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Book review: The plant paradox

2/11/2019

4 Comments

 
Authored by Dr. Sara Jean Barrett
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In summary, Dr. Gundry is proposing that lectins, a protein naturally found in many foods are the culprit of a plethora of disease and by eating a low lectin diet you will find relief. In my opinion, Dr. Gundry took a concept that has been known in the holistic world for decades and has exaggerated and sensationalized it.

I get it, to sell a book you need to make some pretty wild claims, but the arrogance was a bit much for me. Statements like ‘no one has put it all together before’ really bug me. I guess he never read any of Dr. Peter D’Adamo’s books or research that has been widely available for the last 20 years. I don’t agree with all of Dr. D’Adamo’s work but I just don’t believe the claim that Dr. Gundry is the first person to figure out that there might be a connection with lectins and health. I picked a few other sweeping claims that I don’t agree with:


  • “If you have ever experienced brain fog, thank lectins”
    • Well, I can think of a few more reasons you may have brain fog: lack of sleep, stress, hormonal changes, blood sugar imbalances, and dehydration to name a few.
  • A runny nose from eating spicy foods is due to lectins.
    • I firmly disagree with this claim. Capsaicin and allyl isothiocyanate are compounds found in ‘spicy’ foods and they irritate mucous membranes. Head of pepper spray? That is made from capsaicin, not lectins.
  • Europeans are slimmer and generally healthier than Americans because their produce is naturally ripened unlike produce in the US that is artificially ripened with ethelyne oxide.
    • This would take a whole blog post to rebut I will just say that the list of how the US is different from Europe is very long. Consider Europe’s stringent regulation on chemicals, their more active lifestyle, better work culture, and higher quality of food in general. It’s a sweeping generalization to say the way their produce is ripened is the cause of the BMI disparity between Europe and the US.
  • Vitamin D toxicity doesn’t exist.
    • I will agree with him that I too haven't’ seen vitamin D toxicity in practice, but that does not mean it doesn’t exist! It also doesn’t mean that you should recommend people take 10,000 IU of vitamin D daily (his recommendation) especially when he didn’t talk about balancing vitamin D3 with vitamin K2 intake.

His fixation on ‘weight loss’ turned me off. He mentions weight in the first sentence of his book and continues to discuss trying to ‘lose weight’ as synonymous with health. As a proponent of health at every size this gets under my skin.

Let’s move on to the main content- the concept that lectins in foods are bad for all of us. I am not a fan of one size fits all for ways of eating so I should say that up front. Dr. Gundry speaks about lectins as if they are animate and out to damage our bodies- “the first mission of lectins is to pry apart what are called the tight junctions between cells in the mucosal wall lining your intestine”. It is true that lectins are made by plants as a defence mechanism against being eaten by predators but that does not mean that lectins are conspiring to kill us. According to MayoClinic.org “Lectins are naturally occurring proteins that are found in most plants. Some foods that contain higher amounts of lectins include beans, peanuts, lentils, tomatoes, potatoes, eggplant, fruits, and wheat and other grains.”1 Dr. Gundry argues that foods from the Americas have been in our diet for the shortest amount of time so those foods such as nightshades and  squash are particularly problematic because humans just haven’t had time to adjust to eating them. It’s an interesting argument but I just don’t think a low lectin diet is the answer to the multitudes of conditions he lists in his book. Dr. Gundry states if you are lectin sensitive, the negative impact outweighs any positive impact. Lectins have anti-cancer properties. I took the following paragraph from a research paper on lectins and digestive cancers:

“Phase III studies of the effect of plant lectins in cancer patients have shown favorable effects. The ability to induce cell death in a selective manner is a desirable attribute in anticancer therapy and, paradoxically, a trait most of the current chemotherapeutics lack but which lectins have shown. Hence, the growing interest in the study of the activity of plant lectins is due to the biological effects they exert on cancer cells, from identification of tumors to antitumor activity and, additionally, decreased side effects caused by chemotherapeutics.” 2

I suspect the truth about lectins is more complicated than just- lectins damage our bodies, don’t eat them. I have seen that a small number of patients with joint pain respond well to a low lectin diet but I have also seen hundreds of patients with conditions he lists in his book respond well to other dietary changes that are more moderate and inclusive of a variety of foods. His book did not sway my belief that we must approach every patient as a unique individual and what works well for one person’s diet might not work well for another person.

A short summary of my likes and dislikes of his food plan:

Like:
  • Unless you have cancer or a neurological disease he does recommend reintroducing lectin foods when prepared properly. This includes using a pressure cooker for beans and removing the skin and seeds of many foods (pepper, tomatoes, squash to name a few). I advocate eating the widest variety of foods possible so I appreciate that he encourages most patients to expand their food options after an elimination period.
  • He focuses on high quality foods and emphasizes that the majority of food be vegetables.
  • He discusses intermittent fasting and the health benefits.

Dislike:
  • In Phase 1 he recommends strong laxatives and antimicrobial herbs as a way to help rebalance the microbiome. Antimicrobial herbs damage the microbiome and should only be used when necessary.
  • The diet is very limiting. By removing beans, nightshades, squash, certain nuts and seeds and significantly reducing animal protein there isn’t much left to eat! See the safe food list here. 
  • He supports a high fat diet without the warning that there is a percentage of the population who’s cholesterol rises significantly on a high fat diet. I was surprised at this omission considering his background in cardiology.

He does talk about other issues outside of lectins, some of which I agree with and I listed those points below:

  • When we find foods that disagree with us, we try to cover it up (nexium, ibuprofen) instead of changing our diet and this will have long term consequences.
  • We should absolutely not be feeding animals foods that are not part their natural diet (cows being fed corn and soy for example).
  • GMOs are dangerous.
  • Our microbiome is critical for our overall health and wellbeing.
  • Antibiotics are destroying our microbiome.
  • Changes in farming techniques to move away from local, in season produce has negative impacts on our health.
  • Chapter 4 ‘Know Thy Enemy’ is all about other agents that damage our health such as endocrine disruptors, herbicides, artificial sweeteners, preservatives and more. I appreciate a conventional provider coming out against the toxic substances that have been normalized in our society.

I was surprised about his anti-animal protein stance in the book. I am disappointed with the two studies he cited to back up his claims about the dangers of red meat. Here is an excerpt from one of them:

“By examining the per capita availability of macronutrients and the major food groups for 170 countries we are able to identify that countries with dietary patterns that are higher in meat have greater rates of obesity and overweight and higher mean BMI. Considering the findings of adverse effect of obesity on the risk of other chronic diseases revealed by other studies as well as the environmental impact of meat production, the country authorities may advise people not to adopt a high-meat diet for long-term healthy weight management.”3

Countries with higher meat availability are also countries that are more developed and are raising animals in ways that contribute to poor health such as feeding them corn and soy, using high amounts of antibiotics in their feed and other questionable practices. The second study he cites as reason for avoiding red meat used two cohorts. One cohort was predominantly white males living in all 50 US states and the other cohort was women living in the US. In the results they state “Men and women with higher intake of red meat were less likely to be physically active, and more likely to be current smokers, drink alcohol and have higher BMI. In addition, a higher red meat intake was associated with a higher intake of total energy, but lower intakes of whole grain, fruit and vegetables.”4 So I find it hard to use this study to claim red meat is the problem.

I am not arguing we should be eating large amounts of red meat daily. My point is that we shouldn’t use this research to argue that red meat is bad for our health. Especially when the majority of the people in this study were likely eating conventionally raised red meat. That said, I did learn something completely new from this book. N-Glycolylneuraminic acid (Neu5Gc) is a sialic acid widely distributed in animal tissue and not produced in the human body. Red meat, some fish and some dairy are the dietary sources of Neu5Gc. Neu5Gc is found in high concentrations in human cancers and appears to set off our immune system. I read through some articles in PubMed and found that there is some data indicating Neu5Gc may be part of the reason that diets high in red meat consistently correlate with higher incidence of cancer. Dr. Gundry talks about this theory as if it has been proven and that does not seem to be the case. It’s interesting data and the most compelling argument against red meat I have seen because Neu5Gc would be just as prevalent in pasture raised meat as conventionally raised meat but I don’t think the truth has been flushed out yet.

In summary, I disagree with Dr. Gundry’s claims that a low lectin diet is a panacea. I think using a low lectin diet in select patients as part of a GI healing protocol is useful but so are many other strategies that holistic providers have been using for decades.



References:


  1. https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-what-are-dietary-lectins-and-should-you-avoid-eating-them/
  2. Estrada-Martínez, Moreno-Celis, Cervantes-Jiménez et al. Plant Lectins as Medical Tools Against Digestive System Cancers. Int J Mol Sci. 2017 Jul; 18(7): 1403 (PMID: 28671623
  3. https://doi.org/10.1186/s40795-016-0063-9
  4. Pan, Sun, Bernstein, Shulze et al. Red Meat Consumption and Mortality: Results from Two Prospective Cohort Studies. Arch Intern Med. 2012 Apr 9; 172(7): 555–563. PMID 22412075

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Dr. Barrett believes that effective healthcare is a collaborative partnership between the patient and the provider. She wants to break down the hierarchy that often exists in healthcare systems. She strives to build strong relations with my patients and inspire them to make lasting changes in their health. Dr.Barrett's  goal is to dig into the root cause of your conditions and help initiate whole body healing. She is an avid student of holistic healthcare and  constantly brings new information into my practice. No two people are the same, and she creates personalized treatment plans that reflect her patients unique health care needs. Dr. Barrett has been in practice since 2012. Learn more about Dr. Barrett by visiting her professional website.
4 Comments

Bookshelf Wisdom #2: The Good Gut

1/23/2018

0 Comments

 
Authored by Tara McCoy, CHC
​Health coach and book nerd, Tara McCoy, is a voracious reader. Her mission is to find the most insightful and life-changing wellness and personal optimization tips and deliver them to you in digestible, actionable bites. She reads broadly from psychology, medicine to spirituality - hunting down the  best nuggets of wisdom so you don’t have to. Each month, she’ll review a book and dish out the top insights gleaned.
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Photo by Daria Nepriakhina on Unsplash
It’s hard to escape the emerging media excitement about the gut microbiomes impact on human health. While there is much excitement, it can be difficult to sort through what is pre-speculative hype and what is substantial science. Enter, the Sonnenburgs and their recent book, The Good Gut. 

Justin Sonnenburg and Erica Sonnenburg are the preeminent scientists researching the gut microbiota. Together, they run the Sonnenburg Lab out of Stanford’s Department of Microbiology and Immunology. As a direct result of their scientific discoveries on the gut microbiota, The Sonnenburgs found themselves making profound dietary and lifestyle changes in their own lives. Yet, they realized that their friends and the general public were not yet aware of the importance of this “new organ” and its implications for human health. 

To help the rest of us out, they wrote the Good Gut. The Good Gut summarizes the current scientific understanding of the gut microbiota and the practical recommendations for cultivation healthy gut ecology. As someone who has been excitedly following the microbiome research for years, I can honestly say this is *THE BEST* book I’ve read on the topic to date. 

But in case you don’t get around to reading it, here are some key takeaways: 

FIRST, WHAT IS THE GUT MICROBIOTA?

The gut microbiota refers to the community of bacteria and other microorganisms living in the GI tract. The gut microbiome refers to the genetic material these microorganisms possess. This “second genome”, unlike our own genetic material, is rapidly malleable and altered by our lifestyle and dietary changes. For this reason, the community of gut flora serve as an extension of our own genome and have profound implications to our health. 

HOW DOES IT IMPACT HEALTH? 

In the book, the Sonnenburgs refer to the microbiota as our own internal drug factory. When the gut bacteria feed on dietary fiber, a fermentation process occurs, which produces an assortment of molecules that are released and absorbed into the circulatory system. It appears these molecules communicate with our brains and bodies to produce profound health effects. 

Another way it impacts our health, is through the connection between the gut’s impact on the brain via the brain-gut axis. The brain-gut axis is a vast connection between the brain and the gut through neuronal and hormonal communication. In fact, there are so many neurons in the gut, that it has been referred to as the “the second brain”. Studies also show that stress and mood disorders can change the population of the microbiota. This is likely modulated by our autonomic nervous system (stress and relaxation responses) which control things like gut motility and mucus secretion. Thus, stressful states change the environment of the gut, which changes which populations of microbes are likely to thrive there. Inversely, bacteria in the gut also appear to impact mood, perception and potentially even behavior. In mouse models, scientists have shown that they can change mood disorder and personality states by transplanting microbes between mice. With more research, the mechanisms for how the gut flora are able to so profoundly impact mental and physical health will continue to get clearer.

WHAT HAPPENED TO OUR MODERN GUTS? 

For most of our evolutionary history , we subsisted as hunter and gatherers, consuming mostly wild plants and lean meats. The advent of Agriculture 12,000 years ago drastically changed how we eat and live. Another radical change to our diets happened 400 years ago with the industrial revolution, which resulted in our current model of highly accessible, mass produced, highly sweetened, low-fiber processed foods. To investigate the climate in which our physiology (and our relationship with our internal population of microorganisms) evolved in, scientists have studied the last remaining full-time hunter and gatherer tribe, The Hadza people of Tanzania.In stark contrast to modern Americans who consume 10-15g fiber a day, the Hadza consume on average 100-150g a fiber/day. As a result of this dietary fiber diversity and outdoor lifestyle, their gut microbiota has much more diversity than the average American. Our modern lifestyle appears to have stripped our modern microbiotas of their rich diversity, which is thought to explain much of Western disease states. Currently, lack of dietary fiber and the subsequent lack of microbial diversity, is linked to weight gain, increased inflammation and risk of chronic illness. 

WHAT TO DO? 

Just like we focus on feeding ourselves, we’d be wise to also consider how to best feed our internal flora. The Sonnenburgs make it clear that the key to optimizing our microbiota is all about dietary fiber from complex carbohydrates. Complex carbs (unlike simple starches and sugars), survive the transit from mouth to colon, where they are accessible to the microorganisms living in the large intestine. The Sonnenburgs call these foods, Microbiota Accessible Carbs (MACs). Examples of of MACs include beans, whole grains, fruits and vegetable. If we do not consume enough dietary fiber (MACs) our gut bacteria resort to feeding on the mucosal lining of the gut, which serves as a backup carbohydrate source. Normally, the mucosal lining provides a barrier which protects our intestinal and immune cells from contacting the microbiota. When this barrier is compromised, our immune system is exposed to bacteria, which triggers a systemic inflammatory response. In summary, if you are not regularly consuming foods that feed your internal bacteria, they will resort to feeding on your gut wall. This diminishes the quality of your gut barrier, and leads to increased systemic inflammation. 

If you’ve made it this far, I’m sure you’re wondering how to cultivate the health of your internal flora. Luckily, the Sonnenburg’s book focuses as much on illustrating the practical lifestyle recommendations as summarizing the research findings.

Below are some of the top action steps recommended for cultivating a healthy gut microbiota: 

  • Eat a wide diversity of dietary fiber from complex carbs ( MACs ) like beans, whole grains, vegetables and fruits.
  • Reduce consumption of meat and saturated fats, which appear to favor a microbial population which is more inflammatory.
  • Increase probiotic rich foods such as fermented dairy products, kimchi, kefir, sauerkraut etc.
  • Avoid unnecessary antibiotics
  • Spend more time outside, on farms, and in the garden
  • Have pet(s).

For more fascinating science and in-depth recommendations, check out the book!
0 Comments

Bookshelf Wisdom #1: Book Reviews that can Change Your Life

9/12/2017

2 Comments

 
Book nerd and health coach, Tara McCoy, is a voracious reader. Her mission is to find the most insightful and life-changing wellness and personal optimization tips and deliver them to you in digestible, actionable bites.

She reads broadly from psychology, medicine to spirituality -- hunting down the  best nuggets of wisdom so you don’t have to.
As equal parts science lover and self-help addict, it’s not uncommon that my beloved self-help techniques prove ineffective when placed under the lens of scientific rigor. As the science of behavior change becomes stronger, it’s now easier to differentiate between which techniques are self-help “fluff” and which are powerfully transformative. As new research emerges, I’ve had to retire some of my favorite personal development tools that have likely provided short term hope but not necessarily resulted in lasting change. 

​In Redirect, psychologist Timothy Wilson, addresses this increasing conflict between what is popular in the personal development world and what actually has been proven to work in the scientific community. ​He reveals that many popular ways of seeking change - both personal and societal - are ineffective and even 
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potentially harmful. ​For example, depending on whether or not you have low or high self-esteem, repeating positive affirmations can make you feel worse about yourself. This is likely because in people with low self-esteem, the affirmative statements too strongly oppose their self-identity, which can trigger contradictory thoughts that only further reinforce their negative self image. 
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On a more encouraging note, Wilson, shares several surprisingly simple techniques that are proven to induce quick and lasting changes in the realms of happiness and well-being. Rather than focusing on superficial transformations, these techniques seek to transform our internal narratives. The theory is that these narratives create the lens through which we view the world, and thus dictates the actions we take. By changing the lens, we can easily change our behaviors.
 
These updated “self-help” tools are powerful because they don’t require long term, one-on-one counseling but can be done on your own, often in a single intervention.
 
Here are a few of the potent transformative tools that you can try today!
 
STORY EDITING
 
With story editing you can permanently change your internal narrative using simple self-directed exercises. This internal narrative change leads to lasting behavior change that is sustained over time.
 
Here are 2 writing exercises that use story-editing to increase well-being.

  • Best Possible Selves Exercise:
Think about your life in the future and write for twenty minutes, on four consecutive days, about what your life would look like if “everything has gone as well as it possibly could” and your life dreams come true. More instructions here.
 
College students who did this exercise reported greater satisfaction with their lives and greater optimism up to 3 weeks later. The group that had done the Best Selves exercise also visited the health center significantly less than the control group.

  • Pennebaker Writing exercise: This writing exercise is helpful when you are worried and upset about something and are having trouble letting it go. This technique was developed by James Pennebaker, a pioneering psychologist who has extensively studied the connection between writing and health.
 
Write about the problem you are currently experiencing for at least 15 minutes a day for 3-4 consecutive days, ideally at the end of the day and without interruption. You can write longhand, into a computer or even use a voice recorder. Write for yourself only and do your best not to worry about grammar or style. More detailed instructions here.
 
The Pennebaker Writing exercise or “expressive writing” has been studied extensively. Some benefits of this exercise are enhanced immune function, lower blood pressure, decreased heart rate, lowered anxiety, less rumination and fewer depressive symptoms.
 
 
DO GOOD, BE GOOD
 
In this strategy, rather than trying to change your thoughts or emotions, you first change your behavior, which then triggers a change in self-perception and interpretations. This new self-perception makes taking positive actions more likely in the future. This is a variation of “fake it until you make it”.
 
One way to do this is through adopting TINY HABITS, a behavior change method developed by Stanford psychologist BJ Fogg. By creating tiny, consistent shifts in action towards the new behavior or identity you’d like to craft you can change your self-perception and emotional state.
 
For example, if you meditate for 1 minute every single day, sooner or later you will build your identity as someone who is a meditator and dedicated to self-care and health. This will allow you to expand the time spent in meditation as well as more easily build other health habits.
 
STORY PROMPTING TECHNIQUES
 
Story prompting techniques direct people towards new narratives by using subtle prompts that elicit new interpretations of reality.
 
Examples of story prompting techniques are mindset interventions, such as growth mindset interventions in educational settings. Another example is the power of stress perception mindsets to determine how stress impacts our health. The new science of stress shows that our perception of stress (whether it’s seen as a challenge or a threat) determines how it impacts us on a physiological level.
 
You can experience the power of a single intervention of story prompting by watching this Ted Talk which prompts you to adopt a stress positive mindset. This act alone can change your mindset and drastically improve your relationship to stress in the long-term.
 
My take-aways focused mainly on tools related to personal well-being (discussed in chapter 3) but if you’re involved in education, activism, or shaping culture in anyway, read his whole book as it’s packed with resources and interventions relevant to those realms as well.

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