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TPV Episode 39 Show Notes: Gut Health

May 17, 2013 in Podcast, Show Notes

Our thirty-ninth show!
Ep. 39: Gut Health

In this episode, Stacy and Sarah discuss gut health, food allergies vs. intolerances, small intestinal bacterial overgrowth treatment, the various forms of elimination dieting to aid in gut recovery, and H. pylori.

On Sunday, May 12. The Paleo View launched their first ever bonus episode – The Mother’s Day show! Download the first bonus show by clicking here! And be on the lookout for our monthly, pay bonus podcast!

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The Paleo View (TPV), Episode 39: Gut Health

 

  • 0:00 – Introduction
  • 1:19 – News & Views
    • Coming off the Beyond Bacon chaos, Stacy returned to Crossfit and is overall working towards recovery from the stress load
    • Stacy had a great Mother’s Day, complete with Urban Poser’s Samoa Donuts – experienced a refreshing awareness where her sweet tooth was easily satisfied and she didn’t feel the need to go over board
    • Sarah had a great couple of days and is very close to being done with part two of the book and then she will work on the cookbook section, which she is really excited to shift gears to
    • The Paleo Approach is roughly 210,000 words right now, the book is an information dense book and people are getting a tremendous deal
    • Sarah has made the science in the book incredibly approachable, just like it is on her blog, and it is truly a complete guide
    • Part two of the book is all about the practical implementation – what lifestyle factors to focus on
    • The book is a beast, with the nickname the encyclopedia – Sarah feels like she is racing for the finish line, but feels like she is going to make it and is looking forward to her three days off before editing work comes
    • On Mother’s Day Sarah and her family hung out at home and played outside – it was a nice day
    • The special bonus episode went live on Mother’s Day (May 12) and is available on iTunes, but you have to look for it under a song and not a podcast

      • The Paleo View will be offered for free, but the The Paleo View Bonus Shows are offered at a minimal cost to recoup some of the costs that have gone into the show
      • It is $0.99 per episode on the CD Baby site, but we don’t know what iTunes will charge.
      • The show is an expanded ‘News and Views’ format of The Paleo View and is a personal, intimate discussion
      • Despite what Sarah and Stacy anticipated, we are experiencing technical difficulties getting iTunes set-up for the bonus show, please use CD Baby until we resolve these issues
    • Sarah hasn’t yet had a chance to listen to the Bonus Show because of book work
    • Stacy was kind of taken back by the level of intimacy that the discussion took, and feels like mothers and daughters will in particular take a lot away on relationship development
    • Stacy’s treadmill desk broke, so is now working from a standing desk
    • Sarah spends a decent amount of time standing at her treadmill desk, especially when reading fine print or after eating a meal – is overall feeling so much better sitting less
    • Stacy wants a standing desk for work, but is worried about being the weird one and how to handle the days where she doesn’t wear flats
    • Stacy tells the world to go check out whatshouldwecallpaleolife.tumblr.com – it is great when you need a laugh!
    • Reminder, please leave your reviews on both The Paleo View and Bonus Show on iTunes!
    • Welcome new listeners! Happy belated Mother’s Day!
    • Episode 38 is a science-y show about gut health, h pylori, small intestinal bacteria overgrowth, and gut repair
  • 24:53 – Science with Sarah: Why do people react more violently to a food after eliminating it? When you stop reacting to food, is that an indicator that your gut has healed?
    • In every gut there are cells that sample the environment inside the gut and present what they find to the immune system, essentially patrolling
    • If you have a leaky gut, a lot more of what is in the gut leaks out and is presented to the immune system
    • Food intolerances and food allergies are both different kinds of antibodies
    • The cells that produce these antibodies are part of the immune system and are there to develop immunity towards certain things
    • There are a number of cells in the immune system – protectors, therapists to calm, directors
    • When you get to the end of an infection it is the director cells that divide and conquer and makes sure that the immune system doesn’t attack the wrong things and that it deactivates once the threat is gone
    • With a food intolerance and food allergy, the middle management cells are directing antibodies
    • In a normal person you achieve immune tolerance towards the food, which is an equal balance between the middle management cells and the suppressing cells – thus having no symptoms
    • If you have a food allergy or intolerance the system is out of balance
    • When you start any elimination diet you can experience exaggerated responses to small exposures for a number of reasons
    • As your immune system regulates and your body heals, eventually you will end up at a point where both the cells that respond to food are at low levels
    • You could eventually reach the point where exposures to food intolerances will not cause dramatic responses – it is a sign that your system has regulated
    • How long it takes to get there is dependent on a number of factors, including genetics, stress level, sleep quality, nutrient density in diet, hormone regulation
    • During the Cavekids PaleoFX panel, Chris Kresser mentioned that health isn’t having a violent reaction to bad food, that is the process to healing – health is when your body knows how to recover from the exposure to bad food (The Paleo View episode where gut health recovery was discussed with Diane Sanfilippo)
    • Stacy notes that people on a paleo diet will heal their gut in time, that there is another side to the intense negative reactions to an exposure where you body will better handle the minor exposures
    • Thanks to Russ from The Domestic Man for chatting about this topic with Stacy, which sparked the suggestion for this podcast topic
  • 36:57 – Q&A
    • Brittany: Our current Functional Medicine Doctor thinks my family has SIBO (small intestinal bacterial overgrowth) and wants us on FODMAP free diet. With all our other food issues, I am concerned that we won’t get the nutrition needed, that my breastmilk will suffer along with my children’s sleep. What is the difference between FODMAPS, GAPS and SCD?
      • Stacy recommends that they look into a GAPS diet and a very structured approach to healing their gut
      • It can be difficult to put kids on a limited diet, but Stacy has seen and heard amazing success stories from people who take a serious approach to healing their gut
      • Sarah notes that GAPS and SCD are very similar
      • GAPS is more of an inclusive system and includes some detoxification elements
      • The general concept behind both GAPS and SCD is that you starve the bacteria in the gut
      • GAPS places an emphasis on gut healing foods, and both highlight digestive enzyme supplements
      • FODMAPS are fermentable sugars, and are sugars and fibers that are rich in fructose, but also includes sugar alcohols and long fiber chains rich in fructose – they are difficult for the body to digest and absorb, and ferment easy – making it easy for the bacteria to eat
      • These are known as the gassy foods, and in someone with FODMAP sensitivity this is called fructose malabsorption, which means your body is having a hard time digesting and absorbing these sugars so there is more to feed the bacteria
      • The autoimmune protocol combines some of those things, but focuses on the inclusion of foods that normalize gut bacteria
      • Omega 3 fatty acids and fiber are the two foods known to have the most profound impact on the composition of your gut
      • Even though there is a large amount of evidence, there are no scientific studies to back up the impact of a GAPS and SCD diet, the low FODMAP diet has a high amount of scientific research to back it up
      • One of the issues that people face when they adopt a GAPS or SCD diet is that eventually the low crab intake starves the overgrowth, but also starves the good bacteria and you need to introduce prebiotics
      • Which means eating more vegetables, starchy vegetables, fruit
      • Stacy notes that if you are new to a paleo diet, focus on cutting out the junk first, and as you get further into it find ways to maximize the nutrient density of the foods you eat and to ultimately improve your gut health
      • Sometimes you have to eat the things you eat because your body needs it (bone broth, organ meat, sardines, etc.)
      • No matter which of these paths you select, autoimmune, GAPS, SCD, etc. take the nutrient dense road and focus on the foods you can eat, not on the foods you can’t eat, and what lifestyle factors you can change to heal your body
    • (55:45) Heather: Looking for help on how to manage a severe case of small intestine bacterial overgrowth (SIBO).
      • Stacy notes that there is a time and a place for antibiotics, because sometimes food alone cannot solve problems
      • In this case, Stacy suggests probiotic foods to help with the re-balancing of her gut
      • Sarah suggests combining the antibiotics with a nutrient dense, gut friendly diet like what was outlined in question 1
      • There have been case reports of SIBO where doctors have combined two or three different kinds of antibiotics, or even pair with anti-fungals, to manage the bacteria
      • Here are other drugs that have shown effectiveness: rifaximin (brand name is Xifaxan), vancomycin, neomycin, tetracycline, metronidazole, levofloxacin and fluconazole
      • Clinical trials where they have combined antibiotic therapy with probiotics and/or prebiotics have shown even better outcomes
      • (Note, consult a doctor first) The common prebiotic typically used in these studies is VSL-3
      • (Note, consult a doctor first) There are also some good studies on treating with prescript assist, which is soil based organisms, but specifically with irritable bowel syndrome
      • (Note, consult a doctor first) There are also a variety of herbs that can be used as antimicrobials: monolaurin, cat’s claw, wormwood, goldenseal (caution: goldenseal stimulates immune system), pau d’arco, olive leaf extract, garlic, barberry, Oregon grape, oregano oil, extra virgin coconut oil, lactoferrin, DGL
      • A b-vitamin complex is a good idea
      • Digestive support supplements can also go a long way to help restore the gut
      • Turn to primaldocs.com and paleophysiciansnetwork.com
    • (1:08:51) Dana: When an infection is not active, should I still be treating it, beyond what I already do for leaky gut?
      • The standard treatment for h. pylori is the same as the base treatment for SIBO, including herbal supplements, under the supervision of a qualified professional
      • H. pylori is a gram negative bacteria that lives in the upper gastro track and is in 50% of the world’s population, prominent in developing countries
      • 80% of cases are asystematic
      • When they are systematic people experience chronic inflammation of the stomach and small intestine, which causes a lot of misleading symptoms
      • H. pylori causes ulcers, and increases your risk of stomach cancer
      • If you get H. pylori early in life it can protect you from immune related conditions, if you get it later in life it can cause immune related conditions
      • One of the best treatments is a nutrient rich diet – the AIP is a great place to start
      • Talk to your doctor about whether or not you need to treat it and what your options and preferences are
    • Don’t forget to check out the bonus show, leave reviews on iTunes, and we will be back next week!
  • 1:22:54 – Outro

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“How Do I Know When It’s Working?” A Quick Troubleshooting Guide to Paleo

April 15, 2013 in FAQ, FAQ, How To Get Started

yoga1It’s a question that many people new to paleolithic nutrition ask either while they are going through that initial adjustment period (especially when jumping into paleo with both feet but also with gradual transitions) or as the months wear on and the difference is not as magical as anticipated.  How do I know when it’s working?  When will I start to lose tons of weight and have lots of energy?  When will my health conditions miraculously disappear?

Well, the answer is “it depends”.

How different did you eat before committing to paleolithic nutrition?  Generally, the more different you are eating now to before you discovered paleo, the harder and longer your adjustment period.  This is especially true if you ate a lot of carbohydrates before.  It can take up to a month for your body to switch over to a metabolism that runs better on fat and in the meantime, you may feel tired, lethargic, have headaches, and generally feel pretty terrible.  But, this isn’t true for everyone.  And of course, the opposite can also be true:  some people are made so sick by the foods they were eating before that they notice an instant improvement to their health.

What health issues are you challenged with?  In my personal experience, most gut health issues will improve dramatically the first couple of weeks on paleo and then continue to improve slowly over the next six months as your gut continues to heal (for more posts on gut health, see here and here).  Issues relating to inflammation typically take longer to show significant improvement depending on how well you are sleeping and managing your stress (typically another month or two).  Remember that for many health issues, you need to address all of the tenants of a paleolithic lifestyle (get good sleep, manage stress, get outside).

Are you in autoimmune denial?  I was.  While out-of-the-box paleo tackled most of my health issues, I still had unresolved autoimmune issues even after four months of strict paleolithic nutrition.  I had to do the autoimmune protocol (I’ve written about the autoimmune protocol extensively and this is also the topic of my book), in which you also exclude all the gray area foods.  If you have been eating a strict paleolithic diet for two months and are still dealing with health issues, you might have to do this too.  The good news is that after a few months of no eggs, no nuts, no seeds, no nightshades, no alcohol, no NSAIDs, low caffeine and no cheating, with a concurrent focus on eating extremely nutrient-dense foods (lots of vegetables, grass-fed meat, organ meat, fish and bone broth), most people can add at least some of those things back in.

Is your gut in REALLY bad shape?  It is possible that your gut was very leaky before you started paleo, so healing is just plain ol’ going to take a while.  Especially, if you suspect that you have Small Intestinal Bacterial Overgrowth or extensive gut damage, you’ll need to focus on Repairing The Gut, which can take 6 months to 2 years (although you should see continuous gradual improvement).  For all of the posts I’ve written on gut health, click here.

stomach acidHow is your digestion?  You might need to add some digestive support supplements for a little while to help your body heal.  These include digestive enzymes, ox bile, and stomach acid supplements (which are contraindicated for those with ulcers, blood clotting disorders, or taking NSAIDs).  Digestive enzymes and ox bile, while they can be expensive, are generally very safe to take as directed on the bottle (just make sure you actually eat once you take digestive enzymes because taking them and then not eating can cause damage to your gut).  If you are interested in a stomach acid supplement, check out my post on stomach acid here and this post by Steve Wright.

Do you have unknown food sensitivities?  If you’ve had a leaky gut for some time, you may have food sensitivities that you are unaware of.  Many alternative health care practitioners will order an IgG and/or IgA antibody screen which tests for food sensitivities.  The good news is that if you leave those foods out of your diet for a while, you can usually add them back in after your gut has fully healed.  If you have symptoms of Irritable Bowel Syndrome (like diarrhea, constipation, gas, bloating, acid reflux), another possibility is a FODMAP sensitivity.  Other potential culprits include salicylate sensitivity and food allergies (such as latex allergies, citrus, fish and shellfish, tree nuts, eggs, and dairy).

Do you need liver detox support? If you had/have an overgrowth of bacteria or yeast in your gut that are now dying off in great numbers, your liver might be working in overdrive.  B-vitamins (rich in red meat and organ meat), sulfur (rich in cruciferous vegetables and vegetables from the allium family), selenium (rich in seafood and organ meat) molybdenum (rich in organ meat) are important to support the liver.  Milk thistle (extract or tea) may also be helpful.  Choosing foods rich in these substances (or supplements) to help support liver detox is also useful for anyone losing weight, especially if the weight is coming off quickly.  This is because the body uses the fat tissues to store some toxins and excess hormones like estrogen (which gets them safely out of the body’s circulation) and rapid weigh loss has the potential to release these putting an additional strain on the liver.

Are you sleeping enough?  Yes, this has nothing to do with diet.  But sleep has a profound effect on every system in your body and if you are not getting enough of it, you can’t heal properly.  Aim for 8-10 hours per night in a pitch black room (see this post if you’re having trouble getting good sleep).  You can read more about the importance of sleep on the immune system in this teaser excerpt from The Paleo Approach.

Are you stressed? If you are not taking adequate measures to manage your stress (like getting activity but avoiding excessively strenuous exercise, spending time outside, having fun, getting enough sleep and developing strategies to manage psychological stressors), then your stress hormones might be out of whack.  If you have been under high stress for a long time and have trouble sleeping, you may have adrenal fatigue.  Both www.RobbWolf.com and www.BalancedBites.com have lots of great suggestions for healing from adrenal fatigue.

Did you go too low carb? What types of carbs (fruit versus starchy vegetables versus both versus neither) and how many carbs we should eat (varying from ketogenic diets and 20g per day to plenty of “safe starches” and upwards of 300g per day) is probably the most hotly debated topic within the paleo community.  One of the reasons for there being no clear answer as to what is best is that the carb intake of historically-studied and modern hunter-gatherer populations varies wildly.  On one end of the extreme are the Eskimos, who consume a diet composed approximately of 50% fat, 35% protein and 15% carbohydrate.  On the other end of the extreme are the Kitavans, who consume a diet composed approximately of 20% fat, 10% protein and 70% carbohydrate.  And of course, everything in between.  This probably reflects the fact that macronutrient ratios are not as important as food quality and nutrient density.  So, if your introduction to the concept of paleo was through a resource that expounded on the benefits of low carb, it is important to understand that this view is not representative of the entire paleo community and no consensus exists.  It’s also important to understand, that while blood sugar regulation is extremely important, going too low carb can be tough on your thyroid and can decrease leptin sensitivity (see this post and this post).  Also, eating adequate carbohydrates and especially insoluble fiber is important for proper regulation of ghrelin levels (see this post).  So, what is a good carbohydrate intake?  That’s actually highly individual (you can read this series of posts about optimizing your carb intake here, here and here), but if you are not feeling very good on a standard paleo diet, adding a little fruit or starchy vegetables is a good idea to try.

Are you inappropriately IFing? There are many enthusiastic supporters of Intermittent Fasting, but it’s important to understand that this is only appropriate for very healthy people.  If your sleep is not great, if your stress in not managed, if you are substantially overweight or if you have any kind of chronic disease, skipping breakfast (or breakfast and lunch) can cause dysregulated cortisol and undermine your other efforts.  This is not something to experiment with early on in your paleo journey.

What are your goals and how far away from them are you?  If you have a lot of weight to lose, you will probably notice a big drop in weight fairly quickly.  This will be mostly water weight, but don’t worry, fat is also being burned and you should eventually settle down into some nice steady weight loss (slow and steady wins the race, so there is no reason to be frustrated with weight loss if you are “only” losing a half pound per week-that’s actually very healthy!).  When your body seems resistant to weight loss, try addressing sleep quality and stress levels, but also be aware of the impact of female hormones and hunger hormones (levels and sensitivity).  For more tips and tricks for losing weight, see this post.

gray foodsAre you truly complying with paleolithic nutrition?  There are few things worse than being “almost paleo” (depending on your health challenges and what “almost” actually means for you).  While many people can successfully navigate the murky waters of cheats and occasional gluten consumption, if you are asking the question “when will I feel fabulous” while not actually following a paleo diet as strictly as you can, then you might be a person who just can’t cheat or tolerate occasional gluten exposure.  And from a metabolism, hormone and taste-bud adaptation standpoint, allowing yourself the occasional slice of pizza or pie a la mode can really derail your efforts to get healthy and perpetuate cravings, food addictions, and feelings of deprivation.  I advise eating very strict paleo for at least a month before you play with eating small amounts of dairy or legumes or allowing yourself cheat meals (and I recommend a lifelong avoidance of gluten for most people).  If strict paleo isn’t enough to make you feel great, look at the gray area foods in your diet (eggs, nuts, seeds, nightshades, alcohol, caffeine).  Maybe one of them is the culprit (nightshades are my number one suspect).  But if you are truly sticking to it, my guess is you are already feeling much, much better!

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Book Review: The Paleo Autoimmune Protocol: Foods to Include and Eliminate in The Paleo AIP by Anne Angelone

March 18, 2013 in Book Reviews, Resources

The Paleo Autoimmune ProtocolThis e-book  is the third is a series by the functional medicine specialist Anne Angelone of Expanding Qi. It follows both The Autoimmune Diet: Nourishing Your True Identity With Meals That Heal, which is a book aimed more at the general population rather than the paleo community, and The Autoimmune Paleo Plan which I reviewed here.  As a matter of fact, it was my review of The Autoimmune Paleo Plan which, at least in part, inspired this latest book, The Paleo Autoimmune Protocol: Foods to Include and Eliminate in The Paleo AIP.

It is rarely so easy to write a book review.  But, this review is easy for me to write for two reasons.  First, I am intimately familiar with the subject matter, being in the process of writing a  book about diet and lifestyle modifications for autoimmune disease myself (haven’t heard of The Paleo Approach?  Read more about it here).   Second, I was a consultant on this book and provided suggestions and feedback throughout its development.  Yes, this book gets the The Paleo Mom Seal of Approval.

This e-book fills an important void for people trying to navigate the paleo autoimmune protocol.   It is the perfect quick reference guide for people looking for the do’s and don’t's of the autoimmune protocol.  I frequently get asked if I’ve put together food lists of “allowed foods”.  And while these lists will be included in The Paleo Approach, you don’t need to wait until September for this information!  The Paleo Autoimmune Protocol contains lists and charts detailing exactly which foods to eat and which foods to avoid.  In fact, the whole goal of this book is to provide you with detailed lists of which foods are included on the autoimmune protocol and which aren’t and which are for some people. The Paleo Autoimmune Protocol also includes information to help people navigate vegetables to accommodate common sensitivities, including: FODMAPs, SIBO considerations, high histamine foods, high salicylate foods high oxalate foods, food sensitivities, and cross-reactive proteins.  It also includes lists of healing foods to include more of in your diet and a list of immune-stimulating herbs and supplements to avoid.

This book is a companion book to The Autoimmune Paleo Plan, however it stands alone as a quick reference guide for people somewhat familiar with the autoimmune protocol either from one of Anne’s other books, books like Practical Paleo by Diane Sanfilippo (you can read my review of that book here), or from my website.   If you really want to understand the why’s behind the food restrictions in the autoimmune protocol, this e-book won’t tell you that, but if you want to know if broccoli is a FODMAP and whether or not it’s okay for people with histamine sensitivities, this is the book for you!

So, if you are struggling with implementing the autoimmune protocol and think that a quick reference guide of what foods are okay to eat and which aren’t would be useful for you, then I definitely recommend The Autoimmune Paleo Plan.  Where can you find this book?  It is a kindle book available from amazon.com for $4.99.  Don’t worry, you don’t actually need a kindle to buy and read this book.  Free programs and apps are available for computers, tablets and phones (click here for more information).  AND if you’re the kind of person who just prefers a paper book in your hands (or to keep in your purse to refer to while at the grocery store), you can get a printed version of the book as well for only $3 more!

Want to know more about the author?  Anne Angelone is a licensed acupuncturist and functional medicine practitioner with a history of ankylosing spondylitis.  Her practice is called Expanding Qi (also on Facebook and Twitter) based in San Francisco, California.  She is registered both in the Paleo Physician’s Network and Primal Docs.  Anne also offers a month-long teleclass to help individuals get oriented in starting a 30-day Autoimmune Paleo Diet challenge, typically starting at the beginning of each month (the next one starts April 2nd!  You can mention Paleo Mom in the referral box).

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The Science and Art of Paleofying—Part 4 Sugars

December 8, 2012 in Baking Ingredients, Cooking Tips

Creating paleo adaptations of our favorite recipes (a.k.a. paleofying) helps us stay on board with paleo through the holidays (and many other times of the year), help us feel like we can still celebrate and partake in all of the fun and food luxury of the season.  I know that many of you are pulling out your old favorite recipes and wondering what to do with them (I’ve had many questions lately about rules of thumb for flour substitutions, and alternatives for those with nut or egg allergies).  I am too.  I have several family favorite recipes that I am tackling this year.

Paleofying is as much an art as it is a science.  I vaguely remember a time when I did not have extremely well-honed cooking instincts (I think that was back in middle school).  But even starting out as a fairly good cook, there was still a learning curve to all of these new ingredients and to baking without gluten.  After a year of paleo baking (and blogging!), I have a much better understanding of how to adapt conventional recipes now and thought it was high time I share some of this knowledge and experience with you, in addition to my perfected recipes.

This is the fourth in a 6-part post series to help you start the process of adapting your recipes (did I call this a 4-part series before?  Yes, I have realized I needed two extra parts and I reserve the right to expand this to a 7-part series if needed!).  In the first post, I discussed paleo flours and other ingredients that add bulk to a recipe.  In the second post, I discussed binders (ingredients that hold baking together).  In third post, I discussed leavening agents and fats.  In this part, I will discuss sugar.  Part 5 will discuss liquid ingredients and wet-to-dry ratios.  Part 6 will discuss some strategies for doing iterations and troubleshooting your recipes.  You may also be interested in some of my posts that reference paleo baking ingredients:  Important Pantry Items for The Paleo Baker, Paleo Flour Substitutes, Sugar vs. Sweeteners, and Is Sugar Paleo?).

I’ve written about sugar in a couple of posts (see Sugar vs. Sweeteners, and Is Sugar Paleo?).  I don’t want to get into the merit of different sugars in terms of health in this post, partly because I’ve already covered that and partly because this isn’t about which sugar is less bad for you.  We’ve already agreed that we are making a special treat, which means we’ve already decided a little sugar is okay.  This post is just about the chemistry of different sweeteners in your recipes.

Granulated sugar:

Most of the recipes you will be adapting will call for granulated sugar, typically white, light brown or dark brown.  It would be a completely valid choice to just use refined sugar in your recipe (see Is Sugar Paleo?), but really, I know that most of us feel better if we can use healthier options.  So, if your recipe calls for white sugar, the best substitute is Sucanat (also called Evaporated Cane Juice).  This will have a bit of a molasses flavor to it, which you may or may not like in your baking (and depending on what other flavors you have going on, you might not even notice).  Sucanat can be fairly large granules so you might want to pulse a few times in a food processor to replace white sugar in terms of texture too.

Dark Brown sugar can best be replaced by Muscovado Sugar (a.k.a. Barbados Sugar).  This is a rich, dark brown, very molassesy moist sugar that behaves just like dark brown sugar in a recipe (but is unrefined).  I love this stuff.  Light brown sugar is also better replaced by muscovado sugar because of the moisture that it has compared to sucanat, however the molasses flavor is stronger.  You could also replace light brown sugar with sucanat. and a little honey or molasses to replicate the moisture of light brown sugar.  The general rule of thumb is to replace 1 cup of brown sugar with 1 cup of white sugar (or sucanat in this case) + 1 ½ Tbsp molasses (or honey).

The other granulated sugar options that I like in terms of health are is date sugar and maple sugar.  Date sugar can replace either white or brown sugar in your recipe (although again, you may want to add a little molasses or honey for moisture).  Maple sugar has a very strong maple syrup flavor, which may or may not be desired.  No, I don’t like powdered sugar alcohols, stevia, or coconut/palm sugar.  I don’t like palm sugar (a.k.a. coconut sugar) because it is very high in inulin fiber, which is a FODMAP and is not easily digestible by most people.  I don’t like stevia because it has a hormone structure and the longterm effects of regular consumption have not been studied.  I don’t like sugar alcohols because they are gut irritants (with the possible exception of erythritol, but I’m not comfortable enough with its benign-ness to actually recommend it).  Just stick with glucose/sucrose (your body knows what to do with it) and don’t eat too much.

Generally, 1 cup of granulated sugar equals 1 cup packed brown sugar or 1 cup of super-fine sugar.  Really, you can replace granulated sugar cup for cup with any other form of granulated sugar.

One of the biggest things that you will probably consider doing with your recipes is decreasing the overall sugar content.  I typically use as little as a quarter the sugar called for in the original recipe when I’m paleofying.  In this case, it helps to know if sugar is a dry ingredient or a wet ingredient so you can figure out what other adjustments need to be made.  Even though granulated sugar feels dry, it’s really a wet ingredient (although, when it’s creamed with butter, it also adds to the lightness of a recipe and in that respect behaves a little more like a dry ingredient).  It doesn’t contribute that much moisture though, so I’ve been relatively successful drastically reducing the amount of granulated sugar in a recipe without any other adjustments.  However, if you choose to replace sugar with honey, molasses, dried fruit, applesauce etc., you will almost always have to adjust the wet and dry ingredients accordingly.

Liquid sugar:

If a recipe calls for molasses, honey, or maple syrup, then you’re in luck.  If you want to use less that your recipe calls for though, you will have to adjust your wet and dry ingredients, either by adding to your wet ingredients or by reducing your dry ingredients.

If a recipe calls for corn syrup, honey makes a pretty good substitute most of the time.  It doesn’t have quite the thickness or the ability to form long strings (unless you’re making a candy and then it works very well).  You can also replace each 1 cup of corn syrup with 1 cup granulated sugar (like sucanat) plus 1/4 cup whatever liquid is used in the recipe (water, coconut milk, etc.).

If you want to replace granulated sugar with a liquid sugar, then typically adjusting the wet and dry ingredients is necessary.  The exception is if you plan to replace some or all of the flour in a recipe with coconut flour.  In that case, replacing sugar with honey or molasses can actually really help a coconut flour based recipe hold together since coconut flour is such a thirsty flour (it absorbs water like crazy!).

When can you replace granulated sugar with liquid sugar?  This is tricky to do in cookies, but it is possible (see my Orange-Strawberry (Nut-Free) Cut-Out Cookies and Chocolate Cut-Out Cookies (Nut-Free)).  It’s much easier to do with cake and muffin recipes where there’s naturally more wet ingredients.

If you are trying to figure out sweetness levels to gauge how much honey or maple syrup to add, here’s a general guide (this is by sweetness):

3/4 cup sugar = 1 cup unsulphured molasses.
Also, decrease the liquid by 1/4 cup for each cup of molasses, omit any baking powder and add 1/2 teaspoon baking soda instead.

1 1/4 cups sugar = 1 cup honey or maple syrup.  Also, decrease liquid by 1/3 cup.

No, I don’t like agave nectar because it is high in fructose (what’s the point in avoiding high fructose corn syrup if we’re just going to eat agave?).  It might be important to mention that some honey can be high in fructose too.  If you have a FODMAP sensitivity and honey is a problem, there’s a huge variability in the fructose content from batch to batch and brand to brand, so simply trying another brand may be better tolerated.  Honey also has the highest quantity of monosaccharaides, so often those with SIBO can tolerate honey but no other sugars.

Some flavor tips:  I like the combination of maple syrup and honey to provide a more neutral flavor (neither the honey nor the maple syrup overwhelms) such as in my Best Paleo Pumpkin Pie recipe.  Molasses pairs very beautifully with chocolate and coffee flavors and can actually trick the palate into thinking a chocolate flavor is stronger.

Icing/Confectioners sugar:

Icing sugar (a.k.a. confectioners’ sugar) contains corn starch and is not paleo.  You can make a very fine powder by wizzing sucanat in your food processor or blender for a minute (careful when you take off the lid because it does that same powder in the air thing that icing sugar does).  If you need the drying effects of the corn starch in icing sugar (which you may if you’re making a frosting or icing to pipe onto cookies), try adding some arrowroot powder, perhaps as little as 1-2 Tbsp per cup of sugar.  As a general place to start, replace

1 ¾ cups icing sugar = 1 cup ground granulated sugar + ¾ cups arrowroot powder.

Other Ways to Get Sweetness into Your Baking:

Depending on how long you’ve been paleo (and exactly what version of paleo you follow), your sweet tooth will have adapted quite dramatically.  You might even find that your baking is sweet enough with the inclusion of some fruit ingredients and that you don’t need sugar or honey at all.  Here are some other ingredients that add sweetness to baking.

Fresh or Stewed Pureed Fruit—This is anything like mashed banana, applesauce, pearsauce, reconstituted dates, etc.  You might be using this as a binder, but remember that is also adds sweetness to your recipe.

Dried Fruit—dates are magical, but they aren’t the only dried fruit around.  Raisins, dried cranberries (typically sweetened), dried apricots, dried papaya, dried pineapple, dried blueberries, dried strawberries, dried cherries, dried figs and dates all add sweetness and a lovely chew to a recipe.  If a recipe calls for raisins, try replacing with a mix of dried fruit for a different flavor.  Blended, these dried fruit can also help bind a recipe.

Chocolate—unless you are using 100% cocoa dark/baking chocolate or cocoa powder, you are adding sugar to your recipe.  I have had great success with some recipes using only semisweet chocolate as a sweetener (see my Decadent Double Chocolate Cookies (Nut-free, Coconut-free, Egg-free) and Chocolate Cupcakes with Ganache Frosting (nut-free) recipes).

A note on candy making:  it’s very challenging to reduce the amount of sugar when making confections because heating the sugar and making long strings of sugar molecules is the whole reason why you can achieve the desired result (whether a chewy toffee or crunchy brittle).  While changing the total amount of sugar doesn’t typically work, you can often change the type of sugar (replace granulated sugar and water with honey for example).  You can also reduce the total sweetness with other tricks, like adding more nuts to a brittle.

I hope this will get you started on your paleofying adventures.  As you play more and more with these ingredients and get to understand their properties better, it will be easier to intuit what will work in any particular recipe.  But, I still have recipes that take me many iterations to get right.  And of course, if you adapt a recipe that is absolutely awesome, you are welcome to e-mail it to me to share on the blog:  thepaleomommy@gmail.com

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