?

Traditionally synthroid or levothyroxine is prescribed to treat inadequate levels of thyroid hormone and treatment is geared to reach a desired TSH level. Direct T3 therapy (Cytomel) is rarely prescribed due to lack of research and clinical experience. Typically the family doctor will  treat to normalize the TSH, but recent research, and numerous patient complaints may indicate that this is not enough.

More research is required to support T4 and T3 combination therapy, whether it is levothyroxine plus cytomel or natural desiccated thyroid, alone or in combination.

Research finds TSH monitoring is not enough to determine adequate thyroid functioning and some medical doctors agree a 4:1 ratio of T4:T3 predicts patient satisfaction and better health.

What does the naturopathic doctor do to balance the thyroid?

Naturopathic doctors seek to support the thyroid in making T4 and the body’s ability to convert the T4 to the active form of thyroid known as T3.   A naturopathic doctor offers support to people on pharmaceuticals like synthroid or levothyroxine, and is also able to additionally or solely prescribe advice for nutraceutical  support and natural desiccated thyroid.

A naturopathic doctor will:

  • look at the full thyroid panel
  • adrenal health
  • cholesterol panel
  • sex hormone health
  • the function of the liver
  • health of gastrointestinal tract,
  • nutrient balance of things like selenium, zinc, iron and iodine

How is cholesterol linked to thyroid function?

T3 levels are also inversely linked to LDL Cholesterol. When thyroid levels are low, LDL cellular reception is reduced, leaving more LDL in the blood stream.  Emerging research finds treatment with T4 alone (synthroid, levothyroxine) does not always correct the high levels of cholesterol induced by poor thyroid function. Rising levels of LDL cholesterol in peri-menopausal women with symptoms of fatigue should trigger an investigation into the balance of T4 and T3, not just TSH.

What drives T3 levels down?

  • Body shuttles T3 to reverse T3 in times of starvation and stress
  • Poor feedback function in the hypothalamus
  • Thyroiditis
  • High levels of natural and environmental estrogens
  • Epstein Barr Virus

T3 levels are increasingly challenged as xenoestrogens (environmental contaminants) rise in developed countries.  Peri-menopausal women also experience challenges. This is because estrogen (unopposed by progesterone as ovulation slows down), or estrogen mimickers like xenoestrogens (from plastics, pesticides and insecticides) have the ability to bind up Thyroid Binding Globulin and somehow affect the T4 to T3 conversion ratio. Some research points to Epstein Barr Virus impacting the genome and ultimately the function of the thyroid.

For more help optimizing your thyroid function, book an appointment with Dr. Laura M. Brown, ND.

 

Function of Fibre

 Fibre is a form of carbohydrate found in plants. It plays a major role in softening and bulking the stool, promoting regular elimination of waste.  Fibre feeds and balances the micro biome in our gastrointestinal tract.  A diet high in fibre leads to better blood sugar regular, sustained energy and wellbeing.

Good Fibrations

Okay, Forty Three Eighty Fitness fans, this week’s focus in on fibre. Now I don’t really focus on carbohydrates per se, as you noticed in the 6 Daily Diet Tips you all have now. Most people do better on setting their eyes on good fibre. Why the Beach Boys’ song Good Vibrations  comes to mind just now, makes me laugh. What if we had a song called  Good Fibrations?  What would we sing about then? Yes, fibre can make you sing, but not always the way you’d like. So, if you are used to take out food and a lot of white carbs (sugar, bread, crackers, chips etc.,) don’t go wild on adding the fibre all at once. Increase a little day by day. Otherwise, if you are not rushing out  your fitness class before you are done, your friends may be wishing you did! Build your fibre intake up slowly so the micro biome has time to adjust. This will minimize gas and bloating. Read on to learn why fibre is so fabulous.

Benefits of Fibre

naturopathic services in guelph

  • Softens the stool
  • Bulks the stool
  • Traps and prevent re-circulation and promote removal cholesterol from the body
  • Helps regulate blood sugar as they slow the release of sugars (carbohydrates) into the blood stream
  • Feeds the microflora in your gastrointestinal tract
  • Balances the variety of microflora in the gastrointestinal tract
  • Help with weight management

How much?

While most North Americans get less than 5g of fibre a day, the actual recommended amount is up t0 35 g per day. Increase slowly so your micro biome can adjust. Good fibres promote good bacteria, so a slow increase will naturally help promote a healthy gut flora.

GOAL= 35g per day

 

2 Types of Carbohydrates

At a high level, carbohydrates can be separated into two basic groups based how easily and quickly they are digested. A motto I use in clinic with my patients is:

Slow carbs, not no carbs.”

  1. Simple carbohydrates: starch, simple sugars, and fructans. Simple carbohydrates are easily broken down and absorbed in the small intestine.
  2. Complex carbohydrates: cellulose, hemicellulose, lignin, pectin and beta-glucans. Complex carbohydrates are resistant to digestion in the small intestine and once moved further down into the digestive tract into the large intestine will be fermentation by the bacteria located there.

7 Types of Fibre

  • hemicellulose
  • cellulose
  • lignins
  • oligosaccharides
  • pectins
  • gums
  • glucans

Where do you find these fibres?

Hemicellulose -An insoluble fibre found in whole grains. Increases bowel regularity and excretion of cholesterol.Includes:  arabinoxylan, glucans, galantines, xylans, mannans, and pontosans.

Cellulose: an insoluble fibre found in fruits, legumes, vegetables, nuts and seeds. Feeds the micro biome (gut flora) and byproduct is short chain fatty acids.

Lignins- an insoluble fibre found in root vegetables and berry seeds like flax and sesame. Helps feed and balance the natural micro biome.

Pectin is a soluble fibre found in apples, citrus fruits, legumes and nuts. Byproducts include butyrate and other short chain fatty acids. Helps balance the micro biome. Helps heal the gut and may have an effect on cholesterol.

Gums are thickening agents like xanthan, guar, Arabic, acacia, agar-agar, glucomannan and coboxymethyl cellulose. It creates short chain fatty acids in the gastrointestinal tract and promotes a healthy micro biome.

Glucans – Soluble fibre found in oats, barley and rye. Produces short chain fatty acids, stimulates healthy micro biome, reduces LDL cholesterol. Also soluble fibre found in mushrooms like reishi, shiitake, chug, maitake, and cremini. Byproducts include butyrate and other short chain fatty acids. Helps balance the micro biome. Medicinal mushrooms additionally help fight cancer, are antiviral, immuno-modulatory and help reduce inflammation.

Oligo(poly)saccharides: found in root vegetables, onions, garlic, asparagus, banana, chicory artichoke, lentils, beans and peas.  Studies show very helpful in helping you feel fuller longer and reduces intestinal inflammation. Note: FODMAPS (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) These short-chain carbohydrates are not well absorbed in the gastrointestinal tract and can be easily fermented by gut bacteria producing pain, gas and bloating.

How can fibre help me loose weight?

Studies show that “increasing dietary fiber significantly reduces the risk of gaining weight and fat in women, independent of several potential confounders, including physical activity, and dietary fat intake.”

  1. As soluble fibre is fermented in the large intestine it produces hormones that tell our brain we are full.  (glucagon-like peptide (GLP-1) and peptide YY (PYY))
  2. Dietary fibre has the ability to significantly decrease energy intake
  3. Dietary fibre takes energy to digest and therefore reduces the over all sum of caloric intake- digestive energy = energy provided.
References:
Lattimer JM, Haub MD. Effects of Dietary Fiber and Its Components on Metabolic Health. Nutrients. 2010;2(12):1266-1289. doi:10.3390/nu2121266
Tucker LA, Thomas KS. Increasing Total Fiber Intake reduces Risk of Weight and Fat Gains in Women. J Nutr. 2009 Mar;139(3):576-81. doi: 10.3945/jn.108.096685. Epub 2009 Jan 21.

 

Vitamins: Could you be deficient?

Habitual eating habits that lack variety, medications or certain medical conditions  put us at risk for nutrient deficiency. A medical expert review of your current health condition, medications and diet diary is key to screening and finding potential changes that could be a substantial difference in your health and well being. This short review may provide some reminders and insight. Daily requirements for any vitamin vary on age, gender and current system demands. Some supplementation of one vitamin can mask a deficiency of another.

This and more will be covered in Dr. Laura M. Brown’s next complimentary talk entitled Food or Mood at Goodness Me! in Guelph on January 13th, 6:30pm. Register here.

Part 1 of 2:

Part 1: Vitamin A, B1, B2, B3 and Folic Acid

Vitamin A: Conditions that may be associated with Vitamin A deficiency include hypothyroidism (thyroid plays a role in converting beta carotene from our diet to vitamin A), liver disease, alcoholism, gastric or intestinal surgery, intestinal parasites, other gastrointestinal disturbances that cause malabsorption like Celiac, Crohn’s or food sensitivities. Increased levels of inflammation in the body will also decrease your vitamin A status.

Often you can tell if you are deficient if you have mild follicular hyperkeratosis – often felt at the back of the upper arms as you run your hands along, skin has multiple little bumps or feels rough to the touch. Night blindness can also be from Vitamin A deficiency but this can also be from a Zinc deficiency. Vitamin A is best absorbed from your diet and is found in foods like liver, fish liver oils, dairy, eggs. Foods that are high in beta carotene that your body converts to vitamin A are carrots, spinach, kale, cantaloupe and other fruits and vegetables. Women who are pregnant or are capable of becoming pregnant and smokers should never supplement with vitamin A. Vitamin A can put the baby at risk for birth defects and has been linked to increased risk of lung cancer in smokers.

Vitamin B1: Thiamine Conditions associated with psychiatric conditions, aging or insomnia can often be helped with supplementation. A diet low in thiamine can lead to deficiency is as little as 4-5 days. Other triggers can include pregnant women with severe morning sickness including multiple bouts of vomiting, alcoholism, thyrotoxicosis, and major surgery.

Thiamine deficiency is known as “beriberi”. Signs of mild deficiency include fatigue, insomnia, loss of appetite, vague headaches, pain, and difficulty with mental concentration and memory. Some people also experience weakness, weight loss, peripheral neuropathy, edema, tachycardia. Deficiency can also contribute to congestive heart failure. Severe deficiency is known as Wernicke’s encephalopathy in the early stages and Wernicke-Korsakoff syndrome in the later stages. Early signs include psychiatric disturbances, ataxia, ocular palsy, nystigmus. Later stages progress to a chronic neuropathic/psychiatric condition.

Good food sources of B1 include whole grains, legumes, nuts, meat, and enriched flour products.

B2: Riboflavin. B2 is important for helping convert B6 to its active form and is active in homocysteine metabolism, something that is important to cardiovascular /cholesterol health. B2 is also used to help prevent or treat migraines, Parkinson’s disease, psoriasis and some myopathies (muscle pain).

Indications that you may be deficient in vitamin B2 include cracks at the corners of your mouth, swollen tongue, changes in personality, anemia, weakness, depression, seborrheic dermatitis (moist, oily flaky skin condition – cradle cap in newborns and psoriasis/eczema mocking skin reaction in adults aged 30-60), excessive tears, inflammation of the clear membrane that lines your eye (results in vision distortion). Good food sources include meat, dairy, eggs, legumes, fish, poultry, green leafy vegetables, fruits, and whole grains.

Vitamin B3: Niacin B3 is critical in supporting health as it relates to cardiovascular, dermatological, hearing, taste, balance, Alzheimer’s, anxiety, ADHD, dementia, schizophrenia, sleep, osteoarthritis, trigeminal neuralgia, diabetes and alcohol addiction.

Classic deficiency is known as pellagra – the “three d’s”: diarrhea, dementia, dermatitis and sometimes the fourth D…. death.

Early signs that you may be deficient include nervousness, headaches, forgetfulness, apprehension and/or gastrointestinal disturbances.

Food sources include meat, chicken, fish, whole grains, legumes and dairy products.

Folic Acid: Known as folate in foods, folic acid in supplements. Folic acid is key to the intrauterine development of the spinal cord. It is also involved in cardiovascular health, dermatological and neurological conditions, psychiatric many other conditions within the body as it is a key methylator to many biochemical transactions.

As adults, folic acids needs stomach acid to help absorb, so if H.pylori present or on a proton pump inhibitor you may be at risk for deficiency. However people with low stomach acid are also at risk for overgrowth of bacteria in small intestine, and these bacteria can make folic acid – so deficiency is not eminent. If you are supplementing with high doses of B12, you may not be able to tell if you have a folic acid deficiency as they present as one in the same – megaloblastic anemia. Other symptoms can be vague or similar to other B vitamin deficiencies: depression, anxiety, headache, fatigue, apathy, confusion, dementia, polyneuropathy, cracks at the corners of your mouth, swollen tongue, brownish pigmented skin, low muscle tone in babies, poor immune response. This is just one of many reasons why it is always advised to seek a medical expert opinion on your supplement regime.

 

From the heart and mind of your local naturopathic doctor, Dr. Laura M. Brown, ND. www.naturalaura.ca www.forwardhealth.ca

 

Source:

Gaby, A. (2011) Nutritional Medicine. Fritz Perlberg Publishing. Concord, NH.

Cholesterol: The New, the Tried and the Natural

Lower Cholesterol

Let’s take a moment to remember what cholesterol is all about, take a look at the traditional statin drugs, some newer medications on the market and talk a little about natural therapies that can provide valuable service to your cardiovascular health.

I want help now

The big push over the last few decades has been to lower cholesterol to lower the risk cardiovascular events such as pulmonary emboli, myocardial infarction, and stroke. Sometimes we get so caught up in lowering one marker, we loose sight of the bigger picture. Cholesterol is only one component to cardiovascular health, however it is one that can be easily targeted with medication and tracked through blood analysis.

Cholesterol is a necessary component and building block for many of our hormones, Vitamin D and substances that help with digestion. We could not survive without it. The trouble comes when excessive cholesterol populates our blood stream, it is easily oxidized and creates deposits called plaques in our arteries.

Excessive cholesterol comes from our diet (cholesterol, trans fat, saturated fats or even if we consume too many carbohydrates) or from hereditary factors that affect cholesterol production. The plaques take up space and narrow the path that our blood flows through. When the plaque builds up enough it can block our blood supply, starving off the tissue it is designed to feed – this is an infarction.

The word infarction means “plug up or cram”.  Sometimes a piece of the plaque can break off (emboli) and float through our blood stream and get caught in areas where the vessels are narrowed like our brain or lung and lead to a restriction of blood supply (another type of infarction).  A myocardial infarction (MI) is when an area of the heart is starved of oxygen and the muscle tissue subsequently dies. A transient ischemic attack (TIA) is where there is temporary interruption of blood flow in the brain. A hemorrhage is where the integrity of the blood vessel wall fails and blood escapes.

Ok, so it makes sense to pay attention to excess cholesterol!

The Stats on Statins

 HMG Co-A Reductase Inhibitors (i.e. atorvastatin/Lipitor, Fluvastatin/Lescol, lovastatin/Mevacor, pravastatin/Pravachol, simvastatin/Zocor, rosuvastatin/Crestor)

Cost at most $300/year CND

Generally: statins reduce LDL by 20-60%, increase HDL by 5-15% and reduce Triglycerides by 7-30% Statins are prescribed more to reduce cardiovascular event risk, rather than to reduce cholesterol levels.

Evidence of being able to treat to target levels doesn’t exist. Research has found that less than half of patients on 80mg per day will achieve at target LDL of <2mmol/L.

Most will find if they have no benefit at 10mg, they will not have any increased benefit at 80mg. Also, on the note of dosage, higher dosed statins affect HbA1c, a factor measuring your blood sugar and risk of type II diabetes. In a pooled analysis of data from 5 statin trials, intensive-dose statin therapy was associated with an increased risk of new-onset diabetes compared with moderate-dose statin therapy.

Women:  For women, unless they have existing cardiovascular disease there is no evidence that lowering their lipids will decrease their risk of coronary heart disease related death.

 Men: For primary prevention in men, the absolute benefit of statins use over 5 years (the reduction of major coronary events) is around 1.5%. That means if their risk of cardiovascular disease was 8 or 9% with no statins, while on statins, their risk is 7%. For secondary prevention in men (meaning they have already had one coronary event) their absolute benefit is 4%. This means if they have had a stroke, heart attack, heart failure, angina, TIA in the past, if they take the statin their risk is 16% where as if they didn’t it would be 20%.

Simvastatin is a first line of therapy. In one study, for every 12 people treated, one life was saved. Another study showed over 5.4 years of therapy for every 31 people treated, 1 death is prevented. Simvastatin will reduce LDL by 35% and usually the prescribed amount is 20-40mg daily.

Most common side effect: Often induces muscle pain (myopathy or at extreme rhabdomylosis).

About 50% of people will stop taking statins after 3 years due to their adverse effects.

Muscle pain aggravated by alcohol, advanced age (>80), chronic renal insufficiency, grapefruit juice, small body frame, liver health, untreated hypothyroidism, gender (women more affected than men), infections, perioperative periods, vigorous exercise, vitamin D deficiency. Drugs that will increase the muscle aches: Amiodarone, Azole antifungals, Calcium channel blockers, Cyclosporine, HIV protease inhibitors, Fibrates, Macrolide antibiotics (clarithromycin, erythromycin), and occasionally Nicotinic acid. If there is potential for drug interaction, the best choice is pravastatin.

 

What about the new drugs?

Alirocumab (Praluent ) about $14,600/yr USD

Evolocumab (Repatha ) about $14,100/yr USD

Benefit is there is no muscle pain however these are at a much higher cost and are self-injected every two to four weeks rather than taken orally. They work by blocking PCSK9 inhibitors, (monoclonal antibodies) and the medication is able to lower the LDL cholesterol circulating in the blood. Research is limited however so far it shows to lower LDL levels by about 60 percent. It also lowers the risk of heart attack and mortality related to heart disease over about a one to two-year follow-up.

What is available naturally?

Limit dietary cholesterol intake to <300mg per day

Restrict transfats and saturated fats

Limit carbohydrate intake

Eat more vegetables and fruit

Increase plant sterol intake to 1g 2x/day

Include up to 40g of fibre per day (most North Americans get <8g per day!)

Limit alcohol to 1 drink per day for women and 2 for men – have some days alcohol free

Regular Exercise

A Good Night Sleep

Supplements to help regulate blood glucose & incorporate healthy fats

There are numerous cardiovascular supplements you may wish to consider with your healthcare practitioner. Too many to mention here and they are specific to an individual’s overall need and one must be careful to have the right dose, duration and be sure there is no interaction with other medications or supplements.

 See Dr. Laura M. Brown ND for your personalized cholesterol lowering treatment plan

Fish Oil

One universal supplement that has been well studied is Fish Oil. Omega 3 and now new to the market Omega 7 has shown to be of benefit for many health factors. Omega 3 is well researched and there are over 20,000 published scientific reports that support its health benefits, including that are cardiovascular health. Fish oil has been shown to reduce serum triglyceride levels. A recent report on Omega 7 shows in a double blind placebo controlled study with 60 subjects and a baseline C Reactive Protein (inflammatory marker) at 2-5mg/L showed a 44% drop in CRP. You can look for Omega 3’s and will find them in most health food stores. On a side note, Metagenics has some serious research behind the Omega 7 and has combined the 3+7 in a formula rightfully called Mega 10. You can find Mega 10 at Forward Health.

 From the heart and mind of your local naturopathic doctor, Dr. Laura M. Brown ND.

References available upon request.