:: Step 6: Food and Fitness Planner

Why We Measure Gut Health
The reason we measure gut health is that it can have a profound effect on your emotional state. Someone who has never had a bad experience in their life can suffer from anxiety or depression if the gut microbiota is disrupted. When I speak of the gut I am referring to the approximately 27 feet between the esophagus and rectum. This part of the body is known as the enteric nervous system (ENC), is lined with approximately five hundred million neurons (brain cells) and has bidirectional communication with the main brain (the one between your ears) primarily through the vagus nerve. This is why some refer to the gut as the second brain.
 
The microbiota is simply the microbial taxa associated with humans. There are many different ways the microbiota can become disrupted which in turn can and will affect your emotional state. The questions on the Gut Health Checklist will uncover some of the issues which can cause a disrupted microbiota.
 
When you open your Gut Health Checklist you will notice a disclaimer at the bottom. Very important to review this before filling out the Gut Health Checklist. 
 
After filling out the Gut Health Checklist you will be taken to the Gut Health Progress Tracker which will enable you to monitor your gut health. 
 
If any of your numbers were a 5 or above you will need to contact a Functional Medicine Practitioner
Food & Fitness Planner

Getting consistent control of your emotional state includes consistent control of what you eat, drink, and the type and amount of exercise you get. Why is it important to plan your food and fitness schedule? It is important because the process of an unconscious attack on the body with food, alcohol, or drugs can start a day or even days before you indulge in a behavior that will throw you completely off course and out of control. Planning your food and fitness schedule is a big part of reprogramming these behaviors, and you need to plan them out until it becomes automatic.

Starting from the top, you have a start date and end date. You always want to plan your food and fitness schedule the day before so on this first page you start on Sunday and plan your food schedule for Monday. On Monday, you plan your schedule for Tuesday and so on.

Food & Fitness Plan Instruction Set

Food Plan: Please plan your meals the day before. If you are working with a Registered Dietitian or Nutritionist, you will need to mark in estimates of the following along with the type of food. For a more comprehensive breakdown of the foods, you eat look up, “Glycemic Index” on Google.

Protein: Meat, protein powder etc.
Carbs: These are carbohydrates such as fruits and vegetables
Grains: These are grains such as bread, muffins, bagels, etc.
Fat: Grams, tablespoons or teaspoons of fat along with the type of fat.
Water: Estimated amount of water and everything else you drink.Water: Estimated amount of water


Sleep: Sleep is a very fundamental issue when taking control of your emotional state and Food & Fitness plan. The body sees sleep deprivation as a state of stress and cortisol is a stress hormone. Cortisol causes, in turn, the release of insulin.

Emotionally Driven Food - This is where you mark in your emotionally driven food or drink. Identify the emotion and use The Stop and Replace System to initiate change and take control.

Fitness Plan - Please plan your fitness schedule the day before. Mark down the type of workout and amount of time. If you did aerobics only mark in your approximate heart rate.

Weight - A recent study has found that people, who were most successful at maintaining a consistent weight, weighed themselves every day. You must ultimately determine if this is going to work for you.

Recommendations if Numbers on the Gut Health Checklist are High

Identify Inflammatory Foods (Excerpts from the Functional Emotional Fitness Book)

The Inflammatory 9

1.     High IgG4 Food Antigens: Symptom improvement confirmed by the elimination of beef, pork, lamb, egg whites, and wheat.

2.     High Lectin Foods: This includes grains, legumes nuts, seeds, and nightshades. Grains, in particular, can also alter the composition of gut microbiota.8 More on this below.

3.     FODMAP’s: I will do a comprehensive overview of FODMAP’s 

4.     Alcohol and Sugar: Alcohol increases intestinal permeability by disrupting the microbiota. The dysbiosis caused by alcohol can perpetuate the habit of drinking.7Refined, and artificial sugars alter the composition of the gut microbiota.8

5.     NSAIDs: Nonsteroidal anti-inflammatory drugs include Aspirin, ibuprofen, and naproxen. These drugs are linked to the onset of IBD.9

6.     Milk Fat: MF increases the presence of Bilophila wadsworthia which is a gut bacteria associated with IBD and Colitis.10

Note: Ghee is exempt as it is free of lactose, casein, and whey.

7.     Polyunsaturated Fats: Certain PUFAs disrupt the balance of the gut microbiota.10

8.     Preservatives: I discovered this one inadvertently while researching Candida antimicrobials. The nearly universal antimicrobial activity being attributed to grapefruit seed extract is merely due to the synthetic preservative agents contained within. Natural products with antimicrobial activity do not appear to be present.35 The assumption based on this research is that preservatives act as an antimicrobial. If one takes an antibiotic or antimicrobial, they must be accompanied by probiotics to assist in preventing dysbiosis, but I am certain very few people know that preventives act as an antimicrobial.

9.     Caffeine: Cortisol36 is a stress hormone, and caffeine can cause a robust increase in cortisol.37 I know how hard it is to quit caffeine and there are many benefits to coffee. There should, however, be a consideration to switching to decaf until the dysbiosis is under control.

Other Considerations

Antimicrobials and Antifungals: It is unknown whether oil of oregano, neem or other herbal antimicrobials disrupt the gut microbiota. I was unable to use berberine and several other antimicrobials and antifungals because of a bad reaction to them. The antimicrobials and antifungals significantly worsened my dysbiosis.

Nuts, Seeds, Legumes: These foods are high in lectins and may facilitate the translocation of both dietary and gut-derived pathogenic antigens to peripheral tissues, which in turn causes persistent peripheral antigenic stimulation.11

Assumed reaction to lectins is often confused with oligosaccharides which is a FODMAP and IgG4. It was not until I identified IgG4 food antigens that I finally edged my way to one hundred percent recovery. This is why IgG 4 is at the top of the list.

Nightshade Examples

  • ·       Tomatoes
  • ·       Tomatillos
  • ·       Eggplant
  • ·       Potatoes
  • ·       Goji Berries
  • ·       Tobacco
  • ·       Peppers (bell peppers, chili peppers, paprika, tamales, tomatillos, pimentos, cayenne, etc)

Omega 6 and Omega 3 Disparities

Omega 6 is pro-inflammatory, and omega 3 is anti-inflammatory, but both are necessary as part of a healthy diet. The dilemma arises when the ratio of omega 6 to omega is too high.

Example: Almond milk is low in lectins and FODMAP’s, so it appears on the surface to be a good milk replacement. Nutritional information is hard to find, so I was unable to determine the omega 6 to omega ratio. After incorporating it into my gut health blender I became inflamed, so I looked closer and did some math. I found that it takes one cup of almonds to make four cups of almond milk. One cup of almonds has an omega 6 to omega 3 ratio of 2029:1. Even divided into four for a cup of almond milk is still a ratio of 507:1. This is what some people refer to as a cup of inflammation.

Chopped walnuts, on the other hand, are low in lectins and FODMAP’s and have an omega 6 to omega 3 ratio of 4:1. Unfortunately, walnuts are on the IgG4 list.

Safrole

Black pepper and cinnamon are part of a small group of foods that contain safrole. Safrole is a known carcinogen that was banned as a food additive by the FDA.142 This is not to say that black pepper and cinnamon are dangerous because the amount is so small. It did, however, bring up the issue of whether food that contains this substance is inflammatory. The answer to this for me was an emphatic yes. I replaced pepper with turmeric which is anti-inflammatory.

When the intestinal barrier has been breached, you can become sensitive to some foods, so paying close attention to your reaction to everything you put in your mouth is important. This is one of the many reasons the foundation of Step 6 of Functional Emotional Fitness™ is a Food and Fitness Planner.

Cruciferous Vegetables

Cruciferous vegetables also known as brassica vegetables are a double-edged sword. First of all, they are the most nutrient dense of all vegetables. Some glucosinolates in Brassica vegetables possess anticarcinogenic activity.

In contrast, progoitrin and indolylic glucosinolates degrade to goitrin and thiocyanate, respectively, and may decrease thyroid hormone production by blocking iodine uptake. Collards, Brussels sprouts, and some Russian kale (Brassica napus) were found to have the greatest potential for decreasing iodine uptake by the thyroid.152 It is estimated that cooking them lightly or steaming them will deactivate the glucosinolates by eighty percent.

Cruciferous Vegetables Examples

  • ·       Arugula
  • ·       Bok Choy
  • ·       Broccoli
  • ·       Brussels Sprouts
  • ·       Cabbage
  • ·       Cauliflower
  • ·       Collard Greens
  • ·       Horseradish
  • ·       Kale
  • ·       Kohlrabi
  • ·       Maca
  • ·       Mizuna
  • ·       Mustard Greens
  • ·       Radish
  • ·       Rutabaga
  • ·       Turnip
  • ·       Watercress
  • ·       Wasabi

I would first like to say that in my case the damage to the intestines and the microbiota from the three worms I identified was extensive and severe. Because of this, I had to comply with virtually everything I outlined here. This may not be the case for some people.

I can say that as soon as I eliminated the raw collard greens and kale the remainder of my symptoms improved. The most noticeable was a significant increase in energy focus and the elimination of an occasional lump in my throat that I noticed after the collard greens.

FODMAP Breakdown

FODMAPs are a collection of short-chain carbohydrates (sugars) that aren’t absorbed properly in the gut, which can trigger symptoms in people with IBS. Here is a breakdown of this acronym.

Fermentable: Process through which gut bacteria ferment undigested carbohydrate to produce gases.

Oligosaccharides: Fructo-oligosaccharides (FOS) & Galacto-oligosaccharides (GOS) are found in foods such as wheat, rye, onions, garlic and legumes/pulses. Human beings do not have enzymes to digest oligosaccharides, so we are dependent upon a balanced microbiota which will ferment these sugars. No one is speaking clearly about this because which bacteria ferment this sugar is still in question. It is recommended that anyone with DBS/IBS reduce their intake of oligosaccharides.

Note: Foods high in GOS were the most offensive, and I was able to identify and reduce or eliminate them immediately. Polyols were not nearly as offensive as GOS but still had to reduce or eliminate them.  

Disaccharides: Lactose is found in dairy products like milk, soft cheeses, and yogurts. This is not Paleo, so I was already not eating this.

Monosaccharides: Fructose is found in honey, apples, high fructose corn syrups, etc. The idea here is not to eat foods that are higher in fructose than glucose. I cannot confirm whether I reacted to this, but I reduced it just in case. I no longer use any sweetener including stevia.

And

Polyols: Sorbitol & Mannitol are found in some fruit and vegetables and used as artificial sweeteners. I ate avocados every day which are high in polyols but cannot confirm if I reacted to them. I am however removing them from my diet during the recommended two to six-week FODMAP elimination period.

FODMAP Background

The FODMAP diet was developed by Monash University out of Australia in the mid-late 2000’s. I was aware of this diet for quite some time, but I did not feel the medical literature was substantial enough to try it. This changed after doing eleven cycles of 48-hour fasting to regenerate the immune system and reverse the aging process. Through the course of this fasting, I experienced a vast improvement in symptoms but had a significant setback at the eleventh fast. This made me take another look at the FODMAP diet. This is one time I wish I had not waited for confirmation from the medical literature.

In August of 2017, an article was published titled “Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis.135” For me, this article had overwhelming evidence of the effectiveness of the FODMAP diet for DBS/IBS.

FODMAP Apps

Monash University developed a Low FODMAP Diet app available for iOS and Android. This app was fundamental as it gave me immediate access to the largest database of high FODMAP foods along with the amounts you should eat to keep FODMAP’s low while going through the rebalancing process of the microbiota. The app also contains a booklet on the fundamentals of FODMAP’s.

Another app I found useful for one feature is the FODMAP Helper. It allows users to vote on whether they had a good or bad reaction to a specific food. In the Monash app, it stated that canned lentil soup was low FODMAP, but on the FODMAP Helper, it reported that 70% had a bad reaction, so I avoided this food. 

FODMAP Issues

It is first important to understand that this is not a permanent diet. It is best viewed as a 2-phased intervention, with strict reduction of all dietary FODMAPs followed by reintroduction of specific FODMAPs according to tolerance. For me, however, there were some foods so offensive that I will not be reintroducing them.

·       Any patient with gut symptoms may potentially improve with the reduction of FODMAP intake whether the underlying disorder is functional or primarily organic. This may be cause for overlooking a more serious issue.127

·       Fructans and galacto-oligosaccharides have prebiotic actions. Their restriction, in the setting of the low-FODMAP diet, may lead to a reduction in beneficial bacteria.127

·       Studies have not examined the microbiome of patients with IBS following the reintroduction of high-FODMAP foods to tolerated levels. 127

·       There is some evidence that people with gastrointestinal disorders who undergo dietary change may be at increased risk for disordered eating behaviors.127

It is recommended that a FODMAP diet is applied in appropriate situations with proper education, preferably by a health professional trained in its delivery. Given the recent history of this diet, it has been at best difficult for me to find anyone trained in the delivery of this diet. This is in part why I feel the Monash app is an absolute necessity.

Lectins

There seem to be three schools of thought regarding inflammation and those are people who recommend the elimination of high lectin foods, those who recommend a low FODMAP diet and those who recommend a low IgG4 inducing food antigen diet to bring down inflammation. In my case, I had to address all three as I found they all caused inflammation. There are exceptions to the rule in but initially, I wish I had addressed all three. The reaction from nightshades and legumes was so significant that I will not eat that group of foods again. The nuts and seeds I eat are carefully calibrated, and I have permanently eliminated beef and pork. 

The IgG4 Antibody

IgG4 is a unique antibody biologically and structurally. The production of IgG4 antibodies appears to be driven in part by cytokines that mediate allergic responses.149

The question is what foods initiate this response. Initially, the answer was beef, pork, lamb, and wheat. This 2005 study indicated IgG4 antibodies to milk, eggs, wheat, beef, pork, and lamb were commonly elevated. Significant improvement was reported in pain severity, pain frequency, bloating severity, satisfaction with bowel habits and effect of IBS on life in general at 3 months. Symptom improvement was maintained at 6 months.148

I found the above to be accurate. This was disconcerting on a couple of fronts. First, this took a lot of digging and was the last and most significant piece of the inflammatory equation. I was lulled into thinking that the one food that was safe was meat as none of the IBS resources I looked at mentioned this. Second, I was born in Nebraska, and it was disturbing that I had to give up beef and pork. This did not last long however after I started to feel better.

In 2017 another small IgG4 study was implemented that covered 90 foods. In this one, they separated egg whites from yolks and found it was specifically the whites that increase IgG4. I had already figured this one out via extensive experimentation. There was another surprise to me, and that is ginger caused a significant increase in IgG4.150

This study loops back around to increased intestinal mucosal permeability which has been reported to be an important pathophysiologic factor in IBS. The improvement I had by eliminating beef pork, and egg whites confirmed their role in this equation.

IgG4 Food Antigens

Following is a list of foods from the above study that showed an increased concentration of antigens which of course over activated IgG4. If you have noticed, wheat has made three lists which include this one, lectins and FODMAP’s.

  • ·       Wheat
  • ·       Gluten
  • ·       Gliadin
  • ·       Onion
  • ·       Lettuce
  • ·       Leek
  • ·       Taro
  • ·       Walnuts
  • ·       Cocoa
  • ·       Ginger
  • ·       Egg White
  • ·       Apple
  • ·       Orange
  • ·       Pineapple
  • ·       Soybean
  • ·       White Radish
  • ·       Egg Plant

IgG4: A Complex Confused Equation

IgG4 antibodies not only block IgE mediated food allergies but also block the reactions of food antigens with other IgG subclasses, reducing inflammatory reactions caused by the other IgG subclasses of antibodies to food antigens. This makes for a complex, confusing picture when attempting to determine which foods may be causing a significant rise in IgG4 and how much is too much. An IgG4 food is also difficult to detect because this is an accumulative antibody and you may not feel the effects of for a day, two days or maybe a week whereas IgE allergens appear right away.  

Every study on symptom improvement regarding IgG4 including a Cron’s study in 2016 all agree that the exclusion of milk, beef, pork wheat and egg whites improved symptoms. I not only found this to be true it was the most significant part of the DBS/IBS equation.

Getting a single test in my case did not reveal the complete picture, but it is important to understand which tests should be done if any. In my case, the IgG4 test was the most important, but few entities offer it, and there is a question as to insurance coverage. My insurance covers virtually every allergen test except for the IgG4. I made a list of tests below under “Getting Tested.” Keep in mind there will always be false positives or false negatives. This is why the gold standard for allergy testing is trying a food and then monitoring the reaction.

The Timeline of Identifying Inflammatory Food

According to Mayo Clinic total transit time, from eating to elimination in stool, averaged 53 hours. For me, this timeline is 42 to 44 hours. I found this to be a critical piece of the inflammation equation because if I woke up toxic and nauseous, I suspected the food I ate the previous day which kept me confused about what was making me toxic. With the Mayo Clinic information, I now go back two days which I found to be very accurate. This also significantly sped the process of identifying inflammatory foods.

There were also offensive foods that were not on the FODMAP, lectin or IgG4 radar like green banana flour.

Phase 1, Step 2: Reducing Inflammation with Diet

Diet: I noticed a significant difference after committing to a modified Paleo Diet as outlined by “The Paleo Approach.” The modification I made was eliminating nuts, seeds, and legumes’ I also looked at the FODMAP diet, the SCD diet, and the GAPS diet. If you are a vegetarian “The Wahls Protocol” is very good. Aside from missing the superscript, The Paleo Approach is more scientifically comprehensive than any other book I have read on diet and nutrition.

Water: The amount of water you drink must be well calibrated during detox or rebalancing of the microbiota. There are many formulas to follow, but even drinking water can be overdone. I will tell you that I am 6’ 1”, 175 pounds and I drink two to three liters per day.

Meal Frequency: Emerging findings from studies of animal models and human subjects suggest that intermittent energy restriction periods of as little as 16 hours can improve health indicators and counteract disease processes. The mechanisms involve a metabolic shift to fat metabolism and ketone production and stimulation of adaptive cellular stress responses that prevent and repair molecular damage. The baseline for meals in a 24-hour period is to eat every four hours with no snacks in between meals and a 12 to 16 hour fast every day. Ultimately you have to find your own circadian rhythm within the baseline parameters.

Top 5 Gut Health Supplements

1.      Magnesium ThreonateElite Magnesium Citrate-Epsom Salt

2.     NATURELO for MenFor WomenNo Iron

3.     Krill Oil

4.     Nano Particle Curcumin

5.     Dr. Formulated Once Daily Women’s Probiotics

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Gut Health Progress Tracker

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