#15 Functional Medicine Returns! Elimination diets and healing with food

October 10, 2016 | By Matthew Watto, MD

Stop feeling helpless in the face of vague complaints like fatigue, digestive problems, mood swings, inability to lose weight, etc. Learn to treat any chronic disease without writing more prescriptions. Heal yourself and your patients with the power of food. Join us for the return of Functional Medicine physician, Dr. Yousef Elyaman, as he schools us on elimination diets, phytonutrients, liver detoxification, going “paleo” and more. This is a deluxe episode so we’ve included a time key below. You’re welcome.

Clinical Pearls:

1. Use the 80:20 rule. Try to make 80% of your food paleolithic (unprocessed).
2. Eliminate the chemicals when possible (processed foods, plastics, cleaning products, cosmetics, etc.)
3. Workarounds for your budget: home garden and/or frozen foods.
4. Preserve phytonutrients – Avoid microwaves. Lightly saute or eat veggies raw.
5. Try an elimination diet for one month then reintroduce foods one at a time.
6. Assess patient readiness and prescribe diet that fits their degree of commitment.
7. Basic lab panel to consider: Check homocysteine, zinc, 25OH Vit D, B12, RBC folate, RBC magnesium (use diagnosis of fatigue).
8. More specialized labs: 
   1. SpectraCell – Micronutrient panel.
   2. NutraEval Plasma by Genova Diagnostics.
   3. Check for MTHR mutation (if off then patient needs methylfolate).

Dr. E’s Four steps to healing with food

1. Ensure a nutritionally dense diet.
2. Remove bothersome foods.
3. Replace deficiencies.
4. Rebalance the system.

Disclosures:
Dr. Elyaman reports no relevant financial disclosures for this topic.

Learning objectives:
By the end of this podcast listeners will be able to:

1. Appraise the quality of a patient’s diet and identify potential sources of intolerance/food sensitivity
2. Counsel patients on sustainable dietary changes to remove potentially bothersome foods and chemicals
3. Perform a basic laboratory evaluation to identify deficiencies
4. Identify resources for patients and providers to facilitate education and adherence

Show breakdown
0:00 Intro.

02:30 Welcome Dr. Elyaman.

03:15 Stuart bums everyone out with a current event.

04:30 Functional Medicine defined.

07:10 Logistics of educating patients on dietary changes.

11:15 Four steps to healing with food.

15:00 Use food to treat chronic disease.

16:45 Fats and a nutritionally dense diet.

20:00 Alzheimer’s and food.

23:45 Phytonutrients.

27:45 Eating on a budget.

33:40 Genetically modified foods, lectins and autoimmune disease.

40:30 Elimination diets.

46:00 Multiple sclerosis, Milk and casein.

50:00 Autism’s interplay with diet, genes, folate metabolism.

53:00 How to boost liver detoxification.

56:00 The Wahl’s protocol for multiple sclerosis.

58:30 Paleo diet.

1:00:00 Patient adherence.

1:07:35 Testing for and repleting vitamin deficiencies.

1:11:15 Fast food salad and inflammatory markers (Stuart derails the show again).

1:14:30 Dr. E’s Take home points.

Links from the show:

1. The Institute of Functional Medicine’s Elimination Diet Plan
2. Stanford FODMAP Diet Handout
3. Visit Dr. E’s website for Absolute Health
4. Institute of Functional Medicine website – https://www.functionalmedicine.org
5. Learn the basics – Intro To Functional Medicine by Dr. David Jones and Sheila Quinn
6. MSQ questionnaire from Dr. Hyman’s website – assess medical symptoms and toxicity
7. DASS 21 questionnaire – for anxiety, depression, stress
8. A study of macronutrient type on ApoE levels in ApoE2, E3, E4 genotypes
9. Video on the “10 Americans” study by the Environmental Working Group – chemicals in cord blood https://youtu.be/0-kc3AIM_LU
10. EWG.org (environmental work group) – gives the Dirty Dozen and the Clean 15
11. Gluten free diet removes anti islet cell Ab in a child https://www.ncbi.nlm.nih.gov/pubmed/12434905
12. Dr. Terry Wahls TED Talk – Diet for Multiple Sclerosis (the Wahls protocol)
13. The Paleo Diet book can be purchased here
14. Handful of nuts per day lowers mortality in both of these studies https://www.ncbi.nlm.nih.gov/pubmed/25833976 and https://www.ncbi.nlm.nih.gov/pubmed/26548503
15. 23 and Me genetic testing
16. SpectraCell – Micronutrient panel
17. NutraEval Plasma by Genova Diagnostics
18. Stuart’s Omron blood pressure cuff