What Makes Chocolate Beneficial?

When it comes to the benefits of chocolate, it basically all comes down to one thing – the percentage of cacao. The percentage of cacao is derived from the cacao bean – which includes the cocoa butter, cocoa powder, and the chocolate liquor which is produced from dried ground beans and sometimes called cocoa mass. By the way cacao refers to the name of the chocolate tree (Theobroma cacao), its pods and the beans inside whereas cocoa refers to the by-products of the cacao bean – the cocoa power and cocoa butter. I’m probably going to confuse the two somewhere in this article; essentially there really is no difference once the actual product is in your hands (and mouth).

The higher percentage of cacao equals a higher amount of flavonoids (also known as bioflavonoids). Flavonoids are powerful antioxidants founds in fruits, veges, herbs, and other plant-based foods. Antioxidants help protect us against damage caused by free radicals as a result of toxins from our environment and lifestyle (mental stress, poor diet, etc.).  Flavanols (spelled with two ‘a’s), are a class of flavonoids that are high in tea, red wine, and cocoa.  They are a type of antioxidant that are very beneficial to blood vessels. They keep arteries flexible and can even reduce your blood pressure (if it’s high). But don’t go crazy here now – chocolate also has sugar added to various amounts depending on the type you’re eating, and sugar increases inflammation, which can be a problem for blood vessels and your blood pressure.

So as flavanols are a subgroup of flavonoids, epicatechins are a subgroup of flavanols. The catechins make up what are called proanthocyanidins, also known as OPCs (oligomeric proanthocyanidins) – these are kick-ass antioxidants. Proanthocyanidins can be found in many plants, such as apples, acai, cinnamon, grape seed and grape skin, red wines, bilberry, cranberry, black currant, green tea, black tea, and others.  Oh yeah – and cacao beans. Actually, cacao beans contain the highest concentrations, but it all depends on how they were grown and processed. Two tablespoons of natural cocoa has more antioxidant capacity than 3 ½ cups of green tea, ¾ cup of blueberries and 1 1/3 glasses of red wine. Raw cocoa is ideal since flavanols degrade during cooking (high temp) and the commonly used alkalizing processes. Flavanols are bitter so most chocolate goes through processing steps that remove a lot of these beneficial antioxidants.

As cocoa makes its way from bean to cocoa powder and chocolate, the concentration of antioxidant compounds can be affected by a variety of biological and processing conditions.  Genetics can vary greatly between cacao trees, thus affecting the concentration of antioxidants four-fold from one bean to another. Fermentation of fresh cacao beans also tends to decrease antioxidant content as does roasting of cacao beans and treatment of cocoa powder with alkali.

Processing with alkali is called dutching – it breaks down the flavanol antioxidants naturally found in cocoa and chocolate. The extent to which the flavanols are lost is related to how heavily the cocoa or chocolate is dutched. Dutched cocoa can be identified on the ingredient panel of a food when labeled as “cocoa processed with alkali.”  Unfortunately, food labels do not state the extent of alkalization of a cocoa powder, so you should choose a natural cocoa for maximum antioxidants.

Chocolate Fats

Healthy Chocolate & Cacao Butter

Cocoa butter is obtained from whole cacao beans, which are fermented, roasted, and then separated from their hulls. About 54 – 58% of the residue is cocoa butter. Cocoa butter is one of the most stable fats known, a quality that coupled with antioxidants naturally prevents rancidity. Cocoa butter has a high content of saturated fats derived from stearic and palmitic acids. These are beneficial types of saturated fats. Stearic acid is also found in grass fed beef and palmitic is high in dairy fat (butter). Around 30% of the fat is also oleic, which is the same monounsaturated fat in olive oil. The moisturizing abilities of cocoa butter are frequently recommended for prevention of stretch marks, treatment of chapped lips, and as a daily moisturizer. I like to break it up and put it right in a smoothie (see photo).

What’s Not To Love About Chocolate?

Other than the sugar (depending on the percentage of cocoa you’re eating), the two other compounds in chocolate that tend to give it a bad rap are the caffeine and theobromine.

Caffeine, as well all know, is a stimulant that is high in coffee, teas, guarana, yerba mate, and many energy drinks. For plants, caffeine is a natural insecticide. Caffeine as well as theobromine, paraxanthine and theophylline, are part of the methylxanthine family – psychoactive stimulants.

Symptoms of too much caffeine (too much ingested or impaired breakdown of it) include: nervousness, irritability, panic attacks, OCD, ADD, phobias, anxiety, muscle twitching, insomnia, headaches, heart palpitations, and digestive problems. But hey – there really isn’t a whole lot of caffeine in chocolate – even the pure unprocessed stuff. A typical 3.5oz bar of 70% cocoa is going to have roughly the same amount of caffeine as a cup (6-7oz) of coffee. If you’re eating 70% or higher chocolate, you’re probably not going to eat the whole bar. If you are, well you might have a problem. If you’re using <70% cocoa (not recommended) then there is even less caffeine in there so you’d have to eat more to get more caffeine. But you’d never do that, right? – Waayy too much sugar.

So what’s that theobromine? Theobromine is what’s known as an alkaloid and is a stimulant to the central nervous system. It acts as a vasodilator (a blood vessel widener), a diuretic (urination aid), and heart stimulant. Theobromine has also been identified as one of the compounds contributing to chocolate’s reputed role as an aphrodisiac as well as the compound that makes a person crave chocolate (could be the sugar too).

Some people don’t break down theobromines (or caffeine) well in their liver so they can develop toxicity symptoms from chocolate and tea. These symptoms can range from headaches to fatigue to painful “locked-up” joints. Animals don’t break these alkaloids down well at all; theobromine is what will kill your dog, cat, or horse if they eat too much chocolate.

Enjoy Good Chocolate

You should shoot for chocolate that is at least 70% or higher cocoa; 80% is ideal. Milk chocolate is only around 10% cocoa (such as a Hershey’s bar) and semisweet is around 35%. The lower the percent of cocoa, the less antioxidants and the more sugar it contains. You should also look for Fair Trade chocolate. Fair Trade practices ensure that cacao farmers, (who typically live in developing countries in South America, Africa, and Southeast Asia,) receive a guaranteed minimum price for their products, enjoy safer working conditions, and employ sustainable growing methods that benefit their own health as well as the planet. Slavery still exists in many cacao farms, especially in Africa, and child labor/slavery is a huge problem. Currently no organic cocoa beans are coming from Ivory Coast, so organic chocolate is unlikely to be tainted by slavery (or pesticides & herbicides).

So, it comes down to this: Whether it’s a special holiday like Valentine’s Day, Easter, or your birthday, chocolate can be good for your health, or bad for your health. Eat Organic Fair Trade chocolate that is at least 70% cocoa and not processed with alkali. And don’t go crazy on it. If you’re craving chocolate, you’re probably craving the stimulants in there (caffeine or theobromine) and you should look into why you need that stimulation – you’re probably under more stress than your body can handle. If you can’t handle the taste of “rich” chocolate, especially 80%, then you’re most likely dealing with a sugar sensitivity – a sweet tooth that needs to be dealt with. Look into the Paleo Diet and the Two Week Test; (yeah, after Valentine’s Day of course).

Alec Baldwin seems to have broken his sugar addiction and dropped 30 pounds of weight in just four months. At just under two pounds a week average, that’s a healthy way to lose weight. Baldwin claims he cut sugar from his diet and began to exercise more regularly. That’s pretty much as deep as my sources go on this one. Pathetic I know, if you’re looking for some good trash gossip on celebrities, but it’s good to see some high profile people lose weight and become healthier and more fit at the same time – no “Hollywood Grapefruit Diet”, or some other gimmick, or drugs.

Sugar can act just like a drug in your body though, which is why it can be so hard for so many to break the addiction and get sugar out of their diet. Too much sugar in your diet over time leads to higher and higher insulin levels which eventually makes your tissues resistant to insulin – they no longer pay attention to it. So you need more and more sugar, which tells your body to create more and more of the hormone insulin, to perform the job of proper glucose metabolism, where it once required much less of the hormone. Obesity, cardiovascular disease, cholesterol problems, and most other health problems ranging from immune system issues to ADD can be linked to insulin resistance. Type II diabetes of course is leading that parade.

Now hopefully Baldwin just didn’t shun sugar and resort to calorie-void sweeteners such as sucralose (Splenda) and aspartame (Nutrasweet). They’re 600 times and 200 times sweeter than sugar, respectively. Although many think that the calories matter, calories in do not equal calories out. Using fake sugars that are hundreds of times sweeter than regular white sugar keeps your “sweet tooth” active, which is the neurologic craving for sugar – and it affects the insulin sensitivity of the tissues too.

So to officially break any sugar addiction you need to eliminate all sugar, including those natural sugar alcohols, (xylitol, sorbitol, erythritol, maltitol), as well as the bad artificial sweeteners too. How about honey and maple syrup? Those are the only two natural sweeteners that are okay to use, for most, but you may need to eliminate them one hundred percent depending on your sugar dependency. Molasses is typically fine too. It contains some minerals, not that you need to eat it just for that reason though. Be careful with stevia – even though it’s natural and low-cal, it can be up to 300 times sweeter than sugar too. Agave – of course you’d never touch that junk.

So do you ditch all the sugar including fruits and other carbohydrates or just limit your intake? That all depends on how addicted you are and how much it’s contributing to your health problems. Even if you don’t have a known health problem eating sugar every day is not healthy. Can you go at least one day without? If you can, you’re probably not addicted. Check out the Paleo Diet – I think it’s a great place to start and a great diet for everybody to follow. Also, though a little more strict but it does the job, is the Two Week Test.

Now for a commercial interruption: It’s winter so don’t forget to check your vitamin D levels and possibly supplement!

Demi Moore is said to have been rushed to a hospital recently for exhaustion which some speculate is a mix of drug abuse and stress from her recent marital problems. Be that as it may, one drug problem she has is to the caffeine in energy drinks. Supposedly she’s addicted to Red Bull and consumes them like water.

Caffeine is actually a drug, and millions of people are addicted to coffee, soda, and especially energy drinks. It’s a growing problem fueled by sports icons and celebrities. Energy drinks don’t have a place in the diet. Actually I’d say they are completely unnecessary at all times, with the rare exception when they’re used as an ergogenic aid for sports enhancing performance (not during training but during competition). Even then, however, they can be dangerous if abused as caffeine and other stimulants in energy drinks can drive the sympathetic nervous system too hard resulting in serious health consequences, such as those cardiovascular in nature. Energy drinks may kill you.

Ditch your energy drinks and other sugary drinks you consume throughout the day, including 100% fruit juice. Stick with water only or some tea here and there (a bit of honey if you need some sweetness).

Thanks for watching (reading).

Just some of the topics covered are:

• What exactly is “cardio” exercise?
• How to build your aerobic system correctly and efficiently
• HIIT – High Intensity Interval Training
• Strength conditioning for endurance athletes- it’s a good thing if done correctly
• Improving your health and fitness without sacrificing one or the other
• Can a training for a half or full marathon kill you?

Who is dying from high cholesterol?

Cardiovascular problems, such as heart disease and heart attacks, are a major health problem in today’s societies – they’re the number one cause of death. Cholesterol is often implicated as a major player in these types of problems. High cholesterol may be a factor of an underlying problem, or it may just be a coincidence that one’s cholesterol is elevated due to other health problems, related or unrelated to the cardiovascular system. Typically, due to medical intervention, patients are already on cholesterol lowering medications yet they’re still having health problems, and definitely not living any longer. So if it was just all about high cholesterol causing heart disease and lowering cholesterol resolving these problems then there would be a major improvement in this healthcare crisis.

Cardiovascular disease is caused by a wide range of nutritional, lifestyle and environmental factors that result in inflammation that gets out of control. Sure genetics most likely have some factor, but minimal compared to the rest. The genetic link is typically a cop-out when someone doesn’t take control of their own health. Toxins, infections, excessive stress, lack of proper exercise and diet are far more damaging to the heart than high total cholesterol.

I’m not at all insinuating that high cholesterol is okay, but I am definitely saying that less is not necessarily better. There’s more to it than just that. Cholesterol just doesn’t shift to a dangerous level without other contributing factors. A poor diet and overall health lead to unhealthy cholesterol levels whether that’s low, (as mine were back in the early 1990s), high, or imbalanced. I’ll discuss this more in a bit.

Why do you need cholesterol?

I have been trying for years, decades actually, to raise my cholesterol. Finally after a more significant (call it strict if you like) change in diet, it’s happening and that’s a good thing. You see, low cholesterol is often much more dangerous than high cholesterol even though we’re led to believe that cholesterol is evil. A cholesterol level below 160 mg/dl is said to increase one’s risk of many cancers, stroke, neurological problems such as memory loss and dementia, and many other health problems ranging from digestive to hormonal. I often tell a patient that if they had to pick one, high cholesterol is better than low. Of course, a healthy level is best – which is based off the components that make up cholesterol as discussed below.

Some notable cholesterol functions:

• It acts as a precursor to vitamin D – low cholesterol means it will be more difficult to absorb this vitamin necessary for a healthy immune system, bones, and DNA. More on vitamin D here.
• It is the precursor to all steroid hormones such as glucocorticoids which control blood sugar, mineralcorticoids which regulate electrolyte balance and blood pressure, and sex hormones such as progesterone, estrogen, and testosterone.
• It is used to synthesize bile acids in the liver, which are important for the digestion of fats. These bile salts are then stored in the gallbladder.
• Cholesterol is found in every cell of your body and is a necessary component of a healthy brain that needs to store and recall memory, process ideas, and function at its highest level.

About 20 years ago my total cholesterol level dropped to 92 mg/dl. I was a student at the University of Miami, well known for its pre-med program. The leading physician at the student health center at that time thought I was extremely healthy; I had the “best” cholesterol level he had ever seen. As nice as he was, this unenlightened doctor did not realize that it was actually perhaps one of the worst he had discovered. I, at the time, knew no better and clearly didn’t know the dangers of such a low level. I was training hard, studying hard, and following the low-fat, high carbohydrate diet of the late 1980s-early 1990s.

Good, bad & ratios

Most of us know that cholesterol is made up of HDLs, LDLs, and VLDLs (which are mostly triglycerides). The HDLs tend to remove cholesterol from tissues so many think of them as the “good” cholesterol whereas the LDLs tend to deposit cholesterol into tissues, so we are told this is the “bad” stuff. In reality it is not that cut and dry, because there are also good and bad LDLs, and good and better HDLs.

Triglycerides are major transporters of dietary fat in the bloodstream – especially fat that has resulted from excess carbohydrates in the diet. On average, a diet consisting of 60% or more of carbohydrates can increase triglyceride levels as can heavy alcohol use. I’ll leave the determination of “heavy” up to you, but typically that means two or more drinks per night, sometimes less.

Your tissues need cholesterol or you will die; so not all LDLs are as bad as they’re made out to be. All cholesterol  particles can be either large or small. Ideally you’d like to have more large, buoyant HDLs and LDLs than small, and more small VLDLs/triglycerides than large. These can be measured through a more thorough lipid analysis, and are readily available today – click here for more info.  One sign that your LDLs are most likely large (good) rather than small (bad) is your HDL to triglyceride ratio. If your HDLs are at least one-half of your triglycerides, then you most likely have large LDLs. So for example, if your HDLs are 40 and your triglycerides are over 80, you have some work to do.

Another good ratio to look at is the total cholesterol to HDL ratio. Most lab reports say this ratio is normal if it is 5:1 or lower. That is still very high, and in my opinion you should shoot for 3:1, if not lower. So if your total cholesterol is 180 and your HDL is 60 that is good. If your total cholesterol is 250 with a  HDL of 100, LDL of 130 and triglyceride of 100 that is also good!

The LDLs really freak people out. I tell patients that it is almost impossible to pass a cholesterol test today. At least one result from the lipid panel is most likely going to be flagged. You’re destined to fail – healthy or not. You see, what has happened is that the LDL upper limit was dropped several years ago by most labs from 138 to 100. So now a LDL of say 125 is considered high, regardless of whether they are the small or large LDLs. Interestingly, around the same time this happened, the pharmaceutical industry was trying to get the upper limit of total cholesterol lowered from 200 to 190. That way, if your cholesterol level was 195, your doctor would recommend a statin medication “for your health.” This never happened, but the LDL was soon lowered – a whopping 38 points. Uncanny coincidence. So now a lipid panel of say 190 total cholesterol, 65 HDL, 105 LDL, and 100 triglycerides, (a triglyceride makes up 1/5 of the total cholesterol, so 100 = 20 of the total points), which is excellent, is flagged as having a high LDL. That’s not cool.

LDLs however are the big issue when it comes to heart health but it is the oxidized LDLs rather than LDLs per se that contributes to atherosclerosis and “cholesterol problems.” What causes LDLs to oxidize? Free radicals, unhealthy fats, and a high carbohydrate diet cause the oxidation.

Free radical damage is often the result of lack of antioxidants in the body, such as vitamins A, C, and E but perhaps more importantly are all the healthy antioxidants found in fruits, vegetables, and herbs. Vitamin D is also a very important antioxidant – and one that won’t be well utilized by a low cholesterol body. Coenzyme Q10 is a very an important antioxidant needed by the heart and for the body to make energy. Statins (cholesterol meds) block CoQ10 from being made naturally in the body, therefore increasing free radical damage and further oxidizing LDLs. The more stress one is under – physical, nutritional, and emotional – the more free radical damage your body will succumb to.

Unhealthy fats mean partially hydrogenated “trans” fats as well as all polyunsaturated vegetable oils – corn, soy, sunflower, safflower, peanut, cottonseed, and yes definitely canola. More on that here.

And yes high carbohydrates (refined sugar especially) will lead to oxidized LDLs. More on cutting the carbs here.

Oxidized LDLs cause the body’s immune system to respond by sending in specialized white blood cells to absorb the oxidized LDLs. This creates what are called foam cells which are not able to process the oxidized LDLs, so they ultimately grow then rupture, depositing a greater amount of oxidized cholesterol into the artery wall. This of course triggers more foam cells, continuing the cycle. Foam cells can accumulate and lead to atherosclerosis (inflammation in the vessel wall), a thrombus or emboli (properties of a stroke), from all the accumulated plaque (fats and cholesterol particles). The occlusion of small vessels results in ischemia and can also result in a stroke and myocardial infarction (heart attack).

The point here – small, dense LDLs are the problem because they’re easily oxidized. Once you get more and more oxidized, you’re in trouble.

Cholesterol and Satan (I Mean Statins)

Statins are known as HMG-CoA reductase inhibitiors – they stop the synthesis of a compound called mevalonate from being formed. Mevalonate is the precursor of cholesterol, but also the precursor of squalene and coenzyme Q10 (ubiquinone), as previously mentioned.

Statins, other than blocking how cholesterol and other compounds are made, are touted as beneficial as some studies show they greatly increase the amount of nitric oxide made by the blood vessel lining which results in stroke reduction and its residual neurological effects.Some also say that statins protect against stroke by increasing the body’s ability to dissolve blood clots independently of both nitric oxide and cholesterol. Of course, as mentioned previously, you can significantly lower your risk of stroke by limiting your number of oxidized LDLs. Additionally, nitric oxide is made naturally in high amounts in healthy individuals with adequate protein intake (via the amino acid arginine) and proper cofactors (primarily manganese and vitamin B6).

The Lancet recently published a study saying how safe and effective statins are. These studies often come out to reassure doctors and patients that “all is good.” This one is no different. You can see the study here. The participants in this study either had already had a heart attack or some other form of cardiovascular disease or a condition that would place them at high risk. Also they looked at cancers and non-vascular mortality, not “health.” Oh yeah, it’s worth mentioning that one of the two researches received funding from several drug companies that make statins and has been on drug company advisory boards and even received a honoraria from Pfizer.

How about Pfizer? They make Lipitor, the top-selling drug in history, which lost its patent on November 30, 2011. What a sad day. They pulled in $11 billion worldwide for Lipitor sales last year. Now that some new generics have taken 63% of sales recently they’re down to just a measly $4 billion on the drug, if sales stay up. Speaking of money – here’s an interesting preview of a film called “$29 Billion Reasons to Lie About Cholesterol”. Remember Crestor was pulled off the market (2004 I believe) after being linked to kidney failure. It’s back on the market with that nifty little black box warning. Ever read one of those? Nobody has.

So do you go on a statin if your cholesterol is too high or you’re at some cardiovascular health risk? Personally I think most are putting themselves at more of health risk by doing so, but of course I’m not saying you should stop your medication if you’re on one, but you should understand what they do and really look into why one has been recommended to you. I’ve seen patients on statins for cholesterol levels well below 200, but their doctor thinks “lower is better.” I’ve seen many patients on them who have had pain and fatigue (shoulder pain is very common from statins) yet their doctor tells them to push through it. Many still have pain after they get off the meds.  I even saw a guy who was on a statin to “prevent a heart attack” because his family member, a smoker, had a heart attack. Really. The statin brought his cholesterol down from the 170s to the 120s. These are scary, but true stories. High cholesterol is not the primary cause of heart disease and statins don’t decrease this risk for most people. Statins do however impair vitamin D metabolism and CoQ10 production as previously mentioned, as well as squalene production.

Squalene accumulates at the greatest concentrations in the skin, where it has a vital role as a free radical scavenger, preventing the harmful effects of the degeneration of fats. Adequate concentrations of squalene in the skin prevent oxidative damage from ultraviolet light. Squalene is also a substance that protects people from cancer, so yeah squalene is important. You may have heard of claims that “sharks don’t get cancer.” This is because squalene is super high in shark liver oil. I don’t know if sharks get cancer and I don’t think you should go shark hunting. But you should naturally keep your squalene levels high.

As a sort of side note – I think it’s rather comical that medical doctors think they’re protecting their patient by checking the liver enzymes (AST & ALT) when they prescribe a statin. The liver has to detox these meds and of course cholesterol is made in the liver but there are often functional problems (detoxification impairments) long, long before the enzymes become elevated. I’ve never seen a person taking a statin have elevated liver enzymes yet I’ve seen plenty of them with adverse statin reactions (“side-effects”) – pain, fatigue, and memory problems are the most common.

Less is often not better when it comes to cholesterol

Sure you still need a lot of HDLs and healthy LDLs, but ultimately you need cholesterol. For years after coming off my 92 mg/dl cholesterol plummet, my total cholesterol level hovered between the 130-150 range. My HDLs were always around 50, so that was good, and my triglycerides were always between 70-90 – also good. My LDLs in the 60-80 range – also good. But overall – too low! So back in August 2011 I changed my already very healthy diet to one that was even more healthy for me. I had been eating a diet approximately 55-60% carbohydrate, 20-25% protein, and 20-25% fat. The fat was mostly extra virgin olive oil, butter, nuts, and seeds as well as some fish oil. In August I adjusted to approximately 10-20% carbohydrate, 20-25% protein, 60-70% fat. Additionally, for fats, I significantly reduced my nuts and seeds and added in a lot of coconut oil and coconut milk, more butter, avocados, and a lot of eggs, (pasture raised of course from my 12 hens). In the carbohydrate category I almost completely eliminated all grains with the exception of some corn, rice, and sweet potatoes which I eat on hard intensity or long duration exercise days – this amounts to anywhere from 0-4 times a week. The majority of carbohydrates are from vegetables and some fruit. Oh yeah, 80% dark chocolate too. Did I develop cardiovascular disease? Nope. For the first time ever my total cholesterol hit 170. My HDLs went up over 50% to 78 and my triglycerides dropped even lower to 48 while my LDLs stayed at 82. That’s great to see. And if you’re following, notice that my HDLs, which ideally should be at least one-half of the triglycerides, are actually 1.6X MORE than the triglycerides. What I’ve done is decrease my risk of cancer, stroke, and dementia. Now where was I…

So what’s it all come down to? Diets high in saturated fat and cholesterol don’t cause heart disease. Check out the cool video below to learn even more than what I have here. Actually it’s the high carbohydrate diets and so-called “heart healthy” vegetable oils (corn, soy, canola, safflower, peanut, etc) that are linked to heart disease, cancer and most all diseases. A diet high in carbohydrates and inflammatory oils increase LDLs and oxidize them – and that can cause atherosclerosis.

How to naturally lower or raise cholesterol to a healthy level for you

Are you, “unable to control your cholesterol with diet and exercise”?  What does that even mean? Most doctors don’t exercise or eat well and they sure don’t how to prescribe it. So they fall back on the “diet and exercise alone aren’t enough” motto and recommend a statin. Proper exercise and a healthy diet can do wonders for your health and your cholesterol. That doesn’t mean you cut out all the fat from your diet and get up from your desk a few times a day to walk to the water cooler. Here are some recommendations with the concept that maintaining heart health is about keeping inflammation at bay.

• Remove all refined sugar (that includes juice) and grains from your diet. Triglyceride levels quickly drop with a low carb diet. Check out the Paleo Diet and Two Week Test here to get started.
• Oatmeal? What a joke. Does Wilford Brimley look healthy to you?
• Exercise! Aerobic exercise is a great way to start especially if you’re already on a statin (or any med for that matter). Strength training may be beneficial for you too.  More here. It may be advised for you to have a stress test before engaging in any physical activity. Then again, if you don’t move and engage in some physical activity, isn’t that hazardous to your health?
• Eat a lot of organic vegetables – the more the better. Sorry, corn and potatoes are not veges.
• Keep the fruit to 1-2 servings a day; more only if you exercise intensely or for a long duration.
• Eggs don’t raise cholesterol. Actually, they most likely will lower it. Make sure they’re pasture raised. Butter, heavy cream, avocados, and my favorite – coconut milk & oil. Eat them up, yum.
• Ditch all the trans fats and polyunsaturated vegetable oils – more here and here.
• Consider a fish oil supplements too – not a rancid brand from Sam’s Club but one such as Nordic Naturals.
• More on inflammation here.

Still want to pop that statin pill? Remember that the CoQ10 you’ll deplete prevents atherosclerosis by reducing the accumulation of oxidized fats in blood vessels. It also can lower high blood pressure, regulate the rhythm of your heart, and improve chest pain and exercise toleration if you have angina. You can get CoQ10 naturally from red meat (grass fed), but it’s tough to eat enough. You’ll lose more CoQ10 over the age of 40 and with exercise too so if you take a statin then you’ll quickly become depleted. A general recommendation is 200mg a day. But hey – remember – I’m not your doctor. If your current doctor won’t work with you in your quest to become healthy then go find one who will. It’s your heart and your health.

So what’s the deal against turkeys and is this a plot set forth by Vegans? I’m not sure if we can point the finger at Vegans, but I can tell you with certainty that the reason is not because of the turkeys, but because of the high amount of carbohydrate-rich foods consumed during Thanksgiving. Hmmm…Vegans like carbs – interesting. Okay, enough giving those Vegans a hard time, for now.

All the high carbohydrate foods, especially the sugar (and alcohol) consumed during Thanksgiving stimulates the release of insulin which then carries most of the other amino acids from the blood into the muscles, except for tryptophan. Left hanging out in the blood, and now unopposed by other amino acids, tryptophan is allowed to cross the blood brain barrier. When it does get to the brain it triggers an increase of the neurotransmitter serotonin, which has a sedating effect on your body. (Think Lexapro & Prozac if you’re into medications.) Furthermore, this increase in serotonin can continue on and increase melatonin levels, which is the hormone naturally made by your pineal gland when it is time to sleep.

Additionally, the more stuffing, potatoes, gravy, sugary cranberry sauce, pie, and other carbohydrates consumed subsequently produce more insulin. This will eventually result in your blood sugar crashing down, so you’ll become even more tired. Actually, too many carbs, especially those refined carbs, over time can lead to depression; almost like Thanksgiving every day in your head, and that’s not a good thing. For more on carbs and insulin, click here.

The sugar-tryptophan connection is also the reason why a warm glass of milk before bed helps some people sleep. It’s the milk sugar (lactose), not the calcium or any other nutrient in the milk. And this is the same reason why some nice hotels offer a candy on the pillow or a cookie before bed to their guests, (yeah, it’s a nice gesture too).

How about the opposite effect of carbohydrates and tryptophan? That would be another amino acid called tyrosine and not more carbs but actually protein (or the absence of excess carbs). The increase of tyrosine in the brain allows for more norepinephrine to be produced and that is actually a stimulant to the nervous system. So, if you ate mostly turkey with a bunch of green vegetables for Thanksgiving (kinda like a Paleo-Type meal) then you would actually have the opposite effect – that of an upper rather than a downer. Tyrosine is also a precursor to thyroid hormone, and that’s very important as without it, hypothyroid symptoms might occur such as weight gain, fatigue, and poor mental clarity. Hey, sounds like Thanksgiving meal all over again.

The giant gummy packs a whopping 32,000 calories and has a one year shelf life. It even comes with its own case – or is that a coffin? You’ll soon need one too if you decide to satisfy your corn syrup craving.

What else is there to say other than it comes in four flavors – raspberry, orange, red cherry, and (WHAT?) green apple. 26 pounds of green apple is just wrong. And I was so close to clicking ‘buy.’

This post is not about whether you should get the flu shot or not. That’s not my job to tell you what you should do. Actually, it’s nobody’s job to tell you to get a flu shot (or not get one) and that includes your own primary care physician. I believe in informed consent and an individual making an informed decision based off unbiased information they have been provided and researched themselves. Unfortunately, most people don’t know much about the flu vaccine other than what the news or their doctor tells them, so they think there is nothing wrong with receiving the flu shot. They’re told it will prevent the flu and comes without any risk – or the risk of catching the flu will be much, much worse. These claims, as well as others claims such as how deadly the actual flu virus is, are not entirely true. I have never received the flu shot and neither has anyone in my family. Most of my patients share the same philosophy. We believe in maintaining a strong immune system through living healthy lives and taking natural preventive measures, as described below, and making choices which promote health and well-being. The flu shot is not part of that plan. Flu vaccines weaken the immune system and many times make a person actually more predisposed to illnesses. I believe the vaccine carries too great a risk to one’s health – from the chance of developing Guillain-Barre syndrome to other immune system complications such as allergies, autoimmune diseases, and ear infections. Toxicity issues are associated with many of the vaccines given today as mercury and formaldehyde are still present in many shots. Their link to Autism and developmental learning and behavioral disorders is strong.

Each year, federal health agency officials try to guess which three flu strains are most likely to be prevalent in the U.S. the following year to determine which strains will be included in that following year’s flu vaccine. When the match between the vaccine and circulating viruses is close, the flu vaccine is thought to provide a 70-90% chance of temporary immunity to selected strains in healthy persons less than 65 years old. (The only way to get natural and permanent immunity to a strain of flu is to recover naturally from the flu.) For those over 65 years old, which is one of the target groups, the efficacy rate drops to a mere 30-40%. It is however considered to be 50-60% effective in preventing hospitalization or pneumonia and 80% effective in preventing death from flu caused by the covered strains. The vaccine typically contains two type A and one type B strain. This year’s winners are:

A/Christchurch/16/2010, NIB-74 (H1N1) (an A/California/7/2009-like virus);
A/Victoria/210/2009, NYMC X-187 (H3N2) (an A/Perth/16/2009-like virus);
and B/Brisbane/60/2008

How accurate is this year’s vaccine? Uh, well, – we’ll know that at the end of the flu season.

The CDC recommends a yearly flu vaccine for everyone 6 months of age and older as the first and most important step in protecting against this serious disease. Yes, it is “the most important step.” Eating well and taking other measures to stay healthy (such as washing your hands) are not as important to the CDC.

Interesting though, the FDA says that the vaccines should only be used for the immunization of persons aged 4 years and over because that’s what their studies show to be as safe (less dangerous) and is provided in the drug’s package insert. For example, in the Fluvirin package from Novartis it states, “The safety and immunogenicity of FLUVIRIN® have not been established in children under 4 years of age.” In GSK’s Flulaval it says, “Safety and effectiveness of FLULAVAL in pediatric patients have not been established.”

The drugs also note that it is not known whether they are excreted in human milk. Many drugs are excreted in human milk, so they advise caution when administering the vaccine to a nursing woman. It is also not known whether the drugs can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Furthermore, the vaccines have not been evaluated for carcinogenic or mutagenic potential, or for impairment of fertility.

The four main vaccines you’re likely to come in contact with are the following. Each drug also contains residual amounts of egg proteins (ovalbumin), as well as other preservatives. Thimerosal (mercury) is used in manufacturing of the drugs but some companies remove all of it before completion. GSK, as you can see, leaves it in. Here’s a fun fact that’s not so fun. Actually since it’s Halloween I’ll call it a scary fact: One dose of thimerosal exceeds the EPA’s safety limit of mercury exposure by over 250 times.

• Fluzone (Sanofi Pasteur) – No mercury. Formaldehyde up to 100mcg
• Fluvirin (Novartis) – Mercury in multi-dose (25mcg), not single. No formaldehyde
• Flulaval (GlaxoSmithKline) – Mercury (25mcg) and formaldehyde (25mcg) all doses
• Afluria (Merck) – Mercury in multi-dose (24.5mcg), not single. No formaldehyde

**So, as you can see, if you’re going to vaccinate a zombie I’d choose GSK’s Flulaval. I don’t know if it would kill the zombie but it’s worth a shot. For humans who want to at least stay away from mercury and formaldehyde, ask for Afluria or Fluvirin in the SINGLE DOSE. What??? You have a choice? Probably nobody told you that.**

Hey, how about that Tamiflu? That is the drug available if you get the flu that blocks the enzyme neuraminidase. Neuraminidase inhibitor medications prevent new virus particles from being released, thus slowing or stopping the spread of the virus. On average, a person recovers 30% faster on Tamiflu. Common adverse drug reactions associated with Tamiflu include nausea, vomiting, diarrhea, abdominal pain, and headache. Rare reactions include hepatitis and elevated liver enzymes. See how to naturally block the neuraminidase enzyme below.

The flu vaccine is not the answer in avoiding the flu. Staying in good health is.

Some tips for staying healthy and preventing all viral infections:

• Avoid refined foods such as white sugars and flours which suppress the immune system
• Avoid fake sweeteners such as Splenda and Nutrasweet
• Avoid “bad” fats – partially hydrogenated oils – these are proven to dampen the immune system
• Reduce the amount of omega 6 fats in your diet which are in many packaged, baked, and fast foods. They’re the corn, soy, safflower, peanut, and yes even canola oil. More here.
• Eat organic fresh fruits and vegetables and lots of them
• Drink plenty of  pure filtered water
• Limit caffeine intake (coffee, tea, chocolate, soda of course because of the sugar too)
• Check your vitamin D level and consider supplementing. All about vitamin D here.
• Exercise daily, at least 30 minutes (see information under Fitness)
• Wash your hands frequently, especially after visiting public places
• Get plenty of high quality sleep (and correct those sleep problems). More here.

If you get the flu, or any virus for that matter: Follow the information above and:

• Take elderberry extract. The Israeli extract commonly referred to as Sambucal is proven to block the neuraminidase enzyme responsible for viral replication. This can be used for support during the cold season by taking 2 teaspoons,(1 teaspoon for children), 4 times a day. It can significantly reduce infection time. Some studies show that this can resolve flu symptoms in as fast as 2-3 days, compared to a typical 6-7 day infection period.
• Vitamin C?  I rarely find vitamin C in its common ascorbic acid form to be of any benefit to a person, other than to acidify their tissues which can have its own advantages (and disadvantages). More important is to eat plenty of organic, nutrient-rich fruits and vegetables to get all the natural phytonutrients found in the whole food. I also like Camu powder for its natural vitamin C content. I like the products Camu Supreme and Thera Supreme, available in my office or here.
• The mineral selenium is also known to help with the immune system and fight viruses. Typically 200mcg a day can be beneficial.
• Rub your thymus reflex point. Your thymus is the master gland of your immune system and rubbing over this typically tender spot will help to support the organ’s function. The area to rub is on the right side of your body midline to your armpit at the level of your nipple. The area can be tender in a small place or as large as 3 inches vertical to 2 inches lengthwise. Rub out the tender areas in a firm, circular motion for 1-2 minutes, 4-5 times a day – or better yet, get someone to do it for you! It will feel more tender than what you can do yourself!

Vitamin D takes calcium from the digestive tract and brings it to the blood where it can then head off to perform many of its functions such as building bones, pumping the heart, and contracting your working muscles. But vitamin D is needed for more than calcium metabolism – it’s necessary for a healthy immune and nervous system – so it’s very important your level is adequate especially going through the typical cold and flu season.

Free Vitamin D Right from the Sun

When the Sun’s rays enter the Earth’s atmosphere at too much of an angle, the atmosphere blocks the UVB portion of the rays. This occurs during the early and latter parts of the day and during the winter season, increasing as one moves further away from the equator. This is called “Vitamin D Winter.”

Latitudes above 40 degrees north (New York City, Denver) will experience Vitamin D Winter from around November through early March. Between zero degrees to around 35 degrees north or south allow year-round vitamin D production, higher levels closer to the equator. Here in central North Carolina we’re just above 35 degrees so you can estimate that our Vitamin D Winter is primarily for three months – December, January, and February, with November and March providing some UVB days. An interesting and fun fact is that if your shadow is longer than you are tall, (an indicator of the oblique angle of the Sun), you are not making much vitamin D. So check your shadow!

No UVB rays here

For optimum vitamin D production, sun exposure should be midday between the hours of approximately 10am-2pm. These hours will also vary slightly according to latitude. The closer to solar noon, the more vitamin D produced. During a summer day around noon in Miami an individual with moderate skin pigmentation would require approximately 6 minutes to synthesize 1000 IU of vitamin D but at the same time in Boston it would take that same person ten times longer – 1 hour!

Speaking of skin, the amount of skin exposed is important. At least 40% of the entire skin surface should be exposed for optimal vitamin D production. The torso produces the most, legs and arms some, and the hands and face very little or none at all. Go topless!

Melanin is the pigment that determines our skin color; it is Nature’s built-in protection against skin damage from excess UV ray exposure. This is why those whose ancestry is native to regions near the equator have darker skin than those native to regions located at higher latitudes. It is also why those with darker skin living at higher latitudes have higher prevalence of vitamin D deficiency, and especially those individuals who also live at low elevation as UVB rays diminish as elevation decreases.

Another factor that affects UVB ray and vitamin D exposure is age. Vitamin D synthesis can take up to four times as long for those over the age of 60 and under the age of 20, apparently due to having less cholesterol in the skin. Some claim that many soaps and lotions can negatively affect skin cholesterol levels and therefore impair vitamin D production. Sunscreen also blocks the absorption of vitamin D; a SPF as low as 8 can block as much as 95% of vitamin D production.  And speaking of cholesterol, the statin medications, (ie: Lipitor, Zocor, Crestor, Prevachol), not only block the production of the important antioxidant CoQ10, but they also hinder vitamin D as well.

Glass also significantly limits if not eliminates UVB exposure, so sitting in a sunroom will not bring up your vitamin D levels. Indoor tanning beds and sun lamps do provide UVB rays, and therefore can provide vitamin D, but they should be used sensibly due to their direct exposure. Air pollution can either increase or decrease the UVB rays.

How Does One Actually Make Vitamin D from the Sun?

UVB rays from the sun penetrate the epidermal (outer) layers of the skin and cholesterol (7-dehydrocholesterol) in the tissue of the skin then absorbs this UV light to make vitamin D3, also known as cholecalciferol. This further goes on to become 25-Hydroxycholecaliferol (25(OH)D, also known as calcidiol) in the liver, which happens with adequate niacinamide (vitamin B3)and magnesium levels. This 25(OH) vitamin D level is the one that is the best indicator of vitamin D status. Then with some more niacinamide and iron it becomes 1,25-dihydroxycholecaliferol (calcitriol) in the kidneys. This is the most hormonally active form and our most potent steroid hormone which controls the expression of many our genes.

Those hydroxylation (OH) steps in the liver and kidney are highly dependent on antioxidants such as vitamin A, C, and E in addition to niacinamide, magnesium, and iron. Other nutrients such as vitamin K, boron, and calcium are also very important for the absorption and synthesis of vitamin D. Healthy fats play an important role in vitamin D absorption too, especially the omega 3 fats from fish and flax and saturated fats from eggs, butter, and coconut. A coincidence that coconuts only grow where there is lots of year round UVB exposure? Probably not.  Salmon and egg yolks contain healthy fats, vitamin A, and even some vitamin D!

Speaking of the sun, many people lather up in harmful sunscreens and sunblocks to prevent sunburn. Although this can be somewhat attributed to skin pigmentation, often sunburned individuals are receiving  too much vitamin D and not enough healthy fats, calcium, or antioxidants in their diets (poor hydroxylation). So a diet high in coconut milk/oil, butter, fish oil, and antioxidant-rich food such as colorful fruits and vegetables will not only help with vitamin D absorption, but also prevent sun damage. Healthy fats bring calcium to the soft tissue, including the skin. People who get thick, leathery skin from too much sun exposure are often dealing with too much vitamin D and a lack of healthy fats in their diet which creates a calcium starvation problem in the tissues.

Blood Testing and Your Immune System

The optimum serum level of 25(OH)D is between 50-80ng/mL. If your level is very low you may need to supplement with some Vitamin D3 (not D2) as even an adequate diet and sun exposure may not be enough. But it is not necessarily as simple as what we hear in the news – the vitamin D fad that “everyone is deficient and everyone needs to take vitamin D.” What most do not know is that the 25(OH) vitamin D is often converted to a high amount of 1,25(OH) vitamin D when there is an infection, such as those bacterial in nature as well as autoimmune diseases such as rheumatoid arthritis. So if you’re taking vitamin D because your doctor told you to based off your 25(OH)D blood results, you should be aware that your body perhaps wants that 25(OH)D low because if it increases it more then you will provoke the infection/illness – and that’s a really bad idea. Unfortunately you’re going to have to fight with most doctors to get them to check your 1,25(OH)D level to make sure it is not too high if you also have a low 25(OH)D.

A Few More Things to Mention About Vitamin D

• Vitamin D is key to the proper operation of the innate immune system – this is what defends your body against all infections
• Excess intake of vitamin D is linked to chronic diseases and obesity
• Currently nobody is really quite certain exactly what the normal blood range of vitamin D should be. It is most likely individualized. In other words, you may be fine if your 25(OH)D is 50ng/mL yet someone else may need 80ng/mL.
• At least once, (or more often if it is high), you should have your 1,25(OH)D level checked, especially if your 25(OH)D level is low and you’re considering supplementation. If you supplement and your 1,25(OH)D is high, (especially > 110 pmol/L), you are considered high risk for provoking an existing problem – perhaps an autoimmune issue or infection.
• From my experience, taking the prescription dose of 25,000-50,000IU of vitamin D2, (Deltalin, Drisdol, Calciferol ), and especially the calcitriol medications, (Rocaltrol, Calcijex, Decostriol,) are harmful to patients and quickly result in problems even at just one pill a week. I always see a patient react negatively to these meds – ranging from muscle aches and headaches to digestive problems and fatigue. I, as well as many physicians, have had tremendous success with patients taking 5,000-6,000IU of vitamin D3 once a day and dosing kids at 1,000IU for every 25 lbs of body weight. Some people may need 10,000IU a day for a very short time, but always of D3.
• Vitamin D2 (ergocalciferol) is for plants and fungi. Vitamin D3 (cholecalciferol) is for humans!

Last week I presented my gait evaluation, barefoot & minimalist shoe analysis, and some of my dysglycemia (blood sugar issues) therapies in Bordeaux, France, to over 100 doctors and students from the US, Canada, Europe, and Australia. I was all dressed-up but still ditched the shoes as you can see in the photo. My Powerpoint presentation can be found here (first in the list). If you’re not a physician or therapist you may still find it interesting, especially the first one-third which is about the benefits of barefoot and minimalist footwear. And even more information can be found here on the DRG site – a recent post on orthotics (yeah, I don’t like em’ too much) as well as proper/improper footwear.

Digestive problems are a common complaint for most people. Whether it’s heartburn, bloating, gas, indigestion, constipation, or even more serious symptoms associated with diseases such as Crohn’s, ulcerative colitis, or diverticulitis, often food plays a major role. Unhealthy bacteria, yeast, other types of fungus, parasites, and inflammation can result in an unhealthy immune system, and a poorly functioning body, including your brain. So yes you are what you eat, and your physical and mental performance relies heavily on what you consume.

Although food allergies and sensitivities exist in many people due to an immune reaction to the protein of a food, there are other types of reactions present that cause gut problems. One such problem is perhaps even more prevalent than food allergies, and perhaps the reason for many food allergies as well as a host of gut problems including dysbiosis. This sensitivity has to do with the carbohydrates (sugars) in foods that create bacterial overgrowth.

Small Intestine Bacterial Overgrowth (SIBO) is a chronic bacterial infection of the small intestine.  The infection is often of the bacteria that normally live in the gastrointestinal tract but have abnormally overgrown in a location not meant for so many bacteria. Often SIBO occurs because of dysbiosis – where there is an imbalance of the beneficial bacteria (as well as yeast) with other types of harmful bacteria, yeast, and sometimes even parasites – but also because those bacteria are living off what you’re feeding them.

This healthy bacteria overgrowth in our gut can interfere with normal digestion and absorption of food. Leaky gut syndrome is a name given when there is damage to the membrane of the digestive tract which leads to malabsorption of nutrients such as iron, vitamin B12, vitamins A & D, as well as other nutrients. The bacteria consume and literally live off food unable to be absorbed in the digestive tract, so it grows and grows and as they do, they expel gas which causes abdominal bloating and pain, constipation, and diarrhea. Undigested food particles can enter through the gut lining causing an immune reaction resulting in food allergies and sensitivities. Auto-immune reactions such as Celiac disease and rheumatoid arthritis may be a result of poor digestion from food allergies or SIBO in some people. The gut bacteria can also enter the bloodstream, burdening other areas of the body and creating a toxicity resulting in pain, fatigue, and a host of other symptoms including those neurological, such as memory problems, dementias, and learning disabilities.

FODMAPs refers to Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. These are a collection of molecules found in food that can be poorly absorbed by some people. When the molecules are malabsorbed in the small intestine of the digestive tract, they then continue along their journey along the digestive tract, arriving at the large intestine, where they act as a food source to the bacteria that live there normally. The bacteria then digest/ferment these FODMAPs and can cause a host of symptoms as noted previously.

Fermentation of undigested food happens normally in the colon, and although there is a gradient of bacterial colonization in the small intestine, significant fermentation in the small bowel is abnormal and results in SIBO. Since bacteria eat the starch contained in all grains, SIBO offers an explanation why avoiding all grains, not just gluten grains, helps many people even though they may not be “allergic” to gluten. And also, many people omit gluten from their diet and eat “gluten-free” foods, but see no change in their symptoms. This could possibly be because many gluten-free products contain bean and lentil flours, which is a basically switching one FODMAPs (galactan) for another (fructan).

FODMAPs, especially free fructose, may contribute to SIBO. Fructose malabsorption is defined as the incomplete absorption of fructose in the small intestine, followed by the delivery of fructose to the distal small intestine and colon, where it contributes to rapid fermentation and resultant abdominal bloating. The absorptive capacity of fructose varies from person to person.

The allowed foods are mainly those foods that people ate before agriculture began, and one I recently discussed in the Paleo-Type diet. The diet we evolved to eat over millions of years was predominantly one of meat, fish, eggs, vegetables, nuts, low-sugar fruits. Our modern diet including starches, grains, pasta, legumes, and breads has only been consumed for a mere 10,000 years. In the last hundred years the increase in complex sugars and chemical additives in the diet has led to a huge increase in health problems ranging from severe bowel disorders to obesity and brain function disorders. We have not adapted to eat this modern diet as there has not been enough time for natural selection to operate. It therefore makes sense to eat the diet we evolved with.

Here’s where FODMAPs are found:

• Oligosaccharides (Fructans and Galactans)
• Fructans are oligosaccharides made of fructose molecule chains that are completely malabsorbed because the small intestine lacks hydrolases to break their fructose-fructose bond. For this reason, fructans can contribute to bloating, gas, and pain. Wheat accounts for the majority of people’s fructan intake. Other high fructan foods are globe artichokes, Jerusalem artichokes, asparagus, beetroot, chicory, dandelion leaves, garlic (in large amounts), leek, and onion.
• Inulin and fructooligosaccharide (FOS) are also sources of fructans, and are added to many foods to enhance their fiber content and also to many probiotic supplements to encourage the growth of friendly gut bacteria. Interestingly though it has a negative effect for many people unknowingly. I rarely use probiotics with FOS or inulin because so many people react to these products.
• Galactans are oligosaccharides containing chains of the sugar galactose. The human body lacks the enzymes to hydrolyze them into digestible components, so they are completely malabsorbed. Dietary sources of galactans include lentils, chickpeas, kidney beans, black-eyed peas, broccoli, and soy-based products.

• Disaccharides (Lactose, Sucrose)
• Lactose is milk sugar so all cow, goat, and sheep milk should be avoided as well as those products made from them which still has some sugar content, such as yogurt. Butter is okay since it’s just the milk fat. Cheese will vary per individual based off tolerance and sugar content. (The bacteria in the dairy convert the milk sugar lactose to lactic acid during fermentation into cheese.) Low-lactose cheeses including Swiss, Parmesan, Gouda, Colby, provolone, cheddar, Edam, Muenster, and Monterey Jack may be okay for some. **Interestingly, there can be a few different problems with cow milk. Many people are allergic to the protein (casein, rather than the whey) in dairy, giving them various symptoms. Other may be lactose intolerant where they lack the enzyme lactase to break down the milk sugar, lactose, often resulting in the common digestive complaint of diarrhea. And yet another problem may be the FODMAPs relationship as the bacteria in the gut eat the lactose, fermenting the sugar and giving the person a host of symptoms. Damn dairy!
• Sucrose is table sugar (the white stuff) and should be limited or removed based upon individual tolerance. This includes brown sugar, raw sugar, turbinado, and cane and beet sugars.
• Monosaccharides (Fructose, rather than glucose, in this case)
• Higher fructose (fruit sugar) content is found apples, mango, pears, watermelon, peaches, sugar snap peas, canned fruit, dried fruit, and fruit juice. This is where you should investigate your individual tolerance to certain fruits and find your threshold level. In other words, you may be able to eat one apple, but not two apples or an apple with another FODMAPs food, such as cheese. High fructose corn syrup and agave should always be avoided due to their excessive fructose levels. Honey may or may not be a problem in the FODMAPs diet, especially in low dietary amounts and depending on the source and quality of the honey. Honey with higher fructose content tends to crystallize more than honey with less fructose and more glucose.

• Polyols are also known as sugar alcohols (Sorbitol, Mannitol, Maltitol, Xylitol and Isomalt). Most are too large for simple diffusion from the small intestine, creating a laxative effect on the GI tract. They are found naturally in some fruits and vegetables and added as sweeteners to sugar-free gums, mints, cough drops, and medications. Polyols will produce osmotic diarrhea when consumed in quantities above an individual’s personal threshold, (especially when they are added as a sweetener), or in combination with other FODMAP sources. Apples, apricots, avocado, cherries, raspberries, longan, lychee, nectarines, peaches, pears , plums, prunes, mushrooms, cauliflower, mushrooms, snow peas, and almonds all contain somewhat higher levels of polyols (xylitol). The added sugar alcohols should be removed 100% from the diet.

Omitting FODMAPs from your diet if you feel you are sensitive can have dramatic effects on your entire health. Energy levels often increase, sleep improves, blood sugar becomes more balanced, (since an overgrowth of bacteria in the gut is no longer consuming many of your carbohydrates for energy), mood improves, and many other symptoms improve as your gut heals. Ideally you should refrain from all the FODMAPs for at least a couple weeks, longer if your symptoms are not fully resolved by then, but continue to improve. After a good two weeks of being symptom-free you can try adding in various FODMAPs foods to check your sensitivity and tolerance levels to certain foods. You may find that you can’t eat a food such as wheat at all, but perhaps can handle some dairy periodically such as a particular cheese, for example. In essence, you figure out your FODMAPs threshold – the point at which your symptoms return but you must first clear them out of your diet one hundred percent!

Some physicians recommend using herbs, supplements, and even medications (antibiotics) to help rid the body of bacteria overgrowth quicker than just refraining from the foods that feed it. I have seen this beneficial, but also see it to be very individualized. In some patients I have found they respond well to herbs such as Uva Ursi and Goldenseal, whereas other patients supplements such as biotin and betaine hydrochloride work well. However, whatever the case, total omission of FODMAPs is necessary – the supplements just tend to help resolve symptoms quicker especially if they “accidently” snuck a FODMAPs food into their diet.