6 Must-Read Books for a Healthy 2020

I commute about 10 hours a week. I know, I'm "crazy". Driving is a part-time job for me. What's even crazier is that I don't mind the commute anymore. I got into audiobooks pretty early on in my commuting life (and overcame road rage - mental health is important too!). I've read more books over the last 1.5 years than I have in my whole life. Reading a book (or listening to one) is my favorite way to learn about a novel idea. Podcasts and YouTube videos are great but sometimes have too much fluff, in my opinion.

Books about nutrition, health, and longevity obviously hold a special place in my heart (since I'm a dietitian and all I do at work is think about nutrition). I would like to share the books I've stumbled upon that have changed my personal eating habits and the direction of my career.

The Six Must-Read Books for a Healthy 2020 
1. The Obesity Code by Dr. Jason Fung 
This book changed my life! I began intermittent fasting about 6 months before I read this book but I hadn't fully understood why I had lost weight and kept it off after starting the 16/8 time-restricted eating regimen. This book goes into the details of why insulin is the culprit to weight gain.

2. The Longevity Solution by Dr. James DiNicolantionio and Dr. Jason Fung
This book is filled with valuable information on the components of living a long, healthful life.  And it includes pictures and mechanisms. Dietitians love mechanisms. I read this book as a hard copy (not on Audible). One of my favorite books on longevity.

3. Food - What the Heck Should I Eat? by Dr. Mark Hyman 
This book goes through the different food groups and debunks myths. Many foods are deemed "healthy" or "bad for you" - Dr. Hyman reveals the truth. Although Dr. Mark Hyman can sound a little arrogant at times and has put down dietitians and nutritionists, he still presents valuable information on food. I agree with most of his claims.

4. The Good Gut by Dr. Justin and Erica Sonnenburg 
This married couple is at the forefront of microbiome research. They have become a trustworthy source for emerging scientific information regarding the world of bacteria within us. A majority of my patients have gastrointestinal health problems and  I found this book helpful in understanding a large component to gut health: the microbiome. This book gives the overused Hippocrates quote even more momentum.
“All Disease Begins in The Gut.” - Hippocrates.

5. The Circadian Code by Dr. Satchin Panda
Dr. Panda produces a lot of research on intermittent fasting and health outcomes. I follow his work closely because he is at the forefront of research. This book provides information on understanding your internal clock: Circadian Rhythm. It's SO much more than just a sleep/wake clock.

6. The Longevity Diet by Dr. Valter Longo 
This book provides information on Fasting-Mimicking Diet (FMD) and nutrition recommendations for living a long, healthy life. If prolonged fasting is difficult for you, FMD can be considered an alternative. This book dives into plant-based nutrition and limiting your animal product consumption which has all been shown in longevity research to increase lifespan.

Remember, the authors do NOT know it all. You should always be skeptical of new information and conduct further research on your own. It is important to read these books if you are a healthcare professional (and especially if you are a dietitian or RD2B) because patients/clients may ask you about the claims in these books. Utilize critical thinking when processing new ideas from books. I found all 6 of these books helpful in bettering my health and the health of my patients.

Leaky Gut - The Case Against Gluten

I've looked into "leaky gut" on multiple occasions during my first year working closely with GI patients. I remember after consulting my 3rd patient that had an extensive list of food allergies/sensitivities, I had to investigate what was going on. WHY are these patients positive for ALL 6 of the common food allergens? And also, why are they not presenting with traditional allergen symptoms (anaphylaxis, itching)? In my investigation, I soon stumbled upon a possible cause: increased intestinal permeability AKA Leaky Gut Syndrome. What I found at that time was that something was causing the tight-junctions between intestinal cells to break down. Without tight-junctions, gaps would form between cells allowing for food particles to enter the bloodstream only to result in immune system response. Immune response to a food = "allergy".

I concluded that I would have to circle around to this conundrum at a later time. But for the time being, I had to recommend the only studied diet for this food allergy/sensitivity condition: The Six Food Elimination Diet. The six food allergens are milk, egg, wheat, soy, fish/shellfish, and peanuts/tree nuts. As you can imagine, compliance with this diet is low.

Besides food allergies/sensitivities, other symptoms of Leaky Gut Syndrome include: 

• Diarrhea
• Malabsorption (which can lead to nutritional deficiencies) 
• Poor immune system
• Fatigue
• Skin Rashes
• Food Cravings 

Fast forward to this past week. After a short discussion with my colleagues about gluten, I revisited the connection between gluten and leaky gut. I've never really taken a side for or against a gluten-free diet (except for celiac patients), until now. 

Remember that something was breaking down the tight-junctions causing "leaky gut"? Well zonulin, an inflammatory protein, is the master regulator of inter-cellular tight-junctions. In other words, it regulates "leakiness" by opening and closing the spaces between intestinal cells. 

The next question I had was: What increases zonulin?

GLUTEN. Gluten stimulates zonulin release! Also, lectins do as well, but we usually cook foods high in lectins, which disables the action of the lectins (please eat your beans!). Another stimulus for zonulin release is bacteria - harmful bacteria. If your digestive tract senses harmful bacteria, zonulin will break down the tight-junctions, allowing water to enter the colon to flush the body of the bacteria. For all of us that have experienced food poisoning knows what I mean... DIARRHEA.

This picture below demonstrates how gluten disrupts intestinal permeability. 
Gluten --> Increases Zonulin --> Zonulin widens the tight-junctions --> flow of food particles enter the blood via the gaps between the intestinal cells --> Autoimmune response to these food molecules (which should normally not be there) --> Inflammation and irritation of the GI tract --> Patient presents positive for food allergies/sensitivities 

So should we all be following a gluten-free diet? No, but a gluten-free diet should be considered for those with GI symptoms such as diarrhea, constipation, and bloating. A therapeutic elimination diet would be beneficial in giving the GI tract a break from the gastric irritant gluten. See below for directions on how to do an elimination diet properly. It's also important to slowly increase prebiotic fiber which will help improve the health of your microbiome (the world of bacteria inside of your GI tract). 

If you suspect leaky gut or some gut imbalance, please see your doctor. Could you benefit from removing gluten from your diet? Yes. Do you need to eliminate gluten forever? No, but you should consume anything processed (such as wheat) in moderation.

Can probiotics help? Possibly! Studies suggest that specific strains may improve tight-junctions. There isn't enough research to solidify this claim, but a high-quality probiotic supplement in combination with increase prebiotic fibers is the best place to start to improve overall gastrointestinal health. Two probiotic supplement brands I trust are Metagenics and Garden of Life. 

Side Note: NSAIDs, such as ibuprofen and aspirin, can also increase intestinal permeability. But that is for another discussion. I highly recommend limiting the use of NSAIDs as they have been shown to damage the gastrointestinal tract.

30-Day Elimination Diet 

Step 1: Remove Gluten for 30 days 

Gluten is found in A LOT of commonly eaten foods. Luckily there are plenty of gluten-free options at the grocery store. Once you understand what foods have gluten (wheat, barley, rye, some oats), adjust your mindset to thinking about what you CAN eat. It will make the process much easier. 

Note other names for wheat: durum, einkorn, emmer, kamut, spelt 

Step 2: Think about the foods you CAN eat 

Fresh, whole foods are the way to go. Fruits, vegetables, lentils/beans are a MUST to include because they contain fiber. Fiber is essential to healing the gut and building up a healthful microbiome. Other foods to include are eggs, fish and grass-fed beef, free-range chicken (QUALITY MATTERS when it comes to animal products). It would also be beneficial to include a dietary probiotic such as yogurt or kefir (non-dairy is okay as long as it has the live-cultures). 

What about the carbohydrates?! Well, rice will likely become your friend. And gluten-free oatmeal. Other gluten-free options include quinoa, corn, and millet. 

Step 3: Reinoculate 

It's time to build up that microbiome. It's important to include both prebiotics and probiotics. If you do not like fermented foods, I recommend getting a probiotic supplement. Prebiotic fibers include strawberries, bananas (the greener the better), oats, artichokes, asparagus, garlic, onions, and leeks. 

Step 4: Asses how you are feeling 

If you are still experiencing gastrointestinal issues, I recommend seeing a gastroenterologist so they may rule out any serious GI condition. 

For more information, visit the Mayo Clinic for a good article on Gluten-Free Diet. 

Protein Sour Candy Recipe

This quarter I had a food science course and we had to develop a product that we think should be in the market. Of course my mind went straight to protein... and so did my partner. (We are gym junkies). I thought about protein cereal because I love cereal and there is only one brand I know that has 10 grams per serving. I thought about high protein ice cream, but that would have been an okay idea. Finally we thought of a protein candy. Our target market was obviously going to be individuals that workout regularly and need a protein snack before, during, or after the gym. We even thought this would be a great snack to have during the day to keep muscle protein synthesis stimulated. And so the creating of the Muscle Gummy came to be... with sour liquid BCAA inside!
Over 10 weeks we struggled a bit, slowly overcoming one obstacle after another.  We finally finished our final product this weekend just in time to present tomorrow!

Protein Gummy Recipe

Ingredients

BCAA Liquid: Yields about 50 drops

½ tsp bpi Sports BCAA supplement

¼ cup water

1 tsp tapioca Starch

¼ tsp Citric Acid

Gummy: Yields about 40 Cubes

¼ cup cold water

1 tsp Raspberry syrup

3 packets Knox original Gelatine Unflavored (33g)

¾ cup warm water

1 Tbls Raspberry syrup

1 Scoop Isopure Unflavored Whey Protein Isolate (16g)

Additional Sugar and Citric Acid to coat candies

Procedure

1. Add BCAA to Water and mix well,  add tapioca starch and mix well
2. Heat mixture while stirring constantly until desired consistency
3. Remove from heat and mix in Citric Acid
4. Use a measured syringe to form .625 mL droplets on a cookie sheet and then place in freezer immediately for later use

1. Add ¼ cup water to bowl and add 1 tsp raspberry syrup
2. Sprinkle gelatin over top to begin forming gel and let sit 1 minute
3. Heat ¾ cup water and add 1 Tablespoon Raspberry syrup
4. Pour warm juice mixture over gelatin mixture and mix well
5. Once mixture has slightly cooled add protein powder and mix well
6. Pour 7/8th of the  mixture in a shallow 4/6 bread pan and let stand until slightly gelled
7. Place the rest of the mixture on a hot plate and monitor temperature at >100◦F to avoid gel formation but below boiling (avoid overheating the goal her is just to prevent gel formation)
8. Carefully place frozen BCAA in desired locations (use a cookie cutter for your shapes and references)
9. Pour the remaining warm gelatin mixture over the top to seal the liquid inside.
10. Place in the Refrigerator immediately, and cut into 4 rows of 10

Upon consumption dip or dust the gummies with 5 to 1 sugar and citric acid mixture  

Note: Video below does not show how to insert liquid BCAA into the gummy base. 

Final Result

Our goal was to create a product with 10 grams of protein per serving. We managed 9 grams, so we are satisfied with our ending product! I could get into all the food science concepts incorporated, such as weeping, spherification, and foaming. All of which we had some problem overcoming.  But I will save that for another day!

Thanks for reading.

How Much Protein Do You Really Need?

Fitness people are all about protein. Period. But how much is too much? How much is too little? We'll talk about that shortly. First, let's talk about research! Yay. Credibility is everything (especially when it comes to nutrition). This summer I was introduced to a webinar about protein. The man speaking (Unfortunately, I forgot his name... I have short-term memory loss) broke down the process of when we eat protein or fast how muscle protein synthesis is affected. Muscle protein synthesis in lay person terms means your muscle is growing. We want our muscle growing all the time! So how do we stimulate this "muscle protein synthesis"?  Here is where those gym protein junkies will agree with me. Eating 20 grams of protein every couple hours will simulate muscle protein synthesis. After about 3 hours of eating your body will go into muscle protein breakdown. For example, if you had breakfast at 8am, and didn't eat your next meal until 1pm, that's a 5 hour fast. Breaking any fast at the 2 hour mark will be beneficial to those trying to sustain/gain muscle.
In the webinar, Mr. Protein (for lack of a real name), presented a study on which protein is the best. Whey, Casein, Pea, Soy? Well according to multiple studies, for stimulating muscle protein synthesis, the answer is Whey!

So how much protein should you have? I have met too many people this summer (all were male) that consumed WAY too much protein. To calculate protein you use kilograms not pounds.
"So, what happens if I have too much protein?" Well, the excess protein will be converted into fat. So those that are trying to cut with a HIGH protein diet might need to recalculate grams of protein per day.


The Secret Formula
You guys are in for a treat. I am giving you the formula! First convert your weight from pounds to kilograms. (Divide pounds by 2.2)
Next depending on your type of workout, multiply by one of these factors:
Endurance (running, swimming): 1.2
Sports: 1.6
Weight Training: 1.6-1.8

Not into working out but you are over 40? Use multiply your weight in kg by 1.2.

The number you end up with is how much protein you should consume per day.

For example, I am 110 pounds or 50 kilograms. I workout 6 times a week so I'm going to use the 1.8 factor (I'm trying to gain muscle). That comes out to 90 grams of protein AT LEAST per day to stimulate muscle protein synthesis.

How do I get that much protein?
Well protein shakes aren't a bad idea, I drink one after my workouts. I have been interning at MVUSD and I became inspired by a product they have: a power/energy box. I decided I would try to create my own "Protein Box".

Contained in this snack bag is 70 grams of protein and a bunch of goodies! 

"Well there is a lot of carbs and calories in there." Sure but I need them for energy. I tend to plateau my weight at 110 but as soon as I really focus on getting 90-100 grams of protein a day, the extra couple pounds fall off. 

So go ahead and try increasing your protein intake for a week and see how you feel. And for those that are already eating enough protein, keep at it!