Hurricanes, Climate Change, and Human Behavior

Why Environmentalists Need to Stop Preaching and Start Selling

The spate of hurricanes hammering the American southeast, a region of which I am now a resident, has touched off the usual volley of diatribes regarding climate change. As much as I sympathize with the concerns of my fellow environmentalists, I have lost all interests in their posts on the topic. They have confined themselves to an ideological echo chamber that will, if they do not escape it, continue to bring them defeat after defeat at state houses, court houses, and ballot boxes across the country. My purpose here is to help my fellow environmentalists understand a few important things about the future of environmentalism in America, and the world at large, which takes its cues with regards to environmental policy from scientists and activists here in the United States. This is largely due to two factors — first, the large amount of funding that goes into environmental research in the United States and, second, our (relatively) strong first amendment rights.

Yet the environmental movement in the United States stands to lose both of the former strengths, not to mention the important environmental safeguards that they have fought so hard for. There are a few things they need to understand about their behavior that will determine if tomorrow we wake up to an environment we can live in, or one that is seemingly hell-bent on our destruction.

Environmentalists face a few key choices in the coming years that will determine whether or not they succeed, or fail, in preventing further environmental catastrophes. Their present strategies are obviously failing. They reached their high-water mark with the Obama White House and a democrat and moderate-Republican congress, both of which have disappeared. And, I would argue, neither of which were particularly good for the environment — they just weren’t perceived as being as bad as the alternatives.

All of this comes down to one simple premise: environmentalists need to stop preaching and start selling. Only when they start selling, will they stop losing and start winning. I have noted that a similar problem exists in American medicine. The average doctor thinks their job is to check boxes on complicated check lists. Their reimbursement is tied to little more than this, whether the patient lives, dies, or how much they suffer in between. They do not have “skin in the game,” as Nasseem Taleb would say. Nor do modern day environmentalists, and I believe this lack of an effective feedback mechanism explains why all the king’s think-tanks, lawyers, white papers, symposiums, and conferences are failing to make environmentalism a decisive issue in American politics, when, in fact, it should be.

This is why I studied behavioral economics, and particularly the work of people like Dan Ariely and Thomas Kahnman, who might be called empirical economists. Most of the problems that environmentalists face in the arena of public opinion come down to simple economics. It really is the economy, stupid.

First and foremost, environmentalism, as a deciding factor in people’s political and economic choices, has reached its high-water mark with its present tactics. New tactics are necessary if it is going to continue to make improvements in public health. With the past few decades, the growth of environmental science departments and a resurgence in ecology in American academia has successfully created a generation of young, educated Americans who are ardent environmentalists. Even the most philistine college-educated Americans understand the importance of protecting the environment. Major corporations are putting money into “green buildings” and “environmental quality.” In part this is self-serving — hotels are happy to do less laundry and make a positive PR move, just as any business is happy to cut heating and cooling costs for positive PR. Yet the segment of American society to which the environment is important, let alone the decisive factor, in their political choices, has reached its zenith. Young people are opting out of college due to exhorbitant costs and a relative lack of professional opportunities that will make the necessary student debt worth the risk. Not to mention that everyone who is anyone, from Al Gore to Leonardo Dicaprio, is shouting from the rooftops how important the environment is. The voting publich don’t care. They don’t care because no amount of Arctic ice, happy polar bears, or narwhals are going to put bread on the table for the average American.

What is tragic is that this sale of America’s environmental quality promises to have profoundly negative consequences for public health and for the nation’s wealth. The fastest way for Donald Trump and the Steve Bannon wing of the Republican party to be thrown out of politics is for them to make a bad deal that compromises America’s environment in a way that compromises its health and economy — and that is a real possibility. Why do you think they opposed the TPP? Environmentalists like myself have disowned the democratic party after Obama and the Clintons endorsed what was clearly a thinly veiled scam to give broad economic powers and environmental regulatory powers to a group of unelected bureaucrats. We have enough trouble keeping the bureaucrats down the street in line. And what did Obama’s White House do for the environment, anyway? I vaguely remember a long battle over the Keystone XL pipeline, which, if some reports are true, would actually have fewer negative environmental effects than the current system, in which trains transport oil (trains are prone to derailment, whereas pipelines can be shut off quickly and remotely).

Fortunately, there is an entire field of study dedicated to understanding the economic importance of the ecosystem — ecological economics. It has some of the most profound insights into how we can better structure our societies of any field I have discovered. Between ecological economics and behavioral economics, I have a few pieces of advice for my fellow environmentalists in these apocalyptic times.

  1. Get out of your ideological echo chamber. Stop wasting your time with white papers, symposiums, conferences, think-tanks, and lobbyists. Did Donald Trump get elected using any of those strategies? You are now in a position where you must market to not only moderates in a new way (who did not vote for Hillary), but to Trump’s base. They are not going to be swayed by fancy climate change models or the latest scientific study. I know, I know, they should care about those things. But they don’t. So get over it and just move on. The endless blog posts, op-eds, columns — the entire machinery of solipsistic environmentalist martyrdom has to stop. There is nothing more pathetic than a group of people who can’t shut up for long enough to understand that their current strategy is a failure.
  2. Stop justifying your calls to action with climate change. The people who have bought into climate change have already bought into it. The remainder of America sees it as an attempt to foist yet more regulations and laws upon them that will ultimately be used to undermine their freedoms, while enriching corporations. If Irma, Harvey, wild-fires above LA, and drought in California won’t convince mainstream America that climate change is anthropogenic, then nothing will. Fire and blood could rain down from the sky and the people who are still holding out on climate change would start quoting the Book of Revelations, not the latest white paper on warming ocean temperatures.
  3. Stop trying to fix the world with regulations. Pigouvian economic policies are as outdated as the horse and buggy, blood-letting, and phrenology. Have you noticed that a big part of Trump’s platform was to destroy “job-killing” regulations? Did you notice that all the regulations we already have are still failing to solve America’s health epidemic, which is, almost entirely, due to environmental factors? Have you noticed that many of the big victories for the environment lately have been on the local level? Whether it’s people bringing their own grocery bags to the store or bicycling to work, this progress has been made by individuals and private businesses, not government regulations. I can personally attest to the reality that often these regulations are passed on the premise of protecting the environment, but contain carefully constructed wording that can literally steal money from the poor and give it to wealthy corporations that then pollute the environment. The right to a healthy environment is arguably best enshrined in the 5th amendment, the right to property. Why don’t we just enforce that, instead of passing endless amounts of regulations that seem to just be stifling the kind of competition that gets rid of corporations large enough to subvert democracy and buy their way out of their environmental crimes?
  4. Start basing your arguments on things that the average person cares about. How about the fact that modern factory farming has destroyed the American way of life? That it’s reduced America’s farmers to a generation of share croppers who are sicker, fatter, dumber, and more dependent on the government than ever before? If you haven’t noticed, the message that the government is ruining life for the average American has carried more than a few people to political victory in recent years. Here is how you get someone like Donald Trump elected to the Presidency. First, make the financial and economic life for average people miserable, and make sure that it gets worse every single year. Bankrupt them to the point that none of them own land, and will therefore not have “skin in the game” with regards to flooding, erosion, loss of biodiversity, and so on. If they were still around, America’s independent farmers would now be the most influential and staunch environmentalists in the nation. Instead, main street seems willing to sell its environmental quality to get their jobs back. And who can blame them? What other choices have Wallstreet White Houses and Congresses given them? They have nothing left, and people will sell anything rather than go hungry, or see their children with less opportunity than they had. Consider the fact that thanks to America’s agro-industrial complex, the Gulf of Mexico has a dead zone the size of the state of Texas. How many jobs would that fishery support? After the Deep Water Horizon catastrophe, hundreds of billions of dollars in damage was done to those fisheries. The pollution from that spill will be with us for a long time to come. Point out the fact that for all he money BP and every other oil company is pulling out of the Gulf, those red states are still in the economic doldrums. How many more oil platforms would you need to create the same value as those fisheries?
  5. Start talking about the health effects of environmental pollution. The vast majority of disease is due to environmental pollution. You would bring down health insurance premiums faster by fixing America’s ailing water-infrastructure, by creating building codes (note that these are locally, not state or federally mandated) that create healthy indoor-air, and that preserve outdoor spaces free of light, sound, air, and water pollution. There is a famous essay in environmental philosophy that asks, to wit, should we choose to preserve people, or penguins? Americans have obviously chosen people.
  6. Start talking about the importance of local, clean agriculture to our future. Local agriculture, with integrated farms owned by their operators, are the greatest environmental asset of all time. Farmers are pragmatic. Their priority, so long as they are practicing organic agriculture, is to work with the natural cycles of the land to maximize its health and productivity, while minimizing environmental degradation. And what could be more populist, nationalist, or pro-American than bringing back the family farm?
  7. Point out that our current environmental problems are the result of short-sighted thinking and the “sale” of environmental quality. Is Appalachia any better off for having mined mountains of coal? You may not convince the folks in West-by-God-Virginia to embrace environmentalism, but those of us who live (or have lived) downstream are ever more aware of the problems we face from upstream pollution. And even those bastions of what we might call anti-environmentalism have, as the toxicity of environmental pollution has been made manifest, begun to turn away from those old ideals. There is a resurgence of environmentalism amongst Christians and conservatives in America that had nothing to do with the efforts of modern international academia. My mentor, Rick Sponaugle, comes from coal country, and our entire medical practice is predicated upon the effects of environmental toxicity. Some of the largest class action lawsuits in environmental health have come from the very places that voted for Trump. Those seeds of discontentment will only grow. Those places, that were bastions for anti-environmentalism, will turn into the most rabidly environmentalist regions of the country, in due time.

Environmentalism is in danger of foundering in this nation. Fortunately, there are strong undercurrents of environmentalism in exactly the voting blocks that swept Donald Trump to victory, and that will leave establishment Republicans and Democrats alike without hope of re-election. The key to making progress for our environment now is in changing the tactics of modern environmentalism to attract the moderate and conservative voters who look upon its socialist and academic agenda as ridiculous.

TL;DR: Stop whining about the Trump White House backing out of the Paris Climate accords and deporting illegal immigrants, and get out there and help voters understand that they are all, at heart, environmentalists.

Enzymes, Anti-Nutrients, and Digestion

The following is an excerpt from Doctor Stillman’s online course, “Practical Wellness.” To find out more or to subscribe, visit StillmanMD.com.

Most people do not think of enzymes as, “nutrients,” but the fact that all raw, fresh foods contain active enzymes would suggest that they are important in your diet. Enzymes, unlike minerals, certain vitamins, and macronutrients, can be destroyed by acid, heat, and many other factors, and even when refrigerated will degrade over time.

Enzymes are the molecular machines that perform all of life’s processes, whether they are enzymes in a papaya fruit or enzymes in your liver. Enzymes are complex proteins, which are made up of amino acids. A single enzyme may contain hundreds or thousands of individual amino acids. They may also contain carbohydrates and fats. They depend on a delicate balance of electrical and chemical bonds. The electrical bonds that hold them together can be very delicate. Even a few degrees difference in temperature can destroy an enzyme. The same is true for pH or the concentration of different ions or molecules. Most methods of food preservation change one of these conditions to destroy enzymes, preventing bacteria from generating energy and reproducing, and so preventing the food from spoiling. These methods, however, also destroy the enzymes in the food itself. There are some methods of food preservation, such as pickling, that instead of destroying the food, colonize it with beneficial bacteria. These are called probiotics. Until recently, peoples’ diets included large quantities of fresh, raw foods with active enzymes. These enzymes remain active when eaten and play a role in the digestion of your food. People with diseases that decrease their digestive enzymes, such as cystic fibrosis, require large enzyme pills to be able to digest their food and avoid malnutrition.

Enzymes are most intact in raw, fresh foods, seeds that have been sprouted, or in foods that have been fermented (and not pasteurized afterward). Other methods of food preservation or preparation, including cooking, destroy enzymes.

Within the cells that make up a food, the enzymes are carefully controlled and compartmentalized. The cell is careful not to allow digestive enzymes into parts of the cell that are vital to its survival. These enzymes are stored in special compartments called vesicles or organelles (which may have different names depending on their function, i.e. lysosome, phagolysosome, etc.). If it were to release these enzymes into, say, its nucleus, it could destroy the cell. Pancreatitis is an example of a disease in which digestive enzymes, produced by the pancreas, find their way out of their vesicles or organelles. Severe pancreatitis is life-threatening. The enzymes in the pancreas can literally digest the organ itself, leaving dead, rotting tissue in the center of their abdomen. This is often fatal. There is an old surgical aphorism — “don’t touch the pancreas!” Given that about half of what the pancreas does is to produce and secrete enzymes, this is a testament to the importance of enzymes.

Like a healthy pancreas, food that has been harvested, but not processed, still has its enzymes in its vesicles or organelles, where they cannot destroy other parts of the cell. Food that is crushed or blended will spoil faster, because their digestive enzymes are not contained within organelles or vesicles.

The power of enzymes should not be understated.

The rest of Doctor Stillman’s course, Practical Wellness, is coming to StillmanMD.com soon. Subscribe now to stay up to date with Doctor Stillman’s work.

The Pitch

I’ve had to make a few start up pitches over the last few years. When I spoke with my co-founder, Chris Lee, tonight about a VC he would be meeting next week, Chris asked that I put together a few slides for the pitch.

I genuinely enjoy pitches. There is an art and a science to them, which makes them challenging. Not to mention the high stakes.

How do I condense the reality of the modern medical crisis, and how disruptive meal planning technology will solve it, into two sides?

Simple.

  1. Start with the undeniable reality that America’s best and brightest are failing to deliver on preserving and improving America’s health. And that therefore a new approach is necessary.
  2. Point out that the new approach isn’t just fly-by-night snake oil, but it has a foundation is ground-breaking new research.
  3. Remind them that as Americans run out of cash and credit, they will look for cost-neutral ways to meet their nutritional needs. effective
  4. The opportunities for crowd-science with health and fitness apps has everyone with a brain salivating over the possibilities. Personalized medicine starts here.

Meal Vista is coming this fall to help you revolutionize your diet and your health in a way that won’t hit your wallet.

Wish us luck. Keep an eye out for a pitch with slides along the lines of what I wrote above.

The Biochemical Structure of Your Food

The following is an excerpt from Doctor Stillman’s online course, “Practical Wellness.” To find out more or to subscribe, visit StillmanMD.com.

The nutritional properties of your food depends on its biochemical structure. Its biochemical structure depends on its function in nature, which we call food groups. How to best prepare any food depends on the mechanisms that are present in the food that can help or hinder your digestion. This includes how cells within the food are organized, what enzymes are present, and whether or not the food is exposed to water, heat, or enzymes before you eat it.

Fruits are used by plants as a means to spread their seeds. The fruit, which animals eat, is packed with nutrition and fiber that, when it transits through the animal, provide an excellent fertilizer for the new plant. Fruits are meant to be eaten fresh. They will decompose quickly, which means that if they are going to be eaten, they need to be preserved in some way. Since they are meant to be eaten, they are easily digested, and many of their most important nutrients are lost in the preservation process. The cells within fruits are each compartmentalized carefully to protect their nutrients until the food is eaten. This is why a bruised fruit will turn brown, whereas the same fruit would remain the perfect color on the shelf for months. The force of impact does not directly change the fruit’s color, the breaking of its cells and perhaps the introduction of air into those cells, which will increase oxidation.

Vegetables are perhaps the most diverse food group. This includes starchy root vegetables and fibrous leaves. What we typically think of as vegetables are not meant to be eaten, they are vital to the plant’s survival. They typically require some kind of cooking to be eaten, although many are eaten raw. Sometimes, they have compounds in them that are meant to discourage animals from eating them. A good example would be the spicy compounds in plants in the mustard family and the spicy capsaicin in hot peppers. Some animals have adapted to use these compounds in a medicinal way. Both capsaicin and mustard compounds have powerful health benefits. Vegetables may also require preservation to have any kind of shelf life, although many vegetables are designed as storage devices for plants. Potatoes, turnips, beets — root vegetables of all kinds — tend to keep well, so long as they are dry and cold. Like fruits, the nutritional value of vegetables is highly dependent on their being eaten in a raw state. Vegetables often pack their leaves, roots, or stems with nutrients that are susceptible to oxidation.

Meats, the living organs and muscles of animals, are susceptible to spoilage the moment the animal is butchered. Bacteria are introduced during the butchering process that can quickly make the meat go rancid. Sunlight and air will cause oxidation and spoilage as well. This is why meats are kept cold or are preserved immediately in some way.

Milk and dairy are also highly susceptible to spoilage. They can be fermented with probiotic bacteria to create yogurt or kefir. The sugar in milk and dairy is broken down in the fermentation process. Pasteurization, which is legally required for almost all dairy products, destroys enzymes and degrades certain nutrients in milk. Milk, unlike other whole foods, is acellular — meaning that it does not consist of “cells.” Its nutrients are dissolved in the milk itself.

Eggs are the unfertilized ovum of birds, most commonly chickens. Eggs are divided into the yolk and the white, which each contain different nutrients necessary for the growth and development of a bird. Eggs are highly susceptible to spoilage, but over days or weeks, even at room temperature, because of their hard external shell.

Seeds are a category of foods that includes grains, legumes, and nuts. Seeds are how many plants reproduce, and, unlike fruit, having animals eat seeds defeats this end. Seeds often contain compounds that inhibit digestion by animals. However, seeds are also meant to survive years or even decades in the ground, which means that they need little if any preserving. They can be kept as is, so long as that is dry and usually in darkness. During development, all water is removed from seeds, leaving them completely dry. This is why they do not spoil for long periods of time. Their signal to germinate is water. Soaking seeds will cause them to sprout. This also signals them to deactivate their defenses against your digestion and to turn on the enzymes that they need to grow and mature. This makes them more digestible.

Enzymes are an important subject in biology in general. They are essentially the gears of your metabolism, without which nothing could happen in your body, from the firing of neurons to the digestion of food to the creation of new cells.

The rest of Doctor Stillman’s course, Practical Wellness, is coming to StillmanMD.com soon. Subscribe now to stay up to date with Doctor Stillman’s work.

How Food Spoils: Microbes and Oxidation

The following is an excerpt from Doctor Stillman’s online course, “Practical Wellness.” To find out more or to subscribe, visit StillmanMD.com.

Food preservation is any process or practice that increases the period of time that the food will be edible. Fundamental to this process are two concepts. First, you have to prevent the growth of dangerous bacteria. Second, you have to prevent spoiling of the food through certain chemical reactions. Often, these objectives are one and the same.

To understand why food spoils, it is helpful to understand why it doesn’t spoil on the vine, in the ground, or while it is grazing out in the field. Any living organism has mechanisms to prevent its decay and enable it to survive and reproduce. Every organism has an immune system to fight off disease and repair injury. Once food is picked, harvested, or slaughtered, it slowly begins to decay.

Bacterial growth depends, like any organism, on the right balance of nutrients, temperature, acidity, and humidity or moisture (among other things). Altering any of these factors can preserve food. Salting food removes any water from it, soaking it in acid lowers the pH, which are just two examples of preserving food (covered in more detail below). Foremost, the bacteria must be present and able to reproduce. This is why canning can preserve food. The heat destroys any bacteria and the air-tight seals of the cans or bottles prevent any from entering.

Oxidation is the other process by which food spoils. When you bruise an apple, the air that suddenly can reach the antioxidants in its now damaged cells quickly turns those cells brown. The oxygen in water can cause iron to rust, which turns it from a dark, black or blue color to rust, which is brown. Many preservatives work by preventing oxidation.

Oxidation is opposed by reduction. Oxidation is the loss of electrons, while reduction is the gain of electrons. Oxidation and reduction are not just relevant to food spoilage, but to aging. Free radicals are one of the most important causes of aging. Free radicals are produced by oxidation. Major nutrients like vitamin C and vitamin E, whose health benefits are well known, prevent oxidation, and are called “antioxidants” for that reason.

Preservatives that work through oxidation and reduction may have different effects on food, microbes, and on the human body. Preservatives that work through oxidizing bacteria may also oxidize human cells, resulting in damage to cell components or even DNA, which is carcinogenic or cancer-causing.

Because preservatives are so heavily relied upon by the modern food industry, there is significant industry-sponsored science surrounding their safety, and relatively little data to balance it that comes from unbiased sources.

How do plants and animals prevent these processes from causing their flesh or fruit to rot in the field? They carefully separate their cells into different compartments and control the levels of oxygen, water, and ions in each. This is going on in each and every cell and organ of your body at all times. Microbes or oxidation can chew through these compartments and consume these nutrients. All organisms devote enormous energy to preventing oxidation and microbial invasion to prevent exactly this.

The rest of Doctor Stillman’s course, Practical Wellness, is coming to StillmanMD.com soon. Subscribe now to stay up to date with Doctor Stillman’s work.

Food in Nature: Raw, Fresh Foods

The following is an excerpt from Doctor Stillman’s online course, “Practical Wellness.” To find out more or to subscribe, visit StillmanMD.com.

In order to understand how food is preserved and the implications of how it is preserved to your health, it is important to understand what food is in its fresh, raw state.

Raw foods are foods that have not been cooked or frozen, meaning that their cellular structures and enzymes are intact. Cooking and freezing gradually break down these structures. Even when refrigerated, enzymes and cellular structures gradually break down. As they break down, they become susceptible to microbes including fungi and bacteria that can be harmful if eaten.

Raw, fresh foods have always been a major part of the human diet because of the enormous energy that otherwise goes into preserving food. Freezing has only become possible in the last few decades. Cooking has become simple with modern technology. Prior to this, cooking required labor to find and gather fuel and start and maintain a fire, not to mention creating cooking implements, pots, and pans. For this reason, a large amount of food was consumed raw. Foods that were preserved were often preserved with fermentation or pickling.

Once it is picked or harvested, food can either be prepared for immediate consumption or it can be preserved. Many foods, like beans and nuts, can remain edible for long periods of time without additional preservation. Ultimately, there are a few key ways in which we modify our food to either make it more palatable, digestible, or to preserve it.

To understand the basic principles behind how to prepare food in a healthy way, you have to understand the basics of food biochemistry and microbiology.

The rest of Doctor Stillman’s course, Practical Wellness, is coming to StillmanMD.com soon. Subscribe now to stay up to date with Doctor Stillman’s work.

Mindfulness and Physical Activity

The following is an excerpt from Doctor Stillman’s online course, “Practical Wellness.” To find out more or to subscribe, visit StillmanMD.com.

Exercise in the West has generally consisted of either manual labor or sports. What is interesting is that neither of these takes, as their stated goal, longevity and good health. This is in stark contrast to the traditions of Yoga and traditional martial arts that come to us from the East. These traditions also have much to offer us aside from physical activity. They have sophisticated insights into how to use food, herbs, and our minds to achieve and maintain health.

Yoga has become popular enough in the United States that it requires no explanation. It is worth pointing out that perhaps most of the yoga being practiced in the United States is far removed from its origins, and therefore much of the benefits that people seek from yoga may be absent from modern practice. It is difficult to be more specific than that in guiding you to the yoga practice that would be best for your health.

Traditional martial arts come to us from Southeast Asia. Systems of martial arts are found from the tip of the sub-continent to the northern reaches of Japan and Korea. Many of them unfortunately make the same mistakes in training as Western sports do, like repetitive head trauma or overuse. To find a school of martial arts that will train you in a way that is compatible with longevity as well as physical fitness, find a school where there are old masters who are still physically fit. A successful student will replicate the health, or disease, of their masters. This can also guide you away from sports or exercises that are detrimental to your health. The reason you don’t see people at fifty, sixty, and seventy years old playing soccer or football is that injuries are common in these sports and players are not trained to avoid or recover from them. Yoga and martial arts, in contrast, can be practiced by anyone with meaningful results.

Part of the success of yoga and martial arts to build health is that they typically are comprehensive in their attention to physical fitness. Flexibility, strength, endurance, and speed are all valued and taught. In most cases, mindfulness is an important part of the practice of yoga or martial arts.

Yoga and martial arts typically include some kind of mindfulness practice, though this may be limited. Mindfulness is about connecting to and understanding your present circumstances and your entire being. The physical body is in many ways the gateway to the rest of our beings. Systems of energy medicine, such as acupuncture, may have profound emotional effects through interactions with the physical body. It is no coincidence that the practice of mindfulness is inseparable from the practice of yoga and martial arts. If it is worthwhile to pursue exercise, it is worthwhile to pursue exercise that incorporates mindfulness. Awareness of the body cultivated during exercise can inform therapeutic decisions about many different health issues. Without this awareness, patients and their healers may feel like they are groping blindly forward, instead of making intelligent decisions.

That is why I recommend everyone to have a practice of mindfulness rooted in a strong tradition of healing, such as traditional Chinese martial arts or yoga.

The rest of Doctor Stillman’s course, Practical Wellness, is coming to StillmanMD.com soon. Subscribe now to stay up to date with Doctor Stillman’s work.

Five Steps to Elimination Diet Success

The following is an excerpt from Doctor Stillman’s online course, “Practical Wellness.” To find out more or to subscribe, visit StillmanMD.com.

I have been eliminating and playing with my diet since I was diagnosed with food allergies at the ripe old age of seven. I had to cut out dairy, eggs, and wheat. It did work. I felt better. I could not stick with it, however. The world has come a long way in twenty or so years and it has never been easier to follow an elimination diet. Here are ten quick steps to success on your elimination diet.

  1. Prepare. You can’t just reinvent your diet overnight. You should plan it out. You should research and compile a list of recipes you’re excited to try. Start integrating them into your diet slowly long before you plan to start your elimination diet. Get them just right, so you can smoothly transition to them without feeling like you’re starving for good food. It takes time to learn to cook with new foods, which is what you’ll be doing on an elimination diet.
  2. Rotate. Don’t quit everything all at once. Pick one or two things (more if you think you can handle it) that you think are most likely at the root of your problems. Cycle these things out of your diet for at least two weeks. Cycle them back in and see if you see any worsening of your symptoms. Then pick the next two suspects — rinse and repeat until you’ve found your problem foods.
  3. Find replacements, and make them similar to what you’re used to. If you’re quitting dairy, you have so many options for replacements now it’s almost absurd. They’re even affordable. The importance of replacements should not be understated. You are going to want to eat similar things to what you were already eating. Pay attention to subtle differences too. You may not realize why you even like certain foods. When you eat cake, is it the sweetness you want, or the creaminess of the frosting? Identify what you love about your favorite foods — then go out and find similar foods that are healthy and free of what you’re eliminating.
  4. Eliminate foods with a buddy. There is power in this shared experience. Maybe your buddy has similar problems and is trying to figure out what bothers them. Whether you’re avoiding the same foods or different foods, having someone to talk to, commiserate with, and troubleshoot with can go a long way. You’re also less likely to cheat on your elimination diet if you feel like it would be betraying someone else.
  5. Know what foods you’re avoiding and where they are. There would be nothing worse than going to all the time and trouble of an elimination diet and find out that something you were eating was contaminated. This is why I created Foodwise Mobile! But Foodwise isn’t perfect (we’re working on it — believe me). If your elimination diet isn’t working, get to work reading labels (or scanning barcodes!) to figure out if something you’re eating could be contaminated with something you’re trying to avoid.

The rest of Doctor Stillman’s course, Practical Wellness, is coming to StillmanMD.com soon. Subscribe now to stay up to date with Doctor Stillman’s work.

Hormones, Endocrine Disrupting Compounds, and Your Diet

When most people hear “hormones” they think of how they make them fat, moody, irritable, anxious, or otherwise uncomfortable. This is truly the result of hormonal imbalances. Your hormonal system — called the endocrine system — is an incredibly delicate system. Tiny changes in the amount of hormones in your body can cause vast changes throughout your system. This is why it is so important to understand how your diet affects your hormones. This topic deserves a book unto itself, but there are a few things worth mentioning with respect to elimination diets.

First, that your hormones depend on your nutritional status. The cause of diabetes (type 2) is excessive carbohydrates and sugars in the diet, and I can only describe this disease as a complete catastrophe. It is entirely curable with diet. Carbohydrates and sugars must be limited and essential nutrients like magnesium must be increased. Pay attention to micronutrients like trace minerals. Iodine is essential for thyroid function and is low in our diets because we tend not to eat much fish and seaweed, which are high in iodine. Boron is necessary for hormone production and is likewise low in our food supply.

Second, you should know that chemicals in our environment, including food, air, and water, can all disrupt the endocrine system. They’re called endocrine disruptors. Certain chemicals, like aluminum, bromine, arsenic, lead, or mercury, which may contaminate the food supply or even be used as artificial food additives, are all known to have these effects.

Last, your endocrine system is integral to your nervous system. Many of your endocrine organs are actually made of neurons! Anything that affects the nervous system can affect your endocrine system, causing hormonal imbalances.

Eliminating anti-nutrients and endocrine disruptors, and maximizing your lifestyle and diet for balance in your hormonal system can do wonders for any illness.

Endocrine Disruptors

1. Harvey P, Darbre P. Endocrine disrupters and human health: could oestrogenic chemicals in body care cosmetics adversely affect breast cancer incidence in women? J Appl Toxicol. 2004. http://onlinelibrary.wiley.com/doi/10.1002/jat.978/full. Accessed January 27, 2016.

2. Legler J. New insights into the endocrine disrupting effects of brominated flame retardants. Chemosphere. 2008. http://www.sciencedirect.com/science/article/pii/S0045653508006085.Accessed November 26, 2014.

3. Diamanti-Kandarakis E, Bourguignon J-P, Giudice LC, et al. Endocrine-Disrupting Chemicals: An Endocrine Society Scientific Statement. July 2013. http://press.endocrine.org/doi/abs/10.1210/er.2009-0002. Accessed January 1, 2015.

4. Newbold RR, Padilla-Banks E, Snyder RJ, Phillips TM, Jefferson WN. Developmental exposure to endocrine disruptors and the obesity epidemic. Reprod Toxicol. 2007;23(3):290–296. doi:10.1016/j.reprotox.2006.12.010.

5. Grün F, Blumberg B. Endocrine disrupters as obesogens. Mol Cell Endocrinol. 2009;304(1):19–29. doi:10.1016/j.mce.2009.02.018.

The Endocrine System and Inflammation

1. GREER MA, GRIMM Y, STUDER H. Qualitative Changes in the Secretion of Thyroid Hormones Induced by Iodine Deficiency. Endocrinology. 1968;83(6):1193–1198. doi:10.1210/endo-83–6–1193.

2. Naghii MR, Samman S. The effect of boron supplementation on its urinary excretion and selected cardiovascular risk factors in healthy male subjects. Biol Trace Elem Res. 1997;56(3):273–286. doi:10.1007/BF02785299.

3. Naghii MR, Samman S. The role of boron in nutrition and metabolism. Prog Food Nutr Sci. 1993;17(4):331–349. http://www.ncbi.nlm.nih.gov/pubmed/8140253. Accessed January 20, 2017.

4. Naghii MR, Mofid M, Asgari AR, Hedayati M, Daneshpour M-S. Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines. J Trace Elem Med Biol. 2011;25(1):54–58. doi:10.1016/j.jtemb.2010.10.001.

5. Dandona P, Aljada A, Bandyopadhyay A, et al. Inflammation: the link between insulin resistance, obesity and diabetes. Trends Immunol. 2004;25(1):4–7. doi:10.1016/J.IT.2003.10.013.

6. Festa A, D’Agostino R, Howard G, Mykkänen L, Tracy RP, Haffner SM. Chronic Subclinical Inflammation as Part of the Insulin Resistance Syndrome. Circulation. 2000;102(1).

Celiac Disease and What It Teaches Us About Food Allergies, Intolerance, and the Immune System

Celiac disease is the other end of the food allergy and intolerance spectrum. Celiac disease does not involve IgE, it involves IgG and IgA. These immunoglobulins don’t cause itching, they are the immunoglobulins that your body uses to attack bacteria, viruses, and sometimes microbes. They don’t trigger histamine release, which means they don’t cause itching. But they do trigger inflammation.

IgA and IgG are part of a larger immune response that you know all too well. When you have a cold, the flu, or a bad case of food poisoning, part of your symptoms are really due to the immune system and how it’s attacking the virus or bacteria that is attacking you. IgA and IgG are the bulk of your immunoglobulin response to these infections.

IgA is present mostly in the gut while IgG is present in the gut, breastmilk, and your blood. Foods, from the moment they touch your lips, are having their proteins digested and assimilated by your body as nutrients. These proteins do cross the gut lining, whether in the mouth or the small intestine, and can provoke an immune response, and therefore inflammation, anywhere along the gut, from entrance to exit. These immune responses, however, may not be noticeable. They may start moments or hours after eating. They may include responses anywhere along the length of the gut, whether it’s a headache triggered as soon as you eat the food or one that comes on hours after you’ve eaten it. Maybe it isn’t a headache, but abdominal pain. Maybe it isn’t pain at all, but diarrhea, gas, or constipation. It may also be that these symptoms are due to interactions between the food and the microbiome, rather than your immune system and the food itself (more on that in the next section).

IgA and IgG are powerful stimulators of the immune response. When they are being triggered, they’re also simultaneously triggering the body’s stress responses. This can lead to a vicious cycle in which the food, which you keep eating, constantly stresses your system, robbing your immune system of its power to fight the real threats to your health, and even leading to confusion in the immune system that causes it to destroy your own tissues.

I explain how things go wrong in, “How does your immune system work, and how do things go wrong?”

If IgA and IgG target foods that you keep eating, you essentially turn your gut into an area that your immune system thinks is an infection. If you think that sounds like a problem, you’re right. What happens next is all too predictable — your body stops trying to digest your food and starts trying to kill it.

That means producing lots of immunoglobulins to the gut, where they turn acute inflammation into chronic inflammation.

Not only do IgA and IgG mediated responses cause inflammation in the gut, they can cause inflammation elsewhere, which means symptoms far away from the gut.

So many of our food intolerances, whether the symptoms are abdominal pain, headaches, diarrhea, constipation — the list goes on — are due to these IgA and IgG-mediated responses.