Nutrition Information

(see also General Supplement Notes)

General Sources of Nutritional Information

Physicians Committee for Responsible Medicine. Nutrition Guide for Clinicians. (multiple chapters)
      Micronutrients in Health and Disease
      Celiac Disease

USDA What's in Food and FoodData Central 

USDA Dietary Guidance 

USDA Nutritional Evidence Systematic Reviews  

National Academy of Medicine Dietary Intake Requirements (basically RDAs)
     There are many listings here, some for general topics such as energy requirements and some for groups of specific nutrients.

Linus Pauling Institute Micronutrient Information Center

Immune Function and Micronutrient Requirements Change over the Life Course 

Nourishing Hope (Site for Julie Matthews, a nutritionist who specializes in using nutrition to heal health conditions, particularly neurological ones such as autism, ADHD, anxiety, OCD, etc).  

 

Plant-Based Diets
It is very important when eating a plant-based diet to be mindful about getting adequate nutrition.  The following resources can help.  This is not an endorsement of plant-based eating, I am passing along important information regarding this diet.

Nutritional Assessment of the Symptomatic Patient on a Plant-Based Diet: Seven Key Questions
This paper focuses on seven significant nutrients that must be carefully planned for when eating a plant-based diet.  These are: vitamin B12, iron, EFAs, calcium, zinc, and vitamin D, and complete proteins.  The paper includes a list of additional resources regarding nutrition and a plant-based diet including:

Physicians Committee for Responsible Medicine. Good Nutrition.

 

 

Dietary Fats and Oils

Sources of oils and fats

Microbes in intestines convert fiber into short-chain fatty acids.  This should be vegetable fiber, NOT grain fiber or capsules/drink.  

Salmon Roe - richest source of omega-3 fatty acids (EPA and DHA), contains 1800 of EFAs in one ounce of salmon roe.  Excellent support for the neurological system.  Also high in other nutrients as well.

Salmon Roe – Unsurpassed for Nourishing the Brain

Speak - This is a supplement that is a combination of oils that supports brain function, especially in regards to speech.

Specific Oils and Fats

Black Seed Oil is a mast cell stabilizer.

Chia Seed - contains omega-3 fatty acids and other essential fatty acids including alpha-linolenic and linoleic acid, oleic acid, and palmitic acid.

CLA (Conjugated Linoleic Acid) found in red meat and grassfed dairy, has anti-tumor properties.  

Coconut Oil contains Lauric Acid, an antiviral, and Caprylic Acid, which is antifungal.  

Cod Liver Oil (CLO) Source of omega-3 fatty acids oils as well as vitamin A and vitamin D.  Omega-3 fatty acids increase brain-derived neurotrophic factor (BDNF) which supports growth of new neurons.  They are also anti-inflammatory, especially in the brain. 

Lard is a natural source of vitamin D and choline and contains some vitamin E.  Avoid lard that has been hydrogenated.  

Olive Oil is an excellent source of omega-9 fatty acids, including oleic acid.  It has the highest proportion of monounsaturated fatty acids of all of the liquid vegetable oils.  It contains 13% of RDA of vitamin E and about 10% of RDA of vitamin K.  The extra-virgin variety has a higher mount of polyphenols, which are natural antioxidants.  

What Does Research Actually Say About Healthy Fats? 

Is Saturated Fat Bad For You?
Ketogenic diet therapy doesn't have to include any saturated fat; many people eat a vegan keto diet or one that is vegetarian without dairy, or some other specialized form of keto.  It's possible to make a keto diet that is compliant with almost any other restriction, such as vegan, vegetarian, Mediterranean, carnivore, and others.

Saturated fat, the estimated absolute risk and certainty of risk for mortality and major cancer and cardiometabolic outcomes: an overview of systematic reviews
Absolute risk is much more informative than relative risk- relative risk sounds more catchy but doesn't actually tell you as much.  When thinking about what a study means for you, whether its conclusion means you need to make changes, depends on the quality of evidence and not just the presence or absence of evidence.  This paper found that the evidence supporting a risk from consuming saturated fat was low or critically low quality.  When looking at the results of reducing or replacing saturated fat in terms of cancer mortality, the authors found that the evidence showed a range of 8 fewer deaths to 3 additional deaths per 1,000 people, and the certainty of evidence (quality) was low to very low.  So no clear-cut link between saturated fat consumption and risk of death from cancer.  When considering the impact of saturated fat in the diet and cardiac deaths, they found a rate of two deaths per 1,000 people with low to moderate certainty.  This does not support the strength of the message we get through doctors and public health to avoid saturated fat.

There are other factors to consider when seeing if the results of a study means anything for you individually.  To illustrate this point, consider one study that was included in this meta-analysis (with moderate quality evidence) that found 24 fewer deaths per 1,000 people from all-cause mortality in a treatment group that reduced saturated fat intake.  We need to look at the details to see what the implications are.  Most people being studied are eating the standard American diet, high in ultra-processed foods, and get their saturated fat from sandwiches, desserts and sweet snacks like cookies, cakes, ice cream, pastries; and rice and grain-based dishes like pasta and pizza, and milk and yogurt which is usually sweetened and flavored.  These foods are all high in sugars and simple starches.  Natural foods, including plain meats, cheeses, butter, etc are lower on the list.  The question then is how do you eat- if you eat lots of junk food, fast food, and processed food, then this study might apply to you.  If you already eat a diet primarily of whole foods and low processed foods then these results probably have no relevance for you.

"Nutrition science is full of low quality evidence that applies to a general population eating a low quality diet".  As a patient, we all deserve to have care providers who treat us as individuals.

A short history of saturated fat: the making and unmaking of a scientific consensus 

Dietary Saturated Fats and Health: Are the U.S. Guidelines Evidence-Based?

Metabolic and Mental Health

 What are Metabolism and Metabolic Health, and How Do They Impact Mental Health?
"Metabolism is the set of life-sustaining chemical reactions in organisms.  The three main things that metabolism does is convert the energy in food to energy that is available to power the cell and therefore the organism, the conversion of elements in food into the building blocks to make proteins, lipids, nucleic acids and carbohydrates, and the elimination of metabolic waste.   Another definition of metabolism is "all the physical and chemical processes in the body that convert or use energy".  Metabolism is how we use our food to create energy.  If we consume more calories then we need we need to store the excess energy.  We store some as glycogen in the liver, but most is stored in our fat cells.  It makes sense that our bodies would have evolved with uncertainty about when we would have food and how much we would have, so we would have needed to store up excess for times when we didn't have enough.  

Metabolic dysfunction usually results from too much food intake or eating foods with a poor ratio of nutrients to calories.  If we consistently eat more calories/energy than we need, our bodies first store the excess in our fat cells but they eventually get full, and then we store fat in our organs, called visceral fat (such as fatty liver). Visceral fat interferes with the function of the organ in question and leads to disease states such as type 2 diabetes.  We need to have low levels of insulin in order to access and use the energy stored in fat.  Insulin levels rise when we eat, especially if we eat sugars and simple carbs.  When our insulin levels are high this signals our body to store energy because we have plenty for now.  The state of having high insulin levels from frequent eating is called hyperinsulinemia.  If the state of hyperinsulinemia persists our cells become less responsive to insulin, producing a state called insulin resistance.  This means too much sugar stays in the blood and not enough is available for energy use.

There can also be a connection between mental health and the gut microbiome.
Never fear, the gut bacteria are here: Estrogen and gut microbiome-brain axis interactions in fear extinction

Mitochondria and Mental Health

Brain Energy, Mitochondria, and Mental Health
Dr Chris Palmer, MD, Harvard Psychiatrist

A major change in psychiatry has been going on for awhile now in which more and more clinicians and researchers are recognizing mental health disorders as related to, and sometimes caused by, physical states in the body and therefore using therapies that are meant to address these states.  A primary example of this is looking at brain metabolism (mitochondrial function in the brain).

The Keto diet is a 100 year old, evidence based therapy that can stop seizures that medication can't stop.  This is evidence of how powerful nutrition and diet can be in treating and altering brain function.  Psychiatrists use epilepsy medications to treat people with other mental mental health conditions often, usually off-label, so there's nothing new about using the ketogenic diet to treat other mental health conditions.  Seizure meds are used to treat dementia, eating disorders, anxiety, psychosis, mood disorders, substance use disorders, and others.  

The Brain Energy Theory- Mitochondria do more than just produce energy for cells "mitochondria play a role in directing and allocating resources for cells".  Not all of the food that mitochondria in the brain process is turned into ATP- some is turned into serotonin, dopamine, or cortisol, and they also play a part in regulating those molecules.  Mitochondrial function is one way of understanding the imbalances of the neurotransmitters and hormones in the brain.  They are also involved in regulating inflammation (turning it both on and off) and epigenetics by signaling the nucleus of the cell to regulate the transcription of gene.  They monitor our outer and inner environment; sensing stress levels, food intake, blood sugar levels, and oxygen levels.  

"Mitochondria play a role in our response to trauma- psychological and social stressors."  Trauma and stressors play a role in mental illness, so this connection could be very significant, because while people have known that there is a connection they haven't known exactly what that connection is on a biological level.  He points out that mitochondria seem to be a way to "connect the dots" in the mental health puzzle between factors like trauma, neurotransmitters, sleep, substances like drugs and alcohol (I would add exercise and sunlight too).  These are all things that affect mitochondrial and metabolic health or are affected by it or both.  People with mental health conditions have higher rates of many physical disorders including diabetes, obesity, heart attacks, strokes, and generally have a shorter life expectancy.  This connection also opens up the possibility of more and better treatments.

For people who struggle to believe this connection is real, he explains that mitochondria are what drives metabolism, which is how we take food and oxygen and transform them to keep ourselves alive.  If these processes are disturbed it means illness, and if they are disturbed enough or stop, we die.  Most poisons work by harming mitochondria- that's how they harm or kill you.  Other cellular components can be harmed without nearly as much danger to the organism.  It makes sense that since mitochondria are the most important part of the cell and what keeps it able to perform its function, if they aren't functioning right the cell won't be able to function right.  

Mitochondria can become both under-active AND overactive.  This makes sense because there are mental health disorders involving areas of the brain becoming overactive as well as areas becoming under-active.  If the health of mitochondria impacting the cell's functioning is the cause or major contributing factor to many mental health disorders that would explain why they can be better or worse at different times of day (or different seasons), why they can be worsened by stress and sleep deprivation.  A lot of the details aren't known yet but already the basic insight that mitochondria are central to mental health is transformative of the fields of psychiatry and psychology.

What options are available to support mitochondrial functioning?

There are a huge variety of things available to help mito function including sun exposure, red light therapy, various supplements, glutathione, methylene blue, and more, but these can only help so much if core lifestyle issues aren't addressed.  For example, alcohol is a potent mito toxin so a person drinking a large amount daily is poisoning their mitochondria far beyond what those things can help.  Having healthy mitochondria requires lifestyle changes- eating well and avoiding highly processed foods, sleeping well, exercising, and avoiding excess stress.  

The ketogenic diet and its effect on brain function has been studied for a long time, its known to change neurotransmitter levels, inflammation, the gut microbiome, but Dr Palmer says that he believes the impact it has on mitochondria is its most important therapeutic effect.  The keto diet creates a state in the body similar to fasting, which is known to trigger mitophagy (when the cell breaks down old and defective mitochondria that are replaced by new, healthy ones) and mitogenesis (which is the production of new, healthy mitochondria).  Dr Palmer suggests that these two processes that remove old, defective mitochondria and replace them with more and healthier ones, might lead to long-term healing where a person could potentially go off the keto diet and remain healthy.  People who are on the diet to control seizures will usually be kept on the diet for 2 to 5 years after the point at which their seizures completely stop (some people with seizures must stay on keto for life).  People can experience improvement of mental health symptoms, even very significant improvement or remission in weeks or months.  Psychotic symptoms tend to take weeks if not months to improve especially if severe.  People often wonder if making some changes in their diet, such as eating more fatty fish, will be enough.  Dr Palmer says maybe for people with relatively mild symptoms or conditions, some changes such as eating more fatty fish can help, but he points out that those changes don't stop seizures but the keto diet does, he says  "ketogenic therapy is a unique and powerful intervention".

What about other interventions to support mito health?

Exercise is a really important factor also and should be part of a treatment plan.  The two types of exercise for which there is the most evidence of benefit for mito health are strength training (aka lifting weights, working out to build muscle) and level 2 cardio (which he defines as 3-60 minutes of running, cycling, etc that gets you breathing hard but not out of breath).  Those types of exercise increase the number and health of mitochondria in muscles which then send endocrine signals to your brain that improve brain function.  Exercise alone isn't enough to heal mito, lose weight, or heal type 2 diabetes.  If people exercise more but don't change how they eat they don't get significant or sustained weight loss.  There has been one very well-done study of middle-aged adults who were prescribed exercise.  In addition, half were given the drug metformin to take and the other half were given a placebo.  The group that got metformin didn't get the mito and metabolic benefits of exercise the way the other group did, which is evidence that metformin interferes somehow with mitochondrial biogenesis.  Many other medications, including many psych meds, are known to interfere in mito function and biogenesis, so this should be considered.  Lifestyle behaviors such as drinking alcohol and smoking cigarettes and marijuana are also mito toxins.  

The psych drugs that can do this are mostly the anti-psychotics, which have been known to have metabolic side-effects and neurological side effects.  They can cause significant weight gain (he has seen people gain as much as 100 pounds in 6 months), they can cause type 2 diabetes, they worsen every known risk factor for cardiovascular disease (raise blood pressure, raise triglycerides, worsen LDL levels), and increase inflammatory biomarkers.  

This represents a new way to understand mental illness and what might be happening in the brain, and a new way to treat it.  This is especially important as mental health remains highly stigmatized in the US and research around it receives very little funding in comparison to disorders considered to be physical.  Many mentally ill people are in prisons, shelters, or even on the street.  "There is tremendous injustice, in my mind, in how we treat people with mental illness".  Dr Palmer points out that while psychological and social factors play a role in mental illness, it's no less physical and "real" in that way.  People with mental illness "deserve medically necessary treatment".  If we can get needed care to people in prison or who are homeless and who have mental illness, they won't be in prison or homeless anymore, they can live enjoyable, productive lives. 

 

 

 

 

 

 

Oral and Dental Health

Is It Possible to Reverse Tooth Decay?
The process of remineralization can be monitored by a dentist with imaging.  This can be helpful because it may not be possible to tell if it is happening otherwise.  

Tooth decay can indicate a nutritional deficiency, such as vitamin D.  Can be done with supplementation.  Foods that provide vitamin D include cod liver oil, liver or desiccated liver pills.  Test again after 3 to 6 months.  Also vitamin K2 (which can also be found in many organ meats).  There are 2 kinds of K2 supplements, MK-4 (animal source, and is more active in the body) and MK-7 (which comes from fermented foods such as natto).  Always supplement vitamin K2 when supplementing vitamin D.  Vitamin A can also be found in cod liver oil.  Taking vitamin D increases the need for vitamin A because they work together.   Magnesium catalyzes all of these nutrients and is needed for vitamin D to work. Magnesium is part of the structure of the calcium phosphate tooth mineral structure.  Magnesium deficiency keeps vitamin D receptors from working.  Fermented foods can replenish oral bacteria which helps teeth regenerate.  The body makes bone by first laying down a collagen matrix, made of amino acids, than calcifies that matrix.  These amino acids are found in bone broth (made from the bones and joints of animals), skin (such as pork rinds), and from supplements. 

How to Treat Cavities and Reverse Tooth Decay Naturally
Some cavities in the teeth can actually be healed and eliminated, and others reduced, by making changes in what you eat.  For a dietary perspective there are 4 causes of tooth decay, which are; excess sugar in the diet, excess phytic acid, not enough minerals, and not enough fat soluble vitamins.  Excess sugar feeds bacteria in and around the teeth causing it to multiply and erode the enamel that is protecting your teeth.  This bacteria can also circulate in your body and lead to cardiac problems and many other health problems.  All refined sugars should be removed from your diet.  At first this should also include natural sugars such as maple syrup and most honey, but these natural sugars may be able to be tolerated somewhat later.  

Phytic acid is a substance found in grains, beans, nuts, and seeds.  Phytic acid binds to minerals in the food and keeps those minerals from being absorbed and used by your body.  Just because a food package says that it contains a certain amount of something, doesn't mean that your body will absorb and be able to use much if any of it.  The phytic acid can be greatly reduced by soaking the food and sprouting it before using it (before milling it into flour in the case of grains.  Personal note- most bean and nut flours are made from beans and nuts that were NOT soaked first).  Make sure to get adequate calcium, magnesium, selenium, iron, phosphorous, silica, and other minerals in your diet.  Vegetables, soaked nuts and seeds, and raw (goat and sheep) dairy are some good sources of minerals.  A multi-mineral supplement can help, and eating a lot of probiotic foods can also help.  

Lastly, the fat soluble vitamins including A, E, D, and K are essential for tooth health.  Vitamins D3 and K2 are essential for our bodies to absorb adequate calcium and to put the calcium in our bones, where it is beneficial, rather than elsewhere in our body (such as our arteries) where it can cause disease.  These can be taken as a supplement and can also be found in raw dairy and fermented foods, such as milk kefir and yogurt.  Getting sunshine on the skin is important as a source of vitamin D.  The fat soluble vitamins are found in fat, such as butter, lard, and some oils, so it is important to eat a good amount of these healthy fats.Vitamin A can be made in your body from beta carotene which is found in orange and green vegetables.  

Another tool for healthy teeth is to do oil pulling, which is an ancient Ayurvedic technique, in which you swish oil around in your mouth.  Use about a tablespoon of oil, coconut and sesame oil (not toasted) work well, and swish it around in your mouth for 5 to 20 minutes.  While swishing it around make sure to "pull" the oil through/between your teeth, and make sure to spit it out when done rather than swallowing it.  You can use the plain oil or add essential oils to it including clove, peppermint, cinnamon, and the best one for dental health is myrrh.  Myrrh can also be rubbed on the gums to treat inflammation.  Additionally a re-mineralizing "toothpaste" can be made by mixing baking soda with a mineral supplement (open the capsule and dump the powder in directly) and optionally an essential oil such as peppermint.  

Dr Axe's guide to oil pulling
Dr Axe's homemade baking soda toothpaste
Dr Axe's homemade toothpaste recipe
More on reversing and healing tooth decay from Dr Axe

Bone Loss Around Your Teeth | The Real Cause Will Shock You | The Side Effects Are DEADLY
Bacterial infections around the base of teeth, at the gumline, can erode bone and gum tissue, which can then compromise the teeth.  These bacteria create biofilm around the roots of teeth.  When a dentist or periodontist probes around the base of the teeth, they are checking to see how deep the "pocket" is between the tooth and the gum tissue around it.  Infections in the gums, called "periodntitis", can then lead to bacteria spreading into the bloodstream.  Once the infection is in the blood it can lead to many serious complications including heart attacks, strokes, angina, and arteriosclerosis.  Additionally, chronic bacterial infection in the mouth can cause very bad breath.  

Another significant source of tooth damage and decay is a misaligned bite.  When the teeth don't line up right during the bite, this causes teeth to move and rock in their sockets, which can loosen them and can make the pockets around the teeth larger thus allowing more bacteria into the gums.  Methods of cleaning teeth at home such as brushing, flossing, using a water pick, etc can't clean deep into the pockets and can't remove the biofilm around the roots of the teeth.  Bacteria can also get into the actual bone structure of the teeth, into little holes called microtubules, which is also out of reach of most methods for cleaning teeth.  These bacteria can reinfect an area around a tooth after it has been cleaned.  These bacterial infections lead to actual bone loss in the teeth.  

Standard teeth scraping and descaling don't address the biofilm and the bacteria beneath the surface.  These techniques are meant to slow down bone loss but not to reverse it.  There is a method of measuring how even the bite is.  The teeth should be sharing the impact 50/50 and the teeth should be meeting in the middle, not on their sides.  Laser therapy can remove the infected tissue, sterilize the roots of the teeth, and can even lead to healing of bone and gums around the teeth.

How To GROW BONE Lost To Gum Disease - AMAZING Results!
There is a method of treating periodontal disease and rebuilding bone around teeth called LANAP, which uses a laser. This method leads to slow regrowth of bone that can take several years to get desired results.  This site has more information about the method and the laser it uses.  

New cavity treatment offers no drilling, no filling
This is new, experimental method of filling teeth with a resin that can be applied to cavities between teeth, and doesn't use the traditional method of drilling and filling cavities.  

!!! Warning about nitrous oxide (laughing gas) that is sometimes used by dentists
Nitrous oxide–induced vitamin B12 deficiency
Nitrous oxide can cause harm due to its "conversion of the active monovalent form of vitamin B12 to its inactive bivalent form (3)"

Oil Pulling
Oil pulling is a natural way to treat swollen and receding gums.  Oil pulling means swishing some oil around in the mouth and/or "pulling" it through the teeth.  It can be made with sesame oil (not the toasted kind), which has antibacterial action, or coconut oil.  You can add Triphala Powder (a blend of 3 Ayurvedic herbs including Indian gooseberry, Belleric myrobalan, and Yellow myrobalan) which can prevent bad bacteria from growing in the mouth.  Fennel seeds and cloves are also good and can be chewed.

In one approx. 8 oz jar put 10 to 12 cloves (ground in mortar and pestle, 1/2 tablespoon fennel seeds (ground in mortar and pestle), 1 tablespoon triphala powder, 1/4 cup sesame oil, 1/2 cup coconut oil, close the jar lid and shake well.  Let it sit for 2 days before using, shake it up several times.  Strain the oil into another jar and throw away the leftover sediment.  To use add 1 tablespoon of the oil to 1 tablespoon of water and swish around in mouth for 10 minutes.  Spit it out, do not swallow it. 

Clove Oil For A Toothache or Dental Abscess
An abscess is a fluid-filled cyst.  Clove is anti-fungal (also good to treat candida in the mouth or on the tongue), anti-bacterial, and anti-inflammatory.  It numbs the area in the mouth where it's used so it helps with pain.  You can either chew on a clove directly to release it's oil, or you can put 2 drops in one tsp of coconut oil.  Keep either option in your mouth for 2 to 5 minutes.  Chewing on some garlic has very similar results.  

Supplements and Herbs
Oral Care Extract from Mountain Rose Herbs

Homemade Mouthwash
If toothpaste makes your mouth sore, brush with a solution of 1 teaspoon (5 grams) of salt mixed with 4 cups (1 liter) of water. Pour a small amount into a clean cup to dip your toothbrush into each time you brush.

Rinse your mouth 5 or 6 times a day for 1 to 2 minutes each time. Use one of the following solutions when you rinse:

• 1 teaspoon (5 grams) of salt in 4 cups (1 liter) of water
• 1 teaspoon (5 grams) of baking soda in 8 ounces (240 milliliters) of water
• One half teaspoon (2.5 grams) of salt and 2 tablespoons (30 grams) of baking soda in 4 cups (1 liter) of water  

Keto Recipes and Food Ideas

Basic Foods- avocado, bacon, beef salami, sauerkraut, pickles, artichoke hearts

Basic Eggs- scrambled, fried, soft boiled, poached, hard boiled, baked/coddled.

Egg Dishes
Bombay Frittata (may need to modify cheese/dairy part)
Italian Baked Eggs
Thai Marbled Eggs (omit rice and sugar)
Tiger Eggs
Scotch Eggs

Frittata Variations
Asparagus, artichoke hearts, arugula, chard, bell peppers, broccoli, onions, leeks
Chives, cilantro, dill, parsley, basil, mint, garlic
Bacon, sausage, smoked salmon, salami
Cheese, capers

Snacks and "Fat Bombs"
Crispy Prosciutto Chips
Chicken Cracklins
Chinese tea eggs
Deviled Eggs
Egg Salad
Jerky (beef, beef heart, salmon)
Bacon Beef Liver Pate
Smoked salmon, other fish, oysters, clams

Green Salad Variations
Lettuce, arugula, watercress, other greens
Fresh herbs including basil, dill, parsley, cilantro, mint
Carrots, radishes, bell peppers, beets, red onions
Olive oil, avocado oil, coconut oil, pumpkin seed oil, grapeseed oil, sesame oil, bacon fat
Apple cider vinegar, balsamic vinegar, red wine vinegar, pickle brine
Lemon juice, lime juice, tart cherry juice, pomegranate juice
Pumpkin seeds, sesame seeds, sprouts, tomato, avocado, celery, green onions
Fresh ginger, fresh turmeric, garlic

Salads and Vegetable Dishes
Salade Lyonnaise (salad with poached egg on top)
Chef's Salad
Chinese Watercress With Garlic Stir Fry
Coleslaw ( mayo style, Indian style, Asian style)
Artichokes with Garlic Aoli
Caprese Salad (sub avocado for fresh mozzarella)

Sauces and Condiments
Crispy Garlic
Mayonnaise
Balsamic Vinaigrette
Pesto (nut free)
Guacamole
Fresh Salsa
Salsa Verde
Sesame Sauce

Meat and Main Dishes
Cantonese Ground Beef (skip the cornstarch and rice, modify sauces as needed)
Grilled or Oven-Roasted Santa Maria Tri-Tip (beef)
Fish Larb (omit rice and sugar)
Herby Pork Larb
Kai Sega Wat (Spicy Ethiopian Beef Stew)
Shredded Beef (taco style, korean barbecue style)
Sesame Chicken
Greek Lamb Shanks
Lamb Chops with Rosemary
Grilled Gochujang Pork With Fresh Sesame Kimchi
Vietnamese Slow Cooker Pork
Pulled Pork
Thai Pepper Pork
Pork Chops (grilled, dry rub, cast iron)
Pork Breakfast Sausage Patties
Kielbasa
Ham hocks with collards
Steamed Clams or Mussels
Seared Scallops
Baked Salmon (with dill, lemon, curry sauce)

Common Keto pizza crust recipe (uses dairy)
2 cups grated cauliflower
2 cups shredded mozzarella cheese 
2 eggs 
optional herbs- oregano, basil, thyme, garlic/garlic powder, nutritional yeast

Blend in food processor, spread on silicone baking mat.
Bake at 450 degrees for 15 minutes, then top with sauce, cheese, and toppings, and bake until cheese is melted.

Supplements for Connective Tissue, Soft Tissue, and Muscle Health and Support

Supplements for Connective Tissue Support - Vitamin E, Collagen, Chondroitin sulfate, Glucosamine, D-Ribose, Arginine, Adrenal cortex, Vitamin C (strengthens collagen, protects skin from wrinkles), Vitamin D, Vitamin K, Silica, Aloe Vera juice, zinc (necessary for the production of many proteins in the body, including collagen and keratin).  

Minerals that support skin health.

Nutrients for muscle growth- amino acids, potassium, trace minerals, vitamin A (and other fat soluble vitamins), and vitamin C.  

International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine
"...creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes in terms of increasing high-intensity exercise capacity" (and developing lean body mass).

Vitamin B6 - important for proper protein synthesis especially in connective tissues.  

Hyaluronic Acid - this compound is a humectant, which means that it attracts and holds on to a large amount of water, helping keep tissues (especially connective tissue such as hair and skin) well hydrated and lubricated.  It does add weight to hair so more helpful for people whose hair is frizzy and less helpful for people whose hair is thin and flat.  

Joint Care Extract from Mountain Rose Herbs
Skin Care Extract from Mountain Rose Herbs

Supplements to increase hair growth - iron (which is needed for hemoglobin to bring enough oxygen to the hair roots), zinc (important for making proteins including keratin that hair is made of), not enough zinc results in hair loss, thin and dry hair.  Telogen Effluvium is a condition triggered by shock or stress that causes hair to fall out, turn grey, and become thin and fragile.  Can be caused by pregnancy, surgery, major loss (such as death of loved one), an accident, even over-exercising.  These raise cortisol levels which in turn increases need for zinc.  Excess consumption of alcohol and sugar as well as having too much copper in the body also create a zinc deficiency.  Omega-3 oils are important and can come from supplements or diet.  Vitamin D directly stimulates hair growth.  Taking a supplement won't always help because it may not be being absorbed.  Inadequate bile can reduce absorption, as can gut inflammation.  Vitamin D is best gotten from sunlight.  It is important for immune aspect of hair, such as autoimmune conditions that cause hair loss.  Selenium is needed to convert thyroid hormone T4 to T3 and poor thyroid function can impair new hair growth.  Selenium is also an important antioxidant for hair health, counters alopecia and dandruff (it inhibits fungus that causes dandruff).  Biotin is essential for hair growth and strength.  It is made for us by our gut microbiome.  Folate is a cofactor for a lot of the proteins that our tissues are made of, including hair.  Vitamin C is needed to make collagen which is one of the proteins that hair is made from.  Best gotten from foods, not supplements.  High levels of vitamin C are found in sauerkraut, cabbage, berries, bell peppers, and many other vegetables.  Vitamin C makes collagen strong which also protects skin from wrinkles.  Sea Kelp has trace minerals including selenium, iodine, manganese, and zinc; also has amino acids and B vitamins.  Use sulfate free shampoo, sulfates can dissolve protein in the hair (also don't wash hair too frequently).  Use conditioner with healthy oils to replenish the ones that get washed out. Use a shower filter (or whole house point-of-entry filter) to remove chlorine and fluoride from the water.  

Fluoride in the water supply damages hair and can cause acne on skin.  There are links to 2 options for shower head filters that remove fluoride from the water, this one and this one.  For reference, normal hair loss is about 100 hairs per day.  Anti-hair loss medications work by inhibiting a strong form of testosterone called DHT.  These drugs do this by targeting an enzyme called 5-alpha reductase and if the levels become too elevated this causes pattern baldness aka Androgenetic Alopecia.  A natural way of blocking this enzyme is to rub onion juice (diluted 50/50 with water on your scalp, allow to sit for 15 minutes, then wash it off (you can do the same thing with green tea).  Rosemary oil is another option, it can be massaged into the scalp at night and washed out in the morning.  Other things that inhibit this enzyme include the herb stinging nettle, zinc and apple cider vinegar diluted at least by 2/3.  

Probiotic microbes on our skin help maintain healthy scalp and hair and can be washed out by over-washing hair.  Not eating enough protein, B vitamins, cruciferous vegetables (because it regulates estrogen levels), or trace minerals such as selenium can lead to hair loss (sea salt and sea kelp can also replenish these).  Silica supports healthy hair and connective tissue and can be found in spring water.  Slow thyroid can cause hair loss.  Reduce stress.  PCOS can cause hair loss by increasing insulin.  Sauerkraut is a very rich source of probiotics which are needed to make biotin (and vitamin c).  Collagen is important and can be depleted by low stomach acid which can limit how much collagen your body can break down and absorb.

Copper deficiency causes split ends.  Other important trace minerals include zinc, selenium, silica,

Supplement Notes (Vitamins)

LETTER VITAMINS:

Bioavailability is the fraction of an administered compound that reaches the systemic circulation and is transported to site of action (target tissue).  From Linus Pauling Institute (LPI) 

B vitamins -  (B vitamins should be taken together to maintain the correct ratios of each)

B Vitamins and the Brain: Mechanisms, Dose and Efficacy—A Review

B vitamins are essential cofactors for the functioning of the electron transport chain in the mitochondria.  They are also helpful to minimize the damage to organs and cells from diabetes.

B1 (thiamine) -  supports sugar metabolism.  Has a relaxing and calming effect.  Can reduce symptoms caused by high blood sugar, including tinnitus.

Folinic acid improves verbal communication in children with autism and language impairment: a randomized double-blind placebo-controlled trial

B6 (P5P is the active form) - important for connective tissue production and is an important cofactor in the regulation of neurotransmitters.

Biotin - is sometimes considered to be a B vitamin.  It is made by microbes in our gut and inhibits the yeast in our bodies from turning into it's invasive form (hyphae).  It can also help reduce or stop hair loss.  

B12 - deficiency can be caused by the drug Metformin, eating a vegan diet, and surgery that removes part of the bowel.  It can easily be mistaken for a folate deficiency.  A severe form of B12 deficiency can lead to a type of anemia called Pernicious Anemia because B12 is important for the production of red blood cells and DNA and for the nervous system to function. 

Vitamin C - supports immune function, is a potent antioxidant and important component in the formation of connective tissue.   Very high doses given intravenously have been used to successfully treat sepsis and skin cancer (and possibly other cancers).

Supplemental forms of vitamin C (from the Linus Pauling Institute)

Vitamin D - significantly improves the absorption of calcium from the gut and helps our bodies to put that calcium where it is supposed to be and not where it isn't (calcification is a significant cause of many symptoms/conditions including cataracts, atherosclerosis, vertigo, and arthritis).  The preferred form is vitamin D3 and should be taken along with vitamin K2 (K2 is important for putting calcium into bones).

Vitamin E - supports immune function and reduces inflammation.  It is important for healthy blood and circulation as a blood thinner; it dissolves fresh blood clots, reduces the need for oxygen in body tissues (deficiency of vitamin E increases tissue needs for oxygen, which is why it is connected with chest pain and angina), reduces muscle cramping, helps heal burns, and reduces scarring.  Good food sources include wheat germ oil (if not allergic), sunflower seeds, almonds, raw seeds and nuts, leafy greens, and avocado.

Vitamin K2 (D3/K2)

 OTHER VITAMINS AND SUPPLEMENTS:

Melatonin is an antioxidant that can enter the mitochondria and protect them from oxidative stress, apoptosis, and impaired function (energy production).  Also supports glutathione production, has anticonvulsant properties, reduces the effect of autoimmune diseases, and helps support immune function.  It is best known for inducing sleep at night.

Intermittent Fasting

Intermittent Fasting -
 
The Basics of Intermittent Fasting (from Dr Berg)
Dr Berg claims that intermittent fasting (IF for short) is one of the most effective things a person can do to improve their overall health.  It leads to growth of new brain cells, which in turn leads to improved memory and attention; improvement in mood due to brain healing as well as reduction of inflammation: improvements in immune system function including the growth of new immune stem cells in bone marrow, and an overall reduction in inflammation.  These improvements generally come from healing insulin resistance.  Insulin is actually necessary for all nutrients to enter cells, not just sugar, so insulin resistance leads to a seemingly paradoxical reduction in nutrients while eating "plenty" of food.  A common concern that people have about IF is that they will lose muscle from the body breaking it down to "feed" itself.  This doesn't happen with IF because the body significantly increases its production of growth hormone in order to protect the muscles. 

The basic concept of fasting is for the body to burn energy that has been stored as fat.  This means that the body is not starving when you are not eating, it is simply "eating" its fat reserves. The best indication that fasting is working (the body is eating stored fat) is that you aren't hungry.  Dr Berg clarifies that the principal is to get healthy to lose weight, not to lose weight to get healthy.  Although IF is a powerful tool to help the body achieve appropriate weight loss, weight loss itself is not usually the goal but an outcome of working towards optimal health.  Another way of looking at this is to get to the point where you are controlling your food, not your food controlling you.  IF is often done along with the ketogenic diet.  For more about eating "keto" see this post.

Here are some basic principles:

Skip breakfast, or move breakfast later and later, aiming for around noon.  Many people eat in the morning out of habit more than hunger.  

Don't eat if you are not hungry.  In order to not feel hunger, keep your intake of carbs low at the meals you do eat, around 20 or 30 grams.  If you eat more carbs at lunch and dinner you will be hungry the next morning.  If you are hungry for breakfast one option is to have "bulletproof coffee".  To do this add either butter or MCT oil to your coffee and whiz it in the blender (this emulsifies the fat so you don't have a pool of grease sitting on top of your coffee).  MCT oil will turn into ketones which will help you make it to your first meal around noon.  If you don't drink coffee you can eat a spoonful of MCT oil plain.  Another issue is that your body releases a burst of cortisol around 8 AM which can feel like hunger when it happens.  If you ignore this it usually goes away and your body learns to distinguish this from hunger.  

Avoid snacking.  Every time you eat, whether a snack or meal, your pancreas releases insulin.  More insulin is released after eating carbs, but protein snacks also do cause insulin levels to rise.  Many of the benefits of intermittent fasting come from reducing insulin resistance which is done by reducing the amount and frequency of insulin that your body releases in response to what you eat.  Especially avoid snacking at night which can be particularly hard to give up for a lot of people.  Some tricks to help you be successful changing this habit include keeping busy after dinner, avoid bringing snack food into your house in the first place if possible, and making sure to eat a filing and satisfying dinner.  

A note about cholesterol - the majority of people who transition to eating IF and keto see their cholesterol levels lower, but occasionally they do go up and this can make people nervous.  What's happening is that when fat is burned for energy, cholesterol is left behind because it is not burned that way.  This cholesterol is sent to the liver on it's way out of the body, and if you don't have adequate liver function (which can be the result of having a fatty liver, not enough bile, etc) this cholesterol backs up in your system.  An Advanced Lipid Profile Test will show that if your cholesterol levels are elevated, it's with the large low density particles that are not dangerous.  Dr Berg says that after 14 days of doing combined IF and keto one-half of the excess fat in a fatty liver is gone. 

Specific Tips:

 -Have patience in this process.  It took many years of eating poor quality foods to get where you are before starting.

 -Getting enough potassium (and other electrolytes) can become an issue when eating IF and keto, which leads to discomfort often called "keto flu".  This particularly happens during the transition to eating this way.  This can be helped and even avoided by eating enough vegetables.  Because this can be hard for some people to do, especially when eating during the limited time frame in IF, eating a large salad at one or both of your meals can really help.  Dr Berg suggests eating the salad first, because once you've had your protein and fat, you will probably not be hungry enough to want to eat that much salad. Eating a lot of vegetables also helps because the microbes in your gut microbiome eat the fiber from the vegetables.  Among many things, they produce a kind of fat that reduces blood sugar levels.  For more about the importance of getting enough potassium see this post.  If you still feel "keto flu" symptoms after increasing your intake of vegetables, you might benefit from supplementing electrolytes and B vitamins.  This need should only be temporary while your body adjusts to the new way of eating.

-The two types of food that don't increase insulin levels are fat and fiber.  This could be a spoonful of MCT oil or a cup of bulletproof coffee.  A mostly fiber snack could be plain celery or raw greens.  This may not be appealing but is functional

-Green tea helps insulin resistance and can allow you to fast for longer periods of time.  Other herbs and spices that can be made into tea that can reduce blood sugar and appetite include cinnamon, ginseng, garcinia, and ginger.

-Avoid having a pre- or post-workout protein drink, smoothie, or snack, because this counteracts the benefits of the increased growth hormone that is produced by working out. 

-Apple cider vinegar contains acetic acid which reduces insulin resistance, which appears to be the reason that it can contribute to weight loss.  You can mix some into a glass of water to drink with a meal so that your body will absorb more of the nutrients from the meal and you will feel more satisfied.  

-If you cheat and either eat more carbs or eat during a fasting time, even a small snack or drink or half a glass of wine, it will take you out of the fat-burning mode that you have worked hard to get into, probably for at least a day.  It can be hard to remember that the point here is not about calories, which is what people are often thinking about when they chose to consume something as a "cheat", but about being in a state that is about hormone levels.  

-Lemon juice reduces insulin levels.  It also contains citric acid, which can protect against gout for those at risk of developing it,   because fasting can increase levels of uric acid in the body (not a problem in general).

-Drinking ginger lemon water in the morning is helpful.  Ginger has at least 115 known antioxidants/phytonutrients whose effects include anti-inflammatory, anti-cancer, relief from gas, reduces nausea (including from pregnancy and motion sickness), and decreases insulin levels.   

How to make it:
1/4 cup of ginger (can buy the juice)
juice of 1 lemon
12 ounces of water
If using fresh ginger you can grate or shred it and soak it in the 12 ounces of water for 30 to 60 minutes.  Strain out the fiber and add the juice of 1 lemon.  Drink on an empty stomach.  This will not break the fast.  

For maximum weight loss, the optimal ratio of eating time to fasting time is 23 hours of fasting and then 1 hour, which is one meal, each day.  This is especially helpful if you have a lot of weight to lose or you have pretty severe insulin resistance.  This may be too hard to start off with so it's fine to start with 18 hours fasting and 6 hours eating, which allows for 2 meals a day. 

Why fasting bolsters brain power: Mark Mattson at TEDxJohnsHopkinsUniversity

Top Fasting Benefits: Autophagy Explained- Thomas DeLauer
Intermittent fasting increases autophagy by 5 times.  Autophagy is a process in the body that clears up debris and excess "junk" in and around your cells. 

 

Basics of the Ketogenic DIet

The ketogenic diet is based on the idea of eating in such a way as to make fats the fuel that the body burns for energy rather than sugar.  During digestion fats are broken down into molecules that are called ketones and then burns the ketones as fuel.  Ketones burn more "cleanly" than sugar does, which is the fuel burned by most people who live in industrialized, developed nations.  This keeps blood sugar, and therefore insulin, levels low.  This diet is especially effective for healing neurological problems such as seizures.  It is NOT the same thing as diabetic ketoacidosis.  In the more mainstream medical community a keto diet is defined entirely by the ration of macronutrients in a person's diet, so can include a lot of poor quality processed foods that are not healthy to eat.  The term "healthy keto" refers to a ketogenic diet that is based not only on macronutrient ratios but also on eating foods that are nutrient dense, relatively unprocessed, organic when possible, and which include a wide variety of foods to provide a wide variety of nutrients.  

The guidelines for keto say that of the calories you consume, 20% should be from protein, 65-70% fat, and 5% carbs.  This is difficult for many people to follow because it means calculating how many calories are in different foods.  A way to simplify this is for about half of what is in your plate to be vegetables and salad, about one-quarter to be protein, and the last quarter to be fat.  This seems like not enough fat, but keep in mind that one gram of fat has more than double the calories of one gram of protein or carbohydrates. 

Good sources of information regarding the ketogenic diet:
Andrew Huberman
Dr Boz (Annette Bosworth, MD)

NOTES-

-Need to keep insulin low to burn fat.  Eating, especially eating carbs, triggers the release of insulin.
A common misconception is that eating a high amount of fat is what puts you into ketosis, but it's actually reducing the amount of sugar and starch that determines this.  Lean meat and other protein sources will also trigger the release of insulin, although less.
-Avoid eating grains, sugars, or other starches.  Sugar alcohols (such as xylitol) are allowed but are associated with other health issues including blood clotting, heart attack, and stroke.  Avoid fruit except for some berries (blackberries, strawberries, and raspberries). 
-Eat 7 cups of veggies everyday.  Can help to eat them before eating protein.  No potatoes, but carrots and beets are okay. 
-Eat proteins with fat rather than lean meats/proteins.  This allows you to absorb the fat soluble vitamins such as vitamin D, A, E and K better.
-Eat less often and only when you are actually hungry.  A good schedule is to begin eating around noon and stop eating in the evening, a few hours before bed. 
-Coffee in the morning is fine if you have it black or with butter or MCT oil (use a blender to do this).
-There is normally a spike in cortisol around 8 AM and this can cause you to feel hungry.  This feeling will pass within 30 minutes or so.
-The glycemic index tells you how specific foods influence blood sugar levels, and the insulin index which tells you how non-carb foods influence insulin levels.  The leaner the meat/protein the more insulin is released.  Fat has a neutral effect on insulin levels.
-Suggestions of what to eat include 2 to 4 eggs per day, avocado, bacon, salmon, sardines and other fish, seafood, chicken with the skin on or chicken wings, cheese from grass-fed animals if dairy is tolerated, heavy whipping cream, nut and seed butters, olives, green salads, raw and steamed vegetables, olive oil and balsamic vinegar for salad dressing, handful of nuts and seeds, water with ACV and fresh lemon, coffee or tea (can be "bulletproof" with fat such as butter or MCT oil blended in), blueberries, raspberries, and strawberries.
-Taking exogenous ketones is especially good for people with a lot of insulin resistance. 
-It's okay to take vitamin supplements. 
-If you crave bread you may need more B vitamins.
-If you have gut dysbiosis or SIBO you might feel bloated and unwell after eating vegetables because the fiber is feeding gut bacteria that are in the wrong place.
-Electrolytes in water can help the transition to keto go smoothly. 
-Use sea salt and you will probably need more salt, at least at first.
-Get exercise while fasting, don't eat before or after exercise because insulin turns off fat burning.
- Coconut milk is keto-friendly, coconut water less so.

Mark's Daily Apple on why fat is the better fuel:

Get rid of Insulin Resistance Once And For All (from Dr Boz)
There are three factors about food that influence how much insulin we make.  They are the type of food, the size of the food, and the time the food is eaten.  All food stimulates insulin release, but carbs do it the most.  Protein (especially if lean) raises insulin somewhat, and fat does only a little.  It takes about 4 to 6 hours for insulin levels to return to normal after eating (in healthy people).  As for the effect of food size, if the food is ground up or pulverized it will cause more insulin to be released, so protein powders, grain flours, sugar, and powdered fats raise insulin levels higher than the same food in its more natural form would.  Circadian rhythms tell our bodies to release some glucose every morning at round 6AM to get us going.  This doctor suggests only eating when the sun is up, never after dark, for her insulin resistant patients.  She says that eating food at night (late at night?) keeps blood sugar levels and insulin levels elevated all night.  She suggests compacting your eating time to breakfast only and no other eating.  She says to eat only whole foods, eat mostly fat with a small amount of protein, and lots of vegetables.