The first time I saw a naturopathic doctor was a few years before I contemplated becoming one myself. I had finished my undergrad degree and was bumming around for the summer, working on film sets, trying to get help for some underlying hormonal condition which I now know to be caused by burnout.
The doctor’s office was warm and carpeted. He had a shelf of books, although I don’t remember what they were or were about. I imagine some were medical textbooks. He performed a physical exam that seemed at the same time unnecessary and strangely medical. Still, I hoped would be injected with this particular kind of magic and systems thinking that I expected—that he would look at me and declare me to have too much phlegm or give me some insights into my general state and appearance that had been handwaved as “normal” by the blood tests and various other medical practitioners I’d been to.
I had tracked my food for a week. For breakfast, I had cereal (the healthy kind), skim milk, coffee, and fruit. He held this paper in front of him, and I awaited his thoughts.
“You should stop eating dairy,” he said, not looking up, “It’s not that good for us.” I assumed “us” meant “us humans.” He didn’t elaborate, stating it as if I were apparent.
I remember this 16 years later, although I’m sure he said more things in that appointment.
What does it mean to make these statements to patients? Sometimes, I find myself explaining things, elaborating, discussing how we might try a dairy elimination diet, and making connections between the properties of dairy or this client’s experience with dairy (bloating, inflammation, eruptions of cystic acne).
I was bloated and inflamed with cystic acne, but I don’t remember if I stopped putting milk in my cereal that day. I distinctly remember a year later indulging in a frothy milk latte in a café in Cartagena, Colombia, writing in my journal that I expected it would bloat me and combine poorly with the insufferable heat and humidity outside.
The other day, I was visiting with my friend and naturopathic colleague, playing with her baby on the floor and talking about practice, health, and medicine. I was speaking about the pressure I feel when working with a new patient to solve their problems in the first visit. Often, no one had even acknowledged their problems before, and here was my task to not only acknowledge but already know about and have a solution for these problems. I remember attributing this same magic to the naturopathic doctor I saw in 2008.
My friend nodded, “Many of our solutions are just band-aids. It takes years to shift our thinking and behaviours to make long-term changes to our health.” I remember eating Tiramisu years after this 2008 appointment, developing painful cysts the next day.
One thing was certain: I remembered his (perhaps offhand) remark and started making connections, even if they didn’t lead to long-term behavioural changes.
I still sometimes eat dairy. At this friend’s house, we each had a Greek salad with chicken and all the fixings, including feta cheese. It was delicious. The next day, my skin looked okay. All in all, I’m pretty good at avoiding cow’s milk.
I am more meticulous about avoiding gluten.
I don’t necessarily agree that dairy isn’t good for “us [humans].” I’m not even sure if it’s not good for me. Like most things, it’s nuanced and depends on the terrain (my stress levels, gut health), the type of dairy (organic, fermented) and the amount. So, maybe I’m not entirely convinced. Sometimes, it tastes so darn good, and I don’t care.
I suppose that hearing something is “not good for us” is insufficient for learning. Experiencing how something is not good for us, while better, is still probably not sufficient.
I suppose that sometimes we humans do things that aren’t good for us.
I suppose our lives, like healing, are works in progress.
“There exists in such a case a certain institution or law; let us say, for the sake of simplicity, a fence or gate erected across a road. The more modern type of reformer goes gaily up to it and says, “I don’t see the use of this; let us clear it away.” To which the more intelligent type of reformer will do well to answer: “If you don’t see the use of it, I certainly won’t let you clear it away. Go away and think. Then, when you can come back and tell me that you do see the use of it, I may allow you to destroy it.”
In other words, beware of tearing down structures until you fully understand their benefit.
Chesterton’s Fence can also be thought of as the Precautionary Principle. Not following this principle led to scientific practices like frontal lobotomies or removing the entire large intestine because doctors didn’t understand the benefits of these structures or the consequences of removing them.
A narrow range of focus, i.e., this organ is causing a problem, or we don’t know why it’s here, led to drastic action that resulted in unforeseen, disastrous consequences.
I believe that such is the case with our stomach acid.
The stomach is essentially a lined bag filled with acid. Stomach pH is from 1.5 to 3.5, acidic enough to burn a hole in your shoe. However, the mucus layer of the stomach protects it from being destroyed by the acid. The acid in the stomach helps dissolve and digest the food chewed up by the teeth and swallowed.
Stomach pH is needed for breaking down proteins. Stomach acid also plays a role in absorbing minerals such as calcium, zinc, manganese, magnesium, copper, phosphorus and iron. It activates intrinsic factor, which is needed for B12 absorption in the small intestine.
Stomach acid regulates the rate of gastric emptying, preventing acid reflux.
Fast-forward to a condition called gastric esophageal reflux disease, or GERD. GERD affects about 20% of Western countries, characterized by high esophageal pH and reflux of the stomach acid and stomach contents into the esophagus. While the stomach is designed to handle a shallow pH environment, the esophagus is not. A doorway called the lower esophageal sphincter, or LES, keeps stomach contents where they should be–in the stomach.
In GERD, the tone of the LES is weak, resulting in a backflow of stomach contents. This can damage the esophagus, causing heartburn, pain, bad breath, coughing and even problems like ear pain, sore throat, and mucus in the throat. Silent reflux occurs when these symptoms occur without burning.
The symptoms occur from the stomach’s acidic contents irritating the more delicate tissues of the esophagus. So, rather than treat the root problem, i.e., the reflux, drugs like proton pump inhibitors (PPIs), H2 blockers, and buffers like Tums are recommended to reduce the stomach’s acidity.
Essentially, with GERD, we are tearing down Chesterton’s Fence to pave a road without taking even a moment to consider why the fence might be there in the first place.
About 12% of people are prescribed PPIs. They are given for GERD, gastritis, and IBS symptoms like bloating and stomach pain. Most of my patients are prescribed them for virtually any stomach complaint. PPIs, it seems, are the hammers wielded by many GPs, and so every digestive concern must look like a nail. Most people are put on them inevitably, without a plan to end the use and address the root cause of symptoms, which in most GERD cases are low LES tone.
PPIs raise stomach pH, disrupting stomach function. This causes issues with mineral absorption and protein digestion. Their use results in B12, vitamin C, calcium, iron, and magnesium deficiencies. Many of these deficiencies, like magnesium deficiency, can’t be tested and therefore might show up sub-clinically in tight muscles, headaches, painful periods, disrupted sleep and anxiety, and constipation. Therefore they fly under the radar of most primary care doctors.
No one connects someone’s heartburn medication with their recent onset of muscle tightness and anxiety.
Many of my patients report difficulties digesting meat and feeling bloated and tired after eating, particularly when consuming a protein-rich meal. They conclude that the meat isn’t good for them. The problem, however, is not meat but that stomach acid that is too diluted to break down the protein in their meal, leading to gas and bloating as the larger protein fragments enter the small intestine.
Many digestive problems result from this malabsorption and deficiency in stomach acid, not too much. Zinc is required for stomach acid production, and one of the best sources of zinc is red meat (zinc is notoriously lacking from plant foods). I have recently been prescribing lots of digestive enzymes and zinc to work my patients’ digestive gears.
Therefore, beware of tearing down a fence without understanding why it’s there. Stomach acid is essential for digesting our food, and regulating blood sugar and building muscle mass through protein digestion.
It is necessary for mineral absorption and B12 digestion. Our stomachs were designed to contain an extremely low pH. They evolved over millennia to do this. Stomach acid is low for a reason. It’s highly unlikely that our bodies made a mistake when it comes to stomach acid.
Therefore, beware of messing with it.
Consider that our bodies know what they’re doing. Consider the importance of finding and treating the actual root cause, not one factor that, if mitigated, can suppress symptoms while causing a host of other problems.
Don’t block your stomach acid.
As Hippocrates said, “All disease begins in the gut.”
It is the boundary between us and the outside world, the border where our body carefully navigates what can come in and nourish us and what should stay outside of us: our fence. Beware of tearing it down.
References:
Antunes C, Aleem A, Curtis SA. Gastroesophageal Reflux Disease. [Updated 2021 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441938/
Daniels B, Pearson SA, Buckley NA, Bruno C, Zoega H. Long-term use of proton-pump inhibitors: whole-of-population patterns in Australia 2013-2016. Therap Adv Gastroenterol. 2020;13:1756284820913743. Published 2020 Mar 19. doi:10.1177/1756284820913743
Heidelbaugh JJ. Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications. Ther Adv Drug Saf. 2013;4(3):125-133. doi:10.1177/2042098613482484
You know how you just want the recipe and yet you have to scroll through someone’s long story about their cat and their grandma and a blistery winter day?
Forget all that. I made this curry.
Here’s the recipe (you’re welcome 😜 ):
Ingredients:
1 can coconut milk (full fat, Arroy-D)
2 heads broccoli, chop off the florets into small pieces
2 large bell peppers, chopped into slices
1/2 jar of Thai Kitchen red curry paste (nice, clean, delicious, free of seed oils 👍 )
4 large chicken breasts
Salt, pepper, olive oil.
Directions:
Preheat oven to 350 degrees (you can also do all this in the air fryer). Add chopped chicken breast to a baking pan, add broccoli and peppers, drizzle with olive oil. Cook for 45 minutes (or until everything is cooked).
In a large stir-fry pan, add cooked vegetables and chicken, add red curry paste and coconut milk.
You can serve on rice, but you don’t have to.
Filling, rich in protein and veggies. Delicious, warming. I love Thai curries on snowy days.
It’s day one of my period and I’ve been healing a broken foot for 6 weeks. The weather is overcast, thick, humid and rainy.
My body feels thick and heavy. Clothing leaves an imprint on my skin–socks leave deep indentations in my ankles. My face and foot is swollen. My tongue feels heavy. My mind feels dull, achey, and foggy. It’s hard to put coherent words together.
I feel cloudy and sleepy. Small frustrations magnify. It’s hard to maintain perspective.
My muscles ache. My joints throb slightly. They feel stiffer and creakier.
This feeling is transient. The first few days of the menstrual cycle are characterized by an increase in prostaglandins that stimulate menstrual flow and so many women experience an aggravation of inflammatory symptoms like depression, arthritis, or autoimmune conditions around this time. You might get. a cold sore outbreak, or a migraine headache around this time of month. The phenomenon can be exaggerated with heavy, humid weather, and chronic inflammation–such as the prolonged healing process of mending a broken bone.
Inflammation.
It’s our body’s beautiful healing response, bringing water, nutrients, and immune cells to an area of injury or attack. The area involved swells, heats up, becomes red, and might radiate pain. And then, within a matter of days, weeks, or months, the pathogen is neutralized, the wound heals and the inflammatory process turns off, like a switch.
However, inflammation can be low-grade and chronic. Many chronic health conditions such as diabetes, arthritis, PMS or PMDD, depression, anxiety, migraines, even bowel and digestive issues, have an inflammatory component.
In the quest to manage chronic inflammation, people often explore various avenues, including dietary supplements. One such natural option gaining attention is OrganicCBDNugs. Derived from the hemp plant, CBD, or cannabidiol, is believed to possess anti-inflammatory properties, potentially offering relief to those struggling with conditions like arthritis, anxiety, or migraines.
This organic supplement, with its purported ability to interact with the body’s endocannabinoid system, might provide a holistic approach to tackling inflammation-related issues. As we navigate the complexities of our bodies and the ebb and flow of inflammation, exploring natural remedies like Organic CBD could be a step toward finding equilibrium and promoting overall well-being.
As I telly my patients. Inflammation is “everything that makes you feel bad”. Therefore anti-inflammatory practices make you feel good.
Many of us don’t realize how good we can feel because low-grade inflammation is our norm.
We just know that things could be better: we could feel more energy, more lightness of being and body, more uplifted, optimistic mood, clearer thinking and cognitive functioning, better focus, less stiffness and less swelling.
Obesity and weight gain are likely inflammatory processes. Insulin resistance and metabolic syndrome are inflammatory in nature. It’s hard to distinguish between chronic swelling and water retention due to underlying low-grade chronic inflammation and actual fat gain, and the two can be closely intertwined.
It’s unfortunate then, that weight loss is often prescribed as a treatment plan for things like hormonal imbalances, or other conditions caused by metabolic imbalance. Not only has the individual probably already made several attempts to lose weight, the unwanted weight gain is most likely a symptom, rather than a cause, of their chronic health complaint. (Learn how to get to the root of this with my course You Weigh Less on the Moon).
Both the main complaint (the migraines, the PMS, the endometriosis, the depression, the arthritis, etc.) and the weight gain, are likely due to an inflammatory process occurring in the body.
To simply try to cut calories, or eat less, or exercise more (which can be helpful for inflammation or aggravate it, depending on the level of stress someone is under), can only exacerbate the process by creating more stress and inflammation and do nothing to relieve the root cause of the issues at hand.
Even anti-inflammatory over the counter medications like Advil, prescription ones like naproxen, or natural supplements like turmeric (curcumin) have limiting effects. They work wonderfully if the inflammation is self-limiting: a day or two of terrible period cramps, or a migraine headache. However, they do little to resolve chronic low-grade inflammation. If anything they only succeed at temporarily suppressing it only to have it come back with a vengeance.
The issue then, is to uncover the root of the inflammation, and if the specific root can’t be found (like the piece of glass in your foot causing foot pain), then applying a general anti-inflammatory lifestyle is key.
The first place to start is with the gut and nutrition.
Nutrition is at once a complex, confusing, contradictory science and a very simple endeavour. Nutrition was the simplest thing for hundreds of thousands of years: we simply ate what tasted good. We ate meat, fish and all the parts of animals. We ate ripe fruit and vegetables and other plant matter that could be broken down with minimal processing.
That’s it.
We didn’t eat red dye #3, and artificial sweeteners, and heavily modified grains sprayed with glyphosate, and heavily processed flours, and seed oils that require several steps of solvent extraction. We didn’t eat modified corn products, or high fructose corn syrup, or carbonated drinks that are artificially coloured and taste like chemicals.
We knew our food—we knew it intimately because it was grown, raised, or hunted by us or someone we knew—and we knew where it came from.
Now we have no clue. And this onslaught of random food stuffs can wreck havoc on our systems over time. Our bodies are resilient and you probably know someone who apparently thrives on a diet full of random edible food-like products, who’s never touched a vegetable and eats waffles for lunch.
However, our capacity to heal and live without optimal nutrition, regular meals that nourish us and heal us rather than impose another adversity to overcome, can diminish when we start adding in environmental chemicals and toxins, mental and emotional stress, a lack of sleep, and invasion of blue light at all hours of the day, bodies that are prevented from experiencing their full range of motion, and so on.
And so to reduce inflammation, we have to start living more naturally. We need to reduce the inflammation in our environments. We need to put ourselves against a natural backdrop–go for a soothing walk in nature at least once a week.
We need to eat natural foods. Eat meats, natural sustainably raised and regeneratively farmed animal products, fruits and vegetables. Cook your own grains and legumes (i.e.: process your food yourself). Avoid random ingredients (take a look at your oat and almond milk–what’s in the ingredients list? Can you pronounce all the ingredients in those foods? Can you guess what plant or animal each of those ingredients came from? Have you ever seen a carageenan tree?).
Moving to a more natural diet can be hard. Sometimes results are felt immediately. Sometimes our partners notice a change in us before we notice in ourselves (“Hon, every time you have gluten and sugar, don’t you notice you’re snappier the next day, or are more likely to have a meltdown?”).
It often takes making a plan–grocery shopping, making a list of foods you’re going to eat and maybe foods you’re not going to eat, coming up with some recipes, developing a few systems for rushed nights and take-out and snacks–and patience.
Often we don’t feel better right away–it takes inflammation a while to resolve and it takes the gut time to heal. I notice that a lot of my patients are addicted to certain chemicals or ingredients in processed foods and, particularly if they’re suffering from the pain of gut inflammation, it can tempting to go back to the chemicals before that helped numb the pain and delivered the dopamine hit of pleasure that comes from dealing with an addiction. It might help to remember your why. Stick it on the fridge beside your smoothie recipe.
We need to sleep, and experience darkness. If you can’t get your bedroom 100%-can’t see you hand in front of your face-dark, then use an eye mask when sleeping. Give your body enough time for sleep. Less than 7 hours isn’t enough.
We need to move in all sorts of ways. Dance. Walk. Swim. Move in 3D. Do yoga to experience the full range of motion of your joints. Practice a sport that requires your body and mind, that challenges your skills and coordination. Learn balance both in your body and in your mind.
We need to manage our emotional life. Feeling our emotions, paying attention to the body sensations that arise in our bodies—what does hunger feel like? What does the need for a bowel movement feel like? How does thirst arise in your body? Can you recognize those feelings? What about your emotions? What sensations does anger produce? Can you feel anxiety building? What do you do with these emotions once they arise? Are you afraid of them? Do you try to push them back down? Do you let them arise and “meet them at the door laughing” as Rumi says in his poem The Guest House?
Journalling, meditation, mindfulness, hypnosis, breath-work, art, therapy, etc. can all be helpful tools for understanding the emotional life and understanding the role chronic stress (and how it arises, builds, and falls in the body) and toxic thoughts play in perpetuating inflammation.
Detox. No, I don’t mean go on some weird cleanse or drinks teas that keep you on the toilet all day. What I mean is: remove the gunk and clutter from your physical, mental, spiritual, and emotional plumbing. This might look like taking a tech break. Or going off into the woods for a weekend. Eating animals and plants for a couple of months, cutting out alcohol, or coffee or processed foods for a time.
It might involve cleaning your house with vinegar and detergents that are mostly natural ingredients, dumping the fragrances from your cosmetics and cleaning products, storing food in steel and glass, rather than plastic. It might mean a beach clean-up. Or a purging of your closet–sometimes cleaning up the chaos in our living environments is the needed thing for reducing inflammation. It’s likely why Marie Kondo-ing and the Minimalist Movement gained so much popularity–our stuff can add extra gunk to our mental, emotional, and spiritual lives.
Detoxing isn’t just a trendy buzzword; it’s about fostering clarity and wellness in every aspect of our lives, including our living spaces. A clean, organized home can significantly contribute to a healthier mindset and emotional balance. That’s where Clean 4 You comes in, offering a fresh perspective on home cleaning that goes beyond mere tidiness.
They understand that clutter and grime can weigh heavily on our mental and emotional states, which is why they provide services tailored to create an environment that supports your detox journey. By enlisting the help of professionals, you can focus on nurturing yourself while they take care of transforming your space into a sanctuary.
If you’re seeking assistance specifically designed for individuals with unique needs, the NDIS Cleaner Perth service from Clean 4 You is here to help. This dedicated team is trained to cater to the requirements of those on the National Disability Insurance Scheme, ensuring that every client receives the support they need for a clean and safe living environment.
With a commitment to using eco-friendly products and methods, Clean 4 You allows you to detox your home in a way that aligns with your values, providing peace of mind as you embrace a healthier lifestyle. With their expertise, you can achieve a pristine space that not only looks good but feels good, allowing you to focus on your personal wellness journey.
Finally, connect with your community. Loneliness is inflammatory. And this past year and a half have been very difficult, particularly for those of you who live alone, who are in transition, who aren’t in the place you’d like to be, or with the person or people you’d like to be–your soul family.
It takes work to find a soul family. I think the first steps are to connect and attune to oneself, to truly understand who you are and move toward that and in that way people can slowly trickle in.
We often need to take care of ourselves first, thereby establishing the boundaries and self-awareness needed to call in the people who will respect and inspire us the most. It’s about self-worth. How do you treat yourself as someone worthy of love and belonging?
Perhaps it first comes with removing the sources of inflammation from our lives, so we can address the deeper layers of our feelings and body sensations and relieve the foggy heaviness and depression and toxic thoughts that might keep us feeling stuck.
Once we clear up our minds and bodies, and cool the fires of inflammation, we start to see better—the fog lifts. We start to think more clearly. We know who we are. Our cravings subside. We can begin to process our shame, anger and sadness.
We start to crave nourishing things: the walk in nature, the quiet afternoon writing poetry, the phone call with a friend, the stewed apples with cinnamon (real sweetness). We free up our dopamine receptors for wholesome endeavours. We start to move in the direction of our own authenticity. I think this process naturally attracts people to us. And naturally attracts us to the people who have the capacity to love and accept us the way we deserve.
Once we start to build community, especially an anti-inflammatory community—you know, a non-toxic, nourishing, wholesome group of people who make your soul sing, the path becomes easier.
You see, when you are surrounded by people who live life the way you do–with a respect for nature, of which our bodies are apart–who prioritize sleep, natural nutrition, mental health, movement, emotional expression, and self-exploration, it becomes more natural to do these things. It no longer becomes a program or a plan, or a process you’re in. It becomes a way of life–why would anyone do it any other way?
The best way to overcome the toxicity of a sick society is to create a parallel one.
When you’re surrounded by people who share your values. You no longer need to spend as much energy fighting cravings, going against the grain, or succumbing to self-sabotage, feeling isolated if your stray from the herb and eat vegetables and go to sleep early.
You are part of a culture now. A culture in which caring for yourself and living according to your nature is, well… normal and natural.
There’s nothing to push against or detox from. You can simply rest in healing, because healing is the most natural thing there is.
Whenever I sit with a new patient for an initial intake, I ask about cravings.
From my many conversations about food, appetite and cravings, the most common responses are cravings for salt, or sugar, with many people falling on one end of the preference than the other: “I’m a salt craver” or “I’ve got a sweet tooth”.
However, cravings are so much more than that.
I believe that they are a beautifully intricate process, in which our body is trying to speak to us about what it needs.
Our bodies have developed taste receptors to detect quality nutrients from the environment. While these days sugar is abundant wherever you turn, during our hunter-gatherer times, it was a relatively scarce and highly sought after taste–the taste of ripe fruit, rich with nutrients, the taste of quality calories from carbohydrates, which may have been scarce in times of food shortage or famine.
Salt or “savoury” or umami cravings, often represent a need for more protein. Unfortunately, many of my patients who crave salt (and often calories) find themselves the bottom of a bag of chips, rather than grilling up a chicken breast.
Our modern environment doesn’t necessarily set us up to adequately translate and respond properly to certain cravings. Salted chips were probably not a thing in a natural environment and the only way to satisfy a salt and savoury craving would have been through hunting, consuming meat, or eggs and poultry.
When I was travelling in Colombia I was obsessed with broccoli–it was like I couldn’t get enough of it.
The same thing happened on a month-long trip to Brazil in 2019. Broccoli is rich in vitamin C, sulphur, and certain amino acids. It’s also a decent source of calcium. I’m not sure what nutrient I may have been lacking on my travels, but it’s possible that those cravings meant something for my body. And so I honoured them–I sought out broccoli like it was a magic elixir of health and ate as much of it as I could.
After developing significant iron deficiency after spending a few years as a vegetarian, I became suddenly attracted by the smell of roasting chicken from a local Korean restaurant I was passing by while walking the streets of Toronto.
The wafting smell of roasting poultry was majestic and impossible to ignore. It didn’t smell like sin, or temptation–my body betraying my moral sensibilities or whatever else we often accuse our cravings of—it smelt… like health.
There was no doubt in my mind as the delicious fumes touched my nostrils that I needed to honour my body and start eating meat again. I did and my health and nutrient status has never been better.
Patients will report craving carbs and chocolate the week before their period. The eb and flow of estrogen can affect serotonin levels. A large dose of carbs allows tryptophan, the amino acid that forms the backbone of serotonin, to freely enter the brain. This explains the effect “comfort foods” like starchy warm bread and pasta have on us, creating that warm, after-Thanksgiving dinner glow.
Chocolate is rich in magnesium, a nutrient in which many of us are deficient, that is in higher demand throughout the luteal phase of our cycle, or our premenstrual week.
Cravings are not just nagging, annoying vices, thrust in the path to greater health and iron discipline. They’re complex, intuitive and beautiful. They may be important landmarks on the path to true health and wellness.
Disciplines like Intuitive Eating and Mindful Eating have based themselves on the idea that our bodies hold intuitive wisdom and our tastes, cravings and appetites may be essential for guiding us on a road to health. Through removing restriction and paying more attention to the experience of food, we may be better guided to choose what foods are right for us.
The book The Dorito Effect outlines how our taste cues have been hijacked by Big Food. Like having a sham translator, processed foods stand between essential nutrients and the signals our bodies use to guide us to them. A craving for sweet that might have led you to ripe fruit, now leads you to a bag of nutrient-devoid candy that actually robs you of magnesium, and other nutrients in order to process the chemicals. A craving for salt and umami, or hunger for calories leads you to polish off a bag of chips, which are protein-devoid and laden with inflammatory fats, and only trigger more cravings, and shame.
It’s no wonder that we don’t trust our cravings– we live in a world that exploits them at every turn.
Clara Davis in 1939 was curious about the instintual nature of human cravings and devised a study that was published in the Canadian Medical Assoication Journal (CMAJ). The study was called Self-Selection of Diets by Young Children.
Clara gathered together 15 orphaned infants between 6 to 11 months of age who were weaning from breast-feeding and ready to receive solid food for the first time. These infants, before the study had never tried solid food or supplements. They were studied ongoing for a period of 6 years, with the main study process was conducted over a period of months.
The babies were sat at a table with a selection of simple, whole foods–33 to be exact. The foods contained no added sugars or salt. They were minimally cooked. Not all 33 were presented to each baby at each meal, however the babies were offered an opportunity to try everything.
The foods they were offered were water, sweet milk, sour (lactic) milk, sea salt, apples, bananas, orange juice, pineapple, peaches, tomatoes, beets, carrots, peas, turnips, cauliflower, cabbage, spinach, potato, lettuce, oatmeal, wheat, corn meal, barley, Ry-krisp (a kind of cereal), beef, lamb, bone marrow, bone jelly, chicken, sweetbreads, brains, liver, kidneys, eggs, and fish (haddock).
The nurses who were involved in running the study were instructed to sit in front of the infants with a spoon and wait for them to point at foods that they wanted. The nurses were not to comment on the choices or foods in any way, but wordlessly comply with the infants’ wishes and offer them a spoonful of the chosen foodstuff.
Throughout the study Davis noted that all the infants had hearty appetites and enjoyed eating.
At first, the babies showed no instinct for food choices, selecting things at random, and exploring the various foods presented to them. All of them tried everything at least once (two babies never tried lettuce and one never explored spinach). The most variety of food choices occurred during the first two weeks of the study when they were presumably in their experimentation phase.
Their tastes also changed from time to time, perhaps reflecting some hidden, internal mechanism, growth spurt or nutritional need. Sometimes a child would have orange juice and liver for breakfast (liver is a source of iron, and vitamin C from the orange juice aids in its absorption), and dinner could be something like eggs, bananas, and milk.
Many infants began the study in a state of malnourishment. Four were underweight and five suffered from Rickets a condition caused by extremely low vitamin D. One of the babies with severe Rickets was offered cod liver oil in addition to the other food options. Cod liver oil is a rich source of vitamin D.
The infant selected cod liver oil often for a while, after which his vitamin D, phosphorus and calcium blood levels all returned to normal range, and x-rays showed that his Ricket’s healed.
It is often thought by parents that children, if left to their own devices will eat themselves nutrient-deficient. While that may be true in todays’ landscape of processed frankenfoods, the infants in Davis’ study consumed a diet that was balanced and high in variety. They got 17% of their calories from protein, 35% from fat and 48% from carbohydrates and intake depended on their activity levels.
During the 6 years in which the infants’ eating habits were under observation, they rarely suffered from health issues. They had no digestive issues, like constipation. If they came down with a cold it would last no more than 3 days before they were fully recovered.
In the 6 years, they became ill with a fever only once, an outbreak that affected all of the infants in the orphanage. The researchers noticed their appetites change in response to the illness.
During the initial stages of the fever, they had lower appetites. And, once the fevers began to resolve, their appetites came back with a vengeance. They ate voraciously, and it was interesting that most of them showed an increased preference for raw carrots, beef and beets–which may indicate a need for vitamin A, iron and protein, which are needed for immune system function and recovery.
The habits of the infants to crave and select medicinal foods during times of fever and nutrient deficiency is such compelling evidence of Clara Davis’ craving wisdom hypothesis—were their bodies telling them what they needed to heal?
The self-selected, whole foods diets seems to have a positive impact on the mood and behaviours of the babies, all of whom were living full-time at the orphanage.
A psychiatrist, Dr. Joseph Brennemann wrote an article on them entitled “Psychologic Aspects of Nutrition” in the Journal of Pediatrics on their mood, behaviour and affect, “I saw them on a number of occasions and they were the finest group of specimens from the physical and behaviour standpoint that I have even seen in children of that age.”
In our world we often try to mentalize our food choices: going vegan or low-fat, counting calories, or reducing carbs. We time our eating windows, fast, or try to exert discipline and will over our bodies’ inherent desires.
So often my patients need to be coached through food eliminations, or given meal plans and templates. The art of listening to the body: properly identifying hunger, thirst, fatigue, inflammation, and even emotions like boredom, anxiety, sadness, anger, and hurt, can be a long process.
And yet, I wonder if we clear our palates and offer them a variety of whole, unprocessed, fresh foods, if our bodies will settle into their own grooves–perhaps our health will optimize, our bodies will be able to more readily communicate what they need, our taste receptors and cravings will adjust, and our cravings and appetite will serve the purpose they were meant to–to tell us what we need more of and what need less of or not at all.
I wonder if we listen, what our bodies will tell us.
I wonder if we let them, if our bodies will exhibit the pure instinctual wisdom of nature and the quest for harmony and homeostasis that lies at the heart of our natural world.
The Low Carb, High Fat or “Ketogenic” Diet has been touted as a health solution for weight loss, mental health, hormonal health, as well as a treatment for insulin resistance, diabetes, childhood seizures, migraines, and dementia.
It consists of eating foods like meat, fish, and non-starchy vegetables, and plenty of healthy fats from avocados, coconut, olives, nuts and seeds, while avoiding starchy foods like grains, legumes, fruit and root vegetables.
Our bodies and brains can use two main types of fuel: sugar and fat.
In this 21-day challenge we will teach our bodies to burn fat for fuel.
Some argue that fat is a “cleaner” fuel source than carbohydrates.
Ketone bodies, produced from fat have been shown to decrease inflammation, improve mitochondrial function—our cells’ power supply—and boost cognition. Ketone bodies also keep us full for longer, our brain sharp and focussed, and our energy abundant and sustained.
Many are introduced to low carb diets through their weight loss journeys. When we restrict carbohydrates, our bodies burn dietary fat and body fat for energy. Furthermore, less dietary carbohydrates means less insulin release. Insulin is our storage hormone, that prevents our bodies from breaking down fat, possibly impeding weight loss. When we cut out carbs we reduce our insulin levels, helping to heal insulin resistance, and helping our bodies shed fat.
To be perfectly honest, I don’t believe in diets,
particularly trendy diets that have names and followers, like groupies at a rock concert.
I believe that how we eat has a LOT to do with our individual biochemistry, our genes, our gut bacteria, our culture, our preferences, our job, our family, our free time, our individual health goals and health challenges.
Diet (or since diet is often a trigger word, but honestly all I mean by it is “way of eating”, or daily nutritional practice), is highly individualized. There is no one-size-fits-all diet.
HOWEVER, I do believe in resets.
I believe all adults could do well with a dedicated amount of time: 14 days, 20 days, 30 days, etc.: in which we really examine our relationship with food. In which we strip our diets down to the bare bones and examine our blood sugar, food sensitivities, food addictions, tendencies to emotionally eat, taste buds, etc.
After all, the human “diet” is essentially meat and vegetables. What happens when we strip all the fluff away? What might we discover about our bodies and minds? About our habits? About ourselves?
This way of eating restores metabolic flexibility, gets us burning fat for fuel (in addition to carbs when you add them back in after the 21 days). It helps us manage blood sugar, which is implicated in chronic stress, acne, diabetes, and hormonal disruption to name a few conditions and symptoms.
Obviously this challenge is not for those who struggle emotionally with food and need more one-on-one focused support, but it is an excellent way to be held accountable, to take on a challenge in which you’re given all the tools you need to do the discovery work.
You might discover that this is the best eating style for you.
You might restore your insulin sensitivity but discover that you need some carbs, or certain carbs, to feel your best.
You might discover hidden food sensitivities that have been plaguing you with inflammation for years.
I have been a vegan for 6 years. I also suffer from mental health conditions and possible hormonal imbalances. After doing some research on diets for anxiety and depression, I found that most of them include meat and animal products. I’m wondering: can my vegan diet be harming my mental health? I am primarily a vegan for ethical reasons and would hate to have to harm animals unless you think it’s absolutely necessary for promoting my mental health and wellness.”
Nutrition, especially where it pertains to more emotionally-charged topics like human health, the environment, or animal welfare, is surprisingly controversial.
I know that broaching this subject is a little bit like walking into a lion’s den (lions, for the record, are not vegans), therefore let me preface this conversation with a few disclaimers.
In writing about veganism and mental health, I’m not looking to get into a debate. I am writing to provide information for those who are wondering if it is possible to heal mental health and hormonal conditions, including women’s health conditions, thyroid conditions and adrenal conditions, while following an entirely plant-based diet.
If you feel that you might be triggered by this information and are not willing to approach this essay with an open mind, then this article is not for you.
Let me point out that I fully understand and sympathize with the ethical arguments for veganism. In my 20’s I was vegetarian for five years. For one of those years I was a vegan. Contrary to what some die-hard vegan fans have suggested, I did follow the diet “right” by eating whole foods, balancing the macronutrients of my meals (as best I could), and striving to eat enough. I eventually had to stop, but it was not because I “missed meat”.
While following a vegetarian diet, I took comfort in the fact that no animal had to die for me to survive. I loved the taste of plant-based foods and the ease of preparing them. I was satisfied in knowing that my diet was having a minimal impact on the environment.
(I also enjoyed bathing in the feelings of moral superiority that this diet earned me. However, that’s besides the point.)
Around that time, I read The Ethics of What We Eat by Peter Singer, which remains the single most thought-provoking book on human nutrition that I have read to this day (and I have read mountains of books on human nutrition).
In no way do I advocate for factory farming practices. I urge omnivores to consume the most ethically sourced meat, fish, eggs, and dairy that they can afford. Not only is sustainable animal farming better for animal welfare and for the environment, it is better for human health.
I don’t push for any single one-size-fits-all diet. I believe that an individual determines his or her “perfect” diet through experience. I carefully approach conversations about diet with my patients to avoid shaming their eating habits and pressuring them into a diet that they feel uncomfortable with.
That being said, it is my duty as a doctor to provide my patients with all the information they need to make empowered choices by drawing on the 15 years I have spent studying nutrition through formal education, and personal and clinical experience.
While it may certainly be possible to survive and, perhaps even thrive (depending on your genetics, most likely), on a vegan or vegetarian diet, there are major limitations to this diet that we need to face if we’re committed to supporting optimal mental and hormonal health.
The intention of this essay is to outline some of these limitations.
Protein quality and quantity:
Protein makes up 16% of the human body (62% is water). It is required for body structure: our bones, muscles, connective tissues, skin and hair.
Amino acids, which make up protein, comprise the hormones and neurotransmitters that regulate our mood and gene signalling.
Tryptophan, an amino acid, is used to make serotonin and melatonin, hormones that enable use to regulate our feelings of well-being and circadian rhythms, respectively. Cysteine is used to make glutathione, the main antioxidant of the body that neutralizes cancer-causing free radicals, prevents damage to our DNA, and protects us from the incessant chemical onslaught of our increasingly toxic lives. Glycine and GABA calm the nervous system, prevent over-activation of our brains’ fear centres, and soothe anxiety. Glutamine stimulates the nervous system and fuels our gut and kidney cells, allowing us to absorb the nutrients from our food and filter waste from our bodies.
The human body is essentially a protein sac filled with water that hums with the metabolic activity orchestrated by tens of thousands of enzymes, which are also protein.
When it comes to dietary proteins, not all are created equal. Foods that claim the title “complete proteins” boast all 9 essential amino acids that are not synthesized by the body and must be obtained exclusively from diet. Many vegetarian sources of protein are not complete proteins, and therefore protein-combining must be practiced to avoid deficiency in specific amino acids
Proteins also differ in their absorbability. Some vegan foods rich in protein contain anti-nutrients or fibres that make them difficult to digest. For example, the protein digestibility of whey (from dairy) or egg is 100%, meaning that 100% of the protein from these foods is absorbed. In contrast, only 75% of the protein in black beans is absorbed. Even more dismally, those who hope to get a significant source of their protein from the peanut butter on their morning toast are only absorbing about 52% of it.
The Recommended Daily Allowance (RDA) for protein is 0.8 g per kg of body weight for the average person. However, when it comes to supporting optimal health, the RDAs of important nutrients are set notoriously low. In my opinion, even higher nutrients are required for those with chronic health conditions such as mental health issues, chronic stress, hormonal imbalances, obesity, diabetes, cardiovascular disease, cancer, and autoimmune disease, to name a few.
For my patients I tend to recommend between 1.0 to 1.2 g of protein per kg of body weight per day. For those who are particularly active, who need to lose weight, and who are obtaining their protein from lower-absorbable sources, I may even recommend higher amounts. For women with conditions like PCOS, depression, and anxiety, I often recommend at least 30 g of protein per meal, especially at breakfast, to balance blood sugar, fuel neurotransmitter synthesis, sustain energy throughout the day, and promote optimal adrenal function. I believe the RDA for protein to prevent muscle wasting is set far too low. This is especially true if the protein sources are difficult to digest and of lower quality.
But what about claims that high protein diets can be detrimental to our kidney health? A one-year crossover study showed that active men who consumed very high amounts of protein—over 3 g of protein per kg of body weight—suffered no ill effects.
Getting adequate protein is difficult on a vegan diet but not impossible. Tracking your macronutrients and considering supplementing with a high-quality protein powder, may be required.
Understanding exactly how much protein your diet delivers is essential. For instance, while quinoa is a complete protein, containing all 9 essential amino acids, it only contains 8 g of protein per cup. One cup of black beans contains 39 g of protein but only 29 g are absorbed.
Furthermore, for conditions like PCOS that require managing carbohydrate intake, getting the protein without the additional carbs can be a challenge. Legumes typically contain a 3:1 ratio of carbs to protein—one cup of black beans contains 116 g of carbohydrates. This is often too high for the many women suffering from the mental health and hormonal issues that I treat in my practice, who often feel best when keeping their dietary carbohydrate intake well under 150 g a day.
Autoimmunity:
Chronic inflammation runs rampant in the bodies of many of my patients. More research is coming out showing that inflammation is at the root of most chronic health complaints, such as mental health conditions like depression and bipolar disorder, and hormonal conditions like PCOS and endometriosis. Cardiovascular disease and diabetes are recently thought to begin as autoimmune diseases, spurred on by chronic inflammation.
To manage conditions of autoimmunity and chronic inflammation, it is often appropriate to follow an “anti-inflammatory” diet that is low in allergenic potential.
For patients with hormonal issues, autoimmunity, gut issues, and mental health conditions (which research shows are inflammatory conditions are their root), reducing the diet down to leafy green vegetables, chicken, beef and fish can aid in lowering inflammation, healing the gut and restoring immune function. After a time, foods are slowly reintroduced, to find out what the body can tolerate.
Grains and legumes contain anti-nutrients like lectins and phytates that protect plants from being ingested and destroyed. Along with other common allergenic foods like dairy and eggs, grains and legumes, with their anti-nutrient content, have a high potential for irritating the digestive tract, causing gastrointestinal inflammation and immune system activation, leading to chronic inflammation that permeates the entire body.
The higher protein content in legumes like peas, black beans, lentils, and soy, and grains like wheat and corn, makes these foods staples in plant-based diets. Therefore, even attempting an anti-inflammatory elimination diet as a vegan is virtually impossible. Vegetarian diets are hardly better, as vegetarians often rely on dairy and eggs to balance their diet, both of which are common food sensitivities that can trigger autoimmunity and inflammation.
Vegan studies:
Doesn’t following a plant-based diet confer amazing health benefits, though?
While many studies of vegan and vegetarian diets show benefit for improving markers of various metabolic conditions, like diabetes and cardiovascular disease, it is important to keep in mind that most of these publications are comparing a diet rich in whole grains, vegetables, fruit, nuts and seeds with the Standard American Diet, with its grain-fed, hormone-pumped animal byproducts deep-fried in rancid corn oil.
Therefore, it makes sense that adding a few servings of micronutrient-containing fruits and vegetables to your daily nutritional intake will radically alter your health status. When I first began my foray into the world of plant-based living I felt amazing too. After a few months, though, the health benefits slowly faltered and I started to suffer negative health consequences: weight gain, fatigue, depression, hypothyroidism, IBS, and various nutrient deficiencies.
My health improved when I added some animal products to my vegetarian diet and removed dairy, grains and legumes. However, my experience is a mere anecdote.
To my knowledge there hasn’t been a study comparing a whole foods-based diet that includes ethically-sourced animal products with a whole foods vegan diet. I would be very interested in seeing such a study if it is ever conducted.
Individual variability:
Rich Roll, a vegan super-athlete, is often dredged up as an example of how the human body can thrive on a plant-based diet. However, more than his diet, Rich’s individual genetics may have more to do with his success as an athlete (and his training, clearly).
Even after 8 years of returning to omnivorous living with occasional iron and desiccated liver supplementation, my ferritin level (a measure of iron status) still only hovers around 44 (80 is considered optimal).
My constitution is that of Parasympathetic Dominance. This means I look at a piece of toast and gain 10 lbs. I tend to suffer from congestive lymphatic conditions and a sluggish metabolism. I tend to have low energy unless I constantly stoke my metabolic furnace. When stressed, I tend to gain weight and slip into lethargic depression. If not taking care of myself, I get headaches and suffer from hormonal imbalances.
Like other parasympathetic doms, I tend to have a higher requirement for dietary iron and crave red meat and leafy green vegetables. I seem to do better with a diet higher in protein and healthy fats.
Many of the people I work with fit this profile as well. My patients are highly creative and intuitive, but also suffer from mental health and hormonal conditions and are very susceptible to stress. I find that most do better through moderating their carbohydrate intake, ensuring high micronutrient and healthy fat consumption, and eating more protein, particularly from some red meat.
New research into MTHFR genes reveals that certain diets may have more health benefits for certain individuals. About 40-60% of North Americans are unable to convert folic acid (a synthetic nutrient added to multivitamins and fortified grains) into methylfolate, which is used for a chemical process called “methylation”.
Methylation pathways are involved in the fight-or-flight response; the production and recycling of glutathione (the body’s master antioxidant); the detoxification of hormones, chemicals and heavy metals through the liver; genetic expression and DNA repair; neurotransmitter synthesis; cellular energy production; the repair of cells damaged by free radicals; balancing inflammation through the immune response, controlling T-cell production, and fighting infections, to name a few.
Individuals with impaired MTHFR function often suffer from autoimmune conditions and mental health conditions, such as depression. They tend to feel better when avoiding grains that contain folic acid and eating green leafy vegetables that contain methylfolate. They require higher amounts of protein in their diet. They require higher levels of vitamin B12, which is also important for methylation, and choline, found in eggs and liver, which helps bypass methylfolate pathways, working as an alternative methyl donor. Choline is also necessary for estrogen metabolism.
Nutrients Deficiencies:
You thought I would lead with this, didn’t you? I’ll bet you were wondering when this would come up:
B12:
Of course it’s no secret that the vegan diet is essentially devoid of vitamin B12, an important nutrient for detoxification, methylation, neurotransmitter synthesis and energy metabolism. Animal sources are the only sources of B12. Our gut bacteria can make B12, but how much is absorbed in the colon for the body’s use is not clear.
B12 deficiency is serious. A friend of a friend of mine (no, but really) suffered permanent neurological damage, leading to seizures and almost death, from B12 deficiency. The neurological damage caused by B12 deficiency is irreversible (I’ve had patients who experience some improvement with restoring B12 levels, but it can take some time and the progress is not always linear).
B12 deficiency can have serious neuropsychiatric symptoms that mimic severe bipolar disorder or schizophrenia and that resolve once B12 injections are given. Horrific case reports tell stories of B12-deficient patients treated with rounds of electric shocks for their “treatment-resistant” psychosis, before the true cause of their symptoms was uncovered.
The blood reference range for B12 is roughly 130-500 pmol/L but I find that people don’t feel their best until their levels are over 600, and many experience severe B12 deficiency symptoms under 300. This means that if your doctor tells you that “your blood levels are normal,” your body could still be operating at a sub-optimal level of B12.
For vegans, supplementing with a good, absorbable form of B12 is non-negotiable. B12 from vegetarian sources, such as dairy products, is damaged in the pasteurization process and therefore supplementation may still be required.
Other nutrients:
B12 aside, other nutrients that are commonly deficient in vegan diets are iron, zinc, iodine, EPA and DHA, choline, vitamin A and vitamin D, to name a few.
Zinc is essential for immune function, skin health, neurogenesis (making new brain cells), memory and cognition, gut integrity, neurotransmitter synthesis, and hormonal health, among other essential functions.
Iodine is required for thyroid and ovarian function. It is also important for estrogen detoxification.
Iron is important for supplying tissues with oxygen, optimal thyroid function, and fertility. Menstruating women are commonly operating at a sub-optimal level of iron, resulting in fatigue, dry skin, chronic infections, and heavy periods.
Vitamin D regulates over 1000 different genes in the body. Supplementing with D3 is required for the 70-90% of North Americans who are deficient. Sadly, vitamin D3 supplements are all animal sourced, obtained from the lanolin in sheep’s wool. D2 from mushrooms is a vegan form of vitamin D that is likely not as effective as animal-derived D3.
Vegans are 75% more deficient than omnivores in vitamin D, which is alarming, considering how deficient most North Americans are—that’s 1000 vegan genes that aren’t being properly regulated!
EPA and DHA, omega 3 fatty acids found in fish and algae, are essential for cell membranes and brain function. While DHA can be made from ALA, found in flax and walnuts, many of us are not effective at converting it. Even the best converters among us only synthesize about 18% of our ALA into DHA. Further, the conversion of ALA to DHA requires zinc and iron, two nutrients that are typically deficient in vegan diets.
Even for omnivorous patients with mental health conditions, supplementation of EPA is often required for therapeutic benefit. Vegan supplements of algae-derived EPA and DHA exist, however, many of the studies that show benefit for fish oil supplementation in depression, bipolar and OCD require that the EPA to DHA ratio be 3 to 1 or higher. This high EPA to DHA ratio is not available in algae-sourced supplements that I have seen, making it almost impossible to derive enough EPA from vegan sources.
That being said, it is possible to supplement with iron bisglcyinate, iodine, zinc picolinate and vitamin A, inject methylcobalamin weekly, chug algae oil by the jugful, and drip vitamin D2 drops on your tongue and hope for the best.
You can pray to the methylation gods that your MTHFR enzymes are all operating at top speed so that your body doesn’t need to depend on protein and choline-dependent pathways for its liver function and DNA repair.
You can dump Vega protein powder into your smoothies and hope that you don’t have a sensitivity to grains and legumes (vegan protein powders usually contain some combo of rice, soy, and pea). You can obsessively track your macronutrients on My Fitness Pal.
You might still be ok.
There are a few people, the Rich Rolls of the world, who will claim that they feel great on an entirely plant-based diet. They do all of the above-mentioned things and feel amazing and I’m happy to hear it! However, I wonder how these genetically gifted individuals would fare if following a nutritionally complete whole foods omnivorous diet that contains grass-fed chicken, fish, meat, gelatin, eggs and, perhaps, dairy, in addition to a variety of plant foods.
If just one important nutrient pathway that depends on iodine, zinc, vitamin D, iron, B12, EPA or DHA is working sub-optimally, if you’re suffering from a hormonal condition, a mental illness, an autoimmune disease, or a digestive issue, then it’s possible that, if you follow a vegan or vegetarian diet, you’ll never feel as well as you’re meant to.
In the words of a vegan-turned-omnivore friend of mine, when disclosing why she decided to start eating meat again:
“I still love the environment and animals, of course, but I just love myself more.”
I talk about 8 functional foods that can help calm inflammation, boost neurotransmitter synthesis and restore common nutrient deficiencies that might contribute to low mood and mental health conditions.
My name is Dr. Talia Marcheggiani. I’m a naturopathic doctor with a focus in mental health and emotional wellness as well as hormonal health and hormone balancing, and today I’m going to deliver a short video about some foods that you can add to your diet to help your mental health.
These are all medicinal foods that act like prescriptions, like anti-depressants, that you can just add to your diet. So, a lot of these foods are recommended based on the idea that depression is an inflammatory condition in the brain. There’s more and more research that shows that there’s low levels of inflammation in people who have depression and anxiety and other mental health conditions like bipolar disorder, schizophrenia, ADD, ADHD and even sub-diagnostic symptoms, such as brain fog and cognitive disruptions. So all of these are a result of some kind of inflammation in the brain. And so a lot of these foods are working to heal depression and anxiety with their ant-inflammatory properties.
And so the first thing that’s recommended to eat are lots of anti-inflammatory fats. These are omega 3 fatty acids such as fish oil. So you can either increase the amount of fish oil by having fatty fish three times a week. You can remember what a fatty fish is by the acronym SMASH. And SMASH stands for sardines, mackerel, anchovy, salmon and herring, and also trout, so SMASHT. And these kinds of fish are rich in the omega 3’s EPA and DHA. Our body can make EPA, but some of us have impaired ability to make it. And so supplementing is necessary for a lot of these people. If you’re looking for a fish oil, make sure you look for one that has a higher amount of EPA compared to DHA. This is very important, because studies on depression are very favourable for fish oil supplementation, but the ratio of EPA to DHA has to be at least 3:1 or higher, and the higher the ratio, the higher the amount of EPA relative to DHA, the better the anti-depressant effects, and the mood-regulating effects. So, fish oil actually showed positive outcomes treating bipolar disorder and schizophrenia, so there’s a mood-stabilizing effect as well. And we think because our brain is made up largely of DHA and EPA, but also the anti-inflammatory effects are very helpful for mood and emotional balancing and mood balancing.
Coconut oil is also another great oil you can add to your diet. Coconut oil is a saturated fat, but it’s rich in something called Medium Chain Triglycerides. So these are saturated fats that the body uses readily for energy. So they don’t go through the normal process of digestion that other fats have to go through. They’re absorbed in our lymphatic system. So we get those fats, the energy from those fats, right away.
Coconut oil is very anti-bacterial and anti-fungal, so it can help regulate bacterial balance in our gut and it can give you a boost of energy. There’s also some evidence that being in ketosis, so this means relying on fats for energy, as opposed to carbohydrates, and, to an extent, proteins. Being in ketosis, so burning fat for fuel: body fat or dietary fat, has a mood-stabilizing effect. And so you might read about intermittent fasting, Ketogenic diet. I wouldn’t recommend doing that without working with a functional medicine practitioner, nutritionist or a naturopath, because there are some negative downsides to doing those kinds of diets prolonged, without supervision, but there is some growing evidence for that. But one thing you can do is add coconut oil to a morning smoothie, or eat a couple of tablespoons in the morning, even looking at some Bulletproof coffee recipes, that can also help with keeping your mood steady or your energy high in the morning.
Staying on the topic of fats and nuts, something that is really great for mental health are Brazil nuts. And Brazil nuts are high in a nutrient called selenium, which our body needs to create an anti-oxidant, the main anti-oxidant in our body, glutathione. You may have heard me talk about n-acetyl cysteine, NAC, which is an amino acid that I often recommend for people with bipolar disorder, for schizophrenia and, to an extent, depression and anxiety, and especially personality disorders, like borderline personality. There can be a very strong mood-stabilizing effect with NAC. And that’s probably because—we’re not exactly sure why that is—but it’s probably because NAC is the precursor to what our body uses to make glutathione, but we can’t make glutathione without selenium. So two brazil nuts a day, and they’re really delicious and fun to eat, they’re big nuts—two brazil nuts a day gives you the 200 mcg of selenium that’s the therapeutic dose. It’s also helpful for thyroid health.
Another thing I tend to recommend and am recommending a lot more in my practice is collagen, specifically gelatin, but for the more health-food minded people, going with a collagen hydrosylate supplement from grass-fed meat is something that I often recommend. But, for most people and myself, I just throw some gelatin that you can buy at Bulk Barn, into a shake or into a seed bowl, or into something that I’m eating like oatmeal, or I’ll make jello out of it.
So, gelatin is really rich in collagen, so it’s made from the hooves of animals, and collagen has a gut-stabilizing effect, so it can help heal the gut. A lot of us suffer from something called “leaky gut” in which inflammation in the gut makes its way to the rest of our body and can affect our brain. Leaky gut can often result in “leaky brain”, resulting in inflammation in the brain and then mental health symptoms. So, collagen helps to repair the gut barrier and the blood-brain barrier. It’s also very anti-inflammatory because it’s high in an amino acid called glycine, which is a calming neurotransmitter as well as an amino acid. It can also help balance the immune system. So anyone that has a low level of autoimmunity, or maybe your immune system is on the sluggish side and you’re getting colds and flus and infections more readily than others, collagen is a great supplement for that. Because our main sources of protein: meat, legumes, whole grains, nuts and seeds, don’t contain a lot of glycine. We’re pretty glycine deficient in our society because we’re not eating that much gelatin, we’re not getting as much bone broth. And so you can get collagen from from making bone broth, from stewing bones and accessing that bone marrow, or you can get it from something like gelatin, which is from hooves, from the collagen-rich membranes, the cartilages, of animals. There’s also fish collagen for more pescatarian-oriented people.
Collagen is also really great for anti-aging, for treating hair loss, for skin and for cellulite. So, all aesthetic things that might bring someone in to my practice, but also really great for mood balancing. A good source of protein as well.
You can either just throw it into a shake, mix it into some water or make your own jello. And I make jello by boiling some fruit, about a cup of blueberries in water. I boil it until the blueberry juice is extracted, then I add a couple tablespoons of gelatin and then I put it in the fridge until it’s hard. And you have a natural jello you can serve to your kids. It’s pretty good.
Another great food to help balance your mood and mental health is turmeric. Turmeric, or curcumin, as it’s scientifically called, is a spice that is used mostly in India. It’s a yellow spice, it stains things yellow: your clothes, your counter, your intestines. It has very very strong anti-inflammatory benefits. It also helps the liver detoxify, it’s been shown to have anti-cancer properties, it’s a really powerful, nutrient-rich plant, root. So studies have shown that two grams per day of turmeric actually outperformed Prozac for treating depression and probably this is due to its anti-inflammatory properties in really lowering inflammation in the brain, which we know is really one of the underlying roots of depression. The way that we get to that inflammation is different in every person with depression, but there is this kind of common thread of inflammation that’s going on in every case of mental health condition, mental illness. So, adding turmeric to foods, or supplementing with turmeric, is a great way to combat that inflammation and keep moods balanced.
Some other foods you might want to add to your diet are foods that are rich in zinc. So, these are mainly things like pumpkin seeds. You’ve got to get around two cups, though, of pumpkin seeds, to get a decent therapeutic dose of zinc, or oysters. Or you can supplement with zinc. Zinc, again, is anti-inflammatory, it can help heal the gut. We need it to make neurotransmitters and enzymes that our brain needs to rebalance mood. And there’re also some studies that zinc increases something called BDNF. BDNF is a chemical in the brain that help with neurogenesis, this is the creation of new neurons in an area of the brain called the hippocampus. So you may have heard “you can’t teach and old dog new tricks” or that our neurons never regenerate once we reach a certain age, and this is not true because new research has shown that we do have neurogenesis, something called neurogenesis, that increases and changes and grows new neurons even as we age. And so anyone suffering from brain fog or really high amounts of cognitive stress, or mental illness, maybe benefit from zinc as that increases the neurogenic abilities of the brain. It’s also very anti-inflammatory and it can help with leaky gut and leaky brain situations. Vegetarians, unfortunately, are often deficient in zinc just because we get most of it from animal products and animal sources, but really upping your pumpkin seed intake might get you to a therapeutic level of zinc or you can supplement as well.
Another really great addition to your diet to help balance mood and to improve your mental and cognitive health are fermented foods. So, these include things like kefir, kombucha, kim chee, saurkraut, and yogurt, if you do dairy. These things, they contain probiotics, and studies show that it may be better to supplement or to add fermented foods to your diet rather than supplementing with a probiotic, and this is obviously an individualized recommendation that would have to be made by a doctor, but adding fermented foods to your diet, especially if you make them at home and ferment them at home, like you make your own kombucha or your own kefir, that can actually boost the probiotic capacity of your gut. Probiotics actually make neurotransmitters, they make things like serotonin, and the calming neurotransmitter GABA and they can help us digest our food, like gluten, as well as combat inflammation and regulate our entire immune system. It’s also important to feed those probiotics with something called resistant starch that you can find in carbohydrates that have been cooled to room temperature after they’ve been cooked, so, for example brown rice that’s after it’s been cooked as been cooled to room temperature, potato starch, green bananas, black beans, and jerusalem artichokes. These are all starches that bacteria feed on and that keeps them populated in the gut. Coconut oil tends to kill more pathogenic bacteria and therefore can promote a healthy bacterial balance.
And lastly, I’m going to talk about leafy greens. So, adding a cup of spinach, or two cups of spinach or chard to your diet will give you the amount of magnesium you need. Magnesium has a calming effect on the body. We need it to make the neurotransmitters like serotonin, dopamine and melatonin, to help with sleep. Magnesium also can help balance mood and help us with stress. A lot of us suffer from stress. It can also make our brain more resilient to stress, as stress is one of the major causes of neuro-inflammation in people with mental illness and this can be stress from a significant trauma, it can be psychosocial stress, interpersonal stress, the stress of being out of work, even long-term chronic stress or burnout from school and work and things like that. So, two cups of spinach gives you your daily magnesium serving. You can also get it from chocolate but you need to eat quite a bit of chocolate.
So, in boosting your mental health, or in promoting mental and emotional wellness, you can add all of these foods to your diet and balance your inflammation, feel good and nourish yourself.
Current research suggest that gluten can increase systemic inflammation, contributing to a worsening of mental health symptoms, as well as other inflammatory conditions, such as pain and autoimmune disease.
Transcript:
Hello, you guys, my name is Dr. Talia Marcheggiani and I’m recording to you guys from my clinic in Bloor West Village. It’s call Bloor West Wellness Clinic, in Toronto, Ontario, Canada. And today, I’m going to talk to you guys about how a gluten sensitivity might be the underlying cause of your mental health conditions or other inflammatory conditions such as arthritis, migraines and digestive symptoms like IBS.
One of the reasons that I’m recording this video is because gluten is a really hot topic in the health and wellness industry and you’ve probably encountered your own versions of gluten-free food, or articles on the internet about how gluten is this evil toxin and there’s a lot of misconceptions around this and so I’m going to just talk a little bit about what gluten is and my own journey with cutting gluten out of my diet and how I came to that space where I was willing to do the experimentation and cut it out and see what my results were.
So, gluten isn’t a toxic substance per se, I mean there’s opinion around this in certain circles based on what it can do and how it affects the immune system and the results it can have on digestion, if you have sensitivity to it. But, what gluten is, is it’s a protein complex; it’s a bunch of proteins that are found in grains—wheat, rye and barley. And the protein complex consists of different proteins called gliadins. I might use gliadin and gluten interchangeably; it’s the same thing.
And, so, there is a health condition called Celiac Disease that’s a very serious health condition; it’s an autoimmune condition where the body attacks an enzyme called transglutaminase that’s involved in processing gliadin molecules. So this is not a reaction to gluten, per se, it’s an autoimmune reaction that’s caused by, that’s caused any time the body comes into contact with gliadin or gluten.
And celiac disease is a very serious health condition, it affects about 1% of the population, but there’s some room there for debate. So, some people think that you acquire celiac disease as you go on, and there’s evidence for that. And also, some people think that there’s a great underestimation of how many people are affected by celiac disease, that the number is higher than 1%, but that a lot of the cases do undetected.
And so celiac disease is diagnosed by blood tests. We’re looking at transglutaminase and endomysial antibodies, but the gold standard diagnosis is doing an intestinal biopsy. So, that’s how you find out if you have celiac disease, or not. So some people have done a blood test and they’ve tested negative for celiac disease, but are exhibiting some of the symptoms and so an intestinal biopsy will tell you yes or no definitively whether you have it or not.
Now, whether someone with celiac disease should avoid gluten or not isn’t really the debate here, I mean, that’s obvious. So, if you have celiac disease you have to avoid gluten 100%, it can’t be in your diet. You can’t even have a crumb of it. You have to use special toasters, or toaster bags, for your gluten-free toast. You have to make sure that your oatmeal hasn’t been contaminated by gluten. You can’t shop at Bulk Barn because there could be cross-contamination with gluten-containing substances. So, it’s almost like an allergy, you really have to be careful about coming into contact with gluten. And when people avoid gluten, if they have celiac disease, then that disease is managed.
So, whether someone with celiac should avoid gluten or not is not up for debate. What is is in this grey area, which is what you’ll be reading about online and that you’ll hear certain professional say is kind of myth, is this idea of non-celiac gluten sensitivity or gluten sensitivity. These are people who don’t have celiac disease, but for one reason or another notice that, when they take gluten out of their diet, they feel better. And when they reintroduce gluten they feel worse. And the symptoms are complex, just like in celiac disease. So, in celiac, people can get rashes, they can get joint pain, they can experience brain fog, they can experience brain damage, they can get arthritis, they can start getting other conditions such as thyroid conditions and so the symptoms are so wide-spread because of the inflammation that is triggered by eating gluten, and this is also the case with non-celiac gluten sensitivity—people who avoid gluten.
So, my story was that when I was a student at the naturopathic college, one of the things that I was exposed to in first year was this idea about elimination diets and leaky gut, which I’ll explain in a bit more depth, but you might have heard me write or talk about leaky gut. And, this idea that things like gluten or dairy could be contributing to some symptoms that I was experiencing and that a lot of patients were experiencing, and that taking these foods out in a systematic fashion, so doing a really clean diet, or a “hypoallergenic diet”, or a diet that’s basically chicken, rice and maybe some spinach, that that would heal a lot of the complaints that I and many others were experiencing, but that probably gluten was implicated in that.
So I was really resistant to this for at least two years. So, I wasn’t an early adopter at all to this idea, a lot of my classmates got the information, they went out and they started eliminating a lot of these foods from their pantries and they tried eliminations just for fun—well, for fun and also to experiment and to heal themselves and to “walk the talk”, as we say. But, I was living with my Italian grandmother and I would have toast for breakfast, I’d have pasta for probably lunch and dinner. I was getting gluten in my diet a lot and the idea of taking it out and resisting those familial pressures was—I just didn’t want to deal with it.
But, throughout the first couple of years of school I was also getting migraines on an almost weekly basis. And these migraines would take me out for the entire day. So, for the entire day I’d be throwing up, lying in the dark with a cloth on my head, trying to take some Advil, or something to mitigate it, but this was a chronic thing that I was going through.
Best case scenario, I’d get these once a month, but they were things that I was getting often. And I also had this life-long problem with bloating, these kind of IBS symptoms, like gas and bloating and, when I first started the naturopathic college, it was amazing to me that that was something we were talking about, because I’d kind of written that off as just being something, a peculiarity or particularity about my body that I’d just have to live with and it didn’t even occur to me that something that wasn’t considered a “disease”, per se, could be something that warranted attention and that had a treatment that went along with it, and a cause.
So I was kind of intrigued by that idea, like “oh, you mean I don’t need to be bloated?” and that, even though I’m not sick, like I’m healthy, I don’t have a disease, I don’t have high cholesterol or some of autoimmune disease, or type one diabetes, or something like that, but that the idea that an imbalance, or symptoms that were uncomfortable could be treated was totally new and exciting for me.
And so there was this intrigue in being gluten-free, but also this resistance to it.
And then, I think I was at a talk at school where we were given—it was sort of an information session, we were given free samples of a 7-day detox that involved shakes. And so, I did that because I had this free box, probably worth about $80 and I just decided, “ok, well I’m going to do this detox, it will be good for me. It will be sort of my introduction to eliminating a lot of these foods. It’ll be easy.” And it was really difficult. The first two days I had massive headaches as I was withdrawing from a lot of the things I was addicted to, such as caffeine, sugar and, probably, gluten, as well. But that sort of set the stage because I felt a lot better after that process, even after only that week of eliminating the foods. And so, when I started introducing the things I was eating normally back in, such as pasta and bread, I felt a lot worse. So, that discrepancy kind of woke me up to the idea that maybe these foods aren’t that great for me. And then I began a process of elimination and noticed really good results. I mean I don’t get migraines any more. It’s very very rare, and it’ll be a combination of weather and other factors and stress and overwork. But, that once-a-week, or even once-a-month, being in the dark with a cloth on my head, no noise and vomiting all day: that’s in the past. And now when I reintroduce gluten I can maybe tolerate a bit of it, but I definitely notice a difference in my energy levels, in my digestion, and just in my mental functioning and in my mood when I make a habit of having it more often. So, I’m basically grain and gluten-free and have been so for about 4 or 5 years.
So, why is gluten bad? Why gluten? Why is that an issue? The obvious answer is that it’s so present in our society. So, in North America, gluten is one of the main staples in our diets. So, pasta for lunch, bread or a sandwich for dinner, and toast for breakfast, or cereal. We’re getting gluten as a main source in our diet, in wheat, very often. And so, when we’re exposed to certain foods continually, we become more susceptible to an immune response against those foods.
But also, gluten has, we see in the mechanism of celiac disease, there are these, this genetic predisposition to react to gluten. And so on immune cells, and we know that our digestive system is the gateway between our bodies and the external environment. And so, how our immune system kind of “educates” itself is by sampling things from the environment and deciding what’s us—and we shouldn’t attack ourselves, because that creates an autoimmune issue—what’s us, what’s ourselves and what’s food, what’s useful to the body, what’s supposed to be incorporated into the body as fuel—and what is not helpful for the body, what is toxic, what is foreign, and what we need to defend against, like bacteria and viruses.
So, our digestive system is kind of involved in sampling from the environment, deciding and showing those pieces of the environment to the immune system, and letting the immune system decide what it’s going to do about these things.
So, when we’re eating foods we’re kind of presenting them to the immune system. And our immune cells have different receptors, so they’re called receptors, but they’re sort of like, you can describe them as like locks for keys or little sort of antennae that feel out the environment. And so people with the receptors, HLA-DQ2 and HLA-DQ8 receptors, on their immune cells, those people tend to react and to connect those receptors with gliadin molecules, so gluten molecules, and that signals an immune response from the body. And when the body thinks it’s come into contact with something that it needs to trigger an immune response against, so that means something foreign, something threatening to us and to our health, then a whole inflammatory pathway starts to take place.
So, think about when you get a cold. You come into contact with the virus and the reason that that virus doesn’t kill us is because our immune system reacts to it. When you get a cold, depending on what virus you’re in contact with, you might get the swollen throat, and the pain, and maybe a fever, and maybe some mucus production, some runny nose. You might feel tired because it takes a lot of energy to mount an immune response like that.
So, when we’re experiencing inflammation, it’s really useful for us, because we’re killing off the things that could kill us, basically we’re at war with something from our environment, but it also doesn’t feel great to be in that state. And so we get into trouble when we’re in an inflammatory state and it’s not for the right reasons, like that we’re trying to attack something (acutely) and get rid of it.
So, a lot of people have these receptors. So even though only 1% of people react to gluten in the sense of celiac disease, about 30% of people express these HLA-DQ2/8 receptors on their immune cells. And so, coming into contact with gluten on a regular basis could be problematic for these people and it could trigger some inflammation.
Another thing that gluten does is create a leaky gut situation. So, I’ve talked about leaky gut before. Our intestinal cells, so our intestine is this long tube from our mouth to our anus, and it winds around and it goes from mouth to esophagus, to stomach, to small intestine, large intestine, and then rectum and anus, and different things happen along that process. And in our small intestine, we have these really long, they’re kind of like cylindrical cells. And, on one end, on the end that’s in contact with what we eat, there’s these little fingers, these villi that reach out into the environment and that maximizes our ability to absorb the things that good for us—the foods that we eat. And, in between—so, the villi kind of control, ok we’re going to break down the carbs, and we’re going to break down the amino acids, from proteins and we’re going to break down the fatty acids, and we’re going to absorb all of the ions and the minerals and the vitamins and we’re going to control how we take them in. We’re also going to control how we take in foreign substances, because we’re going to, remember, show them to the immune system and say “take a look, this is what’s in our environment. This is what you guys might need to prepare yourselves to defend against if this becomes a problem for us.”
And so, we really control, tightly, what we’re taking in through our intestine. So our intestine doesn’t just want to open up the gates and let whatever is outside in, it’s got these really specialized mechanisms for letting certain things into the body. And, so, between these intestinal cells. You imagine these cylindrical cells, almost like a hand, with little fingers, and they’re lined up all along your intestine. And between them are something called tight junctions. And so those, they might become more or less permeable depending on the state of the gut, and that’s controlled by something called zonulin.
Zonulin will open up that permeability and let things in between the cells. And lower amounts of zonulin will maintain a more closed environment. And so one thing that gluten has been shown to do, or gliadin, is increase levels of zonulin, which opens up our intestine to the external environment. And think about the things we eat. Think about the things that swallow, by accident or intentionally, the things in our environment that are toxic, or giant pieces of protein from foods. So, protein in and of itself can cause an immune reaction. We have children that are deathly allergic to peanuts and other nuts.
So, it becomes problematic when we have all this stuff just entering our body. And so gluten opens up the gut to allow all these things to enter the body. And so we end up mounting an immune response to things that would otherwise be harmless to us, like dairy, or eggs, those kind of things that are actually nutritious and helpful for our bodies. So, we start to enter this state. When we’re in a leaky gut state we start to enter a state of inflammation. And inflammation has widespread effects. In my case it was migraines and bloating and digestive symptoms, a foggier mind, foggier brain and lower mood as well. And in some people it can be bipolar disorder. It could be worsening of symptoms on the autism spectrum. It could be depression and it could be anxiety. And when we’re in that inflammatory state we have higher amounts of something called, they’re like excitotoxins, or endotoxins. And so these are toxins like lipopolysaccharides, or LPS, as it’s most often referred to, that trigger anxiety, they activate the limbic system, they activate the amygdala; these are fear centres in our brain.
We also have something called the Blood Brain Barrier (BBB). And that’s really similar to the intestinal barrier with the tight junctions, and that prevents things from getting into our brain that are in our bloodstream. So, it’s like we have this second wall of defence because our brain is so important to our survival and fluctuations in our brain chemistry have really disastrous effects. So we have this extra sort of layer called the BBB that prevents things from getting into our brain. And when we’re in a high inflammatory state, like when we’re exposed to gluten, we get these cross-reactions where what keeps our blood brain barrier intact starts to separate, so we get this leaky brain picture. So we’ve got a leaky gut and also a leaky brain happening. And so we’re getting these toxins, and we’re getting inflammatory mediators entering the brain.
And more research into depression and other mental health conditions has shown that inflammation might play a giant role in low mood. There was one study done with patient who were hospitalized for bipolar disorder. So, these were people who were in a psychiatric facility. And they measure their blood for antibodies against gliadin. And they found that there were elevated antibodies in these people. So, there wasn’t a control group, they weren’t testing against non-bipolar, or people that didn’t have a bipolar diagnosis, but they found that every single patient, who was diagnosed with bipolar disorder and was hospitalized, so their symptoms were severe enough to require hospitalization, had elevated levels of antibodies to gliadin. Then they retested them some time later and found that having high levels of gliadin, or even further rises in gliadin antibodies, predicted whether they were rehospitalized. So, we can infer from that that their symptoms worsened. And so we know that there is this connection between mental health conditions, you know, depression and anxiety and bipolar and even psychosis (and gluten sensitivity). Another study showed that there were high levels of antibodies in people who had psychosis and psychotic symptoms.
So, we know that there is this connection with mental health and with inflammation and that this inflammation can be worsened by a gluten sensitivity or gluten reactivity and that maybe 30% or more of people are susceptible to reacting to gluten in some kind of way. And that gluten just in and of itself might cause this leaky brain situation or leaky gut situation. So, one thing I do is that I don’t do this with every single patient that I see who comes in with depression or anxiety or stress. I mean I don’t jump right into prying gluten from their hands, because my own experience was that it took me literally two years to think about removing it and I had to come to it on my own. But, I might plant the seed, or we might do something like a trial run. Especially someone who’s got mental health symptoms, or is coming to me for mental wellness, and they also have digestive symptoms. I mean, those two things together are a clue that doing some elimination diet, or some leaky gut healing or removing foods like gluten could be a good idea.
But I might present the option to them. We find that most treatment does really need to have 100% compliance rate. So, some patients will come back and say, “you know, I kind of took gluten out, maybe 70-80%” and that’s really great, because I think that it sort of sets the stage for creating a gluten-free lifestyle and doing a gluten-free trial, but really what the research is showing is that we need to 100% take it out to allow the gut healing and the brain healing to occur and to lower those inflammatory mediators.
But, the good news is that it usually takes about 2 to 4 weeks to get symptoms to really come down. So, it’s not like you’re on this trial for life and you can go back to your pasta—if you don’t notice any change after 2 to 4 weeks, at all, then you can go back to your pasta with the peace of mind that this isn’t an issue for you. But, if you do notice some improvement after removing it, then it is something that we can investigate either down the line, when you’re ready, or something that you might want to consider. It’s sort of like planting that seed. But, I don’t pry out of my patients’ kicking and screaming hands. It will be something that we might work on down the road, and something that is always kind of on the table or on the back burner for future attempts and experimentation.
And so, the gold standard, when it comes to treating gluten sensitivity, is just to do an elimination, so take gluten out of your diet for about a month, 100% out, as best you can. There are blood tests that you can do and those can show an elevated antibody response to gluten or gliadin or wheat as well as other foods. The one I do on my patients looks at about 120 different foods. And this is great because having a piece of paper that shows you what your immune system is dealing with in the moment that you got the blood work done is useful. And people tend to, when it’s a blood test, it tends to hold more authority than simply the subjectivity of symptoms. But, really, the best way to see how gluten affects you or how certain foods are affecting you in your immune system is to do an elimination diet, remove it 100% from your diet, give your body some time to heal and then reintroduce it and see what it does to you once you’ve healed from the state that it’s put you in.
Doing that removal is important because the antibodies are only one part of the immune system and so when I’ve done a food sensitivity test on myself, I felt crappy because you have to eat the food for a while. So I was reintroducing gluten into my diet and I didn’t have a high gluten antibody. I had antibodies to other foods, but not gluten. So I kind of psychologically was like, “well, I guess I’m ok to eat it, then.” And went back to eating it a bit more regularly and then experienced really terrible symptoms and my mental health took a decline and then I had to take it out again.
So, the labs don’t necessarily tell the whole story. What does tell the whole story are your symptoms. So, taking gluten out for 2 or 4 weeks is what I recommend most people do. And, so how do you take it out? So, really what the goal is, because, and I’m saying this piece now because there were some articles that were floating around, it was a few months ago, but I’m sure they’re still around, that said, “going gluten-free is unhealthy. It’s dangerous.” And I was really confused by that because I was like, it’s not like wheat is this really important food in our diet that’s giving us all kind of nutrients. We fortify grains with things like folic acid and other B vitamins, like riboflavin. But, they’re not super nutritionally dense, and it’s not like we have a calorie deficiency where we need to get more carbs and calories. I’m not telling people to avoid spinach, or something that is really giving them a lot of nutritional currency, so why would it be harmful to take gluten out?
And then I realized how it’s often being taken out. So, you go to the grocery store and you find that there’s a whole gluten-free section. They basically have gluten-free breads or gluten-free Oreo cookies. And those gluten-free Oreo cookies are for, like, celiac children that want to join in with the rest of the group. They’re not like, “oh, I’m eating these gluten-free Oreo cookies. These are a healthy choice that I’m making.” It’s a substitute for a junky food. You’re substituting one junky food for another junky food, but the only thing is that you’re still maintaining your gluten-free status while on the substitution.
And when it comes to gluten-free breads vs. whole grain breads or whole wheat breads. Probably whole wheat breads have more nutritional bang for their buck; they’re higher in fibre, they have more nutrients. And gluten is a protein, which is what causes the immune system reactivity that it does, but if you don’t react to proteins, they’re healthy for us and we need them, because they contain the amino acids and they fill us up, and they do all the other things that proteins from other foods do. So, usually gluten-free bread doesn’t have very many proteins in it.
So, yeah, if you’re choosing between nutritional value of a gluten-free bread versus a whole wheat bread, then the whole wheat bread is better for you. So, we see this in people that do gluten eliminations and they’re kind of like, ok I’m going to take my wheat pasta and I’m going to have rice pasta instead. I’m going to take my gluten-free toast in the morning, or my gluten toast, my wheat toast in the morning and have gluten-free toast instead. So, that’s not the healthiest way to go about it. It might be a good way to transition when you’re trying to do an elimination. It gives you peace of mind, it allows you to still have your Oreos. It’s not creating a giant change, then that could be helpful. But really what we’re aiming to do is not just substitute wheat products, or gluten-containing products, for non-gluten-containing products and leave it at that, we’re trying to shift into a more traditional diet, like a Mediterranean diet or a Paleo diet, that’s higher in the fruits and the vegetables, and that’s higher in the healthy fats and that’s more protein-rich, and that the proteins are from better, cleaner sources. So, that’s the end goal. So, it’s not that we’re happy with patients eating rice flour and tapioca bread. It’s about switching to a cleaner and more sustainable diet that our bodies evolved to thrive on.
However, the immuno-reactivity of gluten is really what we’re trying to deal with when we’re going on a gluten-free diet, especially the 2 to 4 week trial run. And so what you’re doing on that 2 to 4 week period that’s allowing you to stay on gluten, if that involves gluten-free rice bread, then that’s another story and I think, as a naturopathic doctor working with people who are struggling to get rid of gluten and see if that’s an issue for them, I think that’s ok for the short term.
So, it’s not that going off gluten is bad for you, it’s how we do it. Are we changing our habits for better ones or are we kind of sustaining some of the same Standard North American Diet habits and just cutting the gluten out and thinking that that’s healthy for us, or that that’s going to cause weight loss, or whatever.
No, this is a different thing that I’m talking about. I’m talking about gluten as a root cause of inflammation that then leads to psychiatric disorders, such as bipolar, depression, and anxiety.
And, so one thing I’m going to say as well is that sometimes it’s not enough just to take out gluten and so what I do—or other foods that are suspect, right, so dairy could be another culprit in this or things like eggs, or soy. There’s many things that we could react to. But we often start with gluten. So, often taking the food out isn’t enough and we need to do some gut healing with things like l-glutamine, which I mention in my amino acid talk and also restoring the probiotic balance and doing some things that are just helping repair the gut, getting digestion back on track, getting your digestive motility moving through things like digestive enzymes and bitter herbs and things that like. And so, I’m just going to mention three probiotics that have been shown—they’re called “psychobiotics”. They’re nicknamed that because of the beneficial effects on mental health and in another lecture I was also talking about how the probiotics in our gut are also responsible for producing serotonin that our body has available to it, which we know is the “happy hormone”, that’s what the selective serotonin re-uptake inhibitors work on. So, getting the right balance of bugs in your gut could be just as effective, potentially, as taking an antidepressant medication. So, that’s really cool. But the three bugs that a lot of research has been done on are the Lactobacillus casei, Bifidobacteria longum and Lactobacillus helveticus, which has been shown in studies to actually decrease anxiety and to lower levels of cortisol, which we know is also implicated in depression and anxiety and probably other more serious psychiatric disorders.
So, I hope that was enlightening. We talked about how gluten can contribute to inflammation, leaky gut and thereby exacerbate or create mental health issues. How going gluten-free is not the same as going “whole foods” and how going gluten-free might be the answer or at least a part of your self-care process in healing from mental health conditions.
Thanks a lot, guys. I hope you’re having a good New Year, a good 2017, and I’ll see you soon.
My website is taliand.com and you can contact me at connect@taliand.com. I’m a naturopathic doctor and I focus on mental health and I work in Toronto, Ontario, at Bloorwest Wellness Clinic.
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.
