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Interview – Food Pharmacy


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The Fasting Mimicking Diet Can Increase Your Gut’s Good Bacteria

Earlier this year, the science journalist Dag Kättström gave us a quick course on the fasting mimicking diet. He told us about studies which show that a fasting mimicking diet can start healing processes in the body.

And since then there has been new research emerging that we thought was interesting; a new study was published on how fast mimicking diets positively impacts intestinal health. So, we reached out to Dag again. The following is a mini interview with him on the topic and the study findings:

– What is the latest research showing on the matter?

Researchers have investigated whether fasting diets can help various inflammatory bowel diseases which are grouped together under the term IBD – Inflammatory Bowel Disease. They used mice in the study and the results show that those who ate cycles of fasting mimicking diet had fewer symptoms and even rebuilt mucous membranes in the intestines compared to those who ate as usual or were on a complete fast. For those who are more curious, you can read the entire study here.

– Sounds positive, but how about a quick refresher on what a fasting mimicking diet is?

Well, American researchers have discovered that if you eat about one third of your normal calorie intake for five days and keep your protein intake very low,  the effects are positive in the form of reduced inflammation and generally better health stats. In fact, you get better health effects by eating a little during a fast, in comparison to not eating at all. This is supported in the new study as well. The intestines of the mice improved with the fasting mimicking diet, while that was not the case with a complete fast.

– Okay. What is the likely cause of this effect then?

One reason may be that fasting mimicking diets strengthen good bacterial strains such as lactobacilli and bifidobacteria. In the case of a total fast, with only water, no such reinforcement is noticed. Rather, inflammatory-driving strains such as paraprevotelaceae receive a boost.

Another thing the researchers think is important is that fasting mimicking diets somehow regulate the TNFα protein. It is a very powerful protein that can both trigger strong inflammation and stimulate new cell formation. While fasting, the levels of TNFα go down and the inflammation in the intestine decreases, but when you start eating again something surprising occurs. The mice that fasted completely regained levels of inflammation, while those who mimicked fasting had less inflammation and instead had new cell tissue in the intestines.

Similar effects have been found by researchers in previous studies of fasting mimicking diets and autoimmunity.

–  Ok, but this positive effect doesn’t occur when you are on a complete fast?

Perhaps it is due to the fact that the body is completely deprived of food that it does not prioritize repair, while a typical starvation diet with reduced calories and limited protein, strengthens the body for the future when more food will be available. These are processes that have evolved over billions of years of evolution and are likely to be found in similar forms in all animals. When eating fasting mimicking diet for five days, these processes are turned on.

So how will researchers move forward with the gut research?

Above all, these results must be repeated on people, but the researchers hope that the diet plan will eventually help people. The IBD diseases, such as Crohn’s and Ulcerative colitis, are severe conditions that cannot be cured and more tools are certainly welcome for those who suffer.

Have you investigated whether fasting mimicking diet helps other intestinal problems such as IBS?

Not yet. And as many people with IBS can attest, it is quite individualized as to what helps. But I personally think that the most interesting fact is that the latest study suggests that good intestinal bacteria can be strengthened by the diet. It could be good for everyone.

But we’ll have to wait and see. Right now, a total of 24 clinical studies on the fasting mimicking diet are underway, ranging from the effects on cancer to weight loss. It will be extremely interesting to continue following the research.

– Thank you, Dag!

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PCOS, Oral Contraceptives and Inflammation (part 2)

On Monday, we published the first part of our PCOS interview with sexual health advisor Jenny Koos, also known as Vulverine. If you missed Monday’s post, you will find it here.

Polycystic ovarian syndrome, PCOS, is part of or a precursor to a metabolic syndrome, and women with the diagnosis often have irregular menstrual cycles and can suffer from acne, increased hair and obesity around the waist. Many also have problems with ovulation and therefore difficult to get pregnant.

The syndrome can be divided into several different types and so far Jenny has told about the insulin-resistant type as well as the fact that a large portion of PCOS women have problems with glucose tolerance. PCOS is a people’s disease with a basis in diet and health and, as Jenny herself puts it, it’s not just about a couple of ovaries.

Okay, time for part 2.

–If the first and foremost type of PCOS is the insulin-resistant, what are the others?

The second most common type I see is PCOS developed after the use of the pill, so-called post-pill PCOS. I meet a number of women every month who are put on birth control pills in their teens due to irregular cycles, PCO and pimples, all of which are quite normal in the first years before the menstrual cycle has really started. Then they stay on the pill for X years, regardless of whether they want a contraceptive or not.

When they stop, the menstruation cycle will not always return, and after a couple of months they go to the gynecologist and see the “pearl band”. At the same time, acne has often broken out because the pills they have taken previously reduced skin sebum production. Now it is overproduced instead and goes wild because the androgens that have been oppressed shoot up to the roof. Many times, this post-pill acne is at its worst about 6 months after getting off the pill, and then slowly improves, and the menstrual cycle and androgen levels usually settle within 1-2 years.

All of this is due to the fact that birth control pills raise SHBG, which binds up testosterone (this is one of the main reasons why many lose their sex drive on the pill). SHBG remains elevated for many months after termination, and just before the patient believes that the drug’s effect should be over, the androgens break through and she believes that the acne is “her own” and not a delayed side effect of the contraceptive.

The tragic thing in this scenario is that in most cases the patient is put on the pill just to treat her “PCOS”.

– Is contraceptive pill a viable drug treatment for PCOS?

No, birth control pills are not a treatment for PCOS, but they offer a masking of symptoms. The anti-androgenic varieties, e.g. Yasmin can remove acne and hirsutism and provides a monthly bleeding. For those suffering from such symptoms, it is often a welcome treatment.

Because a too thick uterine mucosa is a cancer risk, the gynecologist would of course like for you to menstruate every now and then. But you no longer have a menstrual cycle on the pill, and have not “fixed” this issue either. In other words, PCOS can be masked with birth control pills, but they will not help one to heal it – on the contrary.

Remember that insulin resistance is the main cause of PCOS, and the known side effects of the hormone disruptive contraceptives are insulin resistance. Another thing that contraceptive pills unfortunately do is to create nutritional deficiency, typically the nutrients needed to drive a healthy menstruation cycle. It is also proven that they cause chronic inflammation.

From a health perspective, bioidentical progesterone, properly dosed, would be much better than the progestin of the median, if regular bleeding is the target. Treating cyclically with true progesterone also lowers the LH secretion from the brain. One might wonder why this is not used to a greater extent?

Inserting a hormone disruptive contraceptive whose whole point is to shut down ovulation, in a body struggling with just ovulating, may seem somewhat counterproductive – especially in women who do not actually want the preventive effect of birth control pills.

– Is it true that PCOS can also be linked to inflammation in the body?

Yes, it can also be an inflammatory PCOS. If you have IBS (which is also a rather murky diagnosis), you probably suffer from chronic inflammation. It expresses itself as stomach issues, eczema and rash, pain – and / or PCOS. In this situation, you need to review what drives the inflammation, work with your stress management and switch to an anti-inflammatory diet. Antioxidants like NAC can work, probiotics are a good idea, but you have to remove the irritants first. Severe and / or chronic stress gives similar effects, see e.g. this study on how cortisol affects inflammation.

– Is it a congenital disease?

There is a great deal of evidence that toxins in fetal life and during childhood can trigger PCOS, and that the father’s weight and mother’s level of AMH during pregnancy (read more here and here) will affect. Thus, to some extent you can inherit the conditions for PCOS, however the environment also plays a role in its development? You control, to a large extent, yourself how your genes will express themselves, and if you know what triggers it then you can keep it in check. I have met many, many clients who have healed their PCOS!

In health care it is reiterated that “the cause of PCOS is unknown” as a mantra, and one focuses on managing individual symptoms or facets of the syndrome. But with a holistic perspective on, what in our western diet and lifestyle has changed as PCOS has increased – i.e. lack of darkness and sunlight, combined with chronic low-intensity stress and constant intake of sugar in a generation of high -ambitious women – it is no wonder that about 1 in 5 women suffer from this metabolic syndrome.

“When any condition crosses disciplines and does not have a full investment in [one of them], it often falls through the cracks. There are elements of reproduction in PCOS, but most reproductive endocrinologists mostly do in-vitro fertilization and are not necessarily interested in metabolism. Medical endocrinologists, who are mostly interested in metabolism, are usually interested in reproduction and ovarian function. ”- Dr Dumesic (The Atlantic, 2015)

– Finally, what can a woman who has the diagnosis do to improve her PCOS?

  • Learn the Justisse Method so that you can learn to identify your ovulation and get an overview of your cycle health.
  • Promote ovulation by:
    • regulating your blood sugar through diet,
    • control your thyroid function
    • adapt an anti-inflammatory lifestyle and diet as much as possible
    • handle stress
    • Make sure you’re getting important nutrients, especially regarding magnesium and vitamin D.

These factors improve if you give up caffeine completely. If you have to lower androgens that are already high, you can use a variety of herbs and supplements, eg. alphalipoic acid or berberine.

– Thank you, Jenny!

Jenny Koos is Justisse Holistic Reproductive Health Practitioner, but also known as Vulverine, or simply the holistic-minded sexual health advisor. You can find her on facebook and instagram.




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PCOS, Insulin Resistance and Vitamin D (part 1)

A few episodes ago on our Swedish podcast we talked about PCOS with Jenny Koos, a sexual health advisor and Holistic Reproductive Health Practitioner. During the episode we promised that Jenny would appear here on the blog as our very own expert on PCOS and today it is finally time.

– Jenny, tell us. What is PCOS exactly?

Polycystic ovary syndrome, PCO-S, is part or a precursor to a metabolic syndrome including diabetes, obesity and cardiovascular problems. The name has been on the verge of changing for several years to “metabolic reproductive syndrome”, or “Anovulatory Androgen excess”, because “PCOS” is misleading. Explained here:

“[The name PCOS] is a distraction, an impediment to progress,”… “It causes confusion and is a barrier to effective education and communication. It focuses on… polycystic ovarian morphology, which is neither necessary nor sufficient to diagnose the condition. ”(NIH panel, 2012)

– What are the symptoms?

Women with PCOS have an excess of androgens (“male” sex hormones), which can express themselves as an irregular menstrual cycle, acne, increased hairiness according to a “male” pattern, thinning of the scalp, or obesity around the waist. In the long run, it is linked to a higher risk of diabetes and gestational diabetes, cardiovascular disease, high blood pressure and uterine cancer.

However, the syndrome is more complex than singular external symptoms, but conventional medical treatment focuses on suppressing the symptoms, e.g. by completely shutting down the ovulation and causing regular withdrawal bleeding. The problem with PCOS, however, is not that you do not bleed, but you do not ovulate.

– Yeah, we are aware of the issue with ovulation. We have many friends with PCOS who have had problems with irregular periods and difficulty getting pregnant. How common is it with PCOS?

It is estimated that up to 18 percent of women of childbearing age have PCOS, and of course that number isn’t’ including unknown cases. It is a metabolic syndrome, a endemic disease based on diet and lifestyle and is not about arduous ovaries. Read more here, here and here.

– Breakdown for us what it is that’s happening in the body?

In a normal menstrual cycle, the growing follicle (egg shell) actually produces androgens, that is, “male” hormones. However, this androgen in the follicle should then convert to estrogen, and a peak of high estrogen is necessary for the brain to drive the ovulation using the hormone LH. The problem with PCOS is that the follicles stay idling.

The hormone LH from the brain at PCOS is elevated for longer periods than normal – because the brain wants to ovulate, which for various reasons cannot be completed. This can make ovulation tests difficult to read.

When the levels of LH are elevated, the conversion to androgens such as testosterone and dihydrotestosterone increases, giving rise to acne and hirsutism (increased male-type body hair). Even stress is a major contributing factor, as androgens can also be overproduced from the adrenal glands.

– What’s the relationship between androgen excess and ovulation?

Essentially, androgen excess, accumulated from various sources, affects the regulation of the menstruation cycle from the brain, resulting in a vicious circle where the weakened ovulation ends up preventing itself.

In addition, from the “half-mature” follicles (growing eggs that have not come to the end spurt), the hormone AMH is released. Women with PCOS have therefore increased AMH. They also have low SHBG, a transport protein that normally binds free testosterone and makes it inaccessible.

– That’s a lot to keep track of, but so interesting. How is the diagnosis determined?

Well, there is a lot to think about. One or more ultrasounds that show on PCO do not equal that you have PCO-S. Diagnosis cannot be given just by ultrasound!

PCO stands for polycystic ovaries, and means many small semi-mature follicles in the ovaries without any particular one leading or appearing to be ovulating. This phenomenon is known as “the pearl band” when seen on ultrasound. However, the pearl band in itself says nothing about WHY your follicles go and go but don’t come to the party. It may have other things to do than PCOS: puberty, hypothyroidism (underactive thyroid), nutritional deficiency, stress, high prolactin, or some medications.

PCO alone can thus occur during an extended menstrual cycle, during stress, or after recently discontinued use of endocrine disrupting contraceptives, and is therefore, in certain circumstances, “normal”.

According to the AE-PCOS Society, diagnosis can only be made if the person meets all three of these criteria:

  • Irregular cycles and/or PCO
  • Excess of androgens such as testosterone, androstenedione and DHEAS – or symptoms of the same in the form of acne, increased hairs (hirsutism) or obesity (especially around the waist)
  • Do not have any other reason to overproduce androgens, eg congenital adrenal hyperplasia

Thus, if you have been diagnosed with PCOS based solely on an ultrasound, without having taken blood samples, the doctor has not done his job. You could be able to ovulate a few weeks afterwards and thus not have the careless diagnosis anymore!

If you do not have a period for a couple of months it does not necessarily mean PCOS. You may instead have suffered from hypothalamus syndrome, which is not at the ovarian level but means that the brain closed down the menstrual cycle due to malnutrition or overtraining.

Knowing WHY your menstruation cycles are irregular, why it is difficult to ovulate, is absolutely crucial for which treatment will work for you!

– But if a woman finally gets the diagnosis, what does she need to know to alleviate the symptoms? For example, are there different types of PCOS?

Lara Briden refers to 4-5 different types of PCOS, which I think is a helpful approach to finding the drugs that actually work for the individual.

The first and foremost is the insulin-resistant variant. Of women with PCOS, 30% have been shown to have impaired glucose tolerance, another 7.5% have diabetes, and one need not be overweight to have blood sugar problems. Insulin resistance means that you cannot use insulin, which usually means increased production. Insulin resistance does not have to mean obesity or diabetes, but can definitely lead to it.

The insulin resistance factor is the reason why type 2 diabetes is a future risk for those who suffer from PCOS – at ground level it is essentially the same problem. And given that many of us are raised on frosted flakes, instant noodles and candy it’s maybe not so strange that PCOS is increasing.

Hyperinsulinemia affects the growing follicles locally and drives a testosterone production, instead of the estrogen that should actually dominate. High insulin also raises LH from the brain, further increasing the production of androgens in the ovaries. High insulin also lowers SHBG, which means more free testosterone.

A bit more progressive doctors use Metformin, a diabetes medicine, for PCOS. Often, however, the focus is often solely on lowering the androgens, which does not overcome the underlying problem.

– You mentioned PCOS stems from diet and lifestyle, and now you mention the link to insulin resistance and blood sugar levels. Does this mean that women with PCOS should think about what they eat?

Yes, you can definitely greatly reduce your sugar intake and make your insulin receptors more sensitive so the insulin doesn’t shout at them. Low Carb Diets is proven effective, but I would not recommend removing carbohydrate/starch completely, because you need them to be able to ovulate. Eat well and balanced during the day and avoid sugar-roller coasters, even if they consist of raw nutrition balls. Sleep helps, magnesium helps, inositol is an option.

– We’ve heard that vitamin D plays a roll here too, is this true?

Yes, vitamin D is a prerequisite for you to ovulate properly and there is plenty of research on how it is involved in PCOS. For example, it has been shown to induce ovulation in women with PCOS, as it optimizes follicle growth (the growing follicle has receptors for vitamin D), as well as lowers AMH and testosterone. Vitamin D deficiency is associated with insulin resistance, difficulty in ovulating, hyperandrogenism, overweight and so on. In this study, up to 85% of women with PCOS had low levels of vitamin D in their blood.

– Thanks, Jenny! We’ll continue with the rest of the PCOS issues on Thursday. Ciao!

Photo: Jenny Koos.

Jenny Koos is a Holistic Reproductive Health Practitioner, but also known as Vulverine, the pussy whisperer, or simply a holistic-minded sexual health advisor. You can find her on facebook and instagram.





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A day in the life of karate pro Sabina Lääveri

In mid-September we wrote about Sabina Lääveri. You remember…the karate pro who eats almost exclusively vegetarian food. Perhaps you then also remember that we promised to ask Sabina for a detailed diet and exercise diary? And now it’s finally time for us to find out how a vegetarian’s day can look as an elite athlete like Sabina.

– Sabina, can you tell us how a normal November day looks for you?

Of course I can! As an athlete, I spend a lot of time out and about. The days are often very long and I appreciate the little things in everyday life. A cup of coffee at home on the couch early on a dark autumn morning may be taken for granted by some but these are moments that I deeply appreciate. The following is how a typical day can look for me:

05:30 – Alarm clock rings

Occasionally, periodic fasting has worked well for me despite frequent training and during such periods I move up the rest of the day’s meals a few hours. But during a period of very intense training, I eat breakfast. What is important is that I adjust and time what I eat in accordance to when and how I train.

My breakfast consists of:

– Oatmeal with 1 frozen green banana, cinnamon, 1 tablespoon organic peanut butter and frozen berries
– Coffee with oat milk
– Cold water with raw organic apple cider vinegar

A few days a week I plan on a morning workout at the gym before I go to work (that is, my “day job”). I think it’s nice to split up the strength training throughout the week, partly to get the body up and at em’ already in the morning, and partly to be able to prioritize mobility and rehab training – in my case injury prevention exercises mainly for muscles and joints like knees, feet and shoulders.

7:00 AM – Strength training

Warm up
Mobility Exercises
Power Clean 5×5 35 kg
Chin-ups 3x max
Dips 3x max
Clean with burpee 4×8 30 kg
Lunge with rotation and medication ball 6 kg
Box jump 4×8

08:15 – Recovery

– 2 Buckwheat crisps with chia seeds
– Peanut butter
– A banana

11:00 – Lunch

Mia and Lina’s mango stew (love it!). I add to that some beluga lentils, steamed butternut squash, spinach, quick-pickled red cabbage in apple cider vinegar, lime and sea salt. And a lot of cilantro!

Planning is everything for me and always having meals and snacks on hand makes things much easier. I  pack food for both lunch at work and dinner between the workouts. When I prepare the food, I always make large portions so it’s enough for the whole week. A good tip is to store all dry foods in one box, for example vegetables, lentils, potatoes etc., and stew or other like kind foods in another box. That way the food stays fresh longer.

14:00 – Snack 1

– A banana
No surprise.

16:00 – Karate training 1: technique

Warm up
Timing in footwork and striking

17:30 – Dinner

Quinoa with marinated tempeh. Another favorite!
(Are you curious about how Sabina makes this? Check out the blog tomorrow for the recipe!)

19:00 – Karate Pass 2: Situation Training

Warm up
Timing Exercises
Lead – laying under situation training
Sparring 10 rounds

20:30 – Evening meal

– 1 cup hummus with carrot sticks
–  Roasted salted almonds
– Green tea

– What a day Sabina, super busy!

Yeah, I really have to stick to my planning so that things flow. Elite training involves a lot of sacrifice in terms of social life with family and friends.  Leisure time needs to be planned in advance and there is seldom room for spontaneity. But I don’t pity myself though, on the contrary! I live for progress and personal development. To exercise purposefully and be able to control my body down to the smallest movements, to be quick and strong and to fight is pure euphoria. My goal is to make it to the Olympics.

– What inspires you when planning your meals?

Diet has always been an interest of mine and since I have decided to become the best in the world at karate, I also want to optimize my diet to perform as well as possible. The interest in a plant-based diet was associated with listening to Food Pharmacy as an audio book and since then you have inspired my everyday life and lifestyle. Today I am eating almost exclusively vegetarian diets and I have noticed that I recover better, I am more alert during the days and sleep better at nights. Worth gold to me!

But eating strictly vegetarian does require some knowledge. For myself, who wants to maintain muscle mass, I need to keep an eye on how much energy I expend during the day and how much protein I need to eat in order to not lose muscle.

Thank you Sabina! And for those of you curious about her dinner recipe, make sure to come back tomorrow, it won’t disappoint!