Download a transcript of this episode
Show Topics:
1. [3:46] MCAD Disease
2. [11:10] Lower Back Pain & Nutrition
3. [13:49] Suncreen & Vitamin D
4. [21:19] Enlarged Prostate
5. [27:56] Menstrual Symptoms
6. [32:37] Dangerously Low Weight
7. [35:10] Rosacea
8. [38:50] Usable Calories
9. [47:05] Adaptation to Foods
Questions:
1. MCAD Disease
Justin Says: Robb, My wife and I have had a our first born son (Connor) a week ago and just found out today that he has a disease known as MCAD that is apparently fairly common. After sufficiently freaking out, we briefly researched it online and from I gather, it seems to be in the most simple terminology, the fatty acid equivalent to diabetes. Other than this my son is perfectly normal. 7.1 lbs 20″ and breast fed. He sleeps and eats with ease contrary to the horror stories we have heard from friends. My wife and I have followed the paleo life style for several years now varying anywhere from 50-100% strict. She ate about 75% strict throughout her pregnancy breaking mostly for intense cravings (namely, buffalo sauce and chocolate, go figure!). I am a trainer at a local box and she was mildly active up until a day or two before he was born.
After reading up on it, I find the irony of this situation almost poetic considering the foods that make up the “best diet” for this disease: lots of corn starch, no long and medium chain fatty acids, etc.
Have you dealt with any athletes that have this and is there anyway he will be able to somewhat live the lifestyle we have adopted? We decided long ago that we would let him choose his own lifestyle with no pushing in one direction but now we are very worried that he may not even have an option.
2. Lower Back Pain & Nutrition
Joss Says: Short question: can lower back pain worsen or improve with bad or good diet? If so, anything to be particularly careful about? (I’m not talking about obesity, which obviously increases stress on the back, just nutrients effect.) Many thanks.
3. Suncreen & Vitamin D
Jonah Says: Dear Robb, this is a quick one. I’m sure we’ve all heard about how sunscreen impedes our ability to synthesize vitamin D. Is this true and if so significant? and what is the pathway of vitamin D synthesis? Thanks!
4. Enlarged Prostate
Elizabeth Says: Hi Robb, I’m writing because I just got the ‘Are you CRAZY?!’ talk from my boyfriend. He’s been having trouble with his bladder recently and finally went to the doctor. He was experiencing frequent urination and pretty severe stomach cramps. When he went the urine test and blood work came back fine, so the doc recommended that he have an ultrasound and that he go see a urologist. The results from the ultrasound were that he had an enlarged prostate. They immediately recommended an antibiotic (which I dislike). He hasn’t seen the urologist yet. When we were discussing his ‘issues’ I suggested that we try an extremely strict paleo diet for ~30 days to see if it would help with the prostate problems and his overall well-being. He looked at me like I had five heads and said that if I think food is what is causing this I’m nuts.
A little background: He’s 25, 176 pounds, works out 6-7 days – alternating days of cardio and lifting weights. He eats a pretty clean diet (thanks to me!) that includes little to no gluten (unless he eats Subway for lunch) and mostly meats, veggies and fruit at home. He also takes a prescription drug for hair loss (generic of Propecia). I’m not sure if this is relevant or not, but he was also born with gastroschisis.
Basically, I just want to know if there is anything diet/lifestyle related that he can do to prevent prostate issues? Also, could it be something in his diet or the prescription for hair loss that caused the enlarged prostate?
One more thing- this is more of a personal question…how in the world do you get along without second guessing every diagnosis or every piece of advice given by a medical doctor? I have found that since I started reading and really believing that Paleo works, I question EVERYTHING. Perhaps even to the point that I’m rude.
Any guidance you can provide would be extremely helpful. Thanks for all that you do!
5. Menstrual Symptoms
Rachel Says: Hola, I’m a fit 27-year-old female whose body, within the last 2-3 years, recently learned how to ovulate somewhat regularly. With that being said, I am still getting used to the common symptoms that accompany my menstrual cycle. I’m sure these symptoms sound pretty normal but here are a few things I experience:
– for a few days up to a week, I feel like a complete pile of pterodactyl poo and can barley move (doesn’t help when i’m at work)
– for about a week, I have a bottomless stomach and usually gain about 5 pounds by the end of my period
– feel depressed or sad and have a short fuse when dealing with people, especially my boyfriend 🙂
My question: Can you explain what happens to a woman’s body during her menstrual cycle? What does my body need more/less of? What can I do/eat to help alleviate my symptoms so I’m not such a scary monster during this time? Thanks! Your work is much appreciated!
6. Dangerously Low Weight
Scott Says: I have a female friend who is 43 years old, 5′ 10″ and 88 lbs! she has had several small heart attacks and currently eats just about anything and everything including grains, dairy and legumes in order to gain some weight. What would you do for this women? is spiking insulin a good idea? should she be low carb? would high fat put her into a heart attack risk again? how would she gain good weight through paleo?
7. Rosacea
Ray Says: Hey Robb & Greg, Going only 3 months Paleo, but having fantastic results with allergies. For the first time in ~20 years, I’ve gone without daily meds through the spring season. I’m sold.
My question concerns “rosecea”. I’ve never heard of this affliction until a couple of friends were recently diagnosed with it. But as we google around, it seems to becoming more and more commonplace. Can suggesting going Paleo help these folks? So far, the fixes are avoidance of extreme temperatures, and antibiotics.
Also, had a side question about grapeseed oil. I believe the message from Dr. Cordain’s book says to avoid all seed oils. Should I stick with cold pressed olive oil for general cooking needs, or get the mega-jugs of grapeseed oil from Costco?
Thank you for all of the useful info from the podcast.
8. Usable Calories
Jason Says: Rob, this question has bugged me for a while: What percentage of the calories that go into my mouth are digested and metabolized by my body; and, if that’s not the whole story, what’s the whole story? Thanks.
9. Adaptation to Foods
Mike Says: Robb, I thought it’d be refreshing to hear your take on the following devil’s advocate questions (without using the words: “grains, legumes, dairy” in your response):
Some say that referring to a “Paleo Diet” is so vague as to be meaningless, since the time period is so long and the worldwide geography/weather so diverse. Can you expound on how the paleo diet lends itself to a broad variety of specific diets one might eat. Can you opine on whether one’s individual heritage should dictate one’s specific diet, or should it largely be left up to personal preference?
We have been eating grains in progressively processed amounts for about 10,000 years. Couldn’t we humans complete a genetic adaptation to grains if we reverted back to a modest pace of adaptation in that direction?
Thanks.
Thanks so much for your input Robb I was like a little school boy when I saw you responded to the email! My wife and I are starting to get geared up for the “adventure” ahead of us and need all the help/info we can get. We have met with the top physician for this disease in Birmingham last week. She actually recommended alot of the same stuff you have. The only thing she mentioned that I was curious of is the long chain fatty acids. I had the same idea of sticking to them and she said that since they are broken down into the medium chain, they will cause the same issues. This makes since but I was unsure of how it works exactly. Would you agree with her?
This is not my field of expertise, but I would have to say yes, avoid long chain fatty acids. Your body will utilize LCFA through beta oxidation cleaving each FA from the chain so eventually you will have medium chain FA present. Anything larger than a six carbon fatty acid chain will produce similar effects.
Thanks doc, great point I’d not considered there.
Robb, Now that you have touch on the subject I was curious. Paleo has just about fixed everything for other then that blasted back hair problem am I eating to much carbohydrate? Not enough protein? More fat? It’s almost time for shirts off weather and I need to get it figured out! Any suggestions would be great!!
I think your best bet is to eat as much grains, legumes, and dairy as possible. Then, with luck, you may become so sick your back hair begins to fall out.
LOL!!! For the Win!!!
Some n=1 anecdotal evidence on the rosacea: I’ve had a large patch of it right in the middle of my face since my freshman year of college (I’m 34 now). Paleo keeps it virtually invisible – unless I cheat, I will occasionally have tiny patches of a very slight pink cast to my nose and cheeks, but for the most part my skin stays clear.
However, let me go off the wagon with grains, and it will surge right back to life with a vengeance. Dairy products don’t seem to aggravate it in my case (thank you, northern European heritage), but a single meal with grains can be enough to cause a couple days of deep redness and some scaling/flaking.
This means any time I go out, I have to weigh how tasty that microbrewed beer looks against how bad it’s going to make me look in the morning, alas. It takes some really good stuff to tempt me off the paleo path these days, lol.
Thank god for Tequila and rum.
Number 6 sounds like celiac, which used to be known as the wasting disease. If she eats just about anything, my guess is that she probably does not have anorexia or bulimia.
i’m waiting for robb to review Facial Flex in episode #78. can’t wait!
http://www.youtube.com/watch?feature=player_embedded&v=etU_wtP5Pck#at=97
good God! That is some kind of NC-17 thing, right?!
I like the time stamps so that I can go back and listen (repeatedly) to answers I found particularly relevant/informative.
On the adaptation question, I know that you are tired of answering such questions, but as someone fairly new to looking at health and nutrition from this angle, I found it to be very important/interesting/enlightening to hear your (polite) answer.
Here’s one to meld into your cite manager, Robb. It pertains to past comments of the show. FWIW:
All trans-fatty acids linked to higher CVD mortality
April 18, 2011
http://www.theheart.org/article/1213079.do
Geneva, Switzerland – Trans-fatty acids (TFAs) that occur naturally in ruminant fat and those from partially hydrogenated fish oils (PHFOs) both contribute to increased cardiovascular and coronary heart disease mortality, a new prospective study reported at the EuroPRevent 2011 meeting this past weekend shows.
and oddly…
did not find a significant effect of partially hydrogenated vegetable oils on deaths, with the exception of CHD death in men
An epidemiological survey study (food frequency questionnaire), unreliable at best.
Robb, I know what you mean on the back hair deal (they don’t call me Squatchy for nothin! haha). I ended up getting one of those electric back shavers with the swivel handle that I saw for cheap at a discount store. Now I don’t have to get someone to help me do it, lol. Works pretty decent, might wanna check em out 🙂
I’m trying to find a link between Granuloma Annulare and hyperinsulinism. I already tried google-ing it a few different ways and keep coming up empty. They don’t seem to care much about it, because it is only cosmetic. My mother in-law has the severe all over the body kind that doesn’t start until middle age. She also has irritable bowel currently and diabetes runs in her family history, which are both obviously benefitted by switching to a Paleo diet. My wife tells me if it can help the Granuloma Annulare, she’d probably give it a shot. I was hoping you might understand the pathways and treatments they describe which might point to a root cause and or effects of a Paleo diet. Note, it is very common in people with diabetes, but at this point she is not diabetic. Here are some links –
http://www.aafp.org/afp/2006/1115/p1729.html
http://books.google.com/books?id=FKZup1SAI1gC&pg=PA544&lpg=PA544&dq=granuloma+annulare+hyperinsulinism&source=bl&ots=4rBn2kVhnX&sig=_AuOI_kF8b3FCHjhto0zXsZuHWY&hl=en&ei=VVK3TZ3qBoTMgQeX94Bq&sa=X&oi=book_result&ct=result&resnum=8&ved=0CEcQ6AEwBw#v=onepage&q&f=false
http://www.raysahelian.com/granuloma.html
Found this comment about Cordain, but couldn’t locate any corresponding information –
“I was also encouraged to read in the Cordain book that this way of eating can also help with autoimmune disorders, of which I have three (Hashimoto’s Hypothyroidism, endometriosis, and granuloma annulare). ”
Thanks for any insight!
Josh
Hey Robb,
I need some help I have been following a Paleo lifestyle for a few months and before I went full fledged I was eating already a very psuedo paleo healthy diet with the inclusion of legumes, some rice and dairy. I discarded the dairy, legumes and rice. Increased my fat, protein and vegetable, with little to no fruit intake but have noticed I get stuck with GI problems such as constipation and hard, droplet stools. I recently out of frustration reintroduced legumes primarily lentils, pintos, and black beans. My digestive problems have decreased and my stool frequency has improved almost overnight. Note: I am of Latin American decent and do soak and use acidic neutralizers like baking soda or some apple cider vinegar or lemon juice in overnight soaking. My question is do you think this is an acceptable addition given the circumstances or can I go about this another way with certain veggies or fruits or more fat? Thanks.
Just have to do what works amigo, but I generally find folks need a few days, perhaps a week to adjust completely. Have you tried adding probiotics like kraut?
Yeah I noticed it would take a few days but the quality of the stools were no bueno, until the legumes came I might just need more carbs. I’m 19 and run distance in college and started up paleo to settle GI issues and the belly bloat. So far the belly bloats (I feel stronger and leaner gone) but the GI problems shifted from gas to constipation. I take Udos probiotics and just finished a jar of bubbies Sauerkraut whicc is some pretty awesome stuff. If you have anymore recommendations please let me know. Thanks!
About the prostate question…
(Can’t believe I just said that!)
Loren Cordain has an awesome paper on his site that links hyperinsulinemia with both enlarged prostate and hair loss in men.
The minute I heard the listener asking about prostate and then also saying her boyfriend’s on meds for hair loss, I thought of this.
http://thepaleodiet.com/published-research/?dl_page=2
Scroll down and click on “Hyperinsulinemic diseases of civilization: more than just syndrome X.” (I can’t figure out how to directly link to the article.) He’s mostly talking about prostate cancer, but I can’t imagine the same thing couldn’t be said about benign prostatic hyperplasia.)
Amy-
Yea, I mentioned that a bit in the podcast. It is definitely linked.
Just another n=1 observation: I have been on Rappaflo for the last three years for BHP. I started Paleo in December. I began noticing relief from my symptoms in January so I started a 1 week trial of not taking the Rappaflo. Essentially I have titrated myself off of it and have not seen any recurrence of the original symptoms but have received significant relief from the adverse side effects. I think this Paleo stuff might work…
Crazy-talk!
Hey Coach,
To keep the ball rolling with the prostate/hormone chat I had a few questions.
You recommended finding out if there if a conversion problem or if left over conversions are hanging out too long in the system and to get that in order. Question is how so? Ive had hormone problems for years and have spent just as much time trying to correct them. You would think that going to a medical professional would help, but as we have both experienced it has been the opposite (I went in one time with blood work that put Test in the low 300’s – Dr said I was fine (I was 24 then) went back 5 months later with Test in 700’s – Dr said I was fine but my E was 47.) I have been trying to use a lot of Poliquin Bio Sig to assess where my hormones are without blood work. I have found it almost pointless to see a Uro/Endo. To make this a short story, how can one normalize levels on in paleo approach? How to detox? Flush system? Etc.
Also, moving on to females and hormones, besides the paleo “pull-out-n-pray” method of birth control – whats the safest, non-hormonal route recommended. Basically I have had a female athlete confide in me she has been suffering horrible results (3 periods a month, weight gain, emotions unheard of, low libido etc) and recently jumped off. She doesnt want to get preggers (and we know how good you are at helping chicks out with that) so how can she refrain from the baby train. Also anything recommended to rebound her hormones?
You=the man.
Robb,
Regarding Adaptation to Foods “question,” while it is a pain to answer, I learn something new every time you answer the question.
We have a number of engineer and scientific athletes here in the heart of Silicon Valley and they need evidence. I give them the basics, they confirm and they are off to the races. However, one pretty frequent question they ask of Susan and I is how do I answer the “prove it to me” question. They too are stymied by “where do I start?” While this family of questions is really just resistance (http://www.thedominoproject.com/2011/04/do-the-work.html), you should know that while it is painful to answer the question for you, many other people get value out of your answers.
Thanks to you and Greg for your hard work and, most of all, patience (yes, I just said that Greg is patient, this could be a first :-)).
Thanks Saul, really good input. Miss seeing you Amigo! I hope all si well.
Dave, I totally loved this whole seires. Does that make me a lover of true poetry or a disillusioned cynic? An added perk is that the postcards are at a level where even I can understand them? (Grin)I’m up for a national stamp out this word month. I’d nominate awesome’ except once in awhile it’s appropriate. Your talent, output, variety and quality of product deserve the appellation. Is there a super awesome?
Hi Robb
Just want to thank you for handling the “dangerously underweight” question with such sensitivity. I was diagnosed with Anorexia nine years ago and while living Paleo has helped me more than any meds or CBT, there are too many people blindly giving out dietary info to the eating disordered and causing them SERIOUS harm. It was so refreshing to hear you take the responsible route (as you do with every question) and you get major street cred with the recovery crowd for it 🙂
Hope the woman in question 6 gets the help she needs whether or not it is for ED. Thanks again Robb!
Not related to the podcast, but sure Robb will find this interesting.
Limiting carbs, not calories, reduces liver fat faster, UT Southwestern researchers find
http://www.eurekalert.org/pub_releases/2011-04/usmc-lcn041511.php
I have been following Paleo for almost 1 year now. I am mostly 80/20 with 100% no wheat.
I have noticed an increase in depression/saddness.
Is this normal or am I missing some key nutrient in my diet.
I am working on getting more of a variety of veggies in everyday instead of my favorites.
Best regards,
Karen-
Are you training hard? Getting enough carbs to support that?
Hello! Sorry this is long, but I think it might be helpful. I’ve recently been tinkering with my diet in an effort to improve various health problems, and I am really enjoying this site. I would like to add a bit of my own experience because I think it might relate to this question. I haven’t had enough time to browse through the entire site, so I’m not sure if this has been mentioned. In November I tried going gluten free and had a very interesting thing happen – for the first few days, I felt great – stomach problems greatly reduced, energy level very high, etc. Then around the middle of the second week – BAM – restless leg syndrome, fatigue, depression. Now, I had restless leg syndrome once before in my life and noticed that it disappeared completely when I began taking iron supplements for iron deficiency anemia. So, I went to my doctor this time and requested that he test my iron levels. Everything came back “perfectly normal” (haven’t we all heard that). After a month of feeling like this, I decided to get a copy of my results and found out my ferritin was 18. It is my understanding that the only known cause of restless leg syndrome is low dopamine (which can be caused by low iron, even without anemia – especially if the ferritin is below 50). I now have a suspicion that gluten and other harmful food items can stimulate dopamine levels in an abnormal way and perhaps even conceal some of the negative effects of poor nutrition. I highly doubt that my iron levels dropped in these 1.5 weeks since I was eating more meat and none of the previous gluten products had been fortified. I have since then found that my B-12 levels were low-normal and my Vitamin D levels were low. I’m convinced I had a malabsorption issue (although I tested negative for celiac). Very high-quality nutritional supplements have helped me immensely in my mental health. Ideally someday I will get all the nutrients I need from the paleo diet (organic chicken liver and calf liver would probably work better than supplements for the iron and B-12 issues), but I think that, for some people, the healing of the gut can take some time. Have you had any nutritional testing done? Robb, I would love to hear your input on this – does my line of thinking make any sense?
Interesting. Def know there are dopamine elements to grains.
Stress is probably a major cause of back pain and other muscle problems.
I’ve made the observation that people I’ve talked to that have back problems also have other health issues. For a while I thought it was sitting all day that caused short hip flexors and hamstrings which then caused back pain, but I see no such correlation for instance among my colleagues. I sit in front of a computer all day at work. My colleagues who also sit all day and appear to be healthy don’t have any issue with back pain and their posture is fine. Myself and some colleagues who have problems with the back also has other health issues.
I discussed this with a physical therapist and he said that the best predictor for back pain in his practice was a boring job. A chronic boring job means chronic stress.
I can think of two possible mechanisms:
1) A stress response increases muscle tension to prepare for fight or flight. Chronic stress means chronic muscle tension. This leads to tight, short and exhausted muscles. When someone for instance screams “watch out” you get a stress response with protective reflexes that makes you wrinkle your forehead, clench your teeth, bending the head and neck forward etc. Triggering those reflexes (unknowingly) again and again can’t be good. Maybe sensory-motor amnesia come into play here.
2) Chronic stress depletes minerals like magnesium that is important for e.g. muscles relaxation.
I do have wrinkles in my forehead, I have problems with my jaw and I have a vulture neck. This really correlates with 1. I recently checked and I have adrenal fatigue and gut problems. I’m right now doing more tests to see exactly what pathogens are in the gut. When the gut is healed and the adrenals are fine, it will be hugely interesting to see if my posture will get back to normal and if back pain will be gone and if the wrinkles in the forehead will go away too.
Does this resonate well with you, Robb?
Interesting, Have not thought about it like this.
It definitely resonates with ME. I for certain have a job I HATE. It’s the number one stressor in my life. I am very, *very* slowly working up the courage to walk away from my comfy federal salary and ease into what I really want to do (nutrition counseling). My back has been killing me. (Specifically the lumbar/sacral area.)
I’ve really started to pay attention to other things in my environment recently, because my diet is fairly well dialed-in at this point. I sit in front of a computer all day, and besides the fact that the work itself is completely unengaging, I just recently started noticing how tense I am all day. Just like you said — like I’m in fight or flight mode the whole time I’m here. When I notice it, I actively try to loosen up, and it’s only then that I notice just how tight I was. I may be mentally uncomfortable here, but the fact is, there are *no* lions about to mow me down, and no tiger wants to make me its dinner, so there is no reason for me to be poised for danger all day.
Ultimately, the solution is to get the heck out of here altogether, but until I get the cojones to leave (which will be difficult, seeing as I’m a female and all…hehheh), at the very least I can try to relax a little and just *be aware* of how I’m sitting, what my eyes are doing when they’re looking at the screen, etc. (And maybe best of all, go for a nice long walk in the fresh air and sunlight when I get home, which I do as often as possible.)
Anyway, that’s really eye-opening — that the PT said the #1 reason for back pain is an uninspiring job. Spot on, in my case. (And don’t get me started on the insanely strong cleaning chemicals they use here, people’s overwhelming perfume, etc. And I don’t think I have “multiple chemical sensitivity.” I think people just go overboard on obnoxious smells around here. Those don’t cause back pain, just general annoyance.)
Hi Robb,
I just wanted to mention that low stomach acid can also cause rosacea, or something that looks like it anyway. While most of my digestive issues are only marginally better now that I’m eating paleo (it’s only been 50 days), I’ve been taking the Super Enzymes and my rosacea is much improved.
Mary
Estrogen has it’s major peak in the follicular phase and it’s progesterone that has the dominant peak in the LUTEAL phase. I believe you reversed it (?). http://en.wikipedia.org/wiki/Luteal_phase According to Dr. Vliet, http://www.herplace.com and author of several well documented books; most of her clients with similar symptoms as described by the woman in your podcast are suffering from estrogen insufficiency not estrogen dominance (determined by testing) and respond well to a small amount of estrogen supplementation during the last week of the luteal phase. Perhaps good nutrition could make supplementation unnecessary. There is a doctor in NYC who gets clients to stimulate their ovaries by achieving good Vit D levels and supplementing with calcium.
The term “estrogen dominance” often crops up in the ad-copy of those selling over the counter progesterone cream (repeated use can cause overdose and elevated blood sugar). The issue is complicated and many women are lead to illness by believing their problems are caused by “estrogen dominance”. Best to encourage good testing, and offer guidelines to find excellent resources. I believe Dr. Vliet’s books offer a significant piece of the puzzle, not everything, but a good start. Sadly her website is so bad, I fear a midi file will suddenly start playing when I go there.
I have read where a poor woman was, despite her protestations, accused of having anorexia and lying about it and that the eventual diagnosis was celiac… My best wishes!