“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!

AIP FAQ: “I am confused about fruit on the paleo autoimmune protocol. Could you explain?”

February 4, 2013 in FAQ

I am going to be addressing many Frequently Asked Questions about the Autoimmune Protocol in some posts over the next few months.  If you have a question that you think should be answered, you may e-mail me at thepaleomommy@gmail.com.

I get asked about fruit on the AIP very frequently.  I am intentionally vague with my recommendations for and against fruit in the Autoimmune Protocol because tolerance and need are highly variable.  The short answer is, it’s individual.

I will, of course, be going into extreme detail to answer this question in my book.  However, I feel like this question also needs to be answered here.

There are a couple of factors that are going to determine whether or not fruit is okay or beneficial for you to include in your diet, which fruits and how much fruit.

Many autoimmune diseases are very sensitive to blood sugar changes. This is more likely to be true if you’ve had a history of obesity or metabolic derangement. In that case, limiting to one serving of fruit with each meal seems to work well.  Lower sugar fruits like berries tend to be better for blood sugar regulation.  Berries are also high in several vitamins and antioxidants, which can be very beneficial for resolving inflammation.  Other good low-sugar fruits include grapefruit (one of my personal favorites) and other citrus,  melons (except watermelon), kiwis, apricots, and tart green apples.

For others with better blood sugar regulation, fruit can be an important source of carbohydrates in the absence of starchy vegetables. Because of the high frequency of gut dysbiosis in autoimmune disease, most people with autoimmune diseases need to be very careful about starchy vegetables, at least at first.   But, going too low carbohydrate can also be problematic (increases leptin resistance which stimulates inflammation).  So, increasing fruit intake can be very helpful for anyone who is  underweight to normal weight (and not needing to lose weight) but who also doesn’t tolerate starchy vegetables.  In this case, higher sugar fruits and larger portions are typically well tolerated.  High glucose content fruits will be the most helpful for those who want to gain weight.  These include bananas, grapes, apricots, figs, plums, cherries, and pineapple.  Citrus, berries and melon (except watermelon) also tend to have more glucose than fructose.

Fructose contributes more to inflammation than glucose.  So, keeping portions of very high fructose content fruits on the small and infrequent side is a good idea even for those who don’t have FODMAP sensitivities (they aren’t explicitly banned, but do be aware of how you feel after you eat them).  These include mango, red apples, papaya, and watermelon.  Dried fruits tend to concentrate the sugars so extra caution is required in terms of portion size.

As a quick aside (but seems relevant here), starches are avoided for everyone with overgrowths (bacterial or yeast), which is the majority of those with autoimmune diseases.  But, some people suffer undergrowths in which cases starches are very valuable (starches tend to be high in “prebiotics” which is anything hard for you to digest but easy for your gut bacteria to digest). That mostly applies to people with gut disorders like celiac disease and IBD, but also anyone who has frequent diarrhea as a symptom of their disease.

More information on starches:

More information for anyone who is underweight:

More information about my book:

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 sugarDate 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

Real People, Real Paleo: Kimmy and Jamie’s Story UPDATE

September 21, 2012 in Real People, Real Paleo

“Real People, Real Paleo” is a series of posts written by real people who were inspired to share their paleo story with you.  There is such diversity in the challenges that bring us to a paleo diet and lifestyle and in what we hope to achieve by adopting them.  These stories are intended to be a place of inspiration, written by real people, showing the diversity of our needs and our approaches to this way of eating and living, and explaining how each individual’s implementation of paleo meets their needs.  By sharing these people’s stories with you on my blog, I hope to redefine what paleo success is.  I do not believe that eating paleo is purely about losing weight, gaining muscle, and having 6-pack abs.  I believe that paleo is about being healthy enough to thoroughly enjoy life, whatever that means for you, and about sustainability for our entire lives.  If you are interested in writing up your story, email me at thepaleomommy@gmail.com

This is an update on Kimmy’s and Jamie’s Story.

Since I wrote the last post I have tweaked Jamie’s diet a lot as he was still experiencing trouble with sleeping (he hadn’t slept through a single night since 9 months!) and his skin was a lot better but he still had bumps on his arms and legs.

Since I read the book “Practical Paleo”, I have been following the autoimmune protocol for Jamie and have also excluded “FODMAPS” – since the first day I cut the FODMAPS out , he went back to sleeping 12 hours straight every night and continues to do so!

I successfully reintroduced coconut milk, oil and flour and he seems fine with them. I suspect he has a problem with fructose as I have drastically cut down on his fruit intake and he is much much better for it . At the same time I increased carbs from sweet potatoes, turnips, swedes, parsnips, butternut squash, plantains and other safe paleo starches.

I also increased his intake of oily fish, which he absolutely loves – just today he ate a whole can of salmon and a whole can of sardines straight out the can.

 I do feel very restricted cooking for him, but thankfully there is a lot of recipes in “Practical Paleo” and on blogs like the “The Paleo Mom”.

 A typical day looks like this (Autoimmune Protocol, nightshade free, egg free, nut and seed free, FODMAP free)

Breakfast:

  •  homemade breakfast sausage (beef, turkey or pork) with a safe starch (like sweet potato) and vegetables (today he had baked asparagus)

or

  • can of oily fish with safe starch and vegetables
  • smoothie made out of ripe banana and half an avocado (he seems fine with avocado)

Snack:

  • Pumpkin Puck by the “Paleo Parents” (they recently published an autoimmune friendly version of this)

Lunch:

  •  chicken/beef/turkey/lamb/fish  meal (like beef stew, lamb chops with butternut squash and veg etc.)

Snack:

  • very ripe banana

Tea:

  •  either leftovers from lunch or a similar meal, he especially loves pumpkin soup with a side of meat.

I keep his protein portions fairly small now as I have noticed his digestion gets very bad if he eats too much of it.

He also gets a probiotic, magnesium, l-glutamine and b-vitamins as supplements.

 All in all he has improved so so much. He still has got sensory processing problems, but these are not as extreme as they were when he still ate gluten, nuts, nightshades and eggs. He is a very happy child and loves all his food. His skin is super smooth now and his mood is mostly well balanced!

 As for me, I have lost another 5 lbs and feel really good. I have no problems with nuts and eggs thankfully but feel lots better when I limit my fruit intake. I feel best on a low carb diet with lots of fish, grassfed beef, some safe starches and lots of vegetables. I still would never go back to eating a standard diet!