Gut Health and Weight Loss

Ever wonder why some people seem to lose weight easily while others can struggle to shed pounds even when they are exercising and eating well? By now most of us have heard the term “microbiome” and have some understanding of the importance of our body’s “good” bacteria for our immune system and overall health. But did you know your microbiome can also affect your ability to lose weight? 

The purpose of a recently published Mayo Clinic study was to look at why, when following a comprehensive weight loss plan with dietary changes, exercise and counseling, some people have success but some individuals still do not lose weight. This study found that people who did not meet the weight loss goal had an over-abundance of bacteria that have increased ability to metabolize carbohydrates. In other words, their gut bacteria may be extracting more energy from foods compared to other types of bacteria, thus making it harder to lose weight despite calorie reduction.

So what can you do to change and support your microbiome? This was a pilot study, so more exploration needs to be done to make final conclusions and recommendations for improving the microbiome specifically for weight loss. However, we already know that certain lifestyle and diet factors help to support a more balanced and healthy microbiome.

·  Remove or limit processed foods and sugar from your diet- studies have shown that diets high in sugar and refined grains support overgrowth of gut bacteria that are associated with IBS, obesity, and other preventable diseases, as well as fostering a less diverse microbiome. The bacteria in your gut can actually affect your food cravings, so if you crave these things, it’s possible you have an unbalanced microbiome. It will take some focus, but if you cut them out for at least 3 days, your cravings can dramatically reduce as your gut bacteria adjusts.

·  Focus on increasing vegetables and whole foods- conversely to sugar and refined grains, insoluble fibers—sometimes called “pre-biotics”—from vegetables and whole grains promote populations of helpful bacteria and improve bacterial diversity. Not only are these foods healthier in general, they keep your microbiome balanced so it can work with you instead of against you. Try to include a “rainbow” of fruits and veggies during the day and switch to whole grains whenever possible. Need inspiration? Use Pinterest or Google “whole food recipes” for lots of ideas on how to cook with whole foods and also how to have grab-and-go whole food snacks on hand.

· Stop using artificial sweeteners- although they used to be considered a healthier alternative to sugar and are calorie-free, we now know that artificial sweeteners (in diet sodas and other “sugar-free” foods) can change your gut flora, increase glucose intolerance and negatively affect weight. Some suggest that by altering the microbiome in this way, artificial sweeteners are more harmful to health than consuming sugar.

· Try fermented foods- a good source of live probiotics; sauerkraut, kimchi, kefir, yogurt (plain with no added sugar) are good options to add to the diet daily. Once you cut out foods that contribute to an unbalanced microbiome, it can be helpful to add in healthy cultures to support growth of beneficial bacteria.

· De-stress- we now know that there is actually a strong connection between the health of our microbiome and our mental health. Prolonged periods of stress and its effects on your body and nervous system can also negatively impact your gut bacteria. Vice versa, an unbalanced microbiome has also been shown to be correlated with higher risk of depression and anxiety. Make this another reason to change up your nutrition and do some self-care; a happy belly makes a happy brain!

· Exercise- a no brainer for weight loss, but there is research that shows regular exercise can also improve your microbiome, a win-win!

While you’ve likely heard some of these suggestions before when thinking about weight loss, try to reframe them as a way to not only support your health and weight goals but by supporting and promoting the health of your microbiome. The biggest take away is that weight loss and optimal health are more than cutting calories. As with most things, quality over quantity is best.

Healing Congee

@WR36 via Twenty20

I recommend congee to someone almost weekly, especially cancer patients during chemotherapy or to clients recovering from a GI bug or other illness. Congee is an amazing food to eat medicinally to support digestion and overall health and people (even kids!) usually love it. We commonly recommend this to those dealing with nausea, vomiting, diarrhea, low appetite or who are recovering from an acute illness. However, congee is incredibly versatile and can be eaten at any time. In some Asian countries it’s a staple meal in the diet just as much as oatmeal can be in the West.

In Chinese medicine, rice is seen as warming with a sweet taste making it perfect for aiding the organ systems that regulate digestion. When slow-cooked in this fashion with extra fluids it is nourishing, hydrating, very palatable and easy to digest—perfect for digestive ailments when nothing sounds good or is staying down.

I also find that kids love it and it can even be fed to babies who are eating solid foods. When our daughter has been sick with a stomach virus or even a cold she typically won’t touch any food and very little fluids. Congee is the one thing I’ve been able to get her to eat during these times, even as a picky toddler!  

For my cancer patients, I have found that congee can be an incredibly helpful and nourishing food, especially during chemotherapy. For one, it’s super easy to make (especially in a crock pot or Instant Pot) so doable even when you are deeply fatigued. It’s also palatable and can help abate nausea especially when cooked with ginger, so for those who are struggling to eat or keep on weight, it can be a life-saver. It’s also significantly more wholesome and easier on the system than a lot of the mainstream protein shakes that are often recommended by nutritionists and doctors. It’s versatility allows one to add protein when that sounds more appealing and other veggies, and leave them out when symptoms are more severe.

You can make congee with either white or brown rice. We usually recommend white rice for those who have nausea, vomiting or diarrhea as it tends to be even easier to digest. Brown rice is great for nursing moms, people with colds and flus, and just regular use. Short-grain rice works best. The typical ratio of rice to fluid is 1:6 but more is better than less. The longer you cook the congee the easier it will be to digest and absorb the nutrients. Also, if you have homemade broth on hand, that makes this dish even more nourishing!

Instructions:

1)      Take 1 cup of rice and rinse in a fine mesh strainer

2)      Add the rice to a crock pot, Instant Pot, or stock pot, then cover with 6-7 cups broth, water or a combination of the two.

        a.       Crock pot- cook on low for 6-8 hours

        b.      Instant Pot- cook on “Manual” setting at high pressure for 20 minutes

        c.       Stove top- cook on low for 2-4 hours

3)      The end result should be a soft and soupy porridge consistency.  Add more fluids if needed to achieve this. 

The following medicinal foods are things I commonly suggest to add to congee to enhance the healing benefits for certain conditions; best if added about 1 hour into cooking (although OK to add at the beginning especially for Instant Pot):

1)      Fresh ginger root- can either slice 1-2 inches of root into chunks and cook with the rice, then remove before eating, or mince and leave in. Warming and good for nausea, diarrhea and low appetite. Also good for cold and flus with chills.

2)      Carrot- Good for chronic indigestion, reflux or gas.

3)      Celery- Cooling and can help with hypertension and tinnitus.

4)      Leek- Warming, can help aid digestion and good for diarrhea.

5)      Beef marrow stock (use instead of water or other broth)- Good choice for anemia or fatigue; tonifies qi and blood and is very nourishing.

6)      Onion or scallion- Also warming, good for phlegm conditions such as with a cold, cough, or allergies

7)      Radish- Cooling, good for ulcers or GERD

8)      Butternut squash- Boosts qi and energy and provides a sweeter flavor

If you are having strong symptoms and hoping for congee to be medicinal, starting simple with one ingredient is recommended then add more as you understand what your body tolerates. 

If you are in the recovery period from a virus or just like congee as a meal, you can get more creative and add things at the end of cooking such as sautéed veggies, cooked meat or a fried egg on top.  You can make it sweeter and add coconut milk and cinnamon, or feel free to spice it up with turmeric, ginger, pepper, ginger, etc.  I think it’s especially yummy to top with fried shallots and chopped scallions.

Give it a try and let us know what you think!

Carli Gaines, RN, LAc

Grain-free Peanut Butter Chocolate Chip Cookies

These are literally one of my favorite things right now. When Dave came home from the grocery store with a giant bag of chocolate chips ("they were on sale!"), I took this as a requirement that I must make 4 batches of cookies trying to perfect my favorite cookie combo--peanut butter and chocolate--in a somewhat healthier version that at the very least is gluten-free :)

Now, as practitioners who work with kids, we understand the controversy surrounding the peanut. Peanut allergies have skyrocketed in the last 20 years and are can be a very dangerous and serious situation. What we're learning more about is how most conventional peanuts are grown and how contaminated they are with pesticides, fungicides, and other toxins and how that very likely impacts this increase (for a great expert opinion on this check out this article). Not everyone can eat peanuts safely or without inflammation, but if you tolerate them, please make sure to only buy organic peanut butter (our favorite is CB's Nuts). We've been feeding our daughter clean, organic peanut products since she started solid foods around 6 months and so far so good. Her biggest food intolerance to this date, without surprise to her parents, is gluten.

With the PSA aside, not only are these cookies AMAZING, they are super easy and quick to make. Cookies like these really make me wonder why we are so stuck on wheat flour in the West. It's eye-opening how much versatility there is once you start figuring out all the ways to bake without it! We did this with 1 cup peanut butter alone which was still good but found the best cookie resulted with a blend of peanut and almond butter.

All I have to say is: you're welcome!

Recipe for Grain-Free Peanut Butter Chocolate Chip Cookies

 

Ingredients:

• 1/2 cup organic creamy peanut butter
• 1/2 cup organic creamy almond butter
• 1/3 cup honey 
• 1 egg (preferably local and pasture-raised) 
• 1/2 teaspoon baking soda
• 1/2 teaspoon sea salt
• 1/2 cup chocolate chips (to reduce sugar, look for dark chocolate chips or stevia-sweetened chips)
• 1/2 cup chopped pecans

 

Instructions:

1) Preheat your oven to 350F. In a medium bowl, mix together everything except chocolate chips and pecans until a thick, gooey batter forms.

2) Fold in chocolate chips and chopped pecans.

3) Using a tablespoon, or cookie scoop, drop batter onto a baking sheet lined with a Silpat, or parchment paper. The dough will be sticky.

4) Bake for 9-11 minutes at 350F.

5) Once the cookies are lightly browned, remove the pan from the oven, and allow the cookies to rest on the baking sheet for 10 minutes. This step is important- they firm up as they cool. If you try to put them on a baking sheet right away you might loose some cookies.

6) Once the cookies are cool, and firm enough to handle, use a spatula to transfer them to a wire cooling rack to cool completely.

7) Serve at room temperature. Store extras in a Tupperware in the fridge for a week. These also freeze well so are great to make extra batches in advance.

Instant Pot Chicken Tikka Masala (Paleo, SIBO, Gluten-free)

We'll confess; we jumped on the Instant Pot bandwagon last spring and honestly haven't looked back. As busy working parents who value nutrition and home cooking, the Instant Pot has saved us. You can throw ingredients in, set the time, then walk away and give your kid a bath, attention, monitor a meltdown--whatever--all the while knowing your dinner is cooking and, because it will shut off when it's done, you don't have to worry about your house burning down because you forgot about that thing cooking on the stove (admit it moms and dads- you've been there. . . ). Not to mention you can cook things FAST, like a whole chicken in 30 mins (one of our staple meals), or bone broth in 3 hours.

Now that it's winter, we are full force into cooking stews, soups, and other delicious warm meals. We wanted to post a couple of our current Instant Pot favorites in our house, starting with this Chicken Tikka Masala.  

I literally love this meal, it is cooked a couple times a month in our house.  It is absolutely delicious, and when cooked in a pressure cooker (especially if you also have a rice cooker), it's extremely easy. This can also be modified for various nutritional needs. The recipe below is gluten-free and can be eaten with rice. If Paleo, substitute the rice for cauliflower rice or eat it as a stew with extra veggies. If following the SIBO diet, make sure you get coconut milk without any thickeners (i.e. guar gum) which we've found at Trader Joe's and other natural food stores. Also omit the rice and choose your sautéed veggies based on the SCD guidelines.

Recipe for Instant Pot Chicken Tikka Masala

 

Ingredients:

• 4 tbsp olive oil

• 1 small onion, chopped

• 1 1-inch piece of ginger, peeled and chopped

• 2 tsp paprika

• 2 tsp ground turmeric

• 3 tsp cumin

• 1 tsp ground coriander

• ¼ tsp cayenne pepper (optional)

• 1 14 oz can diced tomatoes (with juice)

• 1.5 lbs boneless, skinless chicken thighs

• ½ cup chicken broth

• ½ cup canned coconut milk

• Juice of 1 lemon

• Chopped fresh basil or cilantro (optional)

• 2 cups cooked rice or cauliflower rice

• 3 cups assorted chopped veggies (kale, broccoli, green beans, peppers, mushrooms, etc.)

Instructions:

1) If you plan to eat your tikka masala over rice, start cooking your rice in a rice cooker or on the stove per rice instructions.  

2) Select sauté on your instant pot and turn to high heat. Once pot is hot add 2 tsp olive oil, ginger, and onion. Cook for 3-4 minutes stirring until onion is translucent.

3) Select cancel, and add all the spices to the onion mixture scraping the bottom to form a paste. Add the tomatoes, stir, then nestle the chicken on top. Pour chicken broth on top. Secure the lid.

4) Select manual and cook on high pressure for 7 minutes.

5) While the Instant Pot is heating up and cooking, put a large pan on medium heat and add the other 2 tsp olive oil.  Add the 3 cups of mixed chopped veggies.  Cover and cook for 8-10 minutes until soft then remove from heat and set aside.

6) Once the Instant Pot beeps that the cooking is complete, use a quick release. Remove the lid and chop chicken (a fork is fine since it will be nice and tender).

7) Select sauté, and simmer for another 4-5 minutes. Add in coconut milk and lemon juice.

8) Season with salt as needed, and once mixture is thick, serve immediately over veggies and rice and top with fresh basil or cilantro.

Lung Support in Wildfire Season

Shades of Gray: an image of Pilot Butte taken from St. Charles Hospital in Bend on 9/6/17. On a normal day the sky is blue and the butte (1/2 mile away) is clear.

For those of us in Oregon, August has been a really tough month of hot and smoky weather. Unfortunately the wildfires are still raging in many places around the state and will be for the foreseeable future. This brings up a lot of physiological issues as well as emotional grief for people in our area. While fires to some extent are a fact of life (and prevention is a whole other can of worms…) this year has had a higher impact on our air quality than years past. People most affected by wildfire smoke are those with chronic respiratory conditions or other chronic diseases, older adults, children and pregnant women. However, when the air quality is really poor everyone is at risk for experiencing issues. If you haven’t taken some measures to boost your lung health now is a great time!

In Chinese medicine, the lungs are a very important organ system. The lungs are one of the major sources of qi, or “energy,” in the body and also control the surface of the body—both interior (lungs/airways) and exterior (skin/nose)—and therefore are our first line of defense from allergens such as smoke as well as viruses and bacteria. They are also usually the first part of our body to be impacted by these external factors.

When your lung qi is strong, you feel vibrant, energetic, and breathing is easy. On the other hand, when the air we breathe is full of allergens and toxins, such as the wildfire smoke we are experiencing right now in Oregon or smog in urban areas, our lungs are put under a lot of strain and can quickly become depleted of qi.  Symptoms of lung qi deficiency include fatigue, shallow or difficult breathing, weak dry cough, weak voice, skin issues and sweating.

Another issue we face this time of year in Central Oregon is hot dry weather. Dryness is also seen as a pathogenic factor in Chinese medicine that can impact the lungs.  Symptoms of lung dryness include hoarse voice, dry cough, and dry throat and mouth. 

For those who have underlying lung qi deficiency or other chronic diseases and imbalances, the smoke can cause more severe and allergic symptoms such as coughing, wheezing, irritated sinuses, rapid pulse, headaches or burning watery eyes.

Do you feel affected by the smoke? If so, it’s time to take action to support your lung qi so you don’t experience any serious or long-term problems, and also to make sure your immunity is at its best for the coming cold/flu season. Here are our recommendations for supporting lung qi in wildfire season:

1. Check the Air Quality Reports often. The winds are always changing and the air quality fluctuates constantly, so make sure to look at a real-time report throughout the day, especially if you need to be outside. We use the AQI website . Time your outings appropriately and stay inside when the air quality is unhealthy or hazardous. 
2. Reduce exposure. It’s not fun, but stay inside, keep car windows closed and the internal circulation on. Avoid burning candles or wood fire inside as this will increase air pollution. Consider purchasing a HEPA air filter to help reduce particulates in your home. If you are really struggling or at risk, purchase a particulate respirator mask to wear when you do go outside. A bandana or surgical mask will not keep out the small particles that are damaging to the lungs. 
3. Focus on foods. With all the work your body is doing when there is a lot of smoke in the air, it is important to fuel it with the right foods. Keep meals simple and avoid common inflammatory foods such as dairy, wheat, alcohol or greasy/fried foods. Moistening fruits such as pear or persimmon can help to nourish lung yin and combat dryness symptoms. Pungent foods such as onions, garlic and ginger are great, as well as veggies like turnips and radishes.
4. Get acupuncture. Did you know acupuncture can help support your lungs and breathing? Acupuncture has been shown in studies to help support breathing and lung function in people with more serious lung diseases like COPD (1) and asthma (2), showing that acupuncture can have a direct effect on reducing lung symptoms and improving overall lung health. Acupuncture can also help to support your lung qi and keep you well before you have any serious symptoms. A famous Chinese medical saying is that “treating disease when it has already manifested is like digging a well when one is already thirsty.” Prevention is key so don’t wait until you are already suffering. If you fall into one of the categories above for people at higher risk of having issues from smoke, it is even more important to reach out to a licensed acupuncturist for support as well as your medical doctor or naturopathic doctor.
5. Take lung tonic herbs. Again, if you are in one of the high-risk groups, your best choice is to see a licensed acupuncturist or western herbalist for a custom herbal formula to treat your specific symptoms. For those that are otherwise healthy, just wanting to support lung qi and prevent disease, there are some over-the-counter herbal formulas that you could try.  Here are our favorites; these can be found at our clinic, on-line or at natural foods stores:
   1. Rootology Breathe Free: this is a patent formula using Chinese herbs that we prescribe often to our patients to support the lung and sinuses. It is great for allergy support and also for wildfire smoke. It’s full of great herbs to support your lungs, throat, nose and eyes and one of the best things we’ve tried personally and with patients.
   2. Wish Garden Herbs Deep Lung: this formula contains western herbs to support the lungs, so is different in ingredients from the one above but also really supportive. It contains one of my favorite local herbs as well, Mullein leaf, which is all over our high desert.
6. Express your grief: this one's important. Grief is the emotion associated with the lungs and too much of it, especially when we hold onto it and don't express our sadness, can manifest in physical disease along the road. It's hard not to be heartbroken over the loss of our beautiful and beloved forests, especially in areas like the Columbia River Gorge that many of us know and love. Look at old pictures from the areas affected by the fires, share your stories with friends, cry, scream, shout: do whatever it takes to express the sadness you may be feeling. For many it helps to take action--contact your local forestry center and see what you can do to help forest fire prevention and forest restoration to keep our forests vibrant in the future.