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Is it just me, or does it seem like we face the threat of running out of canned pumpkin every year around this time? Either way, this year could be the year it really happens — the year we touch down on Thanksgiving without a beloved pumpkin pie in hand.
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One of my go-to dishes is sausage and peppers because it’s so easy to make, requires minimal ingredients, and is versatile. I usually keep some hot Italian sausages in the freezer, and as long as I have tomato sauce, garlic, onions, and peppers, I’m pretty much all set to make this whenever the craving strikes. You can adjust the recipe to be spicy or not spicy; it’s totally up to you.
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Anxiety is the pits. As someone who has struggled with anxiety since I was in middle school, I can tell you now that it extends into every aspect of my life – including the kitchen. Did I remember to turn the stove off? Did I accidentally get a hair in that batch of cookies I’m serving to my colleagues? It’s that not-so welcome friend that is always in my life. The daily struggle is real.
Anxiety affects everybody differently. Anxiety can be brought on in social situations, it can be triggered by something specific, or it can seemingly come out of nowhere. But when it comes to the kitchen and cooking, there are a few key things I bet every anxious cook can somewhat identify with. Can you relate?
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The slow cooker is great for many things — tenderizing meat so it falls apart with a fork, making an easy chicken stock, even keeping our mashed potatoes warm at Thanksgiving — but its greatest service, by far, is the ability to cook our meals while we’re not around. And our long work days just seem to keep getting longer, don’t they?
I chatted with Stephanie O’Dea, author of the 5 Ingredients or Less Slow Cooker Cookbook, about some of her favorite recipes for extra-long days. Here are five kinds of recipes to look out for, plus some specific recipes to try.
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The other day it occurred to me that we’re coming up on 10 years with this blog. In 2006, I started publishing (what were then) wacky, newfangled ideas about how people should go barefoot (or wear Vibrams), eat more animal fat, slash carbs and eschew grains altogether, avoid (most) vegetable oils, stand up while they work, expose themselves to cold, get off the chronic cardio wagon and climb trees or sprint down their streets like 9-year-olds. Finally, there was the proverbial (and ironic) icing on the cake of suggesting people ask what would Grok do—that now illustrious posterman for all things evolutionary. Ten years ago many of these ideas were still viewed as strange or even flat out wrong.
To jump on the Primal bandwagon then meant weathering a certain share of negative feedback—the jabs from coworkers or friends while dining out, the looks from passersby when working out at the park. So, for years, it was a regular theme on MDA to take up these “social” concerns—to remind folks that they shouldn’t give any energy to others’ judgments, that they are blazing their own trails and that they’re part of a growing and supportive community here at MDA and the paleosphere at large. In other words, we’ve spent a good deal of time talking about not being afraid to be different.
The fact is, however, in these last ten years we’ve seen everything from an explosion of barefoot shoe lines to a popping up of CrossFit gyms all over the country, the growth of standing and treadmill workstations to the expansion of farmers’ markets and cow sharing, a slowly turning tide against fast food to Time Magazine exonerating butter on their cover. “Paleo” is even becoming a category on restaurant menus (and not just Primal ones).
Sure, this is all a far cry from the full Primal picture. While more people are eating butter, fewer are clamoring for lard or duck fat. More people might be picking up kettle bells or doing burpees, but not many are on board with the likes of MovNat or isometrics. Some might be cutting their carb intake, but few take the “extreme” path of avoiding all grains. And Squatty Potties have garnered some media attention, but it’s probably safe to say they won’t be coming to a public restroom near you anytime soon.
And yet, the “health movement” as a whole has slowly been shifting into new territory over the last decade, and some of it looks pretty familiar. While adherence to or belief in the full extent of the Primal Blueprint definitely remains the curious if not offbeat exception, more and more individual components of the model are becoming increasingly less unusual. Let’s face it: it’s a new world when your Uncle Bob has monkey shoes and your Aunt Sharon talks about gluten free options for Thanksgiving.
While we Primal types are ridiculously far from being any kind of majority, numbered are the days perhaps of the Primal/paleo pariah. For the second year in a row, in fact, paleo was the most Googled diet. And while U.S. News & World Report might wish the “caveman” diet would just go away, it doesn’t appear we’re going anywhere but apparently more mainstream.
And this might feel a little strange for those of us who have been doing it since the time people wondered if we had our heads screwed on straight. Five, ten, fifteen or twenty years is a long time to live with the knowledge that your choices are branded unconventional at best, dangerous and deluded at worst.
To some extent, most of us Primal old-timers probably had to cultivate a certain detachment from other people’s opinions—including those of our own families or perhaps even partners. If those around us were especially judgmental, maybe we eventually identified with a maverick identity. We got used to the eye rolls and well-intentioned (or not) warnings. Maybe with a mix of humor and defiance, we took a little (or a lot) of amusement from them, maybe even a certain renegade bravado even. Know any good Primal/ancestral jokes? That’s what I mean.
To be sure, we adopted these Primal-style behaviors and principles first for our health. They made good solid sense. They worked for us—often when nothing else ever had. But explaining ourselves got old. Over time, the cultural pushback maybe edged us toward identifying with the practices as a community more than if they had simply been run-of-the-mill choices. While our initial intentions were pragmatic, the responses we got pushed us toward a collective “niche” association. Those of us who never saw ourselves as rebellious subversives thumbing our noses at big CW probably at least asserted the role of free thinker.
So, what does it mean when our trailblazing isn’t so blazing anymore? When we’re telling the whole truth, how do we really feel about certain long-standing, dissident ideals mass marketed around us? Does it become less gratifying on some level when the way we paved is suddenly much more populated on certain turns of the path? We might not feel the same self-satisfaction wearing our FiveFingers at the gym, but can we find other elements to appreciate here? Are there maybe some advantages to being more in line with at least a growing subgroup of the status quo?
We can and should take this is a victory of sorts. The messages—or many of them—have reached people. More are experiencing the positive impacts of healthy Primal minded choices. More people are really starting to get it.
And for our part, we may have to hang up the hat of the rebel, but we still get to be the model. We get to identify with and even flout our extraordinary health, the rare vitality and the uncommon sense of equilibrium that comes from living a life in keeping with our fundamental blueprints. We get to demonstrate how it’s done and what’s to gain. We have the opportunity of encouraging others to embrace more of the Primal/ancestral vision for themselves.
We can hang our Primal hats on the positive effect our choices and community have made on more people’s lives. Many of us probably have never considered ourselves proselytizers or ambassadors for the Primal/ancestral movement. And yet your example has indirectly advocated for the choices others are now freer to make. You share by example the bigger story of what Primal living can do—not just in terms of literal physical health—but also for greater well-being, even a more expansive and satisfying good life.
And let’s face it, is it such a bad thing to have more selection and accessibility in certain Primal areas—Primal fare suppliers (including Thrive Market), more barefoot shoe choices, more workout tools, more cookbooks, more Primal-friendly fitness clubs, more restaurant options, more health care providers?
And simultaneously, we can agree that there’s still plenty of work to do on this front. I decided a while ago I wasn’t going to be happy until I’d helped 10 million people get healthier. Perhaps I set the bar too low. Who knows where the end is.
Even within the Primal/paleo community, there’s uncharted territory to explore. Science delivers new developments every day. Research on the human microbiome is unfolding as we speak and promises to teach us so much about our risk for disease and our possibility of better health.
We’re learning so much about performing at elite levels in endurance events in healthier, more Primal ways. (Look for my book, Primal Endurance, due out in 2016!) The list goes on and on, my friends.
The ancestral health movement remains cutting edge, and more attention will mean more resources for its research and publications. I’m looking forward to being a part of all that’s coming. There’s much to learn, much to share and—oh, yes—still so many boundaries to push. I hope you’ll join me.
Thanks for reading, everyone. What’s been your experience with learning about the Primal/paleo/ancestral movement? What and when were your entry points? What are you most enthusiastic about seeing as ancestral health takes it to new levels? Share your thoughts, and have a great end to your week.
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Are you dealing with SIBO? If so, you’ve probably tried a low-FODMAP diet and noticed significant improvements in your symptoms. Once you’ve noticed such an improvement, it’s easy to think that this must be the answer—a low-FODMAP (or low-carb) diet has cured you!
Unfortunately, this is not the case. A low-FODMAP (or low-carbohydrate) diet will keep symptoms under control simply by starving the bacteria in your small intestine. When these bacteria don’t have food to eat, they aren’t able to metabolize that food and produce gas as a result. This gas is what causes the common symptoms of SIBO—bloating, abdominal pain, diarrhea (in the case of hydrogen gas), and constipation (in the case of methane gas) (1).
But starving the bacteria over the short term does not eradicate the bacteria, which is what we’re trying to accomplish, as the small intestine is not supposed to contain much bacteria. If you continue this restriction for a long period of time in an effort to kill the bacteria, you’re also starving the bacteria in your large intestine that should be there and that play a vital role in your health.
Simply put, a low-FODMAP or low-carb diet does not eradicate an overgrowth in the small intestine in a short period of time, and continuing on a long-term low-FODMAP/carbohydrate diet in an effort to starve the bacteria to death has potential detrimental effects on the bacteria in the large intestine. I have had clients who have been on long-term low-FODMAP diets prior to working with me who still have positive breath tests for SIBO despite their restricted diet. There is a difference between controlling symptoms and actually clearing the bacteria. We want to do the latter, which has the added benefit of improving symptoms as well.
There have been limited studies on the long-term impact of low-FODMAP diets on microbial balance in the large intestine. The studies we have showing the impact of short-term FODMAP restriction on the microbiome, however, do not bode well for the long-term implications.
FODMAPs are fermentable carbohydrates that help to feed the beneficial bacteria in the large intestine. When you begin to think about them this way, it becomes a lot easier to understand why adhering to a diet low in the substrates that our healthy gut bacteria thrive on may not be a great idea.
Is your SIBO diet controlling your symptoms or actually clearing the bacteria? #sibo
Indeed, the studies to date on the effects of FODMAP restriction show exactly what we would imagine would happen when restricting these beneficial substrates: the overall amount of bacteria was decreased (by 47% in this study), along with a decline in bacteria that produce butyrate (a beneficial substance made when probiotics feed on fermentable fibers) (2). While this particular study did not show a decrease in the probiotic strain bifidobacteria, another study has (3). In my clinical experience, it is very common to see low levels of both the bifidobacteria and lactobacillus strains in my client’s stool tests if they’ve been on long-term low-FODMAP diets.
While these bacteria would likely thrive once again with the addition of prebiotic substances, staying in a chronically diet-induced altered microbiological state is likely not a healthy choice when you start to think about the importance of our microbiome and its effect on our health.
Clearly, more research needs to be done in this area if patients are going to be on long-term low-FODMAP diets. However, after reading this article, it is my hope that you won’t need to be on a long-term low-FODMAP diet to keep your symptoms under control.
So if you’re not treating your SIBO with diet, what is used to treat it?
Rifaximin is the most commonly used antibiotic for treatment of SIBO and has been shown to be safe and well-tolerated (4). Figures vary on its efficacy (with rates as high as 87% in one study), but on average it is about 50% effective (5). However, this may not take into account the necessary difference in treatment for those with methane-positive SIBO. A study on those with methane-positive SIBO shows that when rifaximin is combined with another antibiotic, neomycin, it is about 85% effective (6). If you’re getting tested for SIBO, make sure you’re getting tested for both methane and hydrogen. These tests will guide your practitioner in treating you more effectively.
Herbal antimicrobials have been shown to be at least as effective as rifaximin, and about 57% of those who fail on rifaximin will succeed on herbal antimicrobials (7). I have personally seen this the other way around as well; those who fail on herbal antimicrobials usually do well with rifaximin. Others may need to do multiple rounds of either herbal or pharmaceutical antibiotics to clear the overgrowth.
Whether you choose herbal or pharmaceutical antibiotics, the important thing is that you are using something that will eradicate the bacteria instead of covering up the symptoms with diet change. You’re getting to the root cause of your symptoms!
Now that you’re being treated with herbal or pharmaceutical antibiotics, what should you eat?
If you listened to Chris’ recent podcast with Dr. Pimentel, you’ll know that having happy and fed bacteria is a good thing when treating SIBO—this is not the time to be starving them, as they will “hide” and become more difficult to eradicate. Eating FODMAPs and carbohydrates is exactly what you want to be doing!
In my own practice, I recommend that clients undergoing treatment eat as many FODMAP foods as they can tolerate and that they do not go on a low-carb diet. (I like to see a minimum of 100 grams of carbohydrates daily, and more, if tolerated.)
I also will typically add some kind of prebiotic if the client can tolerate it. A study that compared rifaximin alone versus rifaximin treatment plus partially hydrolyzed guar gum supplementation showed that providing fermentable carbohydrate along with the antibiotic improved success rates from about 62% (rifaximin alone) to 87% (rifaximin plus guar gum) (8).
Of course, I don’t want my clients to be miserable with digestive symptoms during this time, so treatment is always personalized to each client. Some may have no problems whatsoever eating FODMAPs or high-carbohydrate foods, while others may be very sensitive. I encourage clients to eat the maximum amount that they are comfortable with and remind them that in the end, feeding these bacteria is a good thing. They may experience some uncomfortable symptoms like bloating or gas during this time, but as long as it is not interrupting their life or causing pain, the more FODMAPs or carbohydrates they can eat, the better.
As many SIBO sufferers know, SIBO has a high rate of recurrence, which begs the question: what should you be eating after treatment to prevent another overgrowth? In my eyes, that’s the million dollar question right now, and it’s a question we don’t have the answer to quite yet.
For now, I have my clients eat whatever they can tolerate on a healthy, real-food, ancestral diet. If they need to restrict FODMAPs slightly or eat rapidly digested carbohydrates to keep symptoms under control, that’s okay. (However, if you can’t tolerate FODMAPs or complex carbohydrates after your treatment, you’ll definitely want to retest to make sure that you’ve completely eradicated the overgrowth in the first place.) We’ll also investigate any potential underlying causes of their SIBO, such as low stomach acid, pancreatic enzyme insufficiency, intestinal motility disorders, and so on. I know from speaking with Chris that he has come to believe that SIBO—and especially recurring SIBO—is often a symptom of a deeper problem. The solution in that case isn’t just to keep treating the SIBO, but to address that root cause.
There’s a lot we still don’t know about SIBO. As we learn more, some of these protocols may change, but I hope this article has given you a better idea of what you should be doing to heal from SIBO with the knowledge we have now.
Now I want to hear from you: What has been your experience with SIBO?
This is a guest post written by Kelsey Marksteiner, RD. Kelsey is a Registered Dietitian with a Bachelors degree in Nutrition from NYU and a Master’s in Human Nutrition and Functional Medicine. She works in private practice and recommends individualized dietary therapy focusing on biologically appropriate diet principles to aid her clients in losing weight, gaining energy, and pursuing continued health. She is a firm believer that everyone is different, and she tailors her plan for each and every individual. Through her work, she aims to meld the dietary wisdom of traditional cultures with the latest science in integrative and functional medicine to create plans for her clients that work in the modern world. You can learn more about Kelsey on her staff bio page, or by visiting her private practice website. Join her newsletter here!
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Silicone baking pans — muffin tins, nonstick sheet pan liners, loaf pans — can be great if you are short on storage space, hate using cooking spray, or can’t ever seem to get a bundt cake out of the pan to save your life. But then you go to clean them.
They seem like they should be easy to clean, but somehow, there never seems to be a way to get rid of that oily residue. We went to the experts to find out just how you should be cleaning those flexible pans.
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Q: I’m going to be staying at a fancy resort for a weekend wedding. I’m already dropping big bucks on the location, and I want to minimize my food costs wherever I can. Dinners will be included in the experience, but breakfasts and lunches will not.
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In my first article on choking, we discussed how overthinking gets in the way of ingrained movement patterns. An example of this is the baseball player throwing the ball in the dirt. When thinking stops, you are able to do what you know how to do so well.
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