week 7 · gi testing food allergy testing can be done not with severe leaky gut can be helpful if...

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www.flourishmd.com 320-424-0771

Week 7

Reintroduction

Reintroduction

● Start with the foods you want to reintroduce the most● Introduce one food group at a time

○ Try to keep it a pure food in that group○ A food group like dairy may take a week or so

● Watch reactions on the food reintroduction sheet● Eat the food 2-3 times day 1 - watch symptoms d 1,2● No reaction - add the next food on day 3● Reactions - stop and get rid of that food (put it at the end of the list)

○ Either reintroduce down the road or not at all

GI testing

● Food allergy testing can be done○ Not with severe leaky gut○ Can be helpful if you are still having trouble figuring it out

● GI testing (stool)○ Microbiome○ Infections○ Inflammation○ Enzymes○ SCFA

Summary 5 R’s

● Remove○ Foods, bacteria and parasites○ Microdefense Pure Encapsulation

● Replace○ Enzymes, HCL

● Reinoculate○ Probiotics

● Repair○ GI Repair

● Rebalance

Questions

Best food tips

● Eat at home● Cook and eat real ingredients as much as possible● Fresh should be primary foods with some raw● Frozen● Canned

Oils

● Omega -6 oils ○ Highly inflammatory and unstable → increased inflammatory diseases○ Over-consuming omega-6 fats increases numerous health issues

■ CV disease, DM, obesity, pre-diabetes, IBS, arthritis, cancer and AI○ Omega 6 fats fuel the inflammatory pathways and counteract the benefits and

availability of anti-inflammatory omega 2 fats, creating even more inflammation.

● Omega 6 oils: Soybean, safflower, sunflower, cottonseed, grapeseed, corn, canola, and vegetable shortening (Crisco), fake butter○ These undo the benefits of consuming omega-3 fats○ They reduce conversion of plant-based omega-3 fats into active forms by 40%

● Use butter or ghee, coconut oil, lard, EVOO

Coconut Oil

● Fats like coconut oil and animal-stable fats affect cholesterol● Raises LDL - but improves the quality of the LDL by increasing its size

○ This makes it less likely to promote heart disease (small density LDL)

● Saturated fats raise the good cholesterol - HDL● Coconut oil has higher saturated fat

○ Raises HDL and improves TD/HDL ratio - a better predictor of heart attacks than LDL alone

● MCT oil● Antibacterial

Cooking Oils

● EVOO and avocado (can be used at higher temperatures), ghee● Ghee - smoke point 400-500

○ Same nutrients grass-fed butter like cancer fighting CLA○ High in Vitamin D, A, omega 3 fats, and butyric acid

■ Helps boost immunity and helps inflammation - protects against colon cancer

● Coconut - temps to 350 - great baking and med-high saute● Olive oil is best for low heat cooking and raw● Avocado, macadamia, and walnut are great raw

Labels on oils

● Refined - extracted and treated with heat or chemicals in order to remove flaws. This can destroy the healthy benefits of an oil. They are more stable - to use at high heat. “Light” = refined also

● Unrefined - made from cold-pressed source ingredients, never treated with chemicals (hexane) or heat. Retain nutrients. EVOO

● Extra-virgin - unrefined and cold pressed - generally from the first pressing of the source ingredients. Can be fragile - so use for dressing, dipping, and drizzling.

● Virgin - unrefined and cold pressed - generally from the second pressing. Also fragile and reserved for low heat cooking, dressing..

Labels on Oils

● Pure - oils that are a blend of refined and unrefined oils. All of the oil comes from a first pressing, but some batches may be treated with chemicals or heat to remove impurities before bottling.

● Cold-pressed - Oils that are extracted from their source using pressure only. Chemical and heat are not used.

Oils

● Organic, unrefined, cold-pressed or expeller pressed oils● Do research - call and make sure they are truly cold-pressed● “Organic” prohibits GMOs and use of hexanes for extraction in oils

Buying and Storing Oils

● Fats and Oils can be damaged by contact with light, heat, air, or plastics● Many sold in stores are poorly packaged - fat is already damaged● Purchase: dark glass bottles (never in plastic!!)

○ Tight-fitting lid or seal

● Store away from stove and heat ● Store in a cool dark place● Don’t poor directly from the bottle (heat and steam can get into the

bottle and damage the oils)● Close lid tightly immediately - don’t leave open to air.

○ Ideal once open - 2-3 months

● Salad dressings

Saturated fats

● Recommend the healthier oils● This differs from going keto● You may need genetics and full cholesterol panels before considering

keto● If you do keto - use the good fats - not just any fat

Oils Summary

● Avocado - 520 Hi and lo heat, dressing, finishing

● Butter, ghee - 300/480 Hi heat, baking● Coconut oil - 350/450 hi heat, saute,

baking● Duck fat - 375 Hi heat cooking● Lard (pork, bacon fat - organic!) - 375 Hi

Heat● Macadamia nut - 410 Low heat,

dressing, finishing

● Olive oil - 320/465 Hi heat, low heat, dressing, finishing

● Peanut Oil - 230/465 High heat● Rice bran oil - 415 - Low heat● Sesame Oil - 450 - Dressing, finishing● Tallow - 400 - High heat● Walnut - 400 - Dressing and finishing

Top tips in the kitchen

● Get rid of teflon and natural stick pans○ Always pan and cast iron

● Get rid of plastic● Get rid of aluminum foil● Look into enamel, cast iron, stainless steel, glass

Methods of cooking

● Slow cookers ● Instant pot - stainless steel - quick and easy● Microwaves ● Roasting● Steaming● Boiling● Broiling● Grilling● Frying (pan frying - deep frying)

Cooking methods

● Consider foods used in each method○ Food type, herbs and spices added

● Consider browning and AGEs● Consider length of cooking● Consider temperature of cooking● Consider alternative (eating out)● Balance

Instant Pot/Pressure Cooker

● Actually cooks faster due to pressure - not temperature!!○ Usually about 250 - so less than most methods○ Combination of heat and steam that cook the food

● Increases boiling point water and decreases cooking time○ Steam can’t escape - you avoid water-loss and cook foods without losing heat

● Cooks foods more quickly and energy efficiently● Preserved nutrients with 90-95% retention rate (use least liquid)

○ Boiling - 40-75% retained○ Roasting and steaming - 50-90% retained

● Ability to cook at home even with lack of planning● Healthiest of the cooking methods

Slow cookers

● One of the best ways to cook meat to decrease AGEs● Energy efficient● Low heat (Low and slow)● Can prep the night before → fridge.

○ Take it out before work - plug it in and dinner is ready

● Beans, and more (and instant pot) vs canned● Whole 30 slow cooker and instant pot recipe book● Caution of lead (link with course notes)● Reduced AGES (low heat, maintain water content of food)

Steaming and Boiling

● Also reduces AGES● Can keep nutrient levels higher - especially a light steam● Some foods have their most nutrients lightly steamed

○ Broccoli

Microwaves

● Not proven to degrade the nutrients of the food● Not proven to be detrimental to health

○ Just don’t stand right by it

● Do NOT microwave in plastic!● Can be a way to eat healthier - when time is a factor

Use with caution - more rarely

● Frying○ Bad oils○ High heat and AGEs○ Processed foods

● Broiling○ High in AGEs and very decreased nutrient content

● Grilling○ High in AGEs and decreased nutrients

● Any foods at high temperatures● Air fryer? Very high temps, crispy outside

How to improve health with cooking

● Go lean - use grass-fed lean steak, chicken, or fish○ Removing the skin before cooking - reduces HCA formation

● Avoid charring and trim meats● Use marinades

○ Acidic rubs and marinades may help break down some of the muscle in the meat and reduce the number of HCAs on the plate

● Add anti-oxidants to the meal○ Herbs and spices in the marinade○ Make sure other parts of the meal are balancing and healthy

Fish

● High quality protein, good fatty acids, and nutrient rich● Some also store and carry toxins like PCBs, dioxins and mercury● Fish to avoid or limit due to mercury:

○ Shark○ Ray○ Swordfish○ Marlin○ King mackerel○ Tile fish○ Orange roughy○ Ling○ Southern bluefish tuna

Fish

● Fish with the lowest mercury○ Salmon○ Sardines○ Herring○ Trout○ Canned light tuna○ Pollock○ Catfish○ Shellfish: prawns, lobsters, oysters - shrimp

● Eat in moderation: Albacore white tuna and local lakes (check website)● Eat as much as you want from the above list

Fish

● Caution with higher risk for metals and toxins○ Pregnant or nursing women○ Elderly○ Children○ Women who wish to become pregnant

Artificial Sweeteners

● Disrupt the gut microbiome● Increase risk DM● Avoid all artificial sweeteners● Use real sweeteners like honey, maple syrup, brown rice syrup, agave● Use real stevia sparingly

Food Sources Antioxidants

● Apple - 5900 ORAC (red delicious, granny smith)● Plum 4844● Russet potato baked 4649● Wild blueberry 13427● Blueberry 9019● Cranberry 8983● Artichoke heart 7904● Blackberry 7701● Strawberry, raspberry, cherry - 5000-6000● Cinnamon - 267,536 (per 100g)

EFA

● Essential fatty acids - cannot be created by the body● 2 families - Omega 6, Omega 3● Linoleic Acid and arachidonic acid - 2 common omega-6

○ LA - most plant oils○ AA - meat, poultry, eggs

● ALA (alpha-linolenic acid), EPA and DHA - omega-3○ ALA - some plant foods○ EPA/DHA - fatty fish

● Every cell needs EFAs for proper structure and function● Support healthy nerve activity, help produce hormones, and play a role

in inflammation

EFA

● Ideal 4:1 6/3 (average person is 16-20/1)○ This balance will lower inflammation and lower risk chronic disease

● Omega 6 adequate intake:○ Females 19-50: 12 g/d○ Females 51+: 11g/d○ Females pregnant/lactating: 13g/d○ Males 19-50: 17g/d○ Males 51+: 14g/d

● Omega 6● Pine nuts (1/4cup) - 9.4● Sunflower seeds - 9.7● Pecans 1 ounce - 6.4 Brazil nuts - 1 each

Omega 3

● Females 19+: 1.1 g/d● Females pregnant/lactating - 1.4 g/d● Males 19-50: 1.3g/d● Males 51+: 1.6g/d● Flaxseed oil - 7.3 (ALA) - 1 Tbsp, Chia Seeds - 5.1 (ALA) - 2 Tbsp● Walnuts - 2.6 (ALA) - 14 halves, Flaxseed whole - 2.4 (ALA) - 1 Tbsp● Atlantic salmon 3 ounces - 1.8 (EPA/DHA), Herring 1.7 (EPA/DHA)● Sardines 3 ounces 1.2 (EPA/DHA)

Zinc

● Most are zinc deficient● Affects taste, smell, immune system and many enzymatic reactions!● Anti-oxidant as well● Females 19+ 8 mg/d, Pregnant 11 mg/d, Lactating 12 mg/d● Males 11mg/d● Oysters, game meat, crab - 8’s (except oysters - 60)● Ground beef - 5.3, ● lamb, pork, lobster● Dark chicken meat, pumpkin seeds, cashews - 2mg

Vitamin C

● Fruits and vegetables● Citrus has the most (besides red pepper)

Nuts

● Excellent source protein, minerals (Mg, Cu), good fats, Vit E, folate, fiber● Low in saturated fats● Studies show up to 40% decrease in CV disease for nut eaters● Peanuts, walnuts, almonds, pecans, pistachios, hazelnuts and nut

butters - lowered LDL cholesterol by up to 10-15 points● May help dilate blood vessels - due to arginine (lower BP)● Pecans, walnuts, almonds - tryptophan - AA stimulates serotonin● Almonds are great for heartburn● Stabilizes blood sugars

Nuts

● Ounce nuts: 20 almonds, 15 cashews, 18 hazelnuts, 10 walnuts● Eat them as a snack - instead of something else● Put them on oatmeal, in smoothies, on yogurt, on salads● Add to steamed veggies, into baked items● All nuts are good - but walnuts and almonds have the most benefits● Walnuts - omega 3 - heart protective - cognition - AI

○ Ellagic acid - AO known to fight cancer and support immune system○ Other AO also found - up to 16

● Almonds - lower cholesterol, rich manganese, Cu, E, Se, Mg, Ca○ ¼ cup - as much calcium as ¼ cup milk

Food

● Try to incorporate some raw into meals● Various food plans

○ Keto○ Carnivore○ Low carb○ Low fat

● Individualized● Think about variety, microbiome, moderation

Macronutrients

● Class of chemical compounds that provide energy and essential nutrients

● Required by the body in relatively large amounts daily● Proteins● Fats● Carbs

Carbohydrates

● Body’s main source of energy● Some used right away - rest stored in muscle cells or fat cells● Important part of a healthy balanced diet● Source and quality is important ● Best sources provide energy while also providing minerals, vitamins,

phytonutrients and fiber.● Needed for brain function, kidney health, GI health, and muscle function

Carbs

● Other carbs - refined grains and sugars○ Soda, breads, pastas, cakes, pastries, cookies, chips, FF, candy, ice cream and other

convenience foods.○ Avoid most of the time - due to inflammation and disease

● 45-50% calories for most healthy individuals○ Some may need more like 20-40% if using advanced plans

● Add whole unprocessed grains to salad, soup, stews○ Quinoa, amaranth, wild rice (barley and millet if not GF)

● Use beans and legumes in place of animal protein○ Chickpeas, black beans, and more

Carbs

● Replace cereals with full-flake or steel cut oats - top with berries, cinnamon

● Bread or pasta - look for whole grain options● Opt for whole fruit juice over juice

○ More fiber and less sugar - helping BS balance

● For those with BS issues - add fiber/protein to carbs● Juicing….● Smoothies...

Smoothies

● Base liquid○ Brew one qt strong tea - using different herb combinations or tea bags○ Simmer in 2 qts water for 10-15 minutes, cool 20 minutes.

● Ashwaganda root, powdered 1T Green tea, loose 4T● Lemon balm leaf - 2T Turmeric, fresh, ground 1t● Cinnamon, fresh, ground - 1/2t Hawthorne, dried - 2T● Rosemary, fresh (chopped) 1 T White willow bark - 2T● Elderberries, dried 2T● Slippery Elm Bark, powdered - 1T

Base Liquids

● Commercial teas - brew and steep 10-15 minutes. Cool 20 minutes.● Use 4-6 ounces in the smoothie. Store remaining in fridge 7-10 days.● Juices:

○ Unsweetened, pure 100% juice 2-4 oz○ Cranberry○ Pomegranate○ Dark cherry juice○ Purple grape juice○ Orange juice

Smoothies

● ½ cup unsweetened fruit (preferably organic) to blender. ○ Avoid processed with sugars, sweeteners, or syrups.○ Apple, peach, banana, pear, berries, pineapple, strawberries, mango, etc..

● Vegetables - 1 cup any leafy greens or whole vegetables of choice○ Avocado○ Mint leaves○ Beets○ Zucchini○ Cucumber○ Dark leafy greens - chard, kale, spinach..

● Fruits and Greens

Smoothies

● Protein○ Protein powder, whey powder, Functional food, GI food○ Whole oats (soaked overnight)○ Nut butters○ Yogurt

● Flax Seeds - 1-2 Tbsp ground flax seed● Any supplement or nutrient you are trying to get in

○ Great time to get lots of nutrients○ MCT oil, L-carnitine, coconut oil, and more

● Be creative and rotate!

Fats and Oils

● Provide a lot of energy in relatively small amounts of food● Once eaten - can be stored for later use● Supports the brain, CT, and GI system● Essential part of diet (low fat harms)

○ Processed carbs○ Dementia

● We were told fats were bad and causing the issues○ Found out it is sugar!

● There were some bad fats also!

Fats and Oils

● 30% most healthy individuals (children slightly higher)● Can range from 30-60% depending on specific needs/genetics● Top salad with healthy oils (EVOO and walnut)● Fatty fish twice weekly● Add freshly ground flaxseed to morning smoothie or oatmeal

Proteins

● Found in every living thing on earth.● Protein is an essential part of muscles, skin, hair and bones and is found

in nearly every other tissue and body part.● Essential for proper muscle development and function, bone health, CT

strength, tissue repair and growth, blood oxygenation, and basic cell activity

● All are made up of AA - building blocks of life○ RNA, DNA, neurotransmitters, hormones, muscles almost all AA

● We do not store protein, nor do we make all the AA needed● So we need on a daily basis!

Protein

● RDA 46g/d for women, 56 g/d men● Minimum 8 g for every 20 pounds weight

○ Extra needed for pregnant or nursing women, athletes, active, elderly and those suffering from or recovering from illness

● IFM recommends 20-30% of daily calories in most individuals● Excess protein on a consistent basis - can strain the kidney’s● Eating protein from a variety of sources is very important!!● Variety especially for vegans and vegetarians - because plant proteins

don’t have all the essential AA needed● Eat foods that complement each other - legume with rice

Micronutrients

● Nutrients the body needs in small amounts in order to function● Minerals, vitamins and phytonutrients

Minerals

● Group of 16 inorganic nutrients (don’t have a carbon)● Body needs them for normal cell function, growth and development● The body cannot make minerals - “essential” nutrients● Major and trace● Major - need on a daily basis in significant amounts to maintain fluid

balances as well as other health benefits● Trace - need a small amount

Micronutrients - phytonutrients

● Natural compounds of all plant foods○ What gives them colors, taste and smells

● These play a role in many processes○ Toxin elimination, hormone metabolism, and immune system

● Very important part of the diet● More than 25,000 phytonutrients are in plant foods● Fruits and vegetables are rich sources● Whole grains, legumes, herbs, spices, nuts, seeds, teas● Try to get whole form or as close to whole as possible● Eat a variety (each color has different benefits). 1-2 each color/d

Micronutrients - Vitamins

● Group of nutrients essential for normal cell growth, function and development

● Some vitamins are made by the body - there are 13 that aren’t● These are “essential” and we must consume them● Essential consist of fat-soluble and water-soluble● Fat soluble - require fat and bile for absorption into the body

○ Stored in fat cells and liver until the body needs them - so don’t need to consume daily○ Also more difficult to eliminate - may need to monitor levels○ A,D,E,K

● Water soluble - dissolve in water - used right away. Daily.

Glycemic Index and Glycemic Load

● Concepts that can help select foods for supporting blood sugar balance● Not all foods have same impact on blood sugar and insulin● Blood sugar should remain relatively constant

○ A spike in BS tells the body to release more insulin - which can cause a rollarcoaster of up and down blood sugars

○ This can cause energy crashes, brain fog and cravings

● Those with hypoglycemia as well as CV disease, insulin R or DM - maintaining blood sugar is vital in your eating plan

Glycemic

● GI - was to measure the impact of a specific food on BS levels○ Ranks carbohydrate foods on a scale of 0-100 based on how quickly the food will raise

BS levels

● GL - calculated by multiplying a food’s GI (as a %) by the number of net grams of carbs (total carbs - fiber) in a meal or snack.○ The result is a score of how much that serving of food is likely to increase BS

● We all typically eat a combination of foods with different GI levels - the GL may be more accurate on the impact of the meal as a whole.○ Takes into account the actual portions of food

Glycemic

GI and GL

● Encouraged to select foods low-GI and low-GL as often as possible● Both concepts are important● GI - based on lab studies of a certain food● GL - takes into account the portion eaten● Eating appropriate portions of food lower in GI and GL helps stabilize

blood sugar throughout the day● Medium and high GI foods should be eaten with protein, fat or both

○ This helps blunt the glycemic effect of these foods.

● GI - refers to increase in BS with a defined portion○ Watermelon - high-GI but average person eats little at a time

GI/GL

● Variations among individuals in how BS responds to low, medium or high GI foods○ Relatively active person without DM - may have a small increase BS to low-GI food○ Someone with IR - higher blood sugar even with lower GI food

● Most of the food in the IFM plans are low and medium GI● Protein, Nuts and Seeds, Fats and Oils, Non-Starchy vegetables, spices,

and condiments - none or negligible carb - and less impact on BS● High GI and GL foods are not recommended on a daily basis

GI/GL

● Moderate GI (56-69)○ White and sweet potatoes○ Corn○ White rice○ Couscous○ Breakfast cereals like mini wheats, cream of wheat

● High GI (>70)○ White bread○ Rice cakes○ Crackers, bagels, doughnuts○ Croissants, most breakfast cereals

Big ones for me

● No artificial sweeteners● No corn syrup or HFCS● No food colorings● Avoid stabilizers if able● The more pure the better● Watch the dirty dozen - especially potatoes● Corn - needs to be organic due to GMOs● Local if possible● Oils

Pick a topic/area to improve on

● We have covered many topics● Pick one area to work on● Once that is habit - pick another one● Add in little aids in the meantime (spices with grilling)● Don’t stress - just look forward at how can I make a new habit one at a

time● Balance - not all or nothing● Do the microbiome veggie mash-up

Food sources

● Imperfect Foods● Azurestandard.com● Frontier co-op● Farmer’s markets● Thrive Market● Stores - Trader Joe, Whole Foods,

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