It was such a pleasure to host The Spring Center’s very own functional nutritionist, Sarah Choszczyk, our most recent webinar. Sarah and I discussed common fad diets and how they work (or don’t work) as well as elimination-reintroduction diets for food sensitivities. Looking toward the holidays and new year, we talked about prioritizing healthy eating in a balanced and achievable way. As a certified health and wellness coach with a master’s degree in human nutrition and functional medicine, Sarah had so many great tips to share. Thank you for being here to be part of this great conversation!
Recommended products from the webinar with Sarah:
- Enzalase by Master Supplements
- Body Bio PC
- Shop Evening Primose Oil on Body Bio’s site here
For those interested in working with Dr. McCann and her team, we welcome you to learn about becoming a patient at The Spring Center here. Interested in booking a nutrition consultation with Sarah? Get started here!
Check out the replay, transcript, and chat transcript below.
Transcript
Kelly McCann, MD (00:00:03):
Welcome everyone to our webinar series. I’m Dr. Kelly McCann. Thank you so much for being here. And today I have the pleasure of hanging out with my friend. Sarah, do you want to say that for us?
Sarah Choszczyk (00:00:20):
Well, it’s, yeah, it’s Choszczyk. If you want the American pronunciation, we’ll just stick with that. Okay.
Kelly McCann, MD (00:00:28):
Sarah C, my nutritionist friend, coworker. Sarah has been my right hand gal for a long time, and now she’s here as a certified health and wellness coach. She has a master’s degree in human nutrition and functional medicine from the University of Western States and almost 20 years experience working in healthcare, most of which centered around Chinese medicine, western herbalism, functional medicine, and especially nutrition. She provides nutritional support and health coaching to a diverse clientele, including many of our patients and clients, people dealing with complex chronic illness as well as athletes who wish to improve their performance. Thank you so much for being with us, Sarah.
Sarah Choszczyk (00:01:18):
Thanks for having me. I’m excited.
Kelly McCann, MD (00:01:20):
Yes, it’s the perfect time of year to talk about nutrition. Well, it’s always a perfect time of year to talk about nutrition, but especially now heading into the holidays where food is the center of most people’s holidays, celebrations, and so I’m really happy to dive into this with you and to share with our listeners. We’re going to talk about all different sorts of things. I think one of the things I’d love to pick your brain about is let’s talk about fad diets. What are some different fad diets? What are the ones that are really useful? How can people start to more thoughtfully evaluate these different diets to try and find the best diet for themselves?
Sarah Choszczyk (00:02:16):
Yeah, that’s great. That’s great. It’s a good topic to start with. Even now while we’re sort of, like you said, heading into the holidays, people may be a little more relaxed, which is fine about their food heading into the holidays. I think we’ll talk a little bit more about that, about dealing with holiday food later. But at the beginning of the year, oftentimes people will try to pay a little bit more attention to their health. They’ll clean things up, and starting a diet is probably one of the most reported New Year’s resolutions. So yeah, talking about fad diets is a great idea. So a fad diet is obviously, it can be a good diet. It can be a diet that is very restrictive, and the reason it’s a fad is just because it becomes popular, it becomes part of the zeitgeist, it just gets on all the media. So just because a fad diet almost says it’s a fad diet, doesn’t necessarily mean it’s a bad diet, but I think it’s a good idea to look critically at any dietary pattern that is becoming very popular. So for example, we can pick a few, I think popular fad diets right now, very low carb diets. So talking about Atkins, maybe talking about keto, talking about the carnivore diet.
Kelly McCann, MD (00:03:48):
I think those are great places to start.
Sarah Choszczyk (00:03:50):
Yeah, yeah, yeah. Fantastic. So if you’re thinking about an Atkins and a keto type diet, we’re going to be looking at dietary pattern that’s very low in carbohydrates, especially simple carbohydrates, refined carbohydrates, and in some cases even mostly whole food carbohydrates, really focusing on getting your fuel from fat rather than carbohydrates, good healthy fats. You’re going to be getting some fuel, of course from protein. And the thing I want to just point out about some of these diets that we talk about in general is there’s sometimes not a great definition. So when I say keto diet, there isn’t one keto diet that is the only keto diet. There’s actually a lot of different sort of subtypes, but generally it is kind of a higher fat diet, a lower carbohydrate diet, and there are ways to do a keto or an Atkins diet or something like that that can actually be really beneficial.
(00:04:55):
So for example, folks who are choosing really high quality fats like avocados and those mono and polyunsaturated olives and olive oils and avocado oils and nuts and seeds and things like that, rather than choosing the seed oils and the fried foods and bacon, bacon, processed foods, they’re delicious. But really leaning on those things are actually providing fats that are not going to be that great for you. But if you’re also including a lots of colorful non-starchy vegetables, I think that you can get to a point in that sort of, even if it’s more restrictive dietary pattern, that you are getting a lot of really good quality nutrients. Carnivore diet is people really just focus on eating meat. A lot of times people are choosing really high quality, fairly lean proteins, but sometimes a little more fatty eating, a lot fewer plant foods in general. And what I’m finding when I read a little bit of research that comes out on that kind of dietary program that’s very restricted is that long-term use of the carnivore diet actually is contributing to dysbiosis. So I was looking at some information. So doctor’s data does this test. It’s like the GI 360, I think, and some of what they’re finding is that in a carnivore and many other extreme diets that don’t have a lot of plant food is that their test subjects have low levels of phyla that are actually anti-inflammatory, and they have higher amounts of phyla that are inflammatory. These are like proteobacteria.
Kelly McCann, MD (00:06:50):
So
Sarah Choszczyk (00:06:52):
While it can be useful, especially for people with food sensitivities, to adopt one of these more restricted diets, to really eliminate things that they’re reacting to, a long-term pattern like this can be really tough on your microbiome.
Kelly McCann, MD (00:07:09):
Right. Yeah, that makes a lot of sense. You know what I think for clarification, let’s go back a little bit and maybe talk about exactly what you mean by carbs, exactly what you mean by fats and even proteins, because sometimes we make assumptions. We’ve been talking about this for a long time, and then to really delineate out what is a carb, what’s the difference between a grain, and I’ll let you speak to that, but especially with the carbs, because many people have an idea that I eat clean, I eat pretty healthy, but they may be still eating grains, which if you’re trying to eat a lot of carb diet or do keto, you can’t do grains. So let’s clarify that a little bit more.
Sarah Choszczyk (00:08:09):
Absolutely. Great idea. So I like to focus a little bit more on whole food, a whole food dietary pattern. So I’m going to start there when we talk about carbohydrates. So carbohydrates, of course, anything with starches, sugar fibers, so tubers, potatoes, roots, really any root vegetables, potatoes, sweet potatoes, things like that. Squash is another example of something that’s a carbohydrate, very rich in carbohydrates. You can have grains, like you said, whole grains, refined grains, those are mostly carbohydrate, lots of different types of fibers in those legumes. And those are beans, so all kinds of beans, lentils, even peanuts or legumes, although peanuts are, they’re kind of the outlier when it comes to legumes.
(00:09:06):
And then of course you have a lot of fibers and different other types of carbohydrates and starches, starches and sugars, things like that in leafy greens and gosh, fruits, different fruits, obviously lots of different sugars and fruits, mostly fructose, but also sucrose, glucose, other kinds of sugars and fruits. So really anything plant-based is going to be made up of lots of carbohydrates, whereas animal protein doesn’t have as many, certainly can be some, especially when you get into dairy. There’s some carbohydrates and dairy, but really when you’re talking about plant food, it’s going to be lots of carbohydrates. And then when you think of things that are more refined, so breads, pastas, crackers, cookies, things like that, those also contain carbohydrates. They made the plants. French fries. Yeah, exactly. So those are all carbohydrates. So proteins, obviously, we have the animal proteins, we have animal flesh meat, we have fish, eggs, very high protein, and dairy can also be very high protein. And then there’s a lot of protein in plant foods. So again, legumes and whole grains, lots of proteins, and we can talk more about high quality or complete proteins versus lower quality proteins. There’s certain plant proteins that are really amazing. They have all the essential amino acids, which are the building blocks that you need to make proteins in your body. When it’s essential, it means that you can’t make it yourself. You have to eat it.
(00:10:48):
So there’s definitely a lot of proteins in the plant world as well. And then fat, and most people know what fat is. There’s fat in animal food, there’s fat in plants, and there’s all kinds of different kinds of fat. So saturated fat will be kind of the more hard, the hard fat animal fat butter, things like that. Lard and then lard. Exactly. And then you have these other fatty acids that are unsaturated. I don’t want to talk about the chemistry of that. It can get kind of overwhelming, but these are things that are usually found mostly in plant foods, seeds, nuts, seeds, olives, things like that. Fish also have some good different kinds of fats in them.
Kelly McCann, MD (00:11:31):
Yes, essential fats, in
Sarah Choszczyk (00:11:32):
Fact, very much so.
Kelly McCann, MD (00:11:34):
Yes,
Sarah Choszczyk (00:11:35):
Yes, exactly.
Kelly McCann, MD (00:11:36):
So before we go on, let’s talk a little bit about seed oils because seed oils on social media are getting this bad wrap, and I had love to hear a little bit more about the differences between seeds and seed oils and which oils are going to be healthy or not healthy. I think that that’s very confusing for a lot of people
Sarah Choszczyk (00:12:00):
For sure. So there is a researcher that I love from Greece. Her name is Dr. Artemis Simopoulos. She was a researcher with the NIH. She just did a podcast with another functional doctor, Dr. Kara Fitzgerald, and she’s got a book out, let me see, I have my notes right here. It’s called The Healthiest Diet for You Scientific Aspects. And she’s talking about the Crete diet. She’s done so much research in fats, fatty acids, and so when we’re talking about seed oils and other kinds of vegetable oils and fats, you’re looking mostly at the type of fatty acid, whether it’s an omega fatty acid and omega six fatty acid, omega nine. And again, I don’t want to delve too much into the chemistry of that, but needless to say, these are mono and polyunsaturated fats that usually come from different plant sources. So what we find in a very westernized diet is that we have this high omega six to omega ratio.
(00:13:06):
Omega six fatty acids can be a lot more inflammatory. Omega fatty acids can be anti-inflammatory, a lot less inflammatory. And what Dr. Simopoulos has found after years and years of research is the human body has evolved to be the healthiest that a diet that is kind of a one-to-one ratio omega six to Omega-3. But our western diet is like a 20 to one ratio. And a lot of the reason is that a lot of our processed foods, a lot of our fried foods are fried in corn oil, sunflower safflower, cotton seeds, soybean oil, those are all really high omega six oils. And when we think about inflammation, especially in the realm of chronic conditions, we know that so many of the chronic conditions we’re dealing with are really inflammation driven. So that’s kind of the concern with seed oils and a lot of those that are really high omega six.
(00:14:07):
So Dr. Simopoulos really kind of tries to bring attention to the ones that are higher. Omega-3, the ones that are a little bit better ratio for us to use. So these are like flax oil, chia seed oil, some of the rap seed oils, and then the monounsaturated oils are a little different, but they are really healthy too. Olive oil, macadamia nut hazelnut, avocado oil. So really trying to make sure you’re using these in your cooking so that you get that ratio of omega six to omega a little bit closer to what we’re evolved to be working on.
Kelly McCann, MD (00:14:46):
Then a lot of the research out of Israel from the eighties and nineties, that was the foundational research for body bio to create their products, including balance oil, found that four to one, omega six to omega threes was the right ratio. And who knows, it may be one to one, it may be four to one. I think probably physiologically it may differ from human to human, but somewhere closer to four to one or one-to-one than 20 or 30 to one is going to be in the right direction. So things like the body bio balance oil can be another great way to add to your vegetables to add to your salads as it omega six, Omega-3, four to one ratio product. And what Dr. Patricia Kane would always teach would be that we can make things like oleic acid, which is mostly in olive oil and avocado oil, but we can’t make those essential fatty acids, those sixes and those threes, and so we really do need to get them from the diet.
Sarah Choszczyk (00:15:59):
Yeah, absolutely. Absolutely. And fish, we always hear, oh yeah, eating fish is really important for omega threes. And I know there’s a lot of concern with mercury for sure. And microplastics. And microplastics, I mean and everything. So really making sure that you’re sourcing cold water, wild caught fish as much as possible. And also just there’s a little bit of a balancing act. If you’re fairly healthy and you’re eating well and you’re exercising, you’re doing all the things, is it more important to completely avoid fish because you’re concerned about mercury or is it more important to have some fish, know that you’re going to be consuming some mercury, but also know that you’re going to be getting those really good omega fatty acids that will reduce inflammation and maybe even help your system in general deal with that mercury that you’re going to get. A lot of fish has selenium and things like that that can actually potentially help you with that mercury insult.
Kelly McCann, MD (00:17:06):
And I think that that’s where striving for moderation is really important. That’s going to be, and moderation and diversity, I mean obviously that’s going to be the best for a microbiome. For those people who have to eat restricted diets, please take what we’re saying and understand that the goal is not for you to eat the carnivore of diet forever, but to eventually get to the point where you can add diversity. I agree with you. I think that eating sushi every day would be a really poor choice for health, but having an occasional wild caught salmon, if that’s something that you like and enjoy would be healthy. Yes.
Sarah Choszczyk (00:18:03):
And it goes back to the question that you asked at the very beginning. You had mentioned thinking critically, and it really is about, there’s a lot of nutrition information out there, and I am just giving you more as well. And you have to understand that it is a ton of information. There is lots of really good, lots of really good info, lots of scientifically backed info. And I’m not saying that science is the end all be all, but that is the environment where scientists are trying to really look at specific variables and they’re trying to control for other variables, and it’s a learning process. So they find that eggs are good one day and then they find something that maybe not so good the next day and then the next day it’s like, oh, actually, maybe they are okay. I know it’s frustrating. I know it is. Science is not about finding the only one answer. It’s about finding the best answer with the information we have right now. So as you kind of read some of the information out there, listen to people talk about nutrition, it’s a good idea to take a step back, look at some different resources, think about it critically, listen to your intuition, listen to how your body feels when you eat a certain food. Take all of that information and then decide for yourself what is best.
Kelly McCann, MD (00:19:25):
Yes. So for example, Nikki said in the chat that she made some wild caught salmon and the smell just grossed her out so much she can’t eat it anymore, and it’s okay then that’s not your thing, right? There are plenty of other healthy ways to get these nutrients in you that we’re going to cover, and could we reduce the reactivity probably over time? Sounds like you need EMDR potentially for that traumatic experience. I’m sorry, I’m not joking, but I’m not making light of your experience. I’m simply saying it sounds pretty traumatic. And yes, there are definitely things that can help, and there are other ways to get these nutrients in. So just because we say fish is good or eggs are bad or bacon is bad, doesn’t mean that you need to take that a hundred percent,
Sarah Choszczyk (00:20:32):
Right? I mean, if you want to lean more toward eating some freshly ground flax seeds or taking some flax oil or the body balance oil or some walnuts, those all have wonderful omega threes. I struggle with fish too. I know it’s good for me. I get fish from Alaska, my family goes up there, and so I just try to figure out ways that I can eat it. I don’t eat it as often as I should. I know, but I try. So I totally get that. And to your point really quickly, Kelly, there is a lot of anxiety around eating and around food and around nutrition. So I do think especially with folks who are having reactions, I know we may get a little bit more into kind of food sensitivities and stuff, but everyone that I speak to who has food sensitivities also deals with anxiety and it makes perfect sense to me.
(00:21:24):
I have also had food sensitivities, and when you eat something new or when you sit down to a meal, you don’t know what’s in it, it can really cause an actual nervous system reaction. And over time, that just continues to sort of put stress on you. So you do sort of develop this post-traumatic stress response and things like EMDR sometimes are required for that. I know you’ve done a lot of work and a lot of talking to people about nervous system retraining and vagus nerve stimulation. All of that is very, very useful for people who are dealing with food sensitivities. And a lot of times when I talk to patients who are having food sensitivities will also touch on things they can do to calm themselves down before they eat and while they’re eating because it’s not a disconnected thing. It all works together.
Kelly McCann, MD (00:22:14):
Absolutely, yes. We have to be in a parasympathetic state for our digestive tracks to work properly. And if we’re stressed out eating on the run, shoving the food in our car or in 10 minutes in between patients, guys sometimes have to do, yeah, got to take a few breaths, got to calm down, try and shift into parasympathetic as much as possible so that those nutrients can be adequately digested and absorbed so that we can have the benefits of all the food that we are eating. So let’s talk a little bit about food sensitivities and how you might help somebody who’s struggling, whether they know if they have food sensitivities or not.
Sarah Choszczyk (00:23:06):
Yeah, yeah. Okay. Yeah, it’s something more and more people are experiencing, and like you said, sometimes people don’t know if it’s a food sensitivity. And so earlier when I talked about a carnivore diet being a very extreme, but potentially a very useful elimination diet, that’s kind of the first part sometimes to helping to handle a food sensitivity. Actually the first part is trying to figure out what it is your sensitive to. So of course there’s tests, lots of different tests. Not all the tests are perfect, but they can be really helpful in figuring out what direction to go. A lot of times what I have found helpful in a lot of patients and clients is just starting to be mindful of what they’re eating in connection to how they’re feeling. So sometimes that’s just writing down or somehow keeping track of what they’re eating day to day for a few days to a week, and also how they’re feeling.
(00:24:05):
I try to help clients keep that from getting too obsessive. That’s another part of the food sensitivity sort of mental health juxtaposition. It starts to become a little bit of, it’s like too much, but it’s also very helpful just to be aware of what it is you’re eating and then how you’re feeling. And then we can go through it together and see if there are patterns. If a pattern emerges and you find one or two things or even a handful of things that you’re like, I’m pretty sure I’m reacting to these, then the idea is just you cut those out as much as possible. And gold standard of courses completely cut those out couple weeks, several weeks, a month, six weeks, depends on how many things we’re trying to cut out and really what the issue is. And then introducing, that’s the part that gets missed a lot is the reintroduction part, especially if someone is dealing with a lot of food sensitivities or they seem to react to everything.
(00:25:07):
So we try something like the carnivore diet, it’s getting them back to where they can reintroduce. So elimination is really just trying to get your system to calm down, get your immune system to calm down, get your gut to calm down, and to heal a little bit, and then work a little bit on that nervous system part really so you’re feeling safe, so you’re feeling ready to reintroduce. And then the reintroduction part is very systematic. It can seem really slow. I mean, it’s very hard to do. So if any of you out there have tried the reintroduction and you’ve come across frustration because it’s just so slow, I feel you. I totally feel you. But it’s also the most important part to not only figure out what you might still be reacting to, but then also to get that diversity like Dr. Kelly said, and do it in a way that your system feels safe and you’re not sort of exacerbating issues again. So the reintroduction is usually for a lot of people, it’s like a few bites to maybe one small portion of the food, and then you wait a day or two, see how things are going. Sometimes reactions can be delayed, so you just wait a little while you eat, the things are safe, and if you don’t notice a reaction, then you try it again with the same food. So that’s why it’s sort of takes a long time. It could take you a week to 10 days to reintroduce one thing back in,
(00:26:39):
And that’s okay. And if you do end up having reactions, I really like to encourage people not to look at that food and say, I can’t eat this ever again. Put it on a list that says, save for later, try again later. Not now. Not yet. Not yet.
Kelly McCann, MD (00:26:56):
Yes. So if you were counseling somebody and they didn’t know, they really didn’t know and they just want to start somewhere, but they’re eating everything, what might you suggest they take out first? What are the most problematic foods or food groups that you see in most people?
Sarah Choszczyk (00:27:17):
The first thing I would actually ask them is what do they feel like they cannot live without or what do they feel like they could live without? So a lot of what I’m finding in just working with people in general and the approach that I take is figuring out where people are, where they are in their head, where they are in this place that’s very unknown, and meet them there. So I try to ask them, where are you? What do you think about an elimination diet? How does it make you feel? What do you envision? And then we may talk about the main things people can be sensitive to. So we’re talking about gluten, potentially dairy, especially cow dairy. Sometimes people couldn’t be okay with goat, but not so much with cow sheep. Maybe eggs are an issue. Sometimes people find them pretty reactive to eggs.
(00:28:13):
Peanuts really common allergen allergies is a little different than sensitivities, as I’m sure you’ve talked about before. Sometimes people just have generally issues with some of those more hearty fibers. I mean, if they’re eating a pretty standard western diet, they may have a hard time with whole foods like beans and things like that. So we really try to take out that major stuff, gluten, dairy, see if eggs are an issue. Sometimes reducing things like grains and legumes can be helpful for especially digestive symptoms. I don’t love the idea of being off of those forever, but it just depends on the person. So things like that, maybe a start, but really if they’re able to just keep track of what they’re eating for at least three days and then we can look and see what they’re able to and willing to try getting rid of, and then we kind of go from there.
Kelly McCann, MD (00:29:12):
That makes a lot of sense. One of the things that I did when I was trying to sort this out too, is that I would make very simple meals. So I would have, for example, chicken, broccoli and rice. And if I had a reaction, then I would try chicken broccoli and a sweet potato. It sounds super boring, but I figured out that rice was a problem. Rice is rarely a problem for, but because I did that little experiment and was willing to eat similar meals, one dinner one day, one dinner the next day, it was an aha moment. I feel crappy and itchy when I eat rice. And so then I could put that on my not now list.
Sarah Choszczyk (00:30:01):
Do you recall how long it took you to sort of do that pattern before you got to your whole list?
Kelly McCann, MD (00:30:10):
Good question. I think it was probably a couple of weeks to a month. I wasn’t doing it scientifically. It was more like, Hmm, I don’t feel well after I eat that meal. I wonder what it was, and then slowly start to piece it together. I think if I had been more structured, I probably could have figured it out sooner than that, but
Sarah Choszczyk (00:30:34):
It sounds pretty structured to me.
Kelly McCann, MD (00:30:39):
And then doing the food sensitivity testing that we do at the office through our colleague Dr. Ingles, he confirmed everything I knew I had a problem with. It was amazing. And then we’re able to offer immunotherapy, which is fantastic. So not now, not yet for some of these foods, but some of them people get back and that’s really encouraging. Have
Sarah Choszczyk (00:31:06):
You been able to introduce some of those foods back from your list?
Kelly McCann, MD (00:31:10):
Yes. So I was mold exposed. That’s when I developed all these food sensitivities. And it turns out that there’s a relationship amongst phenols with phenol compounds, which are in rice peas and almonds. And so I have issues with all of those things, but the immunotherapy that I did with Dr. Ingels enabled me to eat Now, rice and peas, almonds, I’m still a little allergic to, it’s actually a true IgE allergy, but I can eat gluten-free products with almonds in them just as long as I don’t eat too much.
(00:31:51):
And the more I do the immunotherapy, the easier it is to tolerate. I wouldn’t drink almond milk. I really can’t do a keto product with lots and lots of almond. I tend to avoid that. But yeah, I’ve been able to reintroduce some of the other, just for those of you who don’t know, think about the pepper family. So that’s your peppers, your potatoes, your eggplants, and your tomatoes. There’s a phenolic in there called piperine. And so oftentimes when you have reactions to tomatoes or peppers, you’re going to also have reactions to the ones in that similar family. Not all the time, but sometimes.
Sarah Choszczyk (00:32:39):
Yeah. Yeah. That’s really fascinating. And you perfectly show that it’s a complex issue. You do have these immune system modulated allergies and sensitivities, and then there are some that seem to be, it’s almost like they’re nervous system modulated. So folks who certainly, some of your patients that I’ve spoken to not a lot shows up and then they do the testing that we get from Dr. Ingels and a bunch of stuff shows up and it’s like, okay, well that’s interesting. That sort of says to me either their immune system is totally being just subjugated, whatever, or it’s really their immune system or their nervous system. It’s something where there’s something in there that feels unsafe, and then it’s maybe causing mast cell activation or histamine intolerant histamine intolerance. Absolutely. So it can be really complicated, and if you want to really get down to the bottom of it, doing it just like Dr. Kelly, that can definitely be a way. And she had a really good amount of protein. She was eating chicken. She had some broccoli, which has a lot of really good compounds in it, a lot of green, all the lovely things in broccoli. And then she was eating some carbohydrates as well. So she had the things that her body needed for a short amount of time and she reintroduced as needed. That’s a perfect example of a great, actually very systematic elimination and reintroduction.
Kelly McCann, MD (00:34:17):
Thanks, Sarah. Okay, so if you have questions, folks, please drop them in the chat. Sarah and I are going to continue talking. I’m sorry, drop them in the q and a, not the chat, the q and a section, and we’ll get to them at the end. I did want to pick your brain a little bit about ketones and carnivore. So I recently did an organic acid test and it said that I actually don’t make beta hydroxybutyrate right now, which is really disturbing. And then I got a lumen. Have you seen those lumen things?
Sarah Choszczyk (00:35:03):
Yeah, yeah, I have.
Kelly McCann, MD (00:35:05):
So I got a lumen and it says the same thing. All I do is burn carbs, I can’t, can’t get into ketosis. I’m not making ketones right now. So I’ve been taking some exogenous ketones, trying to get my lumen numbers a little bit better. Very interesting. I think it has to do with the current mold exposure that I’m experiencing, and maybe we can do a little research and circle back on that topic, but very interesting. So even if I was eating keto, and at this point I’ve been low carb for a long time, and what I described as kind of what I eat, a protein, a green vegetable, a slightly starchy vegetable like squash or sweet potatoes, most would be carrots or corn. That would be the most kind of starchy vegetable that I would eat and not getting into ketosis at all. I
Sarah Choszczyk (00:36:12):
Wonder if that small amount of starch is just enough to kick you out.
Kelly McCann, MD (00:36:15):
Yeah, it might be. I just have to do a lot more work in order to get into ketosis than many people could be.
Sarah Choszczyk (00:36:25):
Yeah, yeah, absolutely. That’s probably why there are so many, like I said, so many subsets of keto because there are some keto that allow for 20 grams of carbs, which is pretty low. But then some people, even with 20 grams of carbs, which is enough in what, a little bit of pet sweet potato or some oats, that’ll just kick you right out of ketosis.
Kelly McCann, MD (00:36:48):
Yeah. So I don’t know if you want to talk a little bit more about ketosis or carnivore or shall we move on to healthy eating for the holidays?
Sarah Choszczyk (00:36:56):
Let’s move on to healthy eating. I definitely will have worked a little bit with people on keto. I have noticed that a lot of the people who are doing keto for just for weight loss or for helping with their metabolic flexibility, they don’t feel as well when they are in true ketosis. So I don’t usually make the recommendation all that often if they’re really concerned about their metabolic flexibility. We talk about modulating their carbohydrates and their other macronutrients sort of in a little bit of a pattern. We change things up a little bit. My big concern with doing a long-term keto diet and staying ketosis for a long time, and I know are really, there’s some really good people who are working with keto on things like certain types of cancer and on autism and things like that.
Kelly McCann, MD (00:37:57):
Neurodegenerative disorders.
Sarah Choszczyk (00:37:58):
Yeah, neurodegenerative disorders. The concern I have is, so I pulled this article, it’s from 2015, it’s not super recent, but the quarterly review of biology, the team actually looked at, and this is just one study, so again, don’t take one study and plan your whole life around it, but this is one study. They looked at some data, archeological, anthropological, genetic, things like that. And what they found was that they sort of connected the development of cooking, especially cooking carbohydrates in to the size, the expansion of the size of the human brain and the human brain uses what something like 60% of our blood glucose. It is so hungry and carbohydrates are the most efficient way to make energy and to get glucose to our brain. Certainly as people have seen who are doing keto and stuff like that, you can make really good energy out of fat, out of proteins.
(00:39:07):
It’s just a little more, you have to expend a little more energy, especially with fats. So what this team found was really that our ancestors would’ve been readily able to find tubers, they would’ve been able to find fruits and probably some legumes as they were foraging and they learned how to cook, and they started to develop these salivary amylase. So amylase is an enzyme in the saliva in your mouth that starts to break down carbohydrates, which just points to the amazing efficiency of the system of our body to take carbohydrates and really suck those of the energy it needs to power our giant brain. And I think other Simeon, they have a third of the amount of salivary amylase, something like that.
Kelly McCann, MD (00:39:59):
Oh, interesting.
Sarah Choszczyk (00:40:00):
Yeah. So I just find that very interesting, especially when we are talking about things like ketosis and keto and carnivore and things like that where there’s a pattern where there’s not a lot of carbohydrates being eaten, especially not a lot of those starchy carbohydrates. It’s just interesting. It’s something to think about. I definitely encourage people, again, to just kind of step back and kind of look at the whole forest and make decisions based on all of that information.
Kelly McCann, MD (00:40:33):
It all comes back to personalized choices and what your health goals are, what your body is capable of doing, and how do we move the needle if you’re trying to maintain your health or improve your health and working with a nutritionist health coach can be very beneficial if you are struggling or if you have lots of questions. Okay. Let’s talk about all the me things coming in the next few weeks and months.
Sarah Choszczyk (00:41:06):
Yeah, absolutely. Absolutely. Holiday time. It is so complicated, isn’t it? It’s wonderful, it’s celebratory, but it helps be kind of stressful. So my general thought, this is for myself, and a lot of people find that this is really useful, not just during the holidays, but every day throughout your whole life, having this sort of 80 20 rule or 85 15 rule or 90 10, whatever makes sense for you, where 80 to 90% of the time you are on your program, you are eating, the foods are nourishing that make you feel good, that you feel safe with, you’re doing your exercise, you’re doing your stress reduction, you’re doing all this stuff, and then the rest of the time you’re doing things that bring you joy. You’re having a little pie because you’re with your family or you’re with your loved ones and it makes your heart sore.
(00:41:59):
And that’s obviously for those who are generally doing okay, they’re not dealing with major food sensitivities or chronic conditions that can really, really get in the way. But even in those cases, sometimes you can have a little bit of leeway. There are so many amazing recipes out there, websites of people who are dealing with the same thing you are dealing with, and they are figuring out alternatives and ways to make the things they love at holiday meals with ingredients that are going to be okay for folks with histamine intolerance or food sensitivities, things like that. So really looking for those resources can be helpful. I like to say pick your parties, pick your battles. It’s hard to say no during this time of the year, but that can be kind of freeing and it can, that can be an act of self-care as well. So if you know that doing a big family holiday dinner is going to be stressful because of the food or the political thing going on or whatever it is, it is absolutely okay to say, I’m not feeling my best right now, so I’m going to give myself some time to heal and recover, but let’s go bowling together or let’s have some coffee, or let’s go for a walk.
(00:43:26):
There’s definitely alternatives to the big food-centric stressful events. And no is also a complete answer, so I give permission, not that I need to give you permission, but sometimes
Kelly McCann, MD (00:43:41):
We need to
Sarah Choszczyk (00:43:41):
Hear
Kelly McCann, MD (00:43:41):
That we can take that, right? You can,
Sarah Choszczyk (00:43:46):
Yeah. And if you want to do, I just had a holiday thing myself here at my other job this morning, and so I brought something that I knew I liked and is healthy and is tasty. I shared it with my coworkers and they really liked it, and I got to enjoy their company and have a great time. So you can always bring food to share and that will be okay for you as well. Yeah, and there’s those little things too, like staying hydrated when we might imbibe an alcohol a little bit more than usual. There is a product I just found out about called Z Biotics. Have you heard of this?
Kelly McCann, MD (00:44:37):
No.
Sarah Choszczyk (00:44:38):
Z biotic. Yeah. So it’s a little probiotic drink. It has a strain of probiotic. So when you drink alcohol, it gets broken down to acid and that hangs out in your liver and your liver kind of takes care of it, and it hangs out in your gut and it hangs out into your gut until you excrete it. And that acid aldehyde is what makes you feel like crap the next day. So this Z biotic is this little probiotic. Have an alcoholic drink will actually go into your gut and will hang out there. And when the acid acetaldehyde is in your gut, it’ll eat it all up and it actually helps you a little bit. It helps kind of not feel so bad the next day. I wouldn’t necessarily say drink all you want to, but a bottle of wine and your antibiotic. But if you know you’re going to be going to your company Christmas party and you usually have a few glasses of wine and you don’t feel so good for the next day or a few days after that, that may be something you try along with hydrating,
Kelly McCann, MD (00:45:41):
Yes,
Sarah Choszczyk (00:45:41):
Eating. If you eat,
Kelly McCann, MD (00:45:44):
Michelle, just put it in the chat. So thank you, Michelle. There’s the link if you want that. The other thing that I love for alcohol, I know we sound like a bunch of drinkers, but over the years drinking alcohol has become less and less and less and less and less a part of my life, but a glass of wine at Christmas dinner would be really nice, or Thanksgiving dinner. So enzalase by master supplements is another amazing digestive enzyme that also has this wondrous capacity to metabolize alcohol. So maybe between the Z biotic and the enzalase. Yeah, I can tell you all little stories. So the first time I was given Enza, I was at a medical conference, A4M American Academy for the Advancement of Medicine or something like that, anti-aging medicine, anti-aging medicine, and in Vegas. And I was with the owner of the company. There’s a bunch of eight different doctors at the dinner table, and he passes out two enzalase for everyone and starts pouring the wine. He loves wine. And I had five glasses of wine that night. This was probably 10 years ago now. So my liver worked a little bit better. The enzalase worked. I was up in my seat in the class the next morning at eight o’clock to listen to the lectures without any adverse effects. And I thought, what was that stuff? Oh my goodness. Normally it was like one or two glasses and I’m done ever since I was in high school. So this was magic.
Sarah Choszczyk (00:47:31):
That’s amazing.
Kelly McCann, MD (00:47:32):
And a couple weeks later, I was celebrating New Year’s with my then, then boyfriend, now husband, and after about three glasses of wine, I said, here, honey, it’s 1130. We should probably take our enzalase. And by midnight he was sober. And he is like, what was that? Don’t give me that. So now we take it at bedtime, but you can take it when you drink or when you eat. It is a digestive enzyme, so it helps you digest your food. I love it for food sensitivities as well. So enzalase by master supplements a great way, and it is on the, Michelle dropped the link in the chat, so you want to stock up on your enzolace and check out that Z biotic and see if that can help if you happen to have a few glasses of wine. Alright, let’s go back to food.
Sarah Choszczyk (00:48:24):
Awesome. Yeah, that’s great to know. Yeah, so I think the only other thing I can really think about when it comes to when you’re trying to pace yourself for those holiday meals and it’s really easy to overeat, just delicious, delicious food is kind of the same advice I might give anyone really at any time. Sometimes the timing of the different types of food you eat can really help keep you from overeating
(00:48:56):
Because it has to do with satiety has to do with our hunger and our full cues. Sometimes we forget about that stuff when we’re socializing and having fun or when we’re, like you said, eating in the car or eating quickly between patients. So if you eat some of your foods in a certain order, you can actually really feel that satiation that, oh, I’m full. I don’t need to eat anymore. And so eating your protein first, it’s very satiating. And then eating your high fiber like vegetables, and if you’re a whole grain eater, peas or legumes, things like that, those are very high fiber, those are very satiating. And then you can kind of go towards some of your other carbohydrates. You can have a little bit of dessert. And also that, I don’t know who actually came up with this idea way back when, but it was just a smaller plate because very visual. That’s why the whole, my eyes were big in my stomach. Phrase exists. We’re very visual, especially when it’s beautiful food and it’s a special occasion. So just going for a smaller plate, grab a dessert plate, grab a dessert plate, and instead of using the big serving spoon, grab the spoon from your place setting, grab a bite from that one or two of those scoops are like this much rather than a serving spoon, which is this much. So those little tricks you can do
Kelly McCann, MD (00:50:25):
With my utensils. I have the regular utensils, and then I have these mini forks and these mini spoons, and I just love them for dessert. So you put it in a little tiny plate and my husband hates it. He’s like, whatcha doing? It takes you forever to eat that. Well, that’s the idea. I want to make it last and make it enjoyable so that I don’t overeat and I just really take it all in. Right, take it all
Sarah Choszczyk (00:50:57):
In. Yeah. Yeah. I love it when you go to a place and they make the desserts in a one bite on a little plate or in a little shot glass.
Kelly McCann, MD (00:51:06):
Yeah,
Sarah Choszczyk (00:51:07):
They’re great. You get just a little taste of something wonderful and you can have maybe two of them and it’s not going to be so much and so heavy that you’re just regretting it later.
Kelly McCann, MD (00:51:20):
Yeah,
(00:51:22):
It is tricky. It’s interesting. Everyone in my family is gluten-free and dairy-free, which makes holiday get togethers much easier because we all know that everything that people will bring or anything that we’re making, everyone can eat it. And then one time I went to a weekend with some friends and I only knew a couple people who were there, and most of the people were not gluten-free and dairy-free, and very little of the food was safe for me to eat. They served spaghetti and pizza and I thought, what planet am I on? So I was given a taste of how challenging it can be when you’re the only person with food sensitivities in a world where people just don’t understand you and are accommodating for you. It is difficult, and I think that what you are sharing, Sarah’s is really important. Being able to say no to events that are not going to be supportive for you and eating first before you go to a holiday party so that you don’t have those temptations or bringing your own food that you know can enjoy. That’s a really smart thing.
Sarah Choszczyk (00:52:59):
And to your point, if you’re already handling a little added for whatever reason, it’s definitely a time to double up on your support network. So whether you do therapy, really talking with your therapist, talking with your supportive and loving family and friends, those people, like you said, who might have the same sensitivities or who at least understand and support you and you’ll know, they’ll ask you, what can I make that you can eat? And most of the time they really want, they really want you to be happy and to have a great time and to feel good doing your nervous system retraining programs or exercises, very, very important during this especially stressful time. So all that self-care stuff you do all the time, double up on it if you can.
Kelly McCann, MD (00:54:04):
Yeah, I think our inclination when we get busy is to let that stuff slide. And that’s the exact opposite of really what we need to be doing during this busy time is to stop doing our self-care. I was speaking with a friend of mine who recently moved out of the country and it’s been a super bumpy road for her, and she has so many tools and yet she’s been even more busy, even more overwhelmed and is not really doing very well. And so the more that we can preempt the challenges that we might be facing by taking that extra 10 minutes to meditate, going for a walk, reaching out to a friend, booking extra sessions with our therapist, using our vagus nerve devices, or doing an extra round of limbic system work, those things are going to be so supportive for you as you go through the holiday season. Absolutely. Yeah. Alright. Shall we take some questions? Yeah, sure. Okay. Let’s see. Can you April April’s ask if we could discuss GLA specifically and why would somebody be low in this? So I am assuming that she’s referring to gamma linoleic acid, which is an omega six fatty acid. So do you have some thoughts on that, Sarah?
Sarah Choszczyk (00:55:53):
You know, I don’t, yeah, I’m not really sure. That may be a little beyond my scope.
Kelly McCann, MD (00:55:59):
Okay. I’ll give it a shot. So we don’t have the fatty acid schematic of how that works, but know that the enzymes that will take alpha linoleic acid to EPA and DHA, I think it’s DHA, and then EPA, your omega side. Then you’ve got your omega side, and then you’ve got your omega six side. So you’ve got linoleic acid and then GLA and arachidonic acid kind of that way. The enzymes that will move the pathway forward are the same. So if you eat too many omega threes, you’re going to use up those enzymes and then you’re going to get a little deficient on the omega six side. And so that may be part of the problem.
(00:57:04):
When we finally realized that the standard American diet was 20 to 30 to one omega, six to omega threes, a lot of the functional practitioners and naturopaths and well healthcare, healthcare practitioners recommended a lot of omega threes in the form of fish oil. And so people were taking high doses of omega threes. You go to your cardiologist, you have triglycerides, everybody gets pharmaceutical grade, omega fatty acids. Lovaza is one of the prescriptions, for example, and that’s oftentimes three and four grams of fish oil. And then you’re getting way, way, way out of balance in terms of the omega six side. So I really do think that the balance oil and paying attention to those other healthy fats, the essential sixes and the healthy omega sixes, and that’s really what the GLA is. So trying to either get that in a supplement form or reduce your omega threes from supplementation would be important.
(00:58:14):
And unfortunately, most of the Omega checks and the commercially available Omega fatty acid testing is not completely accurate. It’s what we can order through Quest LabCorp. But really the gold standard would be a fatty acid profile from Body Bio where they’ll look at the sixes, they’ll look at the nines, they’ll look at the long chain fatty acids, they’ll look at a variety of other markers to see how are your fats, how are you doing with your fats, and what do we need to tweak in order to fix some of ’em. Body bio can offer that test through practitioners who have been doing it for previously, but it’s not as available right now. They’re trying to tweak that. But it gets sent to Johns Hopkins. There’s a special lab at Johns Hopkins that does this testing, so hopefully it will be more widely available again soon.
Sarah Choszczyk (00:59:24):
And so if someone is finding that they are not able to go through that omega six chain and produce gamma linoleic acid, do you know if there are specific symptoms that come from that and syndromes that come from that?
Kelly McCann, MD (00:59:40):
Patricia Kane used to teach that a lot of eczema, psoriasis, skin issues were GLA deficiencies. And so I can’t say that I have medical literature to back up that statement. We’d have to go search on that. But when I find that people have low cholesterol or their omega check is really a high, too high, I’ll drastically reduce the fish oil and then add in some of the balanced oil and some of the evening primrose oil. So evening primrose oil is probably the best oil option for supporting that GLA. You can also do barrage oil, but I happen to prefer the evening primrose oil. Great. How much cruciferous vegetables do I need to offset the effects of microplastics? Great question. Roundup.
Sarah Choszczyk (01:00:56):
Oh my gosh. Who knows? Who knows? Yeah, eat as much as you can. I would say, gosh, it’s a world that we live in now. So I think, again, being careful not to miss the forest for the trees. Again, I don’t want to negate the fact that we are eating micro nanoplastics. That’s a serious problem. But really looking at not just cruciferous vegetables, but all kinds of different things. Like really, again, looking at that very diverse diet is really important. But yeah, a bunch go crazy as long as you are okay with them not sensitive to them. I mean, they’re good for a lot of things, lots of great compounds and crucifer vegetables for lots of different, different benefits.
Kelly McCann, MD (01:01:54):
Absolutely. Yeah, I don’t think that unless you’re sensitive to cruciferous vegetables and to the sulfur and the cruciferous vegetables, in which case probably I would suggest more meidum and maybe we’d have to work on what are the root causes for all those sensitivities. But unfortunately, thinking that cruciferous vegetables are going to clean up the microplastics, I don’t think that there’s literature to support that at this point in time. It is very difficult to get out the microplastics in the nano and especially the nanoplastics, unless we’re doing plasmapheresis for people, which is really not plausible for the planet to exchange out their blood. So we really, really need to work on avoidance as much as possible in order to reduce our exposures. When on a limited diet, is it best to eat small amounts of foods you react to in order to improve your food diversity? That’s a good question, Kathy.
Sarah Choszczyk (01:03:01):
That’s a really good question. Really good question. So again, I would go back to the systematic reintroduction. There is certainly a fine line between eating something and having a reaction that is not going to be good for you, that’s going to create inflammation and a further nervous system response that you don’t want to have. And the other side of that is being what we call hormesis, which is like this little bit of, it’s a little stressor, but it’s a healthy stressor and it’s kind of hard to find where that balance is. So it is very individualized. So for you, it may be one thing that you know react to or you used to react to and you haven’t had it for a while trying a little bit. And if you feel generally okay then maybe, and you feel safe enough trying it again, I think of beans, right?
(01:03:50):
I mean, a lot of people say beans give me gas, so I just don’t eat them that often. The reason beans give you gas is probably because your microbiome isn’t really set up to deal with the oligosaccharides and beans. If you ate a little bit of beans a little consistently, your microbiome is an amazing thing. It will shift, it will start producing phyla that can deal with the oligosaccharides, and you probably won’t have a lot, if any gas anymore. So again, you kind of have to work within what you’re able to do. Certainly work with a nutritionist or a dietician or some other nutrition professional who can really meet you where you are and help you navigate that reintroduction. And yeah, that’s all I could say about that, I guess.
Kelly McCann, MD (01:04:37):
No, and that’s really great advice. I think that it’s easy to get trapped in black and white like, oh, that food gave me a problem. I can’t ever eat it again. But to know that there are ways to reintroduce things in very small amounts sparingly, you can make some shifts. And the other thing that I will let people know about too is that we can do immunotherapy. So essentially when you’re eating small amounts of a food sparingly, you’re doing the same thing as immunotherapy where we take dilute doses of the things that you’re reacting to and administering that to the immune system and saying, okay, immune system, this little tiny bit is okay. So whether that’s sublingual immunotherapy drops that you put on your tongue, or immunotherapy such as low dose allergy therapy, which was designed for use in the sixties and seventies by the grandfathers of functional medicine. So these were the doctors who were seeing a multiple chemical sensitivity, all the people who are sick in the sixties and seventies. And they realized that if you went to an allergist, you could only get treatments for allergies, IgE allergies, which is fantastic for those people who have allergies. But for all the rest of us who have food sensitivities and intolerances, it’s not helpful.
(01:06:16):
So these practitioners got together and created LDA, and what they did is they took all the major food groups that people have reactions to that we’ve been talking about. So gluten, dairy, sugar, eggs, corn nuts, citrus, et cetera. And they put them into one mix. They took all these antigens, put them into one mix, and then they diluted it out so that it’s not quite homeopathic, but close. And then they took all the environmental things, dogs, cats, dust trees, grasses, molds, et cetera, put them into one mix, diluted it out. And that can be administered either intradermally or sublingually, usually once every two months to help reduce the reactivity. Amazing, amazing. So that in combination with an elimination diet and a slow reintroduction can be transformative for people’s health.
(01:07:16):
If you are looking for a provider who does LDA, I would suggest going to the American Academy of Environmental Medicine. That’s aaemonline.org. Michelle, I’m sure will put it in the chat for us. Since many of you are not from local, hopefully there is a provider in your area. You can also encourage your provider to consider joining and getting training in LDA because it is super simple and it can be really transformative for people. So I just wanted to put that little plug in there. Okay. Let’s keep going. What type of food sensitivity testing do you recommend? Start with that, and then have you done the Biome site stool test?
Sarah Choszczyk (01:08:10):
So food testing, like I said earlier, there isn’t a gold standard for food sensitivity testing. I will say that a lot of the immune mediated food sensitivities, you have an IgG test, things like that those are pretty good if you are dealing with an immune mediated or modulated, whatever, food sensitivity. If it’s not, or if it’s a little more, I don’t know, what would you say? Subtle. Doing something like the ELECTRODERMAL screening like Dr. Kelly does, like Dr. Ingels does. That can be really helpful too. Dr. Kelly, will you mind talking about how does it work? I still tell– I thought so too. People are like, how does it work? I was like, well, here’s how it works. But I’m not exactly sure what the reaction is. That’s why I feel like it’s a nervous system. It’s a nervous reaction. It’s almost like an electrical impulse, which comes from our nervous system. So it is a really interesting test. But yeah,
Kelly McCann, MD (01:09:18):
It is an interesting test. I call it woo woo in a box because it’s not FDA approved. So let’s think about our bodies as we’re electrical beings. We have different frequencies, other things in the environment have frequencies. So for example, you’ve all heard of the idea of a opera singer who can shatter glass with her voice if she hits the right note in such a way that it matches the frequency of that organism or of that glass. It shatters it. There is a form of treatment for Lyme disease and other infections called RIFE. Rife works on a very similar concept where there’s a frequency of the organism, and if you are able to dial in that frequency with a machine that generates that and you place it near the person, it will destroy the organism.
(01:10:34):
My sense about the electrodermal screening is kind of like that. And when I went to see him and he was testing my food, so as I said, I had figured out all my food sensitivities, gluten, dairy, soy, corn, eggs, nuts, citrus, peanuts, almonds, apples, tomatoes, peppers, and then the rice and the peas. So I knew all my foods and I walked into his office and he literally has you hold a metal rod and then runs a current through the body and then connects the current to a meridian point on your fingernail tip and will run that frequency of that food through the body. And then the computer generates a sound that reflects if it’s good or bad. So if it’s good, the sound is like, and if it’s bad, the sound goes. And so all those foods that my body did not agree with my body, it went, it’s not good. And so that’s how the test works. It’s a little woo woo in a box. It’s
Sarah Choszczyk (01:12:02):
Like a circuit. When the circuit is complete. It’s okay when the circuit’s broken.
Kelly McCann, MD (01:12:09):
Yeah, exactly. So for what that’s worth, electrodermal screening is not very common. There may be some interesting practitioners out there that are doing it. And for our patients, we’re able to use Dr. Ingels, Darren Ingels, who’s down the street as our lab. He also takes patients if you’re interested. And I think that other older chiropractors or sometimes naturopaths might have this as part of their practice if people want to look for it. But food sensitivity testing is really tough. I’ve done all the different food sensitivity testing on myself and my patients. I remember I got a lab back one time and the primary food that it said I had a problem with cashews and I eat cashew milk yogurt on a fairly regular basis. That wasn’t accurate. So I think a combination of your own intuition, your own experience and observation combined with some of these tests can be the most useful way to proceed for the stool test. Do you have any comments about the stool test?
Sarah Choszczyk (01:13:36):
I haven’t used that particular one. What I will say about stool tests, especially if you’re looking at specifically the diversity of your microbiome, you have to remember that a lot of the bacterial phyla in your microbiome are anaerobic. And so when you have a stool sample, all of those are going to die because it’s going to hit the air. So it’s not always going to be accurate unless you can get a stool sample that is if you go to a facility that can get your stool sample, and it can always be done in this very, very tightly controlled environment. It can be handy. You can look for things like secretory IGA and other inflammatory markers. You can look at zonulin and see how your intestinal permeability is. There’s definitely things about most stool tests, including the biome, including the doctor’s data, GI 360 that I think I mentioned earlier is a great test. I think any of those tests can be useful information as long as you are not building your entire life around one single test. If you certainly get a couple different ones, which I know is not always accessible to people, sometimes a little combination of data can be really helpful. And then like Dr. Kelly said, your intuition paying attention to the cues of your body, the communication that your body is really trying to get through to you.
Kelly McCann, MD (01:14:54):
Yes, yes. Stool testing is not quite ready for primetime. And one of the reasons that I say that is I attended a microbiome conference hosted by Dr. Sabine Hasan, who has a full sequencing genomic stool testing lab outside of Malibu, and she actually invited one person who works for a governmental organization whom I have never heard of called the National Standards of Technology and Regulation. No, no, something like that. National Institute of Standards and Technology, sorry, nist, NIST. And they actually did a split sample of seven different commercially available stool tests. So what they did is they had a thousand people who were omnivores and a thousand people who were vegans, and they submitted stool to samples to nist and they homogenized those stool samples. They put them all together and they came up with a standard of a vegan diet in America stool sample, and they came up with an omnivore American stool sample. So this is the standard. This is the branch of the government that comes up with standards for everything, standards for screws, standards for certain kinds of materials that we use in building, and they are very important. I had never heard of them anyway. So now they have this standardized stool for omnivores and vegans and the American culture, and they split sampled them. They sent them three samples to seven different stool labs, these same exact samples, and none of those labs got it correct.
(01:17:05):
They were not reproducible, they were not accurate to each other. So unfortunately, the commercially available stool tests are not great, not at this time. So it may be fascinating, they could certainly get some of your information correct. But even some of the commercial labs, and they weren’t looking at commercial labs like doctor’s data, which I highly recommend. I mean, doctor’s data and denova I think are probably the best stool testing options for functional labs. They’re still not fantastic, as Sarah said, those cultures, and you’re missing a lot of things when you do a culture. And if you watch my interview with Rick Martin on MicroGen DX, this will make a lot more sense because when we’re doing next generation sequencing, we can actually find things. But most of these labs are doing culture and maybe PCR, so they’re only as good as what you’re looking for. So that’s my long-winded spiel on stool testing. I’m sorry everyone.
Sarah Choszczyk (01:18:18):
That’s very good information.
Kelly McCann, MD (01:18:20):
Okay, let’s go back to Jennifer. She asked, do you think it’s important to try and eat eggs? I don’t love the taste of them. I cannot eat a lot of them, and I’ve been wondering if eating them once a week would really make a difference. I can try and find a way to prepare them. What do you think?
Sarah Choszczyk (01:18:38):
Well, I would love to know what the rest of your dietary pattern looks like. Jennifer, if you’re eating a pretty diverse diet, you probably don’t need to have eggs if you don’t like them. If it’s the only source of protein that does not give you pain or skin issues or digestive issues, then there may be a way to try to find a way to, like you said, put them in other foods so that you don’t really taste them
Kelly McCann, MD (01:19:07):
Right. The other thing is choline, which is in the yolk. That’s probably the highest source of choline in our diet, and we need that choline for our brains, for our cell membranes. I’m sure many of you have heard me talk about phosphatidylcholine and Body Bio PC So egg yolks are really a good source of that choline, and yes, you can try and you could also try other sources, but if eggs, if it’s a texture problem, if it’s a taste problem, that is a little bit trickier to get around. Okay.
Sarah Choszczyk (01:19:52):
And supplementation too. I mean, there are certainly people out there who have been eating on carnivore diet for a very long time. Of course, they would’ve died from scurvy years ago if they had not been supplementing. Is it the best way to get your nutrients? No, probably not. Can you eat food and get all your nutrients that you need without supplement? Probably not. Probably not. So if you cannot deal with eggs at all and you don’t really feel like you can eat other things like liver or fish or other things that have some choline, then supplementing certainly an option.
Kelly McCann, MD (01:20:33):
Yes. All phenols have high histamine or is that an individual issue?
Sarah Choszczyk (01:20:42):
All phenols have high histamine.
Kelly McCann, MD (01:20:46):
Yeah, I’m not sure what she means by phenols. So maybe we’ll move on. And maybe Carol, you can clarify what diet for people with histamine intolerance, oxalate issues and need to be on low FODMAPs. Would the carnivore diet be best? This is from Christopher.
Sarah Choszczyk (01:21:06):
Okay. Gosh, Christopher. Yeah, there’s a lot of things going on there. It’s very complex and I recognize that that is a tough place to be. I don’t know that one specific dietary pattern that we’ve talked about or that’s out there might be the one. You may have to look at specific foods that are safe for you, foods that don’t cause reactions, things like that. So obviously looking at low histamine is going to be helpful. Dr. Kelly has a good low histamine, histamine conscious food list with some recipes. I did write that, but I’m not just plugging myself. Sarah wrote, I did well. I took it from a lot of good information that’s already out there on people who’ve done a lot of research on this, so I’m not going to at all take credit for all of that. Same thing with oxalates. Oxalates are a tough thing especially, and other what we call antinutrients in plant food. If you know for sure that oxalates are an issue, then that’s definitely something to work on, reducing a lot of good information about oxalates. Sally Norton has a whole book on oxalates. I can’t remember the name of her book right now. Toxic Super Foods. Yeah.
Kelly McCann, MD (01:22:23):
Yes, toxic Superfoods. That’s it.
Sarah Choszczyk (01:22:25):
Yeah. If you don’t know for sure that your symptoms are from oxalates though, I would try to get a little bit more clear on that before you just start avoiding things like oxalates. Same with FODMAPs. So here’s the thing with FODMAPs, and for those who don’t know, they’re basically starches that are very difficult to digest. Sometimes they can create a lot of digestive symptoms and discomfort in people who have things like overgrowth, small bowel overgrowth, things like that. The thing with FODMAPs is reducing them can be very helpful in reducing your symptoms. And sometimes that’s just what you need for quality of life and for your mental health, but you’re also missing an awful lot of really good nutrients. So what I learned when I went and got my master’s in nutrition was that along with whatever treatment you’re doing for the overgrowth or the IBS or whatever it is, also reducing your FODMAPs for a little while and then doing that reintroduction piece may be helpful so that you are getting some of those soluble fibers and things that will help diversify your microbiota and push out the overgrowth, the things that are going out of control.
(01:23:44):
So working with someone to help you move along that continuum so that you’re not on such a restricted diet for such a long time. And again, there may be a point where you feel safe enough to start reintroducing some things. You may get to that point where you’re like, you have a little bit of discomfort or a little bit of, I don’t feel quite perfect, but I don’t feel terrible. And that may be that sort of training your system or training your microbiota to sort of adjust to some of those nutrients that you’re not used to, but that may not be where you are right now.
Kelly McCann, MD (01:24:23):
Great answer. Okay, next question. Is a four to one ratio omega six to Omega-3, the optimal ratio. If someone has a ratio of one-to-one or less on testing, do they need to stop fish oil or even fish if they have IgG reactions to lots of nuts and seeds? Can they get omega six up with a diet or do they need supplementation? What’s the best supplement for omega sixes and should it be omega six only and not a blend? That was a mouthful. Thank you for sharing that question.
Sarah Choszczyk (01:24:59):
Question. Yeah. Yeah. So the first thing I would say is that there’s a lot of questions there, and you’ll definitely want to be working with someone, with a doctor, with a nutritionist, maybe both if you’re not already. So if you’re sensitive to all nuts and seeds, then probably supplementation is a good idea. Dr. Kelly just talked about evening primrose oil being a really, really good option for omega sixes. For people who have, I don’t remember if this was one of the questions, but people who have issues with fish oils or for supplementation for omega threes, sometimes going straight to the special pro, resolving mediators can be helpful, especially if you’re trying to resolve inflammation, that’s what omega threes turn into. So that may be an option. But yeah, in any case where you’re really sensitive to something and you can’t get that nutrient through your food supplementation for a while is probably going to be necessary. I don’t know if I answered all the questions
Kelly McCann, MD (01:25:56):
There. That’s okay. There was a lot. I think that’s great. We have a few more questions to go and not much time. And then I did mention the balance oil. So the Body Bio Balance Oil I think can be really helpful as well as I’ve been liking Xymogen’s Mono Pure. So if you have a sensitivity, you have fishy burps with your fish oil. The way that they’ve constructed the Mono Pure, which is a fish oil by Xymogen, can be helpful for people who may not be able to tolerate some of the other fish oils. Let’s talk about avocado oil. I’ve heard that avocado oil is often processed with solvents. Do you know of any good quality avocado oils?
Sarah Choszczyk (01:26:48):
Yeah, that’s also a concern with canola oil sometimes. So what I will say is if you’re concerned about the way something is being processed is really going for an organic option, the organic label is very, very tightly regulated, which means, well, lots of different things. So for a production plant or a farmer or a producer or an organization to be labeled organic, they have to follow these certain very tight regulations. And a lot of that is not using any GMO, which is great if you want to be able to eat things like soy or if you want to be able to use things like canola oil, non GMO. A lot of the times they can’t use the same solvents and chemicals and things that a non-organic producer or a farmer can use. So going with an organic avocado oil is probably going to be your best bet, in my opinion. What do you think, Dr. Kelly?
Kelly McCann, MD (01:27:40):
Yes, definitely organic. I think that that is the best way to go. Yes. Okay. Next question. We talked a lot about food sensitivity testing, and I just had Dr. Just had Michelle put Dr. Ingels in the chat. He’s a naturopath who’s licensed here in California. He has some licenses in other states such as Connecticut that I do not. So that’s a possibility. If you’re not local and you’re in a state where I don’t have licensure or if you want to work with an naturopath, and so that’s their for you if
Sarah Choszczyk (01:28:24):
You want it. He’s a lovely person.
Kelly McCann, MD (01:28:26):
Oh yeah, he’s fantastic. We loved Dr. Ingles. I’m sure we’ll have him on the webinar series at some point. He’s one of my dearest friends, so I always like to support him and his work, his interest is mostly autism. He also has a Lyme book out and does a lot of this allergy and sensitivity. We co-hosted a allergy summit in 2023. Okay. Let’s see. How about, is milk thistle helpful to take before or after alcohol?
Sarah Choszczyk (01:29:03):
That’s a great question. There are certain herbs I know a little bit about, but I’m not an herbalist, so I don’t know what all of the benefits of milk thistle are. I know that it’s supported to the liver, but again, when alcohol is metabolized, you get acid all to hide in your gut as well. So I’m not
Kelly McCann, MD (01:29:23):
Sure there’s much for the acid.
Sarah Choszczyk (01:29:25):
I don’t think so. I don’t think so. Just general support for your liver. I don’t know if taking one dose though is really going to do it. I feel like with herbal with many herbs, it’s sort of one of those things that you take regularly if you might want to talk to an herbalist about that.
Kelly McCann, MD (01:29:41):
Yes. If you’re supporting your liver, I love body Bio PC for supporting liver. There’s research that it supports your entire gastrointestinal system. The mucus layer is mostly phospholipids and mostly phosphatidylcholine. So I’m a big fan of PC for all things, gastrointestinal brain health, et cetera. So that’s another option two. And the next part of that question was how is enzalase different from Enzyme Medica Digest gold enzymes? So the Enzymatics professional product is called critical digestion by Enzyme Sciences. So they have their consumer products and they have their professional products. We carry both. I’ve tried the Enzyme Enzymatic equivalent. It doesn’t work the same, don’t, it’s a little bit of magic. I know that the owners of the company don’t advertise that it helps metabolize alcohol. I don’t really know how it works. Maybe it has an ability to digest the acid alde height. I have no idea, but it’s not the same stuff.
Sarah Choszczyk (01:30:59):
There are a lot of different digestive enzymes. And so when you’re getting an enzyme product that is made for the professional level, like the enzalase and the critical digestion, the potency is usually really there. It’s usually third party tested through the roof. It sometimes we’ll have a lot more different types of enzymes. So you have many different types of enzymes that deal with carbohydrates. There are so many different types of sugars that you need to digest. So when you get something from the store, if you just need something here and there or that pizza gives you issues, but everything else is fine, you can try something like the Enzymatica from the store when you eat pizza and it will probably help. But if you have some sort of more chronic digestive things or you have pancreatic insufficiency and you really need a lot more robust support, getting something like the critical digestion or the enzolace is going to give you a little bit more of that consistent critical, that consistent support, in my opinion.
Kelly McCann, MD (01:32:03):
Thank you. That’s great. Hi, Jane. I’m glad you’re here. Hopefully you’re still here. So we’re going to answer your question. What is the recommendation for proper timing of eating healthy foods slash meals during the day, assuming that one is eating the proper ratio of healthy fats and carbohydrates?
Sarah Choszczyk (01:32:21):
That’s a really fantastic question.
Kelly McCann, MD (01:32:27):
We’ll come
Sarah Choszczyk (01:32:27):
Back. Oh, am I here?
Kelly McCann, MD (01:32:30):
Yes. Try again. We didn’t Go ahead. Okay.
Sarah Choszczyk (01:32:35):
So the first part of my answer is going to be to listen to your body, right? So listen for those hunger cues when you feel them. Sometimes I ask people, what does it feel like when you’re hungry? And they go, so that would be my first suggestion is to really think about what does hunger feel for you? But for the most part, a good thing to think about is eating protein at every meal. Yes. Eating breakfast, even if it’s small, making sure you have something in the morning.
Kelly McCann, MD (01:33:16):
Shoot. Come back, Sarah. In the morning. You froze. You froze. So we got the
Sarah Choszczyk (01:33:31):
Oh, yeah. You’re coming in and out too.
Kelly McCann, MD (01:33:32):
Yeah. So we just got that. You said, make sure you have something in the morning. Make sure there’s protein at every meal. What else?
Sarah Choszczyk (01:33:42):
Yes, especially to fuel your workouts, make sure you’re fueling your workouts and that you’re getting a little bit after workouts. So eating throughout the day. I wouldn’t say eating grazing throughout the day, but eating your meals kind of consistently throughout the day. Protein at each meal. Fiber at each meal, but mostly, yeah, intuition. Listening to your hunger cues, listening to your satiety cues and keeping things as consistently as possible.
Kelly McCann, MD (01:34:12):
Got it. Okay. Jamie asked or said, I was diagnosed with MCAS and I’m definitely histamine and intolerant. I’ve been trying to follow a low histamine diet since the diagnosis four years ago, but I continue to get worse. Intractable migraines, IBS, constipation, brain fog, joint pain. Any suggestions?
Sarah Choszczyk (01:34:35):
Yeah, I would think there’s probably some other underlying things that need to be addressed with someone who is burst in mast cell activation and all of its related conditions.
Kelly McCann, MD (01:34:46):
It really sounds like the root cause hasn’t been identified. So when people are continuing to get worse, that sends alarm bells in my head. It’s not just about the diet and trying to enforce a low histamine diet and they’re not doing it well enough. It’s not that at all. It’s that there’s something else that’s disrupting your immune system and causing leading to that hyperresponsive state. And so finding a practitioner that you can work with, I think would be my primary suggestion. Let’s see. Somebody asked about the name of the fatty acid test. Yes. So it was Kennedy Krieger test at Johns Hopkins paroxysmal lab. The peroxisome is a little organelle in the cell, just like the mitochondria is an organelle in the cell. And what that peroxisome does is it makes all of our fats, so it breaks down our fats. It makes our fats. It is super, super important because if we can’t make fats and break down fats, we can’t make our cell membranes, we can’t make our cholesterol, we can’t make our hormones. So super important. That’s what that one was.
(01:36:07):
Let’s see. My husband is doing slit therapy, and I just got his IgG results back, wondering if I can send the results. And can they adjust by adding eggs, dairy, and gluten? I don’t really know. It depends on who you’re working with and how they’re set up to work with you. I would think that if they’re doing slit therapy and ordered IgG results, that they would be willing to alter the sublingual immunotherapy. Okay. Carol R got back to us. Polyphenols are founded food. Dr. Kelly used the word phenol. Phenolics when referring to the almonds, peas, and rice. So reactions to foods are an individual issue?
Sarah Choszczyk (01:36:58):
Yes.
Kelly McCann, MD (01:36:59):
Yes. So polyphenols are not quite the same thing as the phenolics. The phenolics, though, are chemical compounds that can be found in families of foods, is how I think about it. So tomatoes and peppers, green red peppers have within them a phenolic called piperine. So when Dr. Ingles does the testing, he will test and we will treat with the piperine sublingual immunotherapy. You avoid the foods in the family, you treat with the phenolic rather than taking sublingual immunotherapy for every single food, you do it for the phenolics. That’s how they group them together because they’re related rather than having a food immunotherapy for tomatoes and immunotherapy for peppers. Does that make sense? And
Sarah Choszczyk (01:38:02):
Yes. Say polyphenols. We’re talking about plant compounds, mostly plant compounds, sometimes other compounds, but they can include the phenolic acids and other types, flavonoids, tannic acids, things like that. So when we’re talking about polyphenols, it’s like a big word for all of those different compounds.
Kelly McCann, MD (01:38:21):
Okay. Last question and then we’ll let everybody go. Annette said, my daughter and her boyfriend love eating white rice. I have them. It’s unhealthy for the teeth and very starchy. What’s your take on white rice? And what about soy milk?
Sarah Choszczyk (01:38:43):
Yeah, white rice. We have cultures across our globe that eat a lot of white rice too. And again, I really think it matters to look at the entire dietary pattern. So are they also eating fibrous vegetables? Are they eating lots of different colorful fruits and vegetables? Are they eating lots of high quality lean proteins? So again, making sure we’re able to see the forest for the trees. Is it a good idea to maybe incorporate some other whole grains? Yeah. Yeah, definitely. But that would be my thought on one particular food in an entire dietary pattern. And then soy milk was the other question. My thought on soy products in general is that the research that I’ve seen is that especially organic, non GMO soy products can be fine for most people. If it’s something that you’re uncomfortable with, there’s lots of different dairy free milk products out there. You won’t be completely missing one compound if you skip soy milk. But I personally drink soy milk myself, and I know it’s not accessible to some people. Some people are allergic to it. Some people have issues with hormone related conditions. They can’t eat a lot of phytoestrogens and things like that. But a lot of the research suggests that soy products for most people is fine. They’re fine,
Kelly McCann, MD (01:40:19):
Provided it’s non gmo. Non GMO as much as possible. I mean, if your only option is you don’t know, I would steer clear. But if you want to indulge in that, just making sure that your sources are clean. Sarah, this has been amazing. I know we didn’t get to talk about the GLP ones, but we could
Sarah Choszczyk (01:40:46):
Do an entire webinar on how to do GLP -1 for sure. But a lot of the GLP-1, increasing things that I’ve talked about already are things like getting your protein, getting your fiber. It’s very satiating. That actually increases GLP-1. So there you go. There it is right there. Webinar not needed. Right? There’s in the
Kelly McCann, MD (01:41:09):
32nd clip. So this has been amazing. I love all of your information. You’re so well studied and researched. Where can people find you if they want to work with
Sarah Choszczyk (01:41:22):
You? So the best thing they can do is actually find me through your website. So drkellymccann.com. If you hover over services, the very first thing in the dropdown menu is nutrition consultation. You can see me, even if you are not a patient with Dr. Kelly, there’s an option there for a 30 minute or a 60 minute consult. If it’s the first time you’ve seen me, please choose the 60 minute. We can talk about a lot, but I understand it’s not always financially accessible to everyone. So we can do a lot of good work in 30 minutes, and that’s the best place to get that in touch with me.
Kelly McCann, MD (01:42:01):
Fantastic. Yes. Hopefully people will see how amazing you are and seek out your services. So thank you so much for being with us, Sarah. I really, really appreciate you as always my right hand gal for so many years.
Sarah Choszczyk (01:42:19):
Well, thank you for having me, and thanks for such amazing questions from everyone. It was really great.
Kelly McCann, MD (01:42:24):
Yes, thank you. So we will put out the replay sometime next week. Michelle will work on that, and there will be a transcript and then you can listen to the whole webinar or if you missed parts of it. And then just so you know too, our next webinar is going to be with Julie Walraven, our nurse here at the spring center, and she’s going to be talking about IV nutrients unlocking the power of phosphatidylcholine. So we’ll be talking about PC some more and IV versions of that and nutrient therapy and even chelation. And that will be November? No, what is that? December 6th? December 6th at one 30. It starts a little bit later than our usual time of 11 and or one, so at one 30 on the six. And we look forward to seeing you then. Thank you again, Sarah. It’s been great.
Sarah Choszczyk (01:43:26):
Thank you. Thank you so
Kelly McCann, MD (01:43:27):
Much. Thanks everyone. Everyone, everyone. Bye.
Chat Transcript
00:09:41 Michelle Dyroff: Welcome, everyone! I’m Michelle, Dr. Kelly’s assistant and I’ll be hanging out in the chat. If you have questions for Dr. Kelly or Sarah, please put those in the Q&A, found at the bottom of your zoom screen. We’re recording and you’ll get a replay next week!
Feel free to say hi to each other!
00:18:27 Kelly McCann: HI Everyone! Where are you joining us from?
00:18:44 Kelly McCann: I’d love to hear from you all!
00:19:29 Beverly Verwey: Newmarket, Ontario
00:19:52 Kelly McCann: HI Beverly! Thanks for joining us
00:21:07 Michelle: Welcome!!
00:21:52 Jane Rosen: Jane Rosen from Massachusetts
00:22:11 Health Coach DD: Dr. Kara does a lot of good podcasts
00:22:41 Kelly McCann: Hi Jane!
00:23:11 m.nario: reno nevada
00:23:41 Michelle: Hi everyone! Glad you’re joining us today!
00:27:14 Nikki Berry: Hi from sunny Austin! I tried wild caught fish once. The smell was sickening and filled my home for 3 days!! Never did it again. As sensitive as I am now, I think I’d strongly react and be sick. Any help on this?
00:30:14 Nikki Berry: No problem! Was an RN 25 years. And it wasn’t salmon, think it was tilapia or similar that I like.
00:42:12 Carol R.: High histamine?
00:43:41 Michelle: Hi Carol! We’d love to get to your question. Can you drop it into the Q&A section (see the little question mark icon at the bottom of your screen)?
00:55:06 Michelle: Z biotic: https://zbiotics.com/products/zbiotics?variant=26921653076068
00:55:55 Michelle: Digestive Enzyme: https://shop.kellykmccannmd.com/products/enzalase-by-master-supplements?_pos=1&_sid=503ad9d11&_ss=r&selling_plan=3718152451
01:01:58 jamie: I miss being able to have an occasional glass of white wine so much, but that was the first foodstuff to leave the planet for me-even a tiny sip of any ETOH and BAM severe migraine.
01:09:59 Michelle: Giving up foods/drinks we love can certainly be challenging. I can empathize with that! Thank you for sharing, Jamie. Hopefully the benefits outweigh the sacrifice!
01:10:40 Michelle: Evening Primrose Oil: https://bodybio.com/products/evening-primrose-oil?srsltid=AfmBOooW1xaEsyXVIY6OjCXl2ks61qk1DZXD2NlZcI0dh4Knsf-HJnbJ
01:17:23 Michelle: https://www.aaemonline.org
01:21:40 Health Coach DD: Amazing – I had similar issues… I was lighting up like a Christmas tree with sensitivity testing
01:23:17 Health Coach DD: That’s excellent news – my daughter is also highly “allergic” so I am super interested. Unfortunately we are in CT so not sure he does telehealth
01:23:58 Health Coach DD: This stool sample is very different. It’s from Germany. I’d love you to look into it further and report back later
01:24:30 Health Coach DD: I am so super excited about Dr. Sabine Hazan’s work
01:24:52 Health Coach DD: Great minds ✨
01:29:53 Michelle: Body Bio PC: https://shop.kellykmccannmd.com/products/body-bio-pc-100-caps?_pos=1&_sid=30e608a78&_ss=r&selling_plan=3719823619
01:35:38 Health Coach DD: SPMs were a game changer for me!
01:37:04 Michelle: https://dariningelsnd.com
01:37:22 Michelle: Dr. Darin Ingles website 👆
01:45:59 Michelle: https://www.kennedykrieger.org/patient-care/centers-and-programs/genetics-laboratories/clinical-services/peroxisomal-diseases-testing
01:47:47 Carol R.: Thank you!
01:50:05 Annette Douglas: Thanks
01:50:28 Health Coach DD: What about almond milk
01:51:17 Michelle: https://drkellymccann.com/nutrition-consultation/
01:51:52 Michelle: Thank you to Sarah, Dr. Kelly, and all of you for joining today! The webinar replay email will come out early next week!
01:53:01 Rhonda: great talk. Thanks Rhonda
