Authors: Chris Kresser
Tags: #Health & Fitness / Diet & Nutrition / Diets, #Health & Fitness / Diet & Nutrition / Weight Loss
Nutrient
: Iodine
Recommendation
: Iodine is another important nutrient that can be difficult to obtain even in the context of a healthy diet.
I suggest getting iodine from seaweeds (kelp, kombu, wakame, hijiki, arame, dulse), fish (especially cod, shrimp, and tuna), and dairy products if you tolerate them. See the bonus chapter on thyroid disorders on the website for a chart of iodine-rich foods.
If these foods aren’t an option for you, you should supplement with iodine at a dose of 800 mcg per day. Kelp tablets are a good option.
Nutrient
: Selenium
Recommendation
: Selenium plays an important role in thyroid and immune health. Most people get enough selenium from food, but people with thyroid or immune-related issues may benefit from supplementation.
The recommended dose is 200 mcg per day. This can be obtained by taking a selenium supplement or by eating two or three Brazil nuts a day.
See the bonus chapter on thyroid disorders on the website for a chart of selenium-rich foods.
Nutrient
: Vitamin C
Recommendation
: A nutrient-dense Paleo diet with a wide spectrum of fruits and vegetables should provide sufficient levels of vitamin C.
However, vitamin C deficiency is common: 34 percent of men and 27 percent of women don’t get enough.
If you’re dealing with a chronic health challenge, fighting an infection, or just need immune support, I suggest supplementing with 500 to 1,000 mg/day of vitamin C. The liposomal form is best.
We’ve talked about the four micronutrients I generally recommend supplementing—via superfoods like cod-liver oil or in man-made preparations—as well as other micronutrients people with specific health conditions or goals may wish to increase their intake of. But there are some micronutrients that I don’t recommend unless you have a specific reason to do so; these are iron, calcium, beta-carotene, and folic acid.
•
Iron:
Essential for life, but too much causes inflammation and oxidative damage; excess iron can cause everything from blood-sugar problems to depression to fatigue to hypogonadism and hormonal imbalance.
•
Calcium:
Popular as a preventive measure against osteoporosis, but the newest research shows that calcium supplements don’t reduce fracture rates in older women and may even increase the risk of hip fractures. Studies on the relationship between cardiovascular disease and calcium suggest that dietary intake of calcium protects against heart disease, but supplementation may increase the risk.
•
Vitamin E (alpha-tocopherol):
Some authorities recommend supplementing vitamin E to protect against heart disease, but studies show no real benefit and some studies have demonstrated potential harm.
•
Beta-carotene:
Can be converted into retinol (the active form of vitamin A) but it can also be converted into potentially harmful substances that increase the risk of oxidative damage and interfere with active vitamin A metabolism.
•
Folic acid:
By this, I mean the synthetic compound used in dietary supplements and food fortification; folate refers to the forms of the vitamin found in food and in natural folate supplements such as 5-methyl-tetrahydrofolate (5-MTHF). Folic acid can be converted to folate, but this conversion is limited in humans. High levels of unmetabolized folic acid in the blood can mask B
12
deficiency; speed the progression of certain cancers; and depress immune function. Natural folate supplements like 5-MTHF do not have these effects and should be used instead of folic acid for protecting against neural-tube defects during pregnancy and in other situations where additional folate is indicated. See the bonus chapter on supplementation on the website for more on this topic.
For more information on how and why to exercise caution with these micronutrients, please visit ChrisKresser.com/PPC.
Notes for this chapter may be found at ChrisKresser.com/ppcnotes/#ch18.
Here are some final strategies for integrating Your Personal Paleo Code into your life. Think of these techniques as ways to hack your code and therefore make it sustainable for years to come. You’ll also find some information and support on what to do when you’re not having as much success as you’d like.
There’s no doubt in my mind that optimal nutrition is the key to health. Yet, as you know from working through Step 2 (and as I’ve said all along), there’s more to health—and to life—than food. As you also learned in Step 2, social connection is a fundamental human need. Extreme dietary restriction can lead to social isolation, which in turn can cause illness and disease. I’d like to tell you a story that illustrates this.
When I began my medical studies, I interned for a holistic physician who specialized in treating people with chronic illness. We had a patient—I’ll call him Sam—who was only twenty-four years old but was very sick. He was thin as a rail, with dark circles under his eyes, severe fatigue, terrible digestion, depression, skin problems, a dysfunctional immune system, and several other problems.
Both the doctor I was working with and Sam were convinced his problems were food related, so he was on a very restrictive diet. But he just kept getting worse. The worse he felt, the more foods he removed from his diet. At one point, Sam was eating only steamed broccoli, quinoa, and lamb. That’s it—nothing else. He stopped coming in for treatment after a while, and we lost track of him for a time. But about six months later he returned for a visit. He looked like a different person. He had gained about thirty pounds, and his color was good, his digestion improved, his mood lifted, his skin clear. It was an incredible transformation.
The doctor and I were of course dying to know what had happened. We asked him, “Was it diet?” Sam said, “Yep.” “Well, which diet?” we asked. “The candida diet? Macrobiotics?” We listed several other popular diets. (This was fifteen years ago and I didn’t know about the Paleo diet yet!)
He shook his head at each one. Finally, we said, “Tell us what it was, then!”
And here’s what he told us. “It was the beer-and-pizza diet.”
Sam made sure he went out to eat beer and pizza with his friends twice a week, and the rest of the week he ate a fairly healthful diet of foods he liked.
Previously, during his period of increasing food restriction, he had become more and more socially isolated. He couldn’t eat out with friends. His girlfriend broke up with him because he never wanted to leave the house, eat out, or travel for fear of being exposed to toxic foods. And the more socially isolated he was, the more depressed he became. At some point, he decided that life wasn’t really worth living the way he was living it.
Therefore, he didn’t have anything to lose by abandoning his rigid diet and focusing instead on having fun, connecting with his friends, and eating the foods that brought him pleasure. It took only a few months of that to completely change his life. His health improved, he had friends again, he started a new relationship, and he found a new job that suited him much better than his old one.
I hope you understand that I’m not suggesting everyone should go out and eat beer and pizza twice a week. That’s not the point. The point of this story is that there’s more to life than food and that social engagement and pleasure are very important to health. There’s a saying in Chinese medicine—the oldest continuous medical tradition in the world—that reflects this point: “It’s better to eat the wrong food with the right attitude than the right food with the wrong attitude.”
This is why I advise most people to follow something I call the 80/20 rule. It suggests that 80 percent of the time you should closely follow the guidelines I’ve outlined in this book, and 20 percent of the time you’re free to loosen up and just eat what you want to eat. That might mean having beer and pizza once a week for you (although gluten-free pizza and beer would probably be better choices). Or it might mean going out for ice cream with your kids on Saturday nights. Or maybe it means grabbing something quick that isn’t 100 percent Paleo when you’re close to missing your flight.
In reality, most of my patients feel so much better when they follow their Personal Paleo Code that the 80/20 rule becomes something more like the 95/5 rule, or even the 90/10 rule. Often the foods they thought they’d miss the most when they first started (like beer and pizza!) are no longer that appealing, or maybe the pleasure of eating them isn’t worth the price that’s paid the following day. The point of the 80/20 rule isn’t the exact ratio; that’s for you to determine based on your particular health circumstances, preferences, and goals. Instead, the purpose of the 80/20 rule is to make your approach to nutrition more flexible and adaptable, so that it simply becomes the way you eat rather than a diet that you follow.
This is one reason I don’t like to refer to Paleo as a diet or refer to eating non-Paleo foods as cheating. Conceptualizing Paleo as a diet that you cheat on almost inevitably leads to additional stress (from struggling to perfectly adhere to the diet) or a yo-yo relationship with food. For example, before they started working with me, some of my patients had a history of doing Thirty-Day Resets interspersed with periods of almost
completely returning to poor eating habits. Instead of transitioning to a more flexible approach after the Thirty-Day Reset, they tried to adhere to guidelines that were unnecessarily strict for them, which wasn’t sustainable.
There may be something fundamental about human psychology at work here. I’ve noticed—and perhaps you have too—that most people don’t like to be told what to do. This is true even when they’re the ones telling themselves what to do! If you say to yourself
, I can never eat ice cream again,
that can create a dynamic where you eat ice cream just to set yourself free of that sense of overbearing control. The choice is often not completely conscious and may have little to do with actually craving that food. But what if you say,
I can have ice cream occasionally if I feel like it, but I choose not to eat it every day because I don’t feel good when I do
? That shifts the dynamic. It’s no longer about autonomy and control; it’s about what makes you feel healthy and vibrant.
Unfortunately, the 80/20 rule doesn’t always apply to those dealing with serious health challenges or allergies or intolerances to specific foods. It’s never a good idea for someone with gluten intolerance or celiac disease, for example, to just throw caution to the wind and eat half a loaf of wheat bread. That could trigger an immune reaction lasting up to several weeks. Those who are allergic to certain foods or nutrients will have to avoid them 100 percent of the time; however, they may employ the 80/20 rule for other foods that aren’t part of their Personal Paleo Code but won’t cause serious harm. Those with serious, chronic illness may be better off following a 90/10 or a 95/5 rule while still avoiding the most serious potential offenders, like gluten, refined sugar, or whatever it is that triggers a negative reaction. After all, the point of the 80/20 rule isn’t to hurt yourself; it’s to make you feel good.
One of the biggest challenges to adopting a Paleo-type diet, especially at the start, is what to do when you’re eating in a restaurant or traveling and
trying to find good food. Enjoying a meal away from home should be a pleasurable and low-stress experience. Here are some ideas for how to make sure that it is:
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If you’re eating out with friends, take control (in a friendly, helpful way!) and suggest a restaurant that you’ve researched and that you know will be safe for you—and enjoyable for everyone else.
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If you don’t have control of where you’re eating, go online and check out the menu so you aren’t surprised when you get there. Call ahead and see if they can accommodate special requests or if they have special gluten-free options that may not be listed on the menu.
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If you’re in an unfamiliar city, ask the concierge at your hotel or friends, family, and colleagues familiar with that city for suggestions. If you use it, social media can be a big help. Whenever I’m in a city I don’t know well, I’ll write a quick Tweet asking for restaurant recommendations, and I always get great responses.
•
Search Google using keywords like
local, foodie, gluten-free, grass-fed, organic,
and
pasture-raised
together with
restaurants.
Those searches usually turn up some good prospects, including places that often feature locally grown produce and meats and wild fish. At such establishments, the waitstaff is also more likely to know what’s in the food and more willing (and accustomed) to accommodate special requests.
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Use online review sites like Yelp, Chowhound, TripAdvisor, and Urbanspoon to read legitimate reviews of restaurants from people like you.
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Don’t show up starving to a restaurant. That’s a really good way to put yourself in a situation where you are likely to make bad choices (the 80/20 rule notwithstanding). Eat a healthy snack before you leave for the restaurant, especially if you’re going to a place that won’t have much you can eat.
•
Be a pain in the butt. When you go out to restaurants, don’t be afraid to be that person that asks the waiter a million questions. Yes, he might think you’re a pain and it might be a little embarrassing
if you’re out on a date. But think of it this way: you’ll probably never see the waiter again, and if your date is really annoyed by your food intolerances, then is that someone you want to spend a lot of time with? If you’re gluten-intolerant, always ask if there is gluten in a dish you’re ordering, even when it seems like there isn’t. Restaurants use hidden ingredients all the time. And if the waiter seems like he doesn’t know, insist that he ask the chef.
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Avoid sauces. Sauces are likely to contain sugar, gluten, soy, and other ingredients you’re trying to avoid. That’s why eating out at Thai and Chinese places can be a bit of a challenge. If you’re doing that as part of your 80/20 allowance, that’s fine. But otherwise, it’s best to stick with grilled, steamed, or roasted meats, steamed or baked vegetables, and simple starches like potatoes or white rice. They’re less likely to have sauces—and you can ask for them on the side.
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Ask for the dressing on the side. Salad dressings, like sauces, often have a lot of undesirable ingredients in them. In particular, they tend to contain industrial seed oils. If you order a salad, which is otherwise a safe choice, ask for some olive oil and balsamic vinegar instead of the dressing that comes with it.
The information below lists some considerations for the different foods and types of cuisines you’re likely to encounter when you eat out.
Food
: Meat, fish, poultry
Follow Your Personal Paleo Code
: Try to avoid sauces, as they often contain industrial seed oils, gluten, soy, and/or sugar; grilled, steamed, and poached are usually the safest cooking methods.
Food
: White rice
Follow Your Personal Paleo Code
: If you tolerate white rice, many Asian restaurants can serve a simple dish with meat, vegetables, and white rice.
Food
: Vegetables
Follow Your Personal Paleo Code
: Be careful with sauces, which may contain undesirable ingredients.
Food
: Starchy plants
Follow Your Personal Paleo Code
: Baked potatoes are a good choice and are available at steakhouses and other restaurants that serve American cuisine.
Food
: Salad
Follow Your Personal Paleo Code
: A salad with fish, beef, or chicken is available in some form at most restaurants; if in doubt on the dressing, ask for oil and vinegar on the side.
Type of Cuisine
: Mexican
Follow Your Personal Paleo Code
: Order a tostada and don’t eat the tortilla, or order a fish, chicken, or beef plate with rice, vegetables, salsa, and guacamole.
Type of Cuisine
: Chinese/Thai/Korean/Vietnamese
Follow Your Personal Paleo Code
: Meat/fish, rice, vegetables, or rice-noodle soups with meat, fish, and vegetables; be careful with sauces.
Type of Cuisine
: Japanese/sushi
Follow Your Personal Paleo Code
: Bring your own wheat-free tamari to the restaurant and avoid soy sauce.
Type of Cuisine
: Italian
Follow Your Personal Paleo Code
: Italian food is one of the most challenging types of cuisine due to its heavy focus on pasta and bread. Choose a fish or meat dish with a vegetable or salad, and be careful to avoid cross-contamination.
Type of Cuisine
: Indian
Follow Your Personal Paleo Code
: Somewhat difficult because of sauces, but tandoori meat with rice and a vegetable curry might work; ask about gluten in food/sauces.
Type of Cuisine
: Ethiopian
Follow Your Personal Paleo Code
: Like Indian cuisine, Ethiopian can be tough because of the sauces. Choose meat and vegetable dishes without gluten, and avoid the
injera
(flat bread), which often contains wheat flour.
Type of Cuisine
: American/Continental
Follow Your Personal Paleo Code
: Often the safest choice; order grilled meat, vegetables, potatoes, and/or salad.
Type of Cuisine
: Seafood
Follow Your Personal Paleo Code
: Like American places, seafood restaurants are a good choice. Order fish, vegetables or salad, and a potato.
Type of Cuisine
: Barbecue