Carbohydrate Diets in Clinical Nutritional Practice

Carbohydrate Diets in Clinical Nutritional Practice

By Laura Sheehan

I have been using low-carbohydrate diets in my nutritional consulting practice for three years. The results have typically been very good. For the most part, people lose weight, reduce inflammation, improve their digestive function and have better energy. I don’t have a one-size-fits-all diet that I recommend but help people to reduce their carbs to a reasonable level where they start to feel better. This level is different for everyone. People that have severe metabolic issues such as diabetes, heart disease, or obesity, I would recommend that they go even lower carbohydrate. When these people follow a ketogenic diet, they have reversed diabetes and lowered inflammatory blood markers. I do not believe everyone needs to go keto to be healthy however (many nutritionists are espousing this right now).

Some of the most dramatic “low-carb successes” I have witnessed have been Alzheimer’s clients. There have not been very many of them, I admit. But when they do choose to agree to follow a very low carbohydrate (no more than 30 grams of carbohydrates a day) and high fat diet, I have observed amazing results. People that didn’t seem quite “all-there” in the room with you suddenly begin to look you in the eye and engage you in meaningful conversation. It stays that way as long as people are willing to keep the ketogenic diet going. I can immediately tell if they have indulged in sugar when I meet with them.

What would account for this observed effect? A study1 showed that ketone bodies are protective of hippocampal neurons in vitro that have been exposed to a a fragment of amyloid protein, Aβ1–42, a substance found to produce a deficit similar to Alzheimer’s disease.

I have come across many different viewpoints on low carbohydrate diets and their effect on health. The scientific data are mixed2. I personally believe that human beings can be healthy and eat a vast array of different types of diets. What I am looking to do in my practice is to balance out the incredible over-consumption of sugar that most of my clients are guilty of. To this end, a continuum of different lower-carbohydrate diets appears to be useful. Even though the scientific debate is clearly not settled, I believe I have been helping people get healthier, lose weight, and feel better on lower-carbohydrate diets.

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1. Kashiwaya Y, Takeshima T. d-β-Hydroxybutyrate protects neurons in models of Alzheimer’s and Parkinson’s disease. Proc Natl Acad Sci U S A. 2000 May 9; 97(10): 5440–5444.
2. Nordmann AJ, Nordmann A. Effects of Low-Carbohydrate vs Low-Fat Diets on Weight Loss and Cardiovascular Risk Factors. Archives of Internal Medicine. 2006;166(3):285. doi:10.1001/archinte.166.3.285.

Soy beans

Let’s Take a Closer Look at Soy

Let’s Take a Closer Look at Soy

By Laura Sheehan

I was a vegetarian for 20 years and consumed more than my fair share of soybean-based foods. I drank soy milk and ate tofu almost every day. I didn’t have a well-researched reason for doing this. Soy was just available, and from what I heard it was a complete protein, so great, give me lots of soy. I became a very good tofu cook and learned to love the taste of soy milk. Over time, I heard more and more about soy foods. I can’t remember the exact timeline, but I started seeing commercials touting the benefits of soy on TV. I began to see tofu for sale at the regular grocery store. Wow! I thought. They are catching up! So, from the age of 14 until about 34 I practically wallowed in soy. My ears didn’t fall off, nor did I develop a thyroid condition (that I knew of).

This assignment is causing me to reflect on how I feel about soy. Firstly, not being vegetarian anymore, I pretty much don’t care if I never see it again. I’ll eat it occasionally if I go out to eat at an Asian Restaurant (which I practically never do–too many carbs). I also avoid soy milk like the plague because I have heard it’s bad for your thyroid. Are all the terrible things about soy (which I admit I have bought into) true? Let me examine some of my current assumptions one by one, and see if they hold up to the evidence. I consulted Mark Messina’s 2016 review 1 to help me sift through some of the research. I realize with these reviews it is still possible for the authors to cherry-pick the research they like and explain away the research they don’t like. In any case, I would need to thoroughly examine all the studies in a pro- and an anti-review and compare the relative merit of both to truly reach a satisfying conclusion. I will attempt to begin this process here.

Assumption #1: Soy is bad for your thyroid. Messina1 made a very clear point that neither soy foods nor isoflavones have been shown harmful to humans. It was interesting to me that he noted that soy’s negative effects on the thyroid are demonstrated only in vitro or in experimental animals such as rats1. Conversely, one study 2 suggested that soy formula increased the risk of autoimmune thyroid disease in children. Messina did not address this concern.

Assumption #2: Soy is estrogenic and for that reason will mess up your hormones. Doerge’s and Sheehan’s review 3 suggests that this is true. They cite many rat studies, which to Messina may not be necessarily applicable to humans. A 2011 study 4 correlated serum isoflavone concentrations with precocious puberty in Korean girls. Although Messina cited another study 5 done in the United States that contradicted the Korean study, I don’t feel he explained the Korean study away adequately enough, and I still have concerns about the estrogenic effects of soy isoflavones.

Assumption #3: Soy should be fermented if you’re going to eat it at all; never consume isolated soy products.There seems to be a lack of evidence to either or affirm or refute my assumption here. Messina indicates that the isoflavone profile is somehow altered in fermented soy, although he does not discuss the potential health effects of this1. An interesting study from 2010 6 examined the correlation of fermented soy food consumption and lower rates of Type II diabetes among Asian groups. It just makes sense that eating a food the way people traditionally prepared it (that is in this case, fermented) would be healthier. But clear evidence is lacking.

Interesting Incidental Finding: Consumption of soy is protective against breast cancer! 7 This definitely makes me feel better.

In conclusion, from this brief examination I would say soy is neither the nutritional savior that it’s touted to be by the soy industry, and neither is it the nutritional demon that the Weston A. Price people would have you believe. That leaves me pretty ambivalent about soy. There are a lot of other much more important nutritional problems to tackle (like eating too much refined sugar and carbs). I’ve only got limited time with a client and rarely is too much soy, or lack of soy, the problem. So I don’t talk about soy, and most of the time people don’t ask me about it. In one of the rare situations where I have a “soy discussion” with a client, I would have them steer clear of too much industrially processed soy (since it’s pretty much all industrially processed) and focus on whole, traditionally prepared fermented soy foods. This is my general philosophy about pretty much any food, so it can’t do any harm that I can see to extend that philosophy to soy. And since unsweetened soy milk doesn’t really taste very good, I would recommend something like unsweetened homemade cashew milk instead for a dairy intolerant person who absolutely required a milk substitute.
When it comes right down to it, here’s what I believe about soy, and what I would likely tell a client: “There’s a lot of controversy around soy, so it’s probably not a good idea to eat too much soy.”

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References

1. Messina M. Soy and Health Update: Evaluation of the Clinical and Epidemiologic Literature. Nutrients. 2016;8(12):754. doi:10.3390/nu8120754.

2. Fort P, Moses N, Fasano M. Breast and soy-formula feedings in early infancy and the prevalence of autoimmune thyroid disease in children. Journal of the American College of Nutrition. 1990;9(2):164-167. doi:10.1080/07315724.1990.10720366.

3. Doerge DR, Sheehan DM. Goitrogenic and Estrogenic Activity of Soy Isoflavones. Environmental Health Perspectives. 2002;110(s3):349-353. doi:10.1289/ehp.02110s3349.

4. Kim J, Kim S. High serum isoflavone concentrations are associated with the risk of precocious puberty in Korean girls. Clinical Endocrinology. 2011;75(6):831-835. doi:10.1111/j.1365-2265.2011.04127.x.

5. Segovia-Siapco G., Pribis P., Messina M., Oda K., Sabate J. Is soy intake related to age at onset of menarche? A cross-sectional study among adolescents with a wide range of soy food consumption. Nutr. J. 2014;13:54. doi: 10.1186/1475-2891-13-54.

6. Kwon DY, Daily JW. Antidiabetic effects of fermented soybean products on type 2 diabetes. Nutrition Research. 2010;30(1):1-13. doi:10.1016/j.nutres.2009.11.004.

7. Lu L-J, Nayeem F. Adolescent and adult soy food intake and breast cancer risk: results from the Shanghai Womens Health Study. Breast Diseases: A Year Book Quarterly. 2010;21(2):120-122. doi:10.1016/s1043-321x(10)79512-6.

sugar

Effect of Carbohydrate Intake on Depression

Effect of Carbohydrate Intake on Depression

By Laura Sheehan

I was never formally diagnosed with depression and I have never taken depression medication, but I can attest to the effect that altering my carbohydrate intake had on my depression symptoms. In short, I am cured of my symptoms when I avoid refined white sugar, and my symptoms return when I begin to consume refined white sugar again.

Research by Akbaraly et al.1 concluded that a processed-food based diet is associated with increased risk for depression while a whole food based diet is protective. In another older study 2, nondepressed individuals were found to consume more protein relative to carbohydrates, but in depressed individuals, it was the other way around.

So does this mean that high carbohydrate diets are associated in general with increased risk for depression? Recent research has revealed that depression is more a result of systemic inflammation than a chemical deficiency in the brain.3 Because of the inflammatory effect of high blood glucose 4, one can conclude that eating too much sugar and carbohydrates cause depression.

Many nutrition textbooks state that carbohydrate intake should be no lower than 50-100 grams per day. 5 It is my clinical experience that lowering carbohydrate intake in general to these levels can have a positive impact on mood and help individuals with depression.

References

    • 1. Akbaraly TN, Brunner EJ. Dietary pattern and depressive symptoms in middle age. British Journal of Psychiatry. 2009;195(05):408-413. doi:10.1192/bjp.bp.108.058925.
    2. Christensen L, Somers S. Comparison of nutrient intake among depressed and nondepressed individuals. International Journal of Eating Disorders. 1996;20(1):105-109. doi:10.1002/(sici)1098-108x(199607)20:1<105::aid-eat12>3.0.co;2-3.
    3. Leonard B, Maes M. Mechanistic explanations how cell-mediated immune activation, inflammation and oxidative and nitrosative stress pathways and their sequels and concomitants play a role in the pathophysiology of unipolar depression. Neuroscience & Biobehavioral Reviews. 2012;36(2):764-785. doi:10.1016/j.neubiorev.2011.12.005.
    4. Dandona P, Ghanim H. A. Insulin infusion suppresses while glucose infusion induces Toll-like receptors and high-mobility group-B1 protein expression in mononuclear cells of type 1 diabetes patients. American Journal of Physiology-Endocrinology and Metabolism. 2013;304(8). doi:10.1152/ajpendo.00566.2012.
    5. Insel P, Ross D. Carbohydrates. In: Nutrition. 6th ed. Burlington, MA. Jones & Bartlett Learning; 2016: 138-171.

5 Things You Can Do to Improve (or in most cases, reverse!) Diabetes

If you’ve been diagnosed with diabetes, you might be wondering what you can do to help it.  Personally, in our office, when we have put a patient with Type II diabetes on a personalized diet and supplementation program, we’ve seen people dramatically reduce their fasting glucose, H1AC, triglyceride, and cholesterol numbers.  I’m happy to say I’ve heard this sentence many times: “My doctor says I’m not diabetic anymore, and I don’t need meds!”

Here’s a quick summary of what you can do to help yourself if you’ve been diagnosed with type II diabetes (or been told that you’re pre-diabetic).

  1. Cut down the carbs, especially refined carbohydrates such as grains, sugar, and other junk food, but also high carb fruit such as bananas, mangoes, and pineapples. When you’ve been diagnosed as being a type II diabetic, or pre-diabetic, foods such as these will cause your blood sugar to skyrocket, further beating up your blood sugar regulation.  Better to eat low carb fruit such as berries, low carb veggies such as greens, tomatoes, cucumbers, pepper, etc (basically avoid high carb veggies such as potatoes and corn), as well as meats, nuts, seeds, and low carb dairy such as cheese, cream, butter, and cottage cheese.  Most of my patients either use a carb counting app on their phones, or keep track of their carbs using a pen and paper (we call it a diet log in our office).  See the link below for a partial list of good foods for type II diabetics. Keep in mind, you should cut down your carbs, but increase your veggies!  Veggies help to regenerate your liver’s function, which is key to blood sugar stabilization.
  2. Eat more fat and protein. Fat causes very little insulin to be released when you eat, protein (especially higher fat protein sources) causes your body to release more more insulin, but not as much as carbohydrates. A good rule of thumb is that at least 70% of your calories should come from fat and protein for optimum blood sugar control.
  3. Cut down the snacking. Every time you eat, you stimulate the release of insulin. Therefore, cutting down the number of times you eat per day will give your pancreas and insulin receptors on your cells rest, so that they can heal.
  4. Get moving, especially in the morning on an empty stomach. Exercising first thing in the morning helps to re-sensitize insulin, which is of utmost importance when fighting type 2 diabetes. I like to go for a slow jog of 1-1 ½ miles, but if you have more time, you can walk, do yoga, ride a bike, whatever.  Just get moving, preferably in the morning!
  5. Take your blood sugar at least every day. Usually on a program like this, people’s blood sugar, cholesterol, and triglycerides will plummet, so make sure you’re keeping tabs on this, and communicating with your MD.
  6. Take supplements.  There’s lots of supplements that will help with blood sugar stabilization, so this is not a complete list. These are just the ones that I’ve successfully used in my office:
    1. Glyc-Aide-This is my go-to product from Ulan Nutritional Systems.
    2. Gymnema-This has a long history of helping blood sugar issues. I like the one from MediHerb.
    3. Zinc, chromium and magnesium-All of these have been shown to be deficient in the majority of patients with diabetes type II, so supplementing them helps. I like Standard Process for these supplements.
    4. Other supplements for the liver, gallbladder, pancreas, and adrenals-as determined by Nutrition Response Testing.

Honestly, I like to get the 1st 5 steps in place before I recommend supplements.  You can’t “out supplement” the wrong diet, or make up for lack of exercise with supplements.

Give this program a try, and see how you do.  As always, please feel free to leave feedback, or ask questions below.  Thanks for watching.

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Types of Carbohydrates (from a blood sugar point of view)

When people come in to my office, and we start talking about diet, and we start talking about carbs, they invariably say “are all carbs bad for you?”  This is a difficult question to answer, because it’s not about bad or good, it’s about what carbs your body need and can handle, and how much of each.  Every person is different, but there’s some good rules to follow.  Now keep in mind, this is not the article about simple vs complex carbs, or refined vs unrefined, or something else like that.  It’s literally what myself and other nutritional specialists have observed after treating thousands upon thousands of new patients.  It’s more about how to practically apply knowledge of carbohydrates vs theoretical what they’re made of, and how they work in the body (although there’s a place for that, most people just want to know what they should and shouldn’t eat.  So here it is).

  1. White Trash, or White Death, as Arnold Schwarzenegger would call it. Yup, the worst of the worst, white sugar, and white flour and all of its family. I would include in this any refined sugar, and any refined flour, and all its family, cousins, and extended family.  Here you’ll find candy, cakes, soft drinks, juice drinks and fruit juices (even though fruit juices are from fruit, they are still concentrated sugars. I’ve seen them be responsible for serious health problems like high cholesterol, high triglycerides, weight gain, obesity, high blood pressure, suppressed immune function, etc.), cookies, pies, bagels, bread, pasta, doughnuts, rice, rice cakes, pastries, I think you get the point.  These are bad.  No one does well with them.  They might get away with them for a while, but eat enough of them, and they will catch up to you.  Remember the insulin surge caused by these foods may not cause weight gain, high blood sugar, and or triglycerides, it might just cause high cholesterol, blood pressure, or they may just be causing hormonal problems or tumor growth.  Avoid them at all costs.
  2. Whole grains. People are often surprised that I tell most of my patients to avoid them. Why would I do that?  Aren’t they supposed to be “good carbs?”  Don’t they have B vitamins and fiber?  Well, here’s the rub.  A lot of people have digestive sensitivities to them, and they aggravate any health condition they have.  You get more B vitamins from certain veggies, and definitely meat.  You can get plenty of fiber once again from veggies.  Also, it’s very easy to overdo it with these. Take for instance brown rice.  One cup has 45 carbs (ok, so only 41.5 net carbs, since it has 3.5 grams of fiber)!  Considering that most people can only handle 70-100 grams of carbs per day for optimum sugar balancing, having whole grains once per day can severely limit the amount of vitamins and minerals you can get from other carbs, like fibrous veggies.  In this category I’d put brown rice, whole wheat (although I’d avoid this altogether because almost all of my patients with symptoms are sensitive to it, some severely), quinoa (although it’s not as high in carbs as other grains), corn, barley, spelt, and other grains.  The low down on grains is that you are not looking to lose weight, and that you don’t have health problems, you can eat them sparingly. If you’re looking to lose weight, balance blood sugars, inflammation, or reverse an illness, avoid them.  They have a sneaky way of getting in to your diet.
  3. High carb veggies-In here are things like potatoes, sweet potatoes, beans, certain squashes, beets, and some others. They are packed with vitamins, minerals, and fiber, and some are especially high in potassium (extremely important for liver health, especially in how it processes sugars and fats).  They are good for you, but depending on how well you handle carbs, you may need to limit these.  For example, for someone with diabetes or pre-diabetes, or some kind of inflammatory condition, I’d only eat them sparingly.  Basically, this is a grey area, and you’ll have to use some judgement.
  4. High carb fruits-In here are bananas, pineapple, mango, and of course dried fruit. Once again, it’s not that they are bad for you, they are actually good for you if you can handle sugar.  For someone with diabetes or prediabetes, or some kind of inflammatory condition, I’d only eat them sparingly.
  5. Medium carb fruits-In here you’ll find apples, oranges, pears, cherries, blueberries, grapefruit, etc. You can eat more of these, even if you’re a little carb sensitive.  But not too much, or you’ll blow your carb count, and aggravate any condition you have.
  6. Low carb fruits-In here are strawberries, raspberries, and blackberries. You can eat almost as much of these as you want.  Eating a little here and these won’t even bring someone out of ketosis if they are in a ketogenic diet usually!  I put them in my shakes if I’m trying to lose weight, I love fruit.
  7. Low carb, or fibrous veggies-There are a huge number of fibrous, low-carb veggies. There loaded with fiber, vitamins, and minerals.  You can, and should eat a ton of these.  I try and eat at least 10 cups of leafy greens per day (yup, 10 cups).  You need a lot to support liver detoxification, and balance blood sugar.  Some favorites (but I’m not listing them all) are broccoli, cauliflower, kale, Brussel sprouts, spinach, salad greens, peppers, squash, zucchini, onions (a little on the high side of carbs, but not bad), and the list goes on and on.  Unless you’re on a strict ketogenic diet, you can eat pretty much as much of these as you can handle.

Here’s a pictorial representation of the carbs.  As you can see, we should eat plenty of the ones on the bottom.  The ones at the top, everyone should avoid.  In the middle is the “grey” area.  The better your blood sugar metabolism is, the more you can eat. Hope this helps.

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5 Reasons You’re Sick

Sickness and health are big topics in today’s discourse. If you want to be healthy, wouldn’t it be good to find out what makes people healthy, and do that? Wouldn’t is also be good to find out what makes people sick, and avoid or handle those things? In this blog I am going to address what the root causes of sickness are, so you can avoid them and get yourself on the road to health.

Have you ever asked your conventional medical practitioner “why?” If you have, you know it can be a frustrating experience. I had recurring chronic infections in my early 20’s. During this time, I asked several doctors why this was happening to me. They had literally no answer. They wouldn’t even address the question. Instead, it was, “here, just take this. This is what you take for what you’ve got.” Well, what I had just kept coming back, even after I took the meds.

And I wasn’t satisfied. I wanted to fix my problem, and I wanted to know why. It wasn’t until I met Keith Sheehan that anyone even started to answer that question.

Sickness – disease – ill-health – feeling crappy — these don’t just fall out of the sky and hit you in the head. Our natural state is radiant health. So what is going wrong? Here is a list of 5 causes of sickness. From these you can find the real reason for your sickness and health. Then once you find the real reason, take some action to change it!

  1. In general, our diets suck. Or, even if your diet doesn’t suck right now, it did suck for a large chunk of your life. Sickness and health depend primarily on our diet. For example, I was a vegetarian for twenty years and ate mostly bagels, tofu and cake. Sorry, not enough nutrition in those foods to really lay the foundation for health. What we eat keeps us alive, but how well we eat (or ate) determines how well we live.
  2. Even when we do start to improve our diet, we are still eating the wrong diet for us. I thought going vegetarian would be healthier than eating meat. So I was working on eating better, according to the information I had at the time. But the veg diet just wasn’t right for me, as chronic skin problems, hormonal issues and fatigue were cropping up. I had to become more flexible mentally in order to adopt the correct approach for me.
  3. Even when we do start to eat the right diet for us, the soil is depleted and we’re just not getting the nutrition we should from all that good food. Vegetables, fruits, meats, fish – the nutritive content just ain’t what it used to be! According to this article – as yields have gone up, nutritional content of foods has gone down. Like a quality vs. quantity thing.
  4. We’re not taking the right supplements. I have seen several folks just recently who would not start to get better on a program with me until they cut out taking the supplements that were blocking their healing process. It sounds weird, I know. All supplements were not created equal. So I recommend seeking out the proper guidance on what specific nutrient support to take. Because we do need to fill in the gaps that we’re not getting in our diets.
  5. We don’t exercise. Hello? Physical activity, anyone? According to this article, only 20% of us are getting enough exercise. No wonder we’re generally depressed, overweight, tired, and stressed. Exercise is a medicine that will end those problems.
  6. Six? There are six reasons for poor health? Well, mostly there is only one reason. See reason #1. But I’m reserving #6 for stresses and toxins that may be keeping you sick that you will need a professional to locate and identify. You may not be able to do much about #6 right at this point, but you can sure do something about numbers 1,2,3,4 and 5! So get to it!

And even when the pieces of the puzzle are finally in place – proper diet, nutritional supplementation and exercise – then your body will take time to heal. It won’t happen overnight! But there is hope. And we can help! Call our office today to get yourself on the road to better health.

And I’m reporting my food to you.

This morning I had: coffee with butter and cinnamon, cashews, ground beef with onions, sweet potatoes and curry powder

At 12:00 PM I had: Greek Salad with some tuna salad on top. I skipped the dressing but used the juice from inside the bright green (banana)? peppers. Unsweetened iced tea with lemon.

1:30 PM: another cup of coffee. I’ve started using 1/2 caf (mixing full caf with decaf)

3:00 PM: a SP berry bar

I haven’t had supper yet, but I’m likely to have another salad and wings at DipCo. Sauce on the side! And perhaps one alcoholic beverage. But also maybe not. I haven’t decided yet.

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