Podcast Episode #61: Tattoos, “Chicken Skin”, Raw Foods & Blood Sugar

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Topics:
1. Brewers Yeast? [13:52] 2. Coconut oil for Tattoos? [22:13] 3. Gaining weight to help fatigue? [26:05] 4. Keratosis Pilaris, what foods to add what food to avoid? [34:35] 5. Paleo vs. Raw Foods [44:00] 6. Small meals vs large meals and controlling blood sugar [48:23]

Links

MSG information website.
Catching Fire: How Cooking Made Us Human
Take Charge of Your Fertility

Dr. Mercola's video on UVA/UVB rays & Vitamin D (YouTube).
Dr. Mercola's article on UVA/UVB rays & Vitamin D.

Click here to download this episode as an MP3.
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LIZ WOLFE: Hey everyone, I'm Liz Wolfe. I'm a nutritional therapy practitioner, and I'm here with Diane Sanfilippo, who is a certified holistic nutrition consultant and the woman behind Balanced Bites and of course, the New York Times-the four time New York Times Bestselling book Practical Paleo. Remember our disclaimer before we begin. The materials and content in this podcast are intended as general information only, and not to be considered a substitute for professional medical advice, diagnosis, or treatment.
Welcome to episode 61 of the Balanced Bites podcast! What's up, Diane?

DIANE SANFILIPPO: Hey, I'm in San Francisco. Hooray!

LIZ WOLFE: Me too. Well, not exactly. I'm in Fairfield right now, but will be seeing you in San Francisco in a couple of hours.

DIANE SANFILIPPO: Yeah.

LIZ WOLFE: Very exciting. You've told me, do not call it Frisco. Not cool.

DIANE SANFILIPPO: Yeah, nobody who lives here calls it that. We call it SF. I don't even live here anymore, but it's still my city.

LIZ WOLFE: SF.

DIANE SANFILIPPO: Yeah, so…

LIZ WOLFE: That's how I feel about Lenexa, Kansas. That is my city, man.

DIANE SANFILIPPO: Lenexa, Kansas?

LIZ WOLFE: Lenexa. I like Lenexa. Spinach festival. It's good stuff.

DIANE SANFILIPPO: Wow. So hanging out here yesterday all day, I was touring around with Bill and Hayley from Food Lovers Kitchen, and it was really fun to give them a tour. I mean, I love like kind of playing tourist around San Francisco, so that was cool. And we kind of went by…where did we go? For breakfast, we went over to Mama's on Washington Square, which they have amazing omelets, and myself and also Grass Fed Girl, who lives in San Francisco, ordered crab Benedict, so it's eggs Benedict, so eggs with hollandaise sauce. I know, your favorite.

LIZ WOLFE: My favorite.

DIANE SANFILIPPO: And fresh lump crab meat, and we just had it served over potatoes, which I don't know, totally fine with me. Just, you know, get it with no bun, no English muffin underneath. I know people always ask us, you know, how do we eat on the road, so that's pretty much a simple modification and that was really it. I had some tea. Still doing my no coffee, and had a good time. It was-we were touring around down Union Street here, and I was stopped on the street by a fan, who said, Diane? Like hey! I love your podcast, and I mean, I think she was like beyond excited, so hi. I can't remember her name [laughs], but I said hi to her, and I thought it would have been really funny if we had both been walking down the street, like I think her head might have exploded. She was like really excited.

LIZ WOLFE: That's really nice.

DIANE SANFILIPPO: And she was just in town visiting, so she doesn't even live here.

LIZ WOLFE: For the conference? Weston A. Price Foundation conference?

DIANE SANFILIPPO: No, I don't think so. I think she was just visiting a friend, so yeah, so I'll see you this weekend at the Weston Price Conference. Well, I'll see you before that. And then Monday, here in San Francisco, I'll be doing a book signing at Omnivore Books, which is an amazing, amazing like completely food-oriented cookbook store. They've had some really great, like big names and sort of the whole food/foodie cookbook arena. And I guess they had-there's a blog called Smitten Kitchen that has a cookbook out…

LIZ WOLFE: Oh yeah.

DIANE SANFILIPPO: Yeah, so they were there this weekend, or this past weekend, and kind of like just blew up the whole place. And the woman who owns Omnivore Books was like, uh, do you have some kind of huge following that I don't know about? Is this going to like explode my store again? And I kind of joked with her, like you don't know about my following? [laughs] Like, but I told her, you know, not to worry. I don't think it'll be quite as extreme, but absolutely if anybody's, you know, in the Bay Area, you're in San Francisco, come by at 6 o'clock on Monday night at Omnivore Books. It'll be a good time. I'll be signing books, and that's pretty much it, I think. Before next weekend, heading up to Tacoma to teach, up in Tacoma and do a book signing in Seattle, Seattle area, so people can check out the website for those details.

LIZ WOLFE: Wonderful. So I'm heading to the Air Force Academy right after the conference. I'll be in Denver for a hot minute, and then heading up to Colorado Springs to present some nutrition information to the Academy, Air Force Academy and regional firefighters through the First Twenty and Jumpline Tactical Fitness, which I'm really excited about. These firefighters have been occupied so frequently and so much lately, and I really did just want to give a heartfelt thank you to all of the first responders out there. This is particularly poignant given the devastation from Hurricane Sandy, which, to be quite honest, Diane, I didn't fully realize the horrific destruction Sandy left when we recorded last week. We've been out of power. I hadn't had the news running, and my phone wasn't connecting, and the first activity I did after leaving the house and getting reconnected to everything was to record our last podcast, really kind of oblivious to what had gone on up North and as we've had some time to really see and reflect all this damage, just really clear to me that this is going to be a long rebuild and I'm just amazed at the courage of all the first responders in this situation and of course, others in the wildfires that we've seen, just increasingly. And I just wanted to throw that out there.

DIANE SANFILIPPO: Yeah, I-you know, I've gotten a couple of questions about it, like oh, do you know about what was happening, and I do. And my family was without power for at least a week, and I know, like all my buddies back home and at the gym were without power and as far as I know, none of my close friends or family were affected in terms of like trees coming down on their houses. We actually had a lot of that happen last year, so like we've had a huge storm a year ago. But yeah, I was in Texas the entire time that it happened. I think I was in southern California and then Texas, so I've been really disconnected from the whole thing, and we're lucky to do some giveaways coming up on the blog and the website, and I'm hoping to maybe even do some orientation on some stuff that will be focused on people who maybe haven't-maybe without power that week and kind of lost their entire freezer full of grass-fed meat, which I'm sure some people did. And just kind of throw some support out that way.

LIZ WOLFE: All righty, so next on the agenda. You and I've talked about kind of prefacing our question answering segment with maybe doing some special topics here and there. And so let's do a quick little special topic. I did want to have a little discussion about something, and I wanted to talk about what we, you and I, define as our personal markers for health. I'm not talking about what the lab tests say. I'm talking about what you and I look for as our real beacon of how we're doing and what's really important to us as far as health goes. The reason I want to talk about this is because I've just noticed, it's still so pervasive in the media, in CrossFit circles, in Paleo circles, just everywhere that getting as lean as possible is the marker for whether you've, you know, made it to some, to whatever goal, to whatever health goal that you had. You know, you see those, you know, workout inspiration things plastered all over Facebook, and you know, I have to say, even some movements like Strong is the New Skinny, they fall into this trap as well, kind of expressing that how hard you work in the gym, how lean you get, you know, to meet your leanness goal that that's really indicative of health, and that's just not true. And to be honest with you, that's not my marker. I maintain a healthy weight, but I'm not preoccupied with leanness as my primary goal.
So I just wanted to throw out there to folks that my personal markers for how well I'm doing are number one, the health of my skin. I'm really, you know, into this skin/food, health from the inside and from the outside in. I really worry about the health of my skin. And then my other marker is whether my sleep and wake cycles are appropriate. Whether I sleep well, and whether I wake up refreshed. That's it, and that's all. That's really where it begins and ends for me. Now and then, if my digestion acts up, especially when we travel, that's more of an acute circumstance for me. I deal with that appropriately. So that's my two cents on how I'm doing. Diane, what are your personal markers for health?

DIANE SANFILIPPO: I think there's probably a couple that are like day to day markers, and then some that are slightly more long term, like weeks or months at a time. And I think the day to day markers are definitely for me things like skin, as you mentioned. I notice when I eat things, especially, especially when I travel, when I eat things like dairy, my skin just breaks out. And I know that I don't do that stuff regularly. So but digestive function, again, you know, things you usually hit me in a pretty acute way. It doesn't last for more than that one day if something kind of creeps up where I ate something that I normally wouldn't have or I just, even you know, just yesterday, I think, I ate a bunch of raspberries, and I don't normally eat that much insoluble fiber. I just don't find it to be something that makes me feel good, and really did not go well with my system at all. So little things like that are kind of my day to day signs and symptoms, I guess, of what’s going on with my health. And for me, those are also day to day or minors of more food related things than lifestyle, and so the weekly or monthly things are really more about like lifestyle choices. So like what you were saying, just sleep/wake cycles. Like how my energy is throughout the day, how deep or consistent my sleep is. So even if I'm not sleeping as long, if I sleep through that six or seven hours and then just wake up, I tend to wake up without an alarm, like 99% of the time. You know, how do I feel? Do I just wake up? Like that's a good sign to me, unless I'm, you know, waking up a million times throughout the night, which that doesn't normally happen, so if it does, not a good sign.
I think, you know, catching colds or flus often. If I catch one once a year, I'm like, eh, okay. No big deal. Again, with all the travel that we do, things can be really different for immune health, based on travel, and I think largely, I almost think a lot of the bugs we may get exposed to are helping people like us who have generally strong immune systems as it stands, but I think that can also give a little bit of a beat down and just all the time changes. So I really pay attention to my energy levels. I pay attention to whether or not I'm looking for caffeine, even if I'm not drinking coffee. If I'm trying to get tea that has caffeine in it, and I think, you know, the idea of being at a certain level of leanness, and I know, you know, you and I just talk about this a lot because I’m sure some people who are listening are like, oh, they always talk about this, but the reality is we get questions about this every single time we teach. From people who come up to us in person, people at the book signings are always asking about these things, so that's why we keep kind of harping on it.

LIZ WOLFE: Right.

DIANE SANFILIPPO: You know, I think we're going to the Weston Price Conference this weekend, and I think, we know we're going to see people who are healthy and robust, and we know that their goal isn't the same as people who come from a different perspective. It's not about leanness. It's about this internal health because we know we can look at people who are super lean, who are absolutely broken on the inside and it's not the accurate way to do it. But my issue with sort of my metabolism right now is that travelling is really hard on me. It's hard on me because I can only train maybe 2 or 3 days a week sometimes; just the schedule is really hard to keep. Finding a gym that will let me sort of do what I need to do that's based on the programming I've been doing and not just kind of show up for whatever they've been doing, which may not be aligned with [cuts out from 11:51-11:56] I think it's a matter of [cuts out from 11:58-12:01] of really, you know, staying in tune with your own body. [cuts out from 12:04-12:06] Do we need to re-record this?

LIZ WOLFE: You dropped out just for a second, but I don't think anything…I don't think it affected anything, so…

DIANE SANFILIPPO: Okay.

LIZ WOLFE: Yeah. I think we're all right.

DIANE SANFILIPPO: Okay, so, you know, I was looking up some pictures recently from, I guess it must have been about a year and a half ago, when I went on the MovNat trip, and I do this kind of often where I look at old pictures and I remember thinking at the time that I wasn't very lean, and then I look at the picture, and I'm like, yeah, I was. So [laughs] I think some people may need to be taking more pictures than they do, and really getting a different perspective on things, but this whole traveling thing, not keeping my regular schedule, just the inflammation that comes from air travel and the pressure changes, my body is just not, you know, where I would say I want it to be, but at the same time, I'm happy. You know? Like whatever. Maybe I just need to wear something different and just keep going because I'm meeting people and doing what I want to do, and so that really is kind of the other marker for me. Like how happy am I with what I'm doing, and just because it doesn't reflect in smaller jeans size doesn't mean that I'm not successful at maintaining health.

LIZ WOLFE: Right. And this isn't to say that there's anything wrong with having leanness goals…

DIANE SANFILIPPO: Right.

LIZ WOLFE: But if you are preoccupied with leanness, you know, exclusive to gym performance because I love performance goals, you know?

DIANE SANFILIPPO: Right.

LIZ WOLFE: I think performance goals are great, but if you’re really mostly worried about leanness and that's why you’re going to the gym, and your digestion is crap, then we really can't confuse that, that marker of leanness with health, and I really just think that's our kind of final…our final word on the matter, you know?

DIANE SANFILIPPO: Yeah, definitely.

LIZ WOLFE: Cool. All right, onto questions. Question number one. “Brewer's Yeast.” This is from Lucia, Lucia or Lucia, not sure.
“What are your opinions on Lewis Labs Brewer's Yeast? Necessary? Any risk of MSG? Dare I consume? Totes Paleo! Curious about supplementation, having issues with acne due to falling off the Paleo wagon for two weeks and stress (life changes, yadda yadda!).”
So with this one, I am a big fan of Lewis Labs Brewer's Yeast, and this is much like our recommendation of that one specific brand of fermented cod liver oil, one brand and one brand only. I only recommend Lewis Labs Brewer's Yeast. That’s the only kind of brewer's yeast I recommend. And here's why. First, they're the only company I trust that's honest about their sourcing, that fully understands and really knows, you know, from point A to point Z where they're sourcing their product. Their brewer's yeast does not come as a by-product of the brewing process. It comes from non-GMO sugar beets. Sugar beets. Now, I know brewer's yeast seems like sort of a non-Paleo-ish recommendation, and really I honestly don't recommend it, per se. I just found it in my personal research on acne and glucose tolerance, that brewer's yeast might be useful. And I tried it, along with a few other interventions that you can find on my blog and more in my skincare guide, which should be done here in the next couple weeks. And it worked, so because of that, I looked into it more, and I've told a few folks to check it out. I like Lewis Labs brewer's yeast as a whole foods type superfood/supplement-ish complex because, you know, as many people know, Diane, you and I don't like most nutrients in isolation. We don't like supplementing unless it's targeted, purposeful, done in a way that respects and utilizes nutrients in their natural, synergistic state. So brewer's yeast is a source of appropriate amounts of chromium, as what’s' called glucose tolerance factor, which is thought to allow the body to utilize glucose more effectively, which can be a problem in acne sufferers as well as diabetics. The chromium content is present in amounts, to me, that I've studied as helpful and appropriate in the exact scenarios I like it for, which, as I said before, skincare, blood sugar control. It also contains a complex of B vitamins, selenium, a few other components that are really interesting to me. And in my opinion, these all seem to be useful and synergistic, especially with regards to acne and blood sugar control. I personally don't have any MSG concerns at all. I've been personally assured by the Lewis Labs folks via email. I've done a little bit of reading on MSG. A good website for that is…I think it's www.truthinlabeling.org. It's all about MSG, and I'm still learning, but there are folks out there who are also probably thinking this yeast will drive candida. That's a common concern, but this is just totally false. I don't think that conclusion is well supported anywhere. The yeast is not active. It's kind of like saying eating chicken breast is the same as eating a live chicken. It's just not true.
What else on that? If you have any tyromine sensitivity, I probably wouldn't recommend the Brewer's Yeast. It doesn't mean tyromine is bad, but I just have to throw it out there. Also, another quick point, just to cover all bases. Brewer's yeast is identified as brewer's yeast because of the chromium content. I mean, brewer's yeast is technically the by-product of the brewing process-the beer brewing process, but the actual defining characteristic of brewer's yeast is its high chromium content. So even though Lewis Labs brewer's yeast is not a by-product of brewing, its chromium content does put it under that brewer's yeast umbrella. Nutritional yeast, anything not called brewer's yeast is not high in chromium, and it will not afford the same benefit. So again, I like Lewis Labs brewer's yeast. I think you can find it at Whole Foods at this point. I don't have any MSG concerns. No candida concerns. If anyone with MSG sensitivity can actually pinpoint those symptoms as being exacerbated or triggered by Lewis Labs brewer's yeast, I would like to hear because I just don't think that's going to happen, but, you know, you never know. What are your thoughts?

DIANE SANFILIPPO: So I think…I'm trying to kind of frame, you know, she's asking this question in terms of supplementation, and I just want to address sort of the other side of it just a little bit because what most folks are using brewer's yeast or even nutritional yeast for, just sort of from a culinary perspective, is for a cheesy taste, so it's really common that you'll see nutritional yeast or brewer's yeast on ingredient labels. Something like kale chips is where you'll find it pretty often. And it is just used as sort of like a vegan replacement for cheese. So it has this parmesan taste. You and I had some kale chips on our way back from-where were we coming from, Rochester?

LIZ WOLFE: Yup.

DIANE SANFILIPPO: On that epic drive home.

LIZ WOLFE: Oh my goodness.

DIANE SANFILIPPO: And they had nutritional yeast on them, most likely, and so it has been touted for a long time, and I think this is both nutritional yeast and brewer's yeast, as a good source of B vitamins for those who aren’t getting them specifically from animal foods. And perhaps the chromium is, you know, one additional level in the brewer's yeast, and so I'm like, cool, I'm with you on going with that recommendation. Some folks have asked me if it's the same thing when you get B vitamins from animal foods vs. plant foods, and I think because we do have some nutrients that are not the same across the board, like iron, for example, where we have heme iron from animals. You know, heme being short for like hemoglobin for blood, and then non-heme from plants. That those work differently in our bodies, but with B vitamins, they are actually going to work the same way. It just may be a difference in the spectrum and the amount of the different B vitamins that you're getting in plants vs. animal foods. Like you may get a more complete spectrum from animal foods than from plants, but as I said, nutritional yeast or brewer's yeast have been known for a long time as pretty dense sources of B vitamins, which are generally harder to get from plants. That people who aren't eating a lot of animal foods may need. And this is something that, you know, we talked about this years ago when I was back in school, and like I said, many times I had to…we had sort of a vegetarian slant in my school, so they always brought up foods like this as kind of like a superfood. And you may need a lot more of it from a plant food, like the brewer's yeast, to get sufficient levels of B vitamins than you would from animal foods, and this is something like…you know, you can get tons of B vitamins from liver, so you know, people are always looking for these other forms that are kind of more obscure and you have to make them and find them and track them down, but you know, eating some liver will get you tons of those B vitamins. Do you have thoughts to add there?

LIZ WOLFE: My only suspicion is that those built in B vitamins that you're talking about that are in that brewer's yeast help the body to use the chromium that it contains, which I think is why I found it the most helpful compared to just solo chromium supplementation which I did try, just as a comparison. So yeah, I think that's a great point about the B vitamins.

DIANE SANFILIPPO: Well, that's cool because it goes back to whole like synergy and the things we don't know about food forms.

LIZ WOLFE: Exactly.

DIANE SANFILIPPO: And even though this was not really, sort of like a whole food. You know, it is like a…

LIZ WOLFE: It's a complex.

DIANE SANFILIPPO: Yeah, I mean, it's not just an isolated nutrient and you know, this is one of the reasons why in my book I have lists of information on supplements, but then you turn the page and it's all these nutrients that I'm saying you should get and foods to find them in because the reality is, if you can get it from your food, you know, get it that way because you don't know what else you're getting besides just the B vitamins and the chromium. You're probably getting other stuff too.

LIZ WOLFE: Yup. All right, next question. “Coconut oil for tattoos.”
Lindsay says: “Hi ladies, first of all, love your podcast, you inspire me on a regular basis and I have so much to thank you for!” Awww, thank you, Lindsay.
“I actually have two questions, one of which is short, I promise! First, I am hoping to get your thoughts on coconut oil and tattoos. I have a bit of an ink addiction and following my last one, I actually paid attention to the extensive list of crap that is in the lotion the artist recommends for aftercare. I did find a more natural option with things like comfrey, olive oil, jojoba oil, beeswax, aloe and a few other oils, and got to thinking about coconut oil as a much cheaper option. Your thoughts and opinions are appreciated!”
I think that was the only question here.

DIANE SANFILIPPO: Yeah. Or did she maybe say she had two, and then…

LIZ WOLFE: That’s the only one we've got.

DIANE SANFILIPPO: And didn't get to the other one. All righty then.

LIZ WOLFE: [laughs]

DIANE SANFILIPPO: I think coconut oil's a great option. If I were to go out and get ink, I'd probably be slathering it on pretty regularly myself. Coconut oil has some really nice anti-microbial, anti-fungal properties, so I think it makes it an especially good choice in this case. And I'd actually consider making your own sort of ointment or, you know, oil combination from a bunch of the oils that you had mentioned, so perhaps like the coconut oil, which, you know, can absorb pretty quickly on your skin, like if you put that on and in about ten to twenty minutes it's sort of soaked in, but if you want something a little thicker with some more staying power, perhaps kind of blending some of these things that she mentioned with you know, the olive oil, jojoba, maybe the beeswax and aloe, those kinds of things. I don't know. Maybe you have an idea of like a recipe or something else for that, but I think something that would just be a bit thicker to stay on the surface of the skin more might be good.

LIZ WOLFE: Yeah, coconut oil is totally legit for tattoos. I also like the tallow balm from Vintage Tradition. It's really high quality olive oil, which we also know we can get from Kasandrinos Imports, but this olive oil is also blended with grass-fed tallow, which I really like, and it stays kind of almost as if it were suspended in beeswax. That's great. I think the Vintage Tradition, you can just Google that. I really like that stuff, and they'll actually be at the Weston A. Price Foundation conference coming up.
Generally when you see aloe on most commercial products, you're not getting the actual useful or potent aloe that we kind of think of as beneficial. It's actually really a tough thing to find good pure aloe, which is why I don't generally recommend folks go out to the store and get something that says aloe on the label. Diane mentioned doing a blend of oils, which I think is a great idea, and actually Primal Life Organics, which I'm just…I just absolutely love Trina who is the owner is working with me a little bit on my skincare guide with some more specific recommendations. She has some awesome options. I really like Primal Hand Repair, which you can get in a stick or in a tin. That one has aloe butter, unrefined shea butter, beeswax, jojoba oil, coconut oil, extra virgin olive oil. She’s also got one that a lot of CrossFitters use. It's called Torn Up Primal Skin Repair, and that would be great for tattoos as well. The ingredients there are tamanu oil, emu oil, beeswax, hemp seed oil, rosehip oil, sea buckthorn, calendula, frankincense, chamomile, red thyme, cyprus, geranium, lavender, tea tree, and one that I can never pronounce: helichrysum. Anyway, any of her serums would be great, too. Trina's a genius when it comes to, you know, combining these really interesting traditional oils and I definitely suggest you hop over there, if you don't want to make your own.

DIANE SANFILIPPO: Sounds good to me.

LIZ WOLFE: Me too. All right, next up. “Gaining weight to help fatigue.”
Sarah says: “Would gaining weight help me be healthier? I am wondering if I had more fat and/or muscle if my body would have more resources to burn to give me more energy and help me finish healing… I am 5’4 and weigh about 108 pounds–this is up from when I was at my sickest about a year ago and weighed about 102. Most of the body fat I do have tends to hang out on my hips and thighs–my waist is like 26 inches or so and my arms have pretty much no fat on them. I have been considering trying the autoimmune protocol to help with my chronic fatigue, but I’m worried about getting enough calories. To maintain my current weight I feel like I have to pay a lot of attention to eating enough, and even though I sometimes eat more than I feel hungry for, I’ve been stable at this weight for a couple of months. I have been eating pretty strict paleo (plus some raw dairy yogurt and cheese) for about 10 months now. It’s helped a lot with IBS symptoms, endometriosis symptoms, controlling my hypoglycemia, etc. I’m still not at 100% though–some residual stomach pain and quite a bit of fatigue. I am not able to work full time because of my fatigue.”
Diane, your thoughts?

DIANE SANFILIPPO: Yeah, so she's still trying to deal with some different, you know, sort of…trying to figure this out. Like digestive issues that are going on still, so if the autoimmune protocol is something she's really interested in trying, it may be a really good choice, but I'd be careful because it'll narrow the food choices, but if you're fatigued, you know, the big thing I'd want somebody to watch is undereating, and especially because she is so petite at this point already. So I'm okay with her trying an autoimmune protocol to kind of keep working on some of these underlying issues, but that said, I'd really want her to focus and make sure she's not undereating. So I like for people to think about this whole idea a little bit differently than just like calories in/calories out, or even just, you know, a quantity of food. I like for people to think about their body as sort of a nutrient bank account. So if you're fatigued, you're in a situation already, and this could be adrenal fatigue. It could be any type of, you know, high stress situation because I know people are listening who are dealing with adrenal fatigue and maybe aren't exactly in the same possibly underweight situation as she is. So this kind of goes for everyone. If you're in that situation of fatigue, already you're likely depleted of nutrients like vitamin C, B vitamins, and minerals, and I’d say magnesium in particular there, as far as minerals go.
So if you're limiting calories at all, your body can't possibly dig out of a nutrient deficiency hole. Nor can it replenish enough to become sufficient and get you to what we would call more optimal health. So I'd have to see what she's eating regularly in terms of calories. We know that around 1200 calories a day for a female is just what you need to kind of lay in bed and be awake. Probably more like 16-1800 even for a male to just sort of lay and that means without losing weight. That's just a basic metabolic number of calories you need, but it's pretty clear in Sarah's case that more raw materials to build her health are going to be critical. So I might also note, again, if fatigue is the main issue, just those nutrients I mentioned above, the vitamin C, the B vitamins, minerals are super critical, and I'd be on, you know, sort of a nutrient seeking mission to eat foods that are rich in those. So she can definitely check out information in my book. I mean, there's information all over the place on, you know, food sources of these nutrients, but absolutely listed in the book. I would say, she could even look at the athletic performance meal plan because that will be really supportive of more weight gain, sort of mass gain, keeping calories coming in. But I think it really depends on how she's feeling kind of internally. I know,, you know, she said it's been helping a lot with all those symptoms. So that's kind of the approach I would take in looking at those nutrients, and I think controlling the hypoglycemia as long as that's kind of going in a good direction. You know, I would try and see if any other food eliminations are going to help with that residual stomach pain and fatigue because it's really tough to kind of move forward, and if you're not able to work full time because of that fatigue, I would just make sure that you're kind of addressing that. But eliminating more foods beyond a standard Paleo approach for someone like this, I want her to really, really be prepared and making more food ahead of time, so that she's got plenty of food to be eating all day long.

LIZ WOLFE: Yeah, a lot of times eating “enough” is really relative, and I think that's such an important note. Sometimes these questions come in in folks who have, you know, have issues with food in the past and eating not enough calories. They're in recovery and they feel like, oh gosh, I'm eating so much. When really they're not from that healthy absolute standpoint. Sometimes it takes time to really understand what an appropriate amount of food looks like and feels like to eat. It sounds like overall what this person needs is a 100%, like you said, caloric and nutritional support. This is the type of person I’d tell to go everywhere with a Thermos of good, homemade bone broth, so you know, it'll stay warm and palatable all day. Get a constant almost IV of mineral, add some sea salt for a little bit of adrenal mineral support. And get that added healing and nutritional support throughout the day, away from meals. The challenge with someone suffering from chronic fatigue is that temptation also to add a little bit too much sugar to prop up energy levels, and it's really a balance, and you want to make sure you're not relying on carbs to the expense of fats, especially since good fats like butter will carry vitamin A as retinol, which is definitely indicated in cases of endometriosis, which is really one of the things that I picked out from this question.
In fact, I just think that anybody that was born anytime or lived through the last 30 years is probably legitimately vitamin A deficient unless you've ignored, you know, the advice of the government and continued to eat egg yolks, butter, animal foods, and all those really vitamin A rich, you know, foods over the last few decades since they've been demonized. So really, if I were her, I'd get the Green Pasture Blue Ice cod liver oil/butter oil blend in there for some good vitamin A, vitamin K2, and vitamin D. The minerals in that broth I suggested are also really called for in the case of endometriosis and hypoglycemia. And it might also be useful-anytime there's a potential hormonal problem, I would definitely suggest grabbing the book Taking Charge of Your Fertility and doing a little temperature charting to see if you can get an idea of what's going on hormonally without doing more expensive or invasive testing. We've had people write in to us, Diane, and say, you know, Taking Charge of Your Fertility, why aren't you talking about this book? And good on those folks because I really…until I finally cracked that book open and really gave it some time, I did not realize how incredibly valuable it is for so many things besides just, you know, fertility alone. It's a fantastic book, and every woman really needs to get to know herself better from the perspective that book offers. So I would highly recommend it. Cool?

DIANE SANFILIPPO: Yeah, sounds good.

LIZ WOLFE: All righty. Next question. “Keratosis Pilaris-what foods to add/what food to avoid.” And with KP, we'll often call that “chicken skin.” It's kind of like that chicken skin that you'll get on the backs of your arms. Just as a point of reference.
So Aylia-Aylia says: “I have a question regarding keratosis pilaris. I have had several KP-I have had several KP issues (all over arms and legs, as well as butt and parts of stomach) ever since I can remember, and I have been trying to do some research about it and the Paleo diet together. I have not found much, and was wondering if you could help! I started the paleo diet a week ago, and I listened to one of your first podcasts and heard something about fermented cod liver oil and the positive effects it has on your skin. Didn’t know if this would be beneficial to take to help rid myself of the keratosis pilaris, and if so, how much I should be taking. Also, I didn’t know if there were any other supplements or specific foods I can eat (or steer clear from entirely) to help my skin to clear up. Thanks for your time!!
Since I have just started eating Paleo, I am still getting the swing of everything. I usually eat eggs and some type of meat and veggies sautéed in coconut oil for breakfast, leafy greens/steamed veggies and some more protein for lunch, again sautéed in coconut oil or drizzled with olive oil, and (because I am pretty active), I have some type of carb (sweet potato, spaghetti squash, etc) after my workout, along with some more veggies, fat and protein for dinner. Raw veggies for snack, a few nuts, training three days a week, working 2 jobs averaging around 60 to 70 hours per week.” Wow.
“I get as much sleep as I can, but mainly it's around 4-6 hours a night. I take naps when I can. Limit my caffeine intake. I drink licorice tea in the morning and/or some green tea depending on if I need a boost of caffeine or not. I am taking a vitamin D3 supplement, as I have seasonal depression, and a complete B vitamin supplement as well.”
I'll just say a quick little thing here. Absolutely keratosis pilaris is often indicative of vitamin A deficiency. The skin is incredibly complex. It's absolutely amazing the more that I learn about how it works, but definitely the first place I would go is making sure that you're vitamin A deficient. That's the first stop in trying to heal this. I know Diane will have a lot of feedback on vitamin D and good foods coming up, but I'd say again, the cod liver oil/butter oil blend from www.greenpasture.org as well as potentially some topical evening primrose oil can be helpful. You can just puncture the capsules and rub that oil in. As far as the sleep goes, that could very well be a huge, huge bugger. I don't know, Diane, if you're going to address that or not.

DIANE SANFILIPPO: Well, I mean…well, so I think you meant to say vitamin A sufficient.

LIZ WOLFE: What did I say? Whoops.

DIANE SANFILIPPO: Yeah, if you're not sleeping and stress in your system is high, nutrient absorption will be impaired. There are a lot of different reasons for that, a lot of different mechanisms for that. The first of which is, and not the least of which, probably the most important is suppressed stomach acid. So we're not going to be, even getting our entire digestive function working properly, if we're highly stressed, not sleeping, you know, working 60 to 70 hours a week is a lot. 4 to 6 hours of sleep a night is not a lot. The caffeine, you know, I'm glad she's limiting it, but I would really focus on the lifestyle factors here because it doesn't matter what you're eating if…it's like trying to put a plant, you know, grow a seed in soil that just has no nutrients. You know, it doesn't really matter what the food is if the terrain is all wrong. So you know, the terrain is everything. It's like a famous expression, and it really matters what you're putting these awesome nutrients into. You know, if you're dealing with this vitamin A deficiency, you know, take care of your body and yourself and your sleep and your stress reduction, so that what you're putting in with these recommendations will actually do something.

LIZ WOLFE: Mm-hmm.

DIANE SANFILIPPO: I get so many question from people who again just the way they ask the question, I can kind of, you know, read that person and what's going on with that person. But just some other practical things. You know, I've definitely seen good improvements in my own sort of chicken skin situation. It kind of crops up and goes away, and I know what brings it on, and well, no, not what brings it on, but what helps it to stay away is not just getting the vitamin A, which I do often from fermented cod liver oil/butter oil, even topically. I'm using their Beauty Balm, which I think is another great idea. It didn't work well for me on my body. It worked great for me on my face. I tried to put some like on shoulder areas and it didn't work so great. But especially in complementing the vitamin A, I think it's the vitamin D from sunshine and also somewhat from supplementation that will be useful. So I'd say to make sure that you're eating a good amount of cholesterol rich foods, which you are in the eggs that you're doing regularly, and to get out in the sun. So obviously we're getting into winter months here, most parts of the country I’m not sure exactly where she was from, but, you know, it can be tricky to get the sun exposure and I know we've talked about tanning beds before on the podcast, so I just want to bring it up again quickly.
I think tanning is one of those things that, you know, very much like most of what we hear in mainstream media about what's healthy to eat or how to live, you know, tanning's been poorly covered as a topic and the benefits we might get from it in small, you know, increments of regular exposure vs. the damage that's caused by overexposure or chronic, you know, even acute, very intense burns. I think, you know, I think the balance leans more towards a benefit than a harm when we look at like dose and duration of sun exposure done properly. And what I mean by properly is that, you know, this is going to vary from person to person, but the approach that I recommend and remember, you know, this isn't medical advice, but check out your local tanning salon, ask for the beds or the booths with higher UVB rays. Those are the ones that can burn you, so that's the way to remember the UVB: they can burn. Vs. the UVA. Now this is the opposite of what most people will be asking for. It's the opposite of what, you know, the people at the desk at the tanning salon may tell you is going to make you tan faster. But that's exactly the point. You want the rays that can burn you, but you don't want to burn. So you stay in the bed or the booth for a very short amount of time, and then you leave before you're burnt, or you barely get that hint of pink, and then you're done. And that's enough exposure to ramp up some of that subcutaneous vitamin D production without promoting the negative effects of the rays, and the reality is the vitamin D production is coming from that UVB exposure. The UVA exposure actually will downregulate vitamin D production, and this is some stuff that Dr. Mercola talks about. And I'm going to add a link to this video where he's talking about it. Dr. Mercola is huge on vitamin D and sun exposure. I think he moved to Florida if he didn't live there because he just wanted more sunshine. I'm pretty sure Mira and Jayson Calton live in Florida partially because they get awesome vitamin D exposure, and you know, people who know about this stuff tend to move where there's more sunshine or find ways to get more, you know, UVB exposure on their skin.
So I would definitely check out this video, and the reason I'm kind of harping on the vitamin D is because I have found that when I am in the sun, I think that the vitamin A that I'm already eating is just way more active when the vitamin D is in balance. And that for me has been way more therapeutic than just getting in the vitamin A. It's the balance of the vitamin D. It's the right kind of vitamin D. I notice that just after being in Southern California and Texas for a few days, some of the bumps that are on, like my left bicep-I'll sometimes feel them-they've calmed down. So, and I didn't even get a tan. I just got that exposure to the UVB.
Another note about this too is that if you are trying to get the vitamin D exposure from the sun and have it fully develop, it can take about 48 hours. Again, this is according to Dr. Mercola as well. And he recommends not showering your skin with soap or washing your skin with soap during that 48 hours following a sun exposure. And that doesn't mean you can't wash, you know, your armpits and other special parts…

LIZ WOLFE: The pits and the bits?

DIANE SANFILIPPO: Your bits and pieces with some good soap. I like Dr. Bronner's actually. I think we both kind of like their all-in-one soaps. But it doesn't mean you can't wash those parts, but just your overall skin. The skin on your arms and legs, skin that's been exposed to the sun that may have that vitamin D production going on, you don't want to soap that area of your body. And make sure you keep whatever just happened there, there. And the water I guess won't affect it, but the saponification, the soapy..the soapy effect that's happening from your bars and gels and all that will potentially wash that away. So long story short, I think vitamin D is actually kind of the critical piece here, and paying attention to the vitamin A. And you can also do some of this vitamin A-I know, Liz, you've talked about this before-with like some sustainably sourced red palm oil. It's not end form vitamin A, like you would get from liver and the cod liver oil, but it is a carotenoid rich fat, and if you're again doing the vitamin D in combination with it, it may work for you.

LIZ WOLFE: I do like the red palm oil from Tropical Traditions. They've been sold out for a long time, but just again, as that kind of complex. It's not just a source of carotenes, it's a source of a ton of different carotenes as well as the full vitamin E complex, I believe, and a ton of other cool stuff. So you know, if you want to try that, I'll take a little scoop of it now and then just to kind of…to supplement things and I'll also every once in a while use it topically, which, you got to be careful because that stuff is bright red. But, you know, why not?

DIANE SANFILIPPO: Self-tan?

LIZ WOLFE: Yeah. [laughs] You look so Jersey the second you put on, you know, smear yourself with that type of stuff. That's funny.

DIANE SANFILIPPO: Or after just like basically bathing in that stuff. See what happens. [laughs]

LIZ WOLFE: [laughs] All right. Next up. “Small meals..” Whoops. “Paleo vs. Raw Foods.”
Aubrey says: “I have been raw for many years. What are the benefits of paleo over alkaline raw foods? Why would that switch be good?”
It's a very simple question, and I'm going to just say, if you're doing great with alkaline raw foods, then great. I'm not going to try and change your mind if you're doing well. I don't know if Aubrey asked this question because she's not feeling great and she needs a change, or if she's asking it just out of curiosity. But I know a few raw food meat eaters. They do eat meats. They eat it raw. I don't know if that's the case with Aubrey, whether she's eating meat or not. Obviously I think everybody knows that we think animal products are very important. Diane and I have had this discussion about the alkalinity thing, the thing, a few times. And to me, it's at best kind of up in the air. I know there are folks from the Poliquin camp that buy into it, and you know, they’re very scientific folks, yet by my understanding, there's not a lot of supportive, you know, modern research around it, which doesn't always disqualify an idea, of course. There’s a ton of more Eastern medicine ideas about this, which are very interesting.
Anyhow, the benefit of Paleo or at least the way I would incorporate a Paleo lifestyle is a higher level of bioavailable, easily digested nutrients. Cooking breaks down the cell walls of plants and we cannot digest cellulose. So to really get all the nutrients from these plants, it helps to cook them, break them down a little bit before you eat them. You'll be getting greater nutrition, more bioavailable calories as well through cooked food. Catching Fire is a great book to read that tackles this subject of the extraction of calories from food, and of course, I think a lot of folks that do lose weight on a raw food diet kind of will connect that weight loss with greater health, and sometimes that does occur. You know, losing weight can help make you healthier, but just because a certain way of eating over the long term keeps you svelte doesn't necessarily mean you're getting all of the nutrients you could possibly get from your food. So that's my take. What's yours?

DIANE SANFILIPPO: Well, I think the big thing a lot of folks sort of miss when they want to classify a diet as one thing or another is the idea that a Paleo diet is really a broad stroke, sort of overarching idea that we're eating whole unprocessed foods as close to nature as possible. Under that umbrella of whole unprocessed foods, there are tons of ways to tackle a Paleo diet, and I would certainly not tell someone, like you mentioned, you know, if they're enjoying good health and then do what you're doing. And the reality is, you know, there are some folks who seem healthy at the time and may have some long term consequences, though they seem healthy at the time as we know can happen with certain dietary choices. But that said, you know, we know that cooking makes nutrients more bioavailable while diminishing the levels of some nutrients like vitamin C, for example. So clearly, you know, I'd vote for eliminating foods that lead to some digestive distress and blood sugar dysregulation, but outside of that, it's pretty up in the air. Like I tend to think if a food is palatable raw, enjoy it raw. If it's tough to eat or feels tough to digest raw, then cook it. So, you know, people really need to listen to their body and their own instincts. You know, for some folks, a raw food diet is pretty much the worst thing they can do to improve their health. But for a lot of people, eating more fresh, uncooked foods can be really beneficial. Somebody who's got tons of digestive distress, a lot of raw food is the last thing I would tell them to do. We want to pre-digest some of that food for them. Make it a lot easier for them to extract those nutrients, as you said. But I think, you know, I think it's another misconception that eating Paleo is not like an alkaline sort of way of eating, and it really can be. You know, you just have to tailor your own Paleo diet to your needs, and I think in the case of, you know, just eating raw alkaline foods, that may mean not eating any animal foods. I think we've talked about this plenty.

LIZ WOLFE: Mm-hmm.

DIANE SANFILIPPO: Plenty of times on the podcast. Just kind of our take on omitting animal foods and what people will be missing from that. You know, things like the heme iron, some of the B vitamins, B-12 especially. Yeah.

LIZ WOLFE: Yup. All right, this is the last question of the day. “Paleo…” Let's see. “Small meals vs. large meals and controlling blood sugar.”
Rhonda says: “Hi there, thank you for the service that you provide with your podcast! I learn a lot from them.
My question is about trying to move from eating 5 times a day to eating 3 bigger meals. I have adrenal fatigue with low cortisol levels especially in the morning. I have subclinical hypothyroid so I take .5” What does that say? Grain? Gram? “dose of Naturthroid. I also have low progesterone and have been trying to get pregnant for a while. Most of the natural practitioners that I have consulted with have stressed that it is important for me to eat small meals throughout the day to keep my blood sugar stable and not disrupt my adrenals and hormones further. My acupuncturist who is very primal/paleo minded urges me to move away from being dependent on small meals throughout the day because in his opinion it’s only keeping me on the blood sugar roller coaster.”
Let's see…” When I have tried to eat bigger meals based around fats. protein and vegetables I feel very light headed and spacey and worry that I am stressing my adrenals further.” Oh, you know what, Diane? Sorry. .5 grain dose of Naturthroid. Yeah, you pointed out to me they call the thyroid pills grains, so that's my bad. That’s my travel brain.
Let's see…” I also have a sensitive digestive system and feel bloated and gassy when I eat bigger meals. I'd like to become more of a fat burner rather than sugar burner but I’m not sure how to without stressing my system out. I have a hard determining how many carbohydrates to eat to keep an even blood sugar. I am gluten free but I go back and forth with eating gluten free grains and being grain-free because of experimenting with the Body Ecology diet. I also don’t notice much of a difference when I go off grains and I actually think that sweet potatoes and fruit affect my blood sugar more than grains. Thank you in advance.”
Yeah, so details, I'll skip over most of them. Sleep is 8 to9 hours a night, pretty good looking exercise, moderate with good intensity and just the basics here. I think we've got done. So Diane, what is your…what's your take on this?

DIANE SANFILIPPO: So I think…here's the thing to like…She's asking mainly how to move from eating 5 times a day to eating 3 bigger meals, and then giving us tons of background, which is fantastic. But the reality is, if this is your goal and you feel that you have, you know, an acupuncturist or, you know, some kind of health oriented practitioner who's there to support you in it, I think all of the other issues…like this is one of things I say a lot to practitioners who ask me like what to do in different cases. It's like here's the goal, here's the person's background. The background is important. Absolutely important to understand where this person's coming from. But I think that a lot of the background sometimes clouds the person's perception of how a change should feel or how quickly it should go into effect in terms of like a metabolic shift of once they make that change, and so you know, kind of the way I would move forward is definitely one of those cases where I would say, she's going to have to give herself a week or two to get regulated on a lower carbohydrate diet. Like if that's kind of the approach she wants to take, she has to know that it's going to take time and not to sort of let the day to day of the first week or two trip her out because it may not feel perfect. And I know that when people are dealing with some fatigue, it can seem stressful, but the reality is when we want to calm down your digestion, you know, we take out the grain foods. And that means both gluten containing and gluten free grains. So it's a huge thing, you know. I definitely think that needs to happen.
Getting the blood sugar regulated by reducing the carb intake, again, you know, as she’s mentioned, she feels like, you know, the effect even from the whole food, good food carbs, you know, are hitting her, so I would say that working towards getting a much more, you know, fat adapted system, getting used to the low carb meal plan, and that doesn't mean no carbs. It just means maybe less than 100 grams a day for her, that's low enough, that it will sort of yield the results she wants in the longer term. After doing it for a couple of weeks and feeling a little bit of that, you know, possibly not ideal situation, but she has to get out of this sort of back and forth, trying a million different things. Focus on one thing. Do it for about 1 to 3 months very consistently. And when I say 1 to 3 months, I don't mean just one month, I mean, a minimum of one month. Do it for up to 3 months. For most people, like short term low carb intervention isn't really going to be taxing your adrenals the way you think it is. Not any more so than the blood sugar highs and lows or the dysregulated digestive function will.
So when people talk about possible downsides of low carb dieting, it's really a much more long term, much more chronic situation, and I can't imagine that it means in anything less than 3 to 6 months; it depends on the person obviously, but you don't need to put yourself in the situation of like a zero carb diet. If you're getting anywhere over 30 or50 grams a day, it's not going to be super taxing to your system. So you could do something in 50 to 100 grams of carbs a day, just doing that from vegetables, and you should be fine. And I would, you know, try maybe. Look at the blood sugar regulation plan in my book. See how that works for you. The only exception I would give, and I don't know if she mentions some of the intensity of her exercise, gentle yoga, a little bit of weights, she hasn't done that in a while. If she does end up doing some exercise, maybe getting in that little bit of carbohydrate right after the exercise, but not doing it other times of the day, and just really keeping to the non-starchy vegetables. So again, the blood sugar regulation plan in my book really focuses on these things, and it takes a lot of the guesswork out. So I would look at that and see how you're doing. I wouldn't worry yourself that you're not getting enough carbs and you're going to put yourself into worse fatigue because unless you are counting very, very closely, it's really hard to not eat at least 30 to 50 grams of carbs a day. Like, it's so hard to keep your carb count to 30 grams that, if you just don't think about it and just eat vegetables as you want to, you're going to be over that. You're not going to be stressing your system too much. So I would just expect those days or potentially week or two of, you know, not feeling ideal and letting your body reset. Remember how many years it's taken you to get to this point, and give your body some time. Be patient. Let it happen over that couple of weeks, and I can tell you, people who are on my sugar detox, they all chime in and tell each other. People who hit day 3 and day 4 and don't feel great, everyone's in there saying, you will be fine. Like wait it out, ride it out, it's going to go away. You will feel so much better. Just give it a few more days. Give it a week and go from there. So I think it just takes the persistency..persistence-y? Persistence…

LIZ WOLFE: Consistency and persistence.

DIANE SANFILIPPO: [laughs] and consistency of one approach and stay focused on it because otherwise, like wavering back and forth, you never get to see a clean experiment of how does this work for me.

LIZ WOLFE: Yeah, the only other thing I'd add is, anybody that's trying to get pregnant, wondering about their cycles, wondering about their hormones, go buy Taking Charge of Your Fertility, read it. It's pretty eye-opening.
So that's it. We'll be back next week with more of your questions. Until then, you can find Diane at www.blog.balancedbites.com. You can find me, Liz, at www.cavegirleats.com or www.lizwolfentp.com. We will also be at the Weston A. Price Foundation Conference this weekend, so if you're there, feel free to say hi. Love to meet ya. Thanks for listening. We'll be back next week.

Cheers!
Diane & Liz