The Whole View

Episode 445: What Supplements to Take on the AIP?

The Whole View, Episode 445: What Supplements to Take on the AIP?

Welcome back to episode 445! (0:28)

This week is all about supporting your health from the perspective of what you can control. And what you can work with medical professionals on to optimize your own health as much as possible.

Specifically, Stacy and Sarah will be discussing supplements on the autoimmune protocol (AIP) or have been previously and are now in more of a maintenance mode.

Stacy remembers when she first encountered coming across this topic while struggling with digestive issues.

She was not absorbing anything from the food she was ingesting. This caused her to have to re-nourish herself through the use of supplements.

She reminds listeners that what they go over in this show is not har-and-fast. As situations, health, and age change, your needs will change as well.

Both Stacy and Sarah are not medical professionals. So be sure to touch base with your doctor when taking your health into your own hands.

Sarah shares a comment from a member of the Patreon family that she feels sums up the approach she and Stacy takes toward this show.

Today's Sponsor

One of Stacy and Sarah's favorite supplement brands, Just Thrive, agreed to sponsor today's show! (2:30)

They are currently offering Whole View listeners 15% off their order using code THEWHOLEVIEW or you can follow the link above.

Bacillus bacteria are particularly important for gut health, even creating an environment where other probiotic species (like the Lactobacillus in sauerkraut) can thrive. 

Historically, we were exposed to Bacillus in dirt, but in our modern, sterile environments, Just Thrive probiotic has got us covered (no eating dirt necessary!). 

Not only is Just Thrive a potent probiotic, but it also contains a novel strain, Bacillus indicus (HU36), that produces antioxidants and vitamins right inside of the intestines, including lycopene, lutein, astaxanthin, zeaxanthin, beta-carotene, B vitamins, and vitamin K2! 

It can help people with IBS symptoms, digestion, infection, healthy gut, cholesterol, and so much more.

The individual Bacillus strains delivered by Just Thrive have been extensively studied; plus, the good folks behind Just Thrive have published a human clinical trial showing these strains can reduce leaky gut. 

They have 11 other human clinical trials ongoing, which is incredible to see in the supplement industry.

Other shows sponsored by Just Thrive worth checking out:

• 346: Can You Have A Healthy Gut If You Don't Eat Paleo
• 417: Vitamin K2 - Hype or Essential 

Other shows on supplements:

• 61: Supplements
• 234: Will I Have To Supplement Forever?

 

Listener Question: 

A follow-up question from a previous show on Vitamin D inspired the topic of today's show.  (12:42).

Listener Sarah says:

I am wondering what vitamin D supplement you recommend? When starting aip I was still taking my regular one but realized it had soy in it. I just listened to the vitamin D episode and realize how important it is for skin health. I need to get a new one and wanted to see what you recommend. I'm already doing Vital Proteins collagen, zinc, and fermented cod liver oil supplements. Anything else you recommend? I'm 3 weeks in and feel a lot better!! But I do miss eggs, chocolate, and rice cooked with homemade broth the most!! I love your podcast so much and get to listen to podcasts while I sew for my job all day!! You girls really made the day go by fast with your puns and science! Thanks for all the knowledge!

Sarah adds that she believes puns to be the highest form of humor and is glad that (listener) Sarah also enjoys them. 

First, it's worth mentioning that Stacy and Sarah no longer endorse or recommend Vital Proteins collagen. (See Episode 430 for the details.)

Stacy mentions that the formula change in Vital Proteins, depending on listener Sarah's situation, might negatively affect her if she's trying to eliminate gluten contaminants from her diet. 

Stacy also recommends a broth alternative that might help scratch that broth and rice itch!

Sarah starts off by letting listeners know that there are many soy-free Vitamin D supplements out on the market. 

She wants to take Sarah's question and really talk about supplements on the AIP because it's gets asked a very common question.

Taking Supplements While On AIP

Sarah breaks supplements while on AIP into four different categories. (18:25)

She reiterates Stacy's point at the beginning of the show that there's no one-size-fits-all approach to this or any specific list you should be taking while on AIP. 

It all comes down to you and your body as an individual.

1. Missing From Modern Food Supply

This category is all about providing things that are really hard to get from our modern-day food supply. (19:00)

Sarah explains that our modern food supply is actually quite depleted of vitamins and minerals than at other parts in history. 

Produce we get from grocery stores could have half the amount of minerals than what we would have bought 50 or so years ago. This she attributes to the depletion of soil over time.

A lot of this can be remedied by buying high-quality, organic if you can afford to. Or even buying locally grown. 

The better quality dirt produce is grown in and the better quality food the animals consume all play into how much nutrients end up in the products we buy from the store. 

Also, our food is washed so thoroughly before it makes it to the shelves. 

Natural sources for many nutrients, such as bacillus bacteria, are from dirt!

Historically, this is something we would have gotten much more easily due to smaller industries and more home-grown dependencies. 

Just Thrive probiotics are things we would have been exposed to originally that we just aren't getting from our modern food supply.

2. Food-Based Supplements For Nutrient-Dense Superfoods

These are nutrients from superfoods that some might have barriers against getting enough of. (23:10)

Stacy and Sarah have talked extensively about bone broth in the past as something that people are not getting enough of. 

Sarah poses the question of what options you have if you don't like the idea of consuming bone broth or organ meat to get those nutrients. 

Paleovalley is another trusted resource of Stacy and Sarah. They make a great Bone Broth Protein and Organ Complex for consumers looking to supplement those nutrients rather than directly to the source. 

Smidge Liver Pills is another organ supplement that Sarah highly recommends.

Sarah has noticed it's been a lot more difficult to get organ meat during the pandemic. She has relied on supplements much more this last year. 

Stacy also notes that she switched to Paleovalley organ complex a few months ago. She likes how diverse the supplement was.

Sarah and Stacy talked in depth about the benefit of seafood from a nutrient stand-point in Episode 415: Fish oil, Healthy or not? 

Some people, however, don't like or can't eat seafood. For them, Sarah recommends OysterZinc or Cod Liver Oil.

In Episode 373: How Many Vegetables (Part 4) Powdered Veggies, Stacy and Sarah talked a lot about the power of freeze-dried veggies.

Episode 392: Are Mushrooms Really Magic? Part 2 is another great resource for nutrients that often met with barriers. Real Mushrooms offer a great supplement to fill that gap!

Fermented foods are another hurdle that can be bridged by a probiotic like the ones provided by Just Thrive.

Stacy adds to watch out for juices and pulps because you're not getting the whole form of the fruit and/or vegetable, so you may be missing out on some key nutrients.

She personally leans into smoothies as a way to "juice" without juicing.

3. Targeting For Severe Deficiencies

This doesn't necessarily mean targeted synthetic. It could easily mean targeting one of the prior mentioned categories to meet that shortfall. (43:02)

This is where you get into Sarah's "Test Don't Guess" mindset. Here is where you should work with a professional medical expert who can run tests to tell you exactly where your deficiencies are. 

Vitamin D is one of the most common deficiencies doctors see. If your Vitamin D levels are already low, it's very hard to meet that deficiency without supplement help.

Iron and vitamin B12 deficiencies are also among the most common. 

Sarah notes, however, your body could be deficient in something completely different due to genetic issues that put you at a disadvantage for absorbing it. 

Listeners might still supplement with food-based supplements, like taking Real Mushrooms D2 for vitamin D insufficiency. 

Stacy and Sarah talked in the past about Vitamin K2 and whether it's hype or Essential. Listeners might want to add Just Thrive K2 here too. 

Sarah also notes that it often takes more than just changing your diet to get to the appropriate levels with severe deficiencies.

Stacy has personal experience with B12 struggles and Vitamin K2. She shares a little bit about her journey and what she's learned from it. 

None of this stuff is something you would take without testing and monitoring from a doctor. 

Because this is the type of stuff you'd only do with a medical professional, Sarah thinks it's best to go over what types of things it would involve.

4. Targeting For Other Purposes

The "lowest hanging fruit" is digestive support supplements. Here you'd work with a practitioner to assess digestion efficacy through stool testing. (45:00)

This looks for undigested fats and proteins that would otherwise not be there if your digestive system was working optimally. 

It's important because you can eat all the nutrient-dense food you want, but your body isn't breaking them down properly for absorption, they're not providing you with the things you think they are.  

Adaptogens, vitamin C, and magnesium are used to treat adrenal fatigue and chronic stress. 

Sarah adds that adaptogens always need to be adjusted over time which is why store-bought supplements for stress management aren't as effective as you hope/think they will. 

Probiotics might be called for severe gut dysbiosis. Just Thrive is in this category! However, a medical professional will test for this and help figure out the path that's suitable for you. 

CBD for pain and inflammation. Stacy and Sarah talked in-depth about the benefits of CBD in Ep 420 CBD for Pain Management.

DIM or high crucifer intake for hormone imbalances, glutamine for leaky gut, and melatonin for sleep (Ep 314 Is Melatonin Safe) are great avenues a doctor can test for. 

Stacy adds that you might not need all of this, or you might be someone who would benefit from it.

She and Sarah have talked at length about why some supplements they've given priority over others. For example, CBD and melatonin are often lower on their priority list. 

 

Notes for Just Thrive Probiotic

Bacillus is spore-based bacteria naturally found in dirt that are particularly important for gut health.

They produce at least 795 different selective antibiotic molecules that inhibit pathogenic bacteria, fungi, and protozoan parasites, helping maintain a healthy gut ecosystem.

But, among the over 200 different Bacillus species currently identified, not all are equally beneficial, and some may even have pathogenic potential.

That's why it's so important to choose a probiotic supplement using only well-studied beneficial strains, like the four strains delivered by Just Thrive Probiotic.

Bacillus subtilis drives restoration of microbial diversity during infection, stabilizing the microbiome. They increase the growth of well-known probiotic species, including Lactobacillus reuteri and Lactobacillus acidophilus.

It supports gut health by producing essential enzymes to aid digestive function, producing amino acids, synthesizing vitamins, degrading cholesterol, and even contributing to intestinal homeostasis maintenance.

Bacillus subtilis can help antibiotic-induced diarrhea, ulcerative colitis, bacterial vaginosis, urinary tract infection, and candida vaginal infections.

This probiotic species improves gut health by protecting against genotoxic agents and regulating cell growth, differentiation, and signaling.

Sarah loves that Just Thrive Probiotic is free of wheat, gluten, dairy, nuts, soy, salt, sugar, artificial colors or flavors, binders, fillers, allergens, and GMO's. One of her priorities is taking Just Thrive Probiotic daily!

Historically, we were exposed to these awesome Bacillus species in dirt (for example, eating unwashed organic veggies from a local farm, compared to other probiotics that we can get from fermented foods).

But in our modern, sterile environments, Just Thrive has got us covered — no eating dirt necessary!

Sarah also always takes Just Thrive Probiotic with a meal, usually dinner.

Bacillus species are among those known to exhibit circadian rhythm in their relative abundance in healthy conditions (and lose circadian rhythm in metabolic syndrome), peaking after meals and ebbing between meals.

 

Final Thoughts About Supplements While On AIP

Stacy reminds listeners that AIP is an umbrella term. (1:01:20)

She feels it's important to keep nutrient density in mind, but it's crucial to make sure you don't stress yourself out about it either. It's about balance. 

While this is a lot of information to a really simple question, Sarah jokes that a short answer would've have made a very good show. So they dug in deeper than most people would normally need to go. 

Take this information about supplements while on AIP as a base knowledge for what might be beneficial to you in certain circumstances.

It's also critical to find a good practitioner to work with for any next-level stuff.

Also, don't forget to check out Just Thrive and their probiotics and other products.

Thank you, Just Thrive, for sponsoring today's show. And thank you, listeners, for hanging in. 

If you want more of the Whole View and hear how Stacy and Sarah really feel, hop on over to Patreon for bonus unfiltered content. 

See you next week!

Episode 444: Covid-19 Vaccine Myths and FAQ Part 4

The Whole View, Episode 444: Covid-19 Vaccine Myths and FAQ Part 4

Welcome back to episode 444 of the Whole View! This is the surprise second part of last week's Covid-19 FAQ and Myth show, which turned into a mammoth episode.

You haven't yet listened to can find the first part of the show here.

Stacy reminds listeners that she and Sarah are not medical professionals and consult your primary care doctor before making any decisions.

Myths Surrounding Enhanced Infection

First, Sarah has one more frequently asked question to cover before she gets into the real big myths. (2:04)

There has been a lot of misinformation circulating within the scientific community regarding the mRNA vaccine and the whether or not the possibility of "enhanced infection" is possible.

Hematopoietic cells originate in the bone marrow and are responsible for replenishing all types of blood cells for our entire lives.

As a result, they are very important cells in combating infection and are very plugged in to the immune system.

Sarah explains how stem cells work in the body to support and control our immune system and fight off illness.

She also adds that there is zero evidence of any vaccine, including the mRNA vaccine, jeopardizing these cells.

Sarah lists articles here and here for more information.

Just in case, Sarah runs through a hypothetical of what it would look like if these claims were possible.

Pfizer tracked 21 different types of severe infections. And they found no statistical difference between the vaccine and placebo group within 2 months of the second shot.

In Moderna, there were 521 infections or infestations (of any kind) post-vaccine and 621 post-placebo (which is no statistical difference as well).

Finally, Sarah goes over a handful of cases found in both the test and placebo group and the situations surrounding those patients to put perspective into why they might have occurred.

Antibody-Enhanced Infection 

In Episode 425, Sarah and Stacy talked about the antibody-enhanced infection in Dengue Fever cases. (8:19)

Sarah gives a brief recap of how this antibody-enhancement works.

It's important to point out that SARS-CoV-2 (as well as other coronaviruses) have not been shown to have the ability to infect macrophages.

Sarah adds that if this were a real medical concern, it would be the same for all vaccines across the board, not just mRNA vaccines.

This misconception grew from cell cultures reacting during the early vaccine research for SARS (not SARS-CoV-2 aka Covid-19).

While it is a Covid-19 vaccine myth, it did grow from a small grain of truth that we've since learned from because these experiments showed researchers needed to adjust the target.

Sarah reminds listeners that building upon past scientific discoveries is what we owe to these vaccines' speedy development.

Sarah recommends this paper for more information on the history of coronavirus vaccines.

If ADE is possible with Covid, we'll see it with natural infection first, which we have not yet seen.

She shares that scaring people with these myths, not looking at early research study as something to grow from, and using it to spread misinformation upsets her.

We are over 2.3 million deaths globally and over 470k in the USA from Covid-19.

Doing Your Own Research Is Important!

In part 2, Sarah explained that the risk of developing some of these vaccine-induced injuries is 1 in a million. However, no one wants to be that one person.

That's why it's so important to know your own health, potential risk factors, work with your doctor to use all the information available.

That way, you make a choice that works better for you as an individual. And building herd immunity in the low-risk populous will protect those who aren't well enough to get the vaccine themselves.

Sarah adds that with the way research works, there is the possibility that future data may change the landscape of this vaccine. And that's why research and education is so important.

Corporate Myths And Theories

Sarah mentions many of the "questions" she received regarding this topic weren't earnest questions from typical readers looking for information. But rather, people looking to stir up trouble. (21:20) 

She wants to include them in this show because listeners may have family members or friends who have heard them. And she wants to arm listeners with facts.

Stacy adds that if it comes from genuine ignorance and you're looking to educate yourself, there is nothing wrong with asking these types of questions!

However, when others leave inflammatory comments around these topics, she's noticed how obvious it can be that they didn't listen to the show beforehand.

They're just not interested in truth- they are only interested in their own opinion. In those cases, it's not your responsibility to engage with them if you don't want to for the sake of your own sanity.

If they're interested in knowing more, they will do their research. If not- it's not your job to fix other people.

Covid-19 Vaccine Myths: For-Profit Argument

Sarah reminds listeners that it's not in a company's best interest for their products to hurt their customers. It's not a good business model. (25:05)

Also, most of these vaccines are industry-academic partnerships. And the base science tends to be academic (source).

The studies themselves are peer-reviewed (meaning by third-party researchers in the same field), and the FDA review process is independent of scientists. 

This means there has been a TON of non-biassed eyeballs on this data.

While money may be made to some degree, all of the research done on these vaccines was done by academics (not businesses).

Covid-19 Vaccine Myths: mRNA vs. DNA

Sarah takes a minute to underline that RNA is not the same thing as DNA (27:21).

She and Stacy went in-depth in Part 1 about what role RNA plays in the body and how it does not enter the cell's nucleus (where the DNA is housed).

That's what makes mRNA technology so cool! Stacy adds how glad she is just to be aware of the "line" it won't cross. There's a whole nuclear envelope acting as a barrier.

Covid-19 Vaccine Myths: Traces of Controversial Tissue Cells

Sarah explains that neither the Pfizer nor the Moderna vaccine uses cell lines in this form or from this origin any stage of design, development, or production of these vaccines. (29:06)

She also explains what "immortalized" means, where these cells come from, and the roles (and have played) in scientific research.

There are hundreds of different types of these cells- not just the controversial source commonly associated with them.

Sarah adds the ethics in place now are different than the ethics of the 60s and 70s when this first started.

And no sample would ever be taken unless consent was given first. Some of the COVID-19 vaccines currently being studied in clinical trials have used these "historical" cell lines. 

But the Pfizer and Moderna vaccines are not one of them. 

Sarah provides a list of potential vaccines to look closer into before getting if this is an issue you feel strongly about.

There is a great effort in medical research to be ethically uncontroversial, and these cloned cells are only used if alternative ones cannot be.

Covid-19 Vaccine Myths: Hidden Foreign Bodies

Sarah looked into the needles' diameter used with the coronavirus vaccines and how small something would need to be injected into the skin. (37:24)

Anything small enough to hide in a needle would not be able to be read from something as far away as outer space.

Sarah goes through how big these foreign objects would need to be to transmit various distances.

Basically, with the way currents move and physics laws, it's an impossible technology and would burn out pretty quickly.

Covid-19 Vaccine Myths: Bribing Dr. Sarah's

Sarah has received comments regarding her integrity regarding these topics and whether she's been bought off. (41:03)

The answer to that is no. Stacy adds that both she and Sarah genuinely care about the health of their listeners. They've dedicated their careers to health and wellness.

She adds how thankful she is for the "big brain" audience she and Sarah have and the mutual interest in facts and science.

Sarah has applied the same rigorous research to this show as she does every other show.

All she and Stacy aim to do is help people expand their knowledge base to make everyday decisions without guilt, pressure, or lack of understanding challenges.

Everything they do is present science in the most balanced way possible.

Sarah adds that she's a scientist. She's a nerd. All she's really interested in is the facts.

Roll-Out Priorities & Challenges

The rate at which the vaccine can be produced is the reason behind roll-out priority for who gets the vaccine. (47:20)

Basically, they haven't made enough vaccines yet for everyone to get one and focus on people who need it the most while they ramp up production.

Priorities are healthcare professionals and the people who are more likely to get a severe disease and die.

There are different ways to define these populations, and some states are doing it differently. Here are the Phases the CDC recommends:

• 1a - healthcare personnel, long-term care facility residents
• 1b - frontline essential workers, persons aged 75+
• 1c - persons aged 65-74, persons aged 16-64 with high-risk conditions, essential workers not recommended in Phase 1b
• 2 - everybody else

There have been racial inequities in vaccine distribution which is very upsetting to Sarah because the black community is 1.4X more likely to get Covid and 2.5X more likely to die from Covid.

She attributes this to the compounding of different things, including systemic racism and the prevalence of that community in frontline positions.

Less than half of the states keep track of demographic data for vaccine distribution, but we know so far that there are big inequities in distribution (source).

This is a problem that public health officials need to solve. And there are some really good ideas being considered- like mobile sites, door-to-door. 

You can donate to advocacy agencies to help and not participate in vaccine tourism!

Who Should Wait to Get a Vaccine?

Children 15 and younger because clinical trials for that age group have not been approved yet.

Pregnant/lactating women, immunocompromised individuals, anyone on immune-suppressing drugs (even prednisone), and people with multiple severe/anaphylactic allergies should all talk to their doctor.

Anyone with a known allergy to PEG (found in some other vaccines, medications, and laxatives) should also wait.

It's also not recommended for the terminally ill or all elderly.

Sarah also explains a bit about why some governments throughout the world are holding back and why.

She attributes this to trying to get the best out of a limited number of vaccines.

Vaccine Aftercare

Sarah takes another listener question on whether taking Advil or Tylenol after being vaccinated impacts how well it works. (58:25)

She explains that something like Advil is anti-inflammatory will suppress some of the immune response, which is counterproductive to the goal.

She adds that this is actually true for all vaccines!

Instead, you should do the same thing as if you were recovering from a cold or flu: rest, fluids, and nutrient-density focus. 

It's also noteworthy that adults don't take very many 2-shot vaccinations. 

DTap booster every 10 years and maybe annual flu vaccine are both 1-shots. 

The flu-like symptoms come from the second shot (which we're not used to getting). And it's important to rest and recover!

Further Citations & Scientific Literature

Summary of mRNA vaccine technology

• https://www.nature.com/articles/nrd.2017.243
• https://www.frontiersin.org/articles/10.3389/fimmu.2019.00594/full 
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439223/ 
• https://www.nature.com/articles/s41541-020-0159-8
• https://www.nature.com/articles/nrd4278 

Covid Immunity, relevance to all vaccines in development

• https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32137-1/fulltext

Moderna mRNA-1273:

• FDA Briefing Document (54 pages)
• Published Phase 1 trial result
• Published Phase 2/3 trial results 

Pfizer BNT162b2: 

• FDA Briefing Document (92 pages)
• Published Phase 1 trial results
• Published Phase 2/3 trial results

 

Final Thoughts

Stacy thanks any and all listeners for hanging with them through everything! (1:03:01)

She invites anyone who hasn't already joined their Patreon family to consider doing so.

Patreon listeners get bonus content on what Sarah and Stacy really feel about these topics.

Also, Stacy encourages anyone willing to leave a review about the Whole View to do so.

Due to vaccines being such a sensitive topic, your review would help balance negative ones left by those who disagree but don't bother listening to the show.

Thank you so much for listening. Be safe. Be healthy. And we will see you next week!

Episode 443: Covid-19 Vaccines Part 3 - Myths and FAQ’s

The Whole View, Episode 443: Covid-19 Vaccines Part 3 - Myths and FAQ’s

Welcome back to episode 443 of the Whole View. (0:27)      

Stacy explains that this is part 3 of the Covid Vaccine Shows: you can find Part 1 here and Part 2 here.

She thanks every listener for all their positivity and understanding. The point of these shows is to give the information needed to make an informed decision for yourself.

She also extends a bit thanks to Sarah, who has logged a ridiculous amount of hours doing extensive research to arm listeners with all the information she can.

Sarah explains that this show may be on the long side. But she hopes to answer some questions followers have and dispel or shed light on common myths around these vaccines.

Stacy adds that this show is all about the facts. Nothing they say is meant to be opinion based not backed up by science.

She also reminds listeners that she and Sarah are not medical professionals. They are not qualified to give medical advice on whether you should get the vaccine or not.

The best practice is to consult your primary care physician.

Stacy hopes that all this information can help listeners make an informed decision they are happy with.

Listener FAQ: Covid-19 Vaccines Myths

Sarah goes through several positive comments left by viewers, expressing their appreciation of the science included in previous shows and arming them with as much research as Sarah did. (7:45)   

She takes a moment to emphasize that the FDA reports and all of the peer-reviewed papers on these clinical trials are full public access. 

They will be included in these show notes so listeners can go to the source for more information and formulate their own opinions based on the science.

Stacy jokes that will be a theme of the show today: science and information.

The first question Sarah takes comes from a listener on Patreon.

Sarah reminds listeners that Patreon is the best platform to reach them and was the first place they went when pulling questions. 

If you've not joined the Patreon family, she invites you to for bonus content and extra episodes!

Herd Immunity

The first question Sarah takes is about herd immunity and why wearing masks is still encouraged after vaccination. (13:30)

Sarah explains the there are multiple positive outcomes that we hope to get from the vaccines:

• Prevent disability and death
• Ease the burden on the healthcare system to ensure patients get the necessary attention
• Ease the burden on the economy so we can open schools, etc. back up
• Achieve herd immunity, so we don't have to live with covid forever

She adds that even if we can achieve the first three without the fourth, that's a huge win, and we don't necessarily need herd immunity for the vaccine to be a success.

The benefit of herd immunity (why it's ideal) is it limits the spread to pockets that more easily die out because they don't have as many places to go.

Sarah explains that we don't have all the information yet to determine how long immunity from vaccination will last.

There is still a lot of tests needing to be done to accurately calculate those numbers.

Sarah does say that the preliminary data (early outlooks) looks promising for reducing asymptomatic cases.

That's why it's still important to wear a mask in the meantime. We need to keep the disease spread as low as possible to give researchers time to figure out what the future will look like for herd immunity.

Sarah adds that this is actually very exciting early data. She explains data for the newer Oxford/Astrazeneca vaccine maybe 59 percent effective at stopping asymptomatic infection.

However, Sarah emphasizes that we definitely need more data before saying people with the vaccine can go without masks and social distancing.

Long-Term Effects of Asymptomatic Cases 

Sarah jumps to another listener's question on whether those asymptomatic or mild cases carry the risks of long covid or other long-term damage. (22:32)

Sarah recaps long-covid, which she and Stacy talked about long covid and tissue damage on our previous covid shows.

She does a quick recap on what long-term effects are known to be associated with Covid-19 infections, such as the tissue damage seen in long-Covid. 

There's no evidence from the clinical trials about possible long-term damage comparable to mild cases.

Myocarditis is shown to occur in between 15-35% of covid patients and even 15% in young college athletes with mild or asymptomatic cases.

Sarah reminds listeners that not everyone who gets covid will suffer permanent heart damage. She does agree it's a concern but doesn't want to scare anyone.

While this hasn't been methodically studied yet, the early data points to the only likely long-term effect of getting vaccinated being immunity to covid-19.

Stacy adds that many people involved in the clinical trials actually reached out to her and Sarah.

They spoke of the attentiveness they experienced and how closely monitored they were. 

Stacy thanks those followers for sharing their crucial experiences!

Stacy also shares her experiences with long-covid and does not wish it on anyone.

Both vaccines were thoroughly tested for anything and everything that could possibly go wrong.

Pregnant Women

Another listener asks if the Covid-19 vaccines are safe for pregnant women and children yet, due to it being super unclear in the media. (37:20)

Pregnant women were excluded from trials, but some became pregnant after enrolling. Those women were followed closely for monitoring. 

There is very limited human testing in this area. However, WHO recently said pregnant women can get the covid vaccine due to the few cases. No issues with pregnancy were detected in animal studies of vaccines.

Sarah mentions that pregnant women are considered high-risk, and that's definitely something to keep in mind when deciding if vaccination is right for you.

Pregnant women are overall 3-3.5x more likely to require ventilation. And 70% more likely to die from covid than their age and risk factor-matched controls.

It's even worse for AMA, pregnant women aged 35–44 years with COVID-19: 

• nearly four times as likely to require invasive ventilation
• twice as likely to die than were non-pregnant women of the same age

Sarah recommends reviewing this article for more information.

She also mentions that despite being considered "high-risk," the absolute risk is still low.

This is why even though data is preliminary for vaccines, some organizations recommend it. 

CDC recommends pregnant women have a conversation with their doctors.

Another listener asks for recommendations for breastfeeding. Sarah says that nothing is saying that breastfeeding could be problematic. But it does warrant a conversation with your doctor.

Stacy adds that what's in your blood is different from what's in your milk.

Children

Pfizer already tested in 16-18-year-olds. It showed good safety, efficacy consistent with adult data and already has EUA to 16+. (40:41)

Pfizer is currently testing in 12-15-year-olds, fully enrolled, and expect data in the summer.

Moderna is currently testing 12 to 18-year-olds, still enrolling, and hoping to have approval in time for 2021/2022 school year. 

Sarah actually enrolled her daughter because they are having issues filling slots for those studies. She and her family are waiting to find out if she'll be in the trial.

Then they'll move into younger and younger children (6-11 then 1-5). 

They go slow, start with a lower dose to be extra cautious, and so these trials take longer.

Moderna doesn't expect to have data in children 1 to 11 until well into 2022, so we just have to wait for now.

Young Women and Future Pregnancy

Sarah addresses a question from a listener regarding information she heard about the possibility of hurting the lining of their placenta when they want to have children. What is the premise of this? (49:50)

She explains that this is one of those myths based on a kernel of truth but took on a life of its own on the internet.

Sarah goes in-depth about the spike protein and how antibodies affect them. She adds that the same thing has a chance of happening in natural infection.

And even then, the numbers are very slim.

Sarah summarizes that it's not impossible but highly improbable, and we have no examples to point to.

Autoimmune Diseases In More Detail

Sarah covers another question on whether a vaccine could cause something with no history of autoimmune conditions to trigger a response for a lifelong autoimmune condition. (53:02)

She goes in-depth, looking at numerous case reports indicating that vaccines could potentially worsen autoimmune disease activity and increase measurable autoantibody levels. 

This is most likely attributed to the adjuvants in vaccines. 

However, several large-scale prospective studies indicate no link between vaccines and autoimmune disease or autoantibody formation. 

Sarah explores several different studies that looked at this research topic and breaks down what the data shows. 

In fact, early data shows vaccines could potentially reduce autoimmune diseases by preventing environmental triggers for it.

However, this still needs to be studied in a lot more detail before we can say for sure.

Sarah adds that for the covid mRNA vaccines, clinical trials included autoimmune sufferers (even those on DMARDS) and tracked autoimmune disease as possible adverse events.

Sarah revisits vaccine injury, which they discussed in the Covid first show, and the timeframe.

She adds EAU will transition to full regulatory approval once there are 6 months of follow-up data and we're actually nearly there. Clinical trial participants will also be followed for 24 months.

Final Thoughts

Stacy reflects on how much it blows her mind the comparison between the study group and the placebo. (1:07:14)

When out of 30,000 people, you have one person in the study group and one placebo group both have an immune response, it sounds way better to Stacy than if that's the same one person was extrapolated from the data, and the rest left out.

Sarah reiterates that this is the point of these shows: to provide listeners with the big picture and all the data. Not facts that may or may not have been taken out of context.

Stacy mentions that she and Sarah didn't want to skimp on any information. For this reason, decided to cut this two-hour show into two parts. 

Join us again next week for more Covid-19 vaccine myths dispelled! And be sure to pop over and join Sarah and Stacy on Patreon.

Episode 442: How Do I Know What Dietary Protocol to Start With?

The Whole View, Episode 442: How Do I Know what Dietary Protocol to Start with?  

Welcome back to episode 442 of the Whole View. (0:27)      

Stacy welcomes listeners to the show! She hopes everyone has had a great start to the year so far, but if not, it's a new month.

Today's topic is dietary protocol. And Stacy hopes listeners have been seeing fewer advertisements and pressure to conform to a dietary standard that could end up making them not feel right. 

She and Sarah, as always, will approach this topic from the perspective of addressing the difference in the dietary protocols that are focused on health.

Stacy also takes a moment to remind listeners that all the information in this show comes from a place of optimizing health. 

They are not here to tell you to lose weight and fit into your jeans, but rather help you feel better, inside and out. This is a safe place to learn and not to feel pressured.

Listener Question

Sarah reflects on how much this show has documented her and Stacy's individual health journeys and the ups and downs that they've experienced. (4:03)

They are not the type of people to hide their challenges to paint a rosy picture or endorse that approach. 

Their main goal is to endorse a solution-oriented mindset about health, doable, approachable, and sustainable. 

Sherly asks:

Hello Dr. Sarah and Stacy! I was so happy to find your podcast during these strange times and have found all your Covid shows so helpful. I understand that neither of you strictly follow any of the diets you talk about on the show (AIP, Sarah’s Gut Health Diet and Paleo) but rather used them to find out what worked best for you over time. For those of us just starting out how do we go about picking a diet to start from? Is there a hierarchy here? And where does being a “nutrivore” fit into all of this? Apologies if you have already covered this, but I am slowly working my way through your shows. I have come to trust your recommendations and I would like to re-do my own way of eating, I just don't know where to start. Thanks in advance for your help!

The Quick Answer

Stacy explains that, in brief, the autoimmune protocol is an additional step beyond the paleo diet. Its driving strategy is to eliminate potentially inflammatory foods out of the diet still included in paleo (including nightshades).

Nutrivore is more concerned with nutrient-density and taking care of your gut microbiome health.

Sarah jokes and congratulates Stacy for pulling off a great elevator pitch! Though, Stacy urges listeners to stick around a bit longer because there is a lot more to the science behind these protocols.

Sarah explains that the lines between each dietary protocol are pretty blurry. She attributes that blurriness to how these lines are used to hone in on a personalized optimal diet.

She and Stacy have both used these protocols to target their individual triggers and build a diet that works for them.

Sarah and Stacy do not do on this show are rigid rules, "perfection-or-bust," or one-side-fits-all.

Instead, they encourage the understanding of universal truths and bio-individuality.

The Dietary Protocol Hierarchy

Stacy reminds listeners that there is such a thing as taking too big of an initial jump. (13:16)

It's essential to listen to your body and tell you what you need or crave.

Top Level: Nutrivore

The idea of nutrivore is to eat all the nutrients available, both essential and non-essential, that we need to thrive.

This includes nutrients to support a healthy gut microbiome and is very similar to the gut health diet.

The gut health diet provides just a little extra focus above and beyond nutrient sufficiency.

Sarah references Episode 437: Intro To Nutrivore as a great reference if you're looking to focus on a nutrient-dense diet.

She thinks of this as a diet modifier, meaning you can apply nutrivore to any other diet template, including the other protocols on this list.

However, the exception to the "umbrella" of nutrivore is extreme diets, such as raw vegan, carnivore, or some keto variants, which cut out all food sources of specific nutrients. 

Sarah explains the benefit of nutrivore is the ability to give the body all the "building blocks" it needs to do its job on a cellular level.

Paleo Plus or 80/20 Paleo

Sarah explains there are many different versions of the Paleo diet. (18:50)

This is a version that adds a few nutrient-dense, gut microbiome superfoods to provide some extra flexibility.

The most common additions are grass-fed (hopefully A2) dairy, traditionally-prepared legumes, sprouted pseudo-grains, and rice.

“Strict” Paleo

Ideally, this would be implemented with the guiding principles of a nutrivore approach. (20:01)

But it also eliminates empty calorie foods that are often allergy triggers or anything that wouldn't have been available to our primitive ancestors. 

The foods eliminated (processed/refined foods, grains, legumes, and dairy) most commonly drive inflammation while not contributing meaningfully in terms of nutrients.

Paleo should still include an elimination and challenge aspect. 

This is where you do "strict" Paleo for a few weeks to months and then test your individual tolerance to non-Paleo foods to see how you react.

AIP

AIP is the strictest dietary protocol. (23:56)

Nutrivore is the core of this protocol but with the addition of eliminating a larger collection of foods known to cause inflammation.

On top of processed and refined foods, grains, legumes, and dairy, AIP also eliminates eggs, nightshades, nuts, seeds, alcohol.

This dietary protocol includes an equal focus on lifestyle, such as sleep, stress, activity, nature, and connection.

It involves three phases: Elimination, Reintroduction, Maintenance.

Sarah explains that AIP is not meant to be a long-term solution. But rather, the hope is to empower you through self-discovery and set you on a dietary path that works best for you as an individual

Lastly, Sarah recommends visiting the AIP Coach Directory if you're interested in receiving more AIP information.

Dietary Protocol: Where To Start?

Stacy explains that everyone is different, and there is a lot of wiggle room to make sure they are working optimally for you. (27:30)

Moreover, many of them, especially FODMAP diets, aren't meant to be upheld long-term. In those cases, they are more designed for symptom maintenance. 

Sarah explains that anything layer to think about is food sensitivities. 

There is an extra challenge when you have a hyperactive immune system and an unhealthy gut that you can develop allergies, intolerances, or sensitivities to foods that are always super healthy and otherwise something you wouldn't eliminate.

Part of the self-discovery stage could include working with a specialist to target what could be triggering your individual symptoms.

Because we are all different, Sarah explains that deciding where to start depends on few different factors.

Health Challenges And Goals

This is the first side of the coins, Sarah explains. (33:47)

AIP is usually recommended for autoimmune disease or chronic disease.

Paleo or Paleo Plus is great for symptoms without a diagnosis, and using a food journal to target other potential food sensitivities.

Nutrivore or Paleo Plus works well for age-related health challenges.

And if you have no health challenges, in particular, Sarah recommends starting top-tier with Nutrivore.

Mitigating or managing autoimmune or chronic disease, AIP is a good strategy to use.

If you're looking for a healthy weight loss (see our show on weight stigma!), Paleo or Paleo Plus might work best for you. Unless your weight gain is related to autoimmune diseases, like hypothyroidism.

Nutrivore or Paleo Plus is great for people looking for a performance diet or healthy aging.

And for general health, nutrivore is always a great protocol to implement.

Barriers

Sarah explains to listeners that you don't want to make it so challenging day-to-day that you can't stick with it. The idea is to set yourself up for success, see results, and improve your health.

We often justify actions centered on the idea of weight loss and claim that it's for health.

Stacy reminds listeners that diet culture is so pervasive that we don't even realize we're swimming in it. And that we must look at whether or not we feel good.

Especially when it comes to inflammation and autoimmune. It's very important for Stacy that her joint pain is manageable as she ages.

Stacy also shares that at one point, she was using dietary protocols and "getting healthy" as an excuse for losing weight.

She really wants to encourage everyone to ask those questions and challenge themselves and the reasons behind their choices.

You can want to be the best version of yourself while loving and respecting who you are today, without all the ugliness that comes with the culture around it.

Stacy also underlines the importance of emotional and lifestyle aspects and that you can't just diet your way into being healthy.

A few solutions to overcoming barriers are education, coaching, support network, flexibility, and lifestyle before diet.

Maybe you're just not used to shopping/cooking/eating this way.

It could be your budget, time management, energy, or symptoms getting in the way. Maybe your family isn't on board (temptation, no support, cooking for 2+ different diets).

History of yo-yo diet, on-again-off-again, and bad relationships with food can also get in the way.

Final Thoughts

Sarah explains that sometimes the best place to start isn't diet at all. (48:03)

Often, when she gets this question, she asks whether or not the person is getting enough sleep.

This way, we can set up for success before we even get started on changing our diet. 

Sarah references this show for any listeners looking for a reference on the Science Of Habits.

She reminds listeners that this is a journey! There is no one way to do it, and any steps you take on that journey is a great way to do it. 

This really comes down to who you are as a person and how you're able to best perform a task- whether incrementally.

It needs to be an individual choice and a choice you're willing to re-evaluate as you go.

Sarah underlines that the most important thing about starting a health journey is to start it.

Stacy adds that it's not so much what step to take to get you started but what steps will be sustainable.

Stacy talks about how this played into the inspiration behind their third book, Real Life Paleo.

She reminds listeners that messing up isn't a failure. It's about continuing to try.

Sarah agrees, adding not to let perfection be the enemy of the good. It's all about our choices, and we should never feel guilt or shame about them.

The key part of this journey is learning about our bodies well enough to know what we'll be able to come back from and what we never want to repeat again (like the last time Sarah ate gluten).

Stacy encourages listeners to look at healthy choices as an act of self-love for themselves and their bodies.

Thank you so much for listening! Stacy and Sarah are so thankful to have such a fantastic community.

Episode 441: COVID-19 Vaccines Part 2 - Pfizer/BioNTech vs Moderna

The Whole View, Episode 441: COVID-19 Vaccines Part 2 - Pfizer/BioNTech vs Moderna 

Welcome back to episode 441 of the Whole View. (0:27)    

Stacy reminds everyone that this is part 2 of the Covid show on vaccines.

So if you've done listened to part 1, be sure to do so first, so this episode will make more sense.

She also reminds listeners that this show isn't about opinions. We all have our own, and Stacy and Sarah aren't here to debate that.

As always, they are here to break down the science for you to make your own informed choices.

Stacy takes a moment to thank Sarah for doing all the research to make these shows possible.

She and Sarah received a lot of feedback from listeners who enjoyed a straightforward approach to this topic.

Sarah explains that it's always more challenging when she knows they're getting into a topic where there's a lot more disinformation and misinformation to combat.

Especially when they take a more myth-busting approach because that information could have come to you from a trusted source.

Sarah extends her gratitude to listeners for being so open to the science and having an open mind.

Sarah takes a minute to run through a recap of mRNA vaccines and how they work, which she covered extensively in Episode 440.

She also reiterates how important funding for basic science discovery is because we almost didn't get this mRNA research.

Different Variants of Concern

Sarah reminds listeners that the variations we see in the virus are different enough to count as a new strain. (15:50)

They're called "variants of concern" because they have a few mutations that change the virology (basically make a function change).

We know the novel coronavirus mutates very slowly. But because of the sheer number of people, it's infected so far this year, it's had many opportunities to mutate.

The UK and South African variants have a mutation in common, which is how easily the spike protein binds to the ACE2 receptions and speeding up the replication rate.

This means the infection dose we need to be exposed to become infected is slower. It also means an infected person is shedding more virus than other strains.

In fact, the UK strain is showing 40%-80% more contagious than the original virus.

Pfizer/BioNTech and Moderna both have looked into how the antibodies bind to the different strains, including the UK and South African variants.

Why Target The Spike Protein?

Antibodies we make after vaccination bind with the spike protein to block ACE2 binding.

Pfizer/BioNTech has shown that the antibodies that study participants made in response to vaccination effectively bind to and neutralize the UK strain.

Moderna has shown its vaccine is equally good at neutralizing the UK strain.

The vaccines may not work as well against the South African strain but will still provide some protection.

Early data using convalescent plasma shows antibodies against other covid-19 strains don't effectively neutralize the South African strain.

That's bad news for monoclonal antibody treatments, convalescent plasma treatments, and natural infection.

While the Company expects these levels of neutralizing antibodies to be protective, pseudovirus neutralizing antibody titers were approximately 6-fold lower than prior variants.

These lower titers may suggest a potential risk of the earlier waning of immunity to the new B.1.351 strains.

Moderna is working on additional boosters to help bind the South African variant. For more information, check out their latest new release.

Good news, though- a second vaccine against this strain would be easy to make!

Both UK and South African variants have N501Y mutation, which confers a replicative advantage, so when you start shedding the virus, you shed more of it.

This is how scientists currently believe it's more contagious.

The South African variant also attaches to ACE2 receptors more strongly because of two other mutations, E484K and K417N.

Almost all vaccines require "boosters," which is why the Covid vaccine requires two doses to be effective.

• the first dose primes the immune system 
• the second dose elicits even more of a response for a more robust immunological memory

Myth: The Vaccines Were Rushed

The Pfizer/BioNTech and Moderna vaccines' development broke records as the fastest vaccine ever produced. (24:01) 

Sarah reiterates from last week's episode that this was made possible by recent mRNA vaccine technology breakthroughs.

Not because any corners were cut!

The speed is also attributed to having the funds necessary to do multiple things when normally these steps would have been done one at a time.

Because we give vaccines to healthy people, the standard of safety is much higher!

Safety & Efficacy: Phase 2/3 Clinical Trial Data

Sarah explains that phase 2 clinical trials test safety and phase 3 tests for efficacy. (30:05) 

It is possible to do phases simultaneously, which happened with the Pfizer/BioNTech and Moderna vaccines and why it's called Phase 2/3.

All the research has since gone through extensive review, both peer and independent, to provide recommendations to the FDA.

Sarah wants to emphasize just how many expert eyes have been on this project. And that this isn't something to be messed up.

It's also important to note that safety and efficacy are ongoing even after distribution.

Preventing Infection:

Pfizer/BioNTech:

• A total of 43,548 participants underwent randomization of whom 43,448 received injections: 21,720 with BNT162b2 and 21,728 with placebo. 
• There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive BNT162b2 and 162 cases among those assigned to placebo;
• BNT162b2 was 95.3% effective in preventing Covid-19 (95% credible interval, 90.3 to 97.6). 

Moderna:

• The trial enrolled 30,420 volunteers randomly assigned in a 1:1 ratio to receive either vaccine or placebo (15,210 participants in each group). 
• More than 96% of participants received both injections, and 2.2% had evidence (serologic, virologic, or both) of SARS-CoV-2 infection at baseline. 
• Symptomatic Covid-19 illness was confirmed in 185 participants in the placebo group (56.5 per 1000 person-years; 95% confidence interval [CI], 48.7 to 65.3) and in 11 participants in the mRNA-1273 group (3.3 per 1000 person-years; 95% CI, 1.7 to 6.0)
• The vaccine efficacy was 94.1% (95% CI, 89.3 to 96.8%; P<0.001). 

Preventing Severe Disease:

Pfizer/BioNTech

• Among 10 cases of severe Covid-19 with onset after the first dose, 9 occurred in placebo recipients and 1 in a BNT162b2 recipient.
• 90% effective at preventing severe covid-19

Moderna

• Severe Covid-19 occurred in 30 participants, with one fatality
• All 30 fatalities were in the placebo group
• 100% effective at preventing severe covid-19

Sarah explains that there is a lot of overlap in effectiveness between the Pfizer/BioNTech and Moderna vaccines, which means they're basically identical.

Both she and Stacy tell listeners that they are good with taking whichever is available to them first.

Immune Reaction:

Sarah reminds listeners that immunity after natural infection is actually pretty low. (34:45) 

We're still not sure how long immunity from Covid-19 lasts. We know that after 4 months, we still have a lot of protection after vaccination, and we are still monitoring this as time progresses.

At 4 months, results show antibodies are higher after vaccine than in cases of natural infection.

Immunological memory for coronaviruses is quite low: 1 year for the common cold up to 5 or 6 years for SARS.

This is partly because coronaviruses manipulate our immune systems to evade detection, most notably interfering with interferon production and antigen presentation.

We develop an immune response with vaccination without the immune system manipulation from the virus as natural infection.

We still may need regular boosters.

But early evidence shows that vaccine immunity will be longer lasting than natural immunity!

What If You've Already Had Covid?

Most patients develop antibodies after they have COVID-19, but not all patients do.

In other coronavirus infections (such as the common cold), we know that these antibodies last only three to four months before we are susceptible to infection again.

The vaccine produces a strong immune response and lasts at least four months. Check here for more information!

Volunteers who received the Moderna shot had more antibodies in their blood than those who had been sick with Covid-19.

The Centers for Disease Control and Prevention recommends that patients who recently had COVID-19 should wait 90 days before receiving the vaccine.

It's recommended to wait 90 days after recovering before getting the vaccine.

But because results show better and longer-lasting immunity, vaccination is still beneficial to those who have already had it.

Subgroup Analysis: Pre-Existing Conditions

Test groups with pre-existing conditions were not exceeded from phase 2 clinical testing. (40:45)

However, autoimmune diseases aren't concerned with the at-risk group for Covid-19, except if you're on heavy immunosuppressants.

Because people with autoimmune diseases aren't considered at-risk, there isn't a specific subgroup analyzing them.

Instead, a subgroup looked at age, sex, race, ethnicity, baseline body-mass index, and the presence of coexisting conditions.

Pfizer/BioNTech shows similar vaccine efficacy (generally 90 to 100%) across subgroups defined by age, sex, race, ethnicity, baseline body-mass index, and the presence of coexisting conditions.

Moderna efficacy was similar across key secondary analyses, including assessment 14 days after the first dose, analyses that included participants who had evidence of SARS-CoV-2 infection at baseline, and analyses in participants 65 years of age or older (range 86.4% to 100%)

Patients who are immunocompromised (HIV/AIDS, cancer therapy, immunosuppressant drugs - not autoimmune disease) were not included in the initial studies.

We do know that patients with underlying conditions are at higher risk of severe COVID-19 disease.

The CDC recommends that these individuals still receive the COVID-19 vaccine unless there is a contraindication (such as an allergy to prior vaccines).

In fact, Moderna included HIV, 0/80 in vaccination, 1/76 in placebo = 100%

Sarah reminds listeners that even though the vaccine does offer individual protection, that's not what vaccination is all about. It's about community protection!

What We Don't Know

Stacy adds that just because you have the vaccine doesn't mean you can go about your daily life now like you did pre-pandemic.

This is because many others in your community might not be vaccinated yet.

And while you're protected, you could still be shedding virus onto those who have not had the opportunity to.

Combining the vaccine with social distancing and wearing masks can put us in a position to make a difference.

We don't know how long immunity will last and if or when we'd need a booster for it.

Based on what we know of other coronaviruses, experts expect to need a booster every 1-5 years. But we just don't know yet.

We also don't know if it's possible to get an asymptomatic case of Covid-19 after being vaccinated. In fact, it may even be more likely.

That's not all bad, as symptomatic infections are the ones that lead to fatal medical complications.

However, it does increase the risk of spreading the virus to those who have not been vaccinated.

For example, if they are medically not allowed due to cancer or other illness.

Because asymptomatic cases won't help stop the spread until much later in vaccination, that's why we're being asked to continue pandemic protocol even after receiving the vaccine.

Safety 

Sarah explains that everything you'd possibly want to track was tracked for the Pfizer/BioNTech and Moderna vaccines' clinical trials.

For Pfizer/BioNTech, the safety profile of BNT162b2 was characterized by short-term, mild-to-moderate pain at the injection site, fatigue, and headache.

The incidence of serious adverse events was low and was similar in the vaccine and placebo groups.

In Moderna, serious adverse events were rare, and the incidence was similar in the two groups.

There were no specific safety concerns identified in subgroup analyses by age, race, ethnicity, medical comorbidities, or prior SARS-CoV-2 infection.

The most common reactions were injection site reactions (84.1 percent), fatigue (62.9 percent), headache (55.1 percent), muscle pain (38.3 percent), chills (31.9 percent), joint pain (23.6 percent), and fever (14.2 percent).

These are short-lived and similar to what we see with influenza or shingles vaccines.

Remember, these side effects mean that your immune system responds to the vaccine and creates antibodies against COVID-19!

So these symptoms are telling you your immune system is working.

When it comes to boosters and countries rolling out their vaccines, Sarah explains that it's a situation where there's not always a right answer.

Severe Reactions

Sarah explained in depth why severe reactions happen in part 1 (55:10). 

However, severe reactions for the Pfizer/BioNTech and Moderna vaccines are rare in clinical trials due to the smaller number of test subjects.

If there is an instance of severe reaction during clinical phases, the trials would be paused.

Sarah goes over what some of severe adverse reactions and some of the rare reactions that we know other vaccines can cause, such as PEG allergy, Encephalitis, Thrombocytopenia, Gillian-Barre syndrome.

There have been instances of allergic reactions with the Pfizer/BioNTech and Moderna vaccines.

So if you're someone who carries an EpiPen for various anaphylaxis allergies, your doctor may advise you to hold off on getting the vaccine.

This is because they're still trying to figure out what is causing the reaction.

If you know you're at risk, it's safer to hold off until they isolate what's causing it and whether or not you'll react to it.

Sarah goes on to say that the odds of a severe reaction are very, very low.

For example, in the US, there were 6 cases of anaphylaxis reported in the first 272,000 vaccinations.

She says this is why the protocol is that you sit there and wait once you get the vaccine. That way, if you react, you can get quick medical care.

Sarah also explains that that 1 in 50,000 hasn't held since that first wave of testing. Now we're talking more 1 in a 1/4 or 1/2 million, which is a very low frequency. 

Pfizer/BioNTech Moderna  

Final Thoughts

Stacy reminds listeners that education and information are how you make informed indecision.

So in talking about adverse reactions, it's not meant to scare you but give you all the information available to help you choose what's best for you.

She and Sarah were a bit looser this week with their viewpoint of getting the vaccine.

They acknowledge they're human and have their own bias.

But Stacy hopes in by bringing all this information to you, you can feel safe and comfortable with whatever decision you decide.

She and Sarah are not medical professionals and are not here to tell you what to do.

For Stacy, her decision to get the vaccine is based on her health and best for her personally.

Her mother, who has anaphylaxis, would have to make her own choice with her own doctors for what's best for her.

So Stacy feels it's incredibly important to clarify that you should do what's best for you and your health and not make a decision based on what she and Sarah are doing.

Sarah and Stacy want to center this entire conversation on the scientific evidence, data, and facts and not enter it from a position of fear, anxiety, judgment, or emotional bias that is often brought into these types of topics.

If you have follow-up questions or myths you'd like busted or confirm, submit questions via social media pages, websites, newsletters, or on Patreon.

In fact, joining Patreon is the best way to get ahold of Stacy and Sarah.

Be sure to pop over there for bonus content and to hear what Stacy and Sarah really feel!

Thank you so much for listening. We will see you next week!   

Episode 440: COVID-19 Vaccines Part 1 - mRNA Vaccine Technology

The Whole View, Episode 440: COVID-19 Vaccines Part 1 - mRNA Vaccine Technology

Welcome back to episode 440 of the Whole View. (0:27)   

Stacy explains that today's topic is one she and Sarah have received the most questions on possibly ever.

Stacy also lets the audience know that this show will be a 2-parter, possibly a 3-parter depending on how deep in they get.

This show has been long in the making because she and Sarah had to wait for the research publication. Then Sarah has done her own research on top of it to prepare for this show.

Sarah shares that she's been following this topic for about a year now: ever since the novel coronavirus was sequenced.

It's important they lay out the science for listeners, look at the technology and history of vaccines, answer the frequently asked questions, and bust the myths surrounding this topic. (2:08)

She and Stacy decided to divide the show into multiple parts to take their time and do the subject justice.

Stacy takes a minute to address how polarizing the word "vaccine" can be. And she and Sarah are aware of this.

She wants to assure listeners they understand vaccines are a personal decision for everyone, just like every other health and medical choices are.

Stacy and Sarah are here to provide the information you need to be an informed consumer.

 

Note On Vaccines

In this episode, they will discuss the mRNA vaccine technology in the history of vaccines. (2:40)

Next week's episode, Sarah and Stacy will go over the safety and efficacy data for the first two vaccines, Emergency Use Authorization, the Pfizer/BioNTech vaccine, and the Moderna vaccine.

Sarah and Stacy will discuss their thoughts on vaccinations going forward. But Stacy reminds listeners that it's never aimed at telling others what to do. 

She also reminds listeners that she and Sarah are not medical professionals.

If you have questions regarding the vaccine for yourself or your family, discuss them with your doctor.

There is a lot of information that is both true and not true floating around on the web. 

Stacy is very excited to talk about the science and breakdown behind these vaccines and gives a little background on herself for context.

Both Stacy and her mother have anaphylactic reactions to things like gluten due to multiple autoimmune disorders.

Stacy has brought up to Sarah whether or not she thinks getting the vaccine is a good idea for someone with health issues like Stacy's mom.

Stacy also wonders how having the coronavirus, but not having the antibodies, will affect her if given the vaccine.

 

Listener Questions

Sarah reiterates just how many questions they've received from listeners around this subject. (5:10)

She takes a moment to share a few she thinks accurately sum up what they want to cover in this episode.

Mae wrote:

I am sure you don't want to cover this topic, but you are a source I highly trust as I am sure a lot of your other followers do. Would you consider doing a show about the Covid vaccines out there? It's so hard to know what to believe these days.....Not looking to be told what to do, but merely to be presented the information as you do so well in breaking down the real science that is not filtered through such a biased lens.

Meghan added:

Can you please do an episode explaining the science behind vaccines, and explaining how they really work, including the new Covid one. You always do an excellent job of explaining things well in a relatively easy to understand way without shortcutting good science.

Stacy assures listeners that they will do their very best to break everything down.

However, you might still have questions or have heard something different that might conflict with prior information.

Stacy encourages you to reach out via the contact forms on the website for any follow-up.

If you're part of the Patreon family, use direct access to talk with Sarah and Stacy there.

She also encourages listeners not to attack the topic on social media or to put too much emphasis on things you hear without any sources cited.

 

A Brief History of Vaccine Technology

Sarah starts off by going way back into the history of vaccines. (8:27)

The very first form of inoculation was called variolation.

The first variolation for smallpox dates to the 1600s in China and Ottoman Empire and practiced first in Britain and colonial Massachusetts in 1721.

They took the pus from someone suffering a natural smallpox infection. And then they'd would then rub it onto punctured or cut skin of someone who had never been exposed.

If the procedure didn't kill you, you'd have immunity to the illness. However, Sarah noted it was pretty successful in terms of early inoculation.

Sarah explains briefly how cell memory aids in fighting episodes of re-exposures.

This is what gives us immunity or less a severe immune response when exposed.

Development Of A Smallpox Vaccine

Dr. Edward Jenner is considered the founder of vaccinology in the West.

He noticed many milkmaids were immune to smallpox. He realized they were getting infected with cowpox (a related variola virus that is relatively harmless to humans), and the infection built an immunity to smallpox.

In 1796, he inoculated his gardener's 8-year-old son by variolating cowpox pus from a milkmaid's hand.

Jenner then demonstrated this immunity to smallpox by exposing the boy to smallpox 6 weeks later, and he didn't get sick.

That's a lot of confidence! And also, not cool.

Jenner then repeated this experiment multiple times over a couple of years with different people and published his methodology in 1798.

He named his process vaccination because the cowpox virus is called vaccinia.

Doctors started administering this as a smallpox vaccine all over the world in 1798.

This is the first instance of understanding that exposing the body to a weaker version of a virus could stimulate enough of an immune response to tricker cellular memory.

Over the 18th and 19th centuries, systematic implementation of mass smallpox immunization culminated in its global eradication in 1979.

It took just about 200 years from the start of this vaccine to the eradication of smallpox.

Other Vaccine Development

Louis Pasteur's experiments spearheaded the development of live attenuated cholera vaccine in 1897. And then an inactivated anthrax vaccine in 1904. 

Plague vaccine was also invented in the late 19th Century. 

Between 1890 and 1950, bacterial vaccine development proliferated, including the Bacillis-Calmette-Guerin (BCG) vaccination, which is still in use today. 

In 1923, Alexander Glenny perfected a method to inactivate tetanus toxin with formaldehyde.

The same method was used to develop a vaccine against diphtheria in 1926.

Pertussis vaccine development took considerably longer, and a whole-cell vaccine was first licensed for use in the US in 1948.

mRNA vaccine technology

Sarah tells the audience that many of the childhood vaccines given to children today were developed 70 – 100 years ago.

There have been advancements in the vial today that are different from what was in the vial back then.

However, the vaccine technology is pretty much the same now, and it was that then.

Sarah underlines that mRNA vaccine technology was one of the biggest advancements since Jenner and Pasteur's experiments.

 

Modern Vaccines

When looking at vaccines today, they all have the same basic ingredients (18:20)

They all work by stimulating an immune response against what's called an antigen. An antigen is a bad thing that makes us sick.

The body develops immunological memory by the adaptive immune system in response to the antigen. 

It's the same way our immune system develops memory when we've been naturally infected. 

But because vaccines use weaker viruses, it goes without the danger of natural infection.

Vaccinations are very costly and big investments to undertake. So we really only develop vaccines against illnesses that are very, very bad and have a huge impact on society.

Up until now, mRNA vaccine technology hasn't changed much since the 50s.

Traditional vaccines contain three components: antigen, adjuvant, and additives to preserve/stabilize.

AntigenThis is the thing we're developing immunity against.

Antigens come in various types: live, attenuated virus; inactivated virus; inactivated toxins for bacterial diseases where toxins generated by the bacteria cause the illness; or parts of a virus-like split, subunit, or conjugate.

 

1. Adjuvants

Stacy asks about adjuvants and what they do to cause the stimulation. (20:00)

Sarah explains that adding a little bit of dead virus to our arm tissue isn't usually enough to trigger an immune response.

An adjuvant is a compound (most commonly aluminum) that stimulates the immune system. And helps to develop a more robust immune response and stronger immunity against the antigen. 

Adjuvants are why people often feel sick after a vaccine. It's not the virus causing the side effects, but rather the ramped-up immune system caused by the adjuvant.

It's also why many people with autoimmune diseases experience a temporary flare after vaccination. 

If you already have an immune system in overdrive due to an autoimmune system, it makes sense why autoimmune suffers would have more adverse reactions.

Sarah feels it's important to note there is no science showing vaccines cause autoimmune diseases. However, because they're meant to cause an immune response, vaccines can make autoimmune diseases more noticeable.

Sarah recommends this article as a source of more information about adjuvants.

1. Additives

Additives are preservatives, stabilizers, and residuals included in the vaccine.

Sarah explains this is where there can sometimes be egg protein as a residual. So there are certain vaccines out there that people with egg allergies can't have.

Sarah notes there is still one vaccine out there that uses Thimerosal as a preservative. But it has been mostly phased out since the 1980s.

This is because Thimerosal contains traces of mercury.

Stacy circles back to heavy metals and how often they talk about those as being bad. 

She feels it's important to note that going through normal daily life, we encounter things like heavy metals in food and water.

This is why we have livers: so we can flush them out of our systems naturally. It's why she and Sarah talk so much about taking care of our liver.

So when we hear things like, "there's aluminum in this vaccine," it might come off as a red flag. We don't want to put that in our bodies.

Stacy explains why these vaccines work to achieve the response it needs because you're right: your body does not want that aluminum in there.

So it gets agitated and works a little bit harder to flush it out. And that's how the vaccine is able to create the body's immune response.

Stacy shares one way she helps her body is to take extra care of her liver the weeks before getting a vaccine.

That way, she could optimize her body's ability to flush out the substances it doesn't want in there.

Sarah agrees that a great practice is to practice self-care, such as getting enough sleep and eating right before and after getting a vaccination.

 

Always a Cost-Benefit Analysis 

Sarah explains that Stacy brought up a great point: there is always a cost-benefit to mRNA vaccine technology and other types of vaccines. (28:45)

Sarah believes we are at a point now where most of us are disconnected from the actual impacts of viruses like polio and whooping cough.

She shares that her grandfather survived polio when he was 14-years-old. He was wheelchair-bound for 2 years and walked with a cane or walker for the rest of his life. He also developed post-polio syndrome in old age, which caused heart failure.

For Sarah, she is at the tail-end of people's age with a personal connection with some of these illnesses that we heard about.

Gen X and younger generally don't understand a lot of the consequences that come with a lot of these diseases.

Over a century ago, the infant mortality rate was over 20%. And the childhood mortality rate before age five was an additional disconcerting 20%.

That's what vaccination has been able to do for us and society: give us more than a near 50% chance of reaching our 5th birthday.

We only invest in vaccines for diseases with high mortality and/or morbidity.

Sarah explains that mortality equals death. 

Morbidity, on the other hand, anything bad that happens that's not death. It includes severe illness, complications, and lifelong health problems.

For example, morbidity from mumps is basically zero. But 1 in 300 get encephalitis (or brain inflammation) while 1 in 10 men get orchitis (testicle inflammation)

Measles mortality is 1 in 500, blindness is 1 in 500, encephalitis is 1 in 1000, and pneumonia is 1 in 20.

So vaccinations aren't just reserved for high-mortality diseases, but also ones that have a high rate of complications that can impact the quality of life long-term.

Safety Of Vaccine Technology

Safety standards are much higher for vaccines than most medications because we give vaccines to healthy people.  

Some of this was learned the hard way.

For example, in April 1955, more than 200,000 children in five Western and mid-Western USA states received a polio vaccine in which was basically a bad batch. 

The process of inactivating the live virus proved to be defective, so rather in inoculating the children from polio, it ended up giving them polio instead. 

Within days there were reports of paralysis, and within a month, the first mass vaccination program against polio had to be abandoned.

This became a huge issue in the medical community. And it ended up enacting a lot of change in terms of what was acceptable safety standards. 

Sarah explains that now vaccine technology is at the safest point it's ever been. But there is such a thing as vaccine-induced injury.

Vaccine-Induced Injury 

Stacy thinks the realities of the few cases of negative outcomes of vaccines need to be explored. (34:35)

Especially since they risk being taken out of context or misunderstood. 

She wonders what Sarah knows about the frequency of these negative outcomes. And what the science sense about the risk of injury. 

Sarah explains this is extremely well-tracked and well-studied.

The phenomenon of vaccine-related injury is incredibly rare. But she explains we do need to acknowledge it exists.

She attributes social media for taking these few and far between cases and inflaming them in public.

This, in turn, has destabilized a lot of the trust the public has in vaccines, which can be very harmful.

She explains that an adverse reaction is usually something like soreness near the injection site or a bruise, maybe a headache, or anything that doesn't feel normal.

A serious adverse reaction is something that requires medical care and could potentially result in death.

Because of this risk, Sarah believes it's very important to be aware of serious adverse reactions to ensure you're making decisions that are medically in your best interest.

Sarah takes a few moments to summarize some of the more serious adverse reactions from commonly administered vaccines and the odds of experiencing one.

Stacy feels it's super important to address the elephant in the room. And there is no science showing any sort of link between vaccines and autism. 

Adverse reactions can occur from vaccination, but a huge amount of scientific information has really conclusively shown autism is not one of them. 

For more on Vaccine-Induced Injury, Sarah recommends checking here for additional information.

Vaccine And Autoimmune Diseases

Stacy explains that in autoimmune diseases, we often see them "activate" due to an immune system flare up- for example, during pregnancy or nursing.

This isn't to say that pregnancy or nursing caused the autoimmune disease. But rather, it triggered it to activate, and that's why we start noticing the symptoms around that time.

She explains that this holds true with vaccines as well.

If someone starts to notice autoimmune systems after receiving a vaccine, that vaccine itself didn't "cause" the immune disease.

Rather, it agitated the immune system. And that agitation triggered the symptoms of an autoimmune disease that was already lying latent inside the body.

Sarah adds there's no evidence saying people with autoimmune diseases should avoid vaccines.

If anything, they may need more booster vaccines to reach adequate immunity due to the immune system already not functioning optimally.

The Importance of Herd Immunity

Sarah also reminds listeners that vaccines aren't actually about individual protection at all. (46:10)

They protect you individually, sure, but the reason vaccines are so amazing (and why smallpox was able to be eradicated) is because of the creation of herd immunity.

Herd immunity means enough of a community is immune to an illness (cannot get it and cannot pass it) that if there is an individual infection, the illness has nowhere to go. It's stuck.

Herd immunity limits the path for the virus to spread and can be much more easily contained.

Herd immunity also protects members in our community who might have some sort of medical issue that prevents them from being vaccinated themselves. 

Sarah cites children with cancer are unable to get vaccinated due to their health issues.

So being surrounded by people who cannot spread a life-threatening illness is very beneficial to their health and wellness.

Smallpox, which had an incredibly high mortality rate and permanent scarring, no longer exists anywhere in the world because of vaccines!

So while we might want the covid vaccine for individual protection, that's not the primary goal. The primary goal of vaccination is community protection.

 

How mRNA Vaccines Work

mRNA vaccines are the biggest advance in vaccine technology since Louis Pasteur and Edward Jenner. (50:35)

It can revolutionize not just immunizations but also cancer therapy and other drug development.

Brief History of mRNA Vaccine

mRNA stands for messenger RiboNucleic Acid.

Our cells make as an intermediary between the DNA in our cell's nucleus and a protein. 

It also functions as a set of instructions to make protein, which is the intermediate step between DNA and the protein it encodes

The steps are: DNA - transcription -> RNA - translation -> protein

Translation may occur at ribosomes free-floating in the cytoplasm. Or directed to the endoplasmic reticulum by the signal recognition particle.

mRNA was first discovered in 1961 by Sydney Brenner at Cambridge and James Watson at Harvard.

The concept of mRNA-based drugs occurred in 1989 when Malone demonstrated that mRNA could be successfully transfected and expressed in various eukaryotic cells under a cationic (positively charged) lipid package. 

In 1990, in vitro-transcribed mRNA was sufficiently expressed in mouse skeletal muscle cells through direct injection. This became the first successful proof of the feasibility of mRNA vaccines.

After the first mRNA-based drug company was established in 1997, many groups began to research and develop mRNA-based drugs. 

So far, over twenty mRNA-based candidate drugs have entered the clinical trial stage.

A big advance in 2005 when Katalin Karilo and Drew Weissman at the University of Pennsylvania showed how to modify mRNA to get into human cells without triggering an immune response.

Major advances in lipid nanoparticle technology for the mRNA envelope over the last 4-5 years.  

Last 4-5 years, improvements in mRNA vaccines increase protein translation, modulate innate, adaptive immunogenicity, and improve delivery.

This mRNA vaccine technology has been perfected in just the last few years.

This is why the Covid-19 vaccine was able to be developed so quickly. The technology we needed to create this vaccine was already primed and ready to go.

How Do mRNA Vaccines Work?

Sarah explains that the coolest part of mRNA vaccine is that they do not use adjuvants! (58:01)

This is because adding the RNA to the cell nucleus is enough to trigger it to replicate. It doesn't need anything additional to trigger the immune response. 

Two major types of RNA are currently studied as vaccines: 

• non-replicating mRNA 
  • which is what's in both the Pfizer/BioNTech covid-19 vaccine and the Moderna covid-19 vaccine
• virally derived, self-amplifying RNA. 

Conventional mRNA-based vaccines encode the antigen of interest and contain 5′ and 3′ untranslated regions (UTRs). 

Self-amplifying RNAs encode the antigen and the viral replication machinery that enables intracellular RNA amplification and abundant protein expression.

The lipid envelope facilitates entrance into the cell via endocytosis and exit from endosome into cytoplasm

This molecule provides the template in the cytoplasm of a cell for translation by the ribosome. 

And tRNA into the encoded protein, making multiple copies of the protein from each mRNA template.

The protein can then be presented to the immune system through MHC or, like both Pfizer/BioNTech and Moderna vaccine, the protein is transmembrane, so it presents itself! 

Sarah explains that there were some human trials using mRNA vaccines to treat cancer patients. 

So yes, as Stacy brings us, the technology is still pretty new.

But this isn't the first time we're using mRNA technology. It's the first opportunity we've had to utilize the discoveries large-scale.

Ingredients Of mRNA Vaccines

Sarah explains that what makes this new vaccine technology so cool is how few ingredients it requires to make. (1:05:20)

• mRNA (rather than a live attenuated virus, dead virus, or split virus)
• Lipid nanoparticle envelope (rather than viral particles floating around a solution or viral vector-like adenovirus)
  • LNPs often consist of four components: 
  • an ionizable cationic lipid, which promotes self-assembly into virus-sized (~100 nm) particles and allows endosomal release of mRNA to the cytoplasm; 
  • lipid-linked polyethylene glycol (PEG), which increases the half-life of formulations;
  • cholesterol, a stabilizing agent; 
  • and naturally occurring phospholipids, which support lipid bilayer structure. 

It requires no adjuvant, which is SO COOL!

Adding an adjuvant to the lipid envelope has been studied, but it doesn't seem to be necessary.

This is because foreign mRNA and viral proteins are really good at eliciting an immune response.

• mRNA has self-adjuvant properties which activate strong and long-lasting adaptive immune responses through tumor necrosis factor-α(TNF-α), interferon-α(IFN-α), and other cytokines secretion by immune cells
• The foreign viral proteins are presented via MHC-I

Lipid nanoparticles may have a little adjuvant activity in some circumstances. But basically, all of the immune stimulation is targeted against the foreign viral protein and mRNA!

For example, here are all the ingredients for the Moderna Vaccine:

1. The vaccine contains a synthetic messenger ribonucleic acid (mRNA) encoding the pre-fusion stabilized spike glycoprotein (S) of SARS-CoV-2 virus. 
2. lipids (SM-102, 1,2-dimyristoyl-rac-glycero-3-methoxypolyethylene glycol-2000 [PEG2000-DMG], cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC]), 
3. pH Buffering agents: tromethamine, tromethamine hydrochloride, (both drugs for metabolic acidosis) acetic acid, sodium acetate, (both naturally found in our blood)
4. Cryo-stabilizer: sucrose

Sarah jokes about how much she's nerding out about it. 

Advantages

Over the past decade, major technological innovation and research investment have enabled mRNA to become a promising therapeutic tool in vaccine development and protein replacement therapy. 

The use of mRNA has several beneficial features over subunit, killed, live attenuated virus, and DNA-based vaccines. 

1. Safety

As mRNA is a non-infectious, non-integrating platform, there is no potential risk of infection or insertional mutagenesis. 

Additionally, mRNA is degraded by normal cellular processes. And it's in vivo half-life can be regulated through the use of various modifications and delivery methods 9,10,11,12. 

The inherent immunogenicity of the mRNA can be down-modulated to further increase the safety profile9,12,13. 

2: Efficacy

Various modifications make mRNA more stable and highly translatable9,12,13. 

Efficient in vivo delivery can be achieved by formulating mRNA into carrier molecules, allowing rapid uptake and expression in the cytoplasm (reviewed in Refs 10,11). 

mRNA is the minimal genetic vector; therefore, anti-vector immunity is avoided, and mRNA vaccines can be administered repeatedly. 

mRNA vaccines expressing antigen of infectious pathogen induce both strong and potent T cell and humoral immune responses

Even better for viruses requiring cellular immunity like coronaviruses. (Click here for more!)

1. Production 

mRNA vaccines have the potential for rapid, inexpensive, and scalable manufacturing, mainly owing to the high yields of in vitro transcription reactions.

They are really fast to make. Moderna took 2 days to create the RNA sequence to produce the spike protein after sequencing the virus genome in January.

Then shipped its first vial of vaccine to NIH for trials 41 days after that.

This will also mean the vaccine can be modified for new strains (so far, not necessary), and we can get a vaccine even faster in the event of another pandemic!

Myths About the mRNA Vaccines

One of the biggest myths many people believe is that the vaccines were rushed. So we don't know if they're safe. (1:07:30)

The unprecedented investment (funding) allowed for tests normally done serially to be done in parallel. And it allowed for manufacture (normally 6 months to a year) to be done during clinical trials rather than after.

These vaccines build upon vaccine research from SARS and MERS and the knowledge base about coronaviruses from that research.

So we've been researching it longer than people have known about the novel coronavirus.

For example, it was already known that the spike protein bound with ACE2. And that's how SARS-CoV-2 infects cells.

It also builds upon a tremendous amount of mRNA vaccine research and clinical trials of mRNA vaccines for cancer.

mRNA vaccine technology allows for a fast process. It's also very inexpensive to make. Yay science!

Vaccines have some of the most stringent safety standards in all of pharmaceutical development!

They are given to healthy people, not sick, so tolerance for serious reactions is lower. Also, these vaccines were tested thoroughly and have exceeded the standards.

No corners were cut!

Yes, there are still some things we don't know (like whether or not you can get an asymptomatic case after you've been vaccinated and then spread the virus or how long immunity will last), but we do know that the safety profile is excellent.

It's approved for 16 and over because they did tests on adults before children. In fact, the 12-15 age groups are being tested now.

Final Thoughts

One of the biggest reasons these vaccines were able to be produced so fast is because of the timing. (1:10:42)

Scientists have been working on vaccine technology for centuries. And major advancements in the last 30 years have made it possible to produce both efficient and safe vaccines.

This is why basic science funding is so, so important. 

Sarah goes into why this basic funding is so important. Most funding is going to direct human relevance. 

The science that these vaccines are based on comes down to a basic discovery and expanding human knowledge. 

And only after the fact, we understood how it could be applied to improving human life. 

So increasing funding for basic science discovery is very important to Sarah.

Stacy also circles back to how mind-blowing that this basic science discovery could also further our advancement toward a cure for cancer. 

She reminds listeners that there are two vaccines approved for disruption in the US.

Next week, Sarah and Stacy with dive into the science and myths on those to bring you all the info you need to make your own decision.

If you're curious how Sarah and Stacy really feel about this topic, pop on over to Patreon for more science talk and bonus content.  

See you next week!

 

Episode 439: A Conversation around Current Events

The Whole View, Episode 439: A Conversation around Current Events

Welcome back to episode 439 of the Whole View. (0:27)   

Just last week, Stacy and Sarah discussed the New Year and how we can start it off right by forming positive habits.

And then the New Year came and hit us all in the face. 

Stacy takes a minute to reflect on how rough this week has been for everyone. 

She also reminds any new listeners that Sarah is actually a new American citizen. She takes a moment to check in with Sarah on how she feels about every going on in our country.

Checking In With Sarah 

Sarah has been struggling a lot with the Capitol events last week and the iterative unfolding around it. 

She's found it incredibly hard to concentrate on work or even get away from the news alerts.

Sarah shares that she became a citizen because it felt like making official something that already existed.

Sarah explains how difficult it is to put the feelings of alarm, disappointment, concern, and overall violation into words.

She also expresses how she feels as if she's waiting for something - whether it's the other shoe to drop or consequences - or if it what she's waiting for will even happen altogether.

Sarah has been struggling to understand the complex mix of emotions she's been experiencing since last Wednesday. 

She believes her experience is a very common one to many immigrants, in the sense that when she arrived in her new country, everything was different, and there was a lot of culture clash.

Many things are uniquely American that you learn about living here, immersed in the culture. No amount of TV or sharing with others can accurately show those things.

The more she learned about the country and its history, the more she came to appreciate the truly remarkable beginnings of the country. And the model of democracy it represents for the world.

Learning about a country is part of the immigrant process. And learning the history of the country is one thing that made Sarah fall in love with the US. 

Right now, everything going on feels so discordant with what American Democracy means.

Stacy's Realization

Sarah explains it like walking through your home after a burglar has broken in and you don't know what they've taken or touched and violated. (5:20)

That's how these events have made her feel about her adopted home- there's this permeating sense of violation. 

Stacy shares how much she agrees with that analogy. For Stacy, her realization started around May/June.

That was around the time she and Sarah decided to come forward out of the community and talk about things they felt were representative of the messages shared on TWV, in terms of wellness and safety for all. 

Stacy is working through these recent events on two levels: personally, as a mother, and also as someone lucky enough to have a voice in the community.

Stacy tells listeners that she's always been aware of her privilege.

Standing for safety and wellness for all has always been a mission and passion of hers:

• She quit her job to devote more time to get safer beauty products into the hands of everyone. 
• She also has a degree in the Social Justice field and a minor in Women's Studies. 

Advocacy is something that's been at the forefront of Stacy's mind. Yet, she could see the awful things happening and has, at times, been guilty of turning it off and looking away. 

Understanding Privilege

One of the realizations she came to is how privileged she is that she could even do that.

She could separate herself, turn it off, and look away because she is not directly affected or oppressed by the messages being sent.

It is not safe and not encouraging wellness for those vulnerable populations to witness some of the messages being said and not do anything to help or support.

Stacy adds that this is not designed to say, "you can't have free speech." But rather, that free speech isn't what's happening here.

From this realization, she's been making a conscious effort to lean in more, watch more and listen more.

And she's noticed the physical and emotional toll it's beginning to take on her as an empathic individual.

What We Can Do

She wonders some healthy coping mechanisms we can do since we're all going to approach things differently. (9:48)

She also wants everyone to think about what we can do to influence change. 

Stacy shares she is focusing on actionable change. This includes looking at her daily life, the brands she supports and asking herself if that's representative of where she wants to channel her money and support.

As individuals, we know where our values and beliefs are. And we can choose to support others who value the same things.

This is something that's given Stacy a sense of power in a situation where she often feels powerless.

Sarah shares that she's been struggling to find actions she can take in her life the way Stacy was able to. 

She tells listeners she and her family have been having many discussions to promote compassion for the anger behind falling into this misinformation ecosystem.

She's also tried very hard to help her kids understand this moment in the context of American history.

The Importance Of Education In Current Events

Her primary coping strategy has been to talk about what happened, their feelings toward it, and the information. (12:30)

As listeners know, this show is very data-driven. Stacy and Sarah try to stay away from black-and-white rules around wellness, focus on education, and look at the big picture of health.

In a way, she's been applying that same approach to current events to better understand. This way, she can make better-informed decisions. 

Arming ourselves with data-driven information is something Sarah falls back on in times of stress and anxiety. And it's definitely what she and her family are doing currently. 

Stacy stresses how difficult and important it is, as a parent, to have those conversations with our children.

 If our children don't hear it from us - the lessons and values we want to share - they will get it somewhere else.

There is value in being someone who can receive those feelings from your children.

Stacy has always prided herself on her kids' empowerment in coming to her with their frustrations or sad. 

Take Care Of Yourself

Stacy and Sarah have also been working hard to handle their anxiety, so they are emotionally available to family members who need to talk. (17:01)

They've been doing this a lot through CBD oil. For more about CBD oil, see Episode 420.

Stacy has also been working on getting more sleep. If she doesn't get enough sleep, everything in her life crumbles.

Stacy references this Episode 397 for more information on sleep.

Stacy encourages listeners to figure out how they can get better sleep because everything else in life gets easier to take care of if we get enough sleep.

Sarah shares the "Do Not Disturb" feature on her phone has helped her avoid distractions at night.

Stacy also invites listeners interested in mediation to check out the show she and Sarah did on mediation's scientific benefits. 

Final Thoughts On Current Events

Stacy wraps things up by reminding listeners that their feelings are valid and that they are not alone. (23:29)

She knows it's difficult to know the people if your life doesn't think the same as you and wish they would. Or that you have it better than others and feel guilt.

We are all entitled to the way we feel without guilt or shame. There is no benefit to that guilt.

Stacy reminds us that the best thing we can do is feel better, make a change, take action, or whatever it is that will pull you out of that guilt or shame.

She strongly encourages everyone to step away from the shame cycle and really focus on making changes for the better. 

Stacy and Sarah appreciate you being a part of their lives and this show. 

When it comes to protecting and supporting vulnerable communities, Stacy urges listeners to do whatever they can to take action and show that support.

We all must do our part to protect mental and physical wellness during these current events. 

Sarah adds that medication is not the same as admitting failure. 

She feels it's important to give ourselves permission to feel the way we're feeling.

Pulling ourselves out of the shame cycle isn't the same as refusing to let ourselves feel sad. 

For Sarah, the path has always been through, not around, so those negative emotions are crucial to her process. 

She stresses that having those negative emotions is okay, and the most important thing we take away from them is having compassion- compassion for ourselves and compassion for others. 

Stacy thanks listeners for being with us this week. And we will be back with the since next week! 

Episode 438: The Fascinating Science of Habits

The Whole View, Episode 438: The Fascinating Science of Habits

Welcome back to episode 438 of the Whole View. (0:27)

Stacy welcomes listeners to the very first show of the year!

She is still readjusting to life after the holidays and knows everyone can identify with that sluggish feeling of getting back to routine.

Sarah is a little different because she makes habit-centered resolutions every year.

She takes the New Year as a time to reevaluate what she's planning to do in a habit-focused, not goal-focused, frame.

This year, she thought a lot about body shaming and predatory marketing strategies of big business.

She always finds the "new year, new you" mindset nauseating every year. But this year, whether it's because of the "quarantine 15" or something else, it's particularly bad.

Especially given how emotionally vulnerable Sarah is feeling after 2020.

This led Sarah to look into what's new in habit-forming research and refresh her knowledge of the science of habits since she hadn't done so in several years.

There is so much cool science on habits, and Sarah jokes she fell down the rabbit hole.

When she emerged, she realized how actionable it is. And how it can help pull on a lot of threads on how we can set up to succeed, period.

 

What Are Habits?

Sarah suggests they start by looking at what scientifically is considered a habit. (4:00)

She thinks that it's a bit more common to think of habits in the sense of bad ones we want to break, like smoking or nail-biting.

Sarah explains that while we more easily identify "bad habits," habit-forming as a whole is a very important form of learning. 

A habit is a learned action that we perform automatically when we encounter that action's linked stimulus.

When the action is triggered, we perform it automatically and unconsciously. 

Real, fully-formed habits are insensitive to the "reward" phase we initially rely on to form the habit.

Sarah also explains that we perform habitual behaviors in the exact same way every time we encounter the stimulus. 

And once we reach the point where it does matter if there is a reward for performing the habit or not, the behaviors tend to stick with us long-term.

This is true even if the perceived benefit we derive from the behavior decreases over time or no longer distinguish a cause and effect of our behavior. 

Science of Habits In Daily Life

We perform about 40% of our day-to-day actions are habitual, meaning they are determined by stimulus-response associations and requires no conscious thought. (6:00)

We evolved the ability to form habits because it does something important in terms of freeing up thinking resources. 

When we're learning a habit, it starts as a routine to achieve an outcome (i.e., goal-directed), rewarded as reinforcement, and repeated in the same context.

Sarah explains at the beginning of this learning process, the brain must use multiple areas to perform the behavior.

• Basal ganglia is the region of the brain associated with emotion, memories, pattern recognition, procedural learning, and control of voluntary motor movements. 
• The prefrontal cortex is the region of the brain associated with executive function and cognitive control. This includes attentional control, cognitive inhibition, inhibitory control, working memory, cognitive flexibility, information processing, planning, reasoning, problem-solving, organization, and decision making.

As we repeat the behavior and master it, we use the prefrontal cortex less and less to perform the behavior. This is when the basal ganglia takes completely over. 

Once the action becomes a habit, we don't use the prefrontal cortex at all. This frees up valuable executive functions for other tasks!

Sarah used the example of learning to drive a car and "losing time" while driving long distances to show how prevalent the science of habits is in our lives. 

The Science of Habits Behind Social Language

The habit learning system increases efficiency, saving valuable mental energy, but comes at the expense of flexibility.

Stacy jokes that while you can listen to a podcast, such as The Whole View, she doesn't recommend attempting to read the show notes while habitually driving your car.

Sarah agrees that reading is not habitual enough to do while driving because words are heavily reliant on the frontal cortex. The exception to this, she explains, is social language. 

For example, we might be so conditioned to hearing "Hi, how are you?" from a stranger, if they say, "wonderful day, isn't it?" we might automatically answer with something like, "Great! How are you?"

Sarah explains social language is a form of habitual learning due to our use of "programmed responses." 

She references a scenario when someone passes you on the street and asks how you are. 

They don't really want to know all the horrible things that might have happened to you that morning. Because you're socially aware of it, you have a programmed response along the lines of, "good, how are you?"

Sarah also shares encounters with her grandmother, who has dementia.

She explains that much of their conversations revolve around these scripted, programmed responses.

This is because her grandmother spent a lifetime building those responses. So her deteriorating memory can more easily hold onto them.

 

Why Focus on Habits?

Sarah notes that we tend to fall back on habits, whether good or bad, when we're distracted, stressed, anxious, or tired. And we tend to perform automatic behaviors more often. (12:45)

Sarah explains that this is why it's so important to focus on what kinds of habits we're forming. 

We want the behavior we perform when unconsciously to help us toward our goals, rather than undermine us. 

This is both why bad habits can undermine our ability to progress towards a goal. And why good habits can keep us on track (without the need for willpower or self-control) even when life gets overwhelming.

Studies have shown that people who score highly in self-control measures don't achieve their goals because of that self-control exertion. 

Rather, these people are highly effective at forming good habits that contribute to successful outcomes even when on "auto-pilot."

Sarah explains we can actually use this system to make changes that can stick through stressful times and tiring days.

We won't need to muscle our way through healthy changes if we can focus on the habit that drives the behavior. 

 

How to Form a Good Habit

Stacy jokes that she thinks of herself as someone in control to a disturbing level. (14:54)

While she was listening to Sarah, she began to think of all the things that creep up on her that she doesn't always have great willpower about. A lot of those things are also things she doesn't tend to have focused habits for.

She poses the question to Sarah whether she could have difficulty forming habits in those areas because the behaviors hit her brain differently?

Setting Up The Learning Phase

To answer Stacy's question, Sarah dives into the protocol from this scientific paper about the formation science of habits. (16:02)

The paper aims to guide physicians in helping to improve their patient's health by focusing on habit formation.

1. Decide on a goal that you would like to achieve for your health.
2. Choose a simple action that will get you towards your goal, which you can do on a routine basis.
3. Plan when and where you will do your chosen action. Be consistent: choose a time and place that you encounter at least daily.
4. Every time you encounter that time and place, do the action.
5. It will get easier with time, and eventually, you should find you are doing it automatically without even having to think about it.

The Role Of Time In The Science Of Habits 

Sarah informs the audience the commonly accepted "21 days to make or break a habit" is, unfortunately, a myth. 

Research actually shows the average length of time to form a new habit is 66 days. However, it can vary from 18 to 254 days. That's about 8 months!

Sarah explains that when we think about this in terms of developing good habits, we realize we need to get from the 21- or 30-day "challenges" we see everywhere.

It's just not long enough.

Stacy says that for her, a 30-day challenge has felt like a habit by the end and wonders if Sarah can shed any light or hope on that.

Sarah explains that there are a few things at play here:

• First, habit-learning is inherently easier for some people. Generally, a really strong memory can speed up the time it takes to form a habit.
• The difficulty or complicatedness of the task also plays a role in how quickly we're able to habitualize it.
• How often we repeat the task throughout the day. If we're only doing the behavior once a day, it will take longer.

What We Do To Help

There are some things that we can do to support habit formation. And potentially speed up the time investment as well!(21:33)

First, Sarah explains that starting off with a positive attitude can significantly help how quickly we learn the behavior.

Stacy says it makes so much sense that someone being open and excited about change has an easier time making that change.

A study evaluating habit formation's psychological determinant revealed that starting with a positive attitude about the new behavior predicted a higher level of automaticity after four weeks and habit maintenance at 8 months. 

• Participants were motivated to develop a flossing habit with persuasive information about the benefits of flossing and instructed to floss daily. 
• A questionnaire measured attitude by asking strongly agree to disagree with statements related to the information strongly. 
• The more the person understood the benefits of flossing, the more likely they were to form a strong flossing habit! 

Sarah shares that she saw a lot of herself in this study.

She is a person who always sees empowerment in knowledge. And she naturally seeks out the science behind any particular choice she is making.

It's understanding the whys behind those benefits that drive the choices she makes into becoming habits. 

She tells listeners that finding out and understanding the whys behind their choices can help them reach their goals.

The Role Of Reward In The Science Of Habits

Sarah reminds listeners that once a habit is fully formed, a reward no longer matters. (23:50)

However, thinking about how we can up the reward in the beginning stages can help speed up how long it takes us to fully form the behavior.

• A simple neurological loop, called the habit loop, is at the core of every habit. 
• The habit loop consists of a stimulus or cue, an action performed in response to the stimulus, and a reward. 
• This reward reinforces the loop while the habit is being formed.

Studies show increasing the perceived reward strengthens habits beyond the impact of repetition. 

This means it takes fewer repetitions for a rewarded behavior to become a habit than an unrewarded behavior.

Types of Rewards

Pleasure is a positive and immediate sensory outcome that we perceive as a reward. 

Sarah explains we get pleasure from delicious foods and intoxicating substances. It's what makes them so easily habit-forming. 

Pleasure is a left-over survival instinct that drives up that reward.

This triggers the brain to seek out and consume high-fat foods as often as we can to bulk up the fat stores needed to survive scarce food times.

What Sarah finds most interesting is how habit formation changes this reward. Once we have a junk food habit, we don't experience the enjoyment of it in quite the same way. 

Intrinsic motivation is wanting to act because of the anticipated inherent enjoyment of doing so. 

Sarah explains that this reward is where positivity plays the biggest role. 

Sarah explains that intrinsic motivation has shown to be a more powerful reward than extrinsic motivation or action to please others. 

For example, people who quit smoking for themselves have far greater chances for success than smokers who quit for their families.

Positive outcome expectancy involves understanding a good effect will result from the action. The other side is a negative outcome expectancy, which hinders habit formation. 

Studies have shown that associating a negative experience with a task devalues the reward. 

And Sarah explains that understanding how negative expectancy can derail our progress can help us avoid pitfalls. 

You can apply these studies' insights by thinking of ways to up the reward ante when you perform your repetitive task.  

Sarah reminds listeners that it's okay if the reward is delayed. Some studies show it might even be better to be delayed. What matters is that the reward is clearly associated with the behavior.

Sarah and Stacy talk a moment about instances of dog training. And how much more effective positive reinforcement is.

 

How Science Of Habits Can Help Break Bad Behaviors

Sarah explains that the best way to break a bad habit is to replace it with a good one. (32:41)

This is because breaking a bad habit means that ceasing doing something we learned to do automatically. And it's harder to break a bad habit than it is to form a new one.

Sarah also tells listeners one thing not to do: exert willpower!

Studies show that using willpower or self-control not to do something causes a rebound effect. 

One study found that people who suppressed their thoughts about eating chocolate ended up consuming significantly more chocolate than those who didn't. 

Sarah explains that finding something you like to eat instead of chocolate decreases our urge to obsess over something we want and can't have.

A similar study found that smokers who tried not to think about smoking ended up thinking about it and craving it even more.

How Can We Break A Bad Habit?

Sarah suggests creating some interference with the behavior. This forces the prefrontal cortex to kick in, stop the automatic behavior, and think about what it's doing. (37:19)

Sarah cites this study showed forcing people to eat popcorn with their non-dominant hand at the movies helped break the habit of snacking at the theatre. 

This same study found that habitual popcorn eaters even ate stale popcorn without thinking about it and supports the idea that reducing reward doesn't break a bad habit.

Other studies have shown that if you delay the behavior long enough for conscious thought to kick in, the brain can switch to goal-directed behavior.

Sarah tells listeners that this can be as easy as moving the snacks to a different cupboard. 

She also adds these strategies aren't an automatic, over-night solution. But disrupting the behavior gives you time to modify it. 

Removing The Stimulus

The best way to break a bad habit is to remove the stimulus. (40:45)

Studies have shown that removing the cue or trigger for a habitual behavior is one of the most effective ways to break a bad habit. 

This is why so many people find it easier to quit smoking while on vacation. Or why wellness retreats can be such a great jump-start for a health journey. 

Similar studies have shown that changing the environment is important for treating substance abuse. 

Sarah suggests applying the insights from this research by thinking through the habit you want to break and identifying the stimuli. 

If it's not possible to remove the stimulus entirely, think about how you can change or disrupt the stimulus enough that your prefrontal cortex has to kick in.

If you can manage to do it, you can switch to goal-directed behavior instead.

Sarah also warns of unintentional removal of a good habit stimulus. A break from school or work for the holidays has shown it can disrupt the habit of going to the gym. 

She adds that this is why it's so easy to derail from our healthy lifestyle over the holidays. And explains why it's so much work to get back on track in January!

One last strategy Sarah finds worth mentioning is mindfulness:

One study shows mindfulness reduced craving-related eating by over 40%. Another showed increased the success of quitting smoking by 5x over the American Lung Association's Freedom From Smoking treatment! 

New Year, Same Amazing You!

Stacy takes a moment to highlight she and Sarah have been using the word "bad" to reference some parts of the science of habits. (45:00)

She reiterates it doesn't mean you are a bad person for having formed a habit you now want to modify.

They are using the word "bad" more as an umbrella term for something that does not positively affect your health. 

She and Sarah are not here to judge anyone or make anyone feel bad.

Their goal is only to help you make the best choices you possibly can for you and your body,

Stacy doesn't try to change her habits because it's a new year.

There is no "new year, new Stacy" because it's too much too fast and just not sustainable.

Stacy encourages you to be realistic about the changes you're making, why you're making them, and to be sure you're making them for the right reasons.

Keeping these things in mind, we set ourselves up for success.

We can also avoid failure or other negative experiences that can sabotage our progress. Or make it more difficult the next time we try.

Sarah reminds listeners that the key to success is to maintain the routine long enough to reach a habit.

This means setting up a routine that's sustainable!

 

Final Thoughts

Stacy shares that she got a lot of great things out of this show. And there are several things she plans to work on going forward. (53:09)

She loves the idea of approaching things from a place of positivity and rewarding herself accordingly- like buying a new plant!

Stacy takes a minute to update listeners on her houseplants.

Sarah shares she is keeping her resolutions simple this year.

Her main resolution is to make a big batch of soup every week, so there's always have homemade soup around. Not even to drink more of it, just to have it.

She also wants to identify and (hopefully) remove her snacking habit stimuli. 

She wants to make sure any snack she has is an intentional choice and not automatic.

Finally, Sarah wants to keep up my good bedtime and morning routines in the hope that they will soon become habits.

Stacy reminds listeners that having an "accountability buddy" to talk with is very important when setting yourself up for success.

Sarah shares that she hopes learning the science of habits helps listeners break behaviors and establishing better ones.

She adds that there is no rule saying we can only make resolutions on January 1st. And thinking about habits on a continuous level can help us be the best we can.

Stacy reminds everyone to check out Patreon for bonus content from this episode.

Thank you so much for listening, and we'll see you next week!

Episode 437: Intro to Nutrivore

Welcome back to episode 437 of the Whole View. (0:27)

Stacy welcomes new listeners and takes a quick moment to introduce herself.

Stacy had a 20-year career in Federal Regulation and Law. She jokes about how she tries not to talk about it because it's such a boring topic.

Discovering how what she put in and her body affected her health was a life-changing experience for her.

Now she works as her own boss. Stacy leads a large team (mostly women) focused on getting safer, non-toxic products into consumers' hands. She also does weekly podcasts with her co-host, Dr. Sarah Ballantyne.

Sarah also introduces herself to any new listeners. She has a medical research background and a Ph.D. in Medical Biophysics.

Sarah also had a similar translational type experience as Stacy. While navigating her academic research career and struggling with over a dozen different health conditions, Sarah discovered just how much the food we eat impacts the way our bodies work.

Looking at her lifestyle choices and their impact on her life opened a new pathway for her.

Now Sarah is an author, blogger, health educator, and thinks of herself as a "science translator."

Her goal is to dig deep into the literature and act as a bridge to the academic research community she used to bring that information to everyday people who can benefit from it.

The Mission Of Nutrivore

Stacy tells listeners that one of the best things they've done to help bridge that gap looks at the specific nutrients within different forms of food and how they affect our bodies.

She adds that they've gotten so deep in the weeds, they want to look more big picture as to what being a "nutrivore" means from a whole health perspective.

Stacy also hopes that doing this will provide more context for the science of past and future shows.

Sarah tells the audience that she and Stacy have been throwing the word "nutrivore" around a lot lately.

She thinks that it would be helpful to ground ourselves in understanding what the ultimate goal is. That means getting away from diet jargon.

Sarah also shares that this is a fantastic episode to share with friends and family overwhelmed with diets.

There are so many "fad diets" approaches out there that can be next to impossible to separate out what is an influencer making commissions off of selling a supplement line versus something rooted in science that may be misinterpreted.

Sarah and Stacy try to stay as close to science as they possibly can. They use science to guide recommended health principles.

The vast majority of scientific studies tell us that focusing on a nutrient-rich fuel source, as well as other lifestyle factors, are the things that support health.

Diets vs. Health and Wellness

Stacy shares a huge mental shift of focusing on the outcome being health helped her navigate. (6:18)

"Diet" is a word used to sell you a weight loss product that actually depletes your body of nutrients. Or it could be referring to how you eat.

And so, instead of using a term used that way, it's easier for Stacy to think of nutrient-density as a way to achieve the ultimate goal: health.

Stacy tells listeners that the justification for all the things we do are all around this idea of health and wellness.

As so, as confusing as that is, one of the things that people get askew is the idea of nutrients.

She attributes this to macro and micronutrients. And they are entirely different.

Stacy suggests they start with the very basics and go over what they mean by "nutrient."

She also reminds listeners that the goal of every one of these shows is never to cause shame or guilt, whether for past choices or future ones.

Stacy adds one is perfect, and no one ever will be perfect. But we can make choices if we know what health looks like, and the more choices we make toward that goal, the better off we'll be.

What Are Nutrients?

Sarah dives into what the different nutrients are. (8:53)

She explains that Macronutrients are protein, carbohydrates, and fats, and they amount to energy. So what they do is supply our body with the energy required for chemical reactions to occur. 

Micronutrients are amino acids, fatty acids, vitamins, and vitamin-like compounds, minerals, and phytonutrients. 

These are the building blocks for cellular structures and resources needed for all those chemical reactions to happen.

Sarah explains that they're called "macro" and "micro" due to the amount of each that we need to consume.

So we need larger amounts of energy to drive all these chemical reactions. And then we need smaller amounts of building blocks and resources.

Sarah explains that our body breaks it down into individual amino acids when we digest a protein before it's absorbed. The protein itself is a macronutrient, while the amino acid is a micronutrient. However, the body needs both equally.

Without either nutrient, our cells stop being able to do the things they need to do their jobs.

Sarah believes it would be helpful to talk about a few examples of a biological system. And how it uses nutrients to sustain itself or drive its function in some way.

When you understand that we use these nutrients are up in chemical reactions, it becomes a lot easier to see why we need to replenish them by consuming those nutrients constantly.

Essential and Nonessential

Stacy shares how it's been helpful for her to think about things in terms of essential and nonessential things.

Sarah agrees, saying that the classification of essential and nonessential nutrients is very interesting.

Anything labeled essential has two things in common:

1. We know that our bodies can't make it at all or anywhere near enough of what we need, so we need to get it from outside sources
2. There is an identified disease that occurs from deficiency of that nutrient

Vitamin C and Iron are both classified as essential because Scurvy or Anemia comes from insufficient quantities.

With nonessential nutrients, we can make them ourselves in a dire situation, or there's never been a deficiency-disease identified from not getting enough.

Fiber would be an example of a nonessential nutrient.

Sarah explains that this is a misnomer because we do actually need both to function properly.

She adds that with nonessential, it means that you won't die without them. And that it's very different from saying you'll be healthy without them.

What It All Means

Stacy shares how mind-blowing it is to think about how her body and make something automatically when it needs to.

Sarah talks a little bit about Vitamin A and how some people are genetically unable to make their own. And how this relates to how we need to think about consuming active forms of vitamins that we can get from food.

Stacy agrees, sharing how we much rather get the nutrients her body needs from food, and not supplements, whenever she can.

Sarah also takes a minute to emphasize there is a lot of science showing that nutrients in a multivitamin are very poorly absorbed.

They tend to go straight through you, and part of that has to do without the nutrients are put into the tablet or capsules.

Sarah explains the steps folic acid goes through as an example and what can impact our ability to absorb it into our bodies.

She also reiterates that it's best to get as much as we can from our food because it's so much easier for us to get the nutrients we can use from there.

How Are Nutrients Used in Our Body?

Sarah wants to use this next example mostly just to show how complex these processes are. (23:22)

There are about twelve biological systems, and they are things like the muscular and skeletal systems.

Central Nervous System

She will be talking about the central nervous system in this example.

She also explains that the central nervous system controls much more than just your brain, but also your heart, lungs, etc.

Biologically speaking, without your brain controlling your central nervous system, your body can't do anything. It turns out brains are really necessary for health!

For example, B-vitamins are used by the mitochondria in our cells in the chemical reactions (together called the Kreb's cycle or citric acid cycle) to make the cellular energy molecule (called ATP) from sugars and fat we eat, as well as glycogen at fat we store.

The nervous system (brain, spinal cord and nerves) needs:

• Vitamin B1: neurotransmitter production
• Vitamin B6:  neurotransmitter production
• Choline:  neurotransmitter production
• Vitamin B12: myelin sheath
• Copper:  myelin sheath
• B vitamins in general: ATP production / mitochondrial function
• Vitamin D: gene expression, biorhythms
• Calcium: nerve impulses
• Potassium: nerve impulses
• Sulfur: cell regeneration, oxygen use
• Omega-3 Fats: nerve signaling and cellular health, maintains blood-brain barrier
• Tryptophan:  serotonin, melatonin
• Phenylalanine: dopamine
• Glutamate, glutamic acid: GABA
• Polyphenols: promote neuronal signaling, increase production of antioxidant and anti-inflammatory agents

Our brains are very unique because it has this special barrier. Not everything in the blood can get into the brain, which's different from other tissues.

This barrier protects the brain from pathogens and toxins that might be in the blood, and without sufficient Omega-3 fats, we can't maintain that barrier's integrity.

Sarah adds that this is a very generalized list of nutrients the central nervous system needs to function.

Check out this study for more information on how dietary factors influence the central nervous system!

The Immune System

She adds that she often talks about the immune system as a "nutrient hog" because it's the most greedy system in terms of nutrients it requires to function optimally.

When it's not working properly, it tends to turn on inflammation and not be able to turn it off.

This is often called "systemic inflammation" and contributes to every chronic illness, such as autoimmune disease, cardiovascular disease, asthma, diabetes, kidney disease, etc.
Sarah sums up that an immune system that cannot regulate itself is a very bad thing.

The immune system needs:

• Vitamin A:  immune regulator, differentiation
• Vitamin D: immune regulator, Treg cells
• Vitamin E: antioxidant
• Vitamin K2: antioxidant
• Vitamin B12: cell production, methylation
• Vitamin C: antioxidant
• Zinc: T-cell development and activation, cytokines
• Selenium: antioxidant, cell function and activation
• Iodine: phagocyte health
• Iron: antioxidant enzymes
• Magnesium: thymus gland
• Copper: cytokine production, cell proliferation
• Flavonoids: antioxidants
• Omega 3 fats: phagocytes

It turns out that nutrient insufficiencies (which is different from deficiencies because we're getting some, just not enough) pretty dramatically impact how the immune system is functioning.

Sarah says that specifically Vitamins A and D are really important for immune regulation, which reigns in the system, so you don't get that system-wide inflammation.

Our immune system also identifies cells that may be up to some cancer-like shenanigans and kill them off before becoming cancerous.

So part of the process of cancer development is the immune system failing to identify those cells.

 

Deficiency vs. Insufficiency

Sarah explains that just between these two systems, nearly every essential and nonessential nutrient is represented.   (33:55)

Stacy takes a moment say how interesting she finds insufficiencies versus deficiencies.

She adds that due to the high levels of deficiencies there are, the levels of insufficiencies much be way higher.

Sarah defines insufficiencies as not consuming the recommended daily allowance of a specific nutrient.

The "recommended" numbers are set based on a body of scientific literature for which 97.5% of the population will not show a deficiency.

Sarah also explains that that recommended number should be seen as a minimus and not a goal. And there's still a percentage of the population that that won't be enough for.

She defines a deficiency as, if doctors measured it in your blood, you wouldn't have the amount considered in the normal range, or you have some sort of symptom associated with not having enough of that nutrient.

Sarah explains that deficiency in a single nutrient can impact the function of multiple biological systems.

If a biological system is missing a nutrient required for optimal function, the body can not be optimally healthy.

In fact, nutrient deficiencies are linked to every chronic illness!

How Prevalent are Nutrient Deficiencies?

Stacy asks about how prevalent nutrient deficiencies are. (39:10)

Sarah explains that one of the main ways deficiencies are studied is through food journals. Scientists have people send in their meals, and they study them that way.

The following chart includes food and supplements like multivitamins:

Sarah repeats how each of the nutrients is important to every system of the body. They all use them.

And when you're deficient in something, a system that needs it to function isn't functioning to its highest capacity.

Sarah adds that when you take supplements out of the equation, these numbers get even worse:

For example, the immune system not operating at full capacity can't heal a cut, fight off an illness, or even turn itself off as best as it should.

Sarah also includes examples from the liver and brain not functioning optimally.

She also explains that our genetics play a big role in how susceptible we are to nutritional deficiencies.

And it's not always predictable how long our bodies can go "running on fumes."

Top 10 Nutrients We’re Deficient In

Stacy asks about which nutrients are the most common for deficiencies and where we might find a solution. (43:54)

Sarah says that an estimated 90% of Americans are deficient in at least 1 essential nutrient!

She also explains there are ten nutrients out there that over half of us are said to be deficient in.

Vitamin A

Sarah tells the audience that roughly 56% of us are diffident in Vitamin A and recaps how Vitamin A is very often found in animal food sources.

Vitamin A is important for our bones, eyes, immune health, maintenance and normal regeneration of all our barriers (like the gut and blood-brain barriers), and more.

Sarah drops that the top food source for gaining Vitamin A is the liver and pauses for dramatic effect.

Stacy adds that organ meat is a high-optimized source for almost all of the deficiencies on this list.

But before Sarah gets too deep into that, Stacy reminds listeners not to worry- you can take a pull for that.

Stacy also wants listeners to understand that she and Sarah go so deep into where you can find all of these things in foods because taking a multivitamin isn't always as readily absorbed or as high in quality as something you can get from a food source.

Stacy shares that she's not actively putting organ meat on her family's table, and so for her, the best way to get it is in supplement form.

She adds that it is not an extraction; it is a whole food that is dehydrated and powdered.
Sarah lists red meat, organ meat, pork, poultry, fish, and shellfish are all good sources of Vitamin A.

Vegetable sources must be converted into an active form, which is very inefficient (as low as 3%).

How It Effects Us

Stacy adds it takes a few years for these deficiencies to catch up with us, and we won't notice how being deficient is affecting us right away.

She recognizes that not everyone eats meat, and that's okay. Fish and eggs also get you very far if you're able to prioritize them.

Stacy shares that in her youth, being a vegetarian did affect her health negatively long-term because she wasn't eating the correct kinds of foods to supplement what she wasn't getting from animal sources.

Vitamin B6

Sarah explains that approximately 54% of us are deficient in Vitamin B6. (51:02)

Vitamin B6 is essential for cellular energy, metabolism of amino acids and lipids, required for gluconeogenesis, synthesis of neurotransmitters, and hemoglobin, supporting the methylation cycle.

Sarah takes a minute to explain to listeners how the methylation cycle works for turning proteins on and off.

Peppers, onion family, pistachios, liver, fish, meat (poultry and red meat), sunflower seeds, garlic, and dark leafy greens are all great sources of Vitamin B6.

Stacy asks about other forms of B Vitamins and if they're found in similar food sources.

Sarah answers that it's a good general rule.

Vitamin B9

Sarah tells the audience that 75% of us are deficient in this B Vitamin.

She explains that it's essential to metabolize nucleic acids and amino acids, cell division, and production of red blood cells, supporting the methylation cycle.

Food sources for B9 are organ meat, green veggies, leafy greens, legumes, beets, asparagus, avocados, papayas, strawberries, and seaweed.

Vitamin D

75% of us are deficient in Vitamin D.

Stacy tells viewers that the best source of vitamin D is from the sun!

Sarah adds that where this vitamin comes from is due to our cholesterol's response to that UV radiation.

Stacy and Sarah went further into detail in Episode 354!

This nutrient controls the expression of over 200 genes.

Vitamin D is critical for the function of mineral metabolism, bone mineralization and growth, biosynthesis of neurotrophic factors, hormone regulation, cell survival and division, circadian rhythms, barrier tissue health, and immune system health.

Sarah tells the audience that it's very important to get their vitamin D levels tested. And if they're low, look at supplementation.

The dose sufficient to bring you up to the level you need to be at varies wildly from person to person. And that is controlled by how your body regulates vitamin D and your environmental factors.

Too Much Is A Thing?

Sarah also explains that it's very hard to get enough from food on its own if you're already deficient.

She also adds that there's a happy medium range and such a thing as too much Vitamin D.

She does say it's usually cured by supplements and very hard to do with just food alone.

Top food sources include fish, grass-fed dairy, oysters, pastured eggs, grass-fed meat, pasture-raised meat, shrimp, other shellfish, mushroom (D2), and tofu (D2).

Stacy loves the idea of animals living a happy life outside in the sun and that the best animal products for our health come full circle.

Sarah says this goes as far as plants grown in depleted soil as well. So how our food is raised is very important to our health as well.

She also reminds listeners that eating snout to tail means nothing is going to waste.

Vitamin E

Sarah explains that around 60% of people are deficient in Vitamin E.

She adds that it functions as an antioxidant throughout the body, which is quite important for immune function.

It's also very important for anti-aging of cells.

Top food sources for Vitamin E are nuts, seeds, leafy greens, avocado, olives, organ meat, shellfish, unrefined plant oil, fatty fish, and winter squash.

Sarah also explains that high-fat plant products are the best producers of this vitamin.

Calcium

Approximately 65% of us are deficient in calcium.

Both calcium and magnesium are electrolytes.

Sarah explains that calcium is a large component of bones and teeth, is a cofactor for many enzymes, cell signaling (metabolism, cell division, gene expression), blood clotting, neurotransmitter release and nerve conductance, and muscle contraction.

Sarah explains what being a cofactor is and how it works.

Top food sources for calcium are grass-fed dairy, tofu, sesame seeds, chives, chia seeds, radishes, seaweed, beef, dark leafy greens, and sardines.

Stacy points out that there's more than just dairy on the list.

Sarah agrees and points out how the body more easily absorbs the calcium in dark leafy greens than the calcium in dairy.

In fact, studies on dairy are pretty mixed in terms of osteoporosis.

Stacy adds that stress is big for depleting calcium.

Magnesium 

Around 68% of people are magnesium deficient.

Sarah and Stacy covered magnesium in detail in Episode 409!

Sarah explains that three hundred different enzymes use magnesium. It's also key for ATP synthesis, DNA and RNA synthesis, a constituent of bones and teeth, neuromuscular contractions, production of testosterone and progesterone, metabolism of phosphorus, calcium, potassium, sodium, B vitamins, and vitamins C and E, cofactor in methylation, and the immune system.

Top food sources for magnesium are seaweed, dark leafy greens, chives, pumpkin seeds, fish, soy, Brazil nuts, sunflower seeds, other nuts and seeds, and avocados.

Sarah tells listeners that the "superstar" foods for this nutrient are leafy greens.

She also explains that it's one of the harder nutrients to get adequate amounts of from food sources alone.

Sarah explains why she loves food journals from the point of view of piecing together the puzzle of what we're getting, what we need, and where we need to get it from.

Which is exactly the idea behind nutrivore!

Zinc

Around 73% of people are zinc deficient.

Sarah tells the audience that zinc is everywhere and kind of a do-it-all nutrient.

Sarah explains the diverse functions of zinc include the activity of approximately three hundred different enzymes, DNA and RNA transcription, regulates apoptosis, absorption and activity of B vitamins, muscle contraction, connective tissue formation, insulin production, and testosterone, a component of vitamin D receptor, and immune system.

Stacy says that without looking, she can name the number one source of zinc: oysters! If they are in season and on the menu, she orders them.

Sarah claims that you will have met your zinc quota for the week if you eat oysters once a week.

Sarah adds liver, crab, wild game (red meat), loser, farmed red meat, clams, organ meat, mushrooms, and seaweed are all great food sources for zinc.

She reiterates that so many of us are deficient and so much of our body relies on zinc, that there's never been a better reason to try organ meat and shellfish.

DHA & EPA

Around 70% of people are DHA & EPA deficient. These are also known as Omega fats.

Sarah tells listeners DHA & EPA are used by the body for anti-inflammatory, immune health, vascular health, neural/brain health, vision health, fetal development, supports healthy microbiome, and cellular health in general.

Fish, shellfish, grass-fed meat, organ meat, grass-fed dairy, and seaweed are great food sources for DHA and EPA.

Sarah adds that nuts and seeds can be very high in ALA (especially flax, chia, walnuts), which can be converted into DHA and EPA. Although this is usually inefficiently done- again 3%.

Fiber

Stacy says you can never talk about fiber enough. In fact, if she's eating carbohydrates, she wants to be eating fiber as well.

Sarah says about 90% of us are deficient in fiber!

Sarah explains we need fiber because it feeds the gut microbiome, helps eliminate toxins, helps regulate hormones, regulates gut motility, fermentation produces SCFA, and promotes better sleep.

Plus, it helps you poop!

Sarah explains what happens in our intensities if we don't have enough fiber to bind our waste eliminated by the body.

Some stuff we want to get rid of can actually be reabsorbed into the body if we don't have enough fiber to aid in getting rid of.

Fruits, veggies, mushrooms, and legumes are all great food sources of fiber.

Sarah also reminds listeners that we want diversity in our fibers for the sake of our gut microbiome.

Nutrivore: Frequent Flyer Nutrient-Dense Foods

Sarah and Stacy have done several different shows on the importance of vegetables and vegetable diversity for any listeners interested in checking them out. (1:19:15)

Stacy also recaps a previous show about needing 30 different types of fruits and veggies a week. And how it is not as scary as it sounds.

Sarah shares that certain foods, like liver and other organ meat, vegetables, and seafood, come up repeatedly as the best sources of these nutrients.

Stacy shares how mushrooms and seaweed were on several lists and found that very interesting.

Sarah explains the term "nutrient density" refers to micronutrients' concentration (mainly vitamins and minerals) per calorie of food. 

She also knows that organ meat is a "big ask" for people. There is a big market out there for encapsulating these foods, so don't run away!

Sarah also explains that nutrient-dense foods supply a wide range of vitamins and minerals relative to the calories they contain. 

Low nutrient density foods supply lots of energy without much in the way of additional nutrition. 

Sarah tells listeners that a nutrivorous, or nutrient-sufficient, diet is practically achieved by consuming more nutrient-dense foods, in ratios that provide synergistic quantities of every nutrient.

More Episodes:

A nutrient-sufficient diet must focus on the most nutrient-dense foods available:

• Offal (how to eat nose to tail EP 347)
• Seafood (fish, shellfish, sea vegetables) (seafood safety concerns EP 366)
• Vegetables (8+ servings daily!!!!) 
  • (most recent is 30 a week, EP 424)
  • 373, 335, 304, 286, 152, plus a ton more, talk about different aspects of high veggie consumption, why, what counts, and what that looks like
• Edible fungi (EP 392, 307)
• Fruit (3-5 servings per day) (Case for more carbs, 305)

Other nutrient-dense foods:

• High-quality meat and dairy (Ep 317 Budget vs Quality)
• Healthy fats (EVOO EP 326) (Best fats for gut health EP 414)
• Nuts and seeds (EP 413)
• Herbs and spices
• Fermented foods (EP 155)
• Eggs
• Properly-prepared legumes

Sarah tells the audience that she recognizes that we are all human and that change is hard.

She wants to be sure to permit listeners not to have to go "all-in" immediately if that's not the best way for you to make a long-lasting, positive change in your life.

Sarah also reminds listeners to aim for 30 different fruits and veggies a week!

Nutrivore: The Whole Diet

Stacy loves the idea of taking this all into account when looking at a nutrivore diet.

This is because the focus is on eating what we need to feel like our best selves.

A nutrivorous diet is one in which the goal is to fully meet the body’s physiologic needs for both essential and nonessential nutrients from the foods we eat. 

This is also called a nutrient-sufficient diet.

Stacy tells listeners that a nutrivore diet is about the overall quality of the whole diet. And not about a list of yes-foods and no-foods.  

Stacy shared that, as a person with many food intolerances, she learned the hard way that if you continue to eat a food your body is intolerant to, you're keeping your body from absorbing more of everything else.

That means you then need to consume more of everything because your body still hasn't absorbed everything it needs to function because something like gluten or nightshades are gumming up the works.

Be Nice To Yourself

Sarah explains that though eliminating empty calorie foods helps to achieve nutrient sufficiency, no food is strictly forbidden. There are no "yes" food and "no" foods.

You can "buy" yourself wiggle room with your favorite "junk foods" by eating more nutrient-dense superfoods.

Also, food sensitivities and other dietary priorities can be layered on top of this approach.

Sarah suggests thinking of nutrivore as a diet modifier: you can do nutrivore Mediterranean, nutrivore vegetarian, nutrivore Paleo, etc.

Don't Be Afraid Of Going Nutrivore!

Stacy shares that her body had been able to handle more stress in life because her body is less involved with dealing with inflammatory foods. (1:37:14)

Sarah shares that this might be a great time to emphasize that it only takes a few weeks for our taste buds to adapt to big shifts in our diets. 

Studies looking at taste adaptation to one of a low-sugar, low-salt, or low-fat diet have shown that participants develop a preference for the healthier foods they've been eating over a few weeks. 

This is attributable to our taste buds becoming more sensitive. 

Sarah explains that familiarity and flavor association with positive experiences is another key driver of food preference. 

Studies show that with repeated exposure to foods that we innately dislike, we can lose our aversions to those foods and actually develop a preference for them. 

In fact, we can learn to like new flavors after trying them as few as four or five times. 

What does this mean? If you aren't enjoying the new healthy foods you're adding to your diet, don't give up.

The more of these healthy foods you eat, the more you'll enjoy them!

Final Thoughts on Nutrivore

Stacy shares that her favorite thing she used to tell her kids is your tongue sheds tastebuds like a snake sheds its skin.

And you just have to wait until the next round to see if you like whatever it is then.

Stacy also said it's not so much as figuring out to like a certain food but finding a way to prepare.

She invites listeners to stay open-minded, ready, and willing to get there.
Thanks so much for listening!

Episode 436: What Is Health, and How Do You Measure It?

The Whole View, Episode 436: What Is Health, and How Do You Measure It?

 

 

Welcome back to episode 436 of the Whole View. (0:27)

Stacy welcomes listeners and tells the audience how excited she and Sarah are to have new listeners! 

She suggests they take a moment to introduce themselves.

Stacy has a 20-year career in Federal regulation and law. Her life-changing moment came from discovering what we put in and on our bodies affects our health. 

Now she's her own boss and leads a large team focused on getting safer, non-toxic living products into the hands of everyone.

Dr. Sarah has a medical research background and a Ph.D. in medical biophysics. She used diet and lifestyle to regain her health. 

Now she sees herself as a science translator. Her goal is to build a bridge between the researchers working on expanding human knowledge and everyday people who can benefit from the information.

Stacy explains that a lot of Whole View shows lately have done some very deep dives into the science on topics like foods, lifestyle factors, hormones, and specific nutrients.

She explains it's not about getting your body "beach body ready." But more about your health and feeling good. 

Today she and Sarah want to pull all that together and discuss the basic philosophy of health, how we define and measure the actual goal.

Stacy reminds listeners that she and Sarah are not medical professionals or giving you medical advice.

She and Sarah want to give you information to empower you and take with you to your doctors. 

Perspective & Bias

Stacy battled weight her whole life. (4:55)

As a tween, she was sent to "camp shame," which was basically a place for fat kids to lose weight.

This inevitably propelled her into cycles of yo-yo dieting with gaining, losing, and gaining hundreds of pounds throughout the course of her adult life.

Stacy shares that in coming to a health-oriented approach to her diet, she focused a lot on being a competitive athlete for the sport of StrongMan.

After an injury, it really caused her to re-evaluate how she defined self-care and self-love in the context of self-respect and acceptance.

Stacy explains how big a role acceptance played at this point in her life.

She had accepted her body in the context of her performance as an athlete but needed to work on accepting herself, period.

Lack of self-acceptance is how our societal and cultural beliefs are such that we allow media and marketing to think of ourselves as "less than" and "imperfect."

She also explains that this is how they sell billions of dollars of products to us that encourage us to change.

It is a lot harder to convince somebody to change if they already accept themselves the way that they are. 

Stacy tells the audience that this is where we see things that are NOT healthy:

• Thin, skinny, bikini body
• Jacked, ripped, swole
• Botox, collagen fillers, hair extensions, liposuction, lash serums that cause people to go blind
• Teas, weight loss products, that are actually nutrient depleting 

Stacy tells listeners that these ideas of "health" aren't realistic, but if you do use some of these products, that doesn't make you a bad or unhealthy person.

She jokes that if you love your hair extensions and they make you feel good about yourself, there's nothing wrong with that.

She also adds that the belief that thin = healthy is just wrong.

Health vs. Beauty

Stacy explains that many companies prey on making us feel like we need these products. And some people even risk going blind, hoping that they end up the percentage of people who get the long lashes. (8:40)

Sarah takes a minute to highlight the misdirect between health and beauty.

Unfortunately, Sarah says, it's so pervasive that it's difficult to persuade people into opening their minds.

Stacy adds that stereotypical ideas of beauty don't even equate to a healthy lifestyle.

She cites underweight models are seen as ideal even though underweight is actually detrimental to your health. 

The ideal body type has changed over centuries, and right now, the general belief is one where people believe thin is healthy.

Stacy and Sarah covered this idea in-depth in Episode 421. 

Stacy reminds everyone that science has actually proved the BMI chart is more wrong than right. 

It tends to lead us to "assume" thin people are healthy and overweight people are not.  

Sarah emphasis that there is a really big lag between scientific discoveries, for example, lifestyle changes, and doctors implement it. 

In some cases, this lag can be up to twenty years long. 

For example, for years, doctors would tell them to stop eating high cholesterol foods if someone had high cholesterol.

We know now that our cholesterol isn't impacted by what we eat, but rather our lifestyle and genetics. 

How Doctors Define Health?

Free of disease is a big one. But "lack of disease" doesn't necessarily mean "healthy." (15:15)

Low-risk factors for disease are: 

• • BMI, weight, or waist to hip circumference ratio
  • Blood pressure
  • Serum cholesterol (HDL, LDL, total, and triglycerides)
  • Fasting blood sugar and insulin

Doctors look for normal vital signs, including heart rate, respiration rate, blood pressure, temperature, and other things. 

A regular doctor examination is also something they look at for determining health. 

This takes into account general appearance, heart exam, lung exam, head and neck exam, abdominal exam, neurological exam, dermatological exam, extremities exam, male and female exams, etc.

A lot of day-to-day symptoms, like constipation, headaches, stomach issues, etc., that aren't actually "normal" often go unnoticed because they are normal to us.

This means we don't always talk to doctors about these things because we're still able to function. 

BUT all the things a doctor measures during an annual physical are designed to diagnose disease. And usually, their techniques are quite outdated based on their education and continuous learning. 

Sarah explains that "normal" means the absence of disease and not necessarily healthy. 

Even worse, we can see significant evidence of misdiagnosis of doctors who assume health equals lack of disease when people look a certain way—for example, being overweight. 

Sarah reveals that thin people have heart attacks and strokes while the "overweight" category of people actually have the longest life expectancy. 

She poses the question go what a better science-backed way to look at it is?

A Better Definition of Health

Sarah underlines that the goal of all this is to be healthy and not thin or swole. (20:46)

She offers a better definition of health as being free of symptoms of the disease.

A healthy diet and lifestyle can go a long way toward managing chronic diseases.

This includes symptoms not associated with a diagnosis that is normalized and explained away as signs of stress, or aging, or the idea of "I just need to work out more, eat more fiber, or lose 10 pounds."

These missed symptoms often include headaches, skin conditions like acne, rosacea, eczema; gastrointestinal problems like constipation, diarrhea, flatulence, bloating, super stinky poops or farts, reflux, or belching; fatigue; joint or muscle aches; and even emotional issues like irritability or malaise.

Stacy shares that a big wakeup call for her was when she started monitoring inflammation. 

Every time she would visit a doctor for symptoms associated with her many autoimmune diseases, doctors told was always told she needed to lose weight.

She even shares that no one really looked into or even asked about many of her other symptoms that she, who does not have a medical background, didn't realize were signs of other things.

Had she known, she could have done a lot more sooner. 

Stacy also reminds listeners that this is not aimed at making anyone feel bad about themselves or giving them a list of things to change.

There's a balance to everything. She stressed that the science behind health should act as a compass, rather than a strict set of rules.

Stacy explains you need to love yourself the same way you love your kids or your mom.

You love them because you love them.

Signs of Physical Health

Sarah explains that what we're trying to do is give us better tools to measure health with. (26:15)

She believes the problem is weight is such a poor measure of health. 

Sarah explains that looking at energy levels throughout the day is a good way to measure health. 

• No "crash" at the end of the day
• No need to rely on sugar or caffeine to pick us up
• Don't fall asleep/nap at odd times like on the bus or on the couch after dinner

Body composition is also a good way of looking at health and not weight itself.

We know from the scientific literature that having higher muscle mass is a more important determinant of health than fat mass.

Where your fat deposits are (subcutaneous fat vs. visceral fat), and what type of fat it is (BAT or WAT) is more important as well. 

Sarah explains enjoying the activity is also considered a great indicator of health. This can be as simple as outside play, visiting farms, etc.

The ideal is to enjoy working towards a fitness goal, or just enjoy moving, and not just focusing on losing weight or looking better.

Spontaneous physical play is a great indicator of health (is it fun to race your kid to the bus stop, spontaneously dance to a song on the radio)

Stacy jokes she loves things like spontaneous dance parties, especially when it embarrasses her kids.

Feeling like we need to get up and move after being sedentary too long because it's normal to feel crummy after sitting for too long. 

Sarah believes sleep quality is a huge indicator of health as well.

• Falling asleep quickly 
• Staying asleep
• Wake up feeling refreshed

"Sense of wellbeing" and sex hormone regulation are both good indicators of physical health.

Sarah explains that this includes:

• Having a normal libido (for women, it fluctuates with hormones)
• Wanting and enjoying "sexual relations" (with a partner or by ourselves)
• Regular menstruation

 

Mental Health As A Sign Of Overall Health

Stacy adds she's always seen mental health as a huge indicator of how healthy we are. (35:05)

 Sarah agrees, adding that if you're looking at how healthy you are overall, you're going to want to check in on how you're doing mentally.

This can include ental clarity, problem-solving, and memory, and no brain fog or cognitive challenges.

Sarah adds that a balanced emotional response is also a good indicator of mental and physical health. This means that you're not prone to overreactions.

Sarah adds effective communication, overall happiness, and enjoying life, coping in a productive (not destructive) way, and flexibility to that list.

It's a good sign to enjoy playing and engaging with others, like pets, kids, games, or other close relationships.

Sarah explains another interesting indicator that we're healthy mentally is to be ok being bored and existing inside our own heads without needing a distraction.

Stacy adds that through her work as a foster parent, she's realized how well trauma can hide in ourselves. 

Also, there is no need for "crutches" or willpower (physical + mental health) like caffeine and sugar, self-medicating, smoking, drinking, recreational drugs, etc.

Stacy explains that these crutches can act as a way of avoiding mental health and can negatively impact your physical health.

She urges listeners that when making food choices, focus on ones that are helpful and healing. 

Why It Matters

When we have a healthy lifestyle, we tend to enjoy healthier food and not crave food that can harm our health. (43:45)

Getting enough sleep regulates appetite and food cravings and makes people more likely to CHOOSE fruits and veggies over fast food.  

Sarah explains that stress increases appetite and cravings for energy-dense foods (salt, sugar, fat)

When healthy foods are our normal, we're not consuming addictive hyper-palatable engineered/manufactured foods. 

It's so much easier to really, truly enjoy an apple if we're not eating donuts regularly.

When we're getting enough sleep, we don't need coffee or energy drinks to get us through the day.

Sarah reminds listeners that that doesn't mean you have to give up coffee entirely. The goal is not to rely on it.

She adds that a big part of this is finding better coping mechanisms for when things happen, like an energy crash at 3 pm.

It's easy to reach for the caffeine, but it could be as simple as taking an afternoon walk to recharge.

Stacy explains no one is expected to check every one of these boxes, but it gives perspective on areas of your life to optimize health.

These indicators reflect physical health and mental health and the underlying biology of both. 

They are signs of no nutritional deficiencies, having well-regulated neurotransmitters and hormones, a healthy gut, healthy immune system, healthy cardiovascular system, etc. 

Stacy loves the idea of a crutch not necessarily being a negative thing but relying more on how you use it and benefit your health overall.

How Can We Measure Health?

When measuring your own health, Sarah suggests reflecting on what we've discussed so far:

• Keep a simple journal (if you're troubleshooting, note diet, sleep, activity, emotions/stress, and any symptoms)
• Energy levels
• Mood, malaise, emotional response
• GI symptoms and stool quality/frequency
• Skin health (can also include things like fingernails, hair, etc.)
• Pain: Headaches, body aches, joint, muscle
• Cognition (IQ boosting games that give a score are a fun way to track this)
• Subjective sleep quality (or measure with a tracker)
• Stress, baseline, and response (or measure HRV)
• Health-related quality of life (HRQOL) is an individual's perceived physical and mental health over time. 

She also recommends checking out these resources for a Quality of Life Scale and Quality of Life Sheet. 

No Quick Fix

Stacy adds that there's no quick fix to increasing your health and wellness. (52:21)

She reminds listeners that it's never her or Sarah's goal to have you walk away from these shows feeling like you should be doing something you're not. 

Sarah shares that she loves the idea of people taking on a more holistic view of health that's more than just a number on a scale. 

When we think about health more comprehensively, one thing that starts to become apparent is that there's no magic pill or quick fix that will get us there.

Instead, making healthy choices day-to-day (without the need to be perfect) sustainably and consistently gets us there.

The foundations of health include four pillars:

1. A nutrivore diet! 
2. Sleep (enough and on a consistent schedule)
3. Stress management (work, family, social networks, and nature)
4. Activity (lots and lots of it but not overtraining)

Sarah adds that health is quality of life, and by making better choices, we can better support our health. 

Stacy asks listeners to reflect on their self-worth and check-in with themselves.

She wants everyone to love who they are just the way they are and love themselves without restriction.

Stacy invites you to check out Episode 421 on body image if you liked the positive body message of this episode.

Thanks so much for listening today, and we will see you next week!