I’m tired of hearing mental health conditions blamed on a “chemical imbalance”. Patients everywhere are being told that their mental health conditions are, literally, “all in their heads”. With this diagnosis—often distributed insensitively, and without much attention to the complex factors in thoughts, beliefs, emotions, the environment, biology, nutritional status, mental and emotional as well as physical stressors, and life circumstances (just to name a few) that can contribute to mental health imbalances—patients are left with the message that they are somehow damaged, broken, or that their condition arose out of an inherent weakness that they somehow possess. Through the numerous conversations I’ve had with those struggling with mental health symptoms, I have come to understand that oftentimes there are phrases that rob power more than the term “brain/chemical imbalance”.
Fortunately, there is still more to emerge in the wonderful world of science. Very little actual evidence supports the chemical imbalance theory of depression and researchers and clinicians alike are forced to admit that symptoms of conditions such as depression and anxiety are often the result of multiple factors that come together. Contrary to the common narrative of mental illness being a sign of weakness, evolutionary biologists are uncovering evidence that symptoms of depression might be the result of a highly adaptive strength based on preserving the body during times of great mental, emotional and physiological stress—showing, in fact, that depression and anxiety might in fact be afflictions of the strong, not the weak.
In my practice, I approach depression and anxiety from a functional medicine standpoint. This means, simply, that I look not at the title of the condition my patients come in with (I care very little if you have depression, or anxiety, or bipolar disorder, etc.—the name is not the thing itself), but how the condition occurs uniquely for them. By paying close attention to the multitude of symptoms, thoughts, and factors that influence the mood and emotions, I am able to uncover underlying pathways that point to imbalance in the body and dig up the roots from where the symptoms might have arisen in the first place. Through this method, focussing on the functioning of the body rather than it’s pathology, we’re able to bring the body back into a state of balance and reverse symptoms permanently, rather than simply slapping a band-aid over them.
When it comes to mental health, it is important to emphasize that depression and anxiety (as well as other mental health diagnoses) are not diseases at all; they are symptoms. When presented with low mood, feelings of sadness and worthlessness, lack of motivation, lethargy, brain fog, changes in appetite and weight, abysmal self-esteem and so on—all symptoms that many patients with depression face—we need to follow the threads of symptoms back to the point where things began unraveling. It is necessary to backtrack to the biological imbalances where symptoms first began.
There is an overwhelming amount of research coming out in the field of mental health that links the gut and digestive health to mental health symptoms, indicating that depression might not be a brain chemical imbalance at all, but a gut chemical imbalance. Where there is depression and anxiety, there is more often than not, a digestive issue.
We have always known that the digestive track and brain have an intimate bond. From the vagus nerve that enervates the gut and begins in the cranium, to the mood-regulating neurotransmitters that are created in the gut, we all have the experienced the tummy aches linked to grief or the power of anxiety to loosen our bowels. We’ve all noted the phenomenon that great ideas or moments of clarity seem to spontaneously arise from, not the brain, where we always assumed our thoughts were formed, but the gut (hence the term, “gut feeling”, which we use to characterize intuitive insights).
When it comes to issues with the brain—thoughts, moods, emotions, feelings, etc., where else should we look for answers than our brain’s close cousin, friend and confidant, the gut. Mental health symptoms can arise from impaired digestion in a number of ways:
A failure of the gut cells (enterocytes) to create neurotransmitters. The majority of serotonin (the “Happy Hormone”) is produced in the gut. Inflamed and unhappy gut cells are often unable to make serotonin.
An imbalance in the healthy gut bacteria that influences whole-body health. We have 10x more cells in our gut than in our body in the form of almost 5 lbs of symbiotic gut bacteria. This bacteria ensures our well-being by helping us digest our food, soothing inflammation, educating our immune system, killing off harmful pathogens, creating bulk for our stools and, relevant to the field of mental health, producing neurotransmitters important for regulating mood, such as serotonin and dopamine.
Research has gone into the connection between a low-level of inflammation in the brain and its affect on mood. Inflammation is usually a product of our diet, stress and food sensitivities. In naturopathic medicine and functional medicine we treat inflammation with the assumption that nearly all inflammation begins in the gut. A condition called “Leaky Gut” is a failure of the important seal between the intestinal walls and the rest of the body. When this seal is broken, toxins, proteins and other debris are free to enter the bloodstream, wrecking havoc, setting the immune system off course and, eventually, triggering symptoms of inflammation, autoimmunity and mental health issues.
Our body requires many building blocks to maintain its complex fortress. Difficulties in the digestive cells’ ability to absorb essential fats, amino acids and vitamins required for brain health, hormone regulation, detoxification and immunity, among the thousands of other chemical reactions in the body, will result in impairment in overall functional. Nutrient deficiencies are more common, even in developed societies, than one might think. Deficiencies arise from: impaired absorption, inadequate diet, increased amounts of stress and the ingestion of foods or medications the deplete the body of nutrients. In any case, optimizing the gut’s ability to digest and absorb the nutrients we’re either eating or supplementing is key for improving health and mood.
When it comes to understanding mental health issues I, as a clinician, realize it is hardly ever just one factor involved. Properly helping someone with anxiety or depression heal involves understanding the constellation of potential causes and how they inter-connect and relate to one another. Through this detective work, we can begin the journey of unraveling the imbalances and restoring the body’s ability to function and heal.
Treatment plans usually involve a combination of replenishing essential nutrients that patients are deficient in (deficiency can be detected through blood work, health history or symptoms), repairing the gut’s ability to absorb, restoring the body’s balance of healthy gut bacteria, removing food sensitivities and healing digestive inflammation, balancing hormones, and managing lifestyle stress and environmental factors that may be contributing to low mood.
My patients make impressive commitments to healing and are willing to examine their bodies and past experiences, in order to do the hard work of healing. Beyond my role as a doctor, I am committed to working as a facilitator, teacher and guide. My job is not to tell people the right path to walk, but to help them understand their body’s complex language, listen to the signals and messages that arise from it, and understand what those signals are asking of them.
For more information, click here. I run a practice with a special focus in mental health, youth mental health and hormonal conditions. I work in Bloor West Village in Toronto, Canada.
The gut-brain connection has gotten the attention of researchers and functional medical practitioners. I discuss, briefly, what research has shown us in regards to the complex realm of the microbiome and how depression may be a result of inflammation in the brain, stemming from inflammation in the gut.
My name is Dr. Talia Marcheggiani and I am a naturopathic doctor and mental health expert in Toronto.
Today we’re going to talk about the gut-brain connection and how that can influence your mental health symptoms.
I think we intuitively know that the gut and brain are connected. When you feel mental symptoms of anxiety we immediately notice the effects on our gut.
During times of stress, we know that we have indigestion, we’re more predisposed to things like diarrhea and irritable bowel syndrome.
Even anatomically there’s a nerve, called the Vagus nerve, that directly connects the brain to our digestive system.
This nerve is responsible for putting into that “rest and digest” state.
When this nerve is stimulated, our bodies start to secrete digestive enzymes, saliva starts to be secreted and we’re able to break down our food and absorb the nutrients from the food that we’re eating.
A lot of research has been going on, that you might be aware of, about healthy gut bacteria. And more and more people, especially medical doctors, happily, are prescribing probiotics anytime someone is prescribed antibiotics for a bacterial infection.
Scientists have started to study more about these gut bacteria. We know we have, like, 5 lbs of gut bacteria, sitting in our digestive systems. Over 100 trillion cells, this is more than 10x the amount of cells we have in our physical bodies, and more DNA than we have in our body.
We’re more bacteria than we are human!
And these gut bacteria, we can’t survive without without them, they influence the very physiology we experience and they definitely impact our health.
These bacteria are responsible for helping us digest our food, and for our mental and emotional wellness as well as keeping our immune system in check.
So, a disbalance in bacteria, or an increase in that negative, bad bacteria and not good strains of healthy bacteria, can lead to diseases like autoimmune disease or multiple sclerosis, or things like chronic fatigue syndrome as we’re seeing in research.
Scientists are starting to study more about how the bacterial balance in our gut can influence our mood and mental health.
These gut bacteria can actually produce serotonin. So that’s the happy hormone in the brain. And you may have heard of serotonin, especially if you suffer from depression or anxiety because your doctor might have recommended a kind of medication called SSRIs, or Selective Serotonin Reuptake Inhibitors, or a similar drug, SNRIs, like Venlafaxine, which is a Selective Serotonin and Norepinephrine Reuptake inhibitors.
This is based on on the Monoamine Hypothesis that there is this chemical imbalance in the brain. That your body is either not making enough, or absorbing enough or reacting to serotonin enough.
When we’re given these antidepressants, the idea is that we’re recorrecting this brain imbalance and that’s as much of the story as we’ve got. We don’t know why these brain imbalances are around.
So I think that, if we’re going to stick with this hypothesis, which is still controversial in science, we should look to the gut bacteria because we know that gut bacteria produces a significant amount of serotonin and, if we’re blaming depression and anxiety on serotonin deficiencies, why not look at the gut and find out how we can influence the balance of healthy gut bacteria so that we’re producing enough serotonin. Especially if we’re relying on drugs to correct the imbalance and we don’t have enough serotonin for the drugs to work properly.
Gut cells on their own produce 95% of the serotonin in the body so basically every single chemical that we have in our brain is produced or exists in the gut.
So, we need to be able to feed the gut cells so that they’re producing healthy amount of hormone we need to experience a healthy mood and live our lives in ways that are stress-free and energized and happy so that we can effective in our lives.
Mentally and emotionally, you might know this “gut feeling” that we talk about in language and that’s kind of permeated throughout cultures. So, we know that when we have this feeling in the gut that, it’s almost like an intuition. Some people will say, “I just knew it, because I felt it in my gut.” And I think that we’ve always had this intuition. We’ve always had this connection between what our mental state, our thoughts, beliefs and emotions are telling us and what our gut is telling us.
We think that we think with our brains and that all of the mental symptoms we experience are happening at the level of the brain, but because of this tight gut-brain connection, we know that’s not true.
People that have done brain studies actually find that we have thoughts before we have brain activity a lot of the time so, I wonder if we’re actually thinking with our gut, which is a revolutionary and radical thought, but we’re finding more and more evidence for this in science.
You may have heard of the condition called “Leaky Gut” or the more official, scientific term is “Intestinal Permeability”. Our gut is really selective about what it absorbs for good reason. What happens, though, when we’re experiencing chronic stress, or we use a lot of antibiotics or maybe eat things like high-sugar foods, caffeine, or a lot of alcohol, we can cause gut inflammation, which starts to allow bacteria, food toxins, or whole proteins from food into the blood, into the body by breaking down the integrity of the gut.
So, when it comes to health, for most health conditions, especially when there’s a few symptoms that seem disconnected and it’s hard to find the relationship between them, naturopathic medicine and, now, functional medicine and, hopefully soon, conventional medicine, begins to look at gut health.
So if I’m sitting across from a patient who has a long list of health symptoms that seems like they’re not connected and has digestive symptoms—and 40-60% of the population, in general has some kind of digestive symptom, whether it be bloating after eating, feeling fatigued after eating, just feeling like your food is sitting in your stomach and not really moving through, GERD, so acid reflux, heartburn, diarrhea and constipation, or those IBS symptoms, gas and bloating—when I sit across from a patient with any of those symptoms, the first place we go, in terms of treatment, is to look at the gut.
So how do you keep your gut healthy? There’s a few things. The first is to eliminate anything that’s causing gut inflammation, so this could be excessive caffeine and alcohol, excessive refined sugars, antibiotics without doing a probiotic immediately after or during an antibiotic treatment, chronic mental and emotional stress, or physical stress, and food sensitivities: something we’re eating that’s causing our immune system to react and our gut to become inflamed.
Ensuring a proper bacterial balance by either supplementing with a probiotic or eating a variety of fermented foods such as kefir, yogurt, kombucha or saurkraut, and making sure that we’re eating a variety of whole foods: whole grains, fruits and vegetables, and healthy fibres that are going to feed that healthy gut bacteria.
So, when it comes to mental health, such as depression and anxiety, chronic mental stress, even things like bipolar, OCD, conventional medicine tends to just look at the brain and blame the brain on the host of symptoms that patients might experience.
Naturopathic medicine looks at the entire body. And since we know that the gut and brain are connected, and our patients are simultaneously experiencing mental health symptoms and digestive symptoms, we definitely have to treat the gut.
For more information, you can visit my website at taliand.com, or send me an email at connect@taliand.com.
I work at Bloor West Wellness Clinic in Bloor West Village, in Toronto.
This is a common story that can describe any number of patients I see in my private practice: My patient has been doing well–she’s been exercising regularly; she’s been cutting out sugar and processed foods and watching what she eats. She’s been having salads for lunch. She’s even gotten her husband on board! He’s started to have salads for lunch with his cheeseburger (instead of fries) and given up having a row of cookies in the evening. All things considered, she’s been doing great. However, despite her best efforts, after one month of tiresome slog, restriction and dedication, she’s only managed to lose a few pounds. Her husband? He’s lost 10.
“He has more to lose,” I suggest to her. “Those few pounds you’ve lost are gone for life—slow and steady stays off forever.” I am her cheerleader, but the truth is: hormones, especially when it comes to women.
Hormones are the body’s telegrams. They are produced in glands in tissue like the gut, ovaries, adrenals and brain and act on distant cells in the body, telling them how to behave. When it comes to weight loss, hormones can be the culprit if diet and exercise have failed to produce results. Hormones control appetite, mood, food cravings, metabolic rate, fat gain and distribution and hunger, among other things. Any hormonal imbalance will sabotage weight loss efforts and it’s often the first place I look when a patient has weight loss goals that they aren’t achieving with diet and exercise alone.
The Players:
There are numerous hormones in the body that are responsible for the above actions, however the main ones that we can affect through diet and lifestyle are insulin, cortisol, estrogen and the thyroid hormones. These are just some key players in a team, however just by working on these four, we can start to see results.
Interconnectedness:
Hormones are complex entities, not only for the wide array of effects, but for their tendency to effect the action of each other. For example, high cortisol can effect levels of estrogen, insulin and the thyroid hormones. High insulin can affect cortisol and estrogen. And so on. Working on hormones is like attacking a giant knot and often requires starting from the basics: diet and lifestyle.
Insulin Imbalance:
Insulin is an important hormone in the body—we can’t live without it. Released by the pancreas after a carbohydrate-rich meal in response to rising levels of sugar in the blood, insulin gets sugar into cells where it can be used as fuel. It also brings down blood sugar, making it a main culprit in hypoglycemic crashes and sugar cravings. The problem with insulin, however, is when we overeat carbohydrates and sugar, we overuse the insulin response. The result is abdominal fat, weight gain (insulin tells the body to store fat), a blood sugar roller coaster, mood swings (that “hangry” feeling) and intense sugar cravings and energy crashes.
Balancing Insulin:
Insulin is best balanced by diet, particularly managing carbohydrate intake and emphasizing healthy fats and protein in the diet. Fat and protein slow sugar absorption. This prevents a rise in blood sugar and decreases the need for insulin. The result is feeling satiated for longer, having stable energy and decreasing food cravings.
Morning protein:
The first step in balancing insulin release is to increase morning protein. I recommend aiming for 30 g of good quality, lean protein for breakfast like a chicken breast, or scoop of whey isolate protein powder in a whole foods smoothie. I was once accused jokingly of “not knowing that breakfast is”, when recommending chicken breasts for breakfast. However, perhaps it’s North America that has a skewed sense of what makes a decent morning meal. If the aim of breakfast is to break the fast that you’ve had throughout the night, then starting it off with a high-carb, high-sugar, nutrient-sparse piece of toast or bowl of breakfast cereal seems crazy to me. In Colombia and India, two places I’ve spent some time, we started off the day with a protein-rich stew or meat soup.
To balance insulin make sure that every meal, even snacks, contain some form of protein or a fat. Avoid eating carbohydrates by themselves and keep servings of carbs to a minimum and in their unprocessed, whole form (like large flake oats, quinoa and brown rice as opposed to flours or cereals).
Cortisol Imbalance:
One of the main hormone imbalances I notice when it comes to stubborn weight gain is cortisol imbalance. Cortisol is the stress hormone. It’s released by the adrenal glands, two pyramid-shaped endocrine glands that sit on top of the kidneys, in response to stress. Animals have two modes of operation: fight or flight or rest and digest. Cortisol increases blood sugar and alertness and tells the body to divert attention to gearing us up for combat or escape, and moves us away from investing energy in digestion, immunity and concentration. Cortisol is a wonderful hormone; it keeps us awake, and makes us feel alert and well, priming us to be effective in our busy, stressful lives. However, our bodies weren’t made for long-term stress response and we spend most of our time in fight or flight mode.
Cortisol and blood sugar:
Cortisol raises blood sugar, causing insulin to be released. This starts us on a blood sugar roller coaster trip, leading to sugar cravings, energy crashes and storing fat.
Cortisol and fat distribution:
Cortisol doesn’t directly tell the body to store fat (it happens through other mechanisms that happen in response to high cortisol), but it does encourage fat redistribution. Cortisol tells the body to move fat from the hips and thighs and deposit in the abdomen, face and shoulders, leading to the sexy “Buffalo Hump”. We know that abdominal fat carries more health risks than fat in other areas of the body so this detail can be troublesome when it comes to long-term effects.
Cortisol and the thyroid:
Cortisol impacts the thyroid by preventing the conversion of T4 to the more active T3. T3 and T4 are important thyroid hormones that set the body’s metabolic rate, among other things.
Cortisol and the sex hormones:
Cortisol can lead to estrogen dominance by diverting resources away from estrogen and progesterone production. In menopause, this is particularly troublesome, as the body relies on the adrenal glands, rather than the ovaries, to produce the sex hormones. High cortisol can result in progesterone deficiency and estrogen dominance symptoms, which can negatively affect weight loss. Cortisol also causing accelerated aging and who wants that?
Cortisol Balancing:
The main thing when it comes to cortisol balancing is to Calm Down—or as I like to poignantly put it, Calm the F#$% Down. The way this is done is highly individualized. Some recommendations I have are: meditation, yoga, exploring acupuncture (a wonderful way to balance cortisol, among other things), journaling, taking a day off, re-evaluating priorities at work and at home, etc. Mainly, getting 7-9 hours of sleep a night is essential for managing the stress response.
Taking it easy:
When it comes to weight loss, I often notice that certain efforts hinder our progress. It’s important to keep caloric intake adequate—eating too few calories can stress the body out, causing cortisol release. It’s also important to manage exercise. While exercise can teach the body how to manage stress, it does produce cortisol in the short-term. Therefore it’s important to keep exercise short and intense. Weight-training, short bursts of cardio (no more than 20 minutes) and varying intensities with High Intensity Interval Training, Tabata or Crossfit, are the best choices for weight loss. Training for a marathon or long-distance bike race may be fun and fulfilling, but they are not the best choices for weight loss, as they prolong the stress response and can work against you, rather than in your favour.
When I have a patient who is intensely tracking what they eat and over-exercising my advice is often (and it’s not that well-received, as you can imagine) “Take it easy”. Easing up on exercise and relaxing calorie-counting may be hidden pieces in the weight loss game.
Herbs and supplements:
There are a variety of nutrients to take to support adrenal function. The main things to consider, with the advice and counsel of a trained naturopathic doctor are B-vitamins, magnesium and adaptogenic herbs (the help the body adapt to stress).
Estrogen Dominance:
Estrogen, actually a group of hormones, are female sex hormones. Their main job is to promote the expression of female sex characteristics, the growth of breast tissue and to control ovulation. Estrogen also causes body to fat to be distributed to the thighs, buttocks and lower abdomen. The problem with modern society is an imbalance in the two female sex hormones, estrogen and progesterone. Due to stress and toxic environmental estrogens, or xenoestrogens, among other things, modern women have more estrogen relative to progesterone in their bodies. The effects of this are numerous and include, stubborn weight gain in the thighs (the famed “saddlebags), cellulite, acne, PMS, painful menstrual periods, fibroids, hormonal conditions such as PCOS, and the occurrence of certain female cancers, especially breast cancer. Estrogen can also contribute significantly to anxiety symptoms.
Estrogen balancing:
Correcting estrogen dominance primarily involves supporting estrogen detox pathways in the liver. Chemicals such as I3C, DIIM and calcium-d-glucarate help increase the liver’s ability to clear foreign estrogens from the body. Supporting digestive health also allows us to remove estrogens—they are neutralized in the liver and eliminated through the colon. Leafy greens contain a high amount of these chemicals, so ensuring you get adequate amounts in your diet is important for estrogen metabolism. Ground flaxseed, rosemary and fish oil are also important nutrients for clearing excess estrogen from the body.
Reducing exposure:
Try to reduce exposure to foreign estrogens by avoiding the use of plastic bottles and plastic-lined cans, using natural skincare and body products and natural cleaning aids whenever possible. It’s also important to see a naturopathic doctor 2-4 times a year for a medically-assisted natural detoxification to clear the body of toxic estrogens.
Hypothyroidism:
The thyroid gland sits on the neck, just below the Adam’s Apple. It releases two hormones T4, and the more active T3. These hormones are responsible for setting the body’s metabolic rate—converting fat into heat and energy. Thyroid deficiency, or hypothyroidism is more common in our society than we think (naturopathic doctors have stricter criteria for laboratory reference ranges than conventional medicine—we look for signs of health, not disease). Conventional medicine deems hypothyroidism as having a TSH (thyroid stimulating hormone) level above 5—for this hormone, all you need to know is lower is better—however ND’s will start to treat the thyroid when symptoms are present and TSH is above 2.5. Symptoms of hypothyroidism are stubborn weight gain, constipation, feeling cold, fatigue, especially brain fog, weak memory, hair loss, dry skin and thinning of the eyebrows.
Supporting the thyroid:
The thyroid gland is a fragile organ, sensitive to inflammation and stress. When there is inflammation in the body, often caused by stress, diet or insulin resistance, the thyroid is the first gland to suffer. Most cases of hypothyroidism are autoimmune in nature. Therefore, naturopathic doctors aim to correct inflammation by prescribing an anti-inflammatory diet and looking for food sensitivities. When we identify food sensitivities (through specialized IgG antibody testing or an elimination diet) and remove them from the diet, we can focus on gut healing which treats inflammation and helps repair the thyroid.
Managing stress:
Low calorie diets have the effect of suppressing thyroid function, which leads to the yo-yo dieting effect. Avoid extremely low calorie diets, or opt for intermittent fasting or calorie-cycling instead. Aim for slow and steady weight loss so as not to harm metabolic rate, which makes weight loss more difficult in the long run.
I previously mentioned that cortisol can harm the thyroid and that hormones are interlinked. Cortisol prevents the conversion of T4 to the more active T3, which can slow metabolism.
Nutrients:
A deficiency in iodine, zinc, iron and selenium, among other nutrients, can negatively impact the thyroid. Talk your naturopathic doctor about testing and supplementation.
Summary:
What would a visit to a naturopathic doctor look like? When it comes to hormones, treatment is often complex as it targets the root cause of symptoms and involves detangling the complicated web of hormones that are at play. This can require some diagnostic detective work. A naturopathic doctor will take your complete health history, order labs and perform physical exams if necessary. A common treatment plan might look like this:
Sleep: 7-9 hours per night
Take stress seriously: sign up for a round of acupuncture, start meditation, do yoga, journal, etc.
Measure hormones via saliva: cortisol, testosterone, DHEA, estrogen, progesterone
Identify food sensitivities via an elimination diet or an IgG Food Panel that tests for antibodies to certain foods in the blood.
Correct nutritient deficiencies through diet and supplementation
Herbs for hormonal support: estrogen detoxification, thyroid support, gut healing, adrenal support, glucose control and blood sugar balancing.
Exercise: short, intense bursts that target muscle-building
Diet: high protein, especially in the morning, healthy fats, low carbs and eliminate sugar, processed foods and food sensitivities.
To learn more about how naturopathic medicine can help you lose weight, balance hormones and fight disease, contact my clinic Bloor West Wellness at 416 588 0400 to set up an initial appointment. Let’s get started today!
Want to balance your hormones, energy and mood naturally? Check out my 6-week foundational membership program Good Mood Foundations. taliand.com/good-mood-learn
As far as Canada’s Food Guide to Healthy Eating is concerned, naturopathic doctors differ in their views. In terms of a general guideline, I believe that it does a pretty good job of promoting a healthy diet: focusing on fruits and vegetables, whole grains, nuts and seeds, meat and protein. It even suggests adding healthy oils to the diet and supplementing with vitamin D. Not bad. But, as they say in my family, “Close, but no cigar.” I have one piece of beef with the Food Guide, and it’s not the beef, but rather another cow product that offends me: the outrageously huge influence on dairy.
I never thought I’d enjoy ice cream again. During the 4 months I spent volunteering in Costa Rica, I became obsessed with ice cream. It wasn’t my fault; it seemed that the whole population was obsessed. At the end of a long work day, one could spot businessmen nursing a McDonald’s soft-serve cone, leaning their bodies back from the drips that threatened to send their suits to the dry cleaners early.
This obsession with ice cream, which is damp and cold, is probably not the best thing for people of Kapha constituion, but I knew very little about ayurvedic medicine back then. I also had no idea that one could be intolerant to dairy, which I now know that I am. My almost-daily ice cream treat contributed to a 40-pound weight gain in those 4 short months.
Its seems that, for most people, the hardest part of starting a new diet is figuring out what to eat for breakfast. To help some of my RSNC patients on the road to hypoallergenic, healthier living, I compiled this handout to give them some inspiration for the most important meal of the day. These breakfasts might be appropriate for some on the elimination diet, but since each diet is different, make sure you review the ingredients first to verify that the recipe fits your dietary needs.
So, your naturopathic doctor or 4th year intern has suggested that you do a 3-6 week elimination diet? While at this stage it might seem like a daunting task to give up all of your favourite foods, here is a run-down of some of the tools you’ll need to get it right. Pretty soon, you won’t even miss ice cream (that much)!
The WHY:
The elimination diet is often prescribed to patients who exhibit symptoms of digestive distress (irritable bowel syndrome, inflammatory bowel disease, diarrhea, bloating, flatulence or constipation) and for autoimmune or inflammatory conditions such as arthritis, migraines, asthma, allergic skin conditions or frequent colds and flus, to name a few. The idea is that when there is chronic inflammation in the gut, as a reaction to foods we are sensitive to, the barrier between our gut lining and the rest of the body opens up, allowing particles that shouldn’t be in our blood stream to get in. This can cause widespread inflammation, resulting in symptoms of some of the previously mentioned conditions.
The elimination diet can also be used as a general cleanse or a weight loss tool. Because the diet consists of eating more fruits, vegetables and protein and less processed foods, it often results in the consumption of fewer calories and many patients lose weight on it.
The WHAT:
The Elimination Diet consists of completely removing several foods from the diet for a number of weeks. During this time, usually 3-6 weeks, symptoms of inflammation should resolve as the gut heals. There is a long list of foods that are removed from the traditional elimination diet such as gluten, dairy, eggs, soy, caffeine, sugar, nightshade vegetables (tomatoes, potatoes and eggplants), to name a few. However, some practitioners simply start by removing one or two food-types, often gluten and dairy, in order to eliminate the main perpetrators and to make the task less daunting for the patient.
After the initial period of elimination, foods are reintroduced one at a time, for a few days, to observe if old symptoms return. If the past inflammatory symptoms return with the introduction of a certain group of foods, patients are then advised to stay away from these foods, as they are sensitive to them. Some people, once the gut has healed completely, will eventually be able to return to eating these foods again, but many will not and will have to accept a lifetime free of gluten, for example, in order to prevent their old symptoms from returning. Many foods, when reintroduced, will not cause a negative reaction and both the patient and their naturopathic doctor will deem these foods safe to eat again.
The HOW:
Embarking on a diet where the main staples of many Standard American Diets (bread, cheese, milk, etc.) are banned can be incredibly challenging. For the initial stages of the diet, it is acceptable for patients to replace their old food staples with allergen-free varieties – for example, buying gluten-free bread to make your morning toast. However, in order to promote health and detoxification, the idea is to eventually replace the old habits of eating processed foods with a whole foods diet, ingesting foods that exist in their natural forms with little to no processing. That being said, it is more important to refrain from allergen-containing foods primarily, and explore new ways of eating as you begin to adapt to the diet.
Grocery List:
When given a list of the things you can’t eat, I find it helps to focus on the things that you can, however small it may seem at the beginning. In order to do that, it might help to do an initial grocery shopping trip, removing from your fridge and cupboards the foods that are banned and replacing them with new, healthier, allergen-free varieties.
At the grocery store, stock up on:
Lots of colourful fruits and vegetables of your choice: Start at the periphery of the store and pick up everything that looks good: carrots, celery, kale, spinach, arugula, salad mixes, onions, apples, pears, bananas, avocados, beets, grapes etc. Pick up some frozen vegetables and frozen berries as well, as these come in handy when preparing meals. Read the diet handout carefully for information about what vegetables are allowed on the diet and which ones are to be removed during the initial stages.This is a great opportunity to try new vegetables you’ve never tried before, discovering their health benefits, experiencing their interesting flavours and adding more variety – and nutrients – to your diet.
Meats: Choose your favourite cuts of chicken, lean pork, beef, turkey or whatever else you enjoy eating.
Snack foods: Hummus, gluten free crackers (Mary’s crackers are popular), rice cakes, Lara Bars. Also purchase raw, unsalted almonds, walnuts and other nuts to snack on. Chia seeds are versatile for snacks as well. Purchasing whey isolate protein powder (whey concentrate contains casein, which is a no-no on a dairy-free diet), is another great option for adding to baked goods, smoothies and other gluten-free recipes to increase their protein content.
Condiments: Purchase almond butter, coconut oil and extra virgin olive oil for cooking. Temari sauce is a good substitute for soya sauce (which contains wheat). You can also go nuts on delicious spices and seasonings such as garlic, turmeric, cumin, paprika, oregano, basil, cilantro, sea salt, etc.
Milks: Purchase almond milk – I prefer Almond Breeze original, unsweetened for my morning coffee, baking and cereal, if I have it – or coconut milk (the kind in the can found in the “ethnic” foods section).
Flours: Some gluten-free flours are not the best in terms of how healthy they are for you. White rice flour, tapioca flour and potato flour contain less fibre and nutrients than regular flour so it’s best to stay away from them. At the Bulk Barn you can find grain-free flours like coconut and almond flour, as well as healthier grain flours such as teff flour, quinoa flour and brown rice flour. At my house we buy a variety and mix them together to create a healthy, gluten-free “all-purpose flour” for baking. For more on allergen-free baking, read this post.
Bread: My favourite gluten-free bread can be purchased at Costco in a double-pack and is made by a company called Silver Hills. It is high in fibre and contains omega-3’s making it one of the more substantial, tasteful gluten-free breads available. However, I usually only break it out when I’m desperate for morning toast or really crave a sandwich because, when it comes to gluten-free bread, a lowering of expectations must be in order. These breads must be kept frozen and toasted in order to be enjoyed. Most people on a gluten-free diet simply end up forgoing bread in general. However, I recommend this brand as a good transition as it comes as close as possible to any real bread I used to enjoy.
Pasta: Another Costco brand, TruRoots, makes an ancient grains line of pasta, which contain buckwheat, amaranth, brown rice and quinoa. These make a great substitute when you just want to boil some spaghetti for dinner. Another spaghetti option is making it from spaghetti squash, a great way to increase your vegetable intake and decrease your calorie consumption.
Fortunately there are a number of great gluten-free blogs on the internet and great cookbooks containing easy to make, healthy recipes. Here are some of my favourite websites, but oftentimes I just Google specific ingredients (e.g.: “almond flour pancakes”) or a search term like “gluten-free” or “paleo” to see what recipes come up and then modify accordingly. As you become accustomed to what foods you can and cannot eat, you’ll learn to add and subtract certain ingredients from your favourite recipes, giving them a hypoallergenic twist.
Or click on the “recipes” tag on this blog to peruse some of the gluten and dairy-free recipes that I’ve posted.
Eating Out:
Many restaurants offer gluten-free varieties of their traditional menus such as GF hamburger buns or rice pasta. I find, however, that most ethic restaurants such as Indian, Ethiopian, Thai, Greek, Chinese or Vietnamese, which use rice instead of wheat-containing foods like bread, are naturally gluten-free. Asking if the recipes contain dairy and other foods that you’re avoiding might be necessary in case you aren’t aware of the exact ingredients of the foods you’re eating. For this reason, I prefer eating at home, where you know exactly what’s going into your food.
Eating at a Dinner Party:
It seems that more people have at least a basic awareness of what “gluten-free” means these days. For some, though, it might help to have a prepared explanation of why you’re choosing to eat this way to be able to educate those who are curious about your dietary restrictions. I find it helps to have results on hand; when you look and feel better, not much is left to debate. I find that those who are hostile to someone who is trying to avoid certain foods are often insecure about their own eating styles and, if you suspect that this is the case, it’s best to change the subject and move on.
As for the menu, remember that at most dinner parties salad and meat are usually served. You can simply forgo bread, asking for a burger without a bun or staying away from the bread basket. And, as for dessert, a friend of mine’s strategy is to always bring along her own. If no one else wants to share it, at least she has her own to indulge in and she finds that most people are gracious when you offer to bring dessert. In addition, trying a great, allergen-free recipe is a nice way to introduce the elimination diet to your family and friends (and promote naturopathic medicine).
The elimination diet can seem like a steep hill to climb at first, but, fortunately, hypoallergenic eating is becoming more commonplace, making it easier to find gluten and dairy-free substitutes to the foods you love. After an initial adjustment period, you probably won’t even miss the old foods and besides, feeling great and pain-free is just so much better than reaching for the bread basket.
That is often the health question… On this blog I have openly admitted to loving coffee. Throughout the course of applying my studies in naturopathic medicine to my own life, I’ve been able to make necessary changes to my diet and have watched the way I eat evolve quite dramatically over the past three years. I was once a vegetarian, who ate a carb-heavy diet, full of pasta, and now I follow a whole foods diet, free of diary, gluten, processed foods and refined sugars. There is one thing I’ve been unable to give up for good, however, and that’s coffee.
I can go time without it and often put myself to the challenge to do so. But, while it’s been over a year since I’ve bitten into a baguette, I just can’t say good-bye to coffee forever. And should I even try? When it comes to coffee, there are few foods that receive more mixed messages with regards to the health benefits or risks. Here are some of the pros and cons to visiting your favourite local beanery.
Spring is (finally) in the air! For me that means long walks outside with the dog, time spent reading outside a cafe and, of course, fresh fruits and vegetables! While globalization does provide us with fruits and vegetables year-round (who doesn’t love watermelon in January? Kidding), there is nothing like the taste of in-season, deliciousness. When fruit and vegetables are fresh and local, not only are they better for us and the environment, they require little seasoning and dressing because they are packed full of flavour and nutrients all on their own. Warming temperatures also mean that our bodies are gaining increasingly powerful digestive fire, allowing us to digest raw vegetables again. The dampness of spring can make us feel tired and sluggish, while eating raw, crunchy foods, like this salad, helps us retain feelings of energetic lightness. Salad is back in season! (more…)
So, you’ve probably heard of black bean brownies before. However, just like “therapist”, black bean brownie is not a protected title. There are just as many varieties of recipes as there are hits for “black bean brownie” on google. Some have flour, some barely contain beans, some are full of sugar to disguise their “healthy-ness.” However, I hope this recipe, which I created as a modified version of the White Bean Blondies, is deserving of Black Bean Brownie certification.
I’m tired of hearing mental health conditions blamed on a “chemical imbalance”. Patients everywhere are being told that their mental health conditions are, literally, “all in their heads”. With this diagnosis—often distributed insensitively, and without much attention to the complex factors in thoughts, beliefs, emotions, the environment, biology, nutritional status, mental and emotional as well as physical stressors, and life circumstances (just to name a few) that can contribute to mental health imbalances—patients are left with the message that they are somehow damaged, broken, or that their condition arose out of an inherent weakness that they somehow possess. Through the numerous conversations I’ve had with those struggling with mental health symptoms, I have come to understand that oftentimes there are phrases that rob power more than the term “brain/chemical imbalance”.
