functional medicine

Bread for people who can't eat bread

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There is so much bad bread out there that it’s no surprise that all bread is under the radar, being blamed for various health issues and weight gain. People feel confused and desperately look for alternatives, especially that everyone loves a good vessle for the likes of pate, olive oil or fruit preserve. Sadly, education in this area can be poor, food labelling is misleading, and many of the so-called ‘healthy breads’ are often not any better.

So what is the problem with most of today’s bread?

Processing

Bleached flour, instant leavening with synthetic yeast, added gluten and other improvers may result in an appealing texture, but the end product is not real, nutricious food. It is mass-produced with very little TLC. And bread needs time.

Modern wheat and pesticides

Wheat is the most common grain used in baking and unfortunately, it’s not what it used to be. Large portion of commercial wheat is a GMO, Roundup-ready crop. It means that it can be sprayed with this killer herbicide and resist its highly toxic effects, which makes wheat highly profitable. Roundup (glyphosate) is not neutralised by the soil and can be found in baked goods, non-organic pasta, breakfast cereal and commercial dairy. A large portion of people react to glyphosate and not gluten, as they think.

Anti-nutrients

Cereal grains cannot escape from predators so they produce chemical weapons called ‘anti-nutrients’ that protect them from being eaten, the most notable of which is phytic acid. It blocks mineral absorption in the gut and can trigger digestive distress. Under the microscope, grains seem to be a good source of vitamins and minerals but they are not well utilised by the body, unless the grain has been properly prepared through fermentation. Whole grain and whole meal options, even though they seem to be healthier, are the richest source of phytic acid and unless fermented, they should be avoided.

Gluten

When flour is mixed with water, two proteins called gliadin and glutenin that are present in wheat, rye and barley, combine and form gluten (from Latin ‘glue’). Gliadin aids dough extensibility, and glutenin is responsible for its elasticity. Both help the dough rise and hold its shape. And the more gluten, the more attractive baked goods are to consumers.

All proteins are chains of smaller building blocks called amino acids, and it is the specific amino acid sequence in gliadin that is responsible for gluten sensitivity. More on that later.

Fructans

These are a type of sugar present in wheat, barley and rye. They are highly fermentable and are the main reason for unpleasant digestive symptoms in sensitive people. Bloating, heartburn, pain, cramps, excess gas and changes in bowel movements caused by fructans are often incorrectly blamed on gluten because coincidentally, glutenous grains are also high in fructans.

Real bread

Thankfully, not all bread is the same and health permitting, traditional sourdough bread is your best choice. It is made by fermenting (´pre-digesting´) the dough for 24-48 hours, a length of time that can pose challenge for industrial baking. No wonder that sourdough bread available in supermarkets is not the real deal because it still contains additives that speed up the leavening process without ´pre-digesting´ the grain.

Fermentation neutralises the anti-nutrients to a large degree. It reduces the levels of fructans, breaks down starch and gluten proteins - those with gluten sensitivity may be able to eat sourdough bread. The longer it´s been fermented, the more ‘predigested’ it is, taking the weight off our own digestive and immune systems. Research now shows that wild yeast that naturally occurs in sourdough can even metabolise glyphosate during fermentation, at least to some degree.

Natural leavening lowers bread’s glycaemic index, making it a friendlier option for insulin resistant people and those who want to shed a few pounds. It also eliminates the phytic acid and makes grain nutrients more bioavailable. Saying that, some people won’t be ready for any bread until their their health significantly improves, for which nutritional therapy is the best solution. In other words, the fact that sourdough bread is a better option, still doesn’t make it a suitable food for many people.

Proper sourdough is made only with 4 ingredients:

  • flour (unbleached and free of glyphosate)

  • water

  • sourdough starter (mixture of flour and water which has been naturally colonised by lactobacilli and friendly yeasts)

  • salt

How to find honest bread

Always look for traditional or artisan bakeries. Don’t be shy and talk to the bakers, ask how they make their bread and where the flour comes from. If it free of glyphosate? Honest bakers will only be proud to tell you about their passion that often has interesting stories and heritage behind. True bread is made with true love for baking, and understanding of its science. It is art.

Foods to avoid on my health plans

All my plans are individualised but there are some foods that everyone should limit as much as possible while working with me because they don’t bring any nutritional value needed to improve health. In fact, these can sabotage any efforts to feel better or lose weight, and that can go on for years. If you are unable to give them up or at least reduce their intake, your addiction may be rooted in emotions, unstable blood glucose, yeast overgrowth or poor neurotransmitter status. For example, everyone knows that sugar is bad and yet it can be so difficult to give it up. One of the reasons is that sugar and starchy foods are more addictive than cocaine. People with dopamine imbalances are prone to addictions which includes sugar addiction. The short term effects of sugar help them feel normal: have better energy, a clearer mind, no headaches, etc. But in the long run - the brain cries out for help from all the sugar and junk. The minute you fill your diet with nutritious foods, the body will not crave as much sugar or junk foods anymore.

First, you will have to set your priorities (do you want to feel and look better? are you ready for the change?) and acknowledge that there is no way around it but implement dietary changes. Secondly, set your environment for success. The first and most important step will be to stop buying these foods and replacing them with healthier options. I can help you overcome any challenges so open up if you feel that eating clean proves difficult. Learning new habits takes time as it means you will have to prepare more food at home or learn how to eat out - it’s a process and lifestyle change. Take your time and be kind to yourself - it will be well worth it.

I recommend avoiding or at least reducing the intake of the following foods:

  • White sugar, inverted sugar, glucose syrup, glucose-fructose syrup, aspartame. A little sugar added to the likes of meats in the process of curing is fine. Side note: sugar is still better than the remaining sugar replacements

  • Unnatural food colourings: colourful candy, icing, colourful drinks and ice cream

  • Hard candy, jellies, lollipops

  • Table salt (pure sodium chloride)

  • Starchy snack foods, e.g. crisps, bread sticks, pretzels, crackers

  • Fast food

  • Fried and battered foods, e.g. potato fries, croquettes, calamari, battered fish and chicken, samosa, bhaji

  • Ready-to-eat packaged meals unless they are healthy options

  • Non-organic wheat and corn which includes their flowers and pasta. These are the two main crops that have been genetically modified to be resistant to glyphosate which means they are full of Roundup

  • Fizzy and soft drinks (including diet soda), except for sparking water

  • Fruit juice unless freshly pressed

  • Puffed cereal

  • Muesli (oats should only be eaten cooked and never raw or in the form of Bircher muesli aka overnight oats)

  • The following oils: sunflower, rapeseed, grape seed, safflower, cottonseed unless they are cold pressed, kept in the fridge and used cold

  • Margarine, shortening

  • Processed cheese, e.g. Philadelphia, ‘slices’, string cheese and cheese spread

  • Instant coffee, esp. with added creamer and sugar

  • Instant soup (including ramen), sauces, gravy, stock cubes

  • Jam and Nutella type spreads

  • Ketchup, ready made salad dressing

  • Soya milk (soya yoghurt, tofu, tamari soy sauce, edemame, tempeh and natto might be ok)

End heartburn forever

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Heartburn is a digestive symptom characterised by painful burning sensations in the chest or upper abdomen. It is so common these days that Nexium and Rennie have almost become the new Tic Tacs. Antacids are profitable so the industry is not interested in treating the actual cause. One thing is certain: if you wish to end your heartburn forever, you’ll need to tackle the underlying triggers and not just the symptoms.

True cause and mechanism of heartburn

It is commonly believed that heartburn is caused by too much stomach acid. But heartburn is more related to the incorrect functioning of the lower oesophageal sphincter (the flap that closes the stomach from the food pipe) than acid itself.

Normally, the flap remains open only when food is coming. But when too much pressure is created in the abdomen, the flap is pushed up and remains open towards the oesophagus. Since the oesophagus is not coated by a protective film like the stomach, it can take as little as acidic fumes to cause a severe burning sensation. In other words, there would be no heartburn if the flap remained closed. The four most common causes of increased abdominal pressure are:

  • pregnancy

  • abdominal obesity

  • small intestinal bacterial overgrowth (SIBO)

  • excessive fermentation of carbohydrates; often goes hand in hand with SIBO

Paradoxically, the main cause of bacterial overgrowth and excessive carbohydrate fermentation is low stomach acid. Not only is strong stomach acid necessary to signal the pancreas to release its carbohydrate digesting enzymes, but is also the first line of defence against unwanted organisms. Contrary to the popular belief, it is low stomach acid that is a major culprit of heartburn, and I’ve had great success with clients by restoring their stomach acidity.

Some of the reasons for decreased stomach acidity include:

  • eating a diet rich in processed carbohydrates (bread and other baked goods, pasta)

  • eating too much starch together with animal foods (e.g. burger in a bun, with potato fries)

  • chronic stress

  • prolonged or frequent use of medication

  • helicobacter pylori (h-pylori overgrowth happens when stomach acid is too low, and then the bacteria themselves have the ability to further reduce stomach acidity)

  • autoimmunity against the parietal cells of the stomach

Factors which can further exacerbate the symptoms include:

  • lack of protective microbes in the stomach and oesophagus

  • eating foods that relax the sphincter such as alcohol, chocolate, coffee, garlic, leeks, onions, peppermint, spicy foods, shallots, strong black tea

  • smoking, as it also relaxes the flap

  • foods that delay gastric emptying; mostly high fibre foods

While antacids take the initial edge off, they often make the problem worse in the long run by contributing to the root cause: low stomach acid. This perpetuates the vicious cycle of relying on antacids, unless dietary and lifestyle changes are implemented.

What to do

Heartburn requires dietary and lifestyle modifications. Unfortunately, a diet that is colloquially called 'healthy' often fails to improve the symptoms because e.g. wholemeal bread, bran and whole grains can significantly worsen heartburn. It’s important to note that the reaction to foods is an individual matter, so the diet should be tailored to the person’s needs. Beyond looking into the usual suspects like coffee, sweet drinks and spicy foods , the following can make a real difference:

  1. Consult your doctor about the possible removal of antacids while working on the underlying causes.

  2. Cooking vegetables and stewing fruit might be a better idea than eating them raw.

  3. Optimally, all grains should be removed until symptoms subside but if you cannot live without bread and pasta, spelt is the grain to go for. Rye can be problematic.

  4. Practice simple food combining of eating animal foods with vegetables, and starches also with vegetables. Try not to combine starch and animal foods in one meal until digestion improves.

  5. Be mindful about your milk intake. Soothing as it may initially seem, it can contribute to chronic heartburn.

  6. Fermented foods like sauerkraut or home made yoghurt (can be coconut) are associated with the reduction of symptoms.

  7. Home made stock and broth calm down the digestive tract. They can be used in soups, stews and curries, or enjoyed as a warm drink.

  8. Raw honey should be the sweetener of choice because it has soothing and antimicrobial properties.

  9. Address your stress levels and stress tolerance, practice relaxation and good sleep hygiene.

  10. See a professional to help you restore stomach acidity and address any pathogenic outgrowths. The therapy includes a dietary and lifestyle plan, along with individually tailored supplementation consisting of digestive support, targeted probiotics, antimicrobials and botanicals that soothe the digestive tract.

At GLOW, I deal with various health concerns which can successfully be supported with functional nutritional therapy and lifestyle medicine. The cornerstone of my work is uncovering and addressing the underlying causes. Online consultations from any location, visits on yachts, in villas and workplaces are available.

Article published in The Islander, July ‘19 edition.

Article published in The Islander, July ‘19 edition.

Burnout survival kit

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We all go through moments of stress which is a normal part of life that helps us grow. But chronic stress has a destructive effect on the whole body, often without people even realising that it is the main culprit of their health issues. Eventually, it leads to a burnout called adrenal fatigue, adrenal insufficiency or hypoadrenia. Stress isn’t just ‘in the head’. It is an actual physiological mechanism which involves approximately 1400 various biochemical reactions. In other words, poor stress tolerance requires a holistic approach and not just stress management techniques.

Stress

Stress is body’s response to a stressor. For some, it might be of emotional origin (e.g. trauma), mental (e.g. workload), while others are faced with physiological stress (e.g. chronic inflammation). Regardless of the source, the response is always the same and involves the adrenal glands.

The adrenals and cortisol

During stress, the adrenals release a stress hormone cortisol which helps us fight or flight by providing instant energy. Technically speaking, it raises blood glucose levels so that we have fluel to deal with the stressor. But when stress is ongoing and the adrenals fire cortisol all the time, it eventually ‘exhausts’ the glands, leading to the so called adrenal fatigue - inability to produce sufficient cortisol. It causes a burnout because without cortisol blood sugar cannot be raised any longer... Unless you eat something sweet, have caffeine or alcohol. These, however, cause a blood sugar roller coaster which is a big stressor itself. So unless your diet and lifestyle are balanced, you can get into a vicious cycle of further depleting the adrenals.

Diagnostics

When standard blood test shows low cortisol, it already means a pathological state, namely Addison’s disease. In other words, It’s not a great test to indicate burnout as such because cortisol may test normal in the blood but will be functionally low. Instead, 24-hour cortisol cycle salivary or urine test with four samples taken is a better diagnostic tool. Tests are available in most labs but they are not cheap and symptoms are often sufficient to assume an imbalance.

Can you identify yourself with any of these symptoms?

  • Extreme fatigue

  • Decreased ability to handle stress

  • Loss of tolerance (to situations, things, people)

  • Underactive thyroid

  • Inability to lose weight , especially around the middle

  • Low or no libido, poor sexual performance

  • Low blood pressure, fainting

  • Dizzy upon standing up

  • Cravings for salt, sugar, caffeine or alcohol

  • Anxiety and/or depression

  • Reduced immunity

How to restore the adrenals for optimal stress tolerance

1. Reassess your diet:

The adrenals need a regular influx of certain nutrients to function optimally. Therefore, have three solid meals a day, with breakfast being the most important one. All meals should be based on vegetables, quality animal protein and cholesterol. Yes, you read that right. Cortisol is made of cholesterol so the more building block is provided with diet, the more supported the adrenals are. Butter, pastured eggs, quality bacon, seafood, fattier pieces of ethically sourced meat and grass fed dairy are all good sources. Carbohydrates should come from fruits and root vegetables. Fizzy drinks, fruit juice, baked goods, chocolate bars and the like should be avoided because they wreck havoc on your blood sugar. Remember, fluctuating blood glucose is the most undesirable state for the adrenals, regardless of the source of stress. Reduce caffeine and switch to coconut water, highly mineralised water or alternatively water with a pinch of quality salt - these are all great adrenal tonics.

2. Reassess your lifestyle:

  • Prioritise sleep: often those with adrenal fatigue burn the candle at both ends and are unable to fall asleep because they missed their optimal falling asleep window. Slowly adopt a new habit by going to bed 15-30 minutes earlier each week. Reading books can help tremendously.

  • Get organised: predictability means safety and safety is relaxing. Organise your to-do lists in the order of priority, try a day planner or get a virtual personal assistant, if you can afford it. Deal with priorities and delegate the rest. Not everything can be controlled but get advantage of what you can.

  • Stop intense cardio for a while and swap to walking, yoga, pilates, hiking or similar. High intensity exercise raises cortisol which can be even more destructive.

3. Take care of your overall health: cortisol receptors can be found on most cells in the body. Many chronic illnesses are associated with a prolonged stress response. And the other way round – ongoing health issues are stressors themselves and can burn us out without any apparent emotional stress involved. This is when one feels stressed but doesn’t know why.

4. Supplementation: there is a wide array of various adrenal supporting supplements. The most common ones include adaptogens, glandulars, pregnenolone, vitamin C and B vitamins. Supplementation should always be tailored individually because without the expertise, one may further deplete the adrenals (e.g.it’s common to take the ashwagandha which tends to lower cortisol levels).

4. Most importantly, see a specialist: At GLOW, I deal with various health concerns which can successfully be supported with functional nutritional therapy and lifestyle medicine. The cornerstone of my work is uncovering and addressing the underlying causes which can be both, emotional and physiological. Online consultations from any location, visits on yachts and workplaces are available.

Article published in The Islander, June ‘19 edition

Article published in The Islander, June ‘19 edition