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Join Stacy of Real Everything and Dr. Sarah of The Paleo Mom as they bust myths and answer your questions about a nontoxic lifestyle, nutrient-dense diet, Autoimmune Protocol, and parenting.
Episodes
Friday Oct 09, 2020
Episode 425: Covid-19 FAQ Part 4
Friday Oct 09, 2020
Friday Oct 09, 2020
A Message On Patreon
Long-time listener here, and I adore the Patreon content! I wondered if it would be short content, but "knowing" you, why would I have thought that?! You give so much, and the Patreon episodes are no different. I utterly loved the first two episodes, and really enjoyed hearing about your move from identifying as Paleo and the changes in the Paleo community, especially around racial justice and anti-science.
I'm a Whole30 coach and share your articles and podcasts with my clients so frequently. I also help moderate a Whole30 FB group of about 4,000 over-50 (mostly) women and when it's my turn to moderate I frequently have Science Week - and guess who is featured prominently each time?
I adore the science, the friendly chat, the laughs and the tips. Truly, this new Patreon content is a bright gift in this very dark time. Thank you both!
Thank you, Teri!
For our listeners, if you would like to join our Patreon family, you can find us at patreon.com/thewholeview for bonus and unfiltered content.
Stacy notes that Sarah has moved away from swearing in general and uses some very interesting alternative terms.
So if you're curious and want to be creative, you know where to go!
A Quick Recap
In Episode 401, Stacy and Sarah explored the way out of this pandemic and how to get back to normal life as we know it.They touched a little bit on reinfection cases, which they will be taking at a more in-depth look at today.
They also broke down the science behind wearing face masks.
In Episode 412, Stacy and Sarah talked about how isolation can impact immune function. They also myth-busted some of the concerns that have circulated around it.
They discussed how isolation might affect the gut microbiome, public health messaging, and the huge importance of vitamin D when reducing the risk of Covid-19.
In today's episode, Sarah reminds us that they will be focusing on:
- Reinfection versus Reactivation
- Long haulers (sometimes "Long Covid"
- Longterm complications/damage
Why This Matters
Stacy shares that this has been an ongoing thing for her. (7:50)
Stacy has shared in past podcasts that she had a feeling there were two unknowns that we would find out later on about the Coronavirus:
First, there's an effect on the brain, which has since been shown. And second, that there is a hormonal impact on the body.
Stacy has noticed she gets reactivated symptoms during her menstrual cycles, specifically inflammation.
Stacy feels that it is really important to talk about because there's so much focus on how many people have died.
As someone who's gone through it and now living with the long-term side effects of it, she feels it's important to acknowledge that millions of people in the world survived but are still feeling the effects months later.
She considers herself one of the lucky ones since she had a mild case and cannot be more thankful for that.
Stacy would like the audience to understand that Covid-19 is not like the flu. You don't get it, and then you're done, and you have immunity for a short time until the next strain comes out.
Answers Through Science
And she thinks that Sarah going through the science of it will be very beneficial to people.
Sarah points out that we're now at a point where more research and studies are trying to look at the spectrum of the long term impacts.
It's really important to understand the long-term impact of this so that we can monitor at-risk people for potential health-specific complications in the future.
Sarah also references potential economic impacts we could see due to prolonged symptoms and brain fog keeping millions of people from returning to work.
There are down-stream effects that we need to really understand and be able to wrap our heads around.
Sarah also explains that there's a lot of work that still needs to be done to reduce the spread.
She also explains that we are still at a really high level of new cases every day.
With high community spread, it makes any kind of gathering (school, church, weddings, funerals) all very challenging.
As we're trying to figure out how to continue with precautions to reduce spread, Sarah expresses the need to understand this whole other side of the virus that's not related to the two to three weeks of active infection.
ADE And How It Works
Sarah first wants to look into whether the recent reports that look like reinfection are truly that. (14:26)
Stacy shares that this is something especially concerning to her.
Sarah explains antibody-dependent enhancement of infection (ADE or ADI).
It is a common phenomenon in many other viruses, such as influenza A virus, Coxsackievirus B, respiratory syncytial virus (RSV), Ebola virus, human immunodeficiency virus (HIV) dengue virus.
Dengue Fever is the best understood in terms of the ADE mechanism.
There are four known strains of the virus; when you contract one strain, you get Dengue Fever, and your body mounts a response.
You are then protected for a relatively short time frame of time, not just against the strain you caught but also the other three.
As the antibodies fall in number, there's a window where if you get exposed to one of the other three strains, you can develop a much more severe case.
If you don't get exposed to one of those three, you're still immune to the first strain you caught even after all the antibodies are gone.
If you catch one of the other three strains after the window is closed, you will develop regular Dengue Fever again, but not get the life-threatening reaction.
Sarah explains that that magic sweet spot with a low level of antibodies actually magnifies the infection.
One thing Sarah notes is that the Dengue Fever virus actually replicates inside immune cells.
So when there are high levels of antibodies shortly after an infection, these "eater cells" are able to neutralize the infection.
When there are low levels of antibodies, they're not sufficient enough to neutralize the virus.
This sweet spot typically starts from a few months out from infection and can last to about a year.
What This Means For Covid-19
Reinfections
Covid-19 Spread
Covid-19 Reactivation
What's happened in these few dozen cases of possible Covid-19 reinfection is that people tested positive and were sent home. They recovered and later tested negative. Then, months later, they once more test positive for Covid-19.
Some are similarly sick as the first time, some are sicker the second time, and others are asymptomatic.
This begs the question if it's real reinfection.
Sarah claims that of the researchers studying these cases, nobody is convinced that it's true reinfection.
None of these cases are from immunocompromised people and aren't thought to be very concerning.
Reinfection is a legitimate concern for those with autoimmune disorders, such as HIV.
A more likely explanation for what is going on with these cases is that it's actually viral reactivation.
This means that these people are long-haulers who had a latent period, combined with testing limitations and failures.
It's possible that those negative tests weren't true negatives.
Sarah explains this as the immune system almost beat it, but didn't neutralize it fully, and pulled back fighting too soon.
There's a really wide range in how long people have measurable virus in their systems, and they may not be infectious the entire time.
Sarah explains that there's a lot that we still don't know about the Covid-19 virus and its ability to hide out in our bodies long-term.
Data has shown viral shedding in some people lasting as long as eighty-three days out from the first day of symptoms.
What Studies Show
Some of the recovered/discharged patients showed a positive viral RNA burden for as long as 10 to 27 days after the discharge (Korber et al., 2020; Ye et al., 2020)
Although the median viral shedding duration was 20 days, in some cases, it was observed for 37 days (Zhou et al., 2020).
The prolonged SARS-CoV-2 RNA shedding occurred with a median duration of 53 days and a maximum of 83 days (Li, Wang, et al., 2020).
In addition to this prolonged carriage of SARS-CoV-2, some patients who had recovered from COVID-19 demonstrated recurrence of SARS-CoV-2 (Xiao et al., 2020; Ye et al., 2020; Yuan et al., 2020).
In one study, as much as 9.1% of the discharged COVID-19 patients were shown to be presented with the SARS-CoV-2 reactivation (Ye et al., 2020).
Another study revealed that 14.5% of discharged COVID-19 patients with negative (polymerase chain reaction) PCR, had a later positive reverse transcription PCR (Yuan et al., 2020).
Still another study indicated that the number of such recurring patients can be as high as 21.4% (Xiao et al., 2020).
Another explanation is genetic mutations causing new strains. Sarah explains this is not likely. While there variants, they are not different enough to be considered a new strain.
What Explains Covid-19 Reactivation?
Sarah sums up that the most likely explanation for the resurgence of symptoms is due to the virus's ability to hide inside our bodies. (36:03)
She goes a bit more in-depth on how exactly a virus can hide from our immune systems.
One of the implications of this is that we could have more lasting immunity from a vaccine than natural infection.
It may hide out in exosomes within cells, which are little tiny bubbles inside the cell membrane.
What this all data points to is herd immunity through natural infection is unlikely.
And that we may be able to achieve a more lasting immunity through vaccination.
Links to the Studies Sarah Recommends:
- https://www.frontiersin.org/articles/10.3389/fimmu.2020.01949/full
- https://www.tandfonline.com/doi/full/10.1080/07391102.2020.1790426
- https://pubmed.ncbi.nlm.nih.gov/32838134/
- https://pubmed.ncbi.nlm.nih.gov/32340768/
- https://pubmed.ncbi.nlm.nih.gov/32619697/
Long-Haulers
Stacy references the Scientific Method from a previous episode and explains how we're still mid-process. (40:41)
Sarah wants to acknowledge listeners that this doesn't feel like good news.
The main message that this scientific research has for Sarah is that the efforts going in to protect herself and others are still really important to do, even though we may be getting tired of it.
The science behind wearing masks to slow the spread just gets stronger and stronger.
It's potentially a large percentage of people who fall into the long-hauler or long-Covid category.
Over 30% of long-haulers still have symptoms at 3 weeks, and approximately 10% still have symptoms at 2 months.
Sarah also notes that data might be lacking because not all long-haulers are seeking medical attention if their symptoms are tolerable.
The most common symptoms for long-haulers are fatigue, ongoing shortness of breath, joint aches, muscle aches, brain fog, and difficulty focusing.
Some people report feeling better for a few weeks, while others report not feeling better at all.
The Body's Response
Sarah explains how autoimmune diseases work and how it relates to Chronic Fatigue Disorder, which shows similar symptoms to long-Covid.
Some researchers think what's happening in long-haulers isn't exactly continued infection. But more of the infection melding into Chronic Fatigue.
Another thing that could affect long-haulers is organ and tissue damage, which takes a long time to heal.
Researchers have now started to note Multisystem Inflammatory Syndrome cases in some Covid patients.
This was thought to be more common in children but is showing up increasingly in adults.
MIS typically happens in people who had Covid and recovered from it. It's a very severe, life-threatening (but treatable) inflammatory syndrome.
Clinical features in children have varied but include shock, cardiac dysfunction, abdominal pain, and elevated inflammatory markers.
Adults show severe dysfunction of one or more extrapulmonary organ systems (e.g., hypotension or shock, cardiac dysfunction, arterial or venous thrombosis or thromboembolism, or acute liver injury); 4) laboratory evidence of severe inflammation (e.g., elevated CRP, ferritin, D-dimer, or interleukin-6);
Sarah sums up that in its severe form, patients can develop MIS. But in mild-form, patients show symptoms of long-Covid.
What This Means For Covid-19 Patients
The way this is currently treated mostly by symptom relief, rest, and stress reduction.
Stacy shares that until we know more and the science can catch up with medial solutions, we know what we need to do to at least feel better. And how to continue to reduce the spread.
Stacy reminds us that drinking alcohol can exacerbate long-haul symptoms on the front end.
Sarah explains that alcohol is actually the opposite that's needed to support immune function.
Because we focus so much on the physical side of Covid-19, Stacy reminds us that there's a lot of mental health at play from anxiety.
This anxiety comes from all the things we don't know.
Even if you've already had it, like Stacy, we don't know if we can get it again, if it will be worse the second time, or if we'll be asymptomatic and infect others.
You're not alone. You're not the only one feeling frustrated and exhausted and over it and ready for change. We're on the same team.
Sarah's Helpful Links:
- https://www.nature.com/articles/d41586-020-025986
- https://jamanetwork.com/journals/jama/fullarticle/2771111
- https://www.cdc.gov/mmwr/volumes/69/wr/mm6940e1.htm
Long-Term Damage From Covid-19
Because of the way Covid-19 is effecting our bodies, there's the potential for organ damage that's important for us to understand. (56:11)
Sarah underlines that the most concerning piece of that is cardiac damage. Unlike the other longterm challenges from organ damage, it's something that happens independently of severity.
Sarah talks about a study done in Germany that looked at MRIs of their hearts.
What they found was abnormalities in 78 of the 100 participants with ongoing inflammation.
They showed that this was independent of preexisting conditions.
Sarah believes it's very important for people to understand that this illness isn't just about whether you live or die, or whether or not you need to be hospitalized.
Sarah goes on to say that the unknown factors make the idea of herd immunity much scarier.
By allowing the number of people needed to be infected for herd immunity, we're potentially putting a lot of people in danger of long-lasting complications from Covid-19.
Not Just The Heart
Kidney damage has been seen in severe infections.
Acute kidney injury (AKI) has been reported in up to 25% of critically-ill patients, especially in those with underlying comorbidities.
The type of pneumonia often associated with COVID-19 can cause long-standing breathing issues.
The resulting scar tissue can lead to long-term breathing problems.
An Austrian study also found that lung damage lessened with time.
88% of participants had visible damage 6 weeks after being discharged from the hospital, but by 12 weeks, this number had fallen to 56% (see go.nature.com/3hiiopi).
Sarah also tells us that research suggests Covid-19 does have an effect on the brain as well, but there is still a lot that doctors and scientists don't know.
Studies show Covid-19 can cause strokes and seizures, even in young people.
Covid-19 may also exacerbate and potentially increase the risk of developing Parkinson's disease and Alzheimer's disease.
Sarah's Suggested Further Reading:
- https://www.sciencemag.org/news/2020/09/evidence-builds-covid-19-can-damage-heart-doctors-are-racing-understand-it
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-kidney-damage-caused-by-covid19
- https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351
Final Thoughts
Sarah explains that Covid-19 is the perfect storm of virus. (1:15:25)
The reason this is something we've not really experienced in the last hundred years is because the asymptomatic and pre-symptomatic spread makes it very difficult to control.
Sarah adds that the long span of time for infection adds to the difficulty.
Sarah explains the difference between aerosol and respiratory droplets, and how masks prevent the virus from spreading.
Stacy adds that it's not enough to wear a mask, but to make sure it's properly fitted to your face to keep you and others safe.
Sarah also notes that 6 feet is not enough distance indoors, and that masks will still be needed even after a vaccine rolls out.
Sarah takes a minute to remind about immune health. This means get enough sleep, manage stress, get activity, address vitamin D, eat a nutrient-dense diet, look after gut health, and avoid alcohol.
This is the pattern that Sarah used for her mask, as well as the Fruit of the Loom Masks, and nose pieces. Here's Sarah's post for more information.
Sarah also underlines how important masks are. They're our greatest defense and offense for controlling infection.
Stacy adds that there is nothing political about wearing a mask either.
She and Sarah are here to give the science needed to live life as healthy as possible.
A Big Thank You!
Stacy would like to encourage everyone to have compassion and says thank you anyone continuing to fight the spread.
Your efforts are appreciated!
Sarah also expresses her gratitude toward the audience for following the science and taking action.
Sarah and Stacy will be sharing more of their unfiltered thoughts on Patreon as they recap the episode.
Thank you so much for being here today and being a part of this community we so appreciate. We'll be back next week (hopefully with something happier to talk about)!
Friday Oct 02, 2020
Episode 424: 30 Fruits and Vegetables a Week?!
Friday Oct 02, 2020
Friday Oct 02, 2020
Welcome back to episode 424 of the Whole View. (0:27)
Sarah feels it's important for the audience to know this show is not about guilt. It's about empowering and inspirating!
Sarah has posted in the past that, as a general rule, we should all aim to eat at least 30 different vegetables and fruits throughout the week.
For Stacy, that number was a little mind-blowing. She hopes that by breaking that number down, she can see how far off she really is from reach 30.
She also hopes this helps listeners understand what Sarah meant by that expectation.
This is a topic Sarah has seen many discussions (and panic) about because 30 sounds like a lofty goal.
In this episode, she'll explain where that recommendation comes from and the science behind it.
Sarah believes most people are closer to eating 30 different fruits and vegetables per week than they realize. And she hopes she can help reassure listeners who may find that number overwhelming.
We would like to remind our audience that it's important not to let perfection be the enemy of the good.
This is not about checking boxes, but about setting a fuzzy goal aimed at increasing variety.
Sarah shares several comments from the original post that stuck out to her.
She hopes that by going deeper into this topic, listeners will realize that it's not as scary as a number as it seems.
Where The Recommendation Comes From
Sarah shares some relevant findings from her six-year study of the gut microbiome. (4:47)
Different families of fruits and vegetables are independently beneficial because they feed different subsets of bacteria.
Sarah explains that diversity between the types of bacteria and microbes is the hallmark of a healthy gut. She then explains their interactions affect the human body.
How we achieve diversity is through ensuring there's variety in types of fruits and vegetables we eat. And not that we're picking the same ones over and over.
Sarah recommends the American Gut Project for further research data on the gut microbiome.
Sarah's research shows fruits and vegetables are the best for the gut microbiome.
Nuts and seeds are also fantastic.
But only some legumes and grains are, and they shouldn't replace servings of fruits or vegetables.
Stacy does the math for what she's eaten, not even going back a full week. She shares she's already reached 26 (not including nuts, seeds, or herbs).
She jokes that she's not the type to snack on raw vegetables either!
Does My Store Really Have That Much?
Breaking meals down by ingredient can show how many vegetables we use on a daily basis without us even realizing it. (14:37)
Sarah shares that in her fruit bowl alone, she has 10 different kinds of fruit.
The average grocery store has roughly 200 different fresh fruits and vegetables year-round when counting different varieties separately.
Sarah reminds us that this is a rough guideline and not a list of check-marked boxes.
The goal is to think about variety and swap out different types of foods week-to-week.
Stacy lists kale, carrots, spinach, cabbage, lettuce, squash, tomatoes, potatoes, and mushrooms.
Stacy recommends researching recipes that utilize different types of add-ins to increase variety.
Muffins, oatmeal, and smoothies can all include multiple fruits or vegetables.
Some fruits and vegetables are seasonal, but many are in season year-round.
Stacy explains that seeking out opportunities to add different ingredients is how she could reach so many varieties easily.
Sprouts are a great way to add a micronutrient punch to meals. And Stacy was surprised to find how much her kids liked them as well.
Sprouts are also fun and easy to grow at home!
Stacy reminds us that the more we look at what we're eating daily, the more we realize how easy reaching 30 varieties really is.
Stacy talks about different nightshades, like tomatoes, peppers, and eggplants. She also tells us potatoes are a great root vegetable use and can be combined with other ingredients to enhance variety.
Onions and garlic are great "freebies" that count toward reaching that weekly goal.
Stacy recommends trying roasted radishes for anyone who isn't a radish fan.
Rhubarb and kohlrabi may be a little harder to find, but they are great seasonal vegetables to add to your diet to achieve variety.
Stacy reminds us that frozen is perfectly acceptable. This is because when things are frozen, they're picked at peak ripeness, and their nutrients are maintained.
Sarah explains that it's okay to have a core 5 or 10 foods that you buy every week, just be sure to keep a variety outside of it.
Below is the complete list of vegetables Stacy and Sarah talk about in the episode:
What About My Store's Fruit Variety?
Fruit availably often vary depending on the time of year, but many stores will offer different varieties throughout each season. (43:42)
Sarah would like to emphasize finding a feeling of excitement when something unusual comes into your store.
Don't be afraid to move out of your comfort zone (at your own pace) to try new things.
It's never too late to start becoming more adventurous and widening our varieties.
Stacy points out that there are a lot of opportunities to find foods you like. She shares that she does like prunes (dried plums) and dates despite not particularly liking plums.
Stacy lists blackberries, blueberries, strawberries, and raspberries as fruits she often freezes.
Many types of melons and citrus fruits are available throughout the year. Varieties often rotate based on seasonality as well.
Stacy suggests reaching out to your local garden center if you're interested in growing your own fruit.
Both Sarah and Stacy share stories about plants they've grown (both successfully and unsuccessfully) at home.
Stacy promises not all plants are high maintenance or difficult to grow. She assures us that we are capable of growing them if we would like to.
Sarah also wants listeners to know that many vegetables will grow in containers. So even if you don't have space for a fruit tree, you can still increase your food variety with a small porch or balcony.
Stacy challenges listeners to check out the "exotic fruit" section of their stores and to have some fun and choose something new to try.
Guava, dragon fruit, jackfruit, star fruit, passion fruit, lychee, and rambutan are a few of the fruits found in the exotic section.
Together, Sarah and Stacy named 46 different vegetables and 37 different fruits in this one episode alone.
Stacy shares that her final count is now up to 29 different fruits and vegetables in just 5 days!
Stacy's final verdict? Reaching the recommended 30 was not as scary as she originally thought.
Below is the complete list of fruits Stacy and Sarah talk about in this episode:
Storing and Meal Planning
Sarah tells us that it's surprising how much is available in terms of seasonality and locality. (1:02:40)
She suggests referring to a seasonal produce guide as an easy reference.
Sarah feels storage is important to talk about and that most fruits and vegetables keep for about a week if stored correctly.
Her Gut Health Cookbook also has an entire section on storing vegetables and fruits and is now available.
This free guide from UCDavis is also a great reference for knowing what does and doesn't store well together.
Sarah reminds us that there are many ways to get inventive when storing fruits and vegetables. And not to let lack of space stop us from achieving a great variety.
Soups, stews, stir-fry, salads, smoothies, and frittatas are great recipes that allow you to throw in different vegetables.
Stacy shares one of her favorite tricks with soups is to roast the vegetables first. Then blend them into the soup or stew to get a gravy-like texture.
If you're listening to this episode in the fall, Stacy states now is a great time to play around with different soups and stews.
Stacy recommends meal planning by going through different cookbooks and not to be afraid to have fun with it.
She is also a big fan of Pinterest for finding new recipes. She will pin a bunch of ideas and then go through them with her kids to find things they want to try.
Finding Affordable Fruits and Vegetables
Stacy reminds us that achieving a good variety doesn't have to be impossible or overcomplicated. (1:09:38)
It can also be very affordable. For example, onions, lettuces, cabbage, root vegetables, and spinach are all pretty affordable.
Apples, bananas (Stacy recommends Fairtrade), and oranges are often pretty inexpensive fruits.
In-season fruits and vegetables are generally cheaper, so knowing what's in season can help you shop on a budget.
Sarah makes us aware that eating more vegetables, in general, is a budget-strategy for a grocery bill.
She goes on to say that this is an area that she thinks the Paleo-diet did her a disservice.
She went through a phase early on where she was eating very large portions of meat and getting more protein than she needed.
Meat tends to be a more expensive item on the grocery list, while vegetables tend to be some of the least.
Stacy feels that it's important to make listeners aware that if you or someone you know is part of the WIC Program, some WIC-eligible fresh fruits and vegetables are required by the state.
That includes organic forms of those products (whole or cut).
Sarah urges us to keep in mind that even though grains, wheat, and rice products seem much cheaper, by comparison, there are a lot of budget-friendly fruits and vegetables available as well.
Final Thoughts
Sarah hopes that most of today's listeners realized they, like Stacy, were much closer to reaching 30 than they thought. (1:16:34)
If you're someone who might be farther away from reaching 30, Sarah wants you to know that that's okay. And there are many things you can do to help you increase that variety.
It's okay to baby-step the process.
Sarah doesn't want anyone to feel like they have to readjust their lives to meet the recommendation.
Finally, Sarah would like to encourage our listeners to think about this in a positive mindset. You can do it! And it's okay to iterate towards it.
30 is not a hard-and-fast number; it is a goal. It's there to provide some guidance into what high-variety is.
Stacy reminds everyone that a goal isn't something that's meant to be achieved every single week.
Goals are meant to push us to strive for something better. And just because we don't make it every single time doesn't mean we are failing.
Stacy adds that she hopes this episode leaves you feeling empowered and excited.
If you enjoyed this show, the best thing you can do is share it with others.
If this was helpful to you or cleared your conscience, please let us know. We love to hear from you!
If you're still feeling overwhelmed and would like more information, that feedback is very helpful and keeps us going. (1:24:24)
Friday Sep 25, 2020
Episode 423: The Scientific Method
Friday Sep 25, 2020
Friday Sep 25, 2020
Welcome back to episode 423 of the Whole View. (0:27)
In episode 400 when we talked about why we were moving to The Whole View, we talked about the necessity of having a podcast that focused on the scientific method.
What Sarah wants to be able to help our audience understand are some of the common pitfalls in the alternative health community.
We see this manifestation of bias, of dismissing science that doesn't conform to someone's beliefs.
And we see it in a way that is miscommunicating the value of the different types of studies.
One of the things that Sarah wanted to do is talk about how different studies work, which is what this week's episode will focus on.
There are different structures for different types of studies, and what the weight of evidence is from different types of studies.
We want to help our listeners look at articles from various educators and influencers and empower everyone to understand how science works and how to interpret information.
When articles are cloaked in jargon and complex language that is oftentimes a red flag.
Sarah wants our listeners to be able to identify the various red flags to be cautious of.
The type of scientific evidence that Sarah draws on when she is writing an article is multiple disciplinary and crosses a lot of fields.
Her ability to dig into the science in the level of detail that she can is an entire career's worth of training.
This is a skill that takes years to acquire and is very challenging to develop without rigorous training and experience.
However, Sarah does not think it is necessary for everyone to have this skill.
She is hoping to give listeners a broad enough understanding of what scientific evidence actually is to be able to detect bull feces on the internet.
The Whole View Philosophy
We try to always be honest and upfront about when we have the science to show and what we can try to guess from a hypothesis of that science. (7:51)
Stacy knows that we have talked about what some of these terms mean on the show before.
However, we have been addressing a lot of different topics as we expanded to the Whole View philosophy.
We talk a lot about the importance of bio-individuality.
And you can't learn that if you aren't able to be open to the idea of learning as you go.
To Stacy that is what science is all about.
For her, the scientific method is always changing and learning as you have new information and staying open to that new information.
Science is all about taking the ongoing, upcoming information, and applying it in a way that helps us continue to evolve ourselves.
Stacy thinks it is good for people to be able to check their sources.
We are all perfectly capable of questioning how people reach the conclusions they are sharing in articles.
Listeners you hold us to that standard.
We want to always be a trusted source for you.
Science is the basis of everything we share.
What we are doing in the academic community is using the scientific method to expand human knowledge.
However, this is not a straight line.
Nutritional Sciences
Sarah shared her thoughts on the field of nutritional sciences, which is a young scientific field. (16:09)
Because of this, we are in a renaissance in terms of the expansion of our understanding.
We are at a point where there are big holes in our basic knowledge of nutritional sciences.
Sarah shared some examples.
It is important to understand that because of where we are in this field, we are in this phase where we are trying to lay the groundwork.
Sarah recommends Death by Food Pyramid.
She took a moment to also talk about the way this industry is not rooted simply in the science, that it is heavily rooted in profit.
We are also talking about a field of science where a lot of the people who are communicators of this research have a lot of bias.
Knowing what a communicator's bias is helps you to hear their information objectively.
Removing Bias
Scientists in general try to be aware of their biases.
We try to devise experiments where the biases have no opportunity to affect the results of the experiment.
Sarah shared the ways in which this can be achieved.
You are looking for as many qualititative measurements as possible, as opposed to quantitative or semi-quantitative.
Sarah shared examples of how these terms play out in studies.
In science, we look for as many ways to blind or control so that the bias cannot influence the data that is being collected.
The data is then analyzed and as you draw the conclusions that is where bias comes back in.
However, now it comes in the form of the expectations that are shared in the hypothesis.
The Scientific Method
With the scientific method, you make observations, you collect information, and you ask a question.
You are basically interested in looking at something that no body has looked at before.
The goal is to look at the scientific literuature around that question and use it to formulate what would be an educated hypothesis.
We can look at everything we know about the system and make a guess about what we think is going to happen.
You then design an experiment that will help to answer that hypothesis.
And then you conduct the experiment in as objective of a way as possible.
You analyze the results and draw conclusions.
And then you report your findings.
Often, when you get to that piece of sending the study to journals, you then go through peer reviews.
During peer reviews, a scientific article is typically reviewed by three experts in the field.
As an expert in the field, you bring everything you know to looking at this paper.
You read through it very carefully and you try to identify any methodological flaws and alternate interpretation for the data.
There are three ways you can send it back.
The first is that you can say it is accepted as is.
The second response can be accepted as is with revisions, ranging from minor to major.
Or you can reject the paper.
The review process is all done blinded.
It passes three researchers in the field and the editor, and then it can get published.
The peer-review process is very important because it allows fresh eyes to look for any weakness in the paper.
It is because of peer review that there is such a small fraction of papers that ever get retracted, and it works out to be less than 1 in 1,000.
They are often retracted because of the discovery of a mistake.
The person who is performing this research is just interested in expanding human knowledge, and that is why we see so few examples of fraud or bias to the point of needing to retract a paper.
What to Look For
All scientific papers require a disclosure of competing interests, which is a disclosure of funding. (38:39)
They also have to disclose any potential affiliation that could introduce bias into the study.
There is always a statement, usually towards the end, before the citations.
This is always an important thing to keep in mind.
The affiliations of the authors are also important details to look for.
Just because there is a financial disclosure that is linked to industry, does not mean that the research is biased.
The peer-review process is still the main thing that is supposed to detect bias.
Sarah thinks that the most important thing to look at is the body of scientific literature as a whole.
In the alternative health communities, Sarah thinks that there is a tendency to look at a body of scientific literature and to simplify the findings on the one paper that shows something different.
A lot of the interpretation that we get is either 'this one paper is the truth' or you get a dismissal.
Neither one of these approaches is the right way to look at that one paper that shows something different.
You want to look for the consensus.
And you want to look for what the majority of the data is pointing to.
Scientific consensus happens when you have enough data that the vast majority of experts looking at that data come to the same conclusion.
It doesn't mean that every single study ever done supports that consensus view or that every scientist looking at the body of scientific literature comes to the same conclusion.
However, it means that the vast majority of the data aligns with that explanation and that the vast majority of experts looking at the data agree.
A hypothesis is a possible explanation or a preliminary conclusion or an educated guess.
A theory is when the evidence builds up so much so that you have this scientific consensus and you can start to predict based on the theorem.
Sarah shared an example of how this plays out using the theory of gravity.
Types of Studies - Anecdotal & Expert Opinions
The lowest strength of evidence is anecdotes. (47:34)
"Expert opinions" fall into this realm as well.
This is basically, I'm looking around and not necessarily measuring anything.
It also reflects personal experience and is not necessarily representative.
This is what we might call a handwave explanation.
It is not meaningless.
However, it should be viewed as an indication that there might be something interesting to explore there.
There is nothing about an anecdote or expert opinion that is proof.
It is really the formulation of the initial question.
Types of Studies - Case Reports & Case Studies
From there we can get into studies that start to solidify the question and the need to answer this question and expand on our understanding of that answer. (48:31)
The next level is either case studies or case series.
These are purely observational studies.
A case study is typically an account of something that happens to one person.
And a case series is a group.
It is an anecdote with measurements.
Sarah mentioned her anti-keto stance and said listeners can find more on that here.
Types of Studies - Case-Control Studies
The next improvement in terms of strength of evidence is case-control studies. (51:26)
These are retrospective, which means looking back.
However, you have two groups within the study to compare against.
They then trackback to determine an attribute or exposure that could have caused this.
These studies show correlation, but it is hard to prove causation.
Types of Studies - Cohort Studies
From there we can go to prospective studies, which are called cohort studies. (52:44)
This is where you take a group of people and you follow them over time.
So instead of comparing diabetic and non-diabetic people, you take a pile of people and see which ones develop diabetes.
These are much stronger studies because there is much less room for selection bias.
This study provides a much more rigorous data set.
You have a lot less challenge with selection bias.
These studies show correlation, but it is hard to prove causation.
Types of Studies - Mechanistic Studies
Sarah places a high value on mechanistic studies. (54:46)
These are mostly animal studies and cell culture studies.
With these, you are trying to explain how something is linked.
They provide mechanistic insight and improves understanding of an effect.
It also proves causation by explaining why/how an effect is seen.
Subsequent human trials are required to verify the predicted effects of the intervention.
Types of Studies - Randomized Control Trials
This is considered the gold standard. (56:27)
Subjects are randomly assigned to a test group, which receives the treatment, or a control group, which commonly receives a placebo.
You can then design these to control for different types of bias.
“Cross-over” trials: participants switch from control to treatment, or from treatment to control, groups half-way through the trial.
"Blind” trials: participants do not know which group they are in.
"Double-blind” trials: neither the participants nor the experimenters know which group the participant is in.
Blinding trials helps to remove subconscious bias.
Sarah shared other ways you can remove bias.
You still need to combine the data from a randomized control trial, which is the intervention.
When you have enough information to make a prediction about what is going to happen, you run the intervention to see if your prediction is correct.
However, you still need the mechanistic studies to support that data because they explain why.
Types of Studies - Meta-Analyses
From there that are meta-analyses. (1:01:27)
This is where we pool together the data from multiple randomized control trials and look at a much bigger data set.
And this is a really great way to look at a bigger body of evidence to see if an effect still happens even with all these differences.
Looking at a meta-analyses helps us determine whether a difference is based on how a trial was set up versus a true difference.
These are really important types of studies to do.
Types of Studies - Systematic Review
The height of scientific evidence is called a systematic review. (1:02:22)
This is where you go through meta-analyses all the way through the randomized control trials, you look at the cohort studies, and then you look at all the mechanistic studies.
From there you are able to say, ah-ha, here is what this huge body of scientific evidence tells us, and here is the explanation.
This is again something that Sarah puts a lot of stock into as she is going through something.
They take into consideration the quality of the studies included.
Reviews can help mitigate bias in individual studies and give us a more complete picture.
Lastly, they are the best form of evidence, and either develop consensus or indicate the need for further studies.
How to be Objective
The main takeaway from going through those types of studies is to understand that none of them by themselves is the proof. (1:04:42)
The correlation does not equal causation.
Sarah has a hard time when people approach research with a conspiracy theory mindset and think that the one study that shows the difference must be the truth.
When we ignore the 90% of studies that show the other thing.
Sarah also gets really upset over dismissing that one study because it shows something different.
What it shows is complexity.
To Sarah, she wants to understand why that one study shows something different than the rest.
So that is another thing to look out for.
Avoid cherry-picking and dismissing research.
Science is the pursuit of truth, it is not the pursuit of backing up your opinion.
If it doesn't back up your opinion, change your opinion. That is the scientific method.
The other piece that upsets Sarah is when she sees the dismissal of papers because they were done in a small number of people.
This is the last piece of the thread to pull in here.
Statistical power is related to the standard deviation and the magnitude of the effect.
Sarah explained this in greater detail and why it is a key detail in this all.
Scientists are trained to answer the question with as little use of resources as possible.
This means as small a sample size as possible, and this is because no matter what type of experiment you are doing, increasing the sample number has costs associated with it.
Scientists are trained to do the minimum number of experiments to have statistical significance.
Understanding statistical power is the most important because it is about understanding the magnitude of the effect and how to measure that with confidence.
Not every study needs to be done in 200,000 people to be relevant.
The thing to look for is to look at those P values and look at whether or not that data reaches statistical significance.
The Takeaway
For our listeners, the biggest thing that we want you to take away from this discussion is understanding that if a scientific study is worthy of dismissal, then it is a flaw that is going to get that study retracted. (1:13:48)
The scientific community is really good at policing itself for quality.
Don't let somebody without a science background who is selling you some kind of supplement tell you that the paper being looked at is irrelevant or wrong.
It is not, because if it is it will get retracted.
We have all these different ways in the alternative health community to dismiss science.
The problem with that is when science is really important and relevant, we are basically training ourselves to be conspiracy theorists.
We are training ourselves to dismiss science.
It becomes a slippery slope when we find excuses to dismiss papers, making data meaningless.
When presented with conflicting evidence, if you see dismissal of that evidence, a red flag should go up.
The building of scientific evidence is what is important.
With an open mind to what conflicting data can actually reveal about a system - that is where we can be informed by the science in a way that improves our lives.
At the end of the day, science is all about improving our lives by increasing human knowledge.
Stacy noted that we need to be mindful that this information is complex and we need to be asking if this is coming from a credible source.
For Stacy, she personally looks to review a summary or an abstract and checks the sources from there for any possible flags.
Sarah took a moment to share on intervention studies.
For Special Consideration
There is a type of animal study that is called an intervention study that is called an intervention study. (1:20:20)
This is like the randomized control trials that we do in humans, but we are doing it in animals.
And this is used a lot in drug development and vaccine development.
This has a different weight to a mechanistic study.
You cannot necessarily draw a straight line between data found in an animal study and what to expect in humans.
A mechanistic study is about understanding the biochemistry - understanding how something happens.
Where an intervention study is about measuring the magnitude of effect from this manipulation point.
This is where you do need bigger sample sizes.
And you can't say that because something worked in rats, it will work in humans.
Another thing to look for in smaller studies is the definition of the population that is included.
Sometimes that does mean that you take the information with a grain of salt before we start expanding that information to the general population.
When it comes to vaccine development, one of the challenges is that we want to give it to the entire population.
We need studies that show the safety profile in a heterogeneous population, people with genetic differences, and different conditions.
A study also needs a bigger population to determine if those adverse reactions are happening with this vaccine and the frequency of them.
Having those large sample sizes for an intervention trial is about having a sample that represents the general population so that we can identify efficacy as well as safety.
This is the type of study where you want a really big population.
When a covid vaccine is available, we will dedicate an entire episode to this topic and Sarah will dig in on the science.
We have reached a point where science has become politized and it shouldn't be.
Closing Thoughts
Context is important. (1:27:31)
It is very easy to cherry-pick a quote that someone says and apply it to completely different circumstances.
We are talking about not cherry-picking information, and continuing to educate ourselves.
It is important to look for opportunities to continue learning and expand our understanding of what works.
If you here us have a show about something that contradicts your current opinions/understandings, don't just listen to twenty minutes of the science and skip past the conclusion.
When you just read/listen to a certain part, or skim the information, you will miss important pieces of the whole.
We do our absolute best to always be broad in terms of what we are talking about.
Stacy shared an example of how this plays out with research on red wine and how this plays out in a large sample size.
It is not fair for us to boil down the complexity of science to a soundbite or a sentence without context.
We appreciate your patience and understanding as we try to navigate and boil oceans sometimes on this show.
Our goal is to keep shows to under an hour, and we are rarely able to do it.
We want to make sure that we aren't coming out with a show and sharing simple bullet points on the subject.
Sarah shared her thoughts on how our society's current health standards have shifted the way that we seek information.
It is important to be cautious of predatory marketing practices.
Being willing to revisit recommendations and have a new conversation about something is the scientific method.
It is different than being wrong before - iterating on human knowledge is science.
Sarah shared her excitement for where we are currently at with nutritional sciences.
The reality is that nutritional sciences is young enough that right now we are drawing the best conclusions that we can with the date we have.
However, there is a lot of unanswered questions that science needs to answer for us.
Stacy found it fascinating to look at the relative newness of nutritional sciences when compared to other areas of research.
This is what we are here to do for you.
Sometimes we might find something that contradicts something that we said before.
What Stacy loves is that we are willing to say, well, this is new and it is time to revisit this topic.
You do the best that you can with the knowledge that you have at the time.
The responsibility that Stacy feels we all need to have is to continue to learn so that that knowledge doesn't stay static.
This is where science is magic.
Sarah hopes that this was helpful for our listeners.
We would love to hear your follow up questions, which you can submit via social media or the contact forms on both of Stacy and Sarah's sites.
Thank you for listening!
We will be back again next week and we will strive to make it a shorter show! (1:39:39)
Thursday Sep 17, 2020
Episode 422: Banning Sneaky Toxins in Beauty Products
Thursday Sep 17, 2020
Thursday Sep 17, 2020
Welcome back to episode 422 of the Whole View, where it is upside down world again and Stacy is leading this week's show. (0:27)
Stacy has an exciting update on toxins in personal care products and she wants to share some good news.
In everything that is happening in 2020, celebrating good news is very important.
This year, in January or February, Stacy mentioned that there was an actual hearing that moved progress at a federal level.
Then it was sitting in committee, which is what happens when a bill is made.
There are two bills that are passed and are sitting on the governor's desk in California.
California has a lot going on right now, so they aren't yet signed and in action.
Sarah took a moment to acknowledge our West coast listeners.
We are thinking about you, we hope you are safe, and we know that this is a lot on top of what has already been a lot.
Know that you are all on all of our minds - please take care.
California, Oregon, and Washington - we are sending all our love.
Sarah talked to Stacy about the satellite images from the fires.
Stacy is personally donating half of her commission in the month of September to support food access for those who have been displaced from the California wildfires.
She has such a hard time processing all that is currently going on in the world, and giving her time and money is a way that she is able to positively impact the negative.
Two Bills in California
California represents one-sixth of the United States economy and passing laws there means that businesses have to abide by those rules. (5:28)
Some brands may decide to come up with two formulas.
However, when Stacy says that there are two bills passed and awaiting approval in California, it is a great sign.
It means that we as US consumers of those materials will most likely benefit from them on almost all products.
So while it is a California bill and not a federal bill, these things are incredible for the benefits of everybody.
These bills have been so important to Stacy and her mission.
We didn't know if and when we would see progress on these, so seeing both of these come up in the last few months has been an incredibly positive lift.
Stacy wants to talk a little bit about both of these bills and what they mean to everybody.
Sarah also has some science to share on this all as well.
If this if your first time tuning in and hearing us talk about toxins in personal care products and you want to learn more about this subject, check out these previous podcast episodes: 290, 331, 339, and 395.
Safer Fragrance Bill
The first bill is the Safer Fragrance Bill, which you can learn more about here. (8:05)
This is the first major step towards closing the fragrance loophole.
You have heard us talk about this loophole here before.
When we think about the fragrance loophole, it is not just the toxic ingredients that can be in there.
It is also the ingredients for people with allergens who are trying to avoid things that could cause them personal harm.
This loop prevents them from knowing what is in it because it is literally all hidden under a category called 'fragrance'.
In general, a brand can say that something is proprietary and trademarked as part of its formula and put it all under the word 'fragrance'.
When Stacy is shopping for any sort of product, if the word fragrance is on it - she is out.
Even if a brand says 'natural', it still feels suspect since the brand is choosing not to disclose that information.
Currently, international trade secret laws keep these full ingredient lists secret.
The California legislature is requiring companies to report the fragrance ingredients that have been deemed hazardous by federal government laws and prop 65 or could be potential allergens.
You may still see fragrance and not know exactly what is in some of them.
However, the law is requiring that anything that has been deemed hazardous at all in America is disclosed.
Sarah noted that it is easier for brands to make their products both available for retail in California, as well as nationwide.
If it is disclosed on the product label in California it will have to be on their California Safe Cosmetics website.
You as a consumer, if you are picking something up and it says fragrance, you could then go to that website and see what would be disclosed on that product.
The items will have a prop 65 warning on them and then you would go to the website to see what it is in them from a toxin or allergen perspective.
Favorite Safe Brands
Stacy does want to take a moment to mention some brands that they both use that do not include fragrance. (13:33)
They are all scented but from a natural perspective.
The brands that Stacy has come to use and trust are Beautycounter, Primally Pure, Herbivore, and Henry Rose.
Ninty-five percent of what Sarah uses are from two different companies.
Allitura and AnneMarie Skincare are those two brands.
Sarah would call these both sophisticated crunchy.
They are using science-backed ingredients that are known to improve the health of the skin.
The ingredients in these two brands are plant extracts, natural clays, and there is not a single ingredient on either of their labels that is a wonky chemical.
Those are Sarah's go-to's that her skin responds to.
Sarah noted that there is a bio-individuality when it comes to what our skin responds to.
There are other companies that are doing great work that are keeping their products super clean.
Sarah noted that there are small companies with very high standards about how they source their ingredients.
Just like with any food you consume, be consistent with reading labels.
Formulas change, so be sure to read the ingredients every time.
You can look up ingredients using EWG.
They have a skin-deep database where you can take a picture and scan the barcode of an item to check its safety.
Beautycounter is doing a pop up in Sephora right now if you want to check them out.
Stacy does call this brand out because they are also leading and paving the way in lots of this legislature.
It was their lobbying efforts that brought a portion of this to fruition.
They are also doing safety testing and putting it out there so that other brands can utilize that testing information.
Stacy wants to see the government doing this level of testing as well.
The good news, bad news, on all of this is that it will take companies time to implement these things and to figure out how to be compliant.
We can expect to see this implemented by January 2022.
Toxic-Free Cosmetic Act
The other law, that Stacy is even more excited about, won't go into effect until 2025 because it is much more complex. (19:26)
The Toxic-Free Cosmetic Act is the first in the United States since 1938 to ban some additional ingredients.
We are talking about twelve of the worst offenders, frequently found in personal care products.
All of the brands mentioned above, do not have any of these offenders in their products.
It will spur companies to reformulate and remove these harmful products.
This will also bring safer products to the US market.
Stacy will say that a lot of the brands in department stores, already have formulas available for purchase in Europe, without these toxins in them.
There are eleven currently banned under the 1938 law.
The list of banned ingredients includes: Formaldehyde, Paraformaldehyde, Methylene glycol, Quaternium-15, Mercury, Dibutyl phthalates, Diethylhexyl phthalates, Isobutyl parabens, Isopropyl parabens, m-Phenylenediamine, o-Phenylenediamine, and Per- and polyfluoroalkyl substances (PFAS).
These ingredients are in most personal care and household products, which is why this won't go into effect for some time.
Our hope is that brands will modify their products for consumers across the US.
However, please be aware that perhaps, companies might sell one formula in California and a different formula to other US states.
We will have to see what happens in a few years.
This is huge news!
Many of you helped to make this a reality.
Stacy mentioned this study that is being done in California.
They are looking for participants, and anyone in California is eligible to participate.
Be sure to look into it!
Racial Disparities
There are racial disparities in personal care products. (24:27)
Stacy mentioned the information in this article and the racial disparities in cancer risks, caused by beauty products.
There are many studies, showing how people of color are being exposed at higher rates to these pollutants and toxins that are in hair care products.
The cosmetic products that are marketed to women of color, such as skin lighteners, dyes and hair relaxers, nail polish, contain some of the most concerning chemicals used in cosmetics.
The twelve biggest offenders mentioned above are in these products and are known hormone disruptors and carcinogens.
It is truly incredible to Stacy that we are in the year 2020, and there are marketing techniques that are marketing products that we know are more toxic and unsafe to women of color.
Yet it still happens.
It is not ok.
Stacy is grateful to have found this study that is looking to quantify what is happening.
We have information that we can point to about the type of ingredients that are in certain products.
And we can look at studies that show higher rates of disease linked to using products with these ingredients.
However, until we know exactly what is in products, and what is in people's blood to show what is happening, it is hard to actually do this.
Sarah shared her feelings on how very unfair these marketing practices are.
These products have a 'you don't look right' message behind them, which Sarah feels is so fundamentally wrong and terrible.
Sarah feels that the predatory marketing is so problematic, especially when these products are damaging to health.
There are studies that have tried to correlate this information before, but we need to stop marketing products this way.
It is not ok to rely on these toxic chemicals.
People of color are already disproportionately impacted by environmental pollutants, more likely to have led in their tap water, etc.
There is already so much systemic racism and injustice that is impacting these communities.
It is just another layer on top of that and needs to end.
This is just another piece of this systemic racism puzzle that needs to be addressed.
Sarah is happy to see California wrapping this into their prop 65 warnings.
The skeptic in Sarah is worried that these companies are going to go to another ingredient that is also bad, trading one bad for another.
Stacy reminded Sarah that positive is positive and we are focusing on the good.
There was a study that was done on lupus rates and why we see a higher diagnosis rate in minority women.
We can point to a lot of the products that Sarah mentioned as being so much more harmful than a simple product.
It is a snowball effect of how early are you exposed, how much are you exposed, what are the type of products/ingredients you are being exposed to - to quantify the problem.
There is a problem across the board for everybody.
However, we see that it is extreme on this side.
Positive Changes
Stacy mentioned this incredible study that showed how quickly our health can change when we make a switch to safer products. (37:16)
As always, don't look back at something you have done or have used and feel quilt.
We can only focus on what we can do going forward and be aware.
It is never too late to text 'betterbeauty' to 52886 to get your lawmakers to support these when they come up.
There is also something called CEPA Reform that Stacy wants to mention, known as the Canadian Environmental Protection Act.
If you are in Canada, you can actually sign a petition asking parliament to pass policies that strengthen CEPA by banning harmful ingredients, encouraging transparency, and protecting vulnerable populations.
The Worst Offenders - Formaldehyde
Stacy does want to talk about the bad ingredients and why California would choose to ban these. (40:36)
As we look at the worst offenders, it is important to understand what they are and why they are so bad.
We understand that no exposure is a safe amount of exposure for these twelve chemicals.
This is a few different collections of highly related chemicals.
The first four that they are banning are different forms of formaldehyde.
Those four are: Formaldehyde, Paraformaldehyde, Methylene glycol, Quaternium-15.
Formaldeyhde has been known to be a human carcinogen.
On top of that, it is also an irritant to skin, eyes, and lungs.
It can be found in just about any makeup product that has color.
You can also find it in hair straighteners, nail polish, nail treatments, nail hardeners, shampoos, lotions, soap, and deodorants.
There are multiple roots for absorption through the body with these products, which is another reason why it is so problematic.
The Worst Offenders - Mercury
This is crazy that this isn't banned already, but the heavy metal mercury is also on this list. (44:41)
There is this super awareness of mercury in seafood and why we need to pick seafood with lower mercury levels.
Mercury is a neurotoxin.
Sarah explained the way that mercury is absorbed into the body and the impact it has.
In particular, exposure can damage the kidneys and the lungs can cause kidney failure.
Mercury is in a lot of antiaging products, blemish treatments, and skin lightening products.
This is why it is important to double-check the products you are using.
If you would like help figuring out how to avoid them, Stacy would be happy to help point you to some safer options.
The Worst Offenders - Phthalates
The next chemical is phthalates and is one of the compounds that are in plastics. (48:02)
There is something well understood about this chemical to be an endocrine disruptor.
They can be easily absorbed through the skin and inhalation.
You can also get them through the oral route as well.
There are two phthalates in particular that are being banned in this new law - Dibutyl phthalates and Diethylhexyl phthalates.
These are some of the best understood.
Dibutyl has been shown to be a developmental toxicant, which means it is toxic to a developing fetus.
It has been specifically shown to harm the male reproductive system, and even cause early puberty in boys.
Diethylhexyl also harms the reproductive system and is also a developmental toxicant.
It is also classified as possibly carcinogenic by the International Agency for Research on Cancer.
These phthalates are in a lot of fragranced household products.
Sarah provided examples of these products.
Stacy mentioned a room spray by Primally Pure.
Also, check out this brand of scented trash bags that are free of chemicals.
The Worst Offenders - Parabens
The next chemical class is parabens. (58:13)
Parabens are typically used as preservatives.
They prevent the growth of bacteria or fungi that might cause spoilage of a product.
Parabens are well known to be endocrine disruptors.
There are Isobutyl parabens and Isopropyl parabens.
They have the strongest estrogenic activity among all of the parabens that are widely used in personal care products.
The consequence is that they are estrogen mimics.
So they have pretty strong reproductive toxicity, but they are also strongly associated with estrogen-related cancers.
They are found in shampoos, conditioners, lotions, cleansers, shower washes, and scrubs.
The Worst Offenders - Phenylenediamine
The other ones are m-Phenylenediamine and o-Phenylenediamine, which have fairly strong mutagenic properties. (1:01:22)
They cause mutations in our DNA, which are one of the things that lead to cancer.
When they are mixed with hydrogen peroxide they have mutagenic properties.
This happens all the time since these are common in hair dyes when you are getting your hair lightened.
Stacy mentioned that she use to cough when she was getting her hair colored.
The product would be burning her scalp and then she would be coughing a lot.
Looking back at that, she was ingesting the steam and the air from these chemicals that were mixing together and her body was telling her it wasn't right.
Sarah noted that there is frequent exposure since people have their color updated as their hair grows.
There are temporary dyes that aren't as harsh.
Morroco Method is the brand of hair care products that Sarah uses, and they have henna hair dye options to look into.
Also, look for organic salons in your area - they will be able to help with product and treatment options.
The Worst Offenders - PFAS
The last one on the list is polyfluoroalkyl substances, which are also called the forever chemicals (PFAS). (1:1119)
They have been linked to all kinds of problems.
These chemicals are carcinogenic, immunotoxic, causes liver damage, harm to the reproductive system, and harm to developing fetuses as well.
We think of PFAS as being the thing in Teflon.
It turns out non-stick is something that you would also find in a variety of cosmetics.
These products include dental floss, nail polish, eye makeup, and facial moisturizers.
It is called a forever product because it never breaksdown.
We don't really still know how it builds up in the human body.
This is one of those chemicals that we need to get rid of in everything.
It needs to be not made anymore.
Stacy recommends this dental floss.
Closing Thoughts
Stacy feels like we have covered a lot of ground in this show. (1:36:34)
California is paving the way for hopefully the rest of the country to follow suit eventually.
We hope to see both of these bills become formally and officially signed relatively quickly.
If you are in California, go ahead and shoot him a quick note that you are proud that he is about to sign these into action.
We are excited to see some progress in this area, especially given how far behind the US is compared to Europe and Canada.
Thanks for hanging in!
We will be sharing our real thoughts on this topic over on Patreon, so be sure to stop by there.
If you have follow up questions, comments, suggestions, compliments, we love hearing from you.
You can reach out via social media or via email.
Don't forget to also sign up for our newsletters.
Thanks for listening - we will be back next week! (1:18:26)
Friday Sep 11, 2020
Episode 421: The Science Behind Body Image
Friday Sep 11, 2020
Friday Sep 11, 2020
Welcome back to the Whole View, episode 421 - also known as the best episode of our podcast ever. (0:27)
Stacy wants to preface this show by saying that she read an article called, The Racist Roots of Fighting Obesity, several months ago.
This article blew both Stacy and Sarah's minds in the best way.
They both felt very strongly that they needed to continue to tackle the concept of body image and fatphobia.
However, they wanted to continue this discussion in a scientific way.
There is research and science out there showing how absolutely terrible dieting and fat-stigma is, and what that is feeding into this concept of America getting unhealthier over time.
Before we fully jump in, Stacy also wants to say that no matter who you are or what your health situation is there is no judgment in this show.
Regardless of who you are and what your body looks like, this show today is about just that.
This show is about how our body and our weight does not determine our worth.
It does not determine our health.
Ultimately, it is a vessel to carry us through life, which we want to be as full as joyous and wonderful as we can make it.
This is why we do this show - so that you can find ways to healthfully, sustainably, and in a positive way, bring you to your best self.
We ask of you today and are asking ourselves as well, to challenge and reframe your thinking fatphobia.
More on the Inspiration for this Discussion
This is a journey that Stacy has been on for her whole lifetime, but has been actively working on understanding fatphobia and how it leads to unhealthiness for a couple of years. (3:44)
There is still so much work for her to do, and so much for her to learn.
She is excited to share this topic with listeners today with a scientific perspective.
We have covered this topic a couple of times on episode 353, 358, and have also touched on this conversation philosophically on many other occasions.
Finding that Scientific American article a couple of months ago had an immediate impact on Sarah when she read it.
The concept that the stigma associated with being overweight or obese is far more harmful, if not the harmful thing, about being overweight or obese.
Sarah noted that Scientific American articles are always so well cited.
The author of the article mentioned above was previously known for her work on the 'Fat Is Not the Problem -- Fat Stigma is', which was released in 2019.
Sarah shared more on Dr. Bacon and the program she created known as Health at Every Size.
She wasn't aware of this field of research until she found Dr. Bacon's first article.
It is really hard to separate out the impact of being overweight/obese versus weight discrimination.
Weight discrimination is experienced across the spectrum.
Sarah became really upset with the information she found because she couldn't help but put this research into the context of her own health journey.
She did want to mention that Dr. Bacon does have two books, which you can learn more about here.
Discrimination
Weight discrimination is, by different ways that medical researchers measure this, is the most pervasive form of discrimination. (9:07)
Stacy noted that this is a form of discrimination that is legally allowed.
Despite Sarah's personal experience with weight discrimination, she did not really think of it in terms of this ubiquitous experience.
This form of discrimination intersects with sexism, racism, and classism.
So an overweight woman of color is going to have the layers of discrimination on top of each other.
These are additive layers.
This medical research comes from the intersection between sociology, physiology, and psychology.
To see this written out in a scientific article written out in a scientific journal was really eye-opening for Sarah.
What is really problematic about weight discrimination is that it causes this basic chronic social stress.
Studies have shown that weight stigma is more harmful to health, above and beyond any impact from BMI.
It becomes a self-fulfilling prophecy.
People who experience weight discrimination or perceive weight discrimination, that there is a very strong link between that perception and increased weight.
There have been studies that have looked at this that have shown that people who experience weight discrimination are two and half times more likely to become obese over time, and three times as likely to remain obese and not be able to lose that weight.
It ends up becoming the problem in and of itself.
Over time weight discrimination ends up increasing weight.
This is very problematic because the discrimination is a risk factor for health that then magnifies itself.
Sarah wants to emphasize that this is a really big challenge.
Redefining the Problem
There is a stigma that if you are overweight/obese that it is a personal failure. (14:30)
Obesity can be a symptom of something that is going wrong, and this is not something that is well understood.
It means that we need to be looking at a root cause, rather than saying that obesity is itself the risk factor for the thing going wrong, the thing that is going to cause all of these other problems.
The social stress, the mental health challenges, of being discriminated against because of our weight is compounding an issue that is a root cause that we need someone to help us with.
Dr. Bacon used the analogy that it is like blaming yellow teeth for lung cancer, but it is smoking that caused both lung cancer and yellow teeth.
Sarah feels that she could never find another better analogy than that.
Instead of making it a blame game, it is very important for the medical community, health coaches, and fitness trainers, to be looking at resistance to weight loss and/or obesity as a symptom of something else going on.
Also, we need to be able to look beyond weight as being the problem.
Stacy noted, or we need to not think of weight as a problem at all.
One of the things from the research that was really powerful for Stacy was that you can actually be obese and fit.
Stacy is excited to discuss this element from the research in greater detail.
Weight gain is a symptom of numerous mental and physical health challenges.
In general, as a society, we look at that and define that as not healthy or good.
Eating foods that are less healthy for us and/or moving less is not good for us.
However, calling these things out as choices that are making us gain weight does not help the root cause.
This is also creating shame and judgment and desire to want to comfort oneself with less than healthy choices.
Regardless of what weight someone is, how can we get them to enjoy movement?
And if someone is moving, how the science shows that as being the real measure that we can look at instead of weight.
It is important to find research that reframes these things in a way that can truly drive change if we are all willing to focus on that a bit.
Stacy encourages you to read the references that we will mention throughout this show.
It takes time to dive into things and reflect on them and to then process that in a way that you can impact change.
Fitness as a Metric
The studies that are trying to separate out weight stigma versus weight and the impact of that on health are really fascinating. (22:59)
This is not an easy thing to do.
It is innovative and fascinating to see the way these studies have gone about this research.
Sarah explained the paradigm between BMI and life expectancy, which was explained in further detail in this episode.
This research indicates that our entire perception of what a healthy weight is is probably not right.
Stacy's point about fitness is 100% spot on.
There was a study published in 1999 in one of the top medical journals, and they actually took the time to separate participants out by fit and not fit categories.
They measured their cardiorespiratory fitness and were looking at all-cause mortality.
The fit people, across the weight spectrum, had the same risk of all-cause mortality.
Unfit in normal weight was still 2.2x higher risk, compared to fit in normal weight.
In overweight is was 2.5x higher, compared to fit.
And in obese it was 3x higher, compared to fit.
So it is the magnification of not being fit, with being obese, that serves as the signal.
But if you look at fitness, it is a far more important determinant of all-cause mortality in the study.
This is because healthy habits are really important, which we have talked about on this show before in the context of intuitive eating.
These habits are really important independent of weight and benefit metrics of health independent of weight.
A lot of this research has shown that by making healthy day-to-day choices, this improves things like cholesterol and blood pressure in everybody.
So when we talk about separating out the impact of weight versus weight stigma on health, it really highlights the things that we talk about on this podcast all the time as health-promoting habits being the important thing.
These studies continue to show that losing weight is not necessary for being healthy.
It is much more important to get healthy to lose weight, rather than to lose weight to get healthy.
Stacy and Sarah both shared their personal feelings and experiences with weight stigma and how they felt when they went to a gym.
There was a study looking at 25,000 men over the course of 10 years.
Based on all of their weight, cardiorespiratory fitness was as strong of an independent predictor of cardiovascular disease and all-cause mortality, compared to that of diabetes or other cardiovascular risk factors.
Where Data is Available
For Stacy, she is having all these brain explosions about the base knowledge that is put out there regarding weight and health. (33:21)
Stacy is asking, where is the data that shows that if everyone exercised and ate the exact same that we would all hit this "ideal".
There is no data to show this, and it doesn't exist.
It is hard for us to break this apart because it is so ingrained in the culture.
Stacy realized that our country has a problem when she lost the weight and saw how differently she was treated.
BMI
The entire body mass index was never actually developed as an individual indicator, it was never meant to be applied to one person. (35:57)
It was always meant to be used as a way of measuring entire populations.
When you average it out over a population, then you can start to tease apart some of the interesting correlations.
When you apply it to one person, it has a very high likelihood of being incorrect.
This study found that 51% of healthy people are deemed unhealthy by a BMI scale.
So why would we use something that is a coin flip?
The reason why this type of research is important in cardiometabolic disease is because of two reasons.
One, these are the conditions that have been traditionally linked to overweight and obesity.
This is where the pathologizing of obesity is derived.
It is also important because these are chronic health conditions for which we have a number to follow that we know increases risk.
We don't necessarily have a way of quantifying risk for other conditions.
Sarah provided examples for when these markers come into play when it comes to measuring health.
Cardiovascular Disease Research
There was one study where they took a group of people and they had a control measuring blood pressure, heart rate variability, and cardiovascular stress. (40:20)
Then they had two intervention groups within the study, using presentation scenarios as the structure for the study.
The study was looking at normal-weight people and overweight people.
Sarah referred people to this source.
They've shown that if you are giving this video presentation where people can see you and you have experienced weight discrimination in the past then you have higher blood pressure, heart rate variability, blood sugar is less regulated, cortisol is going to be higher, and your inflammatory markers are going to be higher.
This is such a fascinating way of separating that effect.
Sarah notes how marked this data is, and why this information is so fascinating.
Again, this is why looking at cardiovascular disease and diabetes is such a great model in which to look because we have established risk factors and measurements that are quantified.
Diabetes
With diabetes, studies have shown that there is definitely a link between weight and blood sugar regulation. (43:23)
Sarah wants to emphasize that being overweight is not necessarily the thing that is causing more dysregulated blood sugars.
However, there is a strong association.
The heavier you are, the more likely it is to have dysregulated blood sugars, but the studies show that that is dramatically exacerbated by weight discrimination.
Sarah is not trying to say that having a high body fat percentage is harmless.
What she is trying to say is that the stigma and the weight discrimination on top of that is the bigger effect, or equally problematic effect, as shown by the research.
This makes the intervention point clear.
The intervention point is not to get that person on a diet to lose weight but is instead to get rid of the weight discrimination.
This allows us to break the vicious cycle.
And this is not how this is viewed medically or socially, and this really needs to change.
Sarah referenced this article.
Stronger Predictors
There have also been studies that have looked at all-cause mortality and increase mortality risk. (45:46)
One of the studies was called the Health & Retirement Study and the other was called the Midlife in the United States study.
In both of these populations, it was shown that weight discrimination was associated with a nearly 60% increased mortality risk.
It was the stronger predictor of mortality than any of the other things that they could correct for.
In addition, the association between weight discrimination and mortality was stronger than for other types of discrimination.
Sarah referenced this article and this one as well.
These studies that are trying to separate out the impact of weight versus the mental health challenges that come with weight discrimination are far and few between.
However, there are enough to have some systematic reviews and some metanalysis.
They show over and over again that the far more important thing to be focusing on is not the weight itself, but looking at weight as a symptom and looking at it as a root cause.
Studies have shown that things like healthy eating and activity, these behaviors, really only account for about 25% of the difference in health outcomes.
The other 75% are things like socioeconomic status, exposure to environmental toxins, etc.
These elements are stronger predictors and emphasize that the focus on weight loss as a primary focus is not the right way to go about addressing the public health challenges that are these chronic illnesses.
The USDA dietary guidelines and the dietary industry, which is worth 80 billion dollars a year have magnified fat discrimination, fat-phobia, and fat-shaming when the problem is not the weight itself.
The weight may be a symptom of so many other factors, which serve as the intervention points.
Healthy at Every/Any Size
The idea behind 'health at every size' or 'health at any size' is that the things that matter are not necessarily going to result in weight loss and that is ok. (49:57)
It is about really looking at the mental health piece, because that mental health piece of body shame is really damaging, and combining that with a healthy diet, movement, sleep, and stress management.
Healthy living requires a comprehensive approach that is looking at day to day choices and healthy diet and lifestyle as a point of self-care in an environment where there is no shame associated with overweight and obesity because that is associated with a symptom and not a personal failure.
Stacy took a minute to circle back to this and encourages listeners to please take the time to read this article.
She also talked about how pervasive diet culture is and how it impacts us.
The judgment and discrimination that comes from fat-phobia contribute to factors that reduce health.
It is a big deal that we have science for this.
Sarah shared the details from this study and this one.
The research shows that a weight inclusive approach translates to better long-term behavior changes.
These people are maintaining a more active lifestyle, they are eating more whole foods, they are making more lasting positive change in their day to day choices.
This is because these people are focusing on health and not weight loss.
Sarah feels that this is the big takehome here.
Taking weight loss out of the equation is beneficial.
That doesn't mean that someone who makes all of these changes won't lose weight, it just means that weight loss is not the goal.
Health is the goal.
Weightloss might go with it, and it might not.
It doesn't matter if it doesn't because health is the goal.
None of this discussion is to take away from the importance of a nutrient-dense, anti-inflammatory diet, or getting enough sleep, or living an active lifestyle, or managing stress, etc.
All of these things are still true.
However, instead of implementing these things to lose weight, we are implementing them for the sake of improving health.
Reframing Our Thinking
The thing that has really helped Stacy was reframing her thinking. (58:34)
Getting out and being active is enjoyable.
Part of our problem as a society is the way we frame so many healthy choices as being done for weight loss that it can carry a negative, 'this is work' mindset with it.
We lose the ability to enjoy activities.
As a society, we have come to view exercise as an activity, and we view it as a requirement in a negative way.
For everyone in our life, Stacy wants us to reframe (for everybody in our lives, ourselves included), look for the things that bring you joy, and find ways to do more of them.
The more that we can tell ourselves that, the more we will move away from diet culture.
Stacy feels that it takes a long time to lose away from the 'weight loss is the goal' mentality.
It is so ingrained in us that we have to question it and be acutely aware of it.
When you look to simply find enjoyment in what you are doing, it helps to create awareness and bring you back to the moment.
Letting Go
Even though Sarah has talked about health as being the priority instead of weight loss that doesn't mean that Sarah isn't someone who wants to lose some weight. (1:03:12)
Sarah has thirty to thirty-five years of body image to undo in her own head.
She needs to figure out how to drop this and let it go, and not have weight loss as a goal, not have it as a thing.
Sarah puts a lot of effort into a healthy lifestyle and it makes her feel good.
Through diet and lifestyle and functional medicine, she has been able to manage four autoimmune conditions.
These are the things that are important: how she feels, how much energy she has, what her mood is like, etc.
Sarah knows that it is going to be tuff to avoid sliding into the mindset of, "maybe I will lose a few pounds".
However, she wants to find out how to make that thought process change.
Sarah wants to acknowledge that for anybody who has had a health journey that has included weight loss or weight-loss diets, there is a mindset that is drilled into us.
This mindset is not an easy one to shake.
Sarah wants to wrap up with this science with compassion.
She wants to emphasize compassion for herself, compassion for other people who are hearing this and feeling stuck on how to make that mental shift to find body acceptance.
Sarah doesn't have all the answers on how to do this, but she is working on it too.
This process takes a lot of positive self talk to outweigh all of the years of negative self-talk, and this is Sarah's primary self-focus.
Stacy noted that this negative self-talk compiles onto those negative health factors and potentially gaining weight.
Yes, this is a three times higher risk Sarah points out.
Weight Neutrality
Every time we think about weight as it relates to how our clothes are fitting or whatever justification you're are telling yourself is the alternative to weight loss - remind yourself what you are actually doing. (1:07:21)
You are increasing your likelihood to gain weight that will result in a negative health effect.
This is a good way to stop yourself from justifying that self-imposed diet-talk.
Stacy really likes Lindo Bacon's phrasing of being weight neutral.
So the concept of 'health at every size' or 'health at any size' and being positive are sometimes a little far-reaching, or there is judgment associated with them.
Stacy also feels that it sometimes feeds into this new marketing schtick by people of finding another way of this diet culture to reach you.
Focus on healthy habits.
Focus on the healthy exercise options that you can sustainably do regularly.
Ask yourself how you can improve the nutrient density of the food you are eating and reduce things that cause inflammation or don't make you feel your best.
What can we do to be weight neutral?
To just focus on those things that make us feel good that we know are indicators of health and promote healthy living.
Sarah notes that one of the things she sees is cliques of the health at every size/healthy at any size movement as being a license for people to let go.
However, this is not at all what the movement is about, it is about focusing on these things that are important for health, rather than weight.
The science really does show that weight is not a very good indicator of health.
While we didn't have time to dig into this data in this episode, there is data that shows that if you look at cardiovascular disease risk factors, that there is a large number of "normal weight people" who are not diagnosed.
This is because there is an assumption that if you are a normal weight, you obviously have a healthy diet and lifestyle.
And this is a terrible assumption!
This data shows that we have problems from both sides of the spectrum.
Your weight is not a check box to check.
Closing Thoughts
Stacy is so excited to dive into the medical discrimination factor over on Patreon. (1:13:59)
She has seen this play out both personally and within this community.
The education that health professionals are taught is based on weight being such an indicator, and assumptions to make around it.
Sarah makes such a great point that it is not just about misdiagnosis, that it touches on the other side for people who would not be given the proper medical care that they need because a medical assumption is made that they are healthy based on their shape and size.
This is really a problem, and we are doing a disservice to our entire community and where we are right now.
Stacy thinks this has played into this shift since our great-grandparents when we have begun to see so much change in health.
What was viewed as a healthy body for our great-grandmothers has also changed quite a bit.
Judgment and weight discrimination about bodies have increased as people have more metrics for comparison (video, photos, social media, etc.).
Stacy wonders how these changes have played into our society's overall health.
The more judgments and assumptions are made, the more diet culture is built into billions of dollars industry.
It is not a coincidence that the problem is getting bigger and bigger as the diet industry grows.
We all see it in the science.
This is something Stacy has known for a long time but never knew that there was hard data to support the details.
It really does make you need to step back and rethink things.
We have to be vigilant with our thoughts on weight loss because it is so ingrained, and it is hard to shift your thoughts away.
For Stacy and Sarah, their favorite episodes are the ones that break some barriers in their own minds.
They love the episodes that lead them personally to make some kind of change.
This has been one of those episodes for Sarah.
Once she learned these details, she can't unlearn them.
Now that she knows that this has been a field of research to understand that weight is more a problem from a mental health perspective because of weight discrimination than for the weight itself.
Sarah sees the data clearly that highlights the mental health challenges that come with being the recipient of weight discrimination.
She understands that this is the thing that is harmful and can lead to more challenges that can last a lifetime.
Sarah feels that she needs to reevaluate how she talks to herself about weight, and look at how she broadly talks about weight as well.
This is really important information.
She wants to emphasize to our listeners that she doesn't expect this shift to be easy personally.
This is merely being added to the list of internal work that Sarah has to do in a year that has revealed a lot of need for internal work.
Listeners, thank you for sticking to the end.
If you want to hear Stacy and Sarah's real thoughts on this, be sure to hop over to Patreon to check it out.
We thank you for listening and tuning in.
If you have follow up questions or want to hear more on this topic, we would love to hear from you on social media or via email.
Make sure you are subscribed to our newsletters.
We love to connecting with and hearing from you.
And we hope that you enjoyed this show as much as we did!
Thanks for listening!
Friday Sep 04, 2020
Episode 420: CBD for Pain Management
Friday Sep 04, 2020
Friday Sep 04, 2020
Welcome back to the Whole View, wait for it - 420. (0:27)
And this week we are talking about CBD, for episode 420.
All jokes aside, we did have a CBD episode at the beginning of March for episode 393.
CBD was something that Stacy had to avoid while working full-time, which is crazy because if you are using a high-quality brand there is 0% THC.
However, Stacy has a security clearance that she didn't want to jeopardize.
She had read about it being good for pain management and reducing inflammation, but as of the last episode hadn't tried using CBD for that.
Recently, Stacy had a flair when they were camping and was able to avoid muscle relaxers, heavy-hitting medications, and being completely down for a week, which is what typically happens.
Once Stacy got the initial inflammation down through a few key strategies, the CBD was able to quickly regulate it.
She was able to get her physical therapy in the pool to continue the healing process and had no other issues.
It was crazy!
So today we are going to talk more about Stacy's pain management, and how she got to know what she needed to do to manage it.
Also, how she has been able to add in more strenuous exercise more recently, which she does attribute to adding CBD into her routine.
Sarah has science on the mechanisms for that, which she will explain more.
If you have pain, keep an open mind and find a way to at least try it.
Our Favorite Source
We are partnering with One Farm, the brand that we love for tested, organic, and US-made hemp extract. (3:55)
Because if you are going to try it, we want you to use a brand that will be effective and that is giving you the benefits of CBD that Sarah is going to talk about.
You want to make sure that you use a brand that is tested and safe for you.
This is why we asked One Farm to partner with us, and they are sharing a 15% off code with our listeners.
Stacy recommends a topical CBD treatment as well as consumed, in addition to applying a topical lotion that has the benefits of CBD.
One Farm has an awesome Tumeric lotion, with CBD as the main active ingredient, that Stacy really loves - and it has no orange color to it, don't worry.
Use the code WHOLEVIEW to get 15% off your order using this website link.
If you want to know more about the basics of CBD and more about this brand, be sure to also reference our podcast episode 393.
Sarah has been using One Farm for a long time and they check all the boxes for her.
What inspired her to try CBD was a bunch of questions she received in a session regarding pain management.
At the time she hadn't dug into the science in-depth, but the interest in this topic sparked Sarah to dig deep into the research.
The research essentially talked Sarah into trying it, and she chose One Farm because they are US based, USDA organic, and they do all the right things to ensure the highest quality.
Sarah briefly explained the difference between THC and CBD.
Fibromyalgia pain is really what brought Sarah to incorporate CBD, but she found that it was also so beneficial for her sleep and anxiety.
Stacy's Experience
Very similarily to Sarah, Stacy started with just using it occasionally for when she felt like she needed it. (12:12)
She focused on using it for anxiety, as Stacy didn't think it would help with pain management.
Truthfully, in the beginning, Stacy felt very skeptical of using CBD.
However, after recording episode 393, Stacy realized that it might be more beneficial to begin using it on a regular basis.
Stacy is going to share her personal experience and share the specifics of her regimen.
But please remember, we are not medical professionals.
CBD is a supplement and is not tested or approved as a drug by the FDA, while One Farm is unique in it's USDA organic farming certification.
For a bit of background, Stacy was a competitive lifter and she was Northern Virginia's Strongest Woman.
She competed in the sport of Strongman.
Stacy was working in the garden and took on an in-the-moment physical challenge, which led to a lower back injury.
She went through a whole bunch of doctors and physical therapy for years.
However, it essentially got to the point when the doctor said there was nothing they could do unless Stacy wanted to have surgery.
Surgery would have only led to an 80% recovery, and Stacy was told that she would not be able to lift heavy weights again.
Over the last couple of years, Stacy has been able to get herself to 95%, where she very rarely has a flair and doesn't experience consistent pain like she use to.
Water aerobics and red-light therapy brought some good results, which allowed Stacy to start riding her Peloton bike.
It was also around that time that she begin taking CBD every day.
She doesn't have any pain, all the time, anymore - which is a big deal for Stacy.
Then vs. Now
When Stacy does have a flair it is not as severe as they use to be. (16:45)
A flair use to take Stacy out from work for ten days, she had to get a really heavy prescription and do nothing but lay on her side.
Now she had a flair while she was camping, and the severe part of it lasted four hours until she could take an NSAID.
After one dose of an NSAID, and taking her CBD products, she was able to get into the pool.
From there all she took was CBD.
She was already doing lifestyle factors, consuming low-inflammatory foods, and optimizing her sleep, yet a back flair use to lay her up for over a week and require the use of heavy pain medications to mitigate the pain and inflammation.
Now she is perfectly fine after a few steps and just needs to take the CBD for a few days to keep the inflammation down.
This to her has the potential to change lives.
To know that she has this option changes Stacy's life.
She knowns that can do strenuous family activities, or go on that hike, and even if she tweaks her back she will be ok.
The one thing that she wants to say is that CBD has allowed biking into her life.
When the quarantine began and she could no longer do water aerobics she was crushed.
Not getting her alone time and physical exercise was very hard on her well-being, both physically and mentally.
She got the bike "for the boys" because she was afraid to say she wanted it for herself in case it hurt her back to ride.
Stacy knows that she would have never been able to do that strenuous exercise without this reduction in inflammation.
Being able to take herself to no-pain on the regular, means that if she rides the bike and goes hard it brings her nothing but the positive benefits.
There is no way Stacy could have pushed herself like this before.
Stacy still needs to take care of herself by moderating that her food is optimal for low-inflammation.
If she doesn't take her CBD to keep the inflammation down, it escalates as she sleeps, and when she wakes up the next morning the pain will be at an 8 or 9.
She shares this to show how she reached this point and all the little things that contribute to this big difference.
However, she also knows that there is something very special to the CBD aspect, which Sarah was able to confirm.
Listeners, if you or someone you know is experiencing chronic pain, whatever they need to do to make trying this work - help them.
Stacy was in a place where she had given up, but her quality of life has changed so dramatically since incorporating CBD.
She wants people to know that getting rid of chronic pain is possible.
This is exactly why Sarah wanted to talk about this on the podcast.
The Way it Works in the Body
There is an association with pain killers and being high. (24:24)
So it is a natural skepticism of a pain relief product.
If you are taking a product that is high in CBD but doesn't have TCH, how can it work as a pain relief product?
It doesn't seem like the normal things that we go to for pain without the psychedelic component.
This is why Sarah thinks it is so cool to look at the science because there is actually a lot of it.
To give a brief recap of everything we covered in episode 393, the endocannabinoid system is a system in the human body that is basically the interface between the sensation of pain, the emotional response to that pain, and the physiological response to the pain.
Pain is often caused by an injury, and the body needs to be able to ramp up the immune response in order to heal whatever damage there is.
The context of pain changes how the emotional response is.
It is the endocannabinoid system that is linking all of these things together and puts context to pain.
This system activates the immune response in response to 'I felt pain'.
It is also the system that is responsible for the maladaptation to chronic pain.
Chronic pain comes with mental health challenges and a highly ramped up emotional response.
Cannabinoids, in a variety of situations, has very powerful anti-inflammatory effects, and are both primary and secondary influences on pain.
This means that it influences the primary perception of pain, and the secondary influence on pain is everything downstream from that.
It has been shown to be beneficial in terms of immune regulation, the healing response, mental health, the emotional response to pain, as well as the physical sensation of pain.
Separating THC to Understand CBD
So it has been studied for years and there is a huge wealth of scientific studies. (30:01)
The early studies looked at cannabis as a whole, so a lot of it was looking at medical marijuana use.
Research on pain therapy was being done in cancer patients.
So these studies weren't separating out THC from CBD.
However, over the last few years, there have been a ton more studies that have looked at CBD separate from THC.
There is a huge variety of studies showing that the combination of THC and CBD is effective for pain management.
Sarah referred listeners to this study.
What is really interesting is separating out THC, removing the thing that makes you high, and looking at how effective CBD by its self is.
As this data is accumulating it looks like CBD broadly helps most pain types, but it is not necessarily across the board.
There have been studies that have shown that it works for pain associated with multiple sclerosis, spinal cord injury, brachial plexus injury, and limb amputation, pain associated with kidney transplantation, fibromyalgia, and non-cancer chronic pain.
However, a recent study showed that it did not help with generalized chronic pain, but it did help those patients with sleep, and it didn't help with Crohn’s disease pain.
We are at a point now where the studies are accumulating data showing that it can help in most situations as a very powerful analgesic.
This is where you have to look at dose, regimen, what is going on, possible interferences, etc.
We are still in a place where more science is needed.
Sarah shared where she thinks research on CBD should go next to outline detailed protocol.
For now, we have to really look at individual studies.
Dosage Details
Remember, we are not medical professionals. (33:22)
This is a supplement so be sure to check with your doctor and seek medical guidance before incorporating any new supplements into your routine.
A lot of doctors who use CBD in their practice for various things, they have a protocol for dialing in an individualized dose.
They tend to have people start with a low dose and then creep up to where you have the desired effects.
When it comes to dosage, there is a huge range that had been studied in the scientific literature and there isn't a standardized dose of CBD for specific situations.
Stacy has found that for her own needs that just taking 10 milligrams in the morning is all she needs every day, and this is very little.
The recommended dose on most brand's bottles is 20 milligrams twice a day.
If Stacy has a back flair, she takes about 25.
This is what she needs.
Just as you would tweak your lifestyle factors for what works for you and bio-individuality, when it comes to the science it makes sense that dosage is very individual to you.
Your body may need more or less to feel something.
It is important to ramp up slowly and see what and how you feel.
You do need to find your sweet spot.
Stacy explained what happens if she takes too much and how she found the right dosage for her personally.
Sarah takes 20 milligrams before bed, but she takes 15 if she is having it throughout the day.
She also explained the difference in what she feels based on when she takes it, day versus night.
Stacy typically follows her usage regimen six days a week, and it is only when she is dealing with pain and/or anxiety that she will change up her dosage.
Sarah and Stacy took a moment to discuss the importance of rest and recovery and how this supplement is taken with the goal of aiding in rest and recovery.
We have to do what we can to bring ourselves peace and joy, and to create downtime in our schedules and routines.
Studies on Chronic Pain Patients
There were a couple of really recent studies published in 2020 showing how potent CBD can be as an analgesic. (45:08)
A study that was published in January took 97 patients who had been on opioids for chronic pain for at least a year.
They were between 30 and 65, and it was an even split of men and women.
The study gave the participants CBD in a soft-gel capsule two times daily, and it was a 15-milligram dose.
So they were taking 30 milligrams a day, for eight weeks.
Three of those 97 people opted to not participate.
However, of the 94 that did, the study looked at a bunch of different measurements and they found that in just eight weeks, over half of their chronic pain patients reduced or completely eliminated their opioid use.
This is amazing when you think about the current opioid epidemic.
They also found that their sleep scores improved.
Six of the participants reported that they either reduced or eliminated their anxiety medications.
Four participants reported reducing or eliminating their sleep medications.
The primary goal of the study was to look at how effective CBD was for pain management, and what they showed is that it had these other benefits.
The details on the neurotransmitter impacts were discussed in greater detail in episode 393.
A Study Done on Topical CBD Use
There was another study that was also published in 2020 looking at topical CBD usage. (49:58)
The people who participated had symptomatic peripheral neuropathy.
This group of people used a CBD pain cream that had 250 milligrams of CBD in 3 fluid ounces.
Sarah noted that this is a pretty modest dose.
The study was done over the course of a four-week trial where the patients were divided in half.
Half started with placebo and moved to treatment, and then the other group started with treatment and moved to placebo.
So this is a really good study design.
They were able to show that in just four weeks they had a significant reduction in intense pain, sharp pain, and cold and itchy sensations.
In addition, they reported no adverse events.
Sarah noted that this is what she thinks is really cool, that the safety profile is really high.
It has not been validated as safe for pregnant women, which is really important to mention.
However, in regular adults, there have been studies looking at CBD as a therapy, in addition to studies looking at its use on epileptic seizures in kids.
So there have been a lot of safety studies done, and the data is so strong.
Stacy mentioned this site as her favorite resource for all things pregnant/breastfeeding related.
Closing Thoughts
Stacy is not necessarily blown away or surprised by the science on this, but it is very cool to hear in greater detail. (54:56)
She is also excited to see that people are digging into CBD research in greater detail.
Stacy hopes that her personal experience may motivate someone else to give this supplement a try if they are struggling with pain or anxiety.
Sarah's favorite One Farm product is the unflavored oil, and Stacy loves the lemon flavor in the morning.
If Stacy does take one at night, she enjoys the mint-flavored one.
Stacy uses the topical cream as well.
If you have questions on this topic, please don't hesitate to reach out on either social media or on the contact forms on both Stacy and Sarah's sites.
Please also be sure to subscribe to both Stacy and Sarah's individual newsletter, where they discuss topics like this in greater detail.
Again, we are not medical professionals and are only sharing from personal experience.
Stacy noted that if even one person listens to this show and decides to give it a try and has a reduction in pain, please let her know.
It gives Stacy and Sarah a continued sense of purpose to know what effect they are bringing to listeners as they share on topics like these.
We always love hearing from you, and sharing your story with others also helps to inspire and motivate others.
Thank you so much for tuning in!
Don't forget, if you want to try One Farm visit this website and type in WHOLEVIEW for 15% off.
Thanks again to One Farm for sponsoring this week's show.
And thank you for listening! (59:26)
Saturday Aug 29, 2020
Episode 419: Corn is a gut superfood? No way!
Saturday Aug 29, 2020
Saturday Aug 29, 2020
Welcome back to the Whole View, episode 419 - if we have done our basic math correctly. (0:27)
This week we are talking about corn, which Stacy has so many questions on.
Stacy wants to know why corn is often not suggested and comes out in a way you can recognize.
We all want to know and are sure that Sarah is going to answer these questions.
There are a few things going on here, Sarah notes.
Listeners, you know if the episode begins with a poop question from Stacy, it is only going to get more interesting from there.
A listener question inspired this week's episode, but Sarah wants to give a little bit of history to this topic as well.
Sarah's Microbiome Research
Sarah had been talking about her new gut microbiome eBook, which is called the Gut Health Guidebook. (2:51)
The gut health cookbook is coming out in a few weeks, which is a companion and an extension to the eBook.
One of the things that she did with these eBooks was taking a step back in her research approach from Paleo and AIP.
Sarah worked to look at the science as objectively as she could to understand what the science says.
There were a number of foods that surprised her during her research and one of those foods was/is corn.
Sarah's inbox blew up when she shared this information with her e-newsletter subscribers.
So we are going to talk about this science and why it was so important to Sarah to approach the research for this eBook from a neutral standpoint.
Listener Comment
Linda wrote, "I LOVED your latest podcast with your mother. (4:13)
My husband is a retired educator who worked in both BC and at the Alberta Distance Learning Center in distance learning.
So, everything your mother talked about are words that I have heard over and over.
We live on the east coast in the province of New Brunswick now where he is a retired distance educator at UNB.
Even though I don't have children at home, I listened to every word of this podcast.
I loved what your mother said about journalists.
As a retired journalist, I can relate to the deadlines!
I am 70 and have 7 grandkiddies and am sending this podcast link to my own kids.
Around 6 years ago I began on a very strict Paleo program.
There was a time I listened to probably a dozen- or more - Paleo podcasts.
Yours and Stacy's is the only one I am currently listening to.
I have evolved into a natural way of eating, and away from some of the strict dictates of the old Paleo diet. I do eat gluten now.
And I trust your scientific approach.
You have gotten me to eat mushrooms!
As well, I watch every single one of Stacy's lovely Instagram posts about her life.
Peace to you both during this most difficult time."
Stacy shared her thoughts on the way the show has evolved over time and is so grateful for all that Linda shared.
Sarah told her mom that she did such a fantastic job last week and Linda is the listener comment to prove it.
Evolving Beyond Paleo
Linda's question touches on the evolution of what Sarah considers to be the root of the Paleo diet years ago. (8:36)
It was about looking at the science available at that time.
From 2011 to 2013, Paleo had these big conversations within the community.
Are potatoes Paleo was the big debate in 2011 and 2012.
There used to be a more direct connection between blogging and researchers, which provided direct feedback between influencers and scientific information.
The Paleo diet has always been designed for general health, and then you can kind of layer on as necessary from there.
Way back in the day, the community came together and potatoes were accepted.
We did the same thing around green beans and peas in the pod.
What has happened to Paleo over the last few years is the development of a disconnect between looking at the big picture that science is providing.
Research is constantly evolving and we have to take these updates into account when forming opinions.
This is why this podcast has evolved beyond a Paleo podcast because we are staying rooted in science.
As we reevaluate the merit of some foods, this pulls us away from the rigidity of where the Paleo definition currently stands.
Defining Your 80/20
Stacy pointed out the importance and value of utilizing an elimination diet to see what works best for you. (12:24)
Everyone needs to figure out what is best for them and their unique goals.
Sarah shared on how her approach hasn't changed, and how she has always used data to inform her choices.
It has always been about understanding the physiology and biochemistry of how foods interact with the human body.
Sarah also shared how her latest research for her new eBook has shaped where her understandings currently lie.
Looking at the microbiome gives us more data to go on in terms of informing who these foods might work for and who they might not.
This is the exercise that she wants to go through in this week's episode in looking at corn.
It is a really great example of a food that has been governed by that 80/20 rule.
If we start looking at the science, we can see a much more detailed picture that can help inform whether or not this food is going to work for you.
And it will not work for everybody.
This rooted in science approach is the same approach we have always taken on this podcast, and that Sarah has always taken in her articles online.
And we are continuing now that sometimes things align with the Paleo framework and sometimes things don't.
It doesn't change how we look at the merits of food.
The criteria is and always has been - what is the nutritional value?
How does it impact insulin, hormone systems, immune health, and gut microbiome health?
Can we see if there is a tradeoff? Or is it a clear winner?
This is the same approach we have always taken and will continue to take.
Today we are applying that to this specific example.
This will convey how we look at foods in this sophisticated way, as opposed to just lumping everything up into food groups that are either 'yes' or 'no' food groups.
Listener Question
Our listener question this week is from Natalie. (19:47)
Natalie writes, "I was stumped by corn as great for the gut in your newsletter Sarah.
I thought it was extremely hard to digest.
Could you please share why it is now good for the gut?
Thanks!"
There is some nuance here, as corn hasn't changed.
Sarah thinks that corn has not benefited from the same community conversation as potatoes, rice, and edible potted legumes in the Paleo community.
Corn just hasn't had the benefit of people going back into the scientific literature and trying to understand what corn has to offer.
Sarah has done that work of going back into the literature to understand how corn impacts the human body.
This was motivated by spending six years works on a book about the gut microbiome.
Broad Classifications
Lets preface this conversation with touching on the too broad brush that the Paleo community has painted some foods with. (21:42)
Paleo has typically been described as 'eat like a caveman'.
With the idea to eat the way our Paleolithic ancestors ate - like a hunter-gather.
From there, it is described as no grains, no legumes, no dairy, no processed or refined foods.
The standard definition of Paleo has always been what you don't eat.
What you don't eat isn't the thing that makes your diet healthy.
If we lump together all grains, we are lumping together wheat, rice, barley, corn, and all of these different foods and treating them all as the same.
The same is happening with legumes.
We are treating peanuts and soy the same as black beans, lentils, and chickpeas.
The same is also happening with dairy.
When we look at how foods impact the composition and metabolic activity of the gut microbiome, we have the opportunity to separate out the harmful foods from non-harmful foods.
Instead of taking foods and lumping them all together, we have room to be more detailed in our analysis.
This is really important because there are a lot of ways to look at how foods within a broad category impact our health.
No matter how you dig into the science, you see that not all grains are the same.
If you look at the Paleoanthropological record, there are examples of legume and grain consumption.
Instead of creating rules at this macro level of food groups, let's get much more granular and look at individual foods.
Even if we take this Paleo approach to food, there is enough evidence from both the Paleolithic record as well as modern studied hunter-gathers to indicate that a whole food group approach is not enough detail.
We are missing out.
The more we can vary the diet, vary the nutrients, the phytonutrients, the fiber types, the greater the benefits.
If we can revisit some of these foods, we will get away from dogma and yes/no food lists.
We will also create a framework that is more accessible, which is extremely important.
Starting with the Gut
Why is the gut microbiome a great way to evaluate the merits of individual foods? (31:19)
What types of bacteria want to live in the gut are directly related to the environment they live in.
They are very sensitive to the Ph and the food they are getting to eat, which is what we are eating and not digesting.
Depending on what foods they are eating, that will feed different species.
It is a very sensitive ecosystem to permutation.
You can change your diet and completely change the species of the bacteria that are thriving in your gut in as little as two to three days.
We can measure it pretty easily now as well.
By looking at the bacterial DNA and RNA in stool we can get a pretty good picture of what is living in the small and large intestine.
We can also utilize animal studies, which are a good way to understand gut permeation in the gut microbiome.
It is relatively straightforward to measure what is happening in this system.
Sarah explained more about how we can measure differences.
The more we learn about what our gut bacteria do, the more true the statement is that they do everything.
They basically act as a virtual digestive organ and are basically controlling the health of every cell.
The microbiome is the master controller that is controlling the assembly of the proteins that glue the small intestine cells together.
We can't fix a leaky gut without fixing an unhealthy gut microbiome.
It becomes a central point since they are involved in the health of every cell.
At least 90% of all disease is linked to the gut microbiome in some way.
Sarah shared a list of the many things that gut dysbiosis is linked to.
Stacy wants to know how we can moderate these things for ourselves so that we are feeding our gut bacteria in a way that promotes them to be happy and healthy.
Food is not the only form of medicine.
There are a lot of things in lifestyle that lead to gut health being affected.
No matter what you do, in some cases, things will be impacted regardless.
Give yourself grace that you do the best that you can with the knowledge that you have.
If you continue to have some of these symptoms, that is what modern medicine is for.
Sarah reminded listeners of the fundamental things that are important for gut health.
Surprising Gut Microbiome Friends
As we get into the other foods, there is this whole collection that is good for the gut microbiome but isn't foundational necessarily. (42:23)
If there are foods that you can't tolerate, your gut microbiome is going to be fine if you are doing all the other things.
Sarah thinks this is where corn fits.
As Sarah was going through this research, there were a number of foods that surprised her that fell into this collection.
Certain foods she was expecting, especially based on their fiber measurements.
Here are the ones that are good: black beans, chickpeas, cranberry beans, green beans, lentils, Hmong beans, peas, snap peas, snow peas, and wax beans.
These are all the legumes that are good.
What surprised Sarah is that brown rice is better for the gut microbiome than white rice.
Also surprising, gluten-free oats and barley are good the gut microbiome.
A2 dairy in addition to whey protein is good for the gut microbiome.
However, A1 dairy is not.
Sarah was also very surprised to hear that quinoa is good for the gut microbiome.
Two Points to Consider
That being said, Sarah wants to emphasize two sides of a coin. (45:50)
One, Sarah thinks that these foods where science shows they are good for the gut microbiome are worth a re-look.
If you have been avoiding them for a really long time, consider your individual situation and methodical experimentation to see if they work for you.
These are not foods that are going to be incorporated into the AIP any time soon.
There are problems with all of them.
However, they are foods that deserve a second look.
At the same time, none of these foods are what Sarah would consider foundational foods.
None of these foods are so important for the gut microbiome or so nutrient-dense that we can't be healthy without them.
If these foods don't work for you, you will not be missing anything from what you need for general health.
Corn & Nutrition
Sarah thinks that corn has been thrown into this category within Paleo that generalizes it as a grain. (47:28)
Since corn is a grain, and Paleo defines grains as bad, corn is bad.
One of the things that have not done corn any favor is all the refined and manufactured foods that utilize corn as a base.
These highly processed foods are sort of what gives corn a bad name.
We are eliminating all of these products from this conversation.
However, let's talk about whole corn - sweet corn that is often eaten as a vegetable.
Or we can talk about cornmeal, which is dried and ground whole corn.
Looking at whole corn, corn is a really fantastic source of fiber.
It is also a really good source of B vitamins, vitamin C, and some minerals.
Yellow corn is a really good source of carotenoids and has a fair amount of phytonutrients.
With a cup of fresh sweet corn (that has 132 calories), you are getting 4.2 grams of fiber, 21% of your daily value for B1, 18% of folate, 17% of vitamin C, 14% for magnesium and phosphorus, 13% for vitamin B3, 12% for vitamin B5, and about the same percent for potassium and manganese.
That makes whole corn a nutrient-dense food.
Corn also has some really exciting polyphenols, which Sarah named and explained in greater detail.
If we look at whole corn, it has a lot of compounds in it that are beneficial nutrients, whether they are essential or nonessential.
The Research
Because of the fiber content, there have been a bunch of studies showing that corn can be beneficial. (53:44)
There have been studies showing that corn can enhance satiety.
Corn is also a good source of resistant starch, which can help to flatten the spike of glucose and insulin after a meal.
There was a study done in 47,000 adult men over 18 years that showed that consuming popcorn at least twice a week was associated with at least a 28% reduced risk of diverticulitis.
This is interesting because it has to do with the fiber.
Corn has a lot of insoluble fiber - and the type of bacteria that grow on that fiber type tends to be really important to the probiotic species that is controlling inflammation.
There is also an impact on this fiber type on the regenerative capacity of the gut wall.
So it can basically help to regulate how quickly those cells are turning over.
There are some studies that have looked at how the whole corn is impacting the gut microbiome.
Studies have shown that as little as 2 oz. of whole corn-based food provides the bifidobacterium with the type of fiber that they love.
Bifidobacterium is one of the most important vitamin producers, inflammation micromanagers, and they are a really important species for the gut microbial community in general.
Studies have shown that eating whole corn or corn fiber enhances calcium absorption.
The resistance starch from corn has been shown to be really beneficial as it increases gut microbiome metabolization, producing short-chain fatty acids, which increases the growth of roseburia.
So we have some really great research, especially in humans, showing that corn does some great things.
Stacy's Question
Stacy has noticed over the last few years in accidentally consuming corn starch, that she does not have the same reaction as she does when she consumes corn. (59:47)
Sarah explained the fiber that is in the corn starch and why her body responds differently to it.
The case that Sarah is making is not for corn starch, but for whole corn.
Stacy is right that there are some problems with it, and a lot of those problems are associated with the protein in corn.
When we have either a food allergy or food intolerance, those are driven by antibody production.
What the antibody binds to is a piece of a protein.
So if you take out the protein, even if you are allergic to something, then there is no protein there to drive the allergy.
This is probably why Stacy is ok with corn starch, but not anything that would include the corn protein.
Corn does not have a particularly high allergy rate.
It is estimated that as little as 1% of Americans have an actual allergy to corn.
However, corn has also been shown to be a gluten cross-reactor.
You can react to gluten in ways that don't require antibody production.
Up to maybe 25% of people who make antibodies to gluten, that antibody will also bind to corn.
Sarah explained how this reaction differs based on the antibodies that are being produced.
Corn is definitely something that our bodies have the capacity to create antibodies against and learn as food intolerance.
Probably having a leaky gut makes that more likely.
This is one of two really important reasons, why reintroducing corn has to be informed by your personal health history.
And Sarah always recommends a methodical reintroduction protocol.
Pesticide Residue
There is another piece to this though, and that is that corn is the most heavily sprayed crops. (1:07:18)
Back in episode 405, we talked about the impact of glyphosate on the gut microbiome.
Glyphosate is used extensively on corn.
GMO corn is only used for animal feed, but one of the things that we know is that those fields produce residue that spreads to neighboring non-GMO fields.
The FDA did a pesticide residue monitoring report, which is supposed to come out every two years.
The 2018 report seems to be currently missing.
However, the 2016 report showed that 63% of the food crop corn had levels that were considered measurable and below acceptable maximums.
The maximums are set much too high in the USA.
And this report did not give actual raw data, so it didn't tell us what the levels actually are.
There have always been some studies done from third parties on food from grocery store shelves for third party testing.
High levels of glyphosate were in everything that they tested.
This has to do with how heavily sprayed corn and soy and wheat is, and these foods tend to be in conventional processed foods as well.
Stacy gave a shoutout to one of our previous team members Crystal from Wholefed Homestead, who does a great job talking about heirloom.
Crystal talks about sources and different kinds of things and the difference between heirloom and sprayed foods.
Sarah shared more information on heirloom varieties.
In addition, Sarah covered the way that Genetic Modification is used as a catch-all term.
There is not an issue with the technology, there is an issue with the goal.
Genetically engineered crops have been used to make plants not die when they are sprayed with glyphosate.
We recognize that glyphosate causes gut dysbiosis and is not safe, but is now being used in huge amounts.
This is an example of where the technology is being used with a simplistic idea of increasing crop yield, but it is allowing the food to be sprayed with something that makes it unhealthy for us.
The goal is very important and the big picture is very important.
Humans have been manipulating the genetics of their crops for a few thousand years, and it can be as simple as only planting the seeds from a plant that has specific properties.
Where you don't have that control is in a wild variety, which is another fun thing to look for.
When It Comes Out Looking the Same
Stacy wanted to follow up and revisit her question from the top of the show.
If you are seeing corn in its complete form in your stool, are you digesting it?
And are you still getting all of these benefits that we just discussed?
If it is coming out the other end intact, you did not digest it.
Identifiable things in the stool are very revealing in terms of either digestive processes or gut microbiome.
One of the first things is chewing, which is a really important thing to do to aid in the digestion process.
Our teeth break things up into small bits so that all of the enzymes that our bodies make to digest can access the small bits.
Because corn has a very fibrous outside coating, if we don't chew it well, our digestive enzymes won't be able to access what is inside.
Seeing it intact can mean something as simple as, 'I ate like a vacuum cleaner instead of chewing my food'.
There is plenty in corn that should be accessible to our digestive processes.
And there is way more in corn that is a food for our gut microbiome.
So all of that fiber is feeding our gut bacteria, not us.
Those species of bacteria that are going to help break down whole corn are ones that really need to be nurtured with a gut microbiome friendly diet all the time.
They need to be nurtured with a gut microbiome friendly lifestyle all the time as well.
So while it could be as simple as needing to chew better, it can also be revealing of a missing collection of a species in the gut microbiome that needs to be nurtured on a regular basis.
There could be a missing piece as to why they are not growing very well.
Closing Thoughts
If a food does come out looking the same, thus revealing it was not properly digested, there are a few things you can do.
You can work on gut microbiome health, digestive health, take supplements to support either side of that equation, and work with a functional medicine practitioner who is familiar with gut health.
Stacy feels that we have provided plenty of data and information in this show.
If you have follow up questions you can submit those.
The real real from Stacy and Sarah on what they think about this show can be found on Patreon.
This is a non-PG, tell-all, that is combined from each episode and shared once a month.
Be sure to check it out here!
Thanks for listening!
For anyone who is interested in digging deeper into the gut microbiome and how that interacts with health, be sure to check out Sarah's Gut Health Guidebook.
You can also still preorder the Gut Health Cookbook, which will come out in a couple of weeks.
It has 183 recipes in it that all feature gut health superfoods.
Thanks again everyone, we will be back again next week!
Thursday Aug 20, 2020
Episode 418: Virtual School
Thursday Aug 20, 2020
Thursday Aug 20, 2020
Welcome back to the Whole View, episode 418. (0:27)
Stacy is super excited to welcome back a guest to the show, although no stranger to the show, Sarah's mom - Patsy.
Like most shows, this topic was selected out of a real-life question that Stacy is facing.
Sarah has insider information on this topic, and Stacy told Sarah that she has to share this wealth of information.
Many listeners are starting this process for the first time, but Sarah's mom has been teaching for a very long time.
Her expertise is much needed!
This was very fun for Sarah to have her mom on the show and to shop talk.
Sarah's mom has been a distance education virtual school teacher for most of the last twenty-seven years.
She has been an amazing resource for Sarah's family as they have navigated this new environment.
Patsy has a lot of valuable information to share with our listeners because this is such a new area we are navigating.
One thing that Patsy wanted to note is that she will be sharing information from her experience, but does not represent any particular educational institutions.
Patsy feels very honored to be able to share this information.
Stacy's kids do not start school until September 8 and is currently in complete denial.
Big Shout Out
We are going to talk a lot about the perception of students and what it is like for parents. (5:22)
However, Stacy wants to give a shout out to all the teachers who didn't sign up to be distance learning teachers and who are now trying to make the most of it.
Patsy echoed her appreciation and excitement for how teachers are rising to meet the challenges.
Sarah saw an estimate that approximately one billion students will be going to school in a virtual environment this fall, globally.
Patsy shared a bit about what happened during the last pandemic in 1918 and the differences we face now.
Things have changed so much since Patsy started her career in virtual distance learning, the resources alone have completely changed.
Technology has gotten to the point where it can disappear, and everyone can simply focus on learning.
We are primed to embrace the solution.
And we have a lot of things going for us in a really positive way.
Vocabulary
Patsy broke down the vocabulary around distance education. (9:24)
Correspondance school was one of the first phrases used in America in 1728.
This was when business correspondence courses became available.
Distance education appeared in the literature in 1892 and this was through the University of Wisconsin.
In Florida, they started using the term virtual schools about twenty to thirty years ago.
Then we gradually got into using the term online learning, which is the term that we are switching to.
For about ten years we played with the term distributed learning, which was never picked up.
Now the general term that we use is online learning, but we are still switching between this phrase and distance education.
These two terms mean the same thing.
We also talk about blended learning and face-to-face learning.
Many school districts are looking at this model to see if this will help us both limit the spread of the coronavirus, while still providing students with a classroom experience.
Every school district is set up a little differently and each school is approaching this differently as well.
Laying the groundwork with the vocabulary, Sarah noted, is the way for us to lay the groundwork to set our kids up for success.
Synchronous means that we are all doing it at the same time together.
Asynchronous is when you are doing it at your own pace and at the time of day that works for you.
Patsy feels that having a blended model works great because both social needs are being met, along with encouraging students to work at their individual level and at their own pace.
Accommodations are when we change the curriculum/assignments a little bit to individualize for students.
A modification is for students who are really struggling and suffering from an extreme amount of anxiety or who have distinct learning challenges.
Universal Challenges
The place where Patsy likes to start is with the home facilitator. (16:44)
This can be a parent, guardian, grandparent, or older sibling, and is an incredibly important role.
You have your children learning from home now and it is a pandemic, this isn't forever, but you are going to have to take on a hugely supportive role.
This will not always be easy because some kids do not do homework well with their parents.
However, it is a task that you will have to work through and relationship build around.
Patsy likes to say to parents, whatever grade your child is at right now, you are redoing that grade now.
If your child is in grade five, this year you are also in grade five.
You will know the curriculum and go through the details pretty much at the same level that your child is going through.
The Set-Up
Set up your child. (18:20)
Make sure that they have a space that works for them.
Also, make sure that you are having conversations where your child is participating and being involved in the decisions that are being made about where they are going to work in the home.
Patsy shared some location examples.
Students all have different comfort areas where they learn the best.
Let them try out what they think is going to work and then set a time for reassessing it.
Some kids work well with music, some with social contact, and some find these elements to be distractions.
So this is all very individual.
However, it is a great opportunity for kids to assess what kind of learning environment they are most comfortable in.
Work together to evaluate what kind of learning environment works best for the student.
Consider social interactions, how well they are doing with their assignments, and how much help they need.
You are then teaching these kids to self-assess and to be aware of who they are as learners.
This is considered a twenty-first-century learning skill that carries over into the rest of your future.
These are very powerful skills.
The Adjustment
The first two weeks can feel like chaos. (21:17)
Be patient, be kind to yourself - parents, kids, teachers.
After about two weeks, everything kind of settles down and you start to get into your groove.
Once you find that groove you begin to identify where you can tweak things a bit.
Also, make sure that you ask for your help when you need help.
Sarah shared a bit about how their school is currently structured for her daughters.
One of the things that they have done is set up an entire section of this online platform that is just for communication between parents/at-home facilitators and the teachers.
Sarah has really enjoyed being able to see that immediate communication and she feels more connected with what her kids are doing.
Patsy noted that there are elements to these adaptations that will have the potential to roll over to life after the pandemic and benefit us in positive ways.
Technology
The first thing is that every child needs to have their own computer. (26:04)
This computer needs to have a good keyboard, a good screen, and a good connection to the internet.
It also needs to have the software that they are going to need.
A lot of parents are terrified about their kids being online all day and if they are going to go to sites that are dangerous.
However, it is very important to not load up the computer with so much security that kids can't do anything on their computer.
This adds a lot of frustration to the learning and before long you have an uncooperative student and is resisting doing anything.
Patsy uses Windows Defender on her PC, which is enough security.
From there, it is important to teach your kids to not open a link when they get an email that might contain a virus.
Teach them how to do safe searches.
Part of your job as a home-facilitator is to be checking-in and knowing what your child is doing on the computer.
It doesn't have to be a war, but it is important to build awareness and open dialogue around this.
Access
Stacy noted that it is a privilege to be home and provide this level of supervision. (28:57)
For most people, Stacy included, it means that she is sacrificing her job in order to provide this oversight.
There are also students who are being asked to learn virtually who do not have access to all that Patsy is noting as needed.
In addition, there are students who simply do not have a home-facilitator available.
Stacy asked for suggestions on how to manage these scenarios and how to find a middle ground.
Patsy noted that this is a huge challenge.
She does think that the government does need to put money towards students' access to the equipment and internet that they need to be successful.
Because of where unemployment is currently at, many find themselves in a situation where they need to cut expenses, not add to.
These are problems that need to be solved, and we don't know how long this is going to last.
Patsy can't answer all of Stacy's questions but does want to acknowledge that these are very real questions to be answered.
Getting Creative
In Patsy's work as a distance-ed teacher, she will often have students come to her because the situation in the face to face school was intolerable. (32:55)
It has been heroic the efforts that parents have made to make it work for their kids.
She has seen parents who have gone to shift work, who split responsibilities.
Patsy also worries about students being able to pace at a teacher's pace with due dates.
Research has shown that the least effective thing that a teacher can do is set due dates.
The most effective thing that teachers can do is this whole array of other things that are broad and open and provide choice.
All of these things are so much more successful for the student as a learner than setting a due date.
The due date adds a lot of stress to a family that is already trying to balance many stressors at once.
Patsy has found that families can be very creative.
When they think through a well-designed learning environment and recognize quickly what is not working to find a solution to identify what does work, success can be found.
Having the flexibility to incorporate everybody's life realities into the school day is really important.
Communicating these points with the teacher and asking 'what can we do to make this work with our reality' can really help with the changes that will need to be made.
Also having these conversations with employers is critical.
Sarah encouraged our listeners that if you have extra, or slightly dated devices, to reach out to schools in your area to see what their needs are.
Or if you have the ability to donate to your local schools, this is another way to support the current demands and fix these inequities.
Mindset & Ideas
Many are probably struggling with the constant changes we are having to meet. (41:53)
When Stacy left corporate America, this is not what she was anticipating for what comes next.
Life has been very different for her, as it has been for a lot of people.
Stacy appreciates Patsy taking the time to breakdown what other people have done to make sacrifices for the education of their children.
It is just a privilege to be educated as it is when we look at this from a global perspective.
Stacy noted that this is a good reminder for her to continue to adapt and navigate the changes as they come.
It is a hard pill for her to swallow, but Patsy's perspective is very helpful.
Patsy shared the dining room learning experience example for asynchronous learning that has worked well for many families.
It is helpful when siblings can be both audience and helper, as these are important roles in all settings.
They can help each other, and help keep each other on task.
Be really clear about what the goal is.
There are ways of setting this up to minimize the need for parent contact.
Patsy cautions that the oldest child can fall into a babysitter role, which isn't effective for their learning either.
Also, remember that none of us know how to change to accommodate a pandemic.
If we stay aware, notice what is happening and stay calm, and be kind, we will make it through better than ok.
Doing this peacefully is the best that a lot of families can hope to achieve, and this is huge.
If what you learn during this pandemic is that you can stay calm and believe that you will survive, that will help in your future too.
The Fear of Falling Behind
Sarah raised a point about worries over a gap in education from last academic year's transition. (46:20)
She noted to her daughters who are feeling this concern that they will catch up.
That there will be a time when they return to in-person learning.
The most important thing is to do the best we can in this situation now and recognize that these challenges we are all facing together.
We are all going to have catch up that we will have to play, and we will all catch up at some point.
There will be accommodations for kids in the future.
The pandemic will have a long tail afterward, so don't worry about this not being normal.
Don't worry about this being a different type of rigor in terms of how you are moving through the curriculum.
Do the best you can with how this is right now and we will tackle new challenges as they come.
It is ok to do the best you can for your individual situation.
Sarah knows that a lot of parents are worried about their kids falling behind.
How to Overcome the Fear of Falling Behind
Patsy noted that part of this fear of falling behind is that people are inclined to lean towards passive absorption of the materials when they are working alone, online. (49:23)
They feel that the learning is between them and the computer or them and the piece of paper.
In the classroom, there is a lot of opportunities to discuss every concept, verbally with the class.
So we need to include that piece so that students are actively participating in their learning.
This includes telling people what you have learned.
The home-facilitator can help to have this conversation, other students can help with this (such as a study group), and this will help commit the knowledge to memory.
You can emulate the classroom experience using a number of tools that are available.
This is a very important piece that we need to build into the learning environment for kids who are learning online.
Staying Fully Engaged with Online Learning
Sarah asked Patsy for suggestions on how to get older kids, encourage them, to engage with online learning when they are more inclined not to? (53:19)
Patsy revisited the way that assignment deadlines can create an issue with online engagement and overall burnout.
So first, this is something we need to be aware of.
Just because a student falls off task for a little while, doesn't mean they will continue to stay off task.
This environment is an environment where students learn a lot about themselves, about what motivates them, about their commitment, and how they develop an independent work ethic.
These are twenty-first-century skills, ones you can take forward into a career.
As a whole, we are moving towards this economy where everyone gets to be their own bosses.
To be successful you need to know how to do that, how to be an independent thinker, and how to be independently motivated and committed to your tasks.
These aren't necessarily skills that kids are developing in the traditional academic environment, as opposed to distant ed environments.
Stacy echoed her feelings towards the reality that everyone is in the same boat.
It is important to emphasize how important it is to be kind, be patient, and have grace.
No matter what situation you are in, your child is not the only one in that situation.
The entire world is going to learn how to make accommodations and understandings for this very different environment.
We don't know what that looks like right now.
However, this next generation has an amazing opportunity to shape the world and the environment that they live in.
They will have had access to technological advances that no other generation has had.
Stacy reminds herself that while this is difficult, change comes when you are uncomfortable.
The discomfort, pain, and challenges that we feel right now, will result in some amazing change that can impact the next generation in the way that they approach the world.
Our Social Environment Control is a Win
When you come to social ed you can control the social environment. (1:03:51)
The social environment in a lot of schools deals with bullying as a big issue.
We like to think that sending our kids to school is a great experience, but for a lot of kids, it is traumatic.
When kids come to online education, especially the way learning platforms are structured, most teachers have administered permissions to give an email address and a chat account.
It becomes easiest for them to chat with their other students through that system.
The teachers have access to everything the students do, which allows them to monitor the dialogue and interactions.
Kids, in the comfort and safety of their own home, can turn the computer off, can block a kid, can get away, and are safer than they are in their regular schools.
Being in an online environment is a huge equalizer.
We don't know what gender a kid is, we don't know how old they are, what their ethnicity is, whether they have disabilities, what their appearance is, and we can't tell what their academic abilities are.
In the classroom setting things can get cliquey and it can get rough in that face-to-face environment.
Kids can turn off the distractions, which is very impactful to their overall success.
It can be a very positive experience.
Sarah shared her personal experience with needing to help facilitate social touchpoints while working within the virtual setting.
They have now found these innovative ways to play, even though everyone is in their own homes.
This has been really helpful for them, given that they don't have the socialization piece of in-person learning.
Patsy did Zoom socials with her students that were successful.
The Positive Outlook
Sarah feels that if she were to distill this episode to one thesis statement, it is that Patsy believes that the online learning environment that is happening globally could end up being a positive thing. (1:11:00)
As a teacher, Patsy (and other educators) have been looking for ways to create educational systems that reflect society and where we are at in the most positive ways and to transform.
The beauty of what technology can do for us at this time is that it has the potential to transform education.
All teachers in the world are being forced to become very creative and use the tools to enhance what they have already embraced.
It is pushing the envelope and opening the doors.
We are becoming much more embracing of learning and people's interests and motivation and where they are as individuals and learners.
There are so many options in using technology to help us move past any limiting structures as either learners or personally.
Patsy feels that this has the opportunity to be permanently transformative if change can be permanent.
It is a pretty exciting time that Patsy feels has the potential to be absolutely amazing.
If we can overcome the concerns that we discussed earlier about accessibility limitations, we could accomplish a lot of good.
This forces everyone to be creative and to problem-solve, and to problem solve quickly.
There are so many areas where Patsy feels this can work to society's benefit.
Stacy's Takeaway
The biggest takeaway for Stacy is being open to creating a kind of pod in their home. (1:14:43)
To set aside the space and the time, a routine and a schedule, for this virtual school.
Stacy loves Sarah's idea of Zoom lunches!
She will set up something similar for her kids.
Parents in her neighborhood have been sharing pictures of their setups with each other for ideas and inspiration.
Stacy has some new ideas about how to set up the learning environment within their home.
Sarah reflected on what she too has learned about learning environments within the home.
Sarah's Takeaway
The main takeaway for Sarah in terms of setting up an at-home learning environment is the same takeaway that she learned a decade ago in terms of parenting. (1:20:04)
This has to be individualized for the individual kid.
What works for one kid is not what is going to work for the next kid.
We need to empower our kids with the self-awareness to understand how they learn best.
This is such an important skill.
For Sarah, this is really exciting to think of how to set her kids up for success in a way that is customized to them.
Closing Thoughts
Stacy shared what she learned from one of her children who wanted the autonomy and independence of what they perceived as appropriate for his age. (1:21:29)
They were more successful when given the opportunity to do that on their own and show Stacy that they could handle it.
Patsy said that this is a common experience.
We think we need stricter guidelines as children gain more access to technology when the opposite is actually true.
When you give kids responsibility, you are rewarded tenfold.
Give them the ability to be responsible for their own materials and their own workspace.
It is not a free-for-all, so absolutely be involved with those decisions.
As a parent, you still need to check in to ask how things are working.
Discuss the goals and revisit the goals.
It is a wonderful opportunity!
Having these conversations around something that is education-focused, as opposed to other more personal stuff, leans the conversation to something that can be very positive.
Stacy also noted that more oversight or less oversight is needed per child based on their age, needs, etc.
Patsy noted that it is really important to recognize that a lot of parents are working from home, with children that they too are helping at home.
Probably your teacher is a parent trying to do the same thing, or a grandparent whose grandchildren are doing the same thing.
Know that you are in this boat together.
Be grateful and compassionate.
These are helpful ways to approach all communication.
Recognize how hard everyone is working to make this work for the students.
The beauty of the learning management systems that we have is that it is too simple to ask.
Reach out, edit with compassion, and make your request clear, complete with background information.
Problems will come up, and we have to learn to work through them as opposed to avoid them.
Kids can succeed if they know-how.
Approach this from the mindset that this is a skill that your child needs to develop now.
Look at everything as learning that we are doing.
Embracing a growth mindset is the fundamental positive spin that Sarah plans on bringing forward into this school year.
Huge thank you to Patsy for coming on the podcast and for sharing her wisdom!
Stacy is excited for Patsy to tell us what she really feels on a bonus episode for our Patreon subscribers.
If you are not yet a Patreon subscriber, be sure to check that out here!
We will be back again next week!
Best of luck to those who have already started school, and for those who are preparing to begin.
We hope that you feel more prepared and empowered!
Special thank you again to Patsy! (1:30:18)
Friday Aug 14, 2020
Episode 417: Vitamin K2, Hype, or Essential?
Friday Aug 14, 2020
Friday Aug 14, 2020
Welcome back to the Whole View, episode 417, whereby Stacy and you get to be educated on K2. (0:27)
This is one of those, "I can't say that I'm disappointed that we are talking about this" shows for Stacy.
Although she didn't specifically ask the question, Stacy learned about K2 way back in the day and hasn't learned much since.
Sarah is going to fix that today.
Before we jump in, we want to thank our returning sponsor Just Thrive.
Both Stacy and Sarah have used Just Thrive for years as their probiotic supplement, and swear by their product.
Stacy can't encourage everyone to give it a try enough.
It is the only one that makes a difference that Stacy can actually feel.
Today Just Thrive is actually sponsoring with their K2-7 supplement.
If this is something you would like to try, you can get 15% off your order by entering in the code THEWHOLEVIEW when placing your order.
This code applies to anything on Just Thrive's site.
Patreon Listener Comments
Before we dive into this week's listener questions, we do have some fun comments to read in response to the first bonus audio content posted onto Patreon. (4:49)
For those who don't know, this is a newly launched way that you can support us.
What we are doing to thank our Patreon family is posting bonus audio once a month, that is our behind the scene thoughts on each episode.
This audio is posted for our Patreon family only and is very uncensored.
It is uncensored from both the G-rated perspective, but also the level of unfiltered thoughts and viewpoints that Stacy and Sarah are sharing.
Kelby wrote, "First episode is 🔥! Love you ladies!".
Jan wrote, "I just finished listening to the content and I felt very reassured just to hear you all talking about your philosophy of nutrition.
It was a nice break from the science talk.
Don't get me wrong, I love your scientific explanations, but it is often over my head and I struggle to wrap my brain around it!
It was nice to get a glimpse into your hearts and minds.
Thanks for being two of the lone voices of reason out there.
I've been so discouraged through this pandemic to hear many of my former functional medicine heroes give in to the conspiracy theories.
And I've seen even more of them fall down the dogmatic diet hole (particularly carnivore and keto).
So I feel a sense of calmness and much less anxiety when I listen to you two discuss life in an intelligent, rational manner.
THANK YOU for all you do, and stay strong!!"
If you haven't yet checked out Patreon, you can do so here and check out the July content.
August content will be coming soon!
Listener Question
Mariel wrote, "I’ve seen more brands starting to push vitamin K2 supplements as essential to take, especially if one is taking Vitamin D. (9:28)
I have a policy of avoiding supplements where possible unless they are whole food supplements or I have a medical reason for doing so, so I’m not sure what to make of company claims.
I’ve been scared into buying emu oil since I don’t think the Corganic liver capsules I take are going to give me enough daily K2 (and I don’t plan on eating 100 grams of liver or natto a day), but it’s pricey and I’m not sure if I’m wasting my money.
Help! Thanks!"
Stacy is feeling like Sarah is going to need to educate her on some of the details from that question.
Time & Place
Sarah shares a very similar philosophy to Mariel in the sense that she believes that first and foremost we should be attempting to meet our nutritional needs from diet. (10:21)
Supplements need to be taken with a reason.
We have this tendency to gives ourselves permission to not make the healthiest choices by relying on a multi-vitamin to fill in the gaps.
It is really important to not let a supplement be an excuse to not do the hard work of making healthy choices.
However, at the same time, even when we are making all of the healthy choices, there is a time and a place for supplements.
Sarah feels that supplements need to be taken intentionally and with a plan.
Mariel is right that there is some really important interplay between vitamin D and K2, and some growing science showing us that there is a compelling reason to take these supplements together.
First, refer to this podcast episode when looking for a deep dive into vitamin D.
We are going to start this with the assumption that everyone is on the same page.
That vitamin D is really important and that it is really important to get those levels tested.
We need to supplement accordingly from those results so that vitamin D can be in a functional range.
What is vitamin K?
So what does vitamin K do? (12:50)
Vitamin K is another fat-soluble vitamin.
The fat-soluble vitamins are A, D, E, and K.
The very first role of vitamin K that was discovered was in blood clot formation.
There are two main forms K1 and K2.
K1 is the dominant form that we get from food, which is the dominant form in vegetables and makes up most of what we are getting from our diet.
There are actually 13 different isoforms of K2.
For example, Just Thrive K2 is actually MK-7, so there are 7 repeats of the 5-carbon units in the side chain.
Where do we get it from?
Compared to other fat-soluble vitamins, vitamin K is not stored very readily. (15:36)
Without regular dietary intake, vitamin K stores are rapidly depleted.
So it is more similar to a water-soluble vitamin in the sense that we need to be continually consuming it in order to have enough of it.
Vitamin K1 or phylloquinone is synthesized by plants and is the predominant form in the diet.
The K1 content of plants depends on how much chlorophyll is in their cells.
So leafy greens are the richest sources of vitamin K1: kale (472 micrograms/cup), Swiss chard (299 micrograms/cup), and spinach (145 micrograms/cup) are amazing examples.
The adequate intake level of K1 for men is 120 micrograms per day, and for women, it is 90 micrograms per day.
So on the surface, it looks like vitamin K is very easy to get from diet.
However, there are two things happening here.
One is absorption, and the other is the adequate intake may be set way too low.
Sarah explained the difference between adequate intake levels and recommended daily values.
There is actually some evidence that we want a lot more vitamin K than this, and that K1 is very poorly absorbed into the body.
We are only actually absorbing 5 to 10% of the vitamin K1 we are consuming.
You can double the amount that you are absorbing if you also consume fats with your dark leafy greens.
What is very easily absorbed is K2, which we absorb about 100% of what we are eating.
K2 is synthesized by human intestinal microbiota and found in fermented foods and in animal products.
So while 90% of the vitamin K we consume is K1, about 50% of the vitamin K measurable in the body is vitamin K2.
This varies in different tissues; for example, human liver stores normally comprise about 90% menaquinones and 10% phylloquinone.
We don't understand how the biological activity of the different forms of vitamin K differs.
What we do know is that all vitamin K can do the same job.
However, since we do see different forms of K2 in different tissues, it does imply that there is something important about that.
Right now in terms of scientific discovery, we don't understand what that important thing is.
What does vitamin K do?
All of these different forms basically do the same thing. (22:20)
Vitamin K's top-level function is that it is necessary for the activity of an enzyme called γ-glutamylcarboxylase (GGCX).
This enzyme catalyzes the carboxylation of the amino acid glutamic acid (Glu) to γ-carboxyglutamic acid (Gla).
Remember that post-translational modification, like carboxylation, are essential for turning on or off many proteins.
Vitamin K-dependent γ-carboxylation that occurs only on specific glutamic acid residues in identified vitamin K-dependent proteins (VKDP) is critical for their ability to bind calcium.
So all of vitamin K's roles in the body, which are really diverse, are basically related to calcium metabolism through really being able to activate different proteins that require binding to calcium in order to do the thing that they do.
Where this is applied in human biochemistry is in three main areas.
One is in blood clotting.
The other one is the regulation of a protein called Gas6.
Lastly, vitamin K basically controls where calcium goes into the body and stops it from going into the wrong places in the body.
Blood Clotting
In terms of blood clotting, vitamin K is really interesting here. (25:42)
The blood clotting is a really complex process that is performed in what is called the coagulation cascade.
This is a series of chemical reactions, where each step makes the next step possible.
Several of those steps require vitamin K.
So then with each of those steps, you are basically creating the proteins that make up the clot.
Vitamin K is needed to activate Clotting Factors II (prothrombin), VII, IX, and X, which make up the core of the coagulation cascade.
These proteins undergo a post-translational modification (vitamin K dependent ϒ carboxylation of glutamic acid residues) which enables them to bind calcium and participate in the clotting cascade.
Without vitamin K you couldn't clot, and you couldn't anchor that clot where it is supposed to be.
Vitamin K is also necessary for these other proteins that are anticoagulant.
We need vitamin K both to clot and to regulate clotting so we don’t clot all the time.
Gas6
Vitamin K regulates a protein called growth arrest-specific gene 6 (Gas6). (32:57)
This protein is involved in many cellular functions, including phagocytosis, cell adhesion, cell proliferation, and protection against apoptosis.
Because of these functions, scientists think this is a key protein for the development and regulation of aging.
Through that, vitamin K has been associated as an important anti-aging vitamin.
Gas6 is found throughout the body; the nervous system is its main cellular home, but it is also in the heart, lungs, stomach, kidneys, and cartilage!
Defects or improper functioning of Gas6 has been linked to some serious health issues, including clot formation, atherosclerosis, chronic inflammation, and cancer growth.
Calcium Regulation
Vitamin D and vitamin K work together in a really important way with calcium regulation. (34:24)
This is really central to bone health, bone mineralization, and skeletal health.
Vitamin D both enhances the absorption of calcium from food and also controls the amount of calcium in the blood.
So if you are not getting enough calcium from your food, vitamin D will basically activate the cells that breakdown your bone in order to draw calcium from your bones.
Calcium does a bajillion things in the body.
We operate under a very controlled amount of calcium in our blood, and it is vitamin D's job to control the amount of calcium that is there however it needs to.
The other thing that vitamin D does is promotes the production of a whole pile of proteins that need vitamin K in order to function.
This is where there is this really important synergistic action between vitamin D and vitamin K.
Where vitamin K really takes over in this calcium metabolism piece is vitamin D makes sure there is enough of it around in the blood, and vitamin K controls where it goes.
Sarah referred listeners to this vitamin D review article.
More on the Process
So it does this in a couple of different ways. (36:02)
Vitamin K activates osteocalcin a protein that promotes the accumulation of calcium in bones and teeth.
Osteocalcin (also known as bone Gla protein) is synthesized by osteoblasts (bone-forming cells).
Vitamin K activates matrix γ-carboxylated glutamate protein (MGP), which prevents calcium from accumulating in soft tissues such as kidneys (kidney stones) and blood vessels (calcification, or hardening, and atherosclerosis/plaques which eventually cause stroke, myocardial infarction, DVT, pulmonary embolism, etc.).
Vitamin K-dependent γ-carboxylation is essential to for several other bone-related proteins, including anticoagulation factor protein S, matrix γ-carboxylated glutamate (Gla) protein (MGP), Gla-rich protein (GRP), and periostin (originally called osteoblast-specific factor-2).
Sarah explained the way some studies highlight why you don't want to have high vitamin D and low vitamin K.
There have been a bunch of studies in humans where they have done things like given vitamin D and vitamin K together, and they have shown that together they help to regulate blood pressure, improve the elasticity of arteries, and they have also shown that high vitamin D in the absence of vitamin K can drive this calcification.
This is an impact of what is called vitamin D toxicity, which can possibly be mitigated by increasing vitamin K.
Other Ways Vitamin D & K Work Together
While this is just emerging evidence where more science is needed, but it looks like these two vitamins may work together to help regulate glucose metabolism. (41:04)
There is some science showing that they may improve insulin sensitivity through a variety of different actions together where they are impacting the pancreatic beta-cell function.
Also, there is some emerging evidence that they are working together as immune regulators in some ways.
We know that both vitamin D and vitamin K interact with the immune system, and it appears that their joint action is an overall antiinflammatory reduced oxidative stress action.
Again, more science is needed on this.
Insufficiency Prevalence
So that is everything vitamin K does, so you kind of go - wow! (41:52)
If you think about it as simplistically as helping to turn on proteins that are really important for regulating what calcium is doing in the body, then you understand how important this nutrient is for all the things.
When you look at the adequate intake level, it looks like it is really easy to get enough vitamin K.
However, it turns out that because vitamin K1 is not as easily absorbed, and there may be situations where our need for vitamin K is much higher than that adequate level, that vitamin K insufficiency prevalence might be high.
What is interesting though, is that this has actually not been well studied.
In normal healthy adults, 8-31% have vitamin K deficiency.
However, especially in older adults, more data is needed.
Sarah shared examples of why more research is needed on this and how our lack of information doesn't provide a clear picture.
Two studies that Sarah referenced can be found here and here.
We are at this point where we are still learning about functional vitamin K insufficiency and what the implications are and how this relates to cardiovascular disease.
But what is really interesting is that the other area where vitamin K levels are monitored is in newborns.
There have been studies that have looked at vitamin K deficiency in newborns.
At this point, there doesn't appear to be racial disparities in vitamin K levels, but that has only been tested in newborns because it is a new thing to look at in a functional way in adults.
Sarah's guess as to what is causing our deficiency has to do with our intake of traditional foods, such as fermented foods and organ meats.
The average American diet is a terrible diet for the gut microbiome.
It is full of refined carbohydrates, there isn't enough fiber, the fats are in the wrong amounts and are the wrong kind, and there are not enough phytochemicals.
Our gut microbiome is also extremely sensitive to the nutrient density of our diet.
So if we are eating a nutrient-deficient diet typically the gut microbiome suffers.
It is the sum total of all of the ways that the modern food system has hurt us is being reflected in vitamin K status.
Deficiency vs. Insufficiency
Stacy shared how this information really hones in the message repeatedly to her to be thinking as much as we can how to continue to inject that nutrient deficiency and put a nutrivore mindset into action.
It is not in a vacuum - it is not about one thing, and we see an example of this with vitamin D.
If that is the only thing you are doing, we see examples of how this can have repercussions on other things.
Sarah thinks it also highlights how hard it is to really meet the body's nutritional needs in our current environment.
It shows how much effort needs to go into a nutrivore's mindset in order to truly meet all of our nutritional needs.
This is something where we are going to go back to our 'vote with your dollar', which is the response that we have because we don't have another option.
It takes a grassroots movement in order to be able to show companies that there is really a demand for these nutrient-dense foods that can fill in this nutritional gap.
Stacy mentioned at the top of the show that she started taking K2 early on into quarantine and it was because she was on the Just Thrive site poking around.
She is loving learning about why this nutrient is important but also realizes that she needs to be testing her vitamin D levels regularly as well.
Most people don't have overt symptoms of vitamin K deficiencies.
Deficiency means your levels are so low that you are showing symptoms.
However, vitamin K insufficiency is much more insidious because the problems with this are seen over a really long timescale.
It is not the kind of supplement where you can feel a change when you start taking it.
The main long-term issues that low levels of vitamin K are associated with are osteoporosis and cardiovascular disease.
These are a direct result of vitamin K's roles in calcium.
Toxicity
There is a growing body of evidence basically saying that we want to optimize both vitamin D and vitamin K together. (59:41)
However, there is not enough science showing how much vitamin K to take relative to vitamin D.
Studies have basically shown that if you are taking less than about 800 IUs per day of vitamin D, that that level does not require additional vitamin K.
Over 8oo IU per day, more scientists are basically saying that vitamin D should actually be packaged with vitamin K if you are taking more than that per day.
There is this call for more big studies to look at how the higher doses of vitamin D.
Vitamin D supplementation needs to be customized to your personal needs.
It is important to measure your vitamin D and if it is insufficient, supplement, and retest.
Make sure that you are taking enough to get your vitamin D high enough and not too much that your vitamin D is going too high.
With vitamin K it is really interesting though because there is no upper limit.
There is no actual evidence of a toxic level of vitamin K.
The higher vitamin D is, the more we need vitamin K to help basically work in concert with vitamin D to control calcium.
If we are taking a large amount of vitamin D in order to get our levels into the normal range, that is increasing our needs for vitamin K and what we don't really know is how much vitamin K.
What we know is that the adequate intake level needs to be reevaluated.
However, we can say that there doesn't seem to be any risks when taking large amounts of vitamin K.
Why is 7 the Magic Number?
So why do we want to take K2-7? (1:03:10)
It boils down to a couple of things.
We know that seven is the dominant form of K2 that is produced by our gut bacteria.
Data suggest that vitamin K2 (menaquinone, esp. MK-7) has advantages over vitamin K1 (phylloquinone).
MK-7 form is the best-absorbed form for dietary supplements.
And, it has a long half-life of MK-7 resulted in much more stable serum levels, and 7- to 8-fold accumulation higher levels compared to K1 during prolonged intake.
Among the several vitamin K homologs, only MK-7 (vitamin K2) can promote γ-carboxylation of extrahepatic VKDPs, OC, and the matrix Gla protein at a nutritional dose around RDI.
We know that MK-7 does all the important things that we want vitamin K2 to be able to do, and it has been the best-studied over three years of supplementation.
Studies have shown that supplementation with MK-7 does the things that you would hope taking a vitamin K supplement would do - like improve the elasticity of our arteries and improves bone mineral density.
This is why it is so cool that the Just Thrive K2 is the best-studied form of vitamin K that checks all of these boxes.
They package it with magnesium and zinc to help actually increase absorption.
Closing Thoughts
Stacy is excited to hear from Sarah that this is a supplement that she would see the benefits from over the long-term use of it.
Bone health in general is something that Stacy tries to prioritize.
If this supplement is something you would like to check out, please visit this site here.
Don't forget to use the code THEWHOLEVIEW to get 15% off your order, which can be applied to any and all of their products.
This code is good for subscriptions as well!
Thank you to our sponsor Just Thrive, whom we use and love.
And thank you to our listeners for listening to Sarah's deep dive into the science.
If you have follow up questions, please feel free to reach out via social media or contact forms on both of their individual sites.
Stacy and Sarah will also dive a little deeper into this subject on Patreon.
Thanks for listening and we will be back again next week! (1:09:48)
Friday Aug 07, 2020
Episode 416: How We're Thriving with ADHD in Quarantine & Virtual School
Friday Aug 07, 2020
Friday Aug 07, 2020
Welcome back to the Whole View, episode 416. (0:27)
As our regular listeners can tell, it is opposite day, as Sarah is kicking off the podcast.
This week we are going to be talking about Stacy's experience with children with ADHD, and how they have been handling quarantine and virtual schooling.
Stacy has received this question from a lot of people, especially as we are all getting ready for another school year to begin.
Sarah's kids' start date for school was delayed by two weeks so that all of the teachers could get training on the virtual platforms.
They are in the ramp-up to school phase in their home.
In Virginia, schools were set to begin in August, but have been pushed by a two-week delay as well.
Everyone is looking at how to set their families up for success.
We are going to talk about how Stacy's family has worked to set themselves up for success.
Listener's Question
This week we have a really great question from Brooke. (2:35)
"Long time podcast listener - yes, I’ve stuck with you since the early days and love how your podcast has evolved over the years.
I’m a mom of 3 boys all with varying degrees of ADHD.
My husband has more than a dusting himself but is not formally diagnosed.
Stacy, I loved your description of living in a house of 80%ers - it made me giggle because it totally resonated.
I’d love to hear more about how you look after you, maintain some semblance of normal family life, deal with ADHD behaviors in public and live in a house that’s not a tip when you’re surrounded by ADHD.
In short, how do you not lose your mind with the challenging aspects?
Knowing that the men in my life didn’t choose this just doesn’t cut it anymore.
Many thanks, Brooke."
Stacy's Experience
To introduce everyone to Stacy's experience with this, she has two children - one with ADD and one with ADHD. (5:05)
Her husband is formally diagnosed with more than a dusting.
This also runs on his side of the family, with Matt's brothers all having varying forms.
Stacy wants to note that these are almost always paired with sleep and mood disorders.
A lot of depression and anxiety also pairs in with these conditions.
So when we think about an attention disorder we think of a child who is a busy bee, so to speak or someone who can't focus on a test.
It is a lot more than that though, with a formal diagnosis it affects more than just their ability to focus on simple tasks.
As we talk about the context of this, it is important to remind yourself that this is a medical condition and that it really can't be helped.
While we can do things to modify the lifestyle factors, likely a person in your life that you love has conditions that have some sort of aspect of this.
Stacy would be surprised if there was someone who didn't know someone with depression at some point in their life.
She also shared the way that she processes her feelings around these conditions.
In this week's episode, Stacy hopes to shares tools that are applicable to those who have family members with one of these conditions.
Communication is Key
First things first, is to communicate. (10:34)
If you are not talking about something, that is just making it worse.
Sometimes it is hard to say you are frustrated or to find the words, but this is something that Stacy really encourages in their household.
This is not something to be ashamed of or embarrassed by.
In fact, it’s helpful to be able to point to an explanation of behavior.
For example, one of the brothers who doesn’t have ADD/ADHD gets quite frustrated when another gets distracted and doesn’t do chores.
There’s a feeling of inequality that can then be explained with a medical condition.
This helps to serve as an explanation, not an excuse.
Patience
The next thing is patience. (12:27)
Stacy knows this is a hard one, she is there, but she expects to need to repeat herself before she is truly heard.
To set people up for success, Stacy sets people up with jobs that are consistent, they have a list, they have things they can refer back to for reminders, and they have tasks that are best suited for them.
Stacy reminds herself that it’s not intentional, that their brain literally forgot what they were doing and they went on to do something else.
However, these are tasks that each of the kids picked from a list of everything that needed to be done.
Stacy has raised her kids to be independent, to feel empowered, and to feel that they can succeed in the things they know they have done before.
As they have a new family member, the chores that this family member has are things they have done before.
Again, it boils down to setting them up for success, empowering them, and building their confidence.
It minimizes frustrations to set kids up for success and pride.
With ADHD, this has been critical to their success in quarantine in general.
They approached this season in life as a team and looked at all the shared responsibilities and how to support each and every member of the family.
Most of the time they are happy to help, and they do get an allowance as well.
Stacy and Matt use an app called Green Light, which allows them to manage their chores and pay them via a card that they can load.
Don't have unrealistic expectations.
We as adults are tired of this pandemic as well.
Pick Your Battles
This leads Stacy to her next point, which is to let somethings go and pick your battles. (20:50)
Stacy is far less concerned with the boy's beds being made, than she is with them being kind to one another or if they are generally, genuinely being helpful.
So this is the perspective she tries to maintain when she is frustrated.
Stacy will often ask herself if something is worth it when she finds herself angry or frustrated.
One example that Stacy shared is one of her kid's clothing preferences and giving him room to make those choices.
What he is wearing in not the battle Stacy wants to pick.
It is far more important to Stacy that when her son is outside he helps their elderly neighbor carry her bags into her house, as opposed to what he is wearing.
As a parent, Stacy feels that it is her job to help them become the best version of themselves that they can be.
To also shape them into kind, helpful adults.
She doesn't want to change them to fit the mold that she wants them to be.
One of the things that Stacy does is ask herself, "if this was a behavior that they were exhibiting as an adult, would it be appropriate and would it be beneficial?".
Creating Space
Sarah asked Stacy if she has any strategies for how to defuse anger in the heat of the moment. (28:58)
Stacy does try to do breathing.
Just as a situation is starting to build up and overwhelm you, it is helpful to do that deep breath through the nose and out the mouth.
If you do a deep pattern a few times in a row, it will give you a break to collect yourself before you react.
The thing that is more effective for Stacy personally that her kids and husband respond to is to walk away from things when they are not time-sensitive.
When things are not going in a positive direction, they take a break and talk about it again in a few hours.
Matt does really well if he goes outside and takes a walk to separate himself from what is physically happening.
Self-care resonates with Stacy when she is taking a break.
Creating any space where you can give yourself a break is going to really help.
Use these techniques to ask yourself if your expectations are reasonable, if you could create flexibility or small wins, or can you better understand their perspective.
Whatever is happening to you, you are not alone.
This just happens to be a concentrated season when you feel like you can't get a break.
So you need to create that space to take your break.
Sarah shared that one of the things she has struggled with most during quarantine is the loss of alone time.
There is an overstimulation aspect.
As a family, they have had to have a conversation about how to respect each other's personal time and space.
This ensures that when they come together as a family, that time actually serves as quality family time.
It has been helpful to have spaces where they each could retreat to while they defuse the stuff that is meaningless.
Sarah's Experience
Everyone in Sarah's family is an introvert and everyone needs their recharge time by themselves. (36:14)
They all get more energy from time alone.
In addition to being introverts, they are all very social, so also need social time together.
If they haven't had kind and respectful social time if they haven't had recharge, alone time.
So this has been one of the things they have had to navigate over the summer months.
And they will again have to find a new system as the kids begin school in a few weeks.
Sarah's girls happen to be planners and having an idea of what to expect really helps them.
Knowing what to expect helps them adjust better to change.
Right now they are talking through the different interpretations of the academic schedule and what they could mean for their daily routines.
In Sarah's house, routine is essential.
Sarah shared information from an interview she recently watched that featured a psychologist discussing some of the challenges with quarantine from a mental health perspective.
One of the things that he said is that the brain doesn't know the difference between a big decision and a small decision.
The brain doesn't know the difference between the higher levels vs. lower levels of stress when making a decision.
When we can take decisions out, and rely on routine, this helps to decrease the decision burden on the brain.
This is something that Sarah has really internalized in terms of how they approach their time when every day feels the same.
Routines
Stacy completely agrees with having some sort of schedule, list, or plan that the kids can expect. (40:01)
Regardless of age, or conditions, or personality types, all humans want to know what to expect.
It feels like chaos for most people to go into the day without a plan.
Stacy sets the expectation of what she needs to accomplish each day, and she does the same for the kids.
For the kids, she makes it clear what needs to be accomplished before they have screentime or before they do 'x'.
This way it is up to them to set the pace on their tasks.
Otherwise, there is not much else for them to do besides playing together, being active, reading, etc., which are all things Stacy is in full support of.
This also allows them to have a little sense of control and independence that is really needed for kids as they get older.
Stacy noted how you could set up a toddler for success in their schedule as well.
This can look different and be tailored to each family, but some kind of structure is key for all humans.
The only thing that Stacy would add to Sarah's alone time recommendation is to add in some quality positive time.
You need to proactively create that time that you are spending together either playing games, telling stories, or watching shows together.
Cultivate positivity around the time that you spend together so that when you are together as a family, it doesn't feel like is all you are doing is chores or nagging.
Creating a Process
The last thing that ties into all of this is to create a process that works for the child. (44:22)
Specifically speaking within the context of ADD and ADHD, oftentimes by instinct we do the things that work for us.
However, your child might thrive in a different environment, so it is really important to tailor and figure out exactly what is ideal for that child.
Stacy knows that this is difficult and is something that she continues to work on.
It is our job as adults and parents to bend what we need to do to at least meet our child in the middle to help them be the most successful as they can be.
You can adjust and tailor this over time, and it will get easier as they get older.
For Stacy, for her child to process what she is asking of them, she has to make sure that they are looking at her in the eyes as she talks to them.
She has to go to them and squat down to their level.
Stacy also has to be able to read if/how they are distracted and connect with them physically while she is talking to them to further make sure she is heard.
Sometimes she will also have her child repeat what she said to make sure they heard her properly.
The other thing that Stacy needs to learn and adjust to is to not delegate more than two things to her child with ADHD.
Stacy will delegate one task and then have her child report back once that is done, and delegate another task accordingly.
This is how her child is successful, and he has gotten better.
They have made a lot of progress and they will continue to make progress as he gets older.
But you have to meet your kids where they are, no matter what their difficulties are.
This has been Stacy's guide to success.
Phrasing & Cues
One of the things that are important as you communicate and have patience is to have words for when things are going in a direction that is not positive. (49:34)
When Stacy sees impulse control is a problem, she will say to them, "it seems like you are not in control of your body why don't you go take a break."
In Stacy's house, they have this phrase that they use that helps them recognize what Stacy means and what she is talking about.
This makes it so that Stacy doesn't have to explain herself each time or point out the bad thing they did.
Is all she has to do is say, "Hey - it looks like you are having a moment. Let's take a break and we will come back together later to talk about this."
They also have code words in their family when people are being triggered for things.
Each member of the family uses the code words when they need to, and everyone else respects the rules associated with that word accordingly.
The Lifestyle Things - Family Meetings
Some of the things that Stacy wants to lead into that Sarah can provide input to are the lifestyle things. (52:17)
Family meetings are one of those lifestyle things.
These are used as a way to connect, to get on the same page together as a family, and are not places where Stacy yells at people.
The family meeting is not the place for that.
If things start to get frustrating and voices become elevated, Stacy and Matt will try to pull it back a little bit as parents.
They will encourage their kids to use the 'I feel' phrase to express what they are feeling at that moment.
Creating a forum where everyone feels like they are heard is really critical for not letting situations be a snowball that gets worse over time.
They call family meetings for everything.
Stacy tries to make sure it is not a negative space.
Movement & Diet
Some other lifestyle and diet changes, which Stacy is not going to go super deep into because we discussed them in this episode. (54:29)
You can hear the growth and progress in Cole's life from that episode to now.
One of the things that were big for Cole when he was younger was to provide relief for the physical need for movement.
They did this by using a yoga ball for a chair, providing a tool they could physically fidget with, and ensured that there were breaks.
People with ADHD and ADD have physical energy that builds up in their body and they need physical breaks.
Going gluten-free and limiting dairy were also helpful pieces they incorporated.
They did eliminate dairy for a long time but have brought back high-quality dairy in high-fat forms and in limited quantities.
Stacy has also found that avoiding food dye is also very helpful for her kids.
All of these things help them maintain the highest level of control over their body.
Sarah shared her experience with how one of her daughters react when she eats something with food-dye.
The best way to gauge what your child is affected by is an elimination diet.
There are a million different tests that your pediatrician can run to see what your child is allergic to.
However, the only way to see how your child reacts to things is to remove the foods in question from their diet and reintroduce.
Supplements
We did a show dedicated to melatonin, which you can find here. (1:01:09)
Melatonin has been so helpful because adequate sleep is critical.
Kids with ADHD and ADD often have a difficult time sleeping, especially if they are on a stimulant medication.
Even without medication though, it has been so helpful for Wesley.
He gets anxiety at night and goes through phases when he needs melatonin at night.
Probiotics, because as we have talked about on this show, gut health is health.
He takes Just Thrive probiotics just like Stacy does.
The other two things that Stacy recently mentioned are fish oil and coffee.
Sarah has some science on these two things though, so Stacy is going to turn things over and let her explain the research behind these two supplements.
Omega-3 Supplementation
Coffee needs an update since episode 145 was the last time we covered that, and we haven't covered fish oil supplementation for ADHD in greater scientific detail. (1:02:55)
There have actually been enough studies now looking at fish oil supplementation as a primary approach to ADHD and ADD.
We have studies showing that people with ADHD tend to have much lower levels of the long-chain omega-3's, especially DHA in their blood cells.
There are researchers that actually think that a deficiency in DHA and EPA drives the neurotransmitter imbalances that are causing the behavioral manifestations and cognitive manifestations of ADHD.
Studies have shown that supplementation of doses of at least 500 mg per day very significantly improves both the clinical symptom scores, as well as cognition measurements that are associated with ADHD.
Anoter Listener Question
Sharon asks, "In your recent podcast you discussed your doctor's recommendation to increase your son's fish oil.(1:09:00)
You said he was taking Rosita cod liver oil and I was immediately concerned.
Fish oil and cod liver oil in particular has some major differences.
Cod liver oil is extremely high in Vitamin A.
It can be toxic in large doses and cod liver oil has a large dose, according to WebMD.
You probably know this and are doing just fine, but I wanted to give you this info, just in case."
Vitamin A Toxicity
Sharon is absolutely right that there is a big difference between any fish liver oil and fish oil. (1:09:33)
It is because of the oil from the organs versus the oil from the muscles.
They are both very high in omega-3's, but fish liver oil has a much higher vitamin content.
It has quite a bit of vitamin A, but also a high dose of vitamin D, and it has a little bit of E and K as well.
This is one of the reasons why Sarah chooses cod liver oil because vitamin A dietary insufficiency is very common.
A teaspoon serving of Rosita extra virgin cod liver oil has about 3900 IUs of vitamin A.
That is 78% of the adult daily value.
It also has 395 IUs of vitamin D, which is 98% of the adult daily value.
However, there is a really interesting common misconception about vitamin A toxicity.
The US Institute of Medicine's daily tolerable upper-level intake for vitamin A has been set quite low.
Some vitamins have what is called a UL, an upper level, where they basically say that staying below that level means that you are in a safe zone for avoiding toxicity levels.
So the upper level for vitamin A is different for age and gender.
However, for children ages 9 to 13, it is about 5600 IUs per day, and for adults, it is about 10,000 IUs per day.
This is set based on a couple of different things.
The things that they are looking at to set the upper level are changes to bone mineral density, birth defects, and abnormalities in liver health.
So the data that is going into the UL is basically very narrowly defined.
What is important to understand about vitamin A is that toxicity is extremely rare in the context of whole foods.
It is basically been seen in the consumption of seal liver, polar bear liver - forms of the liver that can literally have millions of units of vitamin A in a very small amount.
And it is typically seen in the context of supplementation in conjunction with vitamin D deficiency.
Vitamin A toxicity requires very high doses of vitamin A.
So in children, we see acute vitamin A toxicity at 300,000 IUs a day, which is an accidental dose.
If you are going to be taking high doses of vitamin A, it is important to know where your vitamin D levels are at.
Test don't guess - and then retest.
There is a growing body of scientific literature showing that vitamin D insufficiency and deficiency is associated with ADHD and that supplementation has been shown to improve symptoms.
The Latest Science on Coffee
Sarah was really interested to see what new research had been published since we did episode 145. (1:17:55)
There are more animal studies looking at caffeine and ADHD.
Caffeine was first adjusted as a management tool for ADHD in 1973, and there have been a variety of studies that have looked at caffeine pills or coffee for symptom management.
Most of the studies have been uncontrolled, and most have been relatively small.
Caffiene is psychoactive for all of us.
Sarah explains how it works in the body, in addition to the downstream effects.
Studies have shown that caffiene consumption works best as a low dose.
Optimal doses are somewhere around 150 milligrams of caffiene per day.
So the studies show that coffee is more effective than nothing, and probably not as effective as various medication options for ADHD.
Of course, the side effects of caffiene consumption are much more tolerable than some of these medications, as some of these medications have really undesirable side effects and higher rates of adverse reactions.
There is a call for coffee to be reconsidered as the first course of action in treatment.
Sarah noted that it would be ideal to address the nutrient deficiencies that are contributing to the neurotransmitter imbalances.
Then use caffiene as a management tool.
Sarah explained the findings from this study released in April, in addition to this paper from 2018.
If you look at the body of scientific literature over the last five years, there is still the same need for big scale, randomized placebo-controlled, clinical trials.
However, the mechanistic understanding has become more robust and has made a stronger case for someone to go and do those big clinical research trials.
Stacy has found it to be more effective and less effective at different times for the kids.
It is one of those things that as you are looking to help your ADHD, the need fluctuates.
And Stacy does feel like it relates to the other things you are doing in your life as to how much caffiene you might need.
Medication
Stacy will say that they were fortunate that none of their boys have gone on medication. (1:26:24)
They have been able to focus on the lifestyle and supplements they have talked about throughout this episode.
Stimulant medication for ADD and ADHD often have side effects that Stacy is trying to avoid.
Matt has been on them from a young age and they are very difficult to come off of as an adult.
The side effects become more dangerous over time, which is also a really hard thing to deal with.
If you are feeling like you need additional support now that you are at home, you could ask your medical professional about a non-stimulant medication that can now potentially be used.
Stacy noted that what is really great about it is that it is not a controlled substance.
Closing Thoughts
Stacy thinks she covered everything. (1:29:34)
Sarah agreed that this was a wide-ranging episode in terms of strategies, but that is the big take home.
This is not about implementing one strategy but instead looking at this from a whole-life, whole-family approach.
Sarah feels that this isn't information that is only relevant to those living with family members with ADHD.
These techniques are helpful to anyone who is trying to adapt to quarantine life.
Putting these strategies into place can help to set us all up for success in not just this new environment, but beyond.
Sarah feels that it is nice to have an episode where we tackle a broad range of strategies because it is grounding.
It helps to reflect on our current strategies to see where to fine-tine.
So much of this is broadly applicable, and yet so much of it needs to be individualized to a child's unique temperament and needs.
The most important thing during this really challenging time is to give all of ourselves some grace.
We are being challenged in ways that are completely new.
This has never happened in human history.
It is a process, and it is ok if it is not easy.
We as parents or caretakers oftentimes want things to be perfect, but it is the difficult times that we work through where we learn and grow the most.
If we let our children learn how to do things that they might not know how to do right away or how to do well, but how to work through their frustrations, this will help them as an adult in a positive way.
If they think they need to just suck it up, then as an adult they are stuck not knowing how to positively and constructively communicate with others.
This has been really important for Stacy as a parent, to remind herself that she is teaching them how to do this better as an adult.
Again, learning how to constructively communicate with other people is a skill that almost all adults want or need to work on.
Thank you listeners for asking these questions.
Stacy hopes that it was helpful.
She is just a mom, as well as a foster mom, and makes mistakes, which is part of what being a parent is.
Every day is not going to be perfect or great.
There will be bad days and good days, and that is ok.
We hope that this inspires you to at least be honest with yourself about those things and to maybe hold a family meeting and share how you are feeling with your family.
Thank you, listeners!
We will be back again next week! (1:38:01)