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The Paleo View

The Paleo View: Parenting, Science, and Gossip

  • (0:40) Welcome

    • Welcome back to The Paleo View everyone!
    • This is the last week that Stacy will be coming to you from a location other than Virginia
      • Matt and Stacy have been on the road for 61 days
      • They are heading back to Virginia the day after this show was recorded
      • Stacy is looking forward to being back home and snuggling her pets
    • Stacy is looking forward to discussing this week's topic, as Sarah and Stacy have been wanting to cover this topic for a while now
      • This week's episode will include information on hormones and body parts, so if you typically listen to this show with little ears around you may want to be careful, depending on your comfort level
      • Sarah noted that this week's episode is about men's health, which is a really fun topic for the hosts
        • The discussion will focus on men's hormonal and reproductive health
      • If you aren't yet ready to discuss these topics with your little one, be sure to listen to this show without your little people around
      • Stacy is looking forward to sharing this discussion with her three teenage boys
    • This episode is sponsored by EverlyWell
      • This is an awesome sponsor for this episode since Stacy and Sarah will be talking about testosterone
      • EverlyWellis an at-home lab testing company that offers a variety of tests, ranging from food sensitivity to metabolism, to a thyroid test, vitamin D, testosterone and general men’s health
      • The tests are private, simple and all processed through certified labs
      • All you have to do is head to EverlyWell, choose your tests, and they’ll be shipped directly to your doorstep
      • Then, once you complete your sample collection and send it back into EverlyWell’scertified labs, they will process your sample and send you your results via EverlyWell’ssecure online platform within just 5 days
      • EverlyWelltakes all of the guesswork out of lab testing and puts the power into your hands to complete a range of important health tests all from home
      • To check out EverlyWellvisit: https://everlywell.com/thepaleoview
        • You can get 15% off with the code 'ThePaleoView'
    • For Stacy, while this week's topic doesn't particularly pertain to her, she is looking forward to applying this week's information to the men in her life
  • (6:52) Q & A

    • This week's episode is inspired by a question from John

      • John writes:

        • "Hi ladies! I know if I say nice things, there's a better chance my question will be answered. Fortunately, that's easy to do. As a researcher myself I love that the Paleo View emphasizes facts over dogma. I know when you answer a question, I will learn something, and that is about the highest compliment I can give a podcast. I love that the two of you are interesting to listen to, and I have been a regular listener since (about) episode 20 (the early shows were good too!!). As one of your '6 male listeners', my question involves men's health. While there have been a number of shows dedicated to women's health, I have often wondered if there would be any link between a Paleo diet (or other dietary factors) and testosterone and/or erectile dysfunction. There's also a pretty substantial supplement business that claims to raise testosterone; any truth in these claims? I know there's the basic 'eat a healthy diet and exercise' but I thought maybe you could bring a more scientific approach to the question. I also feel that many women who have husbands/boyfriends dealing with these issues would be interested in understanding whether/how Paleo might help. Thanks!!"
    • Stacy noted that testosterone is not just a male hormone
      • She isn't sure what all this hormone effects and is looking forward to Sarah diving in on this
    • Sarah wants to take John's question and focus in on:
      • The role that testosterone has on men's health
      • The things that cause testosterone deficiency
        • What this looks like
        • What diet and lifestyle factors might be involved
        • What supplements will help raise testosterone levels
    • Testosterone as the predominantly male sex hormone has a major role in development and puberty
      • It also has a fundamental role in health
      • The crossover with women's health happens as testosterone regulates muscle size/strength, the general turnover of muscle tissue, bone growth and strength, sex drive, sperm production, it impacts mood, cognition, attention, memory, spatial awareness, behavior, negotiation abilities
        • It regulates libido in women as well
      • Sarah shared details from a study that was done on the correlation between testosterone levels and men's negotiation tactics and skills
      • Overall testosterone has a pretty big impact on psychology and physiology
      • Low testosterone can be seen in lack of motivation, lack of healthy competitive nature
        • Stacy thinks about the way healthy competition can be a really good thing
      • Sarah noted that in the male body you really only see testosterone excess in the context of a bodybuilder or a professional athlete doping with testosterone
        • It is not a common physiological occurrence that the male body will make extra testosterone
        • In women, we see testosterone excess in PCOS
          • This condition is hallmarked by elevated testosterone levels
          • Women have so little in our bodies compared to men that we have this room for excess
          • With men, this is not the case
            • The health challenge with testosterone for men is low levels
    • Testosterone generally decreases with age, starting in middle age
      • We see this at a rate of 1 to 2% a year
      • This is considered part of normal aging
      • It is not as dramatic as menopause since it is a gradual decline
        • There are some symptoms that echo menopause though when a man's testosterone is low
    • Symptoms of testosterone deficiency:
      • Hot flashes
      • Reduced body and facial hair
      • Loss of muscle mass
      • Low libido
      • Erectile dysfunction
      • Impotence
      • Small testicles
      • Reduced sperm count
      • Infertility
      • It can lead men to form breast tissue
      • Irritability
      • Depression
      • Low concentration
      • Osteoporosis
    • As is the case with all hormones there is a spectrum
      • A small deficiency in this hormone is going to cause an amount of these symptoms that might be easily dismissed

        • We typically see this in something so minor that we brush it off
      • It is not until it is a really big problem that we ask the question - what is going on
      • With a lot of these symptoms, you might not even tie them with testosterone levels unless you have a really good functional medicine specialist or you go and do the men's health panel from EverlyWell 
    • The problems with elevated testosterone levels we classically associated with bodybuilders
      • We see:

        • Really bad acne
        • Liver damage
        • An increase in heart attack risk
        • Weight gain
        • Aggressive behavior
        • Irritability
        • Impaired judgment
        • Delusions
      • The dominant studies of this are on athletes who dope
    • Stacy noted that she feels there is a stigma around low testosterone levels and the idea of doping or supplementing to raise these levels
      • She reminded listeners that Stacy and Sarah are not judging men for what they might need to do for their health
    • Sarah noted the difference between doping and hormone replacement
      • Doping specifically refers to taking excess

        • You are not trying to achieve normal levels
        • You are trying to achieve high levels for the sake of performance
      • If your levels are low, hormone replacement may be the best treatment
        • This is a conversation to have with your doctor
        • The best treatment may be to take exogenous testosterone
          • This is the exact same thing that an athlete would take

            • The difference is the philosophy behind it
            • If you are taking it as a hormone replacement your goal is to reach normal levels and to regulate your levels
            • As opposed to an athlete who is taking it to increase performance, and their cost-benefit analysis is very different in the context of testosterone excess
  • (23:08) Testosterone Deficiency

    • Beyond the symptoms associated with testosterone deficiency, the health risks include some other bigger risk factors

      • Deficiency increases your risk of:

        • Metabolic syndrome
        • Cardiovascular disease and mortality
        • Inflammation
    • It is worthwhile doing some investigating and really trying to dig a little deeper in terms of measuring testosterone levels and potentially either addressing diet and lifestyle factors and/or testosterone hormone replacement in order to bring levels up to normal in order to reduce those other risk factors
    • Stacy asked how one would know about normal levels
      • Sarah noted that the "normal" range for testosterone levels is huge

        • There is not really a good indicator if one should be at the higher or lower end of the range in order to have optimal whatever it is
        • It is typically diagnosed based on the combination of the actual number and the symptom checklist
        • This is why working with a functional integrative medical practitioner can be very helpful
        • Again, EverlyWellhas a straight testosterone test that is quite inexpensive and also a Men's Health Panel that includes testosterone, DHA, estradiol, and cortisol
    • There are no studies that look at named diets and men's sexual health
    • There is still a lot of information about the role that micronutrients, lifestyle factors and broader dietary factors that can help influence how we implement a Paleo diet to best support testosterone regulation
      • Exercise is one of the best things that both men and women can do to support testosterone levels

        • Specifically resistance training
        • Endurance training does tend to lower testosterone when combined with calorie restriction
      • Sleep is one of the biggest lifestyle influences on testosterone
        • Sarah shared the findings from studies done in an institution

          • When participants were only getting 5 hours of sleep a night, they saw a 15% decrease in testosterone

            • This is basically the same levels as what is seen in a 65-year-old man
            • Testosterone levels seem to be closely tied to the amount of REM sleep we get each night
      • Stress levels are also an important factor to consider when looking for ways to impact testosterone levels
        • Chronic stress is linked to low testosterone
      • As far as diet, there is not much data out there in terms of big dietary trends
        • The relation with diet and testosterone is much more micronutrient focused

          • Deficiency in a few nutrients can cause low testosterone

            • Vitamin A
            • Vitamin D
            • Zinc
            • Magnesium
            • Vitamin K
          • Supplementation in all of these nutrients can restore your levels
            • Through liver, you can get vitamin A
            • Testing your vitamin D levels will be best to see how to reach sufficiency
            • Omega 3 fats help to support testosterone metabolism
          • If you supplement men with these nutrients it doesn't cause testosterone excess
            • It is only related to deficiency in these nutrients driving low testosterone
            • Once you have enough, the system can help regulate itself
      • Chronic alcohol consumption can also cause low testosterone and antioxidants in general
        • If you are not getting enough nutrients from your diet, magnifies the reduction in testosterone
      • There is not a good link between testosterone and BMI
        • But there are some interesting studies that show that losing weight can boost testosterone levels
      • Sarah recommends looking at your intake of the micronutrients mentioned above, evaluating sleep and other lifestyle habits, and see if there is an obvious place where you can make some changes that are likely to help regulate testosterone
        • If testosterone is really low, you are going to want to go right to a functional medicine specialist and look at testosterone replacement therapy
      • Supplements Sarah looked into and recommends based on how safe the supplements are:
        • Get a professional opinion before taking supplements to address a deficiency
        • DHEA
        • Creatine
        • D-aspartic acid
        • Fenugreek
        • Ginger
        • Ashwagandha
      • Stacy wants to reiterate that before you make a smoothie with all the things, that testing your hormone levels and knowing where you are is so impactful
        • While you could do this a variety of ways, Sarah and Stacy both use and recommend EverlyWell
        • You or a loved one can test your hormone levels for under $50 using the code 'thepaleoview'
        • Once you know where your levels are, then you can work with a functional medicine professional to look at your hormone levels and develop an action plan on how to handle
        • Sarah emphasized how important it is to make decisions based on data when we are talking about hormone levels
  • (59:04) Closing Thoughts

    • Thank you so much for tuning in listeners!
    • We hope you found this show helpful
      • There are a number of other topics related to both female and male hormones and health that Stacy and Sarah are hoping to cover in upcoming episodes
    • If you liked this episode, be sure to leave a review on iTunes and share it with people you love
    • Thank you again so much for being here!
    • Stacy looks forward to joining the show from Virginia
    • Sarah thanks EverlyWellfor sponsoring this episode
      • As a reminder, get 15% off with the code 'thepaleoview' at this link
  • (0:41) Welcome

    • Welcome back listeners to episode 363 of The Paleo View!

      • Stacy is joining in from Austin, Texas will solid WiFi

        • Also known as rant quality WiFi
      • After taking a peek at the show outline, Stacy is feeling pretty excited about this week's episode
    • Sarah had a great camping trip, but they were rained out the second night
      • What started as scattered thunderstorms quickly evolved into strong storms with a wind advisory and severe weather water

        • This was going to last 12 hours
        • So they decided to have dinner, pack up and head home at 9:00 p.m.
        • After traveling so late, Sarah had to spend an entire day resting up to offset the lack of sleep from the night before
      • The time that they did have to camp was wonderful
        • They hiked up to a mountain, down to a waterfall and they savored their time together in full-on nature mode
    • Stacy is grateful that she has never had to experience a major storm while camping
    • Matt, Stacy and the boys are excited to explore Austin and to eat at some of their favorite spots
      • They went from cool temperatures at their last stop in Santa Fe to warm temperatures in Texas
      • Before Santa Fe, they were able to visit the Petrified Forest and it was an incredible experience
        • Listeners, add this spot to your bucket list of places to visit
    • This week Stacy and Sarah will be talking about fad diets
      • The question that kicked this all off Stacy received from a friend and had to do with phytonutrients in vegetables as being problematic

        • This friend follows a ketogenic diet
        • Phytonutrients in vegetables are one of the 'why' points that people in the ketogenic community mention when defending their dietary choices
  • (14:06) Phytonutrients

    • Sarah finds this 'why' point to be interesting

      • It is looking at things like phytates and oxalates as being somehow problematic when it comes to mineral and nutrient absorption

        • This isn't true, they don't stop you from absorbing nutrients and they don't leach nutrients or minerals from your body
        • You have bacteria in your gut that actually processes oxalates and phytates and liberate the minerals that are bound
        • Having a healthy gut microbiome is key for being able to absorb the minerals that are bound with phytic acid and oxalic acid
      • There are plenty of other nutrients in even the highest phytate and highest oxalate vegetables that will be absorbed without our gut bacteria there to help
        • So you can't say that you have poor gut health, so it is better for you to avoid these high phytate and oxalate vegetables
        • The way that you grow those bacteria that help to break those down is by eating those foods
        • High oxalate foods include organic radishes, turnips, spinach, and arugula
          • We eat these foods raw and organic, and then we will expose our gut to basically nurture the colony
      • There is no science that would point to any kind of risk associated with eating these vegetables
      • This myth has been busted so many times, and yet it keeps coming back
        • There is a lot of confusion around Phyto versus anti

          • Phytonutrients and antinutrients are not the same things
        • There is a huge body of scientific  literature showing us that a high phytonutrient diet is one of the most important aspects of reducing cancer risks and cardiovascular disease risk
          • Most phytonutrients are incredibly potent antioxidants

            • They are anti-aging
            • They are anti-inflammatory
            • They stop DNA from mutating
            • They can protect against depression and dementia
          • The range of phytonutrients and their effects is spectacular
          • We know that there are two things in vegetables that are responsible for all of the benefits that come with a high vegetable consumption diet
            • One is fiber because fiber regulates our digestive system and feeds our gut microbiome
            • And the second is phytonutrients because of the huge range of benefits that phytonutrients have
              • Sure there is a very very tiny percent of phytonutrients that in isolation could have a negative effect
              • However, they are packaged in this package with so very many more positive effects
            • Vegetables are really really really important
    • Stacy is reminded that this is an exercise in being an educated consumer of information
      • Evaluate the sources of your information
      • Know where these sources are getting their information and look into those sources yourself
    • Sarah and Stacy strive when preparing The Paleo View to provide listeners with the base knowledge to evaluate whether or not something makes sense
    • Sarah has been working to educate people on how to evaluate science and how to value science
    • This podcast should be a place where listeners can ask questions when the information they are seeing is too confusing and to give you the base knowledge that you need to see something in all of the scientific research
  • (29:53) Q & A

    • Jackie says, "what do you think of the Paleo Green diet, Keto Green diet, or the Pegan diet? I have heard Dr. Hyman and Dr. Perlmutter talk about them as it relates to keeping the microbiome healthy by getting tons of low-carb veggies & prebiotic fiber in the diet.
    • This is a few different variations of recognizing limitations within keto
    • Stacy and Sarah have talked about the problems with a keto diet in two previous podcast episodes (hereand here)
    • There were two papers published in 2019 on the ketogenic diet that showed very undesirable shifts in the gut microbiome
    • Sarah has been talking about this for five or six years now, that her deep concern about keto is that it simply doesn't provide enough fiber
      • It's so low carb that it is extremely difficult to get sufficient fiber to support a healthy gut microbiome
      • It is also low fiber diversity
      • Yes, there is a therapeutic benefit to incorporate a ketogenic diet when treating a neurological and neurodegenerative disease
        • People in these situations are taking on a keto diet under medical supervision
      • When we discuss people using a keto diet to support weight loss, this is a different conversation
    • What is happening now that this research is out showing that keto has all these problems:
      • 1) Some people are dismissing every paper that shows that keto might not be great
      • 2) Other people are looking at the information and trying to figure out how to get the benefits of keto while mitigating the detriments
    • Dr. Anna Cabeca is one of the leaders of the Green Keto movement
      • This dietary approach basically combines keto with the alkaline diet

        • The alkaline diet is rich in veggies, low meat, which has also been well busted in the scientific literature
        • The idea is that by eating a lot of vegetables that it is healthy for the kidneys because  the kidneys control the Ph of the body and the phytonutrients in vegetables provide the raw materials for the kidneys to effectively do their job
        • However, there is no scientific evidence supporting the low-meat part of this diet
          • High meat consumption is not strenuous on the kidneys
      • Dr. Cabeca has combined that philosophy of consuming tons of vegetables (especially green vegetables to keep the carbs low) and has basically created a more plant-focused version of keto
        • She recommends using supplements to maintain ketosis on this plan
      • The thought process in this is overall good because you are getting a larger diversity of vegetables and you are getting a lot of fiber
      • However, there are still other concerns that Sarah has about why this dietary approach is not ideal
        • There are things that keto triggers in a low insulin environment

          • We do need to make some insulin because it is important for thyroid health, muscle and bone health, hormone health, and memory
          • There are a lot of things that this super hormone does in the body
        • Low carb diets have this fundamental flaw of not providing us with nutrient sufficiency and missing out on some nutrients that our body really needs
      • It's an interesting thought to try to get the best of keto, but the best of keto is not great
        • There have been a couple of studies that have shown that when you lose weight on a ketogenic diet that you lose more muscle per pound of fat than you do when you are just counting calories
        • It is a fad diet that doesn't live up to its promises
        • Even though Green Keto is a really good thought, it's still not enough
    • Stacy feels that any lifestyle or diet that requires the purchasing of anything to add to your diet means you are missing something
      • If you are being told you need supplements or you need this thing to test your ketones, it means that it's not complete in an of itself
      • It also means that it is not sustainable longterm
    • Both Stacy and Sarah choose to take supplements because they aren't getting all that they need of certain nutrients (like vitamin D) from diet alone
      • But Stacy and Sarah are not here to tell people that they need to take certain supplements because it is missing from the lifestyle they advocate
    • Stacy pointed out the way in which fad diets tend to get hung up in labels
      • She loves the way Sarah describes the way she eats as a low-inflammatory, high nutrient-dense diet
      • It is super important for people to understand
        • This description is a nuance that doesn't sell well as a fad diet book
        • However, it does really help health as it relates to a longterm lifestyle for people to figure out individually what works for them
  • (44:20) The Pegan Diet

    • Jackie also asked about the Pegan Diet which is the terminology spearheaded by Dr. Hyman

      • Dr. Hyman saw limitations in both a vegan and Paleo approach
      • He wanted to take the best of both and combined them into a Pegan approach
      • It's plant-based Paleo, but not in the way that Stacy and Sarah talk about it
    • Sarah wants to preface this part of the conversation about what Pegan is by talking a little bit about what her upcoming book, The Gut Microbiome is all about
      • It is not available for preorder just yet, but she is working really hard on it
      • This will not be a Paleo book
      • She is going through the gut microbiome research and writing about what the research says
      • There is no branded diet in it whatsoever
      • She is building the principles of a healthy diet from the ground up based on our microbiome health
      • When you build this diet from the ground up it looks like a very veggie-rich Paleo diet with that Mediterranean, olive oil type, healthy fat focus
        • Moderate fat
        • Moderate protein
        • High vegetable consumption, including fruit and root vegetables
          • So it is moderate carbohydrate
        • There is room for non-Paleo foods that actually may be very beneficial for us
          • This includes lentils, chickpeas, split peas, gluten-free oats, rice, and A2 dairy
      • This book has no diet dogma behind it and simply reflects the research
    • Dr. Hyman's recommendations include:
      • No sugar
      • Nothing that has pesticides, hormones or GMOs
      • Nothing that is refined or manufactured
      • High vegetable consumption
      • Not too much fruit
      • Healthy fats
      • Limiting or avoiding dairy (goat or sheep instead of cow)
        • Always organic and grass-fed
      • 4 to 6 oz. serving of meat per meal
      • He has a strong focus on food quality
      • Recommends avoiding all gluten
      • Gluten-free whole grains sparingly
      • Lentils are the best
        • Only eat starchy beans every once in a while
      • Functional medicine is also another point that he highly recommends
    • Sarah thinks that this is the best of the trademarked version of a plant-based diet combined with Paleo
      • This might potentially still be a little carb phobic
      • However, it does increase Phyto content consumption
    • Overall Sarah thinks that there is a lot of confusion within the Paleo community, which is why she wrote the Paleo Approach
      • As new research emerges, there are no prominent figures within the community who shares on these findings
      • This means that there are people within the community who are not highly informed individuals who are making recommendations that are not based on scientific evidence
      • There are still people who are following a very high meat consumption version of Paleo
        • There is still a high level of people who follow Paleo as a meme instead of a way of life
      • Stacy and Sarah's approach is to try to correct the record about what Paleo is so that people coming into the community understand the importance of vegetables, eating snout to tail, nutrient density, seafood, toxin concerns, etc.
      • They are trying to create an evidence-led robust scientific foundation for Paleo to stand on
        • So that people coming into the community are not adopting a fad version of Paleo where they are just eating a ton of meat and bacon and dark chocolate
        • Where people instead are eating a low-inflammatory, nutrient-density diet
    • Dr. Hyman has looked at those communication challenges within the Paleo community and has decided to rebrand and create a new thing with a new name that can fall under his umbrella
      • It's a different solution to the challenges that Paleo has right now as it grows and absorbs different alternative health communities and the different priorities that different health communities bring to the Paleo community
    • The Pegan approach is interesting to Sarah because it's basically giving up
      • Paleo has become this unmanageable giant thing, and its a ship now that is getting really hard to steer
      • Let's just create a new thing and rebrand
    • In general, Sarah thinks that Pegan is standard Paleo with room for self-experimentation
    • This generally seems like a thing about branding
      • Sarah just isn't sure what she thinks about that
      • She sees the Paleo community as this really amazing group of people who are really invested in their health and she doesn't want to just jump ship on that to simply have a different framework to say the exact same thing
      • She would rather stay rooted and embedded in this community and help to continue to provide that scientific foundation for her choices and call out where influences from other alternative health communities come into Paleo are misled or nuanced
      • Sarah wants to make sure that this community is really well informed and understands why one food is great, why one food isn't, and all the world of gray in between where foods can have pros and cons and might work for you and might not
        • To be able to approach Paleo in not just a balanced way, or a science-led way, but in a non-dogmatic, non-rule based way
    • Stacy says that it makes so much sense to live in a non-dogmatic way, but use principles
      • This is consistent with what Stacy and Sarah have been talking about on the show for years
      • If you look at the way the Paleo community has gone with Chris Kresser's Paleo Code, Rob Wolff's Wired to Eat, and The Perfect Health Diet, you can find countless resources that show the ways in which the Paleo template has evolved as science has evolved
      • Stacy thinks that it is a lot more difficult for people to wrap their mind around the idea of these are guiding rules about food
        • But they are guiding, and they are not hard and fast
        • You will have to figure out what works for you
      • For Stacy personally, she thinks about food and asks is this nourishing me? Or is it not?
        • And there is the additional factor of, is this detrimental to my health?
      • Stacy and Sarah both shared how they personalize based on the years of experimentation they have done
    • Stacy is baffled that we are still trying to put labels and rules around what everyone can or can't eat
      • She feels like we are all individual people who come from different genetic backgrounds
      • And because of these differences, we tolerate different foods differently
      • It's as simple as getting back to basics
        • Eating real food that supports health
      • The more that we really have this mantra with ourselves, "is it helping me get healthier?"
        • And if it's not, is it harming my health?

          • Am I using it in a way that develops social or emotional development for myself
        • It's not just a vacuum
  • (1:08:37) Closing Thoughts

    • Sarah has to share one really exciting thing before they wrap up with is week's show

      • Next week is The Paleo View's seven-year anniversary!
      • Stacy feels that seven years is a very long time
        • And yet it is interesting, that here they are revisiting the principles that brought them here, to begin with
        • It changed both Stacy's and Sarah's lives in terms of their energy, their health, their weight loss, and so much more
        • The science is still pointing to the guiding principles that got us there, to begin with
      • Sarah finds it amazing that even after recording for seven years, they are not running out of topics to discuss
        • Which is a testament to how important it is to approach diet and lifestyle as an education rather than a sound bite
    • Sarah is so grateful for not just this platform, but The Paleo View listeners
    • Stacy shared on the level of deep connection that she feels towards this community of listeners
    • Stacy would love to meet listeners at her final events
      • Be sure to check out the details here
    • Thank you so much listeners for being here for seven years
      • For showing up at events or each week to download and be with Stacy and Sarah
      • They adore you and hope to share something clever to celebrate the monumental milestone
    • Thank you again so much listeners - Stacy and Sarah will be back again next week!
  • (0:41) Hellos & Happenings

    • Hello, listeners from sunny Arizona!

      • Stacy is loving everything about the southwest, except the internet connection
      • Matt and Stacy were in Sedona when this episode was recorded
      • This stop along their trip has been a great rest and restore spot
    • This week will just be a check-in show since Stacy is having some trouble with the internet reliability
    • There is a topic on the docket for episode 363 that both Stacy and Sarah are super passionate about and incredibly excited to discuss and share with listeners
      • They don't want to record this epic discussion with the chance of the internet going out mid recording
    • Sarah is about to head to the mountains for a family camping trip
      • Sarah's mom is in town and will be joining them for a trip to the mountains
      • They will be escaping the heat, internet connection, and cell service
    • Sarah and Stacy chatted about screen time limits
      • Sarah's husband suggested that she give the time limit features a try but Sarah passed
      • Stacy tried them for a little while when she was still working
        • She set the bedtime feature which was helpful
      • Sarah does use the 'do not disturb' feature on her phone to set boundaries on her time
    • Stacy reminded listeners that if you have been busy working all summer, that simply turning your phone off is a great way to create time to recharge
      • You can even set up your 'do not disturb' feature so that certain people (spouse, kids, etc.) can still reach you via phone call
      • Stacy thinks that having those occasional breaks from your internet is really special
    • Let it be known, Stacy does not like sand.
    • Matt, Stacy and the kids rode ATVs in the desert and had a blast disconnecting and being in the moment
      • Disconnecting is such a great and truly easy way to reconnect with those you love and to fully live in the moment
      • Ask yourself what you need and what really matters and make more time for these things and people
    • Sarah gives talks at business conferences and shares on work-life balance
      • Sarah shares the research on how much you can get done when you take breaks for movement, manage stress, and get enough sleep
      • The very information she shares is a great reminder to Sarah on how and why to take digital media detoxes
      • The mountains are very restorative to Sarah for many reasons, but especially because of the digital downtime the getaway provides
    • Matt and Stacy's boy's first interaction with a cactus
    • Sarah is going to be an American citizen in a week!!
      • She passed her test

        • Sarah worked so hard to pass this test and ultimately over-prepared for it
      • On July 29 she will take her oath
        • By the end of that ceremony, she will have her documentation showing she is an American citizen
      • Sarah's husband will have his ceremony on his birthday
      • Sarah shared on why this is such a meaningful moment in her life
      • America's naturalization process is really unique and special
    • Stacy doesn't think there is much more she can add to Sarah's amazing cherry on top of this check-in show
    • Have a wonderful week!
    • Next week Stacy and Sarah will be back with an amazing episode!
    • Thank you, listeners and huge congratulations to Sarah again!
  • (0:41) Welcome

    • Welcome back to The Paleo View everyone!
    • Stacy is still on the road, and as mentioned last week, is going to talk about how life on the road is going
    • Please welcome this week's special guest, Matt, the other half of Real Everything
    • Matt and Stacy are on day 31 of a 68-day cross-country road trip
      • Recording this week's episode from their Las Vegas hotel
    • This week Matt and Stacy plan to share travel tips from their experience
      • How to eat real food
      • How to plan accordingly
      • What to research during the planning process
      • The lessons Matt and Stacy have learned
  • (3:24) Where to Begin

    • First and foremost, decide on an overall plan

      • Part of Matt and Stacy's plan included how they were going to get to where they wanted to go

        • They initially planned to do an RV trip, but traveling via RV wasn't a fit for them for many reasons

          • Specifically, it is really hard to explore cities with an RV
      • Traveling via minivan has really worked out well
      • Matt and Stacy also looked at all the locations they wanted to visit and exploring their lodging options along their route
        • Stops with friends they could stay with
        • Airbnb
        • Hotels
    • Sarah asked how Matt and Stacy plotted their route (how many miles they would cover each day, how they tracked the details, etc.)
      • Stacy created a Google Doc that started as a list and then turned that information into a table in Google Docs

        • This is an app that they can track on their phone, and even Cole has been able to follow along with their travels plan
        • Matt and Stacy's parents also have access to the document so they can track along with their travels
      • They have also used Google Maps to plot their plans
      • Matt mentioned that they did try using road trip travel apps, but they didn't add any features that were actually helpful
      • Stacy recommends using a tool, whatever you feel comfortable with, to plan this out
        • At first, the planning was happening in Matt and Stacy's heads

          • Then Stacy was capturing details in her Notes app on her phone
          • And eventually, the notes made their way into a Google Doc
          • From there a formal final table was created
      • They started their planning by asking each family member, what two places in the country do you want to visit?
        • This began the plotting process
        • Stacy also had some business to tend to along their travels, which gave them additional points to plot
        • All of these map points and the dates relevant to those various points provided the structure that the trip needs
          • There has been a bit of zigging and zagging in Matt and Stacy's travels, but it has worked out really well for them
      • Another thing to consider is how long your family can be in the car
        • They try to keep it to four hours or less, but they can do 8 to 10 hour days when needed
        • They tried really hard to map out this trip so that they have 4 to 5 hour days on average, with less than a dozen long days on their travel plans
      • Also, look at where you are going and what you are going to want to do once you are there
        • How much time will you need or want at these spots?
        • Keep in mind that you will not be able to see everything
          • For Matt and Stacy's kids, this trip has been great to provide a glimpse into various locations that they want to revisit and explore further
      • The other thing to consider is how to break your days up
        • For example, if you are bringing a pet you will need to stop more often
        • Matt and Stacy are kind of hardcore and avoid breaks
          • They will tell the kids they are not stopping until they need gas again
        • Factor in all breaks into your travel time
        • One of the best things that Stacy did was find a cooler that plugs into the car chargeroutlet in their minivan
          • It is literally a minifridge that also has an electric plug and wheels so that it rolls like a cooler
          • They plug it into the car and then when they reach their destination for that day, they unplug it and bring it into their stop
        • Matt and Stacy also brought along an electric hot water kettleto make their own coffee, Wild Zorapacks and Pique Tea
  • (18:46) Eating on the Go

    • For the most part, Matt, Stacy and the boys have eaten wraps while in the car

      • They have kept romaine lettuce, lunch meat, high-quality cheese, squeeze bottle mayo, and mustard
    • They have also kept trail mixes in stock in the car, but they lean towards the wraps and baby carrots so that people can get in healthy food while on the road
    • Matt and Stacy set up the minivan with the middle seat missing and this is where the cooler and the snack bin lives
      • The snack bin lid serves as the tabletop so that Cole can make people wraps
    • Know your limitations
      • While you are reducing stress in your life without the typical daily stressors (work, house chores, etc.) you are increasing your stress factors in other ways

        • Less than ideal sleep
        • Sitting down for extended periods of time
        • Tracking the mileage logistics
      • So don't add the stress of eating foods that you know are going to cause irritation
        • Stacy has been very careful to not do the things that she know will irritate her

          • She has avoided nightshades, corn, and low-quality dairy
        • This has made a huge difference and has allowed Stacy to feel great
  • (23:21) The Other Things

    • Everyone is starting to feel a bit homesick, but still appreciating the journey as they reach the halfway mark
    • Santa Monica will be a great break for everyone
      • Stacy is separating from the group for a work event
      • Matt and the boys are going to use this bit of time to relax
    • The other piece Stacy wants to mention about planning and being organized - clear bins
      • For short trips, Matt and Stacy typically use storage items they have around the house like paper bags or grocery tote bags
      • However, for this particular trip, they invested in clear stacking bins that allows them to see what is in which bin
        • They simply open the trunk and can see where everything is at
        • Before they left they measured out the space to see how the bins could fit and how many they could fit
    • Matt and Stacy also purchased a Turtle Topperwhich has been a great investment that has helped with their travels
      • The Turtle Toppercame with matching duffel bags that fit perfectly inside the storage container
      • It is also very compact and hasn't impacted their ability to fit in garages
    • When it came to packing, this trip really forced the family to practice a minimalism mentality
      • Even when out exploring, when the boys want to buy something, Stacy challenges them to think about where the item would fit
      • They packed for all weather types
        • Each family also packed two pairs of walking shoes and one pair of sandals
      • Since you can't get mail, you really need to plan ahead for what all you will need
        • You could potentially use an Amazon locker if you were to time your travels exactly right
      • Other clothing items:
        • Raincoats
        • Hoodies
        • Hats
        • Sunglasses
      • A first aid kitwas also an incredibly important addition to their packing list
        • The snafu that happened with Finn that made Stacy feel like a supermom for packing the ultimate first aid kit
    • Being able to think on your toes, research and adapt are all important pieces that you will need while on the road
    • Matt and Stacy also packed some key supplements (anti-gluten pill, activated charcoal, and probiotics)
      • Stacy asked Sarah to share more on the gluten enzymes she recommends and why

        • There are a few different varieties out there

          • The one Sarah keeps in her purse is Glutenza made my Numedica

            • It's not designed so that someone with celiac disease can eat a baguette, but it's designed to protect you against cross-contamination

              • It is also really good at breaking apart similar proteins in other high allergen foods
            • It is a sophisticated supplement and Sarah keeps a bottle of this in her purse at all times
              • It has been a lifesaver for her
          • Matt and Stacy have been happy to have this supplement on hand while traveling as well
    • Whenever they are in a home with a kitchen, the first thing Matt, Stacy and the boys do is meal plan for the exact amount of time they will be with a kitchen and stock up on food supplies
    • They may pick one special place to eat out at but are otherwise trying to avoid eating out
      • Be sure to do your gluten-free research
      • Read reviews
        • Stacy looks for details that show that they understand what it means to prepare gluten-free recipes
  • (50:28) Closing Thoughts

    • Matt and Stacy need to pack up and get ready to leave Las Vegas

      • They are heading to Joshua Tree National Park next
    • One of the things that Sarah wanted to mention is that many of the products that Matt and Stacy mentioned are actually sponsors of the show and offer exclusive deals to Paleo View listeners
    • Stacy and Sarah reach out to sponsors with products that they already use and genuinely love
      • These codes stay open - you can use them all the time
      • Be sure to take advantage of these great deals!
    • Stacy thanked Sarah for sharing details on Glutenza right off the top of her head
    • It was great to catch up again!
    • Sarah and Stacy will be back again next week
    • Special thanks to Matt for joining Stacy and Sarah for this week's show!
    • And thank you to listeners for tuning in!
  • (0:41) Welcome

    • Welcome back to the Paleo View!
    • On this week's episode, we will be discussing chlorine and the science behind what the exposure to chlorine does and how to detox
    • Sarah noted that this is a complex topic that doesn't have straightforward answers
    • Before we dive in, a big thank you to Joovvfor sponsoring this week's show
      • While Stacy and Sarah will be sharing more information on Joovv as the show goes on, check them out here: https://joovv.com/paleoview
  • (3:25) The Downsides & Upsides

    • It is important to start the discussion of the downsides of chlorination with a discussion of the upsides

      • Chlorination is used across the globe as the number one way to disinfect pools

        • It is an amazing killer of microbes
        • Before chlorination of pools was a normal procedure, really harmful illnesses were transmitted through pools
          • Recreational Water Illnesses include a wide variety of infections, such as gastrointestinal, skin, ear, respiratory, eye, neurologic, andwoundinfections. The most commonly reported RWI isdiarrhea. Diarrheal illnesses are caused by germs such as Crypto
        • Chlorination is an amazing tool for making sure that swimming pools are safe from a micro perspective
      • It does come at a bit of a trade-off though
        • Because chlorine interacts with organic molecules, there is a variety of by-products that are chlorine based molecules that are formed and are potentially problematic

          • monochloramines
          • dichloramines
          • i Trichloramines
          • trihalogenometans (THM)
          • haloacetic acid (HAA)
        • There are other halogens that have been used to disinfect pools, but they all also cause similar by-products
          • There is an obvious solution
          • There is a move to create new filtration systems though
            • One of the things that happen with these chlorine by-products is that they are evaporating off the surface of the water and they are all oxidants
            • The mechanism behind a lot of the issues that they cause are all oxidative damage
            • They are highest in the air just above the surface of the water
            • There is a move to create air filtration systems in public pools, especially where elite athletes train
        • A lot of the research stems from studies on elite swimmers
          • They have typically double the asthma rates of the average population
        • There is this really interesting give and take that has to do with the chloramine
          • The amount of chloramine in the air is very different depending on the pool you are swimming in
        • Most of the science has to do with asthma and other lung issues
        • Elite athletes, in general, have higher rates of asthma and higher rates of lung infections
          • We see this in swimmers, cyclists, triathletes, and long-distance runners
          • Chlorine is not awesome because it is a toxic chemical
            • These low levels of chlorine exposure that we are getting through chlorinated water, assuming the water is treated correctly, are associated with problems

              • So is elite training though
              • Take a moment to recognize that while swimmers have higher rates of asthma, so do a lot of elite athletes
                • That is because this level of training actually suppresses aspects of the immune system and over activates other systems in the body
              • Other athletes that don't step foot anywhere near a pool also have higher rates of asthma
                • But chlorine does seem to be a contributor

                  • This is because of the disruption that is happening to the lung barrier
        • Barrier tissues are made up of a type of cell called an epithelial cell
          • These cells have a top and a bottom with different processes happening within both the top and bottom
          • Our skin, lungs, gut barrier and sinuses are made up of epithelial cells
          • All of these tissues have the job of protecting the inside of our body from things happenings outside of our body
          • Lungs and gut are different in the sense that they have to be somewhat permeable
          • So even low levels of toxin exposure in the air above the surface of the pool can potentially disrupt the lung barrier
        • There are some interesting studies showing that it's not just that someone with a predisposition to asthma has asthma made worse by breathing in chloramine, but actually, chloramine is contributing to the development of asthma
        • There are studies showing different sizes of effect
          • The majority of studies are showing that chlorine compounds do contribute to asthma and allergies later in life

            • However, this is not uniform data
            • The magnitude of the effect is very different
              • So there isn't enough data to hone in on a common understanding
              • Where the research is with this is still even just clarifying that the effect exists and understanding the mechanisms
              • The mechanism seems to be the fact that chloramine and these other chlorine by-products are oxidant molecules that cause oxidative damage
                • They cause damage to the lung barrier
  • (15:38) Digging Deeper into the Research

    • What can we do to prevent the negative effects that come with chloramine exposure?

      • There is no science to look at anything like this
    • We can infer that nutrients that are important for lung-barrier function are going to be really important for protecting the lung-barrier against the assault that these chloramine compounds are causing
      • Vitamin A, Vitamin D, Zinc, Vitamin C, Omega-3 fats, and the gut microbiome
      • All of these nutrients are already baked into a Paleo and AIP diet template
    • Sarah inclination out of this is to just be mindful of her barrier tissue nutrients
      • Sarah would also add glycine to the nutrient list even though there is no specific information linking glycine and lungs

        • However, we know that glycine is important for other barriers because it forms connective tissue and there is a lot of connective tissue in the lungs
      • So Sarah would make sure she is adding liver into her mix of foods, checking her vitamin D levels and supplementing accordingly, eating a lot of seafood and vegetables, and making sure she is looking after her stress, sleep, etc.
    • Stacy asked if there is information available on the rate of absorption
      • Sarah didn't see anything with that particular data
      • There were two styles of studies that Sarah found through her research
        • One is done on elite athletes where they are spending hours in the pool every single day and have the highest risk
        • The other studies that are being done on general or pediatric populations are showing a lot more mixed results
          • A lot of this has to do with how much time these study participants are spending in the pool
      • There are some interesting studies where they look at an hour of swimming and looking at mechanisms
        • Chloramine can be absorbed into the skin
  • (25:52) Skin Health

    • Stacy asked if using the dry sauna after swimming is helpful

      • Detoxification, in general, is really helpful

        • Joovvis also really good to help with this
      • We push a lot of toxins out through our skin through sweating
    • The other major concern with chloramine exposure is called chlorine contact dermatitis, which is a form of eczema
      • Chlorine disrupts skin barrier (leaky skin = eczema)
      • When there is a defect in the skin barrier that allows things to cross in that simulates an inflammatory response you get these little patches of inflamed, red, scaly skin
      • There have been some interesting studies that look at an hour in the pool and how that is changing the skin and how it is working as a barrier
        • Sarah shared more on the findings from this study
        • An hour in the pool basically increases the permeability of the skin
          • In the context of other risk factors for eczemathank you are creating this situation where eczemacan form

            • That is why you don't see this happen in everyone, as there are gene mutations linked with eczema
        • Chlorine is basically the barrier disruption that can be that initial event that leads to eczema
          • The study found that the skin returned to normal within 24-hours
    • The chlorine by-products are disrupting the skin barrier in a way that is very recoverable
      • This implies that if we are doing all the other really important skin health things, the impact should be minimal if any at all
      • Give the skin the nutrients it needs to recover quickly
    • There is no data specifically linking an increased risk of chlorine contact dermatitis with vitamin D deficiency 
      • Sarah doesn't think it is a huge leap of logic to go from the nutrients that are important for skin barrier health are going to be important for skin barrier health when that barrier is assaulted by chloramine
    • How to protect your skin against chlorine based eczema
      • Once you have it, don't treat it with histamine creams

        • Its an inflammatory reaction so antiinflammatory creams are going to be the best option
      • If you have a case that needs immediate intervention, go to your doctor
      • However, if it is a minor reaction, it will likely resolve on its own
        • Avoid additional exposure and let it heal
      • If you are someone who regularly gets this skin irritation, you can lube up with vaseline
        • However, this isn't a route that neither Sarah nor Stacy feel comfortable with and shared more on the 'why'
    • There are a ton of post-swimming creams that are marketed that have vitamin C in them
      • Vitamin C is a really important skin nutrient

        • It is a powerful antioxidant
      • Using these products will not be harmful, assuming the other ingredients are also good
      • However, there is zero science on whether or not vitamin C can detoxify chloramine in the skin or reduce chlorine contact dermatitis
    • The ingredients in beauty products are not regulated so it's challenging for the consumer to know what is good and what is not good
      • There is no incentive for companies to collaborate with a researcher to test something
      • Sarah is going to go back that there need to be more regulations on ingredients in personal care products
    • The science is very compelling behind red and infrared wavelengths and the benefits to human physiology in a variety of situations, including skin health benefits
      • There are some really good studies showing that red light therapy in the wavelengths that Joovvprovides in the type of dose-response that Joovvprovides can be beneficial for a variety of skin conditions

        • While we don't have the science to show that Joovvcan help us recover from chlorine specifically we know that it is really good for the skin

          • It can help reduce inflammation
      • For Stacy, the health benefits of regular exercise outweigh what it is that might be happening short-term with the chlorine absorption
        • The benefit of physical exercise is so significant that the minor risk associated with chlorine absorption is outweighed
      • Sarah began the episode with a clear reminder for this very reason
        • Lets remember why we put chlorine in pools before we get freaked out over what chlorine may do to a percentage of us
        • Don't listen to this show and think that you should never swim again because you are worried about the chlorine
          • Use the knowledge of nutrition and how to arm your skin with the nutrients it needs to recover and stay strong
          • Enjoy the benefits of activity
      • Steps to take to mitigate the potential problems associated with chlorine:
        • The nutritional aspects
        • Showering right after you swim
        • Take a look at Joovv
    • To get a hook up with Joovv, you can check it out here: https://joovv.com/paleoview
    • Stacy shared information on salt-water hot tubs versus chlorine hot tubs
  • (53:05) Closing Thoughts

    • Stacy is off to jet set to who knows where next

    • There will eventually be a podcast where Stacy will share the details on how they pulled the trip together
    • This trip was on Matt and Stacy's bucket list and they are so overwhelmed with gratitude that they get to experience a trip like this with their kids
      • So a huge thank you listeners for your support over the years and for helping to make this happen
    • Thanks again to Joovvfor sponsoring this podcast
    • Thank you again for listening! We will be back next week!
  • (0:41) Welcome

    • Welcome back to The Paleo View!
    • Stacy has no idea what day it is
      • The Toth/McCarry crew is currently in Salt Lake City and will soon be heading on to Denver
      • They have a whole lot of country left to explore, and lots of events on the calendar
      • Stacy shared details on their zigzag travel plans
    • Sarah sent out a warm Happy Canada Day to all the Candian listeners! And a Happy Independence Day to the American listeners!
    • Special thank you to this week's sponsor, Wild Zora
      • They are not just sponsoring this show but are also fueling Stacy's family as they are traveling across the country
      • To check them out visit: wildzora.com/thepaleoview
        • Using that link you can get free shipping and 30% off your order
      • Wild Zora is jerky that has vegetables incorporated
        • Stacy said they are delicious and the texture is perfect
  • (7:15) Macronutrients & Micronutrients

    • On this week's episode, Stacy and Sarah are going to talk about macronutrients

      • While this is a little bit of a tangential discussion from the typical micronutrient nerdiness that this show covers, Stacy wanted to dig into this topic
    • Macronutrients were something that Stacy did use to track when she was on a lifting schedule because she found that it did help with her performance
    • Stacy has noticed that it is common to see foods marketed today towards the keto community
      • These foods tend to be macronutrient heavy in one way or another
      • Recently on Instagram Stacy saw someone sharing a  product with crazy macronutrient ratios
        • It was a fat bomb that just didn't make sense on a macronutrient level
      • What concerns Stacy about people going so focused on macros is when all acknowledgment towards balance is ignored
    • Sarah has seen in gyms how they promote macro tracking
      • At her gym, in particular, they have an 'Eat Your Macros' program

        • In these instances, you see some people who aren't nutrient literate hitting their numbers with unhealthy foods/drinks
    • Being overly focused on macronutrients runs into problems when it is not connected to a food quality conversation and a micronutrient conversation
      • There is also this other part of this conversation that is happening right now where we are seeing these macronutrient extreme diets

        • Examples include:

          • Low/zero carb
          • Keto
          • Low fat
          • Carnivore
    • Sarah wants to take this episode to unpack macronutrients a little bit
    • What is the difference between macros and micros?
      • Macros really just translate to energy

        • Macro means big
        • It is nutrients that we need from food in big quantities
        • Carbohydrates, fat, protein and fiber
      • Micro means small
        • It is nutrients that we need from food in small quantities
        • Vitamins, minerals, phytochemicals, essential amino acids, and essential fatty acids
    • The stuff that we need in big quantities translates into energy
      • There is also some raw material stuff in macronutrients

        • Protein is used to make proteins in our body

          • It's not just making muscle, it is making components of every single cell
        • Fat makes up cell membranes
          • Our brain is about 60% fat
          • Hormones are fat based molecules
      • We use some of these things as building materials and the rest we use as energy to drive chemical reactions
      • Fiber is really about feeding our gut microbiome
    • Even though we need micronutrients in small quantities, it is quite a challenge to get micronutrient sufficiency
      • This is the nutrient density piece that is always be covered on the show
      • As soon as you try to get all the micronutrients that your body needs in adequate quantities from whole foods, you are forced into a Paleo or AIP style diet
        • This means eating seafood, organ meat, a ton of vegetables, fruit, nuts and seeds, fresh herbs
        • This is how you get micronutrient sufficiency
  • (14:27) Our Needs Through the Scientific Lens

    • Sarah is going to come at macronutrient guidelines by looking at basic ideas about human anatomy and physiology

      • One of the ways to do this is by looking at hunter-gather intakes

        • What is the macronutrient range that we see among hunter-gather populations, given that human evolution was often driven by the energy density of our food
        • Sarah dug into these studies that have been completed across the world
          • How foods are used to correct macronutrient imbalances
        • We look at these societies that mimic the diet that we would have had for at least the last few hundred, thousand years of evolution
          • These diets don't have any of the chronic health problems that are associated with industrial, western countries
          • We observe the trends and form a hypothesis regarding the macronutrient levels that are likely ideal
      • AMDR
        • The Food and Nutrition Board of the Institute of Medicine has set Accepted Macronutrient Distribution Ranges (AMDR) for protein, fat, and carbohydrates based on evidence from interventional trials with support of epidemiological evidence that suggests a role in the prevention or increased risk of chronic diseases and based on ensuring sufficient intake of essential nutrients

          • Levels of too much or too little are associated with some kind of health problem
        • This is completely based on contemporary studies
          • AMDR for fat estimated to be 20 to 35% of total energy for adults
          • AMDR for protein estimated to be 10 to 35% of total energy for adults
          • AMDR for carbohydrates as an estimated 45 to 65 percent of total energy (and below 25 percent from sugars) doesn’t quite align with hunter-gatherer intakes
    • We can take this information and through the lens of our philosophies on understanding science, we can add some interesting additional things on to that
      • We know that higher protein intake is really really important for weight management
      • We know that there are some genes where lower fat is really important
        • 25% of people have one or more copies of the gene where a diet lower in fat is ideal for their bodies
      • We know that with the modern food supply sugars are actually more important to limit than total carbohydrates
    • When we start to add in this extra insight by taking in an even bigger picture view of the scientific evidence, we can come up with a macronutrient intake range that sort of fits modern science and hunter-gather intakes
      • This will give us a pretty good target with a lot of wiggle room for self-experimentation
    • When Sarah looks at all of this data together, here is what she ends up with:
      • 20-35% of our total calories coming from fat
      • 20-35% of our total calories coming from protein
      • 30-60% of our total calories coming from whole food sources of carbohydrates
    • This is what Sarah refers to as balanced macronutrients
    • This doesn't mean that every meal needs to be super regimented
      • The body seems to respond really well to fluctuations in macronutrients

        • Ex: seasonal variability, macro timing throughout the day
    • These macronutrient ranges don't look like any of the diet extremes
      • To learn more about the challenges that arise from extreme diets, check out episodes 140and 305
    • Fad diets, where the primary goal is weight loss, are not designed to be healthy
      • When we look at macronutrients and we look at them in this way, we are really looking at:

        • What is the range where we are going to be able to maintain health?
        • And these are the ranges that we end up in
          • 30-60% calories from carbohydrates give us a lot of playing room
  • (25:03) The Balancing Act

    • What's curious to Stacy is the idea of this balance of macronutrients

      • If you talk to three different people they would tell you three different things about what the ideal is
      • Stacy does think it is true that it is an individual thing
    • Sarah thinks that what we are learning is that too much or too little of any macronutrient is associated with health problems
      • With micronutrients, we know that there is a range that is considered sufficient for most people

        • Then there are these extra situations where you might need extra of certain micronutrients
      • We also see that kind of variation in macros
        • For example, if you are someone who is very active, that increases your protein requirements
      • Every diet works to help you lose weight, but most of these diets promote both lean muscle mass loss and fat loss
        • Depending on the diet, it can be up to a pound for pound (fat to muscle) loss
        • When you lose muscle, you lower your basal metabolic rate
        • Preserving lean muscle is really important for preserving metabolism
        • If your metabolism tanks than you need lower amounts of calories to keep losing weight
        • If you lose weight too quickly, you increase your hunger hormones, which drives appetite
          • You have this perfect storm of being hungrier than you would normally be
          • Making it harder to maintain your diet
        • One of the ways to get around this is to up your protein intake and to incorporate some weight bearing exercise
          • Aim for a moderate caloric intake so that you are not losing weight too quickly
          • Yes you lose weight more slowly, but it is easier to keep the weight lost off
      • Sarah provided more examples of where people will fall within the ranges based on certain attributes and medical conditions
      • We have within these ranges people who will do better at the low end or at the high end, and there are so many different situations that will determine where you fall
      • We probably are supposed to have seasonal variability as well
      • Sarah recommends playing within these ranges
    • If we are going to take a micronutrient approach and aim to get enough fiber (which is really critical) and enough protein and balance the plant versus animal food so that we achieve micronutrient sufficiency, it almost forces you into those ideal ranges
      • It is incredibly challenging to get enough fiber and not end up with about 40% of your calories from carbohydrates
      • Our dense fiber foods, like 3.5 cups sweet potatoes, has 25 grams of fiber
        • Which would be the USDA fiber allowance for a woman
        • Sarah noted that this probably half of what we actually need
        • This is not a ridiculous amount of sweet potato to eat throughout the whole day, which will give you 150 grams of carbohydrates
        • You can get the same amount of fiber from 24 cups of spinach
          • Which would give you 50 grams of carbohydrates
        • Dense sources of fiber are going to work best for most of us
      • In order to get enough fiber, it is really tough to do without your total carbohydrates ending in the 200 to 300-gram range
      • From a fiber intake perspective, getting enough vegetable matter to get our fiber intake up to where it is supposed to be, that automatically puts us in the higher carbohydrate range
      • If you think about your plate being 3/4 vegetables and using some fat to make things tasty, adding some nuts and seeds, and having quality meats; it is almost impossible to not end up in those balanced macronutrient ranges when you start thinking about micronutrients
    • This is why you need balanced macros
      • You cannot get the micronutrients you need once you start skewing your macronutrients into these extremes
      • You are going to miss out on something
    • There are micronutrients packaged up with our macronutrients that are really important
    • Part of aiming for balanced macronutrients and having a food quality criteria for choosing foods is achieving micronutrient sufficiency
    • Stacy is shocked that it came back around to micronutrients
    • It makes sense that athletes, for example, are turning to products that are targeted to increasing whatever macro they are focused on and not necessarily the micros associated with it
    • Stacy loves the way Sarah framed her explanation
      • That if you think for a minute of just the basic necessity of fiber and the micronutrients you need, and then from there consider the macro piece, you will be in the right headspace
    • It is a struggle overall to achieve balance because there are so many factors that go into it
      • However, when we consider the goal and where we are coming from, we are able to make decisions based on long-term health goals
    • One of the things that Sarah wants to emphasize is that this is a learning curve
      • Sarah will do a 3-day food diary once a quarter

        • She uses the Cronometer app
        • With this data, she is checking in on her fiber, protein, and her micronutrients
        • She lets fat and carbs land where they may because they are going to land in healthy zones if she is getting enough fiber and enough protein
    • Sarah thinks that for most people fiber is where people are most challenged when getting their macronutrients in balance
      • Protein is typically second
    • It takes a few days, maybe a week, of measuring foods and looking at databases for nutrition information to get a sense for where you are at and where you can fine-tune to hit your numbers
      • Find the foods that fill in the gaps for you
      • Figure out what your place looks like
      • Then you can wean off the measuring and logging, and simply execute what you found out about your ideal plate makeup
      • And from there you can check in every once in a while to make sure you are on track
    • Food journaling is a phenomenal tool for weight loss
      • Awareness around what you are eating is really important for the behavioral modification of weight loss
      • However, Stacy noted that for those with a history of disordered eating it can be problematic
      • Be mindful of this when identifying how best to check your macro and micro levels
        • Stacy shared her experience with being respectful of the emotional pieces associated with tracking
        • It doesn't need to be an overwhelming experience if we come from the perspective of what is my intent, what am I trying to achieve, is this food choice the best for me in this moment
    • With that, Stacy suggests eating Wild Zora bars to increase your vegetable intake
      • Sarah loves Wild Zora and it has been a staple in her house for years
      • Zora has a very food quality focus in all of her products
        • She is very micronutrient focused
        • It is both packed with vegetables and high-quality protein
      • The diversity of products that they offer is amazing, especially as a convenience food
      • Wild Zora is a woman-owned, family-run company from Northern Colorado that manufactures meat and veggie bars, dehydrated backpacking meals, soups, and instant teas
      • They have many AIP options available
      • The products are great for packing and leaving in the car
      • Remember, you can go to this site to get free shipping and up to 30% off their products
  • (54:47) Closing Thoughts

    • Thank you to Wild Zora for sponsoring this show!

      • As Sarah noted, health is really about macronutrients and micronutrients
    • Thank you, listeners, for tuning in - Stacy and Sarah will be back next week!
  • (0:41) Welcome

    • Hello Paleo View listeners!
    • Stacy is coming to you from Central Oregon
      • Sarah's mom has been following along with Stacy's travels via social media and loves the amazing family bonding they are having
    • Stacy shared on their latest adventures and the incredible experiences she is sharing with Matt and the boys
    • One of the things that Stacy did before leaving for her trip was to listen to a podcast on intuitive eating
      • This is something she thought she understood in concept, but she wasn't aware that there are specific rules around the practice
      • She wanted to share this information with Sarah so that they could discuss her concerns
      • It is important for Stacy and Sarah to address what the concepts are that are helpful and good when listening to your body when trying to embrace a non-diet culture
        • I.e. looking at living a sustainable life longterm, not in an on-again, off-again, diet rollercoaster
      • Stacy and Sarah eat the way that they eat for longterm health; they focus on nourishing their body so they can be healthy
        • However, they also understand that socially and emotionally food can drive humans
        • There is nothing wrong with this, as long as we are aware of our longterm goals towards health
        • We can apply this still to intuitive eating without going over the edge
    • Sarah also didn't realize that intuitive eating was actually an anti-diet framework
      • For Sarah, she had equated the phrases 'intuitive eating', 'mindful eating' and 'listening to your body' as all essentially the same thing
      • She had used these phrases interchangeably to talk about a concept that is ultimately body awareness
      • Sarah has a high degree of body awareness that was hard earned
        • It is a practice of mental health piece that has gone along with Sarah's Paleo/AIP journey
        • This has gotten her to a place where she really understands her body's signals
      • Now that Sarah understands that intuitive eating is its own thing there are some things that need to be cleared up
        • There are some very important factual details that Sarah needs to share
        • With this particular anti-diet framework there are some things that are not right
        • Sarah does agree with some of the points, but there are some really important scientific backed details that Sarah's needs to address
    • But first, before we get to the discussion on intuitive eating, a word from our sponsor
      • This week's episode is sponsored by EverlyWell

        • EverlyWellis an at-home lab testing company that offers a variety of tests, ranging from Food Sensitivity to Metabolism, to a Thyroid Test and Vitamin D
        • The tests are private, simple and all processed through certified labs
        • All you have to do is head to EverlyWell.com, choose your tests, and they’ll be shipped directly to your doorstep
        • Then, once you complete your sample collection and send it back into EverlyWell’scertified labs, they will process your sample and send you your results via EverlyWell’ssecure online platform within just 5 days
        • EverlyWelltakes all of the guesswork out of lab testing and puts the power into your hands to complete a range of important health tests all from home
      • To check out EverlyWell visit: https://everlywell.com/thepaleoview
        • Use code 'ThePaleoView' for 15% off
        • For more on Sarah's and Stacy's thoughts on EverlyWell, check out this podcast episode
  • (13:40) Where Intuitive Eating has it Wrong

    • Before Sarah goes on her soapbox on where intuitive eating has it extremely wrong, she wants to cover the official trademark details on what this practice actually is

      • From their site:

        • “Intuitive eating is a non-diet approach to health and wellness that helps you tune into your body signals, break the cycle of chronic dieting and heal your relationship with food.  From a nutrition professional perspective, intuitive eating is a framework that helps us keep nutrition interventions behavior-focused instead of restrictive or rule-focused.”
        • “Intuitive eaters give themselves unconditional permission to eat whatever they want without feeling guilty. They rely on their internal hunger and satiety signals and trust their body to tell them when what and how much to eat. They know when they want to eat veggies and also when they feel like having dessert (and don’t feel guilty or have any regrets with either choice).”
    • Conceptually Stacy loves the idea of intuitive eating, but the problem is that in practice this can go terribly wrong when someone is not in tune with their body
      • On the podcast that Stacy listened, the podcast host informed a listener that lethargic and bloated aren't words that foods can make you feel

        • These are sneaky diet culture words
        • Foods are simply energy in, energy out
        • They can't contribute to you feeling bloated
      • This is where Stacy had her 'whoa whoa whoa' moment
        • She is in full support of the belief that we need to listen to our bodies and not be on a diet rollercoaster
        • However, foods can contribute to how your body feels
        • Part of intuitive for Stacy is learning these things, but that is not the definition of this formal movement and program
    • There are concepts from this that Sarah wholeheartedly believes in
      • Behavioral modification is actually a really important aspect of successful weight loss maintenance

        • You can't just throw someone on a diet and exercise program without addressing emotional health and behaviors associated with food and lifestyle
        • This is absolutely part of the healing process
    • Where Sarah completely disagrees with this practice is with this idea that food cannot have a physical consequence for people
      • There is a ridiculously huge body of literature that proves otherwise
      • These studies prove that food can have negative consequences on the body beyond allergies
        • This includes things like feeding the wrong strains of bacteria in the gut and altering hormone systems
      • One of the implications of this is that people are giving themselves permission, unconditionally, to eat whatever they want without feeling guilty
        • This includes this group of manufactured modern "foods" that are so tasty that they trigger eating for pleasure

          • This is a very well studied field of science
          • Hyper-palatable foods override satiety signals and alter dopamine response to food (leading to opportunistic overeating)
          • These are typically foods that contain carbohydrates, fat and some kind of flavor enhancer such as fat
          • These foods are engineered to be so rewarding on a dopamine level
          • We are unable to tell if we are full/satisfied when consuming these foods because they are designed to be hyper-palatable
            • They make it impossible for our neurotransmitters to do their job because they override our ability to tell if we are hungry or not
          • This is well documented in humans and in animal studies
          • These foods drive the overeating behaviors that are unhealthy
            • How can you behavior modify if you are continuing to give yourself unconditional permission to eat these foods that make it impossible to listen to your body and modify behavior
            • An example of this is your dessert stomach on Thanksgiving
      • As a consumer, if you were to say that you will intuitively eat the amount of this thing that is appropriate for you if you let go of diet culture and allow yourself to live in this moment and enjoy this food, that it would be physically impossible
        • This food has been modified to enhance your appreciation of it so that you eat more and more and more
        • Your body is not able to intuitively tell you that you are done
        • For most people that comes with salty snack and desserts
    • Hyper-palatable foods are defined as:
      • High energy density
      • Combination of carbohydrates and fat
      • Flavor enhancers (salt, MSG, additives, artificial flavorings)
      • The table that Sarah referenced: 
      • The studyon how these addictive foods work in our body
      • There is no amount of hyper-palatable food that is safe or won't have this effect
        • The more of it you consume, the more you will enter into this vicious cycle of overeating behaviors, which is a precursor to obesity and binge eating disorder
      • One of the classic properties of hyper-palatable food is a really extensive ingredient list
      • The danger of triggering this dopamine reward center with hyper-palatable foods is that eventually the reward system becomes blunted
        • So you need more and more of the food to get the reward
      • Studies are showing the same changes in dopamine response in people with obesity and binge eating disorder as you see in drug addiction and alcoholism
        • This is because of the continuous consumption of this and how this impacts your dopamine signals over time
        • To the point where we are not listening to our bodies and we have created an addiction to these hyper-palatable foods
    • Sarah completely agrees with the idea of addressing mental health issues and associations with food
      • A lot of Sarah's personal journey has been about healing from a history of binge eating disorder and her very unhealthy relationship with food
      • So much of her journey has been addressing her emotional responses with food and her behaviors around food
      • Sarah doesn't believe that you can achieve healing while saying that you can eat anything
    • Stacy and Sarah 100% agree that diet culture is very detrimental
    • However, what Stacy and Sarah want people to think about longterm is where are you trying to get to with your health
      • This is where they want to focus their choices every day
      •  How you make a choice today should leade to the vision that you have for the future
      • The more whole food, real food choices that you make, the more you will be able to listen to your body and respond appropriately to those signals
      • Am I hungry right now? Or does this taste good?
    • It is so important to understand the gray area
      • There are so many black and white rules out there and programs that people want you to follow
      • You think the rules are easier when you 100% know what you are allowed to do
      • But this is not reality, it is not a longterm sustainable way to live
      • We have got to come to terms with the idea that we are in charge of the things that make us feel our best
      • It is not about assigning an emotional definition to a certain food
        • What is good for you, may not be good for me
      • It takes so much time, and this is still a journey that Stacy and her family are on as they navigate what foods work best for them
  • (33:44) Break the Rules Mindset

    • It is so important to not think of the way we eat as a set of rules

      • If you define a diet based on the foods you do not eat that doesn't make the diet healthy or not
      • What makes a diet healthy is what you put in your mouth, not what you avoid putting in your mouth
      • This is one of the reasons why Sarah has worked so hard to create very thorough educational resources
        • Sarah feels that in public health we are missing these kinds of resources that teach what is in foods that the body needs and what is in foods that can undermine our health
        • It is important to get away from rules and get more into a solid foundation of health and diet education
    • There are still universal truths
      • Nutrient sufficiency is an important aspect for every individual

        • Paleo and AIP are not the only frameworks to hit these nutrient goals
        • There are multiple ways to structure a framework to work for people
        • This is where we hit gray
          • This requires that you understand what works for your own body by experimenting while keeping the principle of nutrient sufficiency in mind
      • All human beings need adequate sleep on a consistent basis
      • Humans do not thrive in a chronic stress environment
      • We have to avoid prolonged periods of being sedentary
        • There are a lot of different ways that we can be active
        • It is simply about moving your body throughout the body
    • Again, this is the gray - recognizing that there are these universal truths and that you have this amazing opportunity to really understand your body
      • Detox your body from the things that prevent you from listening to your body
    • Sarah's biggest criticism of intuitive eating as an anti-diet is that it makes space for these things we call food that completely undermind the principles in which they are based
  • (39:45) When You Are Struggling to Get Results, How to Troubleshoot

    • The first recommendation is to take a solid look at what you are eating

      • Is there something that you are eating that might not be working for you
      • Is there something you are not eating that your body really needs?
        • Are you eating some nutrient dense foods?
        • Or might you be missing a really important nutrient?
    • You can do a three-day food journal
      • Sarah recommends using an app like Cronometer or MyFitnessPal to take a look at the micronutrient details
    • Also, take a look at lifestyle
      • Are you getting enough sleep?
      • Are you proactive in terms of stress management?
      • Are you including activity every single day, but avoiding overtraining?
      • Are you working on human connection?
      • Are you getting outside into nature?
    • There are certain underlying factors that are common that cannot be addressed with diet and lifestyle alone
      • In these scenarios you can:

        • Work with a functional medicine provider
        • Doing testing with EverlyWellto really understand when, where and how a medication, supplementation, short-term intervention, or a change in diet and lifestyle would help you achieve the results you are after, where professional guidance is needed
    • Stacy notes that this is where you have to understand that there comes a point when food may not be the reason why one struggles with weight
      • When you feel like you are doing everything right, there are things that are happening on a deeper level that prevent you from achieving the results you are working towards
    • The recommendations that Sarah is about to share is the opposite of where intuitive eating is going
      • Intuitive eating is saying, look your diet isn't working for you so go ahead and eat whatever as long as you are "listening" to your body
    • We see in alternative health communities in general where we keep eliminating more and more foods when we don't get the results we are working towards
      • This is why there are fad diets right now that are very popular right now that have a very limited collection of foods that are going to dietary extremes
      • These are not healthy practices and they are not scientifically valid
    • When you take a look at the common barriers that are straightforward to test forward, and when you work with an integrative or functional medicine practitioner to help manage these things it can be relatively straightforward
      • And looking at these pieces can make all the pieces of the puzzle fit together
    • To determine where to start, take a look at your symptoms
      • Do food journaling to capture these details
    • Here are the most common barriers:
      • Food Allergies and Intolerance

        • IgE, IgG
        • Possible Food Sensitivities
        • FODMAP Sensitivity
        • Histamine Sensitivity
        • Sulfite Sensitivity
        • Salicylate Sensitivity
        • Oxalate Sensitivity
      • Hormone Imbalances
        • Adrenal fatigue
        • Hypothyroidism
        • Sex hormone imbalance
      • Persistent Infections
        • Parasites
        • H. Pylori
        • Epstein-Barr
        • Lyme
      • Gut Health Problems
        • Poor digestion
        • SIBO
      • Severe Nutrient Deficiencies
        • Vitamin D
        • Any essential vitamin or mineral
    • When one is showing signs of resistance to weight loss, people tend to then adopt a more extreme diet strategy
      • Sarah would call the intuitive eating, antidiet still an extreme diet strategy
      • It is like the extreme opposite of the rules-based one, but it is still getting off course in terms of how food impacts health because it is not just energy in and energy out
    • It is human nature to be attracted to these more extreme approaches
      • If nutrient deficiencies are the thing holding you back from health, cutting out more foods or embracing junk food and not feeling guilty about it, are not going to approach that will correct a nutrient deficiency
      • If anything these approaches will magnify that deficiency
    • Changing our food is not always going to be the solution
      • This is why Sarah thinks increasing our education around health topics so that more people really understand the universal truths about diet and lifestyle, where all the gray areas are, where you have flexibility vs. the need for self-experimentation, and where to troubleshoot in a smart way
    • Whether you embrace dietary rules or are anti-rules, neither of these paths are the solution
      • The solution is a more thorough education for everyone
  • (1:00:23) Closing Thoughts

    • Working towards ideal health is an ongoing journey, that changes based on the various seasons of life
    • Nothing is static
      • You can be doing everything right one day and wake up the next not feeling your best
      • That is not a personal attack on you, it is not because you did something wrong that you need to feel guilty about
      • It's a sign and a symptom for you to say, ok let me listen, let me test, let me do these things to work towards feeling my best
    • If you want rules, ask yourself is this going to help me feel my best
    • For Stacy it is difficult because it is part of a community that she understands and genuinely gets it - diet culture is awful
      • However, she is not on board with the idea of walking away entirely from the idea of health and working to personally define what that means to you
    • Sarah reiterated that it is so important to remember that the goal isn't to get to thin, the goal is to get to healthy
    • There was so much about intuitive eating that Sarah was hugely on board with when she was first reading up on it
      • However, her enthusiasm hit a wall when food quality was completely disregarded
      • Food quality DOES matter
      • We have to nourish our bodies
        • It is not an everything in moderation - this is not what our bodies need
      • We can implement our dietary choices to make room for treats
        • We don't need to feel guilty about making choices that are suboptimal 
      • Yes, let's ditch the diet culture mentality, but it DOES matter what we put into our body
      • Food absolutely can make us feel bloated and lethargic
      • We are programmed to celebrate with food, to socialize with food, and bond over food
        • To say that any emotional response that you have to food means that you have a mental health issue that needs to be addressed is wrong
        • However, Sarah does agree with the fact that addressing our unhealthy attachments to food and our mental health issues around food is an important part of our health journey 
    • Stacy thinks that intuitive eating is appealing to those who are desperately searing for something to feel better; who are struggling emotionally and physically 
      • This program puts them on an unintentional roller coaster that is just as bad for them as what they were doing before
    • You have to know your body and to find the foods that nourish your body
    • To learn more and fine-tune your approach to healthy living, be sure to check out EverlyWell 
    • Ultimately Stacy and Sarah want to educate you and provide you with tools that will help you live your best life
  • (0:41) Welcome

    • Welcome back! Stacy and Sarah are now recording the show bi-coastal
    • Stacy is in Seattle and well caffeinated for this week's recording
    • Matt and Stacy are on day 6 of their summer travel adventure
      • Matt left Virginia and drove across the country to meet Stacy in Seattle, visiting a number of National Monuments with Cole along the way
      • Finn and Stacy went to New York, and Wesley was with Stacy's mom
      • It was nice to all meetup and come together on the West coast
      • Sarah hopes the rest of the trip is smooth sailing and filled with memorable adventures
    • Sarah is still trying to settle into summer with her family
      • It was off to a hectic start, and the kids are starting to settle into free time
      • They are planning to have a low key summer this year
      • The family is working on the next level of their citizenship, so that will be taking up a bit of time
    • Sarah wanted to take this podcast to discuss the recent updates she made to the Autoimmune Protocol
      • She wants to use every channel she has to communicate this latest science
      • In the grand scheme of things, these are relatively small changes, but they are important tweaks
    • The Paleo Approach was published in January 2014, so in those 5 1/2 years there has been a lot of science published that is very relevant to understanding how diet and lifestyle impact immune function
    • Sarah has been procrastinating finishing The Gut Microbiome book
      • She is in this last hard grind of that project and is happy to get distracted by any other project right now
    • The research form the last three to five years has been where Sarah has spent most of her time, which will also feed into the Gut Microbiome book as well
      • Since last fall Sarah has been spending time doing a really thorough review of this literature

        • Looking for new studies that she may have missed
        • Doing targeted searches for specific topics
        • Working to understand what is preliminary research
      • These new revisions to the autoimmune protocol reflect the new science that adds to our understanding of these gray area foods and ultimately shifts that category a little bit
  • (11:15) The Latest Findings

    • There are now two clinical trials published using the AIP where the participants are given The Paleo Approach and The Autoimmune Wellness Handbook

      • They are taken through Angie's SAD to AIP in 6 transition program and then they maintain AIP strictly for another 4 to 5 weeks depending on the study
      • We are measuring improvements
      • The first study was published in fall 2017
        • It was done on patients with active inflammatory bowel disease
        • They transitioned to the autoimmune protocol and over those 6 weeks with what was called a 5-week maintenance phase
        • 73% of the patients were in full clinical remission by 6 weeks
          • So by the time they finished transitioning to the AIP they were in full clinical remission
          • 100% of participants saw improvements in those markers of disease activity and they still all saw continuous improvements in those markers throughout the five-week maintenance phase
          • So a really compelling study right out of the gate
      • Just published last month in 2019 there was a very similarly designed study on women with Hashimoto’s thyroiditis
        • They did the same gradual transition over 6-weeks, followed by a 4-week maintenance phase
        • This study was looking at a condition that is not as straightforward to measure how active the immune attack is
        • They were able to measure a very substantial decrease in the clinical symptom burden
        • The average at the beginning of the study was 92 points, and after four weeks on the full AIP was down to 29
          • Which is basically going from this is impacting my everyday life to this is a minor nuisance
          • This study again produced very compelling data
    • There is a study getting off the ground right now on the impact that AIP plays on Psoriasis and Eczema, and if you are interested and able to support this kind of research, please visit: https://www.indiegogo.com/projects/medical-study-on-eczema-psoriasis-and-aip#/
    • The more medical studies that we have that come out of PubMed and clinical trials that show improvements in health as a result of Paleo/AIP diet and lifestyle changes, the more doctors will be willing to try it with their patients or advise them on these options on how to approach their conditions
      • This will only help others in all corners of the world gain access to the latest information on how to improve their quality of life and overall health and wellbeing
      • The more science and research there is on these topics, the more compelling it becomes for medical professionals
    • A study that shows 73% of participants in full clinical remission is astounding
    • Such powerful data is coming out of these studies as we are able to now start answering the common question - "how long"
  • (23:04) Updates to AIP

    • As a result of these new studies, Sarah has added a gut health superfoods focus

      • This is through all of this new research on the gut microbiome
      • Just in the last few years, we have learned that our gut bacteria control the structure of the tight junctions between our gut cells
    • For a long time now there have been studies showing that gut dysbiosis is potentially a precondition for every autoimmune disease
      • Adding in this extra piece of, "yo, you can't heal your gut barrier if you don't heal your gut microbiome"
      • They have to go hand in hand because your gut bacteria is controlling your gut barrier
      • It makes sense to really nurture our gut microbiome through AIP
    • AIP (the Autoimmune Protocol) is a nutrient-dense anti-inflammatory diet that eliminates all foods that are potential drivers of immune activity in autoimmune disease while focusing on flooding the body with nutrients and providing both the resources and opportunities for the body to heal itself
      • It's basically a more specific version of Paleo, it's a little bit stricter and a little bit more systematic
      • It involves more eliminations, but also more of a what to eat focus
      • There is a reintroduction protocol where you test your individual tolerance to the foods that are eliminated that have a gray area status
        • You find your individual maintenance version of AIP, while also dialing in lifestyle factors that are important inputs to how the immune system is functioning
    • Adding this focus on gut health superfoods really recognizes the importance of restoring the gut microbiome in healing
      • Most of the foods that are gut microbiome superfoods are also nutrient-dense foods

        • A wide variety of vegetables and some fruit
        • Seafood
        • Organ meat
      • Different families of fruits and vegetables feed different species of bacteria and they are independently beneficial
        • It is really about trying to hit as many of those different groups of vegetables every single day
        • That is a different way of thinking about the high vegetable consumption on AIP
      • Some other foods that are also really important on the gut microbiome:
        • Green and black tea
        • Fish and shellfish
        • Extra virgin olive oil
        • Honey and bee products
        • Bone Broth
        • Fermented foods
        • Edible insects
    • Sarah shared feedback on how to slowly build up gut bacteria and how to slowly build up your fiber intake
      • With gut dysbiosis, a large shift in diet can trigger symptoms
      • The way we can get around that is by slowing down that part of the shift
  • (38:34) The Other Changes

    • The other changes to the Autoimmune Protocol are all in the orders of reintroduction

      • Coffee: Regular coffee consumption has been moved from Stage 3 to Stage 1 (occasional basis) and Stage 2 (daily basis)
      • Cocoa: Cocoa and dark chocolate (dairy-free, soy-free) has been moved from Stage 2 to Stage 1
      • Potatoes: These nightshade-family vegetables have been moved from Stage 4 to Stage 3 in peeled form, but remain in Stage 4 unpeeled
      • Cashews and Pistachios: These nuts used to be in Stage 3, separated from other tree nuts and but have now moved to Stage 2 and included with other nuts and seeds
      • Dairy: The highest-protein dairy products (like cheese, cottage cheese, milk, and isolates) have been moved from Stage 4 to Stage 3, with a clarification that these products be from grass-fed animals
      • Legume Sprouts: Legume sprouts were not previously addressed in the reintroduction stages. They are now included in Stage 1
      • Chia Seeds: Chia seeds from the other pseudo grains (which remain in Stage 4) and moved them to Stage 2 with tree nuts and seeds
      • Split Peas, Lentils, and Garbanzo Beans: These have been separated from other dried-bean legumes (which remain in Stage 4) and moved them to Stage 3
    • You can find all of these changes on Sarah's website here:
    • Sarah is working to make this information as widely available as possible, so she has created an eBookthat is the most up to date version of the Autoimmune Protocol
      • It has all of this information in it, but it is also a very comprehensive book
      • It is over 300 pages and it is very practical focused 
      • The eBook also includes 4 weeks of meal plans and shopping lists, and all of the recipes that go with them
      • This gives Sarah a way to directly communicate with the AIP community because she can upload an update to that eBook and those who own the eBook will have instant access to that update
  • (44:29) Closing Thoughts

    • Stacy loves that there is now science to show what AIP does to overall health
    • It takes time for these results to come through, but we are seeing them now and are excited to share these details with listeners
    • Even if you are an old veteran at this, maybe it will give you a reason to reach out to that person that could feel better with their own life and health if they were to make those changes too
    • Thank you, listeners, for tuning in! Stacy and Sarah will be back again next week!
    • Stacy has events planned in a number of locations along their journey
  • (0:41) Welcome

    • Welcome back to The Paleo View listeners!
    • This week Stacy and Sarah are excited to welcome their guest, and good friend, and chef extraordinaire, most interesting man in Paleo, and that's not to mention all the work titles he has - Russ from The Domestic Manis here with us today
    • Sarah noted that she is way overdue for a visit with Russ and his family
    • Stacy is looking forward to seeing both Russ and his wife while Stacy and the family is on the road for their summer travels
    • The experience of preparing for a cross-country road trip has been quite interesting
      • Matt and Stacy will be starting a family podcast about it so they can travel vlog and capture the memories
    • This week Stacy and Sarah asked Russ to join the show to share on his latest project
      • He has been working for about four years on his self-published, latest book, The Heritage Cookbook
      • You can get an e-copy now, or you can preorder a hard copy and automatically receive the e-copy
      • Stacy has seen the eBook and has tested recipes from it
        • She finds this book to be really interesting because it is not just a cookbook, it's an exploration of DNA and ancestry and how our heritage influences our culture, our health, and our food
    • Stacy thought it would be interesting this week to explore Stacy and Russ's experiences with DNA testing and to learn a bit on what they can glean from these tests
    • Sarah geeks out over blood tests and is chomping at the bits to cover this topic
  • (5:56) More on Russ

    • Russ is in the military and has been for almost twenty years now
    • Five years into his service he had a stroke, which came out of nowhere
      • He was hospitalized for awhile
      • He was only 24 at the time
      • While he recovered really quickly, he lost all the function on the left side of his body and had to re-learn how to write and walk
      • A year after his stroke things got way worse and he ended up going back to the hospital and telling them that something was off and not feeling right
      • From that point, he lived in a military hospital for a really long time
        • They ended up diagnosing him with an autoimmune disease, where he has inflammation in his arteries
      • He was put on a ton of medication to try to balance everything within his body
        • The medication was causing all sorts of issues so Russ ended up having open heart surgery
        • It was a really drastic surgery, but he made it out of that ok
        • After a 6 month recovery, it all got worse again because he hadn't fixed any of the issues within his body
        • He went right back on all of the same medications
      • A few years after all of this, Russ found a random blog article covering Robb Wolf's book The Paleo Solution, when it has first come out
        • This book inspired him to change his diet
        • Sure enough, a lot of his issues began to disappear after a month
        • Russ went back to the doctor to have his bloodwork checked, and the data showed improvements in his health
      • Russ began blogging about his experience to hold himself accountable and to share his experience
        • It blossomed into a bigger following than he ever expected since it was just a hobby at the time
        • He ended up getting a book deal working with Stacy and published The Ancestral Table and then Paleo Takeout
        • Russ had planned on publishing more books in the future and he had all these big ideas, but something happened in him where it became really important to learn more about his own family
      • Russ's birth father was in the navy, and he met Russ's mother in San Diego when his father was stationed there
        • They got married and had two children
        • Russ's father was out of the picture when he was three and he was raised by his stepfather
        • There was a level of curiosity that Russ had to explore his ancestry
          • Especially once Russ had kids he wanted to learn more about his DNA and ultimately the traits he passed on to his kids

            • He did DNA research to understand what the science says about his genes
            • And then he worked to learn more about his Dad and where his genes are from
    • Through Russ's ancestry research he learned a lot about his father and family
      • He was able to find extended family members on Facebook and connect with them
      • Once he had a few names he was able to do the research and find his entire paternal ancestry
      • This inspired him to start thinking about the types of food he craves and how genes impact cravings
      • Digging into his heritage and what likely shaped his palate from a genetics standpoint, led him to ask the question - how does this work for others
      • This inspired his latest book, which obviously took a lot of research since it was four years in the making
      • He is very happy with what came out of it and is proud of the final product
  • (10:02) Q & A

    • Stacy asked Russ what his biggest takeaway was from the research he conducted

      • He thought there was going to be these secret foods that were fine-tuned to his genetic traits
      • However, science is nowhere near there
        • There are a few things available in research that shows how our ancestry impacts our digestive abilities
      • Russ realized that the best way to find out how people thrive is to look at historical eating patterns over history
      • So when Russ wrote The Heritage Cookbookit ended up being a food history book
        • He looked up each of the major food groups and looked at what the origin of the food is and this is how he developed and assembled the cookbook

          • You end up with a cookbook where you can look up your heritage and learn about the eating patterns relevant to your background and then you can go to the recipes relevant to those regions
          • The book is nearly 800 pages long and has 300 recipes in it
    • Sarah asked about the research process for being able to teach himself how to cook with these different methodologies
      • Russ first figured out what our actual ancestor breakout is in the United States
      • He then divided up the number of recipes he was going to dedicate to a specific region based on how many people are from that region
      • He looked through history books and looked at the staple dishes for the various regions, and then had to figure out how to make these staple recipes work in a modern kitchen
      • Russ wanted to connect people with their ancestors via these recipes, but to also keep them approachable so that people actually want to make the recipes in the book
      • When creating this book, Russ had his wife in mind
        • She is not an expert chef, but she is great at following a recipe
        • He wanted to keep the recipes approachable at her level
        • She is very particular with the way that she approaches a recipe, and Russ wrote the book with this skill level in mind
    • If you loved Russ's first two books you are going to love how Russ has expanded culturally the same concept, especially from The Ancestral Table
    • Stacy noted how special it is to connect with a culture, even if it is not a part of your ancestry, by reading about that culture's history in this book and then cooking those cuisines
    • Russ shared more about his research process and the way he had to almost play detective with pieces of information that are available, and the way he had to go about testing recipes, piecing the details together
      • It was very important to Russ to bring recipes back to life that may have been fading from use, both within a specific culture and to others who wouldn't have had a chance to try them otherwise
  • (36:07) Experiences with Blood Testing

    • Sarah's personal approach has almost been the flip side of the coin

      • She has used her DNA to really understand her diet
      • The approach that Sarah has taken has been at a micro level, and she loves the way Russ has taken a more macro approach to look at heritage data when deciding how best to eat for our health
      • Sarah also noted how special it is to see the way this book brings back a level on interpersonal touchpoints within the family that have started to fade in the age of connectivity (i.e. learning how to prep a recipe from Grandma)
    • Russ shared on his personal journey finding his ancestral history and visiting the places where his family was from
      • From his research and explorations, Russ found that his DNA test and his ancestary.com results don't define who he is today
    • Russ dedicated this book to his parents and his children
    • Stacy's mother was adopted and up until two years ago she didn't know anything about her birth family
      • When you are adopted you have no idea about your health history
      • Stacy's mom used ancestary.com and 23andme
        • She found a lot of information about her family and was able to meet many family members who were living within a close distance
      • These interactions also allowed Stacy and her mom to understand a lot more about their health history and the kinds of cancer that are prominent within their family
    • Russ shared more about what it meant to find out about his family's history and learning about their lives, where they died, where they are buried
    • Connecting with family members as an adult, when you didn't know they existed your entire life is a bizarre experience to navigate
    • Stacy touched on why some people don't want to utilize DNA and genetic testing when they would rather not know certain details surrounding their family and extended family members
    • Sarah noted that there are ways to utilize genetic testing without opting-in to learn about genetic relatives and to not have your information listed within the database so that others can contact you
      • It is possible to get the scientific, medically relevant details without learning about the family dynamic pieces
  • (1:03:02) Closing Thoughts

    • Stacy thanked Russ for joining Stacy and Sarah on this week's Paleo View episode and for sharing his story

    • Thank you, listeners, for being here!
      • If you have your own story about taking any of these ancestry tests, we would love to hear about them in the comments section on these blog posts or on social media
    • Thank you, everyone, for tuning in!
      • Stacy and Sarah will be back next week, and Stacy will be on the road!
    • (0:41) Welcome

      • Welcome back listeners to The Paleo View to episode 355!
      • We are glad you are here!
      • This week's topic is one that Stacy asked Sarah about long ago, and it has taken her that long to do the research
        • There are a lot of myths around this topic, so this show is more of a myth-busting discussion
        • Be warned listeners, Stacy and Sarah may agree to disagree on various points within this discussion
      • This show is sponsored by Butcher Box, one of The Paleo View' longtime partners on the podcast
        • Stacy and Sarah are so glad to have them back and look forward to telling listeners more about their products
        • You can get $15 off your first order plus free bacon by visiting https://www.butcherbox.com/thepaleoview/
      • The topic this week is wired bras, shapewear, and compression stockings
        • This has been a blog post topic bubbling in Stacy's head for two years
        • However, when Stacy started staying home and left her corporate job, she started wearing wired bras less often and made a statement regarding how she had lowered her risk of breast cancer - which wasn't a true statement, as addressed by her followers
        • Stacy thought it was a scientific fact because it is mentioned so often that wired bras increase your risk of breast cancer
      • Where Stacy thinks that Sarah and her will have some nuances on their discussion is on Shapewear because Stacy has personally worn body shapewear on almost a daily basis, which she found did have positive impacts
      • Sarah found that this was a challenging topic to research
        • To ease the research process, Sarah divided the topic of compression garments into three main areas

          • Shapewear
          • Bras
          • Compression stockings
        • From here Sarah tried to look into what research has been done on each one of these individually
      • Tangent - corset wear and corset training can cause a lot of health issues, which has been known for a long time now
        • This is a different thing because it is no longer a normal fashion anymore
        • Shapewear today doesn't compare even close to the same level of compression that corsets did/do
        • So for today's discussion, corsets are not a part of the discussion
      • Stacy just wants to take a moment to honor Sarah's soapbox about women's appearances
        • Stacy is living for that and is here for it
      • There is societal normalcy that you may want to participate in when it comes to wired bras and shapewear
        • Stacy lost a lot of weight and had a lot of sagging skin; her shapewear gave her comfort during a certain time in her journey
    • (14:05) Research on Compression Garments

      • There is a difference between low-pressure compression garments vs. medium compression garments

        • High pressure would be corset training
      • There is some science that separates out low pressure vs. medium pressure garments
      • There are some documented effects of shapewear, specifically with Gastroesophageal Reflux Disease
        • There have been studies comparing individuals wearing compression garments on the abdomen and those who experience rapid weight gain, as the symptoms are very similar
        • What has come out of this research is a substantial increase in acid reflux, to the point where one paper showed a higher risk of hernias in the top of the stomach
        • So with abdominal compression, there is a doubling of  the amount of reflux and a slowing down of reflux clearing after meals
      • This particular study looked at people who already had GERD (Gastroesophageal Reflux Disease) 
        • They were then studying the occurrence of reflux after a meal and showing that when these individuals had abdominal compression garments on they had twice the amount of reflux events, compared to not wearing anything
        • There have been no studies looking at healthy people without a GERD diagnosis, looking to see if they wear a compression garment if they will develop acid reflux as well
        • It is important to say that the science does not support the statement that wearing abdominal compression garments causes reflux
          •  
        • If you do all of these diet and lifestyle things correct, it should mean that you don't have acid reflux
        • Would compression wear cause acid reflux?
          • There is no way to answer that question at this point
        • Stacy notes that while the science might not be there (yet) that if one is wearing compression wear and is experiencing digestive issues, there may be symptoms to take personal note of
      • Sarah noted that there are plenty of doctors who have been interviewed who have noted that they have seen increased IBS symptoms and urinary incontinence when patients wear compression garments
        • So while the science is not there, Sarah would definitely suggest experimenting with this if you wear tight compression garments and you experience these symptoms - try a week without them, and see what happens
      • There is another study that looked at the higher end of medium compression garments worn to control swelling and scar formation after having a tummy tuck
        • They weren't looking at women who have had an abdominoplasty, they were looking at this type of compression garment because of one of the risks associated with this surgery - deep vein thrombosis (DVT)
        • They were looking to see if the DVT was related not to the surgery itself but to the compression garment worn after surgery
        • They did see a more sluggish blood flow in the femoral vein when women were wearing that compression garment
          • It was made worse by certain body positions that slowed down blood flow
        • There are other benefits and studies showing that if you discontinue wearing the compression garment before the scar is completely matured, that the scar can get much worse
        • So there are other reasons for this compression garment
        • Sarah thought this was an interesting additional thing to look at
        • This is a much higher form of compression than what is normal for shapewear, but it does imply that there is an additional thing to think about for people with blood clotting disorders
      • There was another study that Sarah looked at that researched similar garments being worn for postpartum hemorrhage treatment
        • This measured blood flow in the legs and showed no change, but they were focused on arteries and not veins
      • There are 600 studies looking at different types of compression wear on exercise performance and muscle recovery
      • It is worth noting that there are other therapeutic uses of compression garments
        • After plastic surgery
        • Varicose vein management
        • Wound healing
        • Lymphodema
        • Scar management
        • None of what Stacy and Sarah are discussing today is centered on these well established medical procedures that use compression garments
          • These are different situations
      • There are trends and styles that mimic compression garments and let's be honest, they aren't fun
    • (32:20) Bras and Cancer

      • Both Stacy and Sarah have heard claims, but never dove into the research to see if this statement was supported, that bra wearing (especially wired bras) was associated with an increased risk of breast cancer
      • It turns out that this urban legend originated from a paper from 1991 that was a fairly small study
        • There was a nonstatistically significant trend towards increased breast cancer incidents with wired bra wearing
        • This is where understanding what statistical significance means is really helpful
        • There was high variability in this study, so it is really hard to make average statements because your data is all over the place
        • This 1991 paper, with low-quality data, became an urban legend that caused people to throw out their bras based on this fear factor
      • There was a really well-done study out of the Seattle area that looked at women with cancer and match controls
        • It was a prospective study
        • They looked at bra wearing habits and separated out all the different aspects of bra wearing to determine if there was any link between these aspects and breast cancer incidents
        • They found absolutely zero links
        • This was a 2016 study that conclusively showed that bra wearing does not increase cancer risk
      • Sarah did find a case study of a woman who developed Mondor's disease from wearing too tight of a bra
        • This is something that was seen with a very high level of compression
      • There are no concerns in regards to breast health when women are wearing normal well-feeling bras
      • We as consumers have to learn to look a little deeper
    • (41:28) The Conclusive Science

      • Shapewear has this whole body image part of the conversation

        • Why are we feeling pressure to wear this stuff in the first place?
      • But as Sarah was getting into the research on compression garments, what stood out and is very well studied is the benefits of compression stalkings in particular on athletic performance
      • There has been a lot of studies showing a significant, although modest effect, in strength training athletes wearing compression stockings during and after working out can decrease delayed muscle soreness and improve muscle recovery
        • Any small impact that you can have on improving muscle recovery in strength training equals bigger gains, which is something strength training athletes are all about
      • There is also an effect on endurance athletes
        • A lot of studies have shown that endurance athletes will also have better muscle recovery after training
        • There is also a small improvement in performance in endurance athletes
          • Most of that research has been done on lower body compression
        • There is a couple of studies who have started to look at upper body compression and the results are mixed at this point, there isn't enough data
      • These studies essentially say that by applying some compression to the muscles you are allowing for things like lactic acid build up in the muscles to flush more efficiently and you are allowing the actual repair of muscle fibers to occur more efficiently
      • There have been a few studies that have branched out into those who are not athletes
        • One that stood out to Sarah was looking at patients who had at least two cardiovascular disease risk factors

          • When they were wearing compression garments they fatigued more quickly
          • This shows that studies done on athletes aren't always applicable to us "normal people"
          • If you are an active person with a sport, playing with compression wear is interesting
          • However, if you don't experience these results, it shouldn't come as a surprise as these studies show results in elite athletes
    • (47:48) Closing Thoughts

      • Stacy thanked Sarah for always digging into the science and for being our honest voice and for holding us all accountable to the scientific truth
      • Sarah has the rule for herself that she won't write about or recommend or create resources around something just because it worked for her
        • Evidence led has become her guiding point when creating resources
        • She really tries to understand the full body of scientific literature
        • Sarah is much more interested in understanding the why's behind contradictory information and trying to form a detailed picture
          • Instead of trying to simplify everything as right or wrong
      • Thank you, listeners, for being here and for hanging tough!
      • Sarah thinks Butcher Boxis the right stuff
        • Step by step Butcher Boxlooks after your health from the farm to your plate by sending you a curated collection of high-quality meat to your door on a subscription basis
      • Thank you Butcher Boxfor sponsoring this show!

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