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Episode #32 focuses on questions we commonly receive from female listeners – but that does NOT mean No Boys Allowed! This information is applicable to all listeners!
1: Paleo approaches to birth control & family planning [11:53] 2: How sugar intake affects menstrual cycle length and regularity [16:24]] 3: Fertility & Pregnancy diet [26:06] 4: Pregnancy, water retention & constipation [31:57] 5: Pregnancy food aversions [37:04] 6: PCOS & thyroid problems: should I go “Paleo” or just gluten free? [49:29] Click here to download the episode as an MP3. The episodes are currently available in iTunes, Stitcher & Blog Talk Radio.
LIZ WOLFE: Hey everyone, I'm Liz Wolfe, here with Diane Sanfilippo of Balanced Bites. Welcome to episode 32 of the Balanced Bites podcast. I feel like I sound weird. I feel like I'm like in a well or in a cave or something.
DIANE SANFILIPPO: Well, you are the Cave Girl, so…maybe?
LIZ WOLFE: Yes, I guess so.
DIANE SANFILIPPO: Maaaaayyyybeee?
LIZ WOLFE: I don't know. Okay, so very important business to take care of. Our little reminder that the materials and content contained in this podcast are for general information only, and are not intended to be a substitute for professional medical advice, diagnosis or treatment. So Diane, your book is doing awesome on Amazon.
DIANE SANFILIPPO: Oh my God. [laughs] It's been crazy! Like, I'm super excited to see that it's doing well in this whole pre-sale period, but it's definitely a little scary. Yeah, so yesterday, I was checking out Amazon has like, you know, their regular list and then they have this whole hot new releases section, and the new releases in nutrition yesterday, and actually still this morning, it's ranked number 2, which…it's really funny because it's underneath a Forks Over Knives cookbook. [laughs]
LIZ WOLFE: That cracks me up.
DIANE SANFILIPPO: Yeah, it cracks me up, too. I mean, that's to say nothing of the fact that I'm completely rocking the like Green Living category. I'm like [laughs] this book is not about Green Living. Oh, God, so funny. Or like sustainable living. I think the fact that there's the word “lifestyle” in the title is putting it into that category. I have no idea, but kind of funny.
LIZ WOLFE: And the word balance.
DIANE SANFILIPPO: Anyway, so…yeah, maybe, balanced lifestyle. Yeah, so I wanted, you know, to say thanks everyone for all the support. You know, Amazon dropped the price almost to like 50% of the cover price, which is, I don't know, I think it's really cool that the book's selling at around $20 on Amazon. You get the lowest price that the book goes to within the whole presale period. I think that's also the same at Barnes & Noble. Like, so if the book drops any further and you've already put in a pre-order, you get the lowest price, whatever it may be.
LIZ WOLFE: Mm-hmm.
DIANE SANFILIPPO: I don't think they charge you until it ships. I'm not positive on that, but if they do charge you, then they refund you or whatever. But yeah, then a couple of people on Facebook, I was posting that I was like wow, this is awesome, and somebody was like, why is that awesome? I would be freaked if they kept dropping the price of my book, and I'm like, well, it doesn't actually affect me. Like the way Amazon prices the book, that's up to them and that affects them, and whatever happens for me and the like 2 cents that I get from every book, it basically doesn't change. I mean, it's funny, but yeah, that doesn't change, so I'm psyched. If they want to drop the price and make it more available to people and the book's 20 bucks and the cover price is 40? Hey, more power to them and yeah, if it means they can make the book more accessible to more people, that's cool. So yeah, people…
LIZ WOLFE: The plot of Amazon is taking over the world.
DIANE SANFILIPPO: [laughs] yeah.
LIZ WOLFE: It can do anything they want.
DIANE SANFILIPPO: I know. Yeah, so the only other thing I want to say about the book right now is that I did put up a little preview slash teaser on the blog. I didn't actually write a post that goes along with it, which is not kind of my norm, but I might link it back to a previous post that I have on the site, but it's one of my Useful Guides. It's under the Useful Guides section. It's a free PDF download, and it's a guide to Paleo food. So as much as I'm not a fan of the whole “Is this Paleo? Is this Paleo?” question, I wanted to create a resource just to show how many foods there are under this whole Real Whole Food umbrella, as well as to highlight some of the nuances, like which are the nightshade vegetables, what are goitrogens, which are FODMAPs, and on this guide specifically, they're just kind of highlighted or called out. I'll have other guides in the book that will actually explain more things about nightshades and FODMAPs and all that, but so, all these useful guides that I have are, you know, the ones that I have out right now are on that page. Free PDF downloads. They get a ton of traffic, so you know, if you haven't already grabbed them, grab them, feel free to share them. I think I have a…my name is at the bottom or it says Balanced Bites. Just leave that on there, you know. Don't like try and re-brand it as your own. That wouldn't be very cool. But it's free stuff that I put out there. I just really want to help educate people and make it easy for people to understand, you know, all the information. But all the guides for getting like little tweaks and facelifts for the book, so if you already have them, you know, part of what I really want to make available in the book is stuff that's, you know, easy, one page, you know, shot of information. So there's a bunch of new stuff coming up which Liz, you got to preview one of the new guides that I have coming out, and I think you were pretty much like rolling on the floor laughing.
LIZ WOLFE: [laughs]
DIANE SANFILIPPO: Yeah.
LIZ WOLFE: It is so awesome. I can't even like…I'm dying. It's so funny, and like in a amazingly great way that something that has never been done before, I want to jump through the phone and hug you way.
DIANE SANFILIPPO: [laughs] Hysterical. Well, yeah. I'll talk a little bit more about it when it gets closer, but I've been told by some of my other friends who've seen the preview like not to let it release before the book just because it's one of those things that like, you know, it's like a spoiler if I let it out there beforehand, so I think it's going to be awesome.
LIZ WOLFE: It is so amazing, though.
DIANE SANFILIPPO: You're going to get to that page in the book and like die laughing, but also be like wow, this is so useful. Thank you.
LIZ WOLFE: It will stick in people's minds and there will not be a single person that does not like…like not able to recount that information at the drop of a hat because of that one particular page.
DIANE SANFILIPPO: Awesome. [laughs] Awesome. Now that we've sufficiently teased people, yeah. So what else? Do you want to tell people about some upcoming workshops that we have?
LIZ WOLFE: Yeah, I'm super excited. April 14th in Frisco, Texas is going to be my debut as part of the Balanced Bites workshop team. Like I said last week, we're working super hard on a lot of different…I don't know. I wouldn't say changes or tweaks. I just say enhancements to the whole thing. Things that we can do with two people and the resources that we have that maybe are a little difficult with one person to deal with before. I think it's going to be awesome. Ft. Worth, it's selling. The tickets are selling pretty quickly, and I guess at this point we're inside the late registration window, but people can still get their tickets. And what's the ticket price right now? 60?
DIANE SANFILIPPO: Yeah, 60 bucks. So it's still…I mean, we dropped the ticket price because we really wanted people to have this whole thing be a lot more accessible. So it was 45 early, and 60 late. It's still like almost half of, you know, what the registration price used to be. So if you've got friends who, you know, there's still room. It's definitely getting up there, but there's still room, so if you've got friends who've been on the fence, just have them come out. I mean, we don't-we're not going to be able to get to a lot of these areas again. Like I've been in Texas a bunch, but this is the first time I'm back in the Dallas area since last year, so not going to happen again until we hit Houston in May, but it's a bit of a drive for people in Texas, I think.
LIZ WOLFE: Yeah.
DIANE SANFILIPPO: Yeah.
LIZ WOLFE: Well, I'm real excited if I can just throw this in real quick, just even…I don't think it's fully settled in that I'm now part of the team, so I'm still thinking like, you know, an attendee of these things. I think, I mean it's difficult when you bring somebody in from out of town, like there are prices associated with travel, lodging, and all that stuff, so I'm just so excited that we were able to drop the price because I know, for me, that type of stuff can be cost prohibitive, and I think that was our number one goal, and you know, the changes that we made and the enhancements that we made were to make it as affordable as possible for as many people that could come.
DIANE SANFILIPPO: Yeah.. Yeah, I mean, it just breaks my heart when somebody says, you know, oh, it's too expensive, and like I definitely, you know, I'm definitely one of those people who's like, well, what's it worth to you to come learn for a whole day? And at the same time, you know, I have to understand that like, no, this is a reality check. Like I had a lot of people who would tell me, you know, they were waiting until they got their paycheck to buy a ticket, and that's just the reality of it. You know, like 100 bucks is 100 bucks, and that could be a week's worth of food for someone, and I wouldn't want someone to, you know, have to give up a week's worth of really good food to come learn for the day necessarily, but like, I don't know. I just wanted to do whatever we really could to make it more accessible. I mean, that's really it.
Yeah, so…and not everyone is like as geeked out on this stuff as some people are, and I think, you know, at the higher price, a lot of the super geeked out people were coming because they're just dying to learn whatever else you have to say, which is great. I welcome those people, but I really want the people who are also like on the fence, who's your friend, your mom, whoever else, to just get in there and come learn for the day because it's, you know, it's pretty invaluable. Like people come to the seminar, you know, like I knew a lot of this stuff, but just hearing it again or hearing some different ideas or just being able to ask questions, and hearing other people's questions. Like that's where kind of the meat of the whole thing comes in. It's so interactive that, you know, people are just able to get a lot more from it, just the whole experience, so anyway.
Well, so we'll be in Frisco, which is the Dallas-Ft. Worth area and then the next weekend, we're basically back home for us, the Cherry Hill CrossFit Aspire, which is the Philly area, so if you're in Philly or like South Jersey area, I'm excited. I just love having like local events.
LIZ WOLFE: Oh, I'm so excited.
DIANE SANFILIPPO: I love being able to just drive. Yeah. You're going to like literally roll out of bed into the seminar.
LIZ WOLFE: Yup! Ayup! [laughs]
DIANE SANFILIPPO: And then Houston, May 5th. And yeah. Do we…do you want to announce the next one after Houston or just kind of wait? Want to…?
LIZ WOLFE: No, let's wait. I think it…
DIANE SANFILIPPO: Okay, let's wait.
LIZ WOLFE: And then maybe…
DIANE SANFILIPPO: Well, we've got something coming up on May 19th, but we'll wait to let people know where that one's going to be. All right.
LIZ WOLFE: You got to stick around for that. Okay.
DIANE SANFILIPPO: Questions?
LIZ WOLFE: All right, so…let's hop on into the questions here. And that was only 15 minutes of banter. PS, I think the last one was like 25 minutes.
DIANE SANFILIPPO: Really? It's not really all banter. If we're making announcements, that's not all banter, so you know, that's valuable information for people.
LIZ WOLFE: That's true.
DIANE SANFILIPPO: Yeah.
LIZ WOLFE: All right, so this is, you know, version 2.0 or the sequel to last week's podcast about women's health. And these aren't all specific to women, but these are questions we get from women really frequently, so like I said, if you know a woman, if you are a woman, then this podcast is for you.
Okay, so first question from Christa is about Paleo approaches to birth control and family planning. And we covered this, or at least a little bit of this in a recent podcast where I talked about the copper IUD and a very near-sighted gynecologist named Dr. Bush, so we'll link to that.
DIANE SANFILIPPO: [laughs]
LIZ WOLFE: [laughs] [sarcasm] So yeah, I mean, my advice for birth control and family planning is definitely just the pull out method. I mean, it works ten percent of the time every time.[sarcasm]
DIANE SANFILIPPO: [laughs]
LIZ WOLFE: No, no, don't do that. Don't do that, people. Don't take me seriously.
DIANE SANFILIPPO: I can't help but laugh when I think about the fact that some of these podcasts, not ours currently, but some other podcasts have transcripts and I'm like, you know, how does sarcasm translate on a transcript?
LIZ WOLFE: [laughs]
DIANE SANFILIPPO: [laughs] I don't think it does.
LIZ WOLFE: Oh my God.
DIANE SANFILIPPO: Like, I'm really….I'm sorry, no, that was totally interjected, but I really hope that like, you know, like I've definitely heard like Robb or Chris isn't that sarcastic. Chris Kresser and his podcast, but like Robb Wolf is really sarcastic, which I love, but I'm thinking, somebody who transcribes that needs to put in parentheses “This was sarcasm. Please don't do whatever this was.” It really cracked me up. Anyway.
LIZ WOLFE: [laughs]
DIANE SANFILIPPO: That was sarcasm, folks. Liz was being sarcastic.
LIZ WOLFE: Sarcasm. There is no emoticon for sarcasm, unfortunately. But the only real advice I have is I'm starting to recommend to a lot of my clients do some charting, which I think is-can be really enlightening. I think everybody should at the very least like circle the day in their planner and kind of recognize the patterns and how you feel, especially, you know, the week before. But that's pretty much all I have. Do you have any thoughts on that, Diane?
DIANE SANFILIPPO: Well, as far as the charting, there's definitely like Smartphone apps for that kind of stuff and I would definitely recommend that kind of thing, and I think, you know, if you're not…if you don't have regular periods, then being more risky about, you know, less secure methods of birth control are tricky. Seriously, like, if you have a very regular period and, you know, you kind of know when you're ovulating and all that stuff happening, then it's kind of like, okay, well, you can pretty much know when things are going to be fertile or not, but yeah, if you're not regular, I wouldn't be as risky with your methods, so I don't know. We already talked about this. I definitely want people to just go back and listen to our previous advice. I'm definitely not somebody who likes for people to be on hormonal birth control methods, so that's kind of…I mean, she says family planning, but I think the, you know, the weight of that was really more on the birth control side of things, so yeah. That's kind of it. I just would shoot her back to the previous podcast about that.
LIZ WOLFE: Oh, you know, I do have one more thing. I kind of forgot about this family planning element. I do think it's important to kind of look at the traditional wisdom, the, you know, kind of the Weston A. Price view of things on these more recent indigenous, native cultures. How they planned fertility. How they dealt with that period, like in their cultures, and basically how they spaced children. I don't…like I don't want to pass any judgments or make any recommendations to people that they're not comfortable with, but I do think child spacing, 2-3 years, is really ideal. I know a lot of people want like kids that are close in age, and I understand that, but that's all the more argument for very concerted effort, like a conscientious effort to go on and stay on a very nutrient-dense fertility diet in between children if you want to space them closer than 3 years. Usually, I mean, if a woman was breastfeeding in these traditional cultures for 2 to 3, 5 years, that would kind of take care of the child spacing thing, but I think it's so so important to do the nutrient dense fertility style diet, especially if you want to have kids that are closer than 3 years. So that's the family planning angle.
All right. Next question from Bria. This is about why sugar intake can affect cycle length and regularity. This is a really interesting question, actually, and it involves a couple of different things. First of all, the liver is tasked with a ton of things. The liver has so many jobs to do in your body, but two of those things that are really pertinent here are first in the control of blood sugar, and also in the conjugation of hormones. So it stands to reason then that increased intake of sugar, especially sugar that's kind of evolutionarily inappropriate and, you know, I'm talking about processed foods, refined sugar, that type of stuff. That will burden the blood sugar regulation function of the liver. And any hepatic congestion can affect the body's ability to clear hormones as needed from your body.
So additionally, like the liver helps convert estrogen to its metabolites for excretion. And all other hormones as well. So B6, which is a vitamin, well, I guess all the B vitamins, they're depleted by sugar intake. Part of the reason is because glycolisis, which is the breakdown of glucose for energy, is actually driven by B vitamins. It's a cofactor to that process. So B6 itself is a vitamin that improves the hepatic clearance of estrogen, so I mean, you can see how that directly the hormonal balance of your body. Beyond that, vitamin A is needed to synthesize progesterone, so I mean, deficiency in any of these kind of sugar-depleting vitamins can really disrupt the balance of estrogen to progesterone, and that whole…in the whole menstrual cycle, it's kind of a dance between estrogen and progesterone.
So I mean, many different organs and tissues are involved in estrogen regulation and production. It's not just the liver. It's the thyroid. It's the pineal gland. It's the hormone prolactin. And in general, all of those are affected by high insulin and the inflammatory response. So, you know, we know insulin is a hormone, and the whole hormonal dance is really intricate, and that's just, you know, a really direct reason, in my opinion, why an excess of sugar or even an extreme lack of fat or protein. All of these are building blocks to like proper hormonal function. Even extreme stress, those can all affect the menstrual cycle. I know, for me personally, that week to two weeks before, if I eat a ton of sugar, it's going to be a hell of lot worse for me when I'm on my period, so that's just something that I've observed.
Something that I think is kind of funny is you kind of hear both sides of the fence. Some people say that chocolate, like they crave chocolate on their periods. Some people say chocolate makes them feel better. Some people say chocolate makes them feel worse, and I think this is really interesting because, and this is just kind of my theory on it…some people are eating, I'm sure, like the standard like Hershey chocolate bar like 5% cacao type of chocolate, it's really heavy in sugar. And I would imagine that those people are the ones who, for whom, their period is made worse by eating chocolate. But those people who are eating like I do, like 90% dark chocolate, it's actually not a decent source of magnesium, but it is a source of magnesium. And a lot of times, like when you're kind of around that time of the month, you'll be a little magnesium depleted. Magnesium can also help menstrual cramps, at least for me, so I feel like if you're reaching for like an 88 or a 90% dark chocolate, you might actually be repleting your magnesium a little bit. But if you're just eating, you know, the sugary junk, that's probably just going to make it worse. So, that's my take.
DIANE SANFILIPPO: All right, what's funny is like of everything you said, that was really important and valuable, people are only going to hear the part about the chocolate. Nothing else.
LIZ WOLFE: Nothing about the sugar, just the chocolate, yeah.
DIANE SANFILIPPO: So…well, I like this question. It was a really short one that Bria sent us on Facebook just about sugar and cycle length, but actually I think it's a much more all-encompassing question because of sugar's effect on hormones in general, and especially female hormones, so that's kind of why I wanted to take it. And I think your overall like, you know, high level stuff about the liver and hormone clearance and all that is really important for people to know about. And this definitely relates to pretty much all things female hormonal balance-related. So we have some other questions coming up on this stuff, but just another like high-level on this, and we'll link to the chart, but insulin regulation and the rest of your hormones, like just understanding, too, that DHEA is a sex hormone precursor.
So what DHEA can be inhibited by are things like a vegan diet, which probably that's because of just the stress on the body of not getting certain nutrients, especially B vitamins and iron, but vegan diets, statins which are lowering cholesterol, which is a precursor to all of your hormones. Chronic stress, smoking, anything that raises cortisol can inhibit DHEA production. This stuff will happen by the process of the pregnenolone steal, which I've talked about before. I think I might have talked about it on the adrenal fatigue podcast, but basically, if your body is experiencing too much stress for any reason, so you know, we talked about stress a bunch. But like, it can be stuff that you perceive, I'm so stressed out kind of thing. Or it can be systemic. So anytime your body is stressed, your hormone production does not get prioritized to sex hormones. It's prioritized to stress hormones. And keeping your body in fight or flight mode, or even in a moderate fight or flight, chronic stress mode, can deplete your sex hormone production. And, you know, you need that production to be at a normal balanced place to feel good, have normal periods, not be experiencing other issues, so understanding that high insulin, which can be caused by a lot of sugar intake, will lead to high cortisol, which will then decrease your DHEA production, which then decreases the substrate that you have to build all of your sex hormones.
So it's not really, you know, I say this a lot, but it's not really rocket science that doing things that are stressful to your body or that like we know eating a lot of sugar is not healthy, but like, here's the why. You know? Here's what it cascades into hormonally, and you know, I just had this experience recently where, like, I get a lot of other nutritionists or nutrition coaches who kind of ask me questions about approaching their clients, like, you know, their clients come to them with issues. Like what should they kind of tell their clients? And I had someone recently who said, you know, she was dealing with PMDD, Pre-Menstrual Dysphoric Disorder, so some issues with just hormonal balance and how that affects her period and how it affects her whole life. And her diet is very standard. She's drinking diet sodas, she's eating a lot of sugar, and I kind of said to this other practitioner, look, you know, it doesn't really matter that she has this hormonal imbalance and disorder. What matters is that her diet is still so fouled up that that's what's causing the problem. Like, the hormonal problem is not causing her, you know, sugar imbalance, the sugar imbalance is causing the hormonal problems, and yes, that hormonal imbalance can then make her want to crave more sugar because of the whole issues that you just described, you know, she's got depleted magnesium and other minerals and B vitamins that can make her crave sugar. But the answer to it is just changing the diet and lifestyle so that then those hormonal things can kind of get back in line. So anyway, it can become a little bit of a forward feeding mechanism, but it's always best to kind of control blood sugar regulation and keep insulin levels in check when you're looking at hormonal balance, so we're going to talk about that again, I think, in another couple minutes here, but…yeah. That's it on that.
Who's up next?
[pause] Did we lose you, Liz? I don't hear you.
LIZ WOLFE: What's funny is I just muted it so I could have a bite of my sweet potato.
DIANE SANFILIPPO: Oooh!
LIZ WOLFE: And I just-I literally just talked like…
DIANE SANFILIPPO: Nice.
LIZ WOLFE: for however long.
DIANE SANFILIPPO: I was like, I don't hear you.
LIZ WOLFE: I was like, why is she interrupting me?
DIANE SANFILIPPO: Yeah, I didn't…okay. Well, so…
LIZ WOLFE: Nobody cares about my story about Monika. I was telling a story about how I had a friend named Monika in elementary school, Monika with a K, and that's not this person who asked the question, but I loved Monika with a K so much, and I want this person to know that I love her, too, because she spells her name with a K. Monika with a K.
DIANE SANFILIPPO: Her question.
LIZ WOLFE: I probably should have left that, not so good, I probably should have left that in the mute portion of the podcast.
DIANE SANFILIPPO: Do you want to read her question?
LIZ WOLFE: Yeah, I do. [laughs]
DIANE SANFILIPPO: Oh my God. [laughs] You're awful again today.
LIZ WOLFE: Okay. Awesome. For women who are planning on getting pregnant, how much in advance should she and her partner ideally start following an especially nutrient dense diet? What foods should they focus on? What supplements, etc? And I love this question because this is why I got into nutritional therapy in the first place. I wanted to kind of specialize in fertility and pregnancy and all that good stuff. I personally think ideally 6 months is a great window. As far as you want to stretch it back I mean, 2 years, awesome. As long as you want to. As soon as you know when you're going to plan on getting pregnant, ideally 6 months, but as far out as you can take it, I think is great.
I know Chris Kresser's Healthy Baby Code is linked from the Balanced Bites site. I think that's a great resource. It's really important that you get plenty of folate, not folic acid. That's actually another post that Chris Kresser did that we'll link to: the difference between folate and folic acid. You get folate from beets and liver. Choline is really important from egg yolks, vitamins, all of the fat soluble vitamins, A, D, E, and K2. The fermented cod liver oil/butter oil blend from GreenPasture.org-we'll link to that as well-is a fantastic fertility food. All of us on the panel at PaleoFX on whole foods and supplements agreed, I think, that the cod liver oil/butter oil blend-the fermented blend from GreenPasture.org is the way to go. It really bugged me. I'm going to put this out there when people say, Hey I got the cod liver oil, and they got, I don't know, Carlson's or whatever. Something that they found at the store. I only know of one brand that is produced appropriately in a way that carries the benefits that I tout cod oil liver for, and that GreenPasture.org cod liver oil/butter oil blend. That's the only one I know of that is produced in that way. So that's the only one I recommend.
What else? You can get vitamin A from egg yolks. Biotin is another important one. You can get that from liver and egg yolks, and also DHA, fatty fish. Glycine. I think it's really important to not forget the bone broth. It's really mineral rich. Yeah, that's pretty much my recommendation. We'll link to a couple articles for this.
DIANE SANFILIPPO: Yeah. Yeah, I like that. I mean, I think-I think it's a funny one because a lot of times, you know, women might get pregnant without having planned for it, but I think if you can plan for it, I think that's fantastic and yeah, I'm with you on the 6 months of the nutrient dense foods, and you know, if you're having trouble getting something like liver into your diet. This is another topic that came up a bunch at PaleoFX. We-like I'm still, I'm down in Pittsburgh right now, staying with Bill and Hayley of Primal Palate, and we've been eating burgers a couple days this week, and we had liver in them a couple of times this week. I couldn't help but think about how, you know, maybe if I grew up in a household where liver was always in my burgers, that I wouldn't even had noticed it. Like I just would have thought that's what burgers tasted like. [laughs] But it's been good. I mean, you know, I mean we' feed them to our cats. We feed our cats raw, you know. It was funny. Hayley was like, why am I giving this to the cats? Like we had pastured, you know, pastured chicken livers, and we were like, hold on a second. We need to throw this in our burgers, and it's like, sometimes we talk about this stuff a lot. And we don't have an aversion to these foods, but we're just kind of joking. We're like, oh shoot, we forget to eat them. It's not like we don't like them or want to eat them.
LIZ WOLFE: Yeah.
DIANE SANFILIPPO: We just kind of forget to. So I think, you know, yeah, if that were me. If I were planning, yeah, that's how far out I would look at it, and I wouldn't really change too much about my diet. I would probably just add some things in and just kind of keep a little bit, a little bit of the tight reins on anything that might be kind of off the rails.
LIZ WOLFE: Yup!
DIANE SANFILIPPO: I would definitely watch alcohol intake, you know. If you do get pregnant and you didn't realize it, and you'd been drinking, you know, that week. I just, I mean, that's me. I'm not someone who thinks alcohol is something I need in my life all the time. I enjoy it. I don't, you know, don't tell people never to drink, but I think if I were trying to get pregnant, I don't think I would be drinking alcohol at all because you just don't…you may not know when it's happening. I would just stay away from it, so that's kind of my other…
LIZ WOLFE: [laughs]
DIANE SANFILIPPO: What? Although, you know, you may end up getting
LIZ WOLFE: If you're super drunk, and you use Liz's conception advice, ummmm…
DIANE SANFILIPPO: [laughs] Oh boy. This is how Liz helps her clients get pregnant. No, I'm just kidding. [laughs]
LIZ WOLFE: [laughs]
DIANE SANFILIPPO: I, you know, coincidentally, I just want to mention, too. This was kind of backwards, but it is on the whole family planning thing and the sugar question, and I think we have another question about this, too, but I've had a bunch of people who either start coaching with me or go on the 21 Day Sugar Detox and they basically get pregnant like right away. Because they changed-they changed their whole hormonal balance by taking sugar out, so I would definitely watch the sugar intake. Um, yeah, let's move on to Jenna's question because we are rambling.
LIZ WOLFE: A little bit of rambling. Oh, and real quick, I do want to throw in actually with pregnancy, I think it's important to use some of the writings, especially from the Weston A. Price Foundation on vitamin A and pregnancy because there are a lot of doctors that advise against eating a lot of pre-formed vitamin A. I think it's really important in fetal development, so we'll link to some of that stuff/
DIANE SANFILIPPO: Cool.
LIZ WOLFE: Okay, all right from Jenna: “Pregnancy, water retention, and constipation: I retain less than your average “preggo,” I think, but it’s still noticeable in my feet (and now that I’m almost 9 months, my fingers). And constipation started a couple of weeks ago, and nothing is really helping me get back to feeling normal.”
Maybe we should just kind of…Diane, do you want to cover just constipation in general?
DIANE SANFILIPPO: Yeah, I think I might have talked about this last week, too. Because I don't know specifically…this was just a quick Facebook question, we don't have any background; a lot of times on the podcast submission questions we can get some background and find out what the person's doing. And I know, from what I know about Jenna, I think I've safely seen her around Facebook and Twitter a bunch, so she probably knows a bunch of this stuff, but just in case, people aren't following this, constipation, you know, the tips that I have for people that are dealing with constipation and some of this can be different with the different hormonal situation of being pregnant. I know, too, that on the flip side of that, I've heard a lot of women who when their period comes on, basically they kind of have a bout of diarrhea, and it's like the opposite effect. Like your body is probably just clearing a bunch of hormones, and potentially, if you're dealing with a, you know, different set of hormone balance while you're pregnant, it could be tough for your body to continue to process and detoxify whatever's coming in. So that could lead to some constipation.
The basics on constipation are making sure that you're hydrated, you know, retaining water can be tough, so I don't know. I don't know how much she's salting her food. I don't know how much of that could just be again, that hormonal balance where her body is doing different things with the water than it would normally be. But I would make sure that you're drinking enough because, you know, basically if you're retaining it, you want to make sure that you're drinking enough that it's not putting your body in a situation where it needs to hold on to every drop that you're putting in. But so, enough water. Obviously fermented foods. I mentioned this, again, I think it was last week, but you know, 80% of the dry weight of your stool is bacteria, so if you don't have a good balance of gut flora and most of that is going to be living in your large intestine, where you know, the last stages of digestion and absorption are happening. So making sure that you've got some flora in there. If you are currently eating fermented foods like sauerkraut or kimchi or maybe some, you know, good goat milk kefir or something like that from some local raw milk. if you're doing that, and it's not helping, you know, you may want to try a probiotic supplement. It's hard to know how, you know, how to get your balance in check, and kind of the last step of that is making sure that you are eating some starchy foods. You know, the bacteria in your colon will be able to especially thrive on some of those starchy foods. It doesn't mean that every person needs to be eating a lot of starches to have healthy elimination, but I do find that people, even if they have looser eliminations, either way, that starches tend to help just get everything kind of bound up properly and so kind of both sides of the coin there. If you're constipated, being able to get the gut flora in check, and then giving them something to feed on should help that out. So those are kind of the basics on constipation.
It may be a little bit different for her. I don't know, but relaxing and doing some meditative breathing or really working on just, I don't know, maybe some different kind of visualizations. I think a lot of those people do deal with constipation from stress. Stress is definitely going to impact just the whole peristaltic movement of your digestive system. So if that's something that you're dealing with, I would work on that. I mean, I would take that as…I would focus on the constipation issue first, in terms of, you know, symptoms that are uncomfortable, just a little bit more of a toxic situation than something like just a bit of water retention. More thoughts on that?
LIZ WOLFE: I think that at 9 months, I think there's like the mechanical thing going on where the baby is probably, you know, exerting some pressure on the uterus, on the intestines and all that…
DIANE SANFILIPPO: Hmm, yeah.
LIZ WOLFE: So I mean, there might just be the way it is, you know.
DIANE SANFILIPPO: Yeah.
LIZ WOLFE: Just keep all that dietary and hydration stuff up and felicidades on the pregnancy.
DIANE SANFILIPPO: Yeah, totally.
LIZ WOLFE: Totally.
DIANE SANFILIPPO: I think she was like Paleo Bride or something on Twitter.
LIZ WOLFE: Oh, that's cute.
DIANE SANFILIPPO: Yeah [laughs], she went from Paleo Bride to now being Paleo Preggo. Well, I don't think she changed her name, but she's pregnant, so congrats!
LIZ WOLFE: Congratulations. Cool. Okay, so I guess this will probably. This one's a little bit longer, but I really like this question. All right, so Cae says: “So, I’m now 7 weeks pregnant. I was doing great on “Paleo” before getting pregnant. I was losing weight very slowly but still losing. I was getting healthier. My skin improved. I had cystic acne- when I finally got around to pulling out dairy. I loved not having to eat every 2 hours to keep my blood sugar out of the toilet. And I did not miss the scatterbrained effect of blood sugar instability. Now that I’m pregnant, I can’t seem to eat much of anything except lettuce, tomatoes, fruit and cheese. I can’t even stand the smell of all of that grass-fed lamb we’ve got in the freezer. I can get down a couple of eggs once in awhile. I’m freezing all the time because I can barely eat anything. I’m thinking maybe I could get some goat cheese. That might be less problematic than bovine cheese. I’ve even been sneaking in some grains in just to keep from starving! Do you have ideas or suggestions? I’m not so gluten intolerant that a muffin sends me to the restroom, but after a few days of gluten I start having constipation. Legumes are really problematic for me.”
What do you think?
DIANE SANFILIPPO: So I hear this a lot from pregnant women, and it was submitted a little while ago from Cae, so she may even be out of this phase right now. I've definitely heard it, primarily being a first trimester problem. I don't have my own experience with this, so if anyone else wants to comment on the post we put up and you know, with hints or ideas or whatever they did to kind of get through it, but I've heard this. And I've definitely heard that it's a phase that you'll come back around and, you know, likely by the second trimester, if not before then. So you know, it's tricky. My best advice, which is what I would do, you know, if this were me, is to eat Paleo foods, you know, whichever ones appeal to you. So, you know, she's saying she doesn't…she's not so gluten intolerant that a muffin sends her to the restroom, but after a few days she's having constipation. Well, yeah, you are gluten intolerant. So maybe it's not like having constipation a few days later, yeah, well, it takes a day or two to kind of feel the constipation effect potentially from a food that you're eating, so no, that's not an okay food for you. I know she wasn't saying like I'm going to go eat a bunch of muffins, but, you know, if you experience anything…even if you don't, I just don't see a place for gluten in your life anyway…but constipation, yeah. I mean, it could be even worse than the opposite. So definitely stay away from that, but I just don't see this as a reason to kind of fall back on poor quality, nutrient poor, refined, processed foods when the number one priority is a healthy growing baby.
So I definitely don't have issues with the fact that people might need to change which foods they're choosing, so, you know, if fruit and cheese are what appeal to you, if you do okay with cheese. If you can get a good quality cheese, you know. I think, Liz, you mentioned this. I don't know if it's something that you were talking about this before. If this is something we were talking about offline, but you know, cheese can be a really good source of some fat-soluble vitamins, especially if you're getting a good grass-fed cheese. So I don't really have a problem with that if you feel good eating it. Cheese doesn't work for me, but if it works for you, it is a really nutrient dense food. So, you know, get the best quality that you can. Remember that everything you're putting in is creating substrate to feed this growing baby. So it's not to say like freak out if you, you know, we're off the rails for a couple of days, but just remember that. You know, so I just don't…I don't really have an issue if somebody just, you know, maybe eating a little bit more fruit for a week or two than they normally do, or you know, not getting in as much meat. If that's what your body is craving, and if you revert to something else, maybe it's telling you something. Listen to it. But I think listening to it drive you into a jelly donut is probably not the best answer.
So this is kind of like the case for, I don't know, like, something like I consider like a Paleo treat, like the avocado banana chocolate mousse kind of thing. Like if you're feeling like you need a treat like that, make something that's, you know, from nutrient dense foods that can then feel like it's not something that, you know, you're totally averse to eating. What else? That's kind of it. I think that it passes. I wouldn't let it freak you out. I wouldn't let it worry you. If it carries on for more than that first trimester, I would seek out some things, like maybe acupuncture or an EFT (emotional freedom technique) practitioner. I think a lot of times these things can be very psychological, and you know, that's not to say, you're crazy. It just means people who have aversions to foods, a lot of times it really is totally in your head. Like there's something that's causing you to be averse to it, but I've also heard some pregnant women who say they didn't feel like eating meat at all, but then they took a few bites and they felt fine. And then they continue to eat it, so sometimes you just have to force through that and see how you feel when you do eat it.
The other thing I was going to say about this is a lot of times women say they're very nauseous in the morning, and so the idea of like meat and quote unquote heavier foods turns them off, but sometimes that nausea is just from a blood sugar low. And really you have to eat to kind of get that blood sugar low to rebalance out, and I know that that low can make you averse to things like meat, and you just want to eat sugary things. But just remember that it's physiological in that it's low blood sugar. Eat what you know is right. Just see how you feel . Eat a few bites of it. See if you actually do vomit because it probably will not happen. It's probably something that you're just thinking will happen, and it's not the same as, you know, real morning sickness where you are vomiting all the time, but again, that's another thing that's also closely, closely related to blood sugar imbalances. So I haven't heard tons, and you know, correct me if I'm wrong in the comments, I haven't heard tons of Paleo women complaining about a ton of morning sickness. It's not…we get a lot of questions on the podcast. I haven't seen that one a lot. So, you know, it kind of keeps coming back to this blood sugar regulation thing, but yeah, I just wouldn't use this as a time to kind of get off the rails into poor quality foods. I would just keep it in line with good quality foods, even if that means something that isn't, you know, orthodox Paleo.
LIZ WOLFE: Orthodox Paleo.
DIANE SANFILIPPO: Yeah, I don't know about it.
LIZ WOLFE: I think this cheese stuff is really interesting. I know that, just to provide a little context on the whole cheese issue. Yeah, I was answering that question for someone on Facebook, and it was one of those questions that kind of drive, I think, me nuts, maybe you, too. This whole thing, like, well, if you eat cheese, you're not Paleo,, you're Primal, but if you don't eat cheese, then you're Paleo, except for if you have more than 3 slices in your refrigerator that your husband's going to eat, then you're probably Primal. Like, it's like who cares? Like, you know, you can make anything Paleo in some weird justifying type of way. Like we could say that the only thing that's really nutrient, er, the only thing that's really Paleo is the nutrients you're eating. So Paleo people got lots of vitamins, A, D, E, and K2. So let's eat tons of cheese, egg yolks, and get some sun. Wow, that's sounds pretty Paleo. I don't know. It's like, just look…
DIANE SANFILIPPO: Yeah.
LIZ WOLFE: Keep the focus on nutrient density. What keeps us super healthy and what is a real. whole food.
DIANE SANFILIPPO: Yeah.
LIZ WOLFE: ‘Cause I know when I was first doing the Paleo thing, it was chicken, broccoli, coconut oil. And that was just not…
DIANE SANFILIPPO: Yeah.
LIZ WOLFE: it sounded Paleo to me, but whatever. I just think about..
DIANE SANFILIPPO: Well, I…
LIZ WOLFE: Go ahead.
DIANE SANFILIPPO: No, I think, too, like this whole…the whole Is it Paleo or not? thing, I feel like I'm a broken record sometimes. I think that the whole dairy issue got really muddied up when we were looking at pasteurized processed dairy. It doesn't mean, you know…yeah, we took this word Paleo and maybe Paleo man wasn't chasing down a cow and milking it, but it doesn't mean that that food.
LIZ WOLFE: [laughs]
DIANE SANFILIPPO: Seriously, it doesn't mean that that food isn't nutrient dense and valuable to us. You know, it doesn't mean that it's good for everyone. You know, we know that, but I think that that's where the Weston A. Price approach. I know that like Chris Kresser is pretty keen on raw grass-fed, like good quality, I think it's like A2 vs. A1 milk. If you're going to be really nitpicky about what kind of cows it comes from. But understanding that nutrient density is our focus, between Liz and myself, like we're all about nutrient density. We're all about keeping your digestion in check. So if you…I don't do well with hard cheeses. Like that stinks. But I seem to do okay with butter, so I eat a lot of grass-fed butter, but you know, if you do well with it. If you don't have digestive upset. If you don't have any like weird stuff going on, it's a nutrient dense food. Get the raw, you know, good, you know, well sourced cheese. You're not buying like Schmo cheese at the grocery store that's processed in one of those little plastic wrapped, each slice kind of deal.
LIZ WOLFE: Yeah.
DIANE SANFILIPPO: That's not what we're talking about. And we're also not even talking about organic milk. Like, we're not talking about that stuff. That's not real food. We're talking about raw, unpastuerized grass-fed cheese or milk. That's what we're talking about, so just to like clarify this whole thing on the dairy. I think dairy got demonized. Bad dairy.
LIZ WOLFE: And you know, if you want to opt out..
DIANE SANFILIPPO: Yeah.
LIZ WOLFE: I think if you want to opt out of the dairy argument, like that's totally cool. Like if you don't want to deal with all the differences between the dairy from different animals and the different types of cheese and blah blah blah, that's fine. Make sure you're getting some vitamin K2. Make sure you're getting, you know, vitamin A and all that stuff. But also, I think it's worth saying that there are many, many, many different types of dairy. Not all dairy is the same and people tolerate it different. You were talking about differences between A1 and A2 cows. A2, I believe, is the more ancestral, almost kind of heritage type breed of cattle that produces a, I believe it's a beta-caso or beta-casein or something like that. Basically a component or a like a component of casein that causes, is thought to cause problems in certain people. I know that cow's milk casein can be cross-reactive with gluten sensitivity. It may depend on the type of cow. It may depend, I believe the A2 cows don't produce the same like beta-casomorphin 7, and A1 cows do. I don't know that that's really…I know that Chris is not convinced, necessarily, by that. I don't think that just because we don't see it in the literature, I don't know that that means it's not true. But I think it's an interesting point because I actually do tolerate A2 dairy much better than just something standard from the store. But that also could be because the A2 dairy I get from a farm in Pennsylvania is pastured and much healthier and all that good stuff. Goat's milk is different from cow's milk as well, I think, on the casein issue. And also there are whey cheeses and there are casein cheeses. So you may tolerate whey better than casein. There's just so many different incarnations, and I think it's fun. I love sampling different types of cheese. But I don't know. You don't have to if you don't want to. But just know that demonizing all dairy, to me, it's just silly.
DIANE SANFILIPPO: Well, it's almost to the point of…I mean, this is just my take, but it's almost like demonizing all meat. It's…I mean, I just can't on board with it and so it doesn't mean that, you know, whatever. We're like totally off the rails of this topic, but…
LIZ WOLFE: We are.
DIANE SANFILIPPO: Okay, whatever. Let's move on.
LIZ WOLFE: Let's do it. Let's move on. Yes, okay. Next question from Joy. “I have PCOS and have been advised to eat like a diabetic to correct the insulin levels. I have also been told to eat low carb to control my insulin – but another doc told me to just eat gluten-free. Of course, I have been always trying to eat “Paleo.” Because I have severe PCOS and other autoimmune issues, should I stick to gluten-free with a “Paleo” influence, or really focus on getting carbs lower – which is best for keeping insulin levels low? FYI, I don’t menstruate – but I did recently after 13 years after going gluten-free. (Mostly “Paleo,” but I ate dairy and potatoes.) This was almost 2 months ago and my period hasn’t returned…which is why I’m confused to which way I should go. Should I be concerned with going lower-carb because of hypothyroidism? I know it’s probably going to take time after years of eating a Standard American Diet, but I don’t want to feel so confused all the time. Help! Thanks guys. Love the podcast.”
DIANE SANFILIPPO: So Joy, she's dealing with a couple of things here. She's got, I guess she's got hypothyroidism. She said, you know, she mentioned that PCOS and other autoimmune issues, so I'm guessing that her autoimmunity is the hypothyroidism. So we've talked about this like a bazillion times on the podcast. If you have autoimmune hypothyroid, which is Hashimoto's, you need to be gluten free 100% of the time. There are known triggers in gluten proteins that will provoke the autoimmune response to thyroid proteins. So I have a guide on the website, a Useful Guide that is Finding Hidden Gluten. So you need to make sure that you're not eating gluten anywhere in your diet. If you go out to eat, act as if you are celiac and, you know, carry a gluten free dining card. You can talk to the waiter. You can kind of show them what it is that you can eat, and just be really, really careful about that.
So you know, her questions here, boiling it down, is what route should she take. There's been a lot of kind of back and forth on this whole low-carb/not low-carb. You know, should I eat starches? Should I not eat starches? If you are dealing with these hormonal issues, if you're dealing with PCOS, which is a direct-has a direct relationship with high levels of insulin, I do think a low-carb Paleo approach is the way to go. I don't know what her activity level is like, so this doesn't mean…when I say low-carb, I mean, in the like 50-75 grams of carbs a day range, you know, possibly. That doesn't mean very low carb, which I would consider below 50 grams a day would be very low-carb. If she is exercising, keeping maybe some starchy foods after the workouts just to replenish. She doesn't need to be, you know, on a ketogenic diet, but it will take some time. Getting out insulinogenic foods that are refined, just sugary refined foods that are demanding metabolic processes, without delivering micronutrients, so that's not the case with something like sweet potato, where you're getting tons of vitamins and minerals from the sweet potato, with the insulin response that's fine. But we're talking about standard refined foods, gluten products, any grain products, all that stuff needs to be out. And that's what needs to be out just for general health, so if you're already dealing with an autoimmune condition and a hormonal imbalance, like there's just no reason to follow, you know, just being gluten free. Because to me, when the doctor says “go gluten free” people then go out and buy gluten free bread and gluten free crackers and gluten free cookies and all this stuff, and that's not healthy. Like there's just no reason to think that that's healthy food.
So, you know, what should she focus on? She should focus on keeping sugar low in her diet. If she's exercising, getting some starchy foods in after the exercise is a good idea, but overall, I would say if you want to track a few days of your food to see what you're doing, you know, coming in between 50 and 75 grams of carbs a day, it's probably a good place for you. If that's what you're going to hit naturally eating just tons of vegetable matter, free eating vegetables and just a little bit of starchy stuff. I would keep the fruit to a real minimum, you know, maybe some berries as dessert, but like half a cup. I wouldn't do a ton of fruit, so just keep that really low. And yeah, you know, if she's saying like she understands it's going to take some time, it is going to take some time. You've got a lot of complications with the hypothyroidism is going to really, really affect your periods. So just getting your body to healthy place should be priority number one. You know, avoiding gluten 100% and getting your menstrual cycle back on track, those should be your goals, which I like that she's not talking too much about, you know, weight or body fat or any of that, you know, maybe she's at a healthy weight. We don't know. Just because somebody has insulin dysregulation or hormone imbalances doesn't mean that they will be overweight, but, you know, if you are dealing with some excess weight, I just wouldn't make that a focus, which it doesn't sound like you are. So that's a really good thing. But that's really my take. I, you know, the doctor that's telling you just to be gluten free, it's just not that effective. So I think-I think the low carb is an effective tool for you and just understanding that that doesn't mean zero carbs. It just means, keep an eye on that.
Do you have any more for Joanne there, Liz?
LIZ WOLFE: No, I think you got it all.
DIANE SANFILIPPO: All right, so we'll put a link in here too to the Gluten Guide. And I would take that stuff really seriously. And I would also check out Why Do I Still Have Thyroid Symptoms When My Lab Tests are Normal? That might be a good guide on the Hashimoto's, just a little more information for her on that stuff and how that can all be related to blood sugar and all that.
So where are we for time? Are we ready to wrap it up?
LIZ WOLFE: We are at an hour, just about. I think we can wrap it up. Another hour of time sucked away from everyone. They will never get it back.
DIANE SANFILIPPO: [laughs] Absolutely.
LIZ WOLFE: All right, so anything…
DIANE SANFILIPPO: All right, well..
LIZ WOLFE: everybody.
DIANE SANFILIPPO: Yeah, so hopefully we'll see some of you next weekend in Frisco.
LIZ WOLFE: Yup, come see us, the Balanced Bites workshop and Liz Wolfe comedy show.
DIANE SANFILIPPO: Woo hoo!
LIZ WOLFE:… Woo hoo! I'm really excited. All right everybody, thanks for being here and we'll talk to you next week.
Diane & Liz