The Whole View

Join Stacy of Real Everything and Dr. Sarah of The Paleo Mom as they bust myths and answer your questions about a nontoxic lifestyle, nutrient-dense diet, Autoimmune Protocol, and parenting.

The Whole View, Episode 432: Giving Thanks

Welcome back to episode 430 of the Whole View. (0:27)

This week is all about positive mindsets and giving thanks.

Stacy opens the shows talking about how thankful she is for laughter and how she'd like to take some time this week to focus on what we are grateful for this week.

She also jokes about how embarrassing it is, but she'd like to share one of the meditative practices she's been doing.

Meditation is something that Stacy has often struggled with. She can't sit down and do a guided meditation.

She hopes that it might make you realize, as it did for her, even just taking a couple of minutes to focus on breathing can have a huge impact on your health and wellness.

Sarah explains it's not just about mindset.

It's actually rewires the brain and the connectivity between different areas. It limits the overactive flight-or-fight response and helps to regulate a ton of hormones. It is very well understood as a tool.

Dan Siegel's site and the book can be found by following this link, which Sarah thinks is a great place to start. 

Dr. Siegel studies the science behind mindfulness and how it's impacting the brain and other biological systems. 

Sarah recommends starting with his book Mindset. She adds he has a lot of other great books to check out for kids and teens especially.

Stacy jokes that she will not be reading them. But she is super thankful to Sarah for sharing that information!

Stacy's Breathing Exercise

Stacy explains that she came to this type of meditation while trying to make quiet time for herself. (6:35)

Before then, she wasn't incorporating breathing until she got sick with the coronavirus. 

Lung health was something she could control and manage while she was sick. And it's since been something she's kept on for stress relief. 

Stacy tells listeners the exercise has you breathe in slowly for a four-count, hold it for a four-count, and then exhale for an eight count. 

The goal in doubling the amount of time you're exhaling, you're mindfully slowing down and thinking about needing to exhale slowly.

She adds that she wants listeners to cycle through it three times. 

You should feel your chest rising and your lungs filling. 

When Stacy does this exercise, it takes her about 2-5 minutes to cycle through, depending on how much she wants to do it. 

Positive Affirmations

She tries to practice giving thanks to the things she's grateful for as she practices it.

Stacy shares she is grateful for all the parts of her body doing jobs she doesn't even know they're doing.

"Think about how you're just grateful to exist in that body in that moment, and tell your body that you love it. You have to mean it! Sometimes faking it before making it is okay. You're grateful for being able to do all of those things. Tell your body is whole. You are whole. Your body is a gift. It's a vessel for who you are and what you are. And I know we all get hung up on our imperfections, so the more that you tell yourself: I am whole; I love myself; I love my body; my body is worthy of love; I am worthy love; I am incredible, smart, kind, generous..." All of the things that you can feel proud of, of what you are, think them, say them out loud, whatever you want to do while you practice your breathing."

Stacy shares how ridiculous and silly it seems to her but concedes that it actually is a great way to reflect on mindset while focusing on your wellness.

Within a couple of minutes, she feels so much better and better able to handle her life stress.

Alternatives to Meditation

Sarah jokes that there is science in this, but it may seem a little out-there to regular viewers.

Gratitude journaling is a great alternative if meditation isn't really your thing and has shown to be very effective. Plus, you can even do it digitally if you prefer.

Sarah also tries to jot little things she's grateful for on little scraps of paper and uses them to fill a jar.

There's a lot of resilience that comes out of taking the time to focus on positive things that we can appreciate.

It's really easy to get into this negative thought process and being intentional in thinking about the positives and bringing perspective to our lives.

Especially with the challenges of this year, developing a habit like this can be very beneficial.

Sarah shares her personal experiences with integrating grateful meditation and journaling into her life.

Mindset Is Key

Stacy thinks the idea of being aware of what you're grateful for is beneficial. (17:13)

She shares that she is thankful for her patience.

Stacy jokes that she does not have infinite patience, that she's a perfectionist, and can be very competitive.

She shares that she worked very hard this year on developing more patience, and she's very thankful for the progress she's seen. 

Sarah gives thanks for the strength and resiliency she's developed over the years.

This year really put Sarah to the test, so she's thankful she had that skillset in place to help her navigate.

 

Giving Thanks to Life & Family

Stacy is thankful for the changes she made to her life 18 months ago that made this year so much more manageable.(25:03)

She shares the changes she and her family made for any new listeners.

Stacy is also very grateful for realizing her other dream of being a foster parent. And that her family was up for supporting that dream.

She also shares that they will be fostering two siblings for the holidays.

Sarah gives thanks for rediscovering a very good marriage and that the pandemic allowed them to have a lot of high-quality family time. 

She is also very thankful for the chance to get to know her children at the age they are now.

Stacy talks a little bit about her boys and how they're doing with virtual school.

She also references this post about a comedian reading her 2020 goals list for anyone looking for a laugh.

Sarah is thankful for her team - Charissa, Nicole, Kiersten, and Denise - and their adaptability since many of their 2020 plans wasn't workable this year.

Stacy thinks it's important to acknowledge that adaptability is not only for business but also for helping others who are also stuck at home.

She is also thankful for Penny, who has joined their family 2 years ago now as an emotional support animal.

Stacy and Sarah both share how integral their puppies have been to their emotional health, this year especially. 

Stacy talks about her husband Matt, and how much she's thankful for everything he does. 

 

Giving Thanks to the Community

She also is so thankful for all the frontline workers out there who are doing everything they can to help others. (38:13)

Sarah adds that online shopping, zoom, and the Internet are all on her gratitude list.

Stacy also gives thanks to YOU listeners.

You all support her and Sarah in ways they never imagined possible when they started this podcast years ago. 

Sarah also so thankful for their Patreon family and shares this comment from a listener: 

"There's so much to say, I'll try to make it concise. I will start with this - the reason I joined Patreon was because I wanted to support you. Period. You have both given me so much, more than I can put into words - my heart feels it.

I wanted to support you, even monetarily with a small amount a month (and it really isn't a lot). (The cost of feeding 5 kids in Africa (if you remember the commercial from when we were kids). As it turns out, I'm getting so much from the Patreon content (and I shouldn't be surprised) - more frankness, honesty, and judgement free commentary that continues to make me grow. I feel even more connected to you now. As you say Stacy "I know we'd be besties if we could be".

I call you my gurus and my kids laugh ("what are they monks?", they ask). Wishing you both health safety, love, prosperity, kindness, nachas (have no idea how to explain that in English) and continued personal growth. I encourage anyone who enjoys your podcast as much as I do to support you through Patreon too - you deserve it. Devora"

Stacy is so touched and grateful that she's getting the information she wants and needs.

 

Final Thoughts

Stacy is also thankful for her updated kitchen due to the amount of cooking that's taken place in her house in the last year.

Sarah shares her last gratitude is Stacy. She's so glad to have been able to maintain her friendship with Stacy through doing this podcast.

She is also thankful to Matt and Moira for the work they do produce this podcast.

And the mutual respect she and Stacy have is so amazing.

Stacy jokes that she's blushing. And that she feels the same way.

She's so thankful for Sarah, her drive to be the voice of science, and stand up to do the right thing in the community.

Stacy takes a moment to thank listeners for tuning in today and hopes you have a great rest of the week!

The Whole View, Episode 431: Troubleshooting Dry Winter Skin

Welcome back to episode 430 of the Whole View. (0:27)

Stacy welcomes viewers to this week's show, announcing that she will be leading this week.

She thanks listeners for hanging into the super dense Collagen show last week and supporting Paleovalley, who quickly ran out of bone broth protein after last week's show aired.

Stacy assures listeners that they will now be out of stock for long.

They also have set up their website to allow preorders in the meantime.

You can visit Paleovalley on their website here for 15% off your order.

Stacy also recaps that collagen is essential for skin, which is the focus of today's show.

Things like collagen and gelatin from bone protein can help with certain skin conditions.

Stacy shares she's personally had a lot of great results when acting using collagen.

Stacy reminds the audience that our skincare routine changes throughout the summer and winter months.

 

What You Can Do About Dry Skin

Winter is when we often see flares from dry skin conditions, such as eczema, milia, dermatitis, psoriasis, KP (keratosis pilaris), rosacea, and lupus.

While an anti-inflammatory lifestyle serves all of these, perhaps the AIP, and definitely nutrivore nutrient density, they also need to be treated and fed outside in. 

Sarah and Stacy talked more about skincare in Ep 212: How to Heal Your Skin and Ep 344: Nutrients and Personal Care for Pre-teens and Acne-prone Skin.

Stacy really wants to take the opportunity to talk about what you can do topically to protect your skin even when there's "less light" during these months. 

Stacy takes a minute to talk about Stacy's favorite brand, Beautycounter, is having a 15% sitewide thru Nov. 

Stacy is also happy to help find ways to save even more if you're looking for what will work best for you. Email her: stacy@realeverything.com

Primally Pure has an awesome Black Friday promo coming, but you can use REALEVERYTHING10 all the time for 10% off their products.

Besides products, Stacy shares that there are many other things you can do to help your skin. 

 

Hot Water Can Dry Skin Out

Stacy asks Sarah if she washes her face with hot water because it can inflame rosacea. (7:02)

Sarah answers that she doesn't use hot water, but she's not sure it's cool enough to be considered lukewarm.

Luckily, it's been so long since she's experienced any symptoms of the skin issues that run in her family she doesn't worry too much about it.

Stacy's rule of thumb is if you can see steam from the water, that's too hot, especially if you have dry skin.

She says this is because the hot temperature actually dries out the skin even more.

Sarah jokes that there goes her routine of washing her face in the shower since hers are steaming hot.

 

Changing Pillowcases Often

Stacy explains that as your skin goes through cellular regeneration, you're actually losing skin cells, oil, dirt, and other such things onto your pillowcase as you sleep. 

And then, you're putting your clean face back on that pillow over and over again.

She suggests changing your pillowcase at least once a week, especially if you have a skin condition.

 

Laundry Detergent

What you're using to clean your sheets and clothes is another big one for Stacy.

The soaps and detergents rub off against our bodies throughout the day.

Frequently we see eczema disappearing after simply switch in detergent because it turned out to be a sensitivity to the soap.

Stacy reminds everyone that fragrance-free is best if you have sensitive skin because of the hidden chemicals that can be in it.

Both Sarah and Stacy use Branch Basics in their homes, both as a detergent and a household cleaner.

Probiotic

Stacy also recommends taking a probiotic to help and recommends Just Thrive.

She and Sarah both love Just Thrive.

Stacy explains for healthy skin you need to heal your stomach and body from the inside out.

She also adds that despite the number of products in this show today, it is not sponsored by anyone. These are the products they genuinely enjoy and recommend.

 

Taking Care of Yourself

Stacy also says we need to be sure we're getting more sleep when troubleshooting a skin condition.

Your body regenerates while sleeping, so all the things you do to heal yourself won't help if you're not giving them a chance too.

Sarah expresses how much she loves that things always seem to come back to the same pathways, such as nutrients, gut health, and sleep, no matter what topic they seem to be talking about.

Stacy agrees. She never set out to become a skincare expert but learned to navigate and manage several autoimmune disorders.

Stacy goes over a 4-step skin routine that they've talked about in the past.
When trying to troubleshoot a skin condition, she recommends adding the extra step of exfoliation.

 

Wash

Stacy says the most important thing to do in this stage if you have sensitive skin is to be gentle.

She recommends a gentle soap like activated Charcoal Cleansing Bar or an oil-based cleanser, like Cleansing Balm or Lipid Defense Cleansing Oil

Stacy shares that she does a double wash because she is so prone to acne and other conditions due to her autoimmune issues.

Using a cleansing oil first, followed by an exfoliating wash. She likens this to conditioning her hair before shampooing.

She recommends Clear Pore Cleanser to exfoliate with jojoba beads gently. Jojoba is an oil or fat, most like our skin's natural sebum (oil) and usually works for almost all skin types.

Stacy explains that exfoliation is so important because you need to slosh off dead skin before the new skin can come through.

For your body, use a sugar scrub. 

Stacy refers to this Blue Tansy sugar scrub made for these exact issues. 

The anti-inflammatory benefits combine with sugar and probiotic-rich honey and avocado oil rich in skin food and lipids gently exfoliate and nourish the skin.

 

Tone

Sarah expresses how much she loves toner. It's her favorite part of her skin routine, and she learned it all from Stacy. (25:01)

Stacy goes over how toner can condition very dry and/or aging skin on your face. 

Nutrient-rich Essences, like Hydrating Mineral Essence, are best for dry skin. This is a product Stacy herself uses in her routine!

What it does give your skin food for priming and helps to make the next steps more effective.

For your body, try Primally Pure's Everything Spray. It's what Stacy uses under my arms after she washes to prevent irritation and rashes.

Stacy knows it sounds like she's asking you to do many extra steps but that it's not as tough as it sounds.

You already have your body wash in your shower, so it's as simple as adding another spritz to the routine. 

Sarah uses a mineral-rich toner with a sea-salt base and shares how easy her skin routine is.

Stacy has switched to an Essence with Swill Alpine rose in it.

Sarah shares a fun fact that apple, pears, and stone fruits are part of the rose family.

 

Treat

Stacy says that if there's one step you're going to skip, this is the one you could skip.

Although "treat" means treat for the condition for which you have concerns.

So when skipping this step, you're not treating the problem causing you issues, you're keeping the baseline.

She also tells listeners that this stage is very personalized to the individual.

A serum, like exfoliating Overnight Resurfacing Peel, or facial oil targeting the skin concern is incredibly powerful for so many different skin conditions. 

Stacy does encourage you to do a test patch first before completely diving in, which Sarah found out the hard way.

She also loves the Balancing Facial Oil for skin irritations and finds it works best to help heal the lipid barrier.

Stacy also really loves Herbivore's Blue Lapis facial oil with blue tansy.

So what you've done up until now is get your skin ready. And now, you're giving your skin what it so desperately in search of- lipids!

Stacy also mentions that there are so many different products out there to choose from.

If listeners do decide to deviate from what she and Sarah love and recommend, she asks that you're definitely looking into the ingredients.

 

Hydration

Stacy thinks of this step as the "protection" step and encourages Sarah to take this step when she goes out to walk the dog every morning. (35:54)

She explains that SPF is the biggest in the summer for protection. In the winter, however, it's important to protect your skin from the dry air.

Stacy recommends adding the facial oil to your cream-based moisturizer or using something like the Cleansing Balm as a hydrating mask.

This works well, too, if you have children who lick their lips a lot and end up with the chapped red ring around their lips in the winter. 

She also advises listeners to press it to the areas needing hydration rather than rub.

If for your body, Primally Pure's body butters and Blue Tansy Oil are incredible, but this Ultimate Bath Renewal Set has both a body scrub and a body oil that uses rose water, which is really anti-inflammatory and wonderful if it's still available when you listen.

Sarah adds Buffalo Gal and Annmarie Skincare to her preferred and trusted brands. 

Stacy used to think coconut oil was a catch-all for lotion, makeup remover, and more.

But now she knows that there's no skin food and nutrients in it, so it's not something that should be used and only used. Also, it causes clogged pores. 

Stacy specifies oils, lipids, and balms because the skin's lipid barrier is compromised with these skin conditions.

It means that moisture isn't retained properly, and that's why the skin is dry and becoming inflamed. 

By exfoliating and then nourishing with a fat-based product, you're helping to heal fully rather than just treating topically.

Science on Stratum Corneum

Sarah breaks down the science of skin. 

She tells the audience that skin cells actually regenerate inside, and then push out. So the oldest cells are on the outside layer of the body.

Sarah breaks down the brick-and-morter type structure of the skin and the five layers.

She explains that the cells deeper in are much more sensitive. And that skin itself is only about twenty layers thick.

Some areas, like your eyelids, are thinner. While other areas, like the bottom of your feet, are a little thicker.

The stratum corneum consists of a series of layers of specialized skin cells that are continuously shedding.

For the deeper layers of the skin, hormone environment and nutrient intake are most important.

For the outer layer of skin on the top, we're so far removed from the body's inside, topical nourishment from the outside is most effective.

Sarah also notes that this is not the layer of skin where collagen is most important.

The Bricks

The bricks, also called corneocytes, are mostly made up of keratin. Keratin is a protein also found in hair and nails.

Keratinocytes are created in the lower layers of the epidermis and operate with a phospholipid cell membrane, which can be permeable.

When the keratinocytes are pushed to the stratum corneum, they transform into corneocytes with a more durable cell envelope.

A healthy stratum corneum will shed approximately one layer of corneocytes each day.

New keratinocytes replace the corneocytes from a lower layer of the epidermis.

The desmosomes serve to connect the bricks by joining the corneocytes together.

This forms thanks to the connections of proteins such as corneodesmosin.

For the bricks to shed at a healthy rate, enzymes must dissolve the desmosomes.

The Mortar

Lipids make up the mortar that secures everything in place.

Tiny lamellar bodies present in the stratum granulosum release these lipids.

The lipids float into the space between the bricks and between the layers of corneocytes.

The mortar is very important in protecting the lower layers of the skin. It creates the barrier that keeps out bacteria and toxins.

The mortar and whole of the stratum corneum are slightly acidic due to cellular processes that work to produce the lipids.

The stratum corneum has a pH of around 4 to 5.5. The acidity helps to prevent bacteria growth.

 

Final Thoughts on Dry Skin

Stacy talks about how healthy skin should shed its outer layer every day. (52:09)

However, some nutrients or other internal issues can keep skin from turning over like it should, causing clogging and other issues. 

This is why exfoliation is so important because it helps our skin take that last little step. 

Sarah also warns against overfishing because you don't want to take too much skin off.

She adds that she and Stacy are talking about the face and delicate skin. They encourage everyone to continue washing their hands!

Stacy also talks a little bit about combination skin and the dangers of over-drying areas that need the oil your body is over-producing. 

Lack of sunlight is one of the direct causes of Vitamin D deficiency, which is important for skin health.

Stacy reminds listeners that simple, easy changes can make a world of difference. 

She also adds that she doesn't spend as much time on her routine when she's not having a flare-up.

Thank you for listening, and we will see you next week!

The Whole View, Episode 430: Collagen, Gelatin and Bone Broth, Oh My!

Welcome back to episode 430 of the Whole View. (0:27)

Stacy starts off the show by apologizing in advance for just how long this show is because there is a lot of science around collagen, gelatin, and bone broth.

She assures listeners she and Sarah will break down all the information simply. They will also provide recommendations for the audience.

Stacy shares that sometimes we have to admit that sometimes we get things wrong in the past.

That is why she and Sarah to do all the research they can, so the information and recommendations going forward can set us all up for success.

Stacy reminisces about the paleo community once knew her as the "Bone Broth Lady."

She tells the audience how much better collagen, gelatin, and bone broth has made her body feel.

Stacy also points out that it is an ongoing process. And how changes in the formula of a brand she uses often have her revisiting information about collagen.

Sarah shares that she also uses this brand. After the ingredient change, she tells the audience how flooded her inbox was with questions because many additives are wheat and soy-derived.

She reached out to the company about where this one particular ingredient came from. But she was unable to get a response.

Sarah explains that many of Stacy's followers didn't even realize the formula changed due to the same packaging.

She shares people have been reaching out to them about starting to react.

Her mother has celiac's disease and began reporting joint pain, which stopped as soon she stopped using the product. .

The Collagen Market Boom

After the formula change, Sarah started digging into the research around collagen, gelatin, and bone broth to try and find an alternative. It turned into a "down the rabbit hole" experience for her.

She's written about this research on many occasions for listeners who would like even more information.

Sarah tells listeners how, in the last few years, the collagen industry has boomed. (6:05)

With this boom, technology has also changed. This means that the variety of available collagen, gelatin, and bone broth products and supplements has also changed. 

There's gelatin, collagen protein, collagen peptides, hydrolyzed collagen, collagen hydrolysate, marine collagen, multi-collagen, bone broth collagen, and bone broth protein.

Each are packaged and sold in an ever-increasing collection of products, from protein powders to protein bars, cookies, beverages, coffee creamers, capsules, gummies, and more.

While American consumers spent about $50 million on collagen supplements in 2014, upwards of $293 million is expected to be spent on collagen supplements in 2020.

According to the market research firm Nutrition Business Journal, the global market's projected reach is $7.5 billion by 2027.

One of the results of this boom is the range of manufacturing processes.

As the market saturates with collagen-based products, manufacturers vie for your dollar and loyalty with compelling claims. 

It's important to be an informed consumer. Not all collagen supplements are created equal. 

Sarah explains she really wants to get into the science behind the manufacturing processes are. And the myths surrounding the digestibility of these products.

Paleovalley

Before Stacy and Sarah get into all the science, they take a moment to announce how excited they are to have this episode sponsored by Paleovalley.

Paleovalley makes a bone broth protein that is 100% grass-fed beef bone that is slow-simmered for a long time, just like Sarah makes at home. It's then gently dehydrated and powered. 

Sarah expresses how it's the cleanest product she's come across on the market so far.

Paleovalley has so many great products to offer. Listeners can automatically receive 15% of their purchases by following this link or using the code "thewholeview15" at checkout.

Stacy takes a minute to add the protein powder from Paleovalley is an excellent add-in to many soups and stews for added nutrients.

She also asks listeners to re-think how they supplement. 

Stacy explains how there are so many different ways you can add collagen, gelatin, and bone broth into your life. 

She uses the example that she only likes coffee nowadays with collagen added because she's been drinking that way for so long.

Stacy shares that when she first looked into her research on the subject years ago, she looked at things like Amino Acid profiles.

She mentions that it never occurred to her how or why collagen would be something that could dissolve in cold water. 

Stacy encourages listeners that in the event they get lost in this show's information, remember that ultimately the goal is not to remember everything.

Stacy mentions that on the Paleovalley website, listeners will not find Collagen Peptides. And they will explain a little more on that later in the show.

What is Collagen?

Collagen, gelatin, and bone broth all come from an animal's bone, which is a hard thing. (11:00)

Taking a powder made from bone and expecting to dissolve it in a cold beverage doesn't make a lot of sense. 

Sarah laughs that this is a topic better suited to have visual aids and assures listeners that she will do the best she can without them. 

Collagen is the most abundant protein in our bodies. It accounts for approximately 30% of all our proteins.

Our dominant structural protein is the main building block of connective and interstitial tissues, bone, cartilage, ligaments, tendons, and skin. 

It's also abundant in muscles, blood vessels, corneas, and teeth. 

In fact, there is a role for collagen in just about every cell of the human body, which makes it a phenomenally important protein.

The word collagen comes from the Greek "kólla," which means glue! 

Although collagen functionally acts as a glue—holding cells, tissues, and organs together—and a structural scaffold.

There are 29 currently-identified genetically-distinct types of collagen, encoded by at least 46 genes. Their quaternary structures and architecture categorize them.

The Structure of Collagen

A triple helix tertiary structure is the base for all collagen.

Three polypeptide chains that tightly twist around each other form this helix.

A polypeptide chain is a long string of amino acids, called α-chains, each predominantly composed of a repeating sequence of three amino acids. 

They vary in length from about 600 amino acids to over 3000 amino acids long) 

About a third of the amino acids in collagen is glycine. Glycine is always the first amino acid in the repeating sequence of three amino acids that forms the α-chains. 

The other two proteins making up the repeating sequence are commonly Proline and hydroxyproline.

The collagen triple helix (also called procollagen) undergoes post-translational modifications to become a basic collagen molecule (also called tropocollagen). 

Collagen molecules spontaneously self-assemble into a diversity of larger structures. This is influenced by: 

  • the constituent α-chains (the combination of different α-chains determines which of the 29 types of collagen it is)
  • other matrix molecules (such as elastin, keratin, and proteoglycans) and adjacent cellular elements.

Many different types of collagen can form, depending on how these ropes twist together.

Type 1 Collagen

Type 1 Collagen is the most common and abundant type. (16:28)

Sarah tells the audience that it was the first type of collagen discovered, partly because it accounts for roughly 90% of the collagen in our bodies.

It is categorized as fibrillar collagen because the collagen molecules align to form fibrils, then self-assemble to form collagen fibers. 

It’s very analogous to how a rope (=collagen fiber) is made of several twisted strands (=collagen fibrils), each made of several twisted yarns (=collagen triple helix), each made of spun fibers (=α-chains).

Interestingly, most tissues tend to include multiple collagen types with very small amounts of secondary collagen types. 

Sarah explains how different collagen types tend to integrate and affect biomechanical properties as well as structure.

She gives the example of mixing collagen, how they assemble, and the exact blend of other collagen types with type 1 that provides the strength and shock absorption properties of bone. It also provides the load-bearing properties of tendons and ligaments and the skin's elasticity and other tissues.

Sarah expresses how fascinating this molecule is.

Type 2 and Other Collagens

Stacy tells Sarah how not surprised she is to hear about all this. (18:50)

She also shares how collagen's different aspects are so interesting to her. For example, how it can support digestion.

Stacy explains how surprising it was when Sarah recommended a Type 2 supplement for back pain in a previous episode. She didn't realize there was more than one type!

Sarah adds that Type 2 Collagen is actually vital in the makeup of cartilage.

She explains that when you consume collagen, you are actually digesting it. What ends up getting absorbed into the body is the broken-down building blocks used in other parts of the body.

Sarah also tells listeners that there's no science behind the impacts of consuming specific collagen. 

But what makes Type 2 collagen from whole food sources helpful for back and joint problems is that it's a natural food source of a supplement for joint health. 

Why It's So Important

Sarah explains that it's important to go through the marketing claims if different brands because the science behind it can often be outdated or untrue.

Sarah mentions that a breakdown in collagen production is known to produce a slew of different health problems.

We also know that we stop making collagen through aging, chronic inflammation, chronic stress, nutritional defiance, UV radiation, and various pollutants like smoking.

Sarah tells the audience that this breakdown doesn't just cause sagging skin but health issues like osteoporosis, arthritis, cardiovascular disease, decreased organ function, and more.

She also explains that this is something often attributed to aging, which isn't true.

Interruption, loss, or decrease in collagen production earlier in life can lead to these issues earlier in life.

Stacy shares it's been helpful for her that the more she can improve her digestion, the more she can absorb other nutrients.

Some nutrients specifically support collagen synthesis in our bodies, such as Vitamin C, Copper, and Zinc.

Sarah elaborates more on what makes Vitamin C so interesting. It's actually one of the more common vitamin deficiencies because we burn through it so quickly when we're stressed.

Zinc is also one of the more common deficiencies. Sarah expresses how crazy that is because zinc is so important to so many different parts of the body.

Collagen, Gelatin, and Bone Broth on the Body

Stacy wonders about the validity of topical products and how effective they work, given what she and Sarah know about how collagen works. (26:54)

Collagen is essential for skin structure and function and is actually the decisive protein that determines skin physiology. 

Wound Healing

Sarah explains that wound healing is a complex process that involves the immune system

She adds that some interesting scientific data are showing that topically applied collagen can help with wound healing in several ways:

  • First, exposed collagen fibers from damaged blood vessel walls help recruit platelets to the injury site to begin the clotting process. 
  • During the proliferative phase of wound healing, collagen is secreted by fibroblasts to form new connective tissue, providing a scaffold for the contraction of the wounded area by myofibroblasts. 
  • During the remodeling phase of wound healing, collagen fibers return the tissue to a more normal architecture after reorganization.
  • In fact, collagen largely makes up scars 

One study of long-term care residents showed that pressure ulcers healed twice as fast in the group receiving a 15-gram collagen hydrolysate supplement three times daily for 8 weeks.

Because 3 out of 4 wound healing steps use collagen, physicians use the protein to treat burn victims.

Skin Health

Sarah also tells the audience that there is a lot of research backing collagen, gelatin, and bone broth as essential for skin health. 

She adds that orally taken collagen has shown a lot of success for skin health. However, the science behind topically applied collagen is not quite there yet. 

The dry weight of young, healthy skin is at least 75% collagen, but this decreases as we age. 

One study measured a 68% decrease in type 1 procollagen in the skin of people over 80 years old compared to people between the ages of 18 and 29!

Numerous studies have shown that collagen peptide supplementation improves skin elasticity, reducing the appearance of fine lines and wrinkles.

A 2019 systematic review of eight studies showed that collagen hydrolysate supplementation at doses of 2.5 to 10 grams per day for 8 to 24 weeks showed measurable improvements in skin elasticity and moisture. 

It also showed decreases in fine lines and wrinkles. 

These benefits to visible signs of skin aging are attributable to increased collagen density in the skin and reduced collagen fragmentation.

Sarah believes it's important not to get too wrapped up in the vanity claims with collagen. She would rather focus on the improvements it can make to your body as a whole. 

Joint Health

The wearing down of joint cartilage in osteoarthritis causes inflexibility, pain, and stiffness of predominantly weight-bearing joints such as the knees, hips, and spine. 

Osteoarthritis is the most common form of arthritis. Autoimmune processes don't drive osteoarthritis, like other forms of arthritis. It also accounts for about 25% of primary care physician visits among the elderly. 

There’s accumulating evidence that collagen supplements can prevent and even reverse cartilage degradation in osteoarthritic patients. 

A study of people with mild to moderate knee osteoarthritis showed that 10 grams of collagen hydrolysate daily over 24 weeks significantly improved a measure of cartilage quality. At the same time, those receiving placebo saw a continued deterioration of cartilage. 

Collagen supplements may improve joint health in other contexts as well. 

A study in athletes with activity-related joint pain showed that 10 grams daily of collagen hydrolysate for 24 weeks substantially reduced joint pain- including at rest, standing, walking, carrying objects, and lifting. 

And in another study of general joint pain, patients receiving 1.2 grams daily of collagen hydrolysate were more likely to respond to treatments over 6 months.

Muscles

Loss of muscle mass as we age, called sarcopenia, is a major cause of functional decline and loss of independence in older adults. 

A study of elderly sarcopenic men compared the effects on muscle mass from lifting weights three times per week with or without taking 15 grams daily of collagen peptides for 3 months.

The group taking collagen gained significantly more muscle (an average gain of 4.2kg compared to 2.9kg) and lost more fat (an average loss of 5.4kg versus 3.4kg).

A similar study performed in postmenopausal women showed the collagen peptide group gaining 1.8% fat-free mass (and loss of fat mass) compared to 0.9% in the placebo group. 

Young, healthy men can benefit from collagen supplementation too.

One study in young sports students showed that those that took a 15-gram collagen peptide supplement increased muscle mass and strength more than placebo after 12-weeks of strength training. 

And a study of recreationally-active young men also showed similar results, with the addition of collagen peptides increasing the effectiveness of strength training over 3 months. 

A different a study looking at vitamin C-enriched gelatin, with either 5 grams or 15 grams of gelatin, as a pre-workout supplement in healthy young men, showed a dose-dependent increase in collagen synthesis in their blood an hour after exercise compared to placebo. This may help to prevent musculoskeletal injuries.

Bones

Collagen provides the scaffold for bone mineralization, so it’s no surprise that loss of collagen is associated with osteopenia and osteoporosis. 

In one study of postmenopausal women taking 5 grams of collagen peptides for a year, bone mineral density of both the spine and femoral neck increased significantly compared to the placebo group. 

Another study of a combined supplementation of elemental calcium, vitamin D and 5 grams of a collagen-calcium chelate for a year in osteopenic postmenopausal women, the collagen-containing supplement resulted in much less bone mineral density loss than the group receiving just calcium and vitamin D, with concurrent reduction in bloodborne markers of bone breakdown.

Two mechanisms explain the above benefits of collagen supplements: 

  1. collagen supplies the specific amino acid building blocks for all of our body’s collagen proteins; and 
  2. bioactive peptides produced when we digest collagen (most notably prolyl‐hydroxyproline, but some larger peptides) upregulate the synthesis of extracellular matrix proteins in various tissues (such as by increasing growth of fibroblasts and synthesis of hyaluronic acid).

Food Collagen vs. Supplement Collagen

Sarah explains that to get the benefits of collagen, there is not a difference between food sources and supplementation in terms of health.

Consuming Collagen, Gelatin, and Bone Broth

She also explains how collagen can even aid in absorbing minerals like Vitamin D and Calcium and potentially fighting cardiovascular disease.

Sarah recommends eating foods like bone broth and other organs or foods with a lot of connective tissue such as pot roast or eating off a joint.

Collagen‐rich foods include offal, skin, joints (trotters, duck feet, chicken wings, etc.), any meat that you eat off the bone, and connective-tissue-rich cuts like cheek, jowl, and chuck roasts.

She explains that many of these foods have fallen out of favor in western culture over the last few decades. 

Collagen is an important supplement to take because it adds a nutrient back into our diet that we're not getting on our own. 

When we consume collagen, it's broken down, and the individual amino acids are absorbed directly by our digestive system.

Stacy jokes that when she prepares high-collagen, she aims for that high quality "jiggle" her kids often find kind of gross.

She revisits her previous point about collagen coming from a solid source. When it gets into the not-quite-a-liquid-or-solid state, it's starting to get back to its original form. 

Sarah digresses a moment to talk about the science behind the gelatinous process and its relation to bone broth and other denatured food products. 

She explains that the longer a broth simmers, the richer in collagen it ends up.

A 2019 study showed that long-simmered homemade bone broths (especially using the most collagen-rich tissues like beef marrow bones, chicken feet, or fish heads) can deliver up to 20 grams of collagen protein in one cup of broth.

Stacy invites viewers to check out a previous episode where she and Sarah discussed four day broth!

Collagen, Gelatin, and Bone Broth Digestibility

She takes a minute to clarify myths regarding how digestible raw collagen is versus denatured and other forms.

She breaks down a study performed on a group of people given different collagen supplements. The digestion of each type was measured and compared.

Stacy explains that is why people start with bone broth when they start an elimination diet.

She adds that this is due in part to the over 98% digestibility of bone broth.
Stacy compares this to vegan diets and explains that fruits and vegetables' digestibility, especially raw, is a lot lower.

Sarah breaks down the different degrees our bodies absorb plant and animal proteins from most to least digestible: fish protein, land animal, followed distantly by plant proteins.

She also explains that these levels vary greatly from one to the next and explains a little bit about how and why that works.

Sarah also breaks down how scientists measure how much the body absorbs of each type. She attributes these differences to varying incompatibility of each structure.

Non-Food Sources of Collagen

Stacy suggests they dive into some non-food sources of collagen. (49:49)

Sarah agrees, expressing the creation of supplemental collagen is the place to start.

She recaps how boiling a collagen-rich food denatures the collagen, breaks apart the molecules apart, and then dissolves them into water. This then turns into gelatin. 

Sarah also explains that gelatin was actually a form of glue in ancient Rome. And up until the late 1800s, gelatins were made as fancy dishes and were basically a form of super-rich broth.

However, the product's process in the factory would not allow for the "USDA Organic" label.

Sarah explains that this process is optimized to extract the most gelatin possible. And in this optimization, there has been (in some cases) the introduction of some harsher chemicals in the process.

She also says how surprising it is that it's not possible to find organic gelatin, even though we do have organic meat and enough organic raw materials to make organic gelatin.

However, the process that the product has to go through in the factory would not allow for the "USDA Organic" label.

Legitimacy of Market Claims

Stacy agrees that she also find that all very interesting. Primarily how there are so many different processes in making it. (55:20)

When she first discovered a branch she was using had introduced changes in its ingredients, it started a whole mindset for backing up a little bit and looking deeper into non-disclosed ingredients.

For example, she uses similar industrial acids to make bone broth from different kinds of vinegar and citrus juices.

Stacy also tells listeners she and Sarah will talk about ingredients found on labels. But manufacturers don't disclose the ingredients Sarah described on a label.

This is because it's involved in the "bones" of the product. This is just the base to get to the gelatin, and they aren't at the collagen peptide stage yet.

Stacy explains that they've only covered the process for gelatin, which is something that solidifies as it cools. Getting something like this to dissolve into something else requires the solvent to be hot.

If you're looking for something to add to a cold beverage, it takes even more steps to get to a collagen peptide.

Brand Transparency

Stacy reiterates a takeaway so far is the idea that not all are created equal.

That is why she and Sarah asked Paleovalley to sponsor this show because it's a brand that Sarah has vetted and looked into quite extensively.

She also jokes she's a little heartbroken that they don't carry a collagen peptide. But she assures listeners Sarah will explain a little bit more on why about that later on in the show.

Stacy also reiterates for listeners that the ingredients you may want to be avoiding most, like harsher chemicals, are not going to be listed on the tables as an ingredient.

Stacy explains that she personally went out to a brand to ask these types of questions because there's absolutely no way of knowing otherwise.

She also expresses how unfortunate it is that that's how the system works regarding what manufacturers disclose and not disclose.

But that's why she and Sarah want listeners to understand the process and understand what to look for, ask about, and all that kind of stuff.

Sarah shares she's done similar things with brands, even to the point of having to sign an NDA (Non-Disclosure Agreement) to get the answers to her questions.

Sarah hopes to alert listeners that some products marketed to our community take advantage of our health-consciousness and goals to sell us products without the transparency we deserve.

Collagen Peptides

Moving into the topic of collagen peptides, Sarah reiterates Sarah's point that gelatin becomes a solid as it cools. 

The benefit of collagen peptides as a supplement, compared to gelatin or bone broth protein, is that it dissolves in cold water. 

It does that because it goes through an additional step, where the gelatin is mixed with enzymes that "predigest" the collagen.

The most common enemies used are papain, alcalase, α-chymotrypsin, pepsin, trypsin, collagenase, and bromelain. And they are all enzymes commonly found in our bodies.

Sometimes enzymes are added concurrently with acid treatment. The most common combination is acetic acid and pepsin. The length of this process depends on the proprietary enzyme mix used. 

Sarah mentions that it can be very difficult to get information on what specific brands use during this process.

After enzymatic hydrolysis, the same filtering, concentrating, drying, and grinding as with gelatin takes place.

Sarah thinks it's helpful to understand that there is a wide range of different processes. They are not all-concerning.

This 2019 review paper has a very good summary of the various manufacturing processes used to make collagen peptides.

She also explains that the only advantage of collagen peptides than a food source is the ability to stir it into cold water.

The tradeoff is an opaquing process in manufacturing not listed on the label. 

All the research Sarah has done into these processes has been enough to convince her to switch gears.

Stacy explains it's super difficult to look at this information and know how much she's come to love collagen in her coffee. 

After researching and changing brands, she still feels good. So for her, there are more things to consider, including other additives. 

Marine vs Bovine Collagen

Stacy explains that "Marine Collagen" is just another way to say collagen taken from fish. (1:03:46)

Sarah explains that you can use different source materials to make collagen supplements. The big difference is the little bit of a shift you'll see in amino acids.

Marine collagen typically uses fish scales. Marketers claim it has more glycine, but it depends on the exact source and varies from brand to brand.

  • One major brand's marine collagen is 24.1% glycine, whereas their bovine hide collagen is 20.7%. 
  • Another major brand's marine collagen is 22.7% glycine, whereas their bovine hide collagen is 23.3%. 

Sarah reminds listeners that there is no "rule" that marine collagen is way better. It is mostly up to your specific needs.

Sarah also cautions listeners that having an allergy to the source material can still cause a reaction to the supplement.

One reason to choose marine collagen is an allergy to beef or pork, but not to fish. And this is true the other way around as well. 

Marine and bovine collagen are similar in terms of sustainability.

The Truth About Multi-Collagen Supplements

Multi-collagen supplements typically include several hydrolyzed collagens from various sources. This includes bovine or porcine hide, egg membrane collagen, hydrolyzed fish collagen, and bone broth protein.

Sarah explains that you're paying for all these fancy ingredients with these multi-collagen supplements that your body digests around 99% the same.

Scientific studies have not identified any special bioactive peptides in more expensive collagen hydrolysate ingredients found in multi-collagen supplements to justify the increased expense.

Because the body so readily digests collagen, your body mostly absorbs the constituent amino acids.

She adds that no science shows collagen from one source acts any different from collagen from another source when you consume it, with few exceptions when it comes to types.

Some whole food sources of collagen can contain added benefits. For example, type 2 collagen can also be rich in glucosamine chondroitin, a nutrient well-established to support joint health.

Sarah makes it a point to be clear that the benefit of these supplements is the additional molecules in those tissues and not the different types of collagen itself.

Importantly, there is no one-to-one correspondence between the type of collagen consumed and the type of collagen your body makes.

Bone Broth Protein

This protein comes from dehydrated bone broth.

Sarah cautions listeners to look if a label says that a bone broth protein has been hydrolyzed. This is just a sneaky way to say it went through that enzyme hydrolysis step.

Basically, they make bone broth and then do the industrial enzymes step to dissolve in cold water.

However, if the label says simply bone broth protein or bone broth collagen, you have the least processed option for a collagen supplement! Congratulations!

Digestibility Myths

Brands often market collagen hydrolysate and collagen peptides as easier to digest and absorb than gelatin or bone broth protein.

While this makes sense on the surface (they're predigested with enzymes after all), this is a myth.

When proteins have high compatibility with our digestive processes, they tend to be close to completely broken down. They are absorbed before reaching the large intestine.

Digestibility is measured by looking at the difference between the number of amino acids in the ingested protein versus the amount of amino acids recoverable from the "other" end.

Raw Collagen

It’s true that native (raw) collagen is insoluble and, therefore, not quite digestible by our pancreatic enzymes as some other protein sources. 

  • One rat study from the 1980s compared the digestibility (with or without suppressing stomach acid) of native collagen and gelatin compared to meat, with whole egg as the 100% digestible standard. 
  • After stomach acid suppression, native collagen was only 71% digestible; but with stomach acid added, its digestibility increased to 95%. 
  • On the other hand, gelatin was equally digestible with or without stomach acid, and its calculated true digestibility was 98.8%. 
  • For reference, the digestibility of meat in this study was 97.1%. 
  • Other studies (like this one) show similar results: unless we’re gnawing on raw chicken wings and taking huge doses of antacids, collagen and gelatin are highly digestible proteins. 
  • That means that collagen peptides do not possess a digestibility advantage over gelatin or bone broth protein.

Gelatin vs. Peptides

Sarah also states that there doesn’t seem to be a big difference in how gelatin versus collagen peptides stimulate collagen synthesis once consumed. 

  • In one study, healthy young men received a placebo, a supplement containing 15 grams of gelatin, a supplement containing 15 grams of hydrolyzed collagen, or a supplement containing 7.5 grams each of gelatin and hydrolyzed collagen. 
  • An hour after consuming the collagen, participants jumped rope for 6 minutes to stimulate endogenous collagen synthesis. 
  • Four hours later, researchers drew blood and looked for markers of collagen synthesis to measure. 
  • The study revealed no significant difference between the collagen-derived amino acids circulating in the blood between the three different collagen supplements.
  • Although all showed results substantially higher than placebo. 
  • And, circulating procollagen was 20% higher after gelatin or hydrolyzed collagen compared to placebo. 
  • So, from a supporting-collagen-synthesis-in-our-bodies perspective, gelatin and hydrolyzed collagen perform equally well.

Question Listeners Should Ask

Stacy takes a second to go back and add that another reason someone might choose bovine vs. marine collagen is anyone trying to stay kosher. (1:12:06)

She also adds he the bone broth protein available through Paleovalley is beef and not pork. 

Sarah encourages anyone wondering where the collagen they use comes from to email the brand and ask. 

She expresses how underwhelmed she's been with FAQ lately. She also says these are not the type of questions you'll find just by poking around. 

  1. Are there solvents, or other chemicals, used to wash the hides (or other source materials)? If so, which ones?
  2. Are the hides treated with acid or alkaline during any step, and if so, which ones? 
  3. What agent neutralizes the product if treated with acid or alkaline?
  4. Are there carrier molecules or manufacturing aids used in the drying process, and if so, which ones?
  5. Is the finished product third-party tested for contaminants?

Sarah talks a little bit about third-party testing. And that's the type of transparency companies show. That they are ensuring every batch is at the same level of quality they are known for. 

One recent ConsumerLab.com test of 14 popular collagen supplements contained high levels of the heavy metal cadmium.

Stacy shares that with the brand that she reached out to, the company owner went back to validate with his manufacturer. 

She adds that companies often source their ingredients from elsewhere or off-label, and the answers to these questions aren't on any FAQ list. 

Reading Labels & Icky Ingredients

Stacy encourages listeners always to read their labels. Even if you find one you like, and you buy it regularly, you need to check the label.

Both Stacy and Sarah have been surprised at brands changing their ingredients as of late.

Often brands won't even change their labels, so it can be very difficult to realize something is different until you start to feel crappy.

Stacy also explains that many brands market things as "protein powders," which means It's not pure collagen protein but many other additives.

Stacy knows this can be exhausting and frustrating. That's why she and Sarah spent months researching for this show and talking to brands.

It's also why they feel confident in partnering with Paleovalley on this topic because they know their intent and their brand decisions in the event they make a change.

Don't Be Afraid To Ask

Stacy encourages listeners when looking at brands to ask if they are committed to a certain type of decision for a reason, or would they be likely to change to save a little money?

She knows that the larger a brand gets, the more they have to find ways to cut costs. It's a capitalist market, and she's not shining any hate on that.

Stacy feels that as a consumer if you're putting something in your coffee every morning for your health, she doesn't want additives she doesn't want in her body.

Sarah revisits a list of common ingredients she and Stacy have cautioned listeners against in the past.

Stacy reminds listeners, and she is all about keeping it simple and helping your body just be the best that it can be.

She adds the last thing she wants to do is sell you on needing 47 different things to be well.

You can add just add collagen, bone broth protein, and gelatin to things in your home if what you want is just a workout beverage. You can do that yourself.

Where Stacy Has Landed With This

Stacy cannot let go of Collagen Peptides in her coffee. She says maybe it's something she'll try weaning herself off of, but for now, it's staying. 

She has changed brands and but still uses Paleovalley elsewhere, like smoothies.

Stacy asked the questions mentioned earlier to a brand that listed clean ingredients for their peptide proteins that didn't have all the additives listed in many brands. 

If you're interested in checking them out, visit this equipfoods.com link. Using "STACY" at checkout gets you 15% off!

Even though she isn't switching, Stacy does recommend listeners try Paleovalley's bone broth protein in their foods to see if they like it. She just can't envision her coffee without Collagen Peptides.

Sarah tries to make a pitch to Stacy. She says that the Paleovalley bone broth protein has very little flavor and was skeptical. 

She was super surprised she couldn't taste it in her coffee at all. Sarah also says that because it's not as broken down as peptides, it does foam a little more. 

With winter coming, she's getting back into the habit of a mug of homemade broth as well. She encourages listeners to put bone broth protein in a mug of broth.

Where Sarah Has Landed With This

Sarah completely switched to Paleovalley 100% Grass-fed Bone Broth Protein.

This is because it comes from slow-simmering 100% grass-fed beef bones in filtered water, just like she would at home.

Then it's gently powdered with no additives and never treated with chemicals or high-heat, and it's third-party tested for contaminants. 

Sarah also states that she has not seen a higher-quality source of collagen on the market. 

She adds Paleovalley Bone Broth Protein to her morning coffee.

Sarah does tell viewers it's better stirred in rather than blended since it tends to foam a lot if blended. She also adds it to soups, stews, stir-fries, and even baking. 

It has very little flavor, so she says she can't taste it at all in my coffee. You can turn it into a warm cup of broth by mixing it into hot water and adding salt to taste.

There's also a huge advantage of consuming bone broth protein rather than homemade bone broth: concentration and consistency. 

Incidentally, the most concentrated broths in the study were those made with beef marrow bones simmered for 72 hours. The addition of vinegar has a negligible effect on amino acid extraction. 

These broths delivered close to parity amounts of collagen protein in a one-cup serving. Good news for our favorite traditional healing food! 

On the other hand, bone broth protein is standardized and concentrated, so you know you're getting the right dose every time!

She still uses homemade bone broth for soups, stews, and other recipes that call for broth. But She chooses Paleovalley Bone Broth Protein for her daily collagen supplement.

How Much Collagen to Take

Stacy shares that she isn't really one for paying attention to how much collagen she consumes. So she asks Sarah, "How much is too much and does it count?" (1:37:27)

Sarah tells her that, yes, it does count.

Most studies showing benefit of collagen supplementation, whether gelatin or collagen hydrolysate, used doses between 10 and 20 grams daily.

However, you can consume quite a lot more than that without jeopardizing your diet's amino acid balance as a whole. 

Collagen is an incomplete protein that is completely lacking in the essential amino acid tryptophan, so it has a PDCAAS of zero even though it's highly (98.8%) digestible.

Researchers have used iterative PDCAAS calculations to show that collagen peptides can make up to 36% of our dietary protein. This is while still ensuring they meet indispensable amino acid requirements.

That means that if you're aiming for 150 grams of protein daily, you can safely get a little over 50 grams of that from collagen! For reference, that's three heaping scoops of Paleovalley 100% Grass-Fed Bone Broth Protein.

Final Thoughts

Stacy also adds that paleovalley beef sticks are LEGIT! Her kids ate them immediately and then asked when she was ordering more. She highly recommends listeners grab them if they can!

Sarah adds that their turkey sticks are AIP too! And so good! And they have encapsulated organ meat that includes liver, heart, and kidney!

To sum up, Sarah and Stacy really recommend checking out Paleovalley and all their amazing products. You can follow this link to the website to automatically get the 15% off deal or use the coupon code "thewholeview15" at checkout.

Both Stacy and Sarah share that they share information with you very seriously and are nothing but open and honest.

Stacy reminds listeners that they are even more open and honest over on their Patreon channel, where you can hear even more of their unfiltered thoughts.

Big thanks to Paleovalley for sponsoring this amazing show. Thank you so much for listening, and we will see you next time!

Welcome back to episode 429 of the Whole View. (0:27)

Stacy informs listeners that this show was supposed to be an information-dense show.

However, due to a three-day power outage in Sarah's area, she could not complete the research to do the planned topic a justice.

Stacy expresses how she's heard stories from so many others about experiencing record-breaking numbers of storms.

She is concerned about the increasing intensity of these storms and other instances of climate change.

She and Sarah both live on the east coast. But she talks about the concerns she's had for the record-breaking fires on the west coast this year.

Stacy wants to emphasize that even if you've not been impacted by inclement weather, it could happen.

She shares how her neighborhood lost power for six days earlier this year.

She and Sarah joke about how stressful that can be when you have a freezer full of organic grass-fed meat!

Navigating The Storm

Stacy suggests they talk about how Sarah managed without power. She hopes that it can help listeners develop their own strategies for dealing with a natural disaster.

Stacy also shares how helpful her gas generator has been.

She also suggests anyone with the means to get one should look into purchasing one for themselves.

Sarah shares that one of her biggest struggles was her compulsive love of planning ahead.

She shares that there are still many people who were affected by this storm are still without power.

Sarah expresses how concerned she is about the increasing severity and frequency of the storms she's seen due to climate change.

She also shares how fortunate she was compared to some.

Tips And Strategies Sarah Used

Her camping gear was something she's the most grateful for having.

Items like chargeable flashlights and a portable cookstove came in so handy. It allowed them to cook hot meals.

She also shares that her portable batteries were all thankfully fully charged when the power went out.

Once the cell tower was back up and functioning, they could still use their phones.

Sarah thinks back to when she was a kid, and the power went out.

She remembers how the only way to find anything out was by talking to neighbors. And they went back to that practice.

Sarah shares how it turned out to be a wonderful community experience she's very grateful for.

She jokes how impressed she was with the candle collection she didn't realize she had. She was surprised by how much she impulse buys candles and didn't know it.

Family Time

She was also grateful for the time she spent coming up with things to do as a family.

With spending so much time at home during the pandemic, they really tried to brainstorm new things they could do that really stand out.

She felt like having no power made her feel even more isolated.

So having "practiced" family time was helpful. They played a lot of board games by candlelight and spent a lot of time together in one room.

Her neighborhood really came together when it came to clearing debris in their yards as well as others'.

She is super grateful to live in such an amazing community.

Increasing Storms Due to Climate Change: Advice For The Future

Another thing that's been on Sarah's mind is what she wishes she had. For example, a generator jumped to the top of her list.

She expresses how losing so much food hurt her feelings.

Stacy shares that she and her family bought a cooler for a road trip she swears by.

It plugs into your car and has been very helpful as a portable mini-fridge. If you're interested in checking out the product, you can find it here.

Sarah shares living as far inland as they do, she's never experienced a storm this bad.

She feels that she had grown a little bit too comfortable and wasn't really prepared for an experience like they had.

The Impact of Climate Change

Sarah talks about a previous episode she and Stacy did about sustainability and Mother Earth. And how it impacted her frame of mind during this experience.

2020 has just been so many things one after another, and it caused her to put her blinders on a little bit.

The experience of losing power for so long helped her see that she might have had those blinders on a little bit too tightly.

It allowed her to focus on what she can do to help control her effect on the environment. 20:10

These things happen, and it feels frustrating not just for the experiences you had but also for how our country and the world treat our planet.

Stacy references the practice of showering daily. how there are organisms on us that are actually good for us and don't need to be removed every day.

Even though we can't always control our culture, she asks why we have to put everything we buy in plastic.

For example, what is the point of putting a banana in a Styrofoam container and then wrapping it in plastic when the fruit itself comes in its own natural container?

What We Can Do To Help Climate Change

It's not just about you switching from plastic to renewable sources but changing our mindsets and habits.

Stacy digresses a moment to say that if you're still using disposable face masks for Covid-19 protection, she highly recommends switching to cotton ones.

Sarah says that not only is it better for the environment, but multiple layers of cotton is actually better for you and your health.

Sarah also takes a minute to shout out to her mother, who has done wonders for making homemade masks for her family.

She encourages listeners to look into buying masks from independent sellers, such as those on Etsy.

It supports people trying to make a living through this pandemic, and supporting small businesses is always a great practice.

Final Thoughts

Stacy hopes that this episode has helped listeners think about disaster plans that could help prepare them.

She says something as simple as a car hitting a telephone pole can cause you to be without power for any length of time.

It can happen anytime, anywhere. Tips like camping gear and other things are great ways to stay prepared.

Stacy reminds listeners that thinking ahead is crucial. When something happens, a lot of people have the same ideas, such as going out to get a generator or a propane take.

This means that when you need something, it might not be available to you, and you're forced to go without.

Sarah says that by the time they were to the point of considering getting a propane tank, there were none left. The same thing happened with bags of ice to preserve some of their perishables.

She explains that having icepacks already in the freezer, they could have something to put in the cooler to keep things like medication that needs to be refrigerator cool.

Sarah also shares that there were many complications that she hopes she won't have to deal with next time something like this happens— for example, going to a restaurant for dinner due to not having the power to make their own.

Stacy suggest making a list of the things you can prepare for, as well as the thing you feel like you can potentially make changes to your impact on climate change.

Stacy thanks listeners for joining them in this episode to catch up.

She also assures the audience that they have a spectacular show lined up that Sarah needs just a little more time to research.

Thank you so much for listening and join us next time!

The Whole View, Episode 428: Quarantine Holidays

Welcome back to episode 427 of the Whole View. (0:30)

Stacy welcomes everyone to the holiday season. And reminds us that the holidays may look a little different this year.

She goes on to say that this top has been at the top of her family's mind.

She wanted to make sure that they share with listeners some of the ideas they're talking about for this quarantine holiday season.

Stacy reminds listeners that everything in life is all about mindset. If you approach this as an opportunity for new traditions to carry forward, it can keep the holidays' magic from being completely squelched.

She jokes one way to do this is to start celebrating sooner and shares she plans to put her tree up next week!

She shares she is looking at this as an opportunity to add to traditions her family already has instead of focusing on what she may be missing out on.

Stacy then reminds us that we're definitely not going to feel good about it if we go in with a negative mindset.

Sarah loves the idea of using this as an excuse to extend the festivities (at home).

She shares a story of a neighbor who has Halloween decorations of skeletons dressed up as pirates in their front yard. But for eight days, she was convinced these skeletons were dressed up as Santa-elves.

She has now decided that blending Halloween and Christmas decorations is the most brilliant idea ever.

Stacy takes a moment to make a shout out to anyone listening in from Canada and hopes that you had an amazing Thanksgiving.

She apologizes for the off timing, seeing as both she and Sarah celebrate in the US.

Butcher Box

Stacy takes a minute before jumping into this week's topic to make listeners aware that Butcher Box is offering a free turkey this year.

She lets listeners know that they are not sponsoring this show. But she feels it's such a great deal she wants the audience to know out it.

If you sign up before November 15th, you can add a 10-14 lb, free-range turkey to your box.

You can visit Butcher Box for more info!

Stacy and Sarah have both taken advantage of many different grocery box services, such as Thrive Market and Hungry Harvest.

Stacy adds that it's a great way to limit exposure within our communities as we continue to see increasing levels of Covid cases (which is higher than it's ever been).

Sarah warns listeners that this means is the "height" of the pandemic hasn't actually happened yet.

Stacy thanks Sarah for that dark moment.

Stacy adds that just because we are all "over it," it doesn't mean the danger is over.

She confides that she is very concerned for everyone's loved ones going into this winter gathering season.

Stacy encourages listeners to review and follow the CDC recommended guidelines as they plan their holiday festivities. And to pay attention to any additional guidelines in their specific areas.

She also reminds the audience that she and Sarah are not experts. They are merely sharing what they and their families have decided to do, based on the guidelines that apply.

 

Halloween: Quarantine Holidays

Sarah takes a moment to say how the traditions we're used to doing, like costume and office parties, aren't very safe this year. (10:53)

So she feels it's important to talk about what we can still celebrate.

Stacy shares that Halloween is her favorite holiday. And she admits that they have done very little to celebrate this year because she's been a little upset "normal Halloween" isn't happening.

Every year, she holds a costume party, which is how she's met a lot of fellow paleo-people and made a lot of great friendships and connections.

Stacy's Alternatives

Not having this tradition this year left Stacy a little heartbroken. (12:50)

But after a little research, she decided that this year, their tradition would be working through a "Halloween Movie Watchlist" with her boys, now that they're old enough.

Stacy assures Sarah that not all of the movies are super-scary-horror movies. And that there are many "campy" and fun alternatives.

She also jokes that there are some traditional horror films on that list that she will not be watching, leaving Matt and her oldest son to check off the list for them.

Stacy also shares that she will be starting "You've Been Boo'd" today now that she's fully prepared for which neighbors she's decided to "Boo."

Sarah shares a similar experience when he first moved into her house, where someone left a treat on her doorstep, rang the doorbell, and ran away.

Stacy explains to listeners that it's a pay-it-forward game and is a fun, low-contact way to interact with others.

She also talks about holding a Halloween Scavenger Hunt or a Candy Hunt to get the kids outside and moving around.

She also recommends checking out virtual alternatives for parties and contests.

Stacy also mentions that you very well may love a new idea you try out and want to continue it in future years as well.

You can refer to Stacy's post for more ideas for alternative Halloween activities.

 

Staying on Track During the Quarantine Holidays

Stacy mentions that as we get closer to November, that's where we start to move away from the "fun for the kids" holidays and into gathering seasons with Thanksgiving and Christmas. (21:49)

She adds that this is when we're going to be drawn comfort food while in quarantine.

It becomes even harder to not give in to all that comfort food when we're not feeling our best or getting enough sleep.

Stacy adds that making healthier choices is easier this year since there won't be as much pressure from family or work parties.

If you don't make it or buy it, it's not in your house.

Stacy suggests that whatever it is you want this year, come up with the plan now.

You don't need to wait until New Year to make a resolution. And that you can decide what your holiday season will look like this year.

Stacy shares that her mental health is very tied to physical activity, and that is why she started going on her daily walk.

Her other workout methods weren't doing enough for her. Plus, autumn is her favorite month!

So she decided to go out and find new paths through the neighborhood she doesn't normally go down.

Sarah shares that she also walks for about an hour every morning, rain, or shine.

She shares the secret to this habit is her high-energy dog is only well-behaved if she gets that long walk every morning.

Sarah also has realized some of the inclement weather walks she's been on this summer have been (surprisingly) her most fun walks.

 

The Importance of Mental Health

Stacy tells us that sometimes self-love doesn't feel great in what we're telling ourselves we need to do, but we feel so much better after. (32:14)

For Stacy, physical activity is definitely an act of self-care and self-love because she feels so much better after.

She adds getting more sleep and giving herself a break to her acts of self-care list.

Stacy reminds listeners that beating yourself up when your to-do list starts to slide. Telling yourself negative things isn't helping anything.

It's important to remember this going into this holiday season because it is statistically one of the worst mental-health seasons.

Adding the added stress of a global pandemic isn't doing to make anything any easier.

She shares a quote that's stuck with her:

"Whoever needs to hear this right now, you're staying home, and self-isolating might have saved a life. You don't know that, and you can't point to it, but you are worth congratulating yourself for making that sacrifice for others."

Stacy reminds you that even when something goes unplanned, to give yourself a break and move forward.

 

Practicing Gratitude

Stacy also admits, thanks to Sarah, she's gotten back into gratitude. She jokes that she refuses to call it meditation, however.

Sarah shares that her almost-eleven-year-old is the one that struggles the most with the physical isolation of Coronavirus.

They have worked really hard to schedule video calls and such to try and help with feeling connected.

Her daughter is also very empathetic towards what's going on in the world and with others.

Sarah shared they often practice gratitude to help alleviate some of the stress the pandemic causes.

She cites equal-footed boding with their new puppy is one highlight of being stuck at home.

She goes on to say that this doesn't mean they don't get frustrated. It's all about acknowledging the challenges and that we're not alone in facing them.

 

Connecting Virtually

Stacy points out that we do a lot of connecting through social media and phone calls. But that's not really the same as a face-to-face connection. (41:20) 

She reminds us that as we go into this quarantine holiday season, we need to get better at continuing to connect with others without the aspect of physical touch fully.

Stacy says that it's going to be different from the first few months we were doing this because our body and minds are tired.

We have to make calculated and intentional decisions for how we make those connections with others.

 

Sarah's Quarantine Holidays

Sarah's Quarantine Holiday Plans

Stacy hands it over to Sarah to share what she's planning for her holidays. (42:43)

Sarah's family decided to celebrate Canadian Thanksgiving this year. They are considering celebrating both this year.

She loves that the holiday revolves around spending time and being thankful. It doesn't have a lot of the stress associated with other holidays.

Plus, she loves cooking.

She shares that they had a freezer malfunction, which caused their turkey to thaw.

So they decided to celebrate with all their Canadian relatives this year and eat the now-thawed turkey.

Sarah also tells the audience that her mother has been doing these "Zoom dinner parties" where they cook the same meal and then eat together over Zoom each week.

She shares that due to most of her family still being in Canada, they've gotten pretty used to the separation over the last 15 years.

Sarah has loved how much time they've been able to spend virtually with her family long-distance. And they plan to continue doing so in the future as well.

Stacy expresses how much she loves the idea of making the same meal and have a "dinner party" over a video call.

 

Stacy's Quarantine Holidays

This Thanksgiving is Stacy's mother's 60th birthday. And that for her father's 60th, the family had gone on a European cruise.

So her mother was hoping for a celebration that was also a big deal.

Stacy still wants to do something special for her mother, since her big deal party won't be happening as she'd hoped.

Stacy lives near a bunch of state parks where you can rent cabins.

They're planning to have each family rent their own, cook Thanksgiving dinner, and then figure out a way to be together outside to celebrate the quarantine holidays.

She lets the audience know that they are keeping an eye on the situation and the CDC guidelines.

They are also playing with ideas of isolating beforehand and planning the smartest way to be together.

She also expresses that it's all up in the air and may not happen the way they want it to at all.

Stacy circles back to how important it is to be kind to yourself. If your intuition is telling you something isn't right, listen to your gut.

She also says she's constantly thinking of the worst-case scenario if one of them catches it at a store. And who they could potentially spread it to.

Stacy reminds the audience that you have to do the best with what you know.

 

Covid Reminders for the Quarantine Holidays

Sarah shares that she knows people who have had everyone tested before a gathering. They are also self-isolating before hand.

She also reminds listeners of proper masks to buy and wear. And best practices outside of masks that we should all be doing.

Sarah also explains that there is an ebb and flow to covid cases. Some days consistently show more cases due to when people go in for testing.

She says not to just look at today's numbers. But to look at the seven-day reports and compare those numbers to get an accurate view.

Stacy reiterates how important it is to be safe when forming a "pod."

And that infection can happen when we're not expecting it.

She says that she thinks people are learning since we've been doing this for a while.

But she does underline that it's important to plan to set yourself up for success and safety.

Stacy tells listeners that to have successful quarantine holidays, you will have to think outside the box, keep it virtual, and/or keep it small.

She also expresses how much she likes the idea of small gatherings for quarantine holidays because of their intimacy.

Stacy believes the most important thing is to keep an open and positive mindset. And that creating new fun traditions isn't necessarily a bad thing.

 

New Year's in Quarantine

Stacy expresses how fed up she is with the idea of gaining the "quarantine 15." (1:02:01)

Sarah reminds readers of a prior episode, where they talked about how damaging the stigma of being overweight is to mental health.

She says to expect so much media attention, posts, and stories about the

"Quarantine 15" and that all it does is add to the shame and guilt and feelings of inadequacy.

None of us are living our "normal" lives, and that is reflected in our bodies.

Sarah says that she refuses to allow someone else's perception of how she should be managing her life during a pandemic to make her feel shame about her body. That is not okay.

She will not be trying to lose the quarantine 15 after the quarantine holidays.

When it comes to achieving a healthy weight that centers on healthy choices, Sarah recommends habit resolutions are far more effective for success.

They also allow us to have a positive, self-care mindset. It always allows us the grace to figure out the give-and-take.

 

Final Thoughts

Stacy also warns against fake detoxes.

Stacy shares that one of her resolutions is to get more sleep. She also plans to be more active and work on other habits she'd like to improve.

She also reminds listeners that the clock strikes midnight in 2021 is not a miracle time.

She recommends not thinking all the problems associated with the global pandemic will magically end next year.

2021 will most likely be off to a rough start, and attributing everything bad to 2020 is just setting up for disappointment.

Sarah talks more about the pitfalls of resolutions that may result in biting off more than we can true.

She encourages thinking about manageable steps and progression and making sure we're setting ourselves up for success.

Sarah also says it's important to focus on being able to do the best we can in the situation we're in and give ourselves the grace to not be perfect.

There is not going to be such a thing as perfect for the holidays- this year or next year.

Stacy thanks listeners for sticking with them through 2020.

She hopes that she and Sarah have helped set you on a positive personal path to approach each of the major quarantine holidays coming up.

Stacy invites you to pop over to Patreon for their episode recap and their unfiltered thoughts.

She also reminds listeners of the Butcher Box deal for a free turkey to kick off your quarantine holidays.

Stacy thanks listeners for their support and love!

Thank you for listening!

The Whole View, Episode 427: The Link Between IBS and Osteoporosis

Welcome back to episode 427 of the Whole View. (0:34)

Stacy shares that she's the one who actually requested this topic.

Stacy says she has many people in her life with gut-related issues.

Yet she doesn't really know the difference between IBS, IBD, Crohn's, and Colitis.

She's not sure how she's gotten to this point. But she does know she needs to take a step forward in her knowledge base.

Stacy and Sarah talk about gut health on this show because of how important it is. 

And just like the universe, the knowledge on this is ever-expanding.

Stacy believes that this topic is foundational to understanding gut health.

Sarah shares she's been researching the gut microbiome for over six years.

When she decided to write a book about it, she thought it would be the same amount of information as in her other books.

However, she's found that it changed her perspective on literally everything she and Stacy talk about.

Sarah thinks she's finally at a place in her research where she finally has a handle on the vast amount of research there is out there.

 

Listener Question Regarding Osteoporosis

Sarah dives in with a listener question. (5:05)

"Sarah and Stacy- I am so inspired by your podcast. My husband and I have been listening for years. We binged them all initially, and now listen weekly while preparing dinners together. We have benefited greatly from your advice and recommended products. I have Sarah’s Paleo Approach and sleep books, we use our Joovv everyday, I switched us all to safer Beautycounter products from Stacy about two years ago. So thank you for making such a positive difference in our lives!

My mother was just diagnosed with full blown osteoporosis, notably in her right femur bone. Her bone test four years ago was healthy. My question is whether her struggles with IBS and gut health might have played a role in her diagnosis, and what could she do now to improve it?"

Stacy jokes about how much she loves nice, positive, complimentary questions.

She suggests that before they get into answering the question directly, they look at the root cause.

There is a reason that osteoporosis exists, and it's something they've discussed on previous shows, as well as nutrient deficiencies.

This inevitably leads to IBS and other issues, and how that plays into nutrient deficiencies.

Stacy suggests they back and talk a bit about those other gut-related issues first.

Sarah agrees that explaining the issue is a lot like a spiderweb.

 
It has many different threads coming out of the middle and linking many of the other conditions.
 

What Are The Differences?

Sarah goes back to Stacy's questions at the beginning of the show, regarding the differences between IBS, IBD, Crohn's, and ulcerative colitis. (7:53) 

IBD stands for Inflammatory Bowel Disease, while IBS stands for Irritable Bowel Syndrome.

Crohn's and ulcerative colitis are included under IBD.

What separates them is which part of the bowel is impacted by the autoimmune diseases.

Celiac disease is not characterized as an IBD due to its link with gluten as a trigger but is an autoimmune disease that causes inflammation in the bowel.

Sarah goes on to explain that IBS is a diagnosis of exclusion. It's the label given once all other bowel issues are tested for and ruled out.

Sarah expresses how frustrating IBS can be because it's such a catch-all.

You go in with an irritable gut, and when you test negative for all the things they can test for, they go, "congratulations, you have an irritable gut. 

Sarah shares her personal story of getting diagnosed with IBS-C.

It can be classified as diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), with alternating stool pattern (IBS-A). People can experience:

  • Abdominal pain, cramping, or discomfort
  • Gastrointestinal: change in bowel habits, constipation, diarrhea, inability to empty bowels, indigestion, nausea, passing excessive amounts of gas, or urgent need to defecate
  • Also common: anxiety, depression, discomfort, loss of appetite, or symptoms alleviated by defecation

Stacy asks Sarah whether the depression she spoke of could be caused directly by gut health issues or as a side effect of the symptoms' discomfort.

Sarah shares some of the research that emerged in recent years that points to possible causes.

 

Possible Causes of IBS

IBS might not be just one thing, but possibly a bunch of different things that all get a diagnosis of exclusion label. (16:40)

Sarah goes on to explain that the research in the last 10 years has pointed to two main possible causes that are probably closely related.

And are also a probable link to IBS and other health issues, including mental health.

Food Intolerance

Sarah says one of the most common factors causing IBS patients' symptoms is a food intolerance, with some studies reporting it in up to 89% of their patients.

Patients with IBS understand that specific types of food trigger their symptoms: usually.

These include legumes, vegetables, lactose-containing foods, fatty foods, stone fruits, and artificial sweeteners.

This includes food allergies and is studied via blood tests and trial and error removal.

Another way this is often studied and combated is by putting people on low FODMAP and gluten-free diets, which have shown greater even results.

Stacy takes a moment to underline the fact that there are medications out there that don't even have the 70% improvement rate that these dietary changes do.

Stacy wonders how many doctors are prescribing low FODMAP diets.

Sarah shares that she doesn't have those numbers, but she can say no one talked diet with her through her IBS experience.

Stacy shares when you struggle with these symptoms for so long, you don't really know what "normal" is. 

Often, doctors aren't given information and description that would prove helpful because nothing is out of the ordinary to the patient.

Sarah explains that the issue here is that IBS is kind of a useless diagnosis because there are so many shades of it. 24:57

Sarah thinks that one of the things adding to this percentage of success is that many people who see improvement by going on a low FODMAP diet have never tried changing their diets before that point.

She said that the reason so many people might be responding to a FODMAP diet is that they're eliminating wheat from their diets.

FODMAP intolerance is most typically caused by gut dysbiosis, which co-occurs (chicken vs egg) with stress, poor digestion, leaky gut.

Gut Dysbiosis

This growing body of literature shows that with IBS, there is a loss of bacterial diversity, the establishment of problematic and opportunistic pathogens-like species in the gut, a lack of probiotic species, and many other things we know are associated with health conditions in general. (26:24)

That kind of imbalance in the microbial community in the gut by itself can drive IBS symptoms but can also explain the reactions we see in dietary interventions.

About 60% of the inputs that determine what bacteria are growing in our digestive tract is diet.

And the other 40% is lifestyle, exposures (environmental toxins, supplements, drugs, hormones), stress, sleep, etc.

Sarah explains that the gut microbiome's composition can shift dramatically in just a few days or weeks, depending on what the "starting microbiome" looks like.

What happens in the gut microbiome when diet changes are made is it's finding a new equilibrium.

This eventually reaches stability in about six months.

Unknown vitamin deficiencies (such as Vitamin D), lifestyle factors, and heavy metal or pesticide exposure are also known to drive gut dysbiosis.

Sarah explains that this means you might have a gut-bacterial-profile that produces a lot more gas when you consume gluten or a FODMAP-rich food.

Sarah sums up that FODMAP intolerance is basically a measurement of gut dysbiosis.

 

The Unrealized Impact

Stacy shares how she's recently been seeing a lot of people talk about bloating as being "normal" right now. (30:38)

She believes that just because it's common doesn't mean it's normal.

And that seeing 75% of people having symptom reduction just from going gluten-free is brain exploding results.

Stacy thinks that there's a vast majority of people who aren't talking about it with their doctors, nor are they seeking out functional medicine practitioners and wholistic nutritionists to help.

Most people who are doing that are kind of already making dietary changes.

 

Gut Dysbiosis As An Indicator

Stacy tries to wrap her brain around how many people could be living happier lives, healthier lives, just by making this change. (32:18)

She explains that that's the really important part, and gets us back to the question at hand because it isn't just about discomfort.

This really can cause, especially long-term, serious health problems.

Sarah explains that though it's not the only indicator, you're not going to experience IBS if you have a completely healthy gut microbiome. It's just not something that happens.

The research actually links gut dysbiosis with every chronic illness. 

It's easy to think of it in terms of GI issues but is, in fact, linked to diabetes, obesity, cardiovascular disease, cancer, mental health disorders, autoimmune diseases, asthma, and osteoporosis.

Sarah also explains that it's linked in a couple of different ways.

Gut bacteria are very important modulators of our immune function and control how our immune system responds to stimuli. Gut bacteria also controls our gut-barrier.

Sarah also goes into the connection between leaky gut and the gut microbiome. 

This is because the microbiome is controlling how leaky the gut barrier is. So to fix one, you need to fix the other.

Gut Microbiome and Osteoporosis

If your gut barrier is not working properly, you are not absorbing nutrients properly, such as calcium. (34:41)

Sarah explains that even after we're done growing, our bones are being constantly broken down and built back up.

This is done in equilibrium, and it's what gives us bone structure. 

We lose that balance as we age, but also through nutritional and lifestyle imbalances.

Sarah also explains the more diversity you have in your gut, the more density you have.

The less bone density you have, the greater your chance of having and/or developing osteoporosis.

 

The Question of Obesity

Stacy asks if we're able to call out the issue of obesity for a moment. And whether it's contributes to an unhealthy microbiome, or rather a result of, similar to osteoporosis. (38:40)
 
Sarah explains a phenomenon of weight gain regarding the obesity microbiome and how it drives the increased health risks of obesity.
 
She tells us that the takeaway form the research done is that it's not so much the weight that indicates health status, but the healthy choices.
 
For more information on this topic, check out Episode 421: Body Image.
 
Stacy takes a minute to remind listeners that what is said on this show is not meant to make anyone feel guilt or shame or things like health and/or weight.
 
She explains that what matters is you are doing the best you can do for your health with the information available to you.
 
Adding stress or anxiety does not do anything to help you reach a healthier you.
 

Fixing IBS

Sarah takes a few minutes to run through a quick recap of information covered in previous shows due to these topics' tendency to overlap.

She also goes over a few action-points covered in her Gut Guidebook.

Sarah notes that low-FODMAPS can make dysbiosis worse, even if it improves symptoms, which is why she personally doesn't recommend this diet.

She reminds listeners that more people responded to gluten-free in IBS studies than low-FODMAP. And that wheat is eliminated on low-FODMAP diets as well.

But many gut-microbiome-beneficial foods that might not be contributing to IBS symptoms are cut out as well, putting you at a disadvantage.

Stacy and Sarah discuss the benefits of low-FODMAP diets as a temporary treatment. 

Notable Episodes for More Information

A high variety of veggies, fruit, mushrooms, nuts, and seeds are very important to a healthy gut microbiome. 

If anything increases symptoms, be sure to back off of it and add it back in gradually. 

Try cooked veggies, purees, smoothies for IBS-D, and try raw salads for IBS-C symptoms. 

This is something Stacy and Sarah have covered in many other episodes:

Stacy and Sarah discussed the benefits of increasing fish intake and/or take fish oil in Episode 415: Fish oil, Healthy or not? And the importance of hydration in Episode 406: Got Water?

In Episode 414: Best Cooking Fats for Gut Health, Sarah and Stacy talked about EVOO as go-to fat.

Probiotic foods (sauerkraut, kombucha, kefir), discussed in Episode 329: The Link Between Carb Intolerance & Gut Health, are also great avenues to explore.

Sarah reminds listeners to get enough sleep and do so on a consistent schedule.

Manage stress is also important, as discussed in Episode 397: Practical Tips for the Sleep Stress Cycle.

Sarah also recommends increasing activity (but avoid overtraining), especially walking.

She explains that microorganisms operate on a cycle, so the best practice is to eat distinct meals, with 12-14 hours fast overnight.

What About Milk and Dairy?

Stacy jokes that what Sarah is really saying is we can solve many of these issues by drinking large glasses of fortified cows milk.

She reminds listeners, however, many milk-based products in stores have a lot of additives.

She goes on to say that veggies are not only adding the nutrition you need, but also fiber, antioxidants, and many of the anti-inflammatory properties the body needs.

Stacy tells the audience that that's why milk isn't on their list, but is commonly associated with other lists regarding bone health and osteoporosis.

Sarah jokes about dropping some mind blowing science on us.

She tells us that studies show the strongest dietary factor contributing to healthy bone is fruit and vegetable intact. And that it's much strong than results from dairy intake.

How Fruits and Vegetables Help

Sarah cites that the calcium in fruits and vegetables are actually easier for our bodies to absorb:

"Not only do fruits, vegetables, nuts, seeds, and seafood contain substantial amounts of calcium, but there is scientific evidence that we absorb more calcium from cruciferous vegetables (like kale) than we do from dairy."

Cruciferous vegetables (like kale, cabbage, broccoli, collard greens, and turnip greens) may be the best source of dietary calcium. 

Several studies show that fruit and vegetable intake correlates much more strongly with bone health than dairy intake. 

The scientific evidence is mixed on dairy and bone health.

Some studies indicating that higher dairy consumption may increase the risk of fractures and osteoporosis.

Sarah attributes this to the critical role the gut microbiome plays throughout our entire body,

Yes, to prevent osteoporosis and look after your bones, eat your veggies!

 

Bone Health Nutrients

There’s at least twenty micronutrients that are essential for bone health.

Bone is composed of a mixture of minerals (calcium, phosphorous, magnesium, sodium and potassium, mainly) deposited around a protein matrix that acts as a scaffold.

It’s the combination of inorganic (minerals) and organic (protein) materials that provide bone with both strength and flexibility. 

About 65% of bone tissue is minerals, chiefly calcium and phosphorous.

The remaining 35% a protein matrix, 90 to 95% of which is type I collagen. 

Once fully grown, bones are constantly being remodeled at an equilibrium that decreases as we age. 

As bone density drops, we see the development of osteoporosis.

Sarah also tells listeners that maintaining insulin sensitivity is key to regulating bone remodeling.

Bone Health and Osteoporosis

  • The major protein in bone is collagen. Vitamin C, copper and zinc are essential for collagen formation
  • Calcium, phosphorus, magnesium, potassium
  • Fat-soluble vitamins (A, D, and K2 in particular) are essential regulators in bone mineralization. 
  • vitamin D status influences calcium absorption. So, testing to make sure your serum vitamin D levels are in the functional range (50 to 70 ng/mL is probably optimal) and supplementing accordingly is essential.

Veggies for the win!

Final Thoughts

Stacy returns to the listener's question from the beginning of the show about whether or not a struggle with IBS could later develop osteoporosis. (1:09:02)

She says, looking back at all the science, the answer is yes.

Stacy suggests she now follow protocol for improving gut health.

She also says to be mindful of short-term FODMAP diet. And potentially conferring with a holistic approach.

Stacy explains that when you're experiencing health issues with a certain part of your body, one of the best things you can do is consume animal parts of that body.

For example, bone broth contains many of the nutrients needed to support bone.

Stacy recommends replacing soup and stew recipes that call for vegetable broth with bone broth.

If you're interested in learning more about bone broth, check out Episode 313.

Stacy says one of the most important things to take away from this episode is nourishing your bones with the nutrients you need.

Stacy thanks listeners for spending this time with them.

She reminds us that there a show on collagen on the docket (as soon as Sarah can get her head wrapped around the science).

If you have follow-up questions on anything covered in this episode, Stacy and Sarah invite you to reach out in any way.

Stacy adds that Patreon is the fastest and easiest way to reach them.

So if you haven't joined the Patreon family yet, be sure to pop on over. Check out the bonus content while you're there!

Thanks so much for listening!

The Whole View, Episode 426: Updates and News From Us!

Welcome back to episode 426 of the Whole View. (0:34)

Stacy tells us due to the density of the last few episodes, this time, she and Sarah are going to take a step back, catch up, and give updates after those super wonderful, super long, super informative last few podcasts.

Sarah found that pulling the research together for last week's Covid-19 show and summarizing it was emotionally draining.

And she's sure it was pretty draining to listen to as well since there weren't very many rays of sunshine in it.

Sarah and Stacy decided to do an updates and check-in style show where they have an opportunity to talk about all the little things that are hard to fit into the bigger meaty topic.

Sarah decides to start things off by sharing a bit of feedback on some of the more recent shows.

Stacy jokes that she's shocked Sarah wants to share positive feedback, saying it's something they never do!

 

Feedback on Episode #424

Stacy shares that a part of her feels a little guilt over doing things like this. (2:28)

But she wants to remind listeners (and herself) that it's super important to be aware of and listen to the positive feedback you get in life.

So many times, we focus on the negative things that we hear or think about ourselves. It's important to support and encourage ourselves.

Stacy does remind the audience that while she and Sarah love the positive feedback, it doesn't drive the show topics.

When fans of the show reach out with comments and/or engage with others about the show, it means the world. And encourages her (and Sarah) to continue to do the work that they do.

Stacy takes a moment to thank everyone and reminds us all that it's okay to take a moment to feel good abound yourself.

Sarah segues into sharing this comment:

Sophia says, 

"This is not an inquiry, more of a comment for show #424. I love love love episodes like this one. I easily eat 30+ various fruit and vegetables a week. The produce bill is very high and we have little to no waste, we eat and use all the vegetables! My main comment is don't forget the sea vegetables like seaweed! I love tossing kombu, arame or wakame into soups and stews. I'll use sushi wrap nori like in a lettuce wrap around stir fried zucchinis and baked fish. My husband is not as much of a fan of seaweed as I am but i still find ways to add it to my food after meal prep. Thanks again for your show, I've been listening for years and still love and appreciate every show."

More Thoughts on Fruits and Vegetables

Stacy comments that she's sure there are hundreds of vegetables that were missed in that show.

She agrees that the category of sea-vegetables is such a good one. And she loves to add them as a sea-salt to a lot of her foods.

One of Sarah's staples at her house is every flavor of sea-snacks. For her, Seaweed is a "I feel like something salty" go-to snack in her pantry.

She adds that the great thing about that episode is that they could miss a ton of easy-to-find fruits and vegetables.

And yet they were still able to list 75-80 different kinds by the end.

She also shares how wonderful it was to see that the intended message of "it's okay, you got this, it's not that scary" is what people go out of it.

Stacy shares she also received a lot of comments from people who were similar to her: they were scared by that number at first but then went back and realized they were closer than they originally thought.

Stacy mentions also seeing a lot from people who don't have a ton of time, or they're overwhelmed with picky-eaters, or they're not sure where to start.

She mentions a recent blog post where she outlined every dinner her family ate over 2 weeks and included links to recipes.

This alone got her family up to around 26 for those two weeks, not including breakfast, lunch, or snacks.

Both Sarah and Stacy thank Sophia for adding yet another thing to the ever0-growing list of things people can do to add a number onto that list.

 

Feedback on Episode #421

This next comment comes from a viewer in regards to Episode #421: Body Image. (10:51)

Ashley says,

"I just wanted to write and say thank you for using they/them pronouns so easily when talking about Dr. Lindo Bacon on your most recent episode. I have a transgender child and it means so much to me to hear how inclusive your speech was. You ladies are simply amazing all around. Thank you for everything you do!"

More Thoughts on Pronouns

Stacy shares that this is very kind for Ashley to say, but she feels that it needs to be expected.

When Sarah did the research and found Dr. Lindo Bacon, it was something Sarah was very passionate about. And it mattered to Stacy how important it was to Sarah.

Stacy feels that that is the intent of the show; to care about the health and wellness of everyone. And if they're not respectful of certain groups of people, how can they expect that group to be well. 

Sarah explains while doing her research, she noted that Dr. Lindo Bacon listed their pronouns as "they/them/their" in their "about" page.

She made sure to note it on her and Stacy's outlines because respect and listening to others is something they talk a lot about in this show.

Sarah feels that using the pronouns another person uses to identify themselves is a basic show of respect.

To be gender-aware and inclusive is a really important thing to do in our society today.

Sarah also shares she works hard to pass that respect onto her children, so they understand just because something is more common doesn't mean that it's the only thing that's normal.

Stacy also reminds us that if we do make a mistake and use the wrong word, it's okay. It's okay to be corrected, apologize, and learn.

We don't always realize when we're making assumptions. It doesn't make us bad people.

 

Feedback on Episode #419

In this episode, Stacy and Sarah talked about how corn is a gut superfood.

Stacy expresses how touched she is at hearing this! Thank you, Donna!

 

Checking In With Sarah's Updates

Stacy checks in with Sarah. Sarah comments that the overall theme for 2020 seems to require pretty continuous adaptation.

She adds that rolling with the punches, for her, is easier some days than it is others.

Her puppy is now at the age where she can hang out and doesn't need undivided attention all waking hours, allowing Sarah to dig into bigger projects.

The reason Sarah does things like this podcast is because her brain is happiest when she's feeding it with information and research.

The Coronavirus Pandemic ended up putting a major pause on Sarah's book about the gut microbiome.

She decided to put everything into two ebooks: The Gut Health Guidebook and The Gut Health Cookbook.

She didn't want everyone to have to wait for this long-format information, so she dropped everything to reorganize the project.

Now, she's working on wrapping up the last few topics and developing a new plan for publication.

Sarah is also preparing the next AIP lecture series on January 18th, 2021.

The cart is now open, and there will be Early Bird Pricing until November 1st, 2020.

The plan currently is to teach one session next year.

Sarah is also offering diversity and inclusion scholarships this year. Information on those scholarships can be found right on the main landing page for the course.

Stacy thanks Sarah for taking what they talk about and implementing change.

Sarah jokes that she's a huge planner and how 2020 made it very hard to follow her planned-out trajectory.

It feels good to get back to where she started the year off and get the information out there on the gut microbiome.

 

Checking In With Stacy's Updates

Stacy touches on the Covid updates from last week and how that's impacted her emotionally.

She is still home with the kids, and that it doesn't look like they'll be going back to school any time soon.

She jokes that she's flip-flopped roles with Matt, who used to be a stay-at-home dad for much of her boys younger years.

Stacy also works full-time from home while acting as a virtual teacher, so she has a lot of roles she's juggling.

She says she is still adjusting to all the changes and feels like she's resisting a bit.

Sarah adds that we all miss "normal," but we can't put everything on hold. She assures Stacy she's not resisting change- there's just a lot to adapt to, and it takes time.

Stacy updates listeners on her foster situation.

She says taking on the training process and the paperwork to become foster parents, then bringing a child into the home for about three months, and the process of someone you've become attached to leaving your home is all are huge changes on their own.

Then to add in the family dynamic changes of Matt working and her staying home and a global pandemic, Stacy has undergone a lot of change in 2020.

Stacy shares that the child they've been fostering for several months is no longer with the family. They said goodbye several weeks ago.

Stacy explains that she and her family took some time after to get back.

Through her first foster experience, she learned not to focus so much on just the foster child and his/her acclamation.

She realizes she missed the critical element of spending time with all the kids one-on-one time like she used to. And that she needs to get better at balancing that going forward.

Stacy shares that this was a life-changing experience for her. And that was what she was looking to get out of being a foster parent.

She wants to help more children and help her own children understand the privilege, security, and privilege they all share is special and a gift that needs to be treasured.

A lot of Stacy's time over the last month has been dedicated to processing.

Stacy shares that she feels good about everything that's been happening, but it's not been easy.

Stacy also shares an update on the safer cosmetics bills in California that have been put into action.

California is changing the trajectory of beauty products in the US!

Stacy also explains the role she and Beautycounter played in helping this change come to fruition.

She thanks all those who supported her throughout this journey and helping her bring healthy change to the next generation using beauty products.

Beautycounter's mission is to provide clean and safer beauty products to consumers.

 

Final Thoughts

Sarah thanks listeners. These check-in style shows are a great way to take a break, catch up, and go over updates.

And for the opportunity for checking in on their lives and their projects.

They promise something cool will be in store for you next week!

Sarah talks about the research she's done on collagen and promises there will be something coming up on that topic soon!

Stacy assures listeners that their questions and comments regarding that are being heard. 

She adds that if you enjoyed the conversational feel of today's show, you can check out The Whole View on Patreon for more.

Stacy and Sarah upload weekly bonus content and listen to their unfiltered thoughts on each episode.

Sarah adds it's a great way to support creatives and get questions in front of them more easily.

Thank you so much for your support, positive feedback, and for joining us today.

More science and updates to come!

Stacy and Sarah cannot thank you enough for stumbling through 2020 with them.

Welcome back to episode 425 of the Whole View. (0:27)
 
In previous episodes, Sarah and Stacy have talked a lot about the progression timeline and what is happening in the state of the world.
 
For context, Stacy tells the audience that at the time of this recording it is October 7th, 2020.
 
She feels that it is important to know due to the ever-changing atmosphere around the Covid-19 pandemic.
 
This episode has interesting context for Stacy. Her family (specifically she and her husband) had Covid-19 in late April/early May of 2020.
 
 
She does not plan to revisit that in this episode. However, she believes it to be relevant to some of the long-term side effects the Coronavirus can have.
 

A Message On Patreon

We are always looking for ways to spread positivity in 2020. Before we dive into this episode, we'd like to share with you a wonderful message we received.
 
This message comes from Teri, who is one of our patrons!
 
In case some of our listeners don't know, you can sign up and support The Whole View by becoming a member on Patreon.
 
We provide bonus audio on a weekly basis and behind the scenes looks at our unfiltered thoughts for each episode.
 
Here's what Teri wrote:

Long-time listener here, and I adore the Patreon content! I wondered if it would be short content, but "knowing" you, why would I have thought that?! You give so much, and the Patreon episodes are no different. I utterly loved the first two episodes, and really enjoyed hearing about your move from identifying as Paleo and the changes in the Paleo community, especially around racial justice and anti-science. 

I'm a Whole30 coach and share your articles and podcasts with my clients so frequently. I also help moderate a Whole30 FB group of about 4,000 over-50 (mostly) women and when it's my turn to moderate I frequently have Science Week - and guess who is featured prominently each time?

I adore the science, the friendly chat, the laughs and the tips. Truly, this new Patreon content is a bright gift in this very dark time. Thank you both!

Thank you, Teri!

For our listeners, if you would like to join our Patreon family, you can find us at patreon.com/thewholeview for bonus and unfiltered content.

Stacy notes that Sarah has moved away from swearing in general and uses some very interesting alternative terms.

So if you're curious and want to be creative, you know where to go!

 

A Quick Recap

Today Sarah and Stacy will be focusing on the long-tail symptoms after Covid infection, the reinfection stories that have been circulating, "long-haulers," and the potential long-term effects(4:42)
 
Here is a quick recap of our previous Covid-19 episodes and where you can find them:
 
Episode 396: this was early on, so Sarah and Stacy talked about known (at the time) epidemiology and why it was important to take the Coronavirus shut down seriously
 
They also talked about autoimmune diseases and Covid-19, antibacterial soaps versus natural soaps, and the health effects of using disinfectants.
 
They discussed the evidence efficacy (or rather lack-there-of) of silver-containing solutions. And did a bit of myth-busting surrounding elderberry for autoimmune disease. 
 
Finally, Stacy and Sarah talked about taking Vitamin C, Vitamin D, and zinc.
 

In Episode 401, Stacy and Sarah explored the way out of this pandemic and how to get back to normal life as we know it.They touched a little bit on reinfection cases, which they will be taking at a more in-depth look at today.

They also broke down the science behind wearing face masks. 

In Episode 412, Stacy and Sarah talked about how isolation can impact immune function. They also myth-busted some of the concerns that have circulated around it.

They discussed how isolation might affect the gut microbiome, public health messaging, and the huge importance of vitamin D when reducing the risk of Covid-19.

 In today's episode, Sarah reminds us that they will be focusing on:

  • Reinfection versus Reactivation
  • Long haulers (sometimes "Long Covid"
  • Longterm complications/damage

 

Why This Matters

Stacy shares that this has been an ongoing thing for her. (7:50)

Stacy has shared in past podcasts that she had a feeling there were two unknowns that we would find out later on about the Coronavirus:

First, there's an effect on the brain, which has since been shown. And second, that there is a hormonal impact on the body.

Stacy has noticed she gets reactivated symptoms during her menstrual cycles, specifically inflammation.

Stacy feels that it is really important to talk about because there's so much focus on how many people have died.

As someone who's gone through it and now living with the long-term side effects of it, she feels it's important to acknowledge that millions of people in the world survived but are still feeling the effects months later.

She considers herself one of the lucky ones since she had a mild case and cannot be more thankful for that.

Stacy would like the audience to understand that Covid-19 is not like the flu. You don't get it, and then you're done, and you have immunity for a short time until the next strain comes out.

 

Answers Through Science

And she thinks that Sarah going through the science of it will be very beneficial to people.

Sarah points out that we're now at a point where more research and studies are trying to look at the spectrum of the long term impacts.

It's really important to understand the long-term impact of this so that we can monitor at-risk people for potential health-specific complications in the future.

Sarah also references potential economic impacts we could see due to prolonged symptoms and brain fog keeping millions of people from returning to work.

There are down-stream effects that we need to really understand and be able to wrap our heads around.

Sarah also explains that there's a lot of work that still needs to be done to reduce the spread.

She also explains that we are still at a really high level of new cases every day.

With high community spread, it makes any kind of gathering (school, church, weddings, funerals) all very challenging.

As we're trying to figure out how to continue with precautions to reduce spread, Sarah expresses the need to understand this whole other side of the virus that's not related to the two to three weeks of active infection.

 

ADE And How It Works

Sarah first wants to look into whether the recent reports that look like reinfection are truly that. (14:26)

Stacy shares that this is something especially concerning to her.

Sarah explains antibody-dependent enhancement of infection (ADE or ADI).

It is a common phenomenon in many other viruses, such as influenza A virus, Coxsackievirus B, respiratory syncytial virus (RSV), Ebola virus, human immunodeficiency virus (HIV) dengue virus.

Dengue Fever is the best understood in terms of the ADE mechanism.

There are four known strains of the virus; when you contract one strain, you get Dengue Fever, and your body mounts a response.

You are then protected for a relatively short time frame of time, not just against the strain you caught but also the other three.

As the antibodies fall in number, there's a window where if you get exposed to one of the other three strains, you can develop a much more severe case.

If you don't get exposed to one of those three, you're still immune to the first strain you caught even after all the antibodies are gone.

If you catch one of the other three strains after the window is closed, you will develop regular Dengue Fever again, but not get the life-threatening reaction.

Sarah explains that that magic sweet spot with a low level of antibodies actually magnifies the infection.

One thing Sarah notes is that the Dengue Fever virus actually replicates inside immune cells.

So when there are high levels of antibodies shortly after an infection, these "eater cells" are able to neutralize the infection.

When there are low levels of antibodies, they're not sufficient enough to neutralize the virus.

This sweet spot typically starts from a few months out from infection and can last to about a year.

 

What This Means For Covid-19

Sarah states Covid-19 does not appear to be very good at infecting and replicating inside immune cells.
 
Because of that very important difference, there's no evidence of ADE in Covid-19 (SARS-CoV-2).
 
SARS-CoV, which caused the SARS outbreak in 2002 and 2003, is the most closely related coronavirus causing Covid-19.
 
Sarah explains that from what we know in early vaccine development for SARS-CoV, there was what's called vaccine-enhanced infection.
 
This takes place due to a similar mechanism as ADE.
 
Because of that, Sarah explains we can't say for sure whether or not we will see this occur in Covid-19.

 

Reinfections

We only have a few dozen confirmed cases in the medical literature of what looks like reinfection with Covid-19(20:10)
 
Sarah reminds us that the pandemic is not even a year old yet.
 
She explains that there are seven different coronaviruses that infect humans.
 
Several are responsible for about a quarter to a third of common cold cases annually.
 
Sarah points out that research on these common cold coronaviruses shows immunity doesn't last that long- maybe as little as a year.
 
Sarah outlines several studies that measured infection rates and discusses the results in terms of developing immunity.
 
She references this article for more information.
 
Sarah explains that many test subjects showed partial immunity. This means their bodies had enough familiarity with the virus to fight it with less symptoms.
 
However, it is important to note that during that time, you are still very infectious.
 
Sarah explains that having partial immunity to Covid-19 could potentially result in more asymptomatic reinfections.
 
This would prove to be incredibly difficult to manage from a containment point of view.
 

Covid-19 Spread

About 40% of spread happening right now is from a combination of asymptomatic and pre-symptomatic people.
 
This means that even if you're immune enough that you might not get a symptomatic infection upon a subsequentexposure, you may have a higher likelihood of being an asymptomatic carrier.
 
Sarah tells us that SARS from the 2002 and 2003 epidemic is about 80% the same as the Covid-19 virus in terms ofgnome sequence.
 
It's comparable to 50% to MERS, and less than that to common cold coronaviruses.
 
Immunity to SARS seemed to last typically 2 to 3 years (but up to 6), as measured by memory T cells. 
 
Sarah references several more studies that explore results of immunity in different test groups.
 
Articles with more scientific results and information can be found here, here, and here.
 
Sarah explains that all this data tells us that reinfection is something that we may need to be concerned about.
 
But there's not mechanistically a good argument for thinking we're going to see it this early.
 

Covid-19 Reactivation

What's happened in these few dozen cases of possible Covid-19 reinfection is that people tested positive and were sent home. They recovered and later tested negative. Then, months later, they once more test positive for Covid-19.

Some are similarly sick as the first time, some are sicker the second time, and others are asymptomatic.

This begs the question if it's real reinfection.

Sarah claims that of the researchers studying these cases, nobody is convinced that it's true reinfection.

None of these cases are from immunocompromised people and aren't thought to be very concerning.

Reinfection is a legitimate concern for those with autoimmune disorders, such as HIV.

A more likely explanation for what is going on with these cases is that it's actually viral reactivation.

This means that these people are long-haulers who had a latent period, combined with testing limitations and failures.

It's possible that those negative tests weren't true negatives.

Sarah explains this as the immune system almost beat it, but didn't neutralize it fully, and pulled back fighting too soon.

There's a really wide range in how long people have measurable virus in their systems, and they may not be infectious the entire time.

Sarah explains that there's a lot that we still don't know about the Covid-19 virus and its ability to hide out in our bodies long-term.

Data has shown viral shedding in some people lasting as long as eighty-three days out from the first day of symptoms.

 

What Studies Show

Some of the recovered/discharged patients showed a positive viral RNA burden for as long as 10 to 27 days after the discharge (Korber et al., 2020; Ye et al., 2020)

Although the median viral shedding duration was 20 days, in some cases, it was observed for 37 days (Zhou et al., 2020).

The prolonged SARS-CoV-2 RNA shedding occurred with a median duration of 53 days and a maximum of 83 days (Li, Wang, et al., 2020).

In addition to this prolonged carriage of SARS-CoV-2, some patients who had recovered from COVID-19 demonstrated recurrence of SARS-CoV-2 (Xiao et al., 2020; Ye et al., 2020; Yuan et al., 2020).

In one study, as much as 9.1% of the discharged COVID-19 patients were shown to be presented with the SARS-CoV-2 reactivation (Ye et al., 2020).

Another study revealed that 14.5% of discharged COVID-19 patients with negative (polymerase chain reaction) PCR, had a later positive reverse transcription PCR (Yuan et al., 2020).

Still another study indicated that the number of such recurring patients can be as high as 21.4% (Xiao et al., 2020).

Another explanation is genetic mutations causing new strains. Sarah explains this is not likely. While there variants, they are not different enough to be considered a new strain.

 

What Explains Covid-19 Reactivation?

Sarah sums up that the most likely explanation for the resurgence of symptoms is due to the virus's ability to hide inside our bodies. (36:03)

She goes a bit more in-depth on how exactly a virus can hide from our immune systems.

One of the implications of this is that we could have more lasting immunity from a vaccine than natural infection.

It may hide out in exosomes within cells, which are little tiny bubbles inside the cell membrane.

What this all data points to is herd immunity through natural infection is unlikely.

And that we may be able to achieve a more lasting immunity through vaccination.

Links to the Studies Sarah Recommends:

 

Long-Haulers

Stacy references the Scientific Method from a previous episode and explains how we're still mid-process. (40:41)

Sarah wants to acknowledge listeners that this doesn't feel like good news.

The main message that this scientific research has for Sarah is that the efforts going in to protect herself and others are still really important to do, even though we may be getting tired of it.

The science behind wearing masks to slow the spread just gets stronger and stronger.

It's potentially a large percentage of people who fall into the long-hauler or long-Covid category.

Over 30% of long-haulers still have symptoms at 3 weeks, and approximately 10% still have symptoms at 2 months.

Sarah also notes that data might be lacking because not all long-haulers are seeking medical attention if their symptoms are tolerable.

The most common symptoms for long-haulers are fatigue, ongoing shortness of breath, joint aches, muscle aches, brain fog, and difficulty focusing.

Some people report feeling better for a few weeks, while others report not feeling better at all.

 

The Body's Response

Sarah explains how autoimmune diseases work and how it relates to Chronic Fatigue Disorder, which shows similar symptoms to long-Covid.

Some researchers think what's happening in long-haulers isn't exactly continued infection. But more of the infection melding into Chronic Fatigue.

Another thing that could affect long-haulers is organ and tissue damage, which takes a long time to heal.

Researchers have now started to note Multisystem Inflammatory Syndrome cases in some Covid patients. 

This was thought to be more common in children but is showing up increasingly in adults. 

MIS typically happens in people who had Covid and recovered from it. It's a very severe, life-threatening (but treatable) inflammatory syndrome.

Clinical features in children have varied but include shock, cardiac dysfunction, abdominal pain, and elevated inflammatory markers.

Adults show severe dysfunction of one or more extrapulmonary organ systems (e.g., hypotension or shock, cardiac dysfunction, arterial or venous thrombosis or thromboembolism, or acute liver injury); 4) laboratory evidence of severe inflammation (e.g., elevated CRP, ferritin, D-dimer, or interleukin-6); 

Sarah sums up that in its severe form, patients can develop MIS. But in mild-form, patients show symptoms of long-Covid.

 

What This Means For Covid-19 Patients

The way this is currently treated mostly by symptom relief, rest, and stress reduction.

Stacy shares that until we know more and the science can catch up with medial solutions, we know what we need to do to at least feel better. And how to continue to reduce the spread.

Stacy reminds us that drinking alcohol can exacerbate long-haul symptoms on the front end.

Sarah explains that alcohol is actually the opposite that's needed to support immune function.

Because we focus so much on the physical side of Covid-19, Stacy reminds us that there's a lot of mental health at play from anxiety.

This anxiety comes from all the things we don't know. 

Even if you've already had it, like Stacy, we don't know if we can get it again, if it will be worse the second time, or if we'll be asymptomatic and infect others.

You're not alone. You're not the only one feeling frustrated and exhausted and over it and ready for change. We're on the same team.

Sarah's Helpful Links:

 

Long-Term Damage From Covid-19

Because of the way Covid-19 is effecting our bodies, there's the potential for organ damage that's important for us to understand. (56:11)

Sarah underlines that the most concerning piece of that is cardiac damage. Unlike the other longterm challenges from organ damage, it's something that happens independently of severity.

Sarah talks about a study done in Germany that looked at MRIs of their hearts.

What they found was abnormalities in 78 of the 100 participants with ongoing inflammation.

They showed that this was independent of preexisting conditions.

Sarah believes it's very important for people to understand that this illness isn't just about whether you live or die, or whether or not you need to be hospitalized.

Sarah goes on to say that the unknown factors make the idea of herd immunity much scarier.

By allowing the number of people needed to be infected for herd immunity, we're potentially putting a lot of people in danger of long-lasting complications from Covid-19.

 

Not Just The Heart

Kidney damage has been seen in severe infections.

Acute kidney injury (AKI) has been reported in up to 25% of critically-ill patients, especially in those with underlying comorbidities

The type of pneumonia often associated with COVID-19 can cause long-standing breathing issues. 

The resulting scar tissue can lead to long-term breathing problems.

An Austrian study also found that lung damage lessened with time. 

88% of participants had visible damage 6 weeks after being discharged from the hospital, but by 12 weeks, this number had fallen to 56% (see go.nature.com/3hiiopi).

Sarah also tells us that research suggests Covid-19 does have an effect on the brain as well, but there is still a lot that doctors and scientists don't know.

Studies show Covid-19 can cause strokes and seizures, even in young people.

Covid-19 may also exacerbate and potentially increase the risk of developing Parkinson's disease and Alzheimer's disease.

Sarah's Suggested Further Reading:

Final Thoughts

Sarah explains that Covid-19 is the perfect storm of virus. (1:15:25)

The reason this is something we've not really experienced in the last hundred years is because the asymptomatic and pre-symptomatic spread makes it very difficult to control.

Sarah adds that the long span of time for infection adds to the difficulty.

Sarah explains the difference between aerosol and respiratory droplets, and how masks prevent the virus from spreading.

Stacy adds that it's not enough to wear a mask, but to make sure it's properly fitted to your face to keep you and others safe.

Sarah also notes that 6 feet is not enough distance indoors, and that masks will still be needed even after a vaccine rolls out.

Sarah takes a minute to remind about immune health. This means get enough sleep, manage stress, get activity, address vitamin D, eat a nutrient-dense diet, look after gut health, and avoid alcohol.

This is the pattern that Sarah used for her mask, as well as the Fruit of the Loom Masks, and nose pieces. Here's Sarah's post for more information.

Sarah also underlines how important masks are. They're our greatest defense and offense for controlling infection.

Stacy adds that there is nothing political about wearing a mask either.

She and Sarah are here to give the science needed to live life as healthy as possible.

 

A Big Thank You!

Stacy would like to encourage everyone to have compassion and says thank you anyone continuing to fight the spread.

Your efforts are appreciated!

Sarah also expresses her gratitude toward the audience for following the science and taking action.

Sarah and Stacy will be sharing more of their unfiltered thoughts on Patreon as they recap the episode.

Thank you so much for being here today and being a part of this community we so appreciate. We'll be back next week (hopefully with something happier to talk about)!

 

Welcome back to episode 424 of the Whole View. (0:27)

Sarah feels it's important for the audience to know this show is not about guilt. It's about empowering and inspirating!

Sarah has posted in the past that, as a general rule, we should all aim to eat at least 30 different vegetables and fruits throughout the week.

For Stacy, that number was a little mind-blowing. She hopes that by breaking that number down, she can see how far off she really is from reach 30.

She also hopes this helps listeners understand what Sarah meant by that expectation.

This is a topic Sarah has seen many discussions (and panic) about because 30 sounds like a lofty goal.

In this episode, she'll explain where that recommendation comes from and the science behind it.

Sarah believes most people are closer to eating 30 different fruits and vegetables per week than they realize. And she hopes she can help reassure listeners who may find that number overwhelming.

We would like to remind our audience that it's important not to let perfection be the enemy of the good.

This is not about checking boxes, but about setting a fuzzy goal aimed at increasing variety.

Sarah shares several comments from the original post that stuck out to her.

She hopes that by going deeper into this topic, listeners will realize that it's not as scary as a number as it seems.

Where The Recommendation Comes From

Sarah shares some relevant findings from her six-year study of the gut microbiome. (4:47)

Different families of fruits and vegetables are independently beneficial because they feed different subsets of bacteria.

Sarah explains that diversity between the types of bacteria and microbes is the hallmark of a healthy gut. She then explains their interactions affect the human body.

How we achieve diversity is through ensuring there's variety in types of fruits and vegetables we eat. And not that we're picking the same ones over and over.

Sarah recommends the American Gut Project for further research data on the gut microbiome. 

Sarah's research shows fruits and vegetables are the best for the gut microbiome. 

Nuts and seeds are also fantastic. 

But only some legumes and grains are, and they shouldn't replace servings of fruits or vegetables.

Stacy does the math for what she's eaten, not even going back a full week. She shares she's already reached 26 (not including nuts, seeds, or herbs).

She jokes that she's not the type to snack on raw vegetables either!

 

Does My Store Really Have That Much?

Breaking meals down by ingredient can show how many vegetables we use on a daily basis without us even realizing it. (14:37)

Sarah shares that in her fruit bowl alone, she has 10 different kinds of fruit.

The average grocery store has roughly 200 different fresh fruits and vegetables year-round when counting different varieties separately.

Sarah reminds us that this is a rough guideline and not a list of check-marked boxes. 

The goal is to think about variety and swap out different types of foods week-to-week.

Stacy lists kale, carrots, spinach, cabbage, lettuce, squash, tomatoes, potatoes, and mushrooms.

Stacy recommends researching recipes that utilize different types of add-ins to increase variety. 

Muffins, oatmeal, and smoothies can all include multiple fruits or vegetables.

Some fruits and vegetables are seasonal, but many are in season year-round.

Stacy explains that seeking out opportunities to add different ingredients is how she could reach so many varieties easily.

Sprouts are a great way to add a micronutrient punch to meals. And Stacy was surprised to find how much her kids liked them as well.

Sprouts are also fun and easy to grow at home!

Stacy reminds us that the more we look at what we're eating daily, the more we realize how easy reaching 30 varieties really is.

Stacy talks about different nightshades, like tomatoes, peppers, and eggplants. She also tells us potatoes are a great root vegetable use and can be combined with other ingredients to enhance variety.

Onions and garlic are great "freebies" that count toward reaching that weekly goal.

Stacy recommends trying roasted radishes for anyone who isn't a radish fan.

Rhubarb and kohlrabi may be a little harder to find, but they are great seasonal vegetables to add to your diet to achieve variety. 

Stacy reminds us that frozen is perfectly acceptable. This is because when things are frozen, they're picked at peak ripeness, and their nutrients are maintained.

Sarah explains that it's okay to have a core 5 or 10 foods that you buy every week, just be sure to keep a variety outside of it.

Below is the complete list of vegetables Stacy and Sarah talk about in the episode:

List of culinary vegetables to help reach 30 fruits and vegetables a week

What About My Store's Fruit Variety?

Fruit availably often vary depending on the time of year, but many stores will offer different varieties throughout each season. (43:42)

Sarah would like to emphasize finding a feeling of excitement when something unusual comes into your store.

Don't be afraid to move out of your comfort zone (at your own pace) to try new things.

It's never too late to start becoming more adventurous and widening our varieties.

Stacy points out that there are a lot of opportunities to find foods you like. She shares that she does like prunes (dried plums) and dates despite not particularly liking plums.

Stacy lists blackberries, blueberries, strawberries, and raspberries as fruits she often freezes.

Many types of melons and citrus fruits are available throughout the year. Varieties often rotate based on seasonality as well.

Stacy suggests reaching out to your local garden center if you're interested in growing your own fruit.

Both Sarah and Stacy share stories about plants they've grown (both successfully and unsuccessfully) at home.

Stacy promises not all plants are high maintenance or difficult to grow. She assures us that we are capable of growing them if we would like to.

Sarah also wants listeners to know that many vegetables will grow in containers. So even if you don't have space for a fruit tree, you can still increase your food variety with a small porch or balcony.

Stacy challenges listeners to check out the "exotic fruit" section of their stores and to have some fun and choose something new to try.

Guava, dragon fruit, jackfruit, star fruit, passion fruit, lychee, and rambutan are a few of the fruits found in the exotic section.

Together, Sarah and Stacy named 46 different vegetables and 37 different fruits in this one episode alone.

Stacy shares that her final count is now up to 29 different fruits and vegetables in just 5 days!

Stacy's final verdict? Reaching the recommended 30 was not as scary as she originally thought.

Below is the complete list of fruits Stacy and Sarah talk about in this episode:

List of culinary fruits to help reach 30 fruits and vegetables a week

 

Storing and Meal Planning

Sarah tells us that it's surprising how much is available in terms of seasonality and locality. (1:02:40)

She suggests referring to a seasonal produce guide as an easy reference.

Sarah feels storage is important to talk about and that most fruits and vegetables keep for about a week if stored correctly. 

Her Gut Health Cookbook also has an entire section on storing vegetables and fruits and is now available.

This free guide from UCDavis is also a great reference for knowing what does and doesn't store well together.

Sarah reminds us that there are many ways to get inventive when storing fruits and vegetables. And not to let lack of space stop us from achieving a great variety.

Soups, stews, stir-fry, salads, smoothies, and frittatas are great recipes that allow you to throw in different vegetables.

Stacy shares one of her favorite tricks with soups is to roast the vegetables first. Then blend them into the soup or stew to get a gravy-like texture.

If you're listening to this episode in the fall, Stacy states now is a great time to play around with different soups and stews.

Stacy recommends meal planning by going through different cookbooks and not to be afraid to have fun with it.

She is also a big fan of Pinterest for finding new recipes. She will pin a bunch of ideas and then go through them with her kids to find things they want to try.

 

Finding Affordable Fruits and Vegetables

Stacy reminds us that achieving a good variety doesn't have to be impossible or overcomplicated. (1:09:38)

It can also be very affordable. For example, onions, lettuces, cabbage, root vegetables, and spinach are all pretty affordable.

Apples, bananas (Stacy recommends Fairtrade), and oranges are often pretty inexpensive fruits.

In-season fruits and vegetables are generally cheaper, so knowing what's in season can help you shop on a budget.

Sarah makes us aware that eating more vegetables, in general, is a budget-strategy for a grocery bill.

She goes on to say that this is an area that she thinks the Paleo-diet did her a disservice.

She went through a phase early on where she was eating very large portions of meat and getting more protein than she needed.

Meat tends to be a more expensive item on the grocery list, while vegetables tend to be some of the least.

Stacy feels that it's important to make listeners aware that if you or someone you know is part of the WIC Program, some WIC-eligible fresh fruits and vegetables are required by the state.

That includes organic forms of those products (whole or cut).

Sarah urges us to keep in mind that even though grains, wheat, and rice products seem much cheaper, by comparison, there are a lot of budget-friendly fruits and vegetables available as well.

 

Final Thoughts

Sarah hopes that most of today's listeners realized they, like Stacy, were much closer to reaching 30 than they thought. (1:16:34)

If you're someone who might be farther away from reaching 30, Sarah wants you to know that that's okay. And there are many things you can do to help you increase that variety.

It's okay to baby-step the process.

Sarah doesn't want anyone to feel like they have to readjust their lives to meet the recommendation.

Finally, Sarah would like to encourage our listeners to think about this in a positive mindset. You can do it! And it's okay to iterate towards it.

30 is not a hard-and-fast number; it is a goal. It's there to provide some guidance into what high-variety is.

Stacy reminds everyone that a goal isn't something that's meant to be achieved every single week.

Goals are meant to push us to strive for something better. And just because we don't make it every single time doesn't mean we are failing.

Stacy adds that she hopes this episode leaves you feeling empowered and excited.

If you enjoyed this show, the best thing you can do is share it with others.

If this was helpful to you or cleared your conscience, please let us know. We love to hear from you!

If you're still feeling overwhelmed and would like more information, that feedback is very helpful and keeps us going. (1:24:24)

Welcome back to episode 423 of the Whole View. (0:27)

In episode 400 when we talked about why we were moving to The Whole View, we talked about the necessity of having a podcast that focused on the scientific method.

What Sarah wants to be able to help our audience understand are some of the common pitfalls in the alternative health community.

We see this manifestation of bias, of dismissing science that doesn't conform to someone's beliefs.

And we see it in a way that is miscommunicating the value of the different types of studies.

One of the things that Sarah wanted to do is talk about how different studies work, which is what this week's episode will focus on.

There are different structures for different types of studies, and what the weight of evidence is from different types of studies.

We want to help our listeners look at articles from various educators and influencers and empower everyone to understand how science works and how to interpret information.

When articles are cloaked in jargon and complex language that is oftentimes a red flag.

Sarah wants our listeners to be able to identify the various red flags to be cautious of.

The type of scientific evidence that Sarah draws on when she is writing an article is multiple disciplinary and crosses a lot of fields.

Her ability to dig into the science in the level of detail that she can is an entire career's worth of training.

This is a skill that takes years to acquire and is very challenging to develop without rigorous training and experience.

However, Sarah does not think it is necessary for everyone to have this skill.

She is hoping to give listeners a broad enough understanding of what scientific evidence actually is to be able to detect bull feces on the internet.

 

The Whole View Philosophy

We try to always be honest and upfront about when we have the science to show and what we can try to guess from a hypothesis of that science. (7:51)

Stacy knows that we have talked about what some of these terms mean on the show before.

However, we have been addressing a lot of different topics as we expanded to the Whole View philosophy.

We talk a lot about the importance of bio-individuality.

And you can't learn that if you aren't able to be open to the idea of learning as you go.

To Stacy that is what science is all about.

For her, the scientific method is always changing and learning as you have new information and staying open to that new information.

Science is all about taking the ongoing, upcoming information, and applying it in a way that helps us continue to evolve ourselves.

Stacy thinks it is good for people to be able to check their sources.

We are all perfectly capable of questioning how people reach the conclusions they are sharing in articles.

Listeners you hold us to that standard.

We want to always be a trusted source for you.

Science is the basis of everything we share.

What we are doing in the academic community is using the scientific method to expand human knowledge.

However, this is not a straight line.

 

Nutritional Sciences

Sarah shared her thoughts on the field of nutritional sciences, which is a young scientific field. (16:09)

Because of this, we are in a renaissance in terms of the expansion of our understanding.

We are at a point where there are big holes in our basic knowledge of nutritional sciences.

Sarah shared some examples.

It is important to understand that because of where we are in this field, we are in this phase where we are trying to lay the groundwork.

Sarah recommends Death by Food Pyramid.

She took a moment to also talk about the way this industry is not rooted simply in the science, that it is heavily rooted in profit.

We are also talking about a field of science where a lot of the people who are communicators of this research have a lot of bias.

Knowing what a communicator's bias is helps you to hear their information objectively.

 

Removing Bias

Scientists in general try to be aware of their biases.

We try to devise experiments where the biases have no opportunity to affect the results of the experiment.

Sarah shared the ways in which this can be achieved.

You are looking for as many qualititative measurements as possible, as opposed to quantitative or semi-quantitative.

Sarah shared examples of how these terms play out in studies.

In science, we look for as many ways to blind or control so that the bias cannot influence the data that is being collected.

The data is then analyzed and as you draw the conclusions that is where bias comes back in.

However, now it comes in the form of the expectations that are shared in the hypothesis.

 

The Scientific Method

With the scientific method, you make observations, you collect information, and you ask a question.

You are basically interested in looking at something that no body has looked at before.

The goal is to look at the scientific literuature around that question and use it to formulate what would be an educated hypothesis.

We can look at everything we know about the system and make a guess about what we think is going to happen.

You then design an experiment that will help to answer that hypothesis.

And then you conduct the experiment in as objective of a way as possible.

You analyze the results and draw conclusions.

And then you report your findings.

Often, when you get to that piece of sending the study to journals, you then go through peer reviews.

During peer reviews, a scientific article is typically reviewed by three experts in the field.

As an expert in the field, you bring everything you know to looking at this paper.

You read through it very carefully and you try to identify any methodological flaws and alternate interpretation for the data.

There are three ways you can send it back.

The first is that you can say it is accepted as is.

The second response can be accepted as is with revisions, ranging from minor to major.

Or you can reject the paper.

The review process is all done blinded.

It passes three researchers in the field and the editor, and then it can get published.

The peer-review process is very important because it allows fresh eyes to look for any weakness in the paper.

It is because of peer review that there is such a small fraction of papers that ever get retracted, and it works out to be less than 1 in 1,000.

They are often retracted because of the discovery of a mistake.

The person who is performing this research is just interested in expanding human knowledge, and that is why we see so few examples of fraud or bias to the point of needing to retract a paper.

 

What to Look For

All scientific papers require a disclosure of competing interests, which is a disclosure of funding. (38:39)

They also have to disclose any potential affiliation that could introduce bias into the study.

There is always a statement, usually towards the end, before the citations.

This is always an important thing to keep in mind.

The affiliations of the authors are also important details to look for.

Just because there is a financial disclosure that is linked to industry, does not mean that the research is biased.

The peer-review process is still the main thing that is supposed to detect bias.

Sarah thinks that the most important thing to look at is the body of scientific literature as a whole.

In the alternative health communities, Sarah thinks that there is a tendency to look at a body of scientific literature and to simplify the findings on the one paper that shows something different.

A lot of the interpretation that we get is either 'this one paper is the truth' or you get a dismissal.

Neither one of these approaches is the right way to look at that one paper that shows something different.

You want to look for the consensus.

And you want to look for what the majority of the data is pointing to.

Scientific consensus happens when you have enough data that the vast majority of experts looking at that data come to the same conclusion.

It doesn't mean that every single study ever done supports that consensus view or that every scientist looking at the body of scientific literature comes to the same conclusion.

However, it means that the vast majority of the data aligns with that explanation and that the vast majority of experts looking at the data agree.

A hypothesis is a possible explanation or a preliminary conclusion or an educated guess.

A theory is when the evidence builds up so much so that you have this scientific consensus and you can start to predict based on the theorem.

Sarah shared an example of how this plays out using the theory of gravity.

 

Types of Studies - Anecdotal & Expert Opinions

The lowest strength of evidence is anecdotes. (47:34)

"Expert opinions" fall into this realm as well.

This is basically, I'm looking around and not necessarily measuring anything.

It also reflects personal experience and is not necessarily representative.

This is what we might call a handwave explanation.

It is not meaningless.

However, it should be viewed as an indication that there might be something interesting to explore there.

There is nothing about an anecdote or expert opinion that is proof.

It is really the formulation of the initial question.

 

Types of Studies - Case Reports & Case Studies

From there we can get into studies that start to solidify the question and the need to answer this question and expand on our understanding of that answer. (48:31)

The next level is either case studies or case series.

These are purely observational studies.

A case study is typically an account of something that happens to one person.

And a case series is a group.

It is an anecdote with measurements.

Sarah mentioned her anti-keto stance and said listeners can find more on that here.

 

Types of Studies - Case-Control Studies

The next improvement in terms of strength of evidence is case-control studies. (51:26)

These are retrospective, which means looking back.

However, you have two groups within the study to compare against.

They then trackback to determine an attribute or exposure that could have caused this.

These studies show correlation, but it is hard to prove causation.

 

Types of Studies - Cohort Studies

From there we can go to prospective studies, which are called cohort studies. (52:44)

This is where you take a group of people and you follow them over time.

So instead of comparing diabetic and non-diabetic people, you take a pile of people and see which ones develop diabetes.

These are much stronger studies because there is much less room for selection bias.

This study provides a much more rigorous data set.

You have a lot less challenge with selection bias.

These studies show correlation, but it is hard to prove causation.

 

Types of Studies - Mechanistic Studies

Sarah places a high value on mechanistic studies. (54:46)

These are mostly animal studies and cell culture studies.

With these, you are trying to explain how something is linked.

They provide mechanistic insight and improves understanding of an effect.

It also proves causation by explaining why/how an effect is seen.

Subsequent human trials are required to verify the predicted effects of the intervention.

 

Types of Studies - Randomized Control Trials

This is considered the gold standard. (56:27)

Subjects are randomly assigned to a test group, which receives the treatment, or a control group, which commonly receives a placebo.

You can then design these to control for different types of bias.

“Cross-over” trials: participants switch from control to treatment, or from treatment to control, groups half-way through the trial.

"Blind” trials: participants do not know which group they are in.

"Double-blind” trials: neither the participants nor the experimenters know which group the participant is in.

Blinding trials helps to remove subconscious bias.

Sarah shared other ways you can remove bias.

You still need to combine the data from a randomized control trial, which is the intervention.

When you have enough information to make a prediction about what is going to happen, you run the intervention to see if your prediction is correct.

However, you still need the mechanistic studies to support that data because they explain why.

 

Types of Studies - Meta-Analyses

From there that are meta-analyses. (1:01:27)

This is where we pool together the data from multiple randomized control trials and look at a much bigger data set.

And this is a really great way to look at a bigger body of evidence to see if an effect still happens even with all these differences.

Looking at a meta-analyses helps us determine whether a difference is based on how a trial was set up versus a true difference.

These are really important types of studies to do.

 

Types of Studies - Systematic Review

The height of scientific evidence is called a systematic review. (1:02:22)

This is where you go through meta-analyses all the way through the randomized control trials, you look at the cohort studies, and then you look at all the mechanistic studies.

From there you are able to say, ah-ha, here is what this huge body of scientific evidence tells us, and here is the explanation.

This is again something that Sarah puts a lot of stock into as she is going through something.

They take into consideration the quality of the studies included.

Reviews can help mitigate bias in individual studies and give us a more complete picture.

Lastly, they are the best form of evidence, and either develop consensus or indicate the need for further studies.

 

How to be Objective

The main takeaway from going through those types of studies is to understand that none of them by themselves is the proof. (1:04:42)

The correlation does not equal causation.

Sarah has a hard time when people approach research with a conspiracy theory mindset and think that the one study that shows the difference must be the truth.

When we ignore the 90% of studies that show the other thing.

Sarah also gets really upset over dismissing that one study because it shows something different.

What it shows is complexity.

To Sarah, she wants to understand why that one study shows something different than the rest.

So that is another thing to look out for.

Avoid cherry-picking and dismissing research.

Science is the pursuit of truth, it is not the pursuit of backing up your opinion.

If it doesn't back up your opinion, change your opinion. That is the scientific method.

The other piece that upsets Sarah is when she sees the dismissal of papers because they were done in a small number of people.

This is the last piece of the thread to pull in here.

Statistical power is related to the standard deviation and the magnitude of the effect.

Sarah explained this in greater detail and why it is a key detail in this all.

Scientists are trained to answer the question with as little use of resources as possible.

This means as small a sample size as possible, and this is because no matter what type of experiment you are doing, increasing the sample number has costs associated with it.

Scientists are trained to do the minimum number of experiments to have statistical significance.

Understanding statistical power is the most important because it is about understanding the magnitude of the effect and how to measure that with confidence.

Not every study needs to be done in 200,000 people to be relevant.

The thing to look for is to look at those P values and look at whether or not that data reaches statistical significance.

 

The Takeaway

For our listeners, the biggest thing that we want you to take away from this discussion is understanding that if a scientific study is worthy of dismissal, then it is a flaw that is going to get that study retracted. (1:13:48)

The scientific community is really good at policing itself for quality.

Don't let somebody without a science background who is selling you some kind of supplement tell you that the paper being looked at is irrelevant or wrong.

It is not, because if it is it will get retracted.

We have all these different ways in the alternative health community to dismiss science.

The problem with that is when science is really important and relevant, we are basically training ourselves to be conspiracy theorists.

We are training ourselves to dismiss science.

It becomes a slippery slope when we find excuses to dismiss papers, making data meaningless.

When presented with conflicting evidence, if you see dismissal of that evidence, a red flag should go up.

The building of scientific evidence is what is important.

With an open mind to what conflicting data can actually reveal about a system - that is where we can be informed by the science in a way that improves our lives.

At the end of the day, science is all about improving our lives by increasing human knowledge.

Stacy noted that we need to be mindful that this information is complex and we need to be asking if this is coming from a credible source.

For Stacy, she personally looks to review a summary or an abstract and checks the sources from there for any possible flags.

Sarah took a moment to share on intervention studies.

 

For Special Consideration

There is a type of animal study that is called an intervention study that is called an intervention study. (1:20:20)

This is like the randomized control trials that we do in humans, but we are doing it in animals.

And this is used a lot in drug development and vaccine development.

This has a different weight to a mechanistic study.

You cannot necessarily draw a straight line between data found in an animal study and what to expect in humans.

A mechanistic study is about understanding the biochemistry - understanding how something happens.

Where an intervention study is about measuring the magnitude of effect from this manipulation point.

This is where you do need bigger sample sizes.

And you can't say that because something worked in rats, it will work in humans.

Another thing to look for in smaller studies is the definition of the population that is included.

Sometimes that does mean that you take the information with a grain of salt before we start expanding that information to the general population.

When it comes to vaccine development, one of the challenges is that we want to give it to the entire population.

We need studies that show the safety profile in a heterogeneous population, people with genetic differences, and different conditions.

A study also needs a bigger population to determine if those adverse reactions are happening with this vaccine and the frequency of them.

Having those large sample sizes for an intervention trial is about having a sample that represents the general population so that we can identify efficacy as well as safety.

This is the type of study where you want a really big population.

When a covid vaccine is available, we will dedicate an entire episode to this topic and Sarah will dig in on the science.

We have reached a point where science has become politized and it shouldn't be.

 

Closing Thoughts

Context is important. (1:27:31)

It is very easy to cherry-pick a quote that someone says and apply it to completely different circumstances.

We are talking about not cherry-picking information, and continuing to educate ourselves.

It is important to look for opportunities to continue learning and expand our understanding of what works.

If you here us have a show about something that contradicts your current opinions/understandings, don't just listen to twenty minutes of the science and skip past the conclusion.

When you just read/listen to a certain part, or skim the information, you will miss important pieces of the whole.

We do our absolute best to always be broad in terms of what we are talking about.

Stacy shared an example of how this plays out with research on red wine and how this plays out in a large sample size.

It is not fair for us to boil down the complexity of science to a soundbite or a sentence without context.

We appreciate your patience and understanding as we try to navigate and boil oceans sometimes on this show.

Our goal is to keep shows to under an hour, and we are rarely able to do it.

We want to make sure that we aren't coming out with a show and sharing simple bullet points on the subject.

Sarah shared her thoughts on how our society's current health standards have shifted the way that we seek information.

It is important to be cautious of predatory marketing practices.

Being willing to revisit recommendations and have a new conversation about something is the scientific method.

It is different than being wrong before - iterating on human knowledge is science.

Sarah shared her excitement for where we are currently at with nutritional sciences.

The reality is that nutritional sciences is young enough that right now we are drawing the best conclusions that we can with the date we have.

However, there is a lot of unanswered questions that science needs to answer for us.

Stacy found it fascinating to look at the relative newness of nutritional sciences when compared to other areas of research.

This is what we are here to do for you.

Sometimes we might find something that contradicts something that we said before.

What Stacy loves is that we are willing to say, well, this is new and it is time to revisit this topic.

You do the best that you can with the knowledge that you have at the time.

The responsibility that Stacy feels we all need to have is to continue to learn so that that knowledge doesn't stay static.

This is where science is magic.

Sarah hopes that this was helpful for our listeners.

We would love to hear your follow up questions, which you can submit via social media or the contact forms on both of Stacy and Sarah's sites.

Thank you for listening!

We will be back again next week and we will strive to make it a shorter show! (1:39:39)

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