Occasionally, I will see a patient that is interested in pursing Paleo from the "get go.."
HOWEVER, a great many more are brought to Paleo, "kicking and screaming!"
These individuals usually have seen a few other health care providers, have tried multiple regimens and still don't feel well.... and dietary change becomes a therapy of last resort!
Even "health conscious" folks fall into this camp. They are certain that there MUST be some magical herb...some vitamin combination... some procedure (i.e. a colonic...good luck with that one!!!) that is going to fix their problem.
If a "magic bullet" exist....I DON"T KNOW ABOUT IT!
And if you do...PLEASE SHARE!
So thus begins "Paleo Negotiations"....
In general terms I describe Paleo....as meats, poultry, fish, seafood, fruits and vegetables with a spattering of nuts....
After the look of shock fades...on come the negotiations...
Q: "So, I can have corn, right??"....... A: " No corn is not considered a vegetable...think of it more as a grain."
Q: "I can have potatoes though, right??"... A: "No potatoes, they are a tuber and they contain saponins...which can exacerbate leaky gut." (Note in non- Crohns and Colitis patient...I do allow the occasional sweet potato...No saponins. )
Q: "If I can't have bread, what do I put my peanut butter on??".... A: "GOOD NEWS...you will not be eating peanut butter so that will not be an issue...Peanuts are legumes and legumes are NOT PALEO...you can have your almond butter on celery sticks or apple slices"
Q: "HEY....I thought Dr. Oz said that legumes were GOOD for you...what gives??? .... A: "Let Dr. Oz stick with heart surgery and let doctors WHO ACTUALLY TREAT PATIENTS with nutrition make the recommendations!!!!"
And so on and so forth.....I think you get the idea.....
So how much Paleo is enough Paleo??
My two camps are the IBD (inflammatory bowel disease) and everybody else (IBS, Chronic Diarrhea, Chronic Constipation, Reflux, etc.)
IBD ...is an auto-immune disorder (whatever that is...probably an outdated term, but that is fodder for another post!)...and with this group I am strict strict strict!!
For the first month...I only allow meat, poultry, fish, seafood, vegetables and a small amount of low glycemic fruit...(insulin is pro-inflammatory...NEED TO CONTROL INSULIN!!!) Notable restrictions include eggs (YEP sorry...I do try to re-introduce after a month), tomatoes (especially cherry tomatoes), peppers (not so much bell peppers ..but any pepper that contains a significant amount of capsaicin...exacerbates leaky gut), nuts (allergies and food sensitivities) and absolutely no seeds!! (Seeds have a lot in common with grains and probably are not really Paleo any way...)
After a month if the patient is improved we try to SLOWLY introduce some of the dis-allowed "Paleo-friendly" foods. At this time we may also even try a bit o' honey...(ha ha get it???) and the occasional sweet potato.
The process is slow...but the results can be quite rewarding!
In the "everyone else category" .... I am a little less strict.
I actually will lean more towards a "specific carbohydrate diet" type plan...
This program as described in the book "Breaking the Vicious Cycle"...allows for a little dairy in the form of some cheeses and yogurt....and a few legumes.
The major thrust of the program looks to restrict certain long-chain starches (carbohydrates) that can promote intestinal distress. If this program is not successful (and it usually is) we can move on to a more "Paleo-style" program....
YES I KNOW.....I allow some DAIRY (does dairy have four letters????)....I know I am on the road to perdition!!
Again...I started this piece off with the statement that diet therapy often starts with "negotiations".... Most people are NOT zealots.... they just want to feel better with as minimal disruption to there lives as possible....YES, I do think a stricter interpretation of Paleo is probably better...but I am a realist and I will do what works!
Some general recommendations for both groups.....
I recommend steaming or cooking ALL foods during those initial stages. This breaks down the fiber and increases digestibility. This approach seems to be helpful, especially with those individuals with a very sensitive GI tract. (In fact for very sensitive folks...we adopt a "baby food" style program until we observe some healing..)
I also recommend (2) supplements, digestive enzymes and probiotics.
Digestive enzymes assist the body in breaking down the food. The more digested your food is...the better it will be assimilated and the less problems it will cause you.
Probiotics are another key supplement....more and more data suggest that both IBD and conditions like IBS are related to imbalances of gut flora. By restricting starches and taking probiotics, re-balancing of gut flora can be assisted...If this approach is not successful....I do have a few other tricks up
my sleeve....(another time and another post...)
There it is...in a nut shell (almond...not peanut!!)...stage I of "Paleo Negotiations"... after we observe for month on comes Phase II
Until next time...
-Dr B
HOWEVER, a great many more are brought to Paleo, "kicking and screaming!"
These individuals usually have seen a few other health care providers, have tried multiple regimens and still don't feel well.... and dietary change becomes a therapy of last resort!
Even "health conscious" folks fall into this camp. They are certain that there MUST be some magical herb...some vitamin combination... some procedure (i.e. a colonic...good luck with that one!!!) that is going to fix their problem.
If a "magic bullet" exist....I DON"T KNOW ABOUT IT!
And if you do...PLEASE SHARE!
So thus begins "Paleo Negotiations"....
In general terms I describe Paleo....as meats, poultry, fish, seafood, fruits and vegetables with a spattering of nuts....
After the look of shock fades...on come the negotiations...
Q: "So, I can have corn, right??"....... A: " No corn is not considered a vegetable...think of it more as a grain."
Q: "I can have potatoes though, right??"... A: "No potatoes, they are a tuber and they contain saponins...which can exacerbate leaky gut." (Note in non- Crohns and Colitis patient...I do allow the occasional sweet potato...No saponins. )
Q: "If I can't have bread, what do I put my peanut butter on??".... A: "GOOD NEWS...you will not be eating peanut butter so that will not be an issue...Peanuts are legumes and legumes are NOT PALEO...you can have your almond butter on celery sticks or apple slices"
Q: "HEY....I thought Dr. Oz said that legumes were GOOD for you...what gives??? .... A: "Let Dr. Oz stick with heart surgery and let doctors WHO ACTUALLY TREAT PATIENTS with nutrition make the recommendations!!!!"
And so on and so forth.....I think you get the idea.....
So how much Paleo is enough Paleo??
My two camps are the IBD (inflammatory bowel disease) and everybody else (IBS, Chronic Diarrhea, Chronic Constipation, Reflux, etc.)
IBD ...is an auto-immune disorder (whatever that is...probably an outdated term, but that is fodder for another post!)...and with this group I am strict strict strict!!
For the first month...I only allow meat, poultry, fish, seafood, vegetables and a small amount of low glycemic fruit...(insulin is pro-inflammatory...NEED TO CONTROL INSULIN!!!) Notable restrictions include eggs (YEP sorry...I do try to re-introduce after a month), tomatoes (especially cherry tomatoes), peppers (not so much bell peppers ..but any pepper that contains a significant amount of capsaicin...exacerbates leaky gut), nuts (allergies and food sensitivities) and absolutely no seeds!! (Seeds have a lot in common with grains and probably are not really Paleo any way...)
After a month if the patient is improved we try to SLOWLY introduce some of the dis-allowed "Paleo-friendly" foods. At this time we may also even try a bit o' honey...(ha ha get it???) and the occasional sweet potato.
The process is slow...but the results can be quite rewarding!
In the "everyone else category" .... I am a little less strict.
I actually will lean more towards a "specific carbohydrate diet" type plan...
This program as described in the book "Breaking the Vicious Cycle"...allows for a little dairy in the form of some cheeses and yogurt....and a few legumes.
The major thrust of the program looks to restrict certain long-chain starches (carbohydrates) that can promote intestinal distress. If this program is not successful (and it usually is) we can move on to a more "Paleo-style" program....
YES I KNOW.....I allow some DAIRY (does dairy have four letters????)....I know I am on the road to perdition!!
Again...I started this piece off with the statement that diet therapy often starts with "negotiations".... Most people are NOT zealots.... they just want to feel better with as minimal disruption to there lives as possible....YES, I do think a stricter interpretation of Paleo is probably better...but I am a realist and I will do what works!
Some general recommendations for both groups.....
I recommend steaming or cooking ALL foods during those initial stages. This breaks down the fiber and increases digestibility. This approach seems to be helpful, especially with those individuals with a very sensitive GI tract. (In fact for very sensitive folks...we adopt a "baby food" style program until we observe some healing..)
I also recommend (2) supplements, digestive enzymes and probiotics.
Digestive enzymes assist the body in breaking down the food. The more digested your food is...the better it will be assimilated and the less problems it will cause you.
Probiotics are another key supplement....more and more data suggest that both IBD and conditions like IBS are related to imbalances of gut flora. By restricting starches and taking probiotics, re-balancing of gut flora can be assisted...If this approach is not successful....I do have a few other tricks up
my sleeve....(another time and another post...)
There it is...in a nut shell (almond...not peanut!!)...stage I of "Paleo Negotiations"... after we observe for month on comes Phase II
Until next time...
-Dr B
No comments:
Post a Comment