How to Convert Any Recipe to Real Food

5 steps to convert any recipe to real food

1) Look over the ingredient list. Make a note of the following:

fats sweeteners grains/flours dairy meat products

2) Consider whether the ingredients you listed are processed or whole foods. Some examples:

vegetable oil vs. coconut oil corn syrup vs. honey or pure maple syrup bleached white flour vs. white whole wheat flour pre-shredded cheese vs. a block of cheese you shred yourself breaded chicken fingers vs. raw chicken you can toss in a homemade breading

3) Do you have the substitute ingredients handy or will you need to purchase them? You can make many real-food ingredients yourself–breadcrumbs, for example (whirl dry homemade bread in the food processor), chicken or beef stock, any baked item like burger buns or tortillas, etc. Other ingredients you can buy in bulk, such as coconut oil or white whole wheat flour.

Many people grind their own grains as well, which is even better for you than purchasing even very high-quality whole-grain flours.

4) Let me demonstrate how this works. Look at this recipe for a cheesy broccoli frittata (sounds delicious). Most of the ingredients look fine, but check the fats and dairy products. The recipe calls for just one tablespoon of vegetable oil, but it’s just for sauteing the veggies. Use butter or coconut oil instead. And for the cheese, use a whole chunk that you shred yourself (you can buy some pre-shredded Parmesan cheese that does not contain added ingredients).

This recipe for cinnamon-raisin biscuits is a little more complicated. It calls for biscuit mix and added sugar. We don’t want to use either of those. You could just skip this one, but it sounds great!

Here’s a recipe for basic biscuits. It uses white flour, sugar, and has the option to use shortening, butter or margarine. Go with the butter or sub in coconut oil. Now, compare this to the first recipe. That calls for 1/2 cup of milk. The basic biscuit recipe calls for 3/4. We’ll go with the 3/4 cup since we’re using the basic recipe for a base.

The cinnamon-raisin recipe calls for 1/3 cup sugar. You probably don’t need the biscuits so sweet, but if you want some sweetening, use rapadura, or sub in about 1/4 cup of honey or pure maple syrup. If you use honey or maple syrup, that will add moisture, so stick with the 1/2 cup of milk.

Add the cinnamon to the dry ingredients in the basic recipe, and mix in the raisins with the milk and liquid sweetener (if you’re using it), after you cut in the fat.

That sounds complicated, but it’s just adding cinnamon, raisins, and a little extra sweetener to a basic biscuit recipe which you can mix up in about ten minutes.

Get the idea? You can make any recipe real-food.

5) What you’re looking for when you sub ingredients are ingredients in their most basic, whole form. The less processing something has undergone, generally the better it is for you. Take shredded cheese, for example. Have you looked at ingredient lists on those packages? Cheese is NOT the only ingredient. One is cellulose: basically powdered wood pulp. Yummy. Instead of using that, just buy a block of cheese–the highest quality you can afford–and shred it yourself. Or get one of your kids to do it (not a toddler, and please supervise them).

More real-food versions of common processed ones:

Fresh or frozen fruits and vegetables are a much better alternative to canned (the only canned vegetable I use is tomatoes). Canned fruits usually contain corn syrup and canned vegetables have a lot of added salt. Frozen fruits and veggies are usually just that–fruits and veggies. Obviously fresh (organic if you can afford it) is your best option.

Instead of buying pre-sliced lunch meats, buy a whole ham, whole turkey, whole chicken, etc. Cook and slice it and use the meat for sandwiches, and half a dozen other meals besides.

Try making dairy products yourself, such as yogurt (use whole milk, preferably raw, for this).

You can even make pretty much any condiment yourself–something on my list of soon-to-accomplish real-food goals!

I hope these suggestions and examples have given you the knowledge and confidence to convert any recipe to real-food.

If you want even more ideas for real-food substitutions, and a lot of recipes for things to make yourself instead of buying them, check out my cookbook, Real Food for the

The Science and Art of Paleofying

Paleofying is often used as a derogatory term to describe the process of adapting Neolithic foods, typically desserts and sweet treats, to use only paleo-approved ingredients.  While some people look down on this practice as not addressing the problems of excess carbohydrate consumption and food addiction, I look at it as an important tool—it is a powerful strategy for making paleo accessible and sustainable for the general public.  Eating a restricted diet is much easier when you feel like you can still have birthday cake, can still celebrate a job promotion with a special dessert, can still bring cookies to your kid’s bake sale, can still make pancakes for Sunday brunch, and generally still get to eat delicious foods.  Paleofied baked goods mean that having a treat won’t damage your gut, cause rampant inflammation, or create a cycle of food cravings.  I like the word paleofy.  To me, this represents the union of nutrient-rich, anti-inflammatory “old” foods and modern life.

As we start the lead up to the holiday season, many of us are looking at conventional holiday baked good recipes and wondering how easy those recipes would be to adapt to paleo ingredients.  Yep, I’m doing this too.  Whether these are family favorites or recipes that just look delicious off of pinterest or in magazines, the first step to paelofying is deciding what recipe to start with.  Gluten-free recipes are often a great place to start, as long as the recipe don’t rely too heavily on xanthum gum to hold it together.  Other recipes that are often good bets too are those that use cake flour, use at least a couple of eggs, have dried fruit, have fruit or vegetable purees, have liquid sweeteners (like honey), or that have fairly large amounts of fat in them.

Paleofying is as much an art as it is a science.  I vaguely remember a time when I did not have extremely well-honed cooking instincts (I think that was back in middle school).  But even starting out as a fairly good cook, there was a steep learning curve to all of these new ingredients and to baking without gluten.  After a year of paleo baking (and blogging!), I have a much better understanding of how to adapt conventional recipes now and thought it was high time I share some of this knowledge and experience with you, in addition to my perfected recipes.

This post is the first in a 4-post series.  In this post, I will discuss paleo flours and other ingredients that add bulk to a recipe.  Part 2 of this series will discuss binders (ingredients that hold baking together).  Part 3 will discuss leavening agents and sweeteners.  Part 4 will discuss some strategies for doing iterations and troubleshooting your recipes.  You may also be interested in some of my posts that reference paleo baking ingredients:  Important Pantry Items for The Paleo Baker, Paleo Flour Substitutes, Sugar vs. Sweeteners, and Is Sugar Paleo?).

I am continuing to expand my paleo baking tool kit by playing with new ingredients.  Below is a list of all the paleo flour substitutes I can think of and other ingredients that add bulk to a recipe.  Some of these are still fairly new to me, so I still have fairly limited experience with them.  Which flour substitute(s) you choose really depends on the type of recipe and what the texture of the finished product should be.  I will try and give you enough information to help get you started.

Blanched Almond Flour—This is the stereotypical paleo flour substitute.  A high quality blanched almond flour (like Honeyville Farms or JK Gourmet) is very finely milled and can be quite light compared to other nut and seed flours or even a less finely milled almond flour (like Bob’s Red Mill, which I consider and almond meal).  Generally, it measures 1:1 when substituting for wheat flour.  It works very well in baking where you want a denser crumb, like muffins, coffee cakes and chewy cookies.  In recipes that also have a fairly large amount of wet ingredients, adding a starch or coconut flour can be helpful.

Almond Meal—This is a less finely ground version of blanched almond flour.  It typically uses the whole almond (like NaturAlmond, Trader Joe’s or Honeyville Farms) but some blanched almond flours (like Bob’s Red Mill) actually qualify more as a meal than a flour.  This is best for breading meat, but also can be used for dense baking like dense cakes (e.g. fruit cake), some cookie recipes and pie crusts.  If you are using almond meal in place of almond flour in a recipe, use slightly less as it tends to be denser.

Coconut Flour—This flour has a very high fiber content and absorbs liquid very efficiently, so it is really only used in recipes that have a large amount of wet ingredients.  Because it makes for a finer crumb than nut flours, I like coconut flour for cake and cupcake recipes.  It is also good for shortbread style cookies.  This is a very tricky flour to work with; often 1tsp can make the difference between the texture you are going for and something completely different.  When doing iterations with recipes that use coconut flour, always make small changes to the amount of flour used.  Always sift coconut flour before adding to your recipe, unless you are blending your batter in a blender or food processor.  When you add coconut flour to wet ingredients, the batter will thicken as it sits for the first few minutes.  It’s always a good idea to give your batter time to thicken before putting it in the oven.  The general rule of thumb is to replace wheat flour with ¼ the amount of coconut flour.  This will be sufficient for some recipes; but if you need to bulk up your dry ingredients, you can then add some nut or seed flours to bring the volume up a little (a good place to start is with the same volume you are using of coconut flour).  Different coconut flour brands do behave slightly differently depending on how finely they are ground.  I typically use Tropical Traditions brand now but I find that Bob’s Red Mill behaves very similarly.

Arrowroot Powder—This is the dehydrated and ground arrowroot tuber (not the cassava root).  It is mostly a starch and is great for adding lightness to a recipe (also lovely for thickening sauces).  Arrowroot powder can replace corn starch in recipe 1:1.  You can also mix arrowroot powder with very finely ground granulated sugar to make an acceptable substitute for icing/confectioner’s sugar.  If replacing wheat flour with arrowroot flour to add lightness to a recipe, replacing up to ¼ of your flour with arrowroot is typical.  I love using arrowroot in conjunction with coconut flour for cake recipes.  It doesn’t add much hold to baking that don’t have much binding ingredients, though.  I use arrowroot powder frequently enough that I actually use the Subscribe&Save program from amazon to have it automatically shipped to me.

Tapioca Starch—This starch comes from the ground cassava (a.k.a. yucca, yuca, manioc, tapioca) root.  This is not the same as arrowroot powder.  Even though many people use tapioca and arrowroot interchangeably, they actually have fairly different properties in baking.  Tapioca adds elasticity to baking, helping bind as well as giving more bounce (the cassava root is naturally a very slimy starch).  Tapioca nice to use in paleo bread recipes and can be useful in cake recipes as well to give a little more bounce to the baking.  You can replace up to about half of the flour normally called for in a recipe with tapioca (some gluten-

free baking replaces all of the flour with tapioca, but tapioca is probably the least healthy of the paleo flours, so I don’t recommend this).  Tapioca also isn’t a very good substitute for corn starch, but would do in a pinch.

Most paleo baking you will find on my site and others use various combinations of the above four flours.  But, these aren’t the only paleo flours out there and there are some really great less-frequently used options to consider.

Plantain Flour—Plantain flour is quickly becoming one of my favorite flours to work with, although I am still experimenting with it.  It is simply ground dehydrated plantain.  It does have a distinct plantain taste so it doesn’t work in all baking.  It has a lovely ability to bind (similar to tapioca starch, but with more of a wheat flour like texture and crumb) and generally can be substitute wheat flour 1:1.  It seems to work very well in soft, cakey and/or chewy baking recipes and not as well if you want some crunch or crispness.  A word of caution.  Some flour are labeled as plantain flour but actually contain a mix of different tubers, often containing potato starch in addition to plantain flour.   If you are buying this from a store, make sure to check the ingredients label.  I buy Barry Farm plantain flour from amazon.

Sweet Potato Starch—This is sometimes labeled as sweet potato flour, but this fine white powder is actually a processed flour/starch.  It substitutes well for arrowroot, but has almost no ability to hold baking together.  You can use this as a corn starch substitute or in combination with other flours as a flour substitute.  I’m not super enthusiastic about this starch, but it’s a good option if arrowroot is hard for you to find.

Sweet Potato Powder—This is also sometimes labeled as sweet potato flour, which can be very confusing.  Sweet potato powder is ground dried sweet potatoes and still retains its orange color (sweet potato starch is white).  This is a more interesting flour because it has some fiber and can absorb liquid so it has more ability to hold baking together.  I have used it in pancakes and have played with it as a flour substitute for brownies.  I’m still getting familiar with this flour, but it’s definitely a neat one to play with.

Kuzu Starch—I am just starting to play with kuzu starch (which is ground dehydrated kuzu root, used in Asian cooking).  Apparently, it is even better than arrowroot at thickening and I’m hoping that it will be useful to help get a few recipes I’m working on a little firmer in texture.

Sunflower Seed Flour—For those allergic to nuts or just almonds, sunflower seed flour can be used the same as almond flour (it can be a little denser depending on brand, so you might need to pull back the amount somewhat).  It has the fun property of turning green when used in baking that also contains baking soda (it’s totally safe to eat when it does this).

Hazelnut Flour—This can also be used the same as almond flour, but yields a different flavor to the baking.

Chestnut Flour—This can also be used the same as almond flour, but yields a different flavor to the baking.  It has a  more hold than almond flour, which is very handy, so you can easily use this flour on its own in some recipe.  It’s also quite a bit sweeter so you may want to reduce the sweet ingredients in your recipe if you are using this.

Pumpkin Seed Flour—This is another seed alternative to almond flour.  Pumpkin seed flour measures more closely to almond flour due to its higher protein content.  Also has a distinct flavor and slightly green color and is easier to make at home than most other nut flours.

Ground nuts and seeds—Ground nuts and seeds are a wonderful way to add more texture and bulk to making.  Many of them can help act as binders as well.  Mostly, you’ll be grinding your own in a food processor or blender.  A finer grind will act more like a nut flour, but you can also grind more coarsely which replicates the texture of oatmeal or other whole grain ingredients very well.  Making a mix of different nuts can replicate the flavor and texture of oatmeal and can help fix texture problems when working on denser baking recipes like cookies and muffins.  Ground flax seed also qualifies here as a way to add bulk and texture to baking and is an excellent binder too.  Chia seeds are often used similarly to flax seeds but these are a pseudograin, and Prof. Loren Cordain comes down pretty hard on chia in The Paleo Answer.  My favorites to use are Whole Almonds, Pecan Halves , Walnuts Halves ,  Macadamia Nuts , Hazelnuts (Filberts) , Pistachios , Cashews, Brazil Nuts , Pepitas (hulled pumpkin seeds) , Sunflower Seeds , Brown Sesame Seeds , Black Sesame Seeds , and ground flax seed (golden or regular, which act the same but just look different).  The combination of walnuts, coconut, and pumpkin seeds makes for a fantastic oat-like flavor (see my recipe for paleo porridge, “oatmeal” cookies, and apple crisp for examples).

Finely Shredded Coconut—This is also a good bulking ingredient, similar to ground nuts and seeds but with a slightly different texture and flavor.  Because of the fiber content, it will absorb a little liquid (although nothing like coconut flour), so it does behave slightly differently than other nuts and seeds.

Vegetable Powders—Pumpkin, carrot, spinach, sweet potato, winter squash, red cabbage, and beet powders are all available.  I have only used a handful of these in pancake recipes, but I think these are a very fun way to deal with recipes where you want the sweetness and maybe flavor of these vegetables but are struggling with too many wet ingredients.  These are also a great way to add natural color to recipes (usually you can use little enough that these contribute color but not flavor).

Pureed Green Plantain—This is my newest secret weapon in paleo baking.  Green plantains are very starchy, have a fairly neutral flavor and can act as a binder and give bulk to a recipe.  I have several recipes that use green plantains and many more ideas for this versatile fruit!   Check out my Perfect Paleo Pancakes, Paleo Crepes, and Decadent Double Chocolate Cookie recipes for examples. Watch this video from my YouTube Channel to learn more about green plantains. Ripe plantains are another option, but behave quite differently in baking (sweeter, more flavorful, act more as a binder than a flour).

Pureed or Ground Root Vegetables —Don’t underestimate the versatility of canned or pureed root vegetables in your baking.  And you aren’t limited to canned pumpkin.  Sweet potato, yucca, taro, parsnip, carrot, winter squash, and plantain are all good options (see my recipe for paleo biscuits for an example).  When cooked and pureed, they can both act as a binder and add bulk to a recipe (see my spinach brownies or pumpkin gingerbread muffin recipes as examples).  When ground and raw, they have a very different effect on texture (see my carrot parsnip muffins for an example).  They also can add some sweetness without the use of sugars and the flavors are often well camouflaged by other ingredients.

So, which one do you use?  The classic is to use almond flour on its own or in conjunction with arrowroot, tapioca and/or coconut flour as a first attempt in a recipe.  The reason why this is so common is because the ingredients are fairly easy for most people to find and they are fairly predictable in how they will behave in recipes.  And while I encourage you to play with the other flour substitute options, to get you started on your paleofying adventure here is my basic formula for replacing wheat flour with almond, coconut, arrowroot and/or tapioca flours.

1. For a recipe without many wet ingredients (like cookies):  replace wheat flour with 80-100% almond flour, 0-20% arrowroot or tapioca (depending on whether I want the lightness or the elasticity) and 0-20% coconut flour.  Yes, there is a range here.  I am more likely to use a starch and coconut flour if the volume of flour is fairly high (almond flour is expensive!).

2. For a recipe with substantial wet ingredients (like muffins or cakes):  replace wheat flour with 25% nut flour, 25% coconut flour, 25% arrowroot or tapioca (depending on whether I want the lightness or the elasticity).  Yes, this doesn’t add up to 100%, which is because of the properties of coconut flour.

3. I don’t have a fixed formula for replacing flours when the desired outcome is nut-free.  I just wing it.

4. These are just my first iterations.  Sometimes I change things up as soon as I see the texture and thickness of the batter (that might be harder for you to do if you aren’t used to working with the flours).  After I see what the texture and taste is of my first attempt, I either change quantities or try different flours.  And of course, as I play with other flour substitutes, this may change, my default formulas are likely to change.

I hope this will get you started on your paleofying adventures.  As you play more and more with these ingredients and get to understand their properties better, it will be easier to intuit what will work in any particular recipe.  But, I still have recipes that take me many iterations to get right.  And of course, if you adapt a recipe that is absolutely awesome, you are welcome to contact me using the form on this page to discuss sharing it on the blog.

Paleofying is often used as a derogatory term to describe the process of adapting Neolithic foods, typically desserts and sweet treats, to use only paleo-approved ingredients.  While some people look down on this practice as not addressing the problems of excess carbohydrate consumption and food addiction, I look at it as an important tool—it is a powerful strategy for making paleo accessible and sustainable for the general public.  Eating a restricted diet is much easier when you feel like you can still have birthday cake, can still celebrate a job promotion with a special dessert, can still bring cookies to your kid’s bake sale, can still make pancakes for Sunday brunch, and generally still get to eat delicious foods.  Paleofied baked goods mean that having a treat won’t damage your gut, cause rampant inflammation, or create a cycle of food cravings.  I like the word paleofy.  To me, this represents the union of nutrient-rich, anti-inflammatory “old” foods and modern life.

As we start the lead up to the holiday season, many of us are looking at conventional holiday baked good recipes and wondering how easy those recipes would be to adapt to paleo ingredients.  Yep, I’m doing this too.  Whether these are family favorites or recipes that just look delicious off of pinterest or in magazines, the first step to paelofying is deciding what recipe to start with.  Gluten-free recipes are often a great place to start, as long as the recipe don’t rely too heavily on xanthum gum to hold it together.  Other recipes that are often good bets too are those that use cake flour, use at least a couple of eggs, have dried fruit, have fruit

or vegetable purees, have liquid sweeteners (like honey), or that have fairly large amounts of fat in them.

Paleofying is as much an art as it is a science.  I vaguely remember a time when I did not have extremely well-honed cooking instincts (I think that was back in middle school).  But even starting out as a fairly good cook, there was a steep learning curve to all of these new ingredients and to baking without gluten.  After a year of paleo baking (and blogging!), I have a much better understanding of how to adapt conventional recipes now and thought it was high time I share some of this knowledge and experience with you, in addition to my perfected recipes.

This post is the first in a 4-post series.  In this post, I will discuss paleo flours and other ingredients that add bulk to a recipe.  Part 2 of this series will discuss binders (ingredients that hold baking together).  Part 3 will discuss leavening agents and sweeteners.  Part 4 will discuss some strategies for doing iterations and troubleshooting your recipes.  You may also be interested in some of my posts that reference paleo baking ingredients:  Important Pantry Items for The Paleo Baker, Paleo Flour Substitutes, Sugar vs. Sweeteners, and Is Sugar Paleo?).

I am continuing to expand my paleo baking tool kit by playing with new ingredients.  Below is a list of all the paleo flour substitutes I can think of and other ingredients that add bulk to a recipe.  Some of these are still fairly new to me, so I still have fairly limited experience with them.  Which flour substitute(s) you choose really depends on the type of recipe and what the texture of the finished product should be.  I will try and give you enough information to help get you started.

Blanched Almond Flour—This is the stereotypical paleo flour substitute.  A high quality blanched almond flour (like Honeyville Farms or JK Gourmet) is very finely milled and can be quite light compared to other nut and seed flours or even a less finely milled almond flour (like Bob’s Red Mill, which I consider and almond meal).  Generally, it measures 1:1 when substituting for wheat flour.  It works very well in baking where you want a denser crumb, like muffins, coffee cakes and chewy cookies.  In recipes that also have a fairly large amount of wet ingredients, adding a starch or coconut flour can be helpful.

Almond Meal—This is a less finely ground version of blanched almond flour.  It typically uses the whole almond (like NaturAlmond, Trader Joe’s or Honeyville Farms) but some blanched almond flours (like Bob’s Red Mill) actually qualify more as a meal than a flour.  This is best for breading meat, but also can be used for dense baking like dense cakes (e.g. fruit cake), some cookie recipes and pie crusts.  If you are using almond meal in place of almond flour in a recipe, use slightly less as it tends to be denser.

Coconut Flour—This flour has a very high fiber content and absorbs liquid very efficiently, so it is really only used in recipes that have a large amount of wet ingredients.  Because it makes for a finer crumb than nut flours, I like coconut flour for cake and cupcake recipes.  It is also good for shortbread style cookies.  This is a very tricky flour to work with; often 1tsp can make the difference between the texture you are going for and something completely different.  When doing iterations with recipes that use coconut flour, always make small changes to the amount of flour used.  Always sift coconut flour before adding to your recipe, unless you are blending your batter in a blender or food processor.  When you add coconut flour to wet ingredients, the batter will thicken as it sits for the first few minutes.  It’s always a

good idea to give your batter time to thicken before putting it in the oven.  The general rule of thumb is to replace wheat flour with ¼ the amount of coconut flour.  This will be sufficient for some recipes; but if you need to bulk up your dry ingredients, you can then add some nut or seed flours to bring the volume up a little (a good place to start is with the same volume you are using of coconut flour).  Different coconut flour brands do behave slightly differently depending on how finely they are ground.  I typically use Tropical Traditions brand now but I find that Bob’s Red Mill behaves very similarly.

Arrowroot Powder—This is the dehydrated and ground arrowroot tuber (not the cassava root).  It is mostly a starch and is great for adding lightness to a recipe (also lovely for thickening sauces).  Arrowroot powder can replace corn starch in recipe 1:1.  You can also mix arrowroot powder with very finely ground granulated sugar to make an acceptable substitute for icing/confectioner’s sugar.  If replacing wheat flour with arrowroot flour to add lightness to a recipe, replacing up to ¼ of your flour with arrowroot is typical.  I love using arrowroot in conjunction with coconut flour for cake recipes.  It doesn’t add much hold to baking that don’t have much binding ingredients, though.  I use arrowroot powder frequently enough that I actually use the Subscribe&Save program from amazon to have it automatically shipped to me.

Tapioca Starch—This starch comes from the ground cassava (a.k.a. yucca, yuca, manioc, tapioca) root.  This is not the same as arrowroot powder.  Even though many people use tapioca and arrowroot interchangeably, they actually have fairly different properties in baking.  Tapioca adds elasticity to baking, helping bind as well as giving more bounce (the cassava root is naturally a very slimy starch).  Tapioca nice to use in paleo bread recipes and can be useful in cake recipes as well to give a little more bounce to the baking.  You can replace up to about half of the flour normally called for in a recipe with tapioca (some gluten-free baking replaces all of the flour with tapioca, but tapioca is probably the least healthy of the paleo flours, so I don’t recommend this).  Tapioca also isn’t a very good substitute for corn starch, but would do in a pinch.

Most paleo baking you will find on my site and others use various combinations of the above four flours.  But, these aren’t the only paleo flours out there and there are some really great less-frequently used options to consider.

Plantain Flour—Plantain flour is quickly becoming one of my favorite flours to work with, although I am still experimenting with it.  It is simply ground dehydrated plantain.  It does have a distinct plantain taste so it doesn’t work in all baking.  It has a lovely ability to bind (similar to tapioca starch, but with more of a wheat flour like texture and crumb) and generally can be substitute wheat flour 1:1.  It seems to work very well in soft, cakey and/or chewy baking recipes and not as well if you want some crunch or crispness.  A word of caution.  Some flour are labeled as plantain flour but actually contain a mix of different tubers, often containing potato starch in addition to plantain flour.   If you are buying this from a store, make sure to check the ingredients label.  I buy Barry Farm plantain flour from amazon.

Sweet Potato Starch—This is sometimes labeled as sweet potato flour, but this fine white powder is actually a processed flour/starch.  It substitutes well for arrowroot, but has almost no ability to hold baking together.  You can use this as a corn starch substitute or in combination with other flours as a flour substitute.  I’m not super enthusiastic about this starch, but it’s a good option if arrowroot is hard for you to find.

Sweet Potato Powder—This is also sometimes labeled as sweet potato flour, which can be very confusing.  Sweet potato powder is ground dried sweet potatoes and still retains its orange color (sweet potato starch is white).  This is a more interesting flour because it has some fiber and can absorb liquid so it has more ability to hold baking together.  I have used it in pancakes and have played with it as a flour substitute for brownies.  I’m still getting familiar with this flour, but it’s definitely a neat one to play with.

Kuzu Starch—I am just starting to play with kuzu starch (which is ground dehydrated kuzu root, used in Asian cooking).  Apparently, it is even better than arrowroot at thickening and I’m hoping that it will be useful to help get a few recipes I’m working on a little firmer in texture.

Sunflower Seed Flour—For those allergic to nuts or just almonds, sunflower seed flour can be used the same as almond flour (it can be a little denser depending on brand, so you might need to pull back the amount somewhat).  It has the fun property of turning green when used in baking that also contains baking soda (it’s totally safe to eat when it does this).

Hazelnut Flour—This can also be used the same as almond flour, but yields a different flavor to the baking.

Chestnut Flour—This can also be used the same as almond flour, but yields a different flavor to the baking.  It has a  more hold than almond flour, which is very handy, so you can easily use this flour on its own in some recipe.  It’s also quite a bit sweeter so you may want to reduce the sweet ingredients in your recipe if you are using this.

Pumpkin Seed Flour—This is another seed alternative to almond flour.  Pumpkin seed flour measures more closely to almond flour due to its higher protein content.  Also has a distinct flavor and slightly green color and is easier to make at home than most other nut flours.

Ground nuts and seeds—Ground nuts and seeds are a wonderful way to add more texture and bulk to making.  Many of them can help act as binders as well.  Mostly, you’ll be grinding your own in a food processor or blender.  A finer grind will act more like a nut flour, but you can also grind more coarsely which replicates the texture of oatmeal or other whole grain ingredients very well.  Making a mix of different nuts can replicate the flavor and texture of oatmeal and can help fix texture problems when working on denser baking recipes like cookies and muffins.  Ground flax seed also qualifies here as a way to add bulk and texture to baking and is an excellent binder too.  Chia seeds are often used similarly to flax seeds but these are a pseudograin, and Prof. Loren Cordain comes down pretty hard on chia in The Paleo Answer.  My favorites to use are Whole Almonds, Pecan Halves , Walnuts Halves ,  Macadamia Nuts , Hazelnuts (Filberts) , Pistachios , Cashews, Brazil Nuts , Pepitas (hulled pumpkin seeds) , Sunflower Seeds , Brown Sesame Seeds , Black Sesame Seeds , and ground flax seed (golden or regular, which act the same but just look different).  The combination of walnuts, coconut, and pumpkin seeds makes for a fantastic oat-like flavor (see my recipe for paleo porridge, “oatmeal” cookies, and apple crisp for examples).

Finely Shredded Coconut—This is also a good bulking ingredient, similar to ground nuts and seeds but with a slightly different texture and flavor.  Because of the fiber content, it will absorb a little liquid (although nothing like coconut flour), so it does behave slightly differently than other nuts and seeds.

Vegetable Powders—Pumpkin, carrot, spinach, sweet potato, winter squash, red cabbage, and beet powders are all available.  I have only used a handful of these in pancake recipes, but I think these are a very fun way to deal with recipes where you want the sweetness and maybe flavor of these vegetables but are struggling with too many wet ingredients.  These are also a great way to add natural color to recipes (usually you can use little enough that these contribute color but not flavor).

Pureed Green Plantain—This is my newest secret weapon in paleo baking.  Green plantains are very starchy, have a fairly neutral flavor and can act as a binder and give bulk to a recipe.  I have several recipes that use green plantains and many more ideas for this versatile fruit!   Check out my Perfect Paleo Pancakes, Paleo Crepes, and Decadent Double Chocolate Cookie recipes for examples. Watch this video from my YouTube Channel to learn more about green plantains. Ripe plantains are another option, but behave quite differently in baking (sweeter, more flavorful, act more as a binder than a flour).

Pureed or Ground Root Vegetables —Don’t underestimate the versatility of canned or pureed root vegetables in your baking.  And you aren’t limited to canned pumpkin.  Sweet potato, yucca, taro, parsnip, carrot, winter squash, and plantain are all good options (see my recipe for paleo biscuits for an example).  When cooked and pureed, they can both act as a binder and add bulk to a recipe (see my spinach brownies or pumpkin gingerbread muffin recipes as examples).  When ground and raw, they have a very different effect on texture (see my carrot parsnip muffins for an example).  They also can add some sweetness without the use of sugars and the flavors are often well camouflaged by other ingredients.

So, which one do you use?  The classic is to use almond flour on its own or in conjunction with arrowroot, tapioca and/or coconut flour as a first attempt in a recipe.  The reason why this is so common is because the ingredients are fairly easy for most people to find and they are fairly predictable in how they will behave in recipes.  And while I encourage you to play with the other flour substitute options, to get you started on your paleofying adventure here is my basic formula for replacing wheat flour with almond, coconut, arrowroot and/or tapioca flours.

1. For a recipe without many wet ingredients (like cookies):  replace wheat flour with 80-100% almond flour, 0-20% arrowroot or tapioca (depending on whether I want the lightness or the elasticity) and 0-20% coconut flour.  Yes, there is a range here.  I am more likely to use a starch and coconut flour if the volume of flour is fairly high (almond flour is expensive!).

2. For a recipe with substantial wet ingredients (like muffins or cakes):  replace wheat flour with 25% nut flour, 25% coconut flour, 25% arrowroot or tapioca (depending on whether I want the lightness or the elasticity).  Yes, this doesn’t add up to 100%, which is because of the properties of coconut flour.

3. I don’t have a fixed formula for replacing flours when the desired outcome is nut-free.  I just wing it.

4. These are just my first iterations.  Sometimes I change things up as soon as I see the texture and thickness of the batter (that might be harder for you to do if you aren’t used to working with the flours).  After I see what the texture and taste is of my first attempt, I either change quantities or try different flours.  And of course, as I play with other flour substitutes, this may change, my default formulas are likely to change.

I hope this will get you started on your paleofying adventures.  As you play more and more with these ingredients and get to understand their properties better, it will be easier to intuit what will work in any particular recipe.  But, I still have recipes that take me many iterations to get right.  And of course, if you adapt a recipe that is absolutely awesome, you are welcome to contact me using the form on this page to discuss sharing it on the blog.

So, What Exactly IS Paleolithic Nutrition?

I generally find that most people back away slowly when I start talking about this great new way of eating I’ve found.  My husband acts like I’ve joined a cult or something.  I like to think that I am too critical of a thinker for that and that, although he is one of my heroes, I would not follow Robb Wolf to an alien spaceship in the sky.  But I digress.

As I mentioned before, it wasn’t just weight loss that led me to paleolithic nutrition.  I suffered health issues, from IBS to migraines to asthma to psoriasis to anxiety, not to mention a worthless immune system (which is very inconvenient when living in the petri dish like environment that life with two young kids emulates).  Paleolithic nutrition can completely resolve these conditions (which it has for me already) as well as many others.  It also dramatically reduces your risk factors for cardiovascular disease, diabetes, Alzheimer’s and cancer.

How does a diet address so many different health issues?  These diseases have root causes in common; including gut irritation, high baseline inflammation and insulin sensitivity problems.

So what do you get to eat?  The short answer is fresh, whole foods, including meat, poultry, fish, eggs, vegetables of all kinds, fruits, nuts and seeds.  There are ALOT of wonderful meals you can make using these foods.

What foods do you avoid?  Don’t be afraid.  This sounds worse than it is.  A paleolithic diet avoids all grains, legumes (including soy and peanuts), dairy (except butter, ghee and heavy cream), modern vegetable oils (like safflower and canola), and processed foods.

A few other important factors are avoiding excessive salt, refined sugars, too many carbohydrates (but this doesn’t need to be a low carb diet!) and also trying to balance omega-3 vs. omega-6 fatty acid intake.  I’ll cover each of these in detail in future posts.

Why these foods? A paleolithic diet is one where you eat modern foods similar to what humans ate over the 2.5 million of years of evolution from apes.  The hypothesis is that these are the foods that our bodies evolved to use for optimum health.  As such, a paleolithic diet  avoids eating foods that only became part of the human diet after the agricultural revolution 10000 years ago, which coincides with the advent of the “diseases of civilization ” (such as cancer, diabetes and cardiovascular disease).  The rationale is that the diet and lifestyle of hunter-gatherers is responsible for their apparent health (although they did still lead dangerous, brutal lives).  While we can’t truly test the hypothesis that these foods are what kept cavemen so healthy, there is a wealth of scientific research to support that the foods excluded in the paleo diet are, at best, nutritionally poor and, at worst, harmful to the lining of the gut, disruptive of normal hormone levels, and proinflammatory.  This way of eating protects the digestive system from harmful proteins that cause inflammation (like gluten), protects the kidneys, liver and pancreas from getting overworked and restores balance to your body.

There are many ways to implement paleolithic nutrition, so you can really make this work for your specific needs. As I tweak my own implementation, I am enjoying learning about the detailed biochemistry and physiology of why certain foods are good and others are bad.  If you are also a nutrition nerd, there are some great websites out there to peruse.  I suggest starting with www.thepaleodiet.com, www.robbwolf.com, and www.paleodietlifestyle.com.

What Is The Paleo Diet?

The Paleo diet is the healthiest way you can eat because it is the ONLY nutritional approach that works with your genetics to help you stay lean, strong and energetic! Research in biology, biochemistry, Ophthalmology, Dermatology and many other disciplines indicate it is our modern diet, full of refined foods, trans fats and sugar, that is at the root of degenerative diseases such as obesity, cancer, diabetes, heart disease, Parkinson’s, Alzheimer’s, depression and infertility. – Robb Wolf Okay To Eat AvoidFruits DairyVegetables GrainsLean Meats Processed Food & SugarsSeafood LegumesNuts & Seeds StarchesHealthy Fats Alcohol

Building A Healthy Paleo Diet

Lean proteins

Lean proteins support strong muscles, healthy bones and optimal immune function. Protein also makes you feel satisfied between meals.

Fruits and Vegetables

Fruits and vegetables are rich in antioxidants, vitamins, minerals and phytonutrients that have been shown to decrease the likelihood of developing a number of degenerative diseases including cancer, diabetes and neurological decline.

Healthy fats from nuts, seeds, avocados, olive oil, fish oil and grass-fed meat

Scientific research and epidemiological studies show that diets rich in Monounsaturated and Omega-3 fats dramatically reduce the instances of obesity, cancer, diabetes, heart disease and cognitive decline.

Saturated fat has been demonized by our health authorities and media. What is the basis for this position on Saturated fat? Are current recommendations for VERY low saturated fat intake justified? How much saturated fat (and what types), if any should one eat? Without a historical and scientific perspective these questions can be nearly impossible to answer. In this paper Prof. Cordain looks at the amounts and types of saturated fats found in the ancestral diet:Saturated fat consumption in ancestral human diets: implications for contemporary intakes.

One of the greatest deviations away from our ancestral diet is the amounts and types of fat found in modern grain feed animals vs. the amounts and types of fats found in grass fed or wild meat, fowl and fish. What we observe is wild meat is remarkably lean, and has relatively low amounts of saturated fats, while supplying significant amounts of beneficial omega-3 fats such as EPA and DHA. In this paper Prof. Cordain and his team analyze the complete fatty acid profile from several species of wild deer and elk. The take home message is that free range meat is far healthier than conventional meat: Fatty acid analysis of wild ruminant tissues: Evolutionary implications for reducing diet-related chronic disease.

Image courtesy of The Food Lovers’ Primal Palate - http://www.primal-palate.com

Health Benefits of a Paleo Diet

For most people the fact the Paleo diet delivers the best results is all they need. Improved blood lipids, weight loss, and reduced pain from autoimmunity is proof enough.  Many people however are not satisfied with blindly following any recommendations, be they nutrition or exercise related. Some folks like to know WHY they are doing something. Fortunately, the Paleo diet has stood not only the test of time, but also the rigors of scientific scrutiny.

With a very simple shift we not only remove the foods that are at odds with our health (grains, legumes, and dairy) but we also increase our intake of vitamins, minerals, and antioxidants. Here is a great paper from Professor Loren Cordain exploring how to build a modern Paleo diet: The nutritional characteristics of a contemporary diet based upon Paleolithic food groups. This paper also offers significant insight as to the amounts and ratios of protein, carbohydrate and fat in the ancestral diet.

Come on! Our Ancestors lived short, brutal lives! This Paleo Diet is all bunk, right?

The Paleo concept is new for most people and this newness can spark many questions. We like people to not only read about and educate themselves on this topic but also to “get in and do it.” Experience is perhaps the best teacher and often cuts through any confusion surrounding this way of eating. Now, all that considered, there are still some common counter arguments to the Paleo diet that happen with sufficient frequency that a whole paper was written on it. Enjoy:Evolutionary Health Promotion. A consideration of common counter-arguments.

Does it work for diabetes?

A great question to ask is “Does the Paleo diet work?” Here we have a head to head comparison between the Paleo diet and Mediterranean diet in insulin resistant Type 2 Diabetics. The results? The Paleo diet group REVERSED the signs and symptoms of insulin resistant, Type 2 diabetes. The Mediterranean diet showed little if any improvements. It is

worth noting that the Mediterranean diet is generally held up by our government as “the diet to emulate” despite better alternatives. You can find an abstract and the complete paper here.

Cardio Vascular Disease

According to the CDC, cardiovascular disease is the number one cause of death in the United States. Interestingly however, our Paleolithic ancestors and contemporarily studied hunter-gatherers showed virtually no heart attack or stroke while eating ancestral diets. The references below will explore these facts to better help you understand the heart-healthy benefits of a Paleo diet.

Autoimmunity

Autoimmunity is a process in which our bodies own immune system attacks “us.” Normally the immune system protects us from bacterial, viral, and parasitic infections. The immune system identifies a foreign invader, attacks it, and ideally clears the infection. A good analogy for autoimmunity is the case of tissue rejection after organ donation. If someone requires a new heart, lung kidney or liver due to disease or injury, a donor organ may be an option. The first step in this process is trying to find a tissue “match”. All of us have molecules in our tissues that our immune system uses to recognize self from non-self. If a donated organ is not close enough to the recipient in tissue type the immune system will attack and destroy the organ. In autoimmunity, a similar process occurs in that an individuals own tissue is confused as something foreign and the immune system attacks this “mislabeled” tissue. Common forms of autoimmunity include Multiple Sclerosis, Rheumatoid Arthritis, Lupus, and Vitiligo to name only a tiny fraction of autoimmune diseases. Elements of autoimmunity are likely at play in conditions as seemingly unrelated as Schizophrenia, infertility, and various forms of cancer.

Interestingly, all of these seemingly unrelated diseases share a common cause: damage to the intestinal lining which allows large, undigested food particles to make their way into the body. This is called “leaky gut and the autoimmune response”. Here is a 7-part video series by Prof. Loren Cordain describing the etiology of Multiple Sclerosis. And please watch this TED talk by Dr. Terry Wahls, MD as she describes how she reversed her Multiple Sclerosis with a paleo diet. If you have an autoimmune disease you might consider trying the autoimmune protocol of the paleo diet. If you do, please tell us about your experience.

How Long Does it Take the Gut to Repair after Gluten Exposure?

This is a very relevant question for those who are just embarking on their gluten-free journey.  But, it’s also extremely important for anyone who has been following a paleo/primal/gluten-free diet for a while, but has been inadvertently exposed to gluten.  It sometimes feels as though the longer we avoid gluten, the more sick we feel after accidentally eating some.  This is in large part because the body stops protecting itself from gluten (for example, there may be less mucus in the gut) so when we do consume some, we are defenseless.  It may also be because we forget how we used to feel and are so used to feeling so much healthier.   Whether you are new to paleo or have been eating this way for a while, a common question is:  how long does it take the gut to heal after gluten exposure? 

I have talked about the irritation, inflammation and damage to the lining of the small intestine that can be caused gluten (I promise I will go back and add references to this post soon) and I have mentioned that it can take up to 6 months for the body to fully heal after a single gluten exposure.  After delving into the research more thoroughly, I have discovered that this statement is simultaneously a gross understatement and an overstatement.  Just like the extent of damage that gluten causes varies from individual to individual (see this post for a little bit more on variability in tolerance), so does the length of time it takes to recover.  And it’s not as simple as the more damage you have, the longer it takes to recover.  There are factors that control how sensitive you are (genetics, overall health, diet, stress, nutritional-deficiencies, gut microflora) and there are factors that affect how quickly you heal (okay, it’s the same list of factors, but it’s more complicated than A+B=C).

The cells that line the gut, called enterocytes or gut epithelial cells are organized into hills and valleys (to help maximize the surface area of the gut), forming finger-like columns of cells called villi separated by valleys called crypts.  The enterocytes are constantly regenerating themselves (a pool or resident stem cells supplies the new enterocytes).  As the cells age, they migrate higher up the villi and are eventually shed into the gut to be redigested (yes, we are constantly cannibalizing ourselves).  This is called the “turnover” of the gut epithelium.  In the normal healthy gut, the enterocytes migrate to the top of the villi in in 1-4 days, meaning that all of the villi cells are replaced with new cells every 3-5 days (this gets slower as we age) 1,2,3.  The cells that migrate toward the bottom of the crypts have a longer lifespan of 2-3 weeks.  What does this mean?  A healthy person has an entirely new intestinal lining every 2-3 weeks.

Repairing the intestine following injury (whether that is caused by ingested toxins, infection, or some other injury) is a more involved and complex process that is tightly regulated and controlled by the body (for a detailed understanding of this process, see reference 4).  The healing time varies depending on the extent of injury and studies trying to understand the role of the resident stem cells of the gut show that repair of the crypt and villi structure of the intestinal wall after injury can take anywhere from 2 to 12 weeks (depending on whether the stem cells themselves are injured) in the absence of confounding factors 4,5.

What does this mean?  For healthy individuals without celiac disease or gluten sensitivity (where their bodies are producing antibodies against gluten), the damage to individual cells and the junctions between them that can be caused by gluten is relatively fast to heal, anywhere from a few days to 3 weeks.  For these healthy individuals, most of this time is likely asymptomatic.  Many people report symptoms that only last from a couple of hours to a couple of days after gluten exposure.  This also means that healthy individuals should be able to heal their guts completely after following a 30-day paleo challenge such as a Whole30.

For those with confounding factors, healing is slower. Confounding factors are numerous and include gluten sensitivity (where the body is producing antibodies against gluten which increases inflammation and slows healing), celiac disease (an autoimmune condition), uncontrolled inflammation in the gut (which could be caused by food allergies, food

sensitivities or diseases such as Inflammatory Bowel Disease), nutritional deficiencies (which can be caused by having a very inflamed and damaged gut, but slows healing because not all of the raw materials needed to repair are available), gut dysbiosis (the wrong type, amount and/or location of microorganisms in the gut), infections, stress, body-wide inflammation, and chronically elevated insulin.

How much do these confounding factors slow healing?  The extreme end of the spectrum is those with Celiac Disease, an autoimmune condition triggered by gluten exposure.  One hallmark of Celiac Disease is a shortening or blunting of the intestinal villi which is observed by performing a biopsy of the small intestine (they are typically 3-5 times longer in healthy individuals than those with Celiac Disease).  For those with celiac disease, one study showed that only 66% of patients had a normal intestinal biopsy after 5 years on a gluten-free diet 6.  This means that even after 5 years, 34% of Celiac Disease sufferers had not recovered.  There are no good similar studies evaluating intestinal repair in people with non-celiac gluten-sensitivity, but medical professionals who specialize in treating gluten-sensitivity report time frames of approximately 1½-2 years 7.

It’s probably worth mentioning here that current reports suggest that both Celiac Disease and gluten-sensitivity are ridiculously underdiagnosed.  It is estimated that 1 in every 100 Americans suffer from Celiac Disease but only 5% are ever diagnosed 8.  This means that there is something like 2.5-3 million Americans with celiac disease that have no idea that they have it (when you extrapolate this statistic globally, it’s even scarier!).  Gluten intolerance is estimated to affect 15-20% of the population 9.  The take home message here?  Even if you have never been diagnosed with celiac disease or gluten intolerance, you may have one of these conditions which could be contributing to slowed intestinal repair after switching to a paleo diet or after accidental gluten exposure.

How much gluten can cause a problem?  This is highly individual.  For those with Celiac disease (whether confirmed or undiagnosed), even a minute amount of gluten can cause significant damage to the small intestine in the majority of sufferers 10.  Interestingly, a not unsubstantial percentage of these people (22%) will have significant damage to their small intestine but not suffer any gastrointestinal symptoms.  For healthy individuals, the threshold amount to suffer symptoms is highly variable.  Unfortunately, you don’t know until you test it on yourself.

So, how long does it take the gut to repair after gluten exposure?  Once again, like so many topics I cover on this blog, the answer is “it depends”.  For healthy individuals, healing likely takes only a couple of weeks.  For those with celiac disease (and perhaps autoimmune diseases in general), fully healing the lining of the small intestine may take years.  The rest of us can be anywhere in between.

1 Creamer B et al. “The turnover and shedding of epithelial cells–Part I The turnover in the gastro-intestinal tract”. Gut 1961 2: 110-116

2 Lipkin M et al. “Cell Proliferation Kinetics In The Gastrointestinal Tract Of Man. I. Cell Renewal In Colon And Rectum” J Clin Invest. 1963 June; 42(6): 767–776.

3 Godlewski MM et al “Into the Unknown–The Death Pathways in the Neonatal Gut Epithelium”  Current Pediatric Reviews. 2011. 7(4):337-345

4 Blikslager AT et al. “Restoration of Barrier Function in Injured Intestinal Mucosa” Physiol Rev 87:545-564, 2007.

5 Booth C and Potten CS “Gut instincts: thoughts on intestinal epithelial stem cells” J Clin Invest. 2000;105(11):1493–1499.

6 Rubio-Tapia A “Mucosal recovery and mortality in adults with celiac disease after treatment with a gluten-free diet.” Am J Gastroenterol. 2010 Jun;105(6):1412-20.

7 http://glutendoctors.blogspot.com/2010/04/healing-time-after-removing-gluten.html

8 Lohi S et al. “Increasing prevalence of coeliac disease over time.” Aliment Pharmacol Ther. 2007 Nov 1;26(9):1217-25.

9 http://www.gastroendonews.com/ViewArticle.aspx?d=In%2Bthe%2BNews&d_id=187&i=October%2B2010&i_id=672&a_id=16015

10 Lähdeaho ML et al. “Small- bowel mucosal changes and antibody responses after low- and moderate-dose gluten challenge in celiac disease.” BMC Gastroenterol. 2011 Nov 24;11:129.

What Is A Leaky Gut? (And How Can It Cause So Many Health Issues?)

One of the fundamental principles of paleolithic nutrition is avoiding foods that damage the lining of the gut. Essentially, the gut is just a long, wrinkly tube. Inside this tube, food is digested by enzymes and friendly resident bacteria, breaking down the components of our food to their simplest forms: proteins are broken down into amino acids; carbohydrates are broken down into monosaccharaides; and, fats are broken down into fatty acids. What can’t be digested by our bodies is excreted as waste. Amazingly, a single layer of highly specialized cells (called enterocytes) is all that separates the inside of the tube from the outside. These enterocytes have two very specific jobs: 1) transport the digested nutrients from the “inside-the-gut” side of the cell to the “outside-the-gut” side of the cell; and 2) keep everything else on the inside of the tube. Immediately outside this tube are two important parts of the digestive system: 1) the resident immune cells of the gut whose job it is to protect against pathogens which might accidentally find their way through the enterocytes; and 2) a network of blood vessels and lymphatic vessels that carry the digested nutrients from our food to the tissues in our body that need them (amino acids and monosaccharaides are transported through the blood while fatty acids are transported through the lymphatic system).

A “leaky gut” occurs when either the enterocytes are damaged or the proteins that form the tight bond between these cells and hold them together as a solid layer are damaged (or altered). When this happens, it creates microscopic holes through which some of the contents of the gut can leak out into the blood stream or lymphatic system. What leaks out isn’t big chunks of food. Instead, it’s a combination of many different pathogens: incompletely digested proteins, bacteria or bacterial fragments from those friendly bacteria that are supposed to stay inside your gut, or a variety of toxic substances or waste products that would normally be excreted. When these pathogens leak out, the resident immune cells of the gut recognize them as foreign invaders and mount a response against them (when large quantities of pathogens leak out, other parts of the body, especially the liver, also contribute to the response). Exactly what leaks out, and how much, determines the precise nature of this immune response.

 Some pathogenic substances (like bacterial fragments and toxins) cause generalized inflammation by triggering the release of chemicals called inflammatory cytokines (the chemical messengers that circulate in the blood and tell white blood cells to attack). This type of inflammation has no target so any cell in the body can be an innocent victim. It is the liver’s job to both control this type of inflammation and to filter out the toxins that may be triggering it. When the liver is overworked, the toxins build in the body and the inflammation spreads. This type of inflammation can be a major contributor to health issues ranging from psoriasis and asthma to ADHD and depression.

Other substances (like incompletely digested proteins) cause specific inflammation, which can take the form of an allergy or an auto-immune disease. An allergy is caused by immune cells creating IgE-type antibodies targeting a part of a protein that is specific to the food it originated from (like an antibody targeting the casein in milk resulting in a milk allergy). A very similar type of immune response is caused by immune cells creating IgA-, IgM- or IgG-type antibodies targeting a part of a protein that is specific to the food it originated from. This type of immune response is technically considered a food sensitivity (and not an allergy), and can cause both allergy-type symptoms and symptoms that you might not normally attribute to an allergy, such as: pain, fatigue, and eczema. It is also the formation of these types of antibodies that can cause auto-immune diseases. Antibodies target only a short sequence of amino acids, and not all of the amino acids that form an individual protein. In the case of food allergies and sensitivities, this short sequence of amino acids is still specific to the food it originated from. But, sometimes the antibodies that form in response to “leaked-out” proteins target a sequence of amino acids that isn’t unique to that protein, but instead is a sequence of amino acids also found in many other normal proteins in the human body. When this happens, the body attacks itself thinking its own cells are foreign invaders. For example, an antibody could form against a sequence of amino acids that is found in the insulin-secreting beta cells of the pancreas. When the body attacks those cells, it causes Type I Diabetes. An

enormous range of autoimmune diseases can be caused in this way, from lupus to celiac disease to Graves’ disease (many of which include genetic susceptibility as confounding factor).

It is important to know that, for some individuals, a leaky gut can develop slowly over years or decades. Stress, sleep-deprivation and/or some infections can make matters worse very quickly (and unpredictably). Once you have a leaky gut, it is only a matter of time before related health conditions begin to crop up. Depending on the extent of the damage to the gut lining, the exact substances that leak out, and your specific genetics, the inflammation and immune reactions caused by having a leaky gut can add up to any of a huge variety of different health conditions, many of which can be life-threatening. This is why the gut-friendly, anti-inflammatory paleo diet is known to address so many different health issues: if your gut is healthy, then so are you.

How Do Grains, Legumes and Dairy Cause a Leaky Gut? Part 1: Lectins

One of the fundamental principles of paleolithic nutrition is to protect the lining of the gut by eliminating foods that damage it.  By prioritizing gut health, we are able to treat and prevent the many health issues associated with having a “leaky gut”.  But how exactly do grains, legumes and dairy wreak so much havoc on the digestive tract?  There are several ways in which these foods create holes in the gut lining.  The best understood is the damage caused by lectins.

Grains and legumes contain lectins.  Lectins are a class of proteins found in many types of seeds (like wheat, oats, barley, rice, peanuts, soy, etc.) that are part of the plant’s natural defense mechanism.  A digested seed is not one that can grow a new plant.  To defend itself, the seed from these plants either deter predators (like us) from eating them by making us sick or resist digestion completely or both.  The grains and legumes that have become a part of the human diet since the Agricultural Revolution 10,000 years ago aren’t toxic enough to make most of us severely ill immediately after eating them (otherwise humans never would have domesticated them!).  Instead, their effects are more subtle and can take years to manifest as a life-threatening disease.  You may be wondering why other seeds (like the ones in berries or kiwi or bananas) are okay to eat.  These come from plants with a friendlier defense strategy:  we get to eat the delicious fruit encasing the seeds and then the seeds, which pass through our digestive tracts intact, get to be planted in rich manure.  How do you know the difference between a harmless seed and one that contains damaging lectins?  Here’s the rule:  if you can eat it raw, then it’s okay to eat.  If you have to cook it, it has damaging lectins. 

Lectins are not broken down in the normal digestive process, both because the structure of these proteins are not compatible with our bodies’ digestive enzymes but also because the foods that contain these lectins also contain protease inhibitors (compounds that stop the enzymes from breaking down proteins; more on these in Part 2).  Lectins, which remain largely intact throughout the digestive tract, can damage the gut lining in several ways.  First, lectins trick the enterocytes (the cells that line the gut) into thinking they are simple sugars.  The enterocytes “willingly” transport the lectins from the “inside-the-gut” side of the cell to the “outside-the-gut” side of the cell.  While in transit, the lectins may cause changes inside the enterocyte that either kill the cell or render it ineffective at its job, which leads to more pathogens leaking out of the gut.  Once outside the gut, these lectins activate the resident immune cells of the gut which respond by producing inflammatory cytokines (the chemical messengers that circulate in the blood and tell white blood cells to attack) and antibodies against these foreign proteins.  Because at least part of this response is not specific to the lectin itself, the enterocytes (being the closest innocent bystanders) can be targeted and killed by the body’s immune cells, leading to the microscopic holes that create a leaky gut.

 Gluten is both the best known example of a lectin, and also the most damaging.  In many individuals (like those with diagnosed gluten sensitivity and celiac disease), gluten can weaken the connections between enterocytes, essentially creating a space in between the cells through which gut contents can leak through, adding yet another way that this particular lectin can cause a leaky gut.  Once gluten has passed through the gut lining, it stimulates the resident immune cells of the gut to start producing antibodies.  Gluten is especially insidious because parts of this protein closely resemble many proteins in the human body, so there’s a high likelihood that some of the antibodies produced to target it will also target human cells.  One extremely commonly formed antibody is one against our enzyme transglutaminase. Transglutaminase is an essential enzyme in every cell of the body, which makes important modifications to proteins as they are produced inside the cell.  It also stimulates wound healing, but if antibodies have formed against it, then when it is secreted by damaged cells in inflamed areas of the small intestine (or any other damaged tissue in the body), rather than helping to heal the surrounding tissue, it instead turns it into a target of the immune system.  This is yet another way in which gluten can cause a leaky gut.  Importantly, when antibodies against transglutaminase form, every cell and organ in the body becomes a potential target.  Because an exaggerated sensitivity to gluten is the cause of Celiac Disease, which affects at least 1 in 133 people, its effects on the gut have been the most studied.  Scientists still don’t know which of the many ways that gluten can harm the body apply to all lectins and which are specific to gluten.

Gluten sensitivity has already been linked to dozens of autoimmune diseases.  Even in individuals who do not have celiac disease or gluten sensitivity, it can take up to six months for the gut to fully heal after a single gluten exposure.  While other lectins may not be quite as

damaging as gluten, scientists continue to discover new ways in which foods that contain lectins can contribute to a leaky gut, inflammation and autoimmune diseases.

How Do Grains, Legumes and Dairy Cause a Leaky Gut? Part 2: Saponins and Protease Inhibitors

One of the fundamental principles of paleolithic nutrition is to protect the lining of the gut by eliminating foods that damage it.  By prioritizing gut health, we are able to treat and prevent the many health issues associated with having a “leaky gut”.  But how exactly do grains, legumes and dairy wreak so much havoc on the digestive tract?  The damage caused by the lectins contained in grains and legumes (see Part 1) is made even worse by two other compounds found in these foods:  saponins and protease inhibitors.Legumes and pseudo-grains (like quinoa and amaranth) are high in saponins.  All plants contain saponins, often concentrated in the seed of the plant.  These compounds have detergent-like properties and are designed to protect the plants from consumption by microbes and insects by dissolving the cell membranes of these potential predators.  Saponins consist of a fat-soluble core (having either a steroid or triterpenoid structure) with one or more side chains of water-soluble carbohydrates (this combination of both a water-soluble and a fat-soluble component is what makes saponin act like a detergent, i.e., something that can make oil and water mix).  This detergent-like structure gives saponins the ability to interact with the cholesterol molecules imbedded in the surface membrane of every cell in the body and rearrange those cholesterol molecules to form a stable, pore-like complex.  Basically, dietary saponins create holes in the surface membrane of the cells which line the gut (enterocytes), allowing a variety of substances found in the gut to enter the cell.

There are many different types of saponins, and some bind more easily and more tightly to the cholesterol molecules in the cell membrane than others.  As such, different saponins can create larger or smaller pores, which may be more or less stable.  The larger, more stable and/or more numerous the pores, the more difficult it is for the enterocyte to recover.  Small doses of some dietary saponins (like those found in fruits and vegetables) might be important for aiding absorption of some minerals.  However, legumes, and pseudo-grains contain very high doses of saponins (and, in general, contain types of saponins that interact more strongly with cholesterol).  Dietary saponins from these foods are known to increase the permeability of the gut (i.e., cause a leaky gut), likely by killing enterocytes (cells, in general, do not survive large, irreversible changes in membrane permeability).  Interestingly, even when a sub-lethal amount of saponin pores form in the enterocyte surface membrane, the cell loses its ability to actively transport nutrients, especially carbohydrates.  While slowing down sugar transport from the gut to the bloodstream seems like a great thing on the surface (why beans are so often recommended as a carbohydrate source for diabetics!), the irreversible increase in gut permeability is just not worth it! 

 When large amounts of dietary saponins are consumed (especially in the presence of an already leaky gut), saponins can leak into the bloodstream.  When saponins enter the bloodstream in sufficient concentrations, they cause hemolysis (destruction of the cell membrane of red blood cells).  Saponins also have adjuvant-like activity, which means that they are able to affect the immune system leading to pro-inflammatory cytokine production (again those chemical messengers that tell white blood cells to attack) and can further contribute to inflammation in the body. 

Grains, pseudo-grains (like buckwheat) and dairy contain protease inhibitors.  Protease inhibitors are the seed’s attempt to escape digestion completely.  These are compounds designed to neutralize the digestive enzymes that would normally degrade the proteins (and toxins) found in those plants into their individual component amino acids.  However, when protease inhibitors are present in the digestive tract, it affects degradation of all proteins present at that time.  When the body senses the need to increase protein digestion, the pancreas secretes more digestive enzymes into the small intestine.  Because some digestive enzymes are being inhibited (the proteases which break down protein) while others are not, the balance between the different digestive enzymes is thrown off.  One enzyme that ends up in excessive quantities during this process is trypsin, an enzyme that is very good at destroying the connections between cells.  If there is a large concentration of trypsin in the small intestine, it can weaken the connections between the enterocytes, creating a pathway for the contents of the gut to leak into the blood stream.  To make matters worse, in the presence of an already leaky gut, incompletely digested proteins that cross the enterocyte layer

stimulate the resident immune cells of the gut to release inflammatory cytokines and produce antibodies.  The result is generalized and/or specific inflammation. 

Dairy is designed to create a leaky gut.  Scientists still don’t understand all the mechanisms through which dairy products can create a leaky gut.  However, it seems to be an important aspect for what dairy is designed to do:  feed babies (of the same species) optimal nutrition for rapid growth.  In newborn infants, a leaky gut is essential so that some components of mother’s milk can get into the blood stream, like hormones and all the antibodies that a mother makes that helps boost her child’s immune system.  While this is essential for optimal health in babies, it becomes a problem in the adult digestive tract where there are more things present that we don’t want to leak into the blood stream.  Drinking milk from a different species seems to make matters worse since the foreign proteins can cause a larger immune response.

The damage to the gut lining caused by saponins has been heavily studied in the context of animal feed for poultry, cattle and fish farms.  But, while there is a better understanding of the damaging effects of dietary gluten (at least in humans), the gut irritation and inflammation that can be caused by saponins and protease inhibitors should not be underrated. 

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Why Grains Are Bad–Part 1

Before committing to paleolithic nutrition, I read a whole lot about it.  I read scientific journal articles, books, and some great blogs.  As I delved deeper and deeper into the reasons why paleolithic nutrition is so remarkably healthful, I found myself learning the detailed physiology and biochemistry behind many aspects of this diet.  Although you don’t need to go into as much detail as I have, much of this information is relevant to you and will help inform your choices as you continue to experiment with a paleolithic lifestyle.  I will try to distill the most salient points for you.  First, up:  Why are grains bad for you?

Grains have a particularly high concentration of two types of lectin.  Lectins are a class of proteins (of which gluten is one) that are present in all plant life to some degree.  Two sub-classes of lectins, prolamins (like gluten) and agglutinins (like wheat germ agglutinin) are of particular concern for human health.  These lectins are part of a plant’s natural protective

mechanism (from predators and pests) and are usually concentrated in the seeds of the plant (which is why grains and legumes have so much).  So what happens when we eat these proteins?  Similar to what occurs in individuals with celiac disease (basically, a super exaggerated form of the sensitivity we all have to gluten and other lectins), these lectins can either damage and kill the cells that line your intestines or directly causes spaces to open up between your gut cells.  This causes little holes in your intestines; so, things that are not supposed to get into your blood stream leak out.  This “leak” is made worse by the fact that lectins bind to sugars and other molecules in the gut and then “help” these random other molecule leak into the blood stream.  There are many things in your gut (like E. coli) that are supposed to stay there; and, when they leak into the blood stream, they cause a low level of systemic inflammation.  This can set the stage for many health conditions, including cardiovascular and auto-immune diseases.

There are many lectins and some are more harmful than others.  Gluten is by far the most damaging lectin, but non-gluten containing grains still contain lectins. Wheat germ agglutinin is a very close second in terms of negative impacts on health (it has the added effect of stimulating inflammation), which is why the simple act of removing wheat from your diet a la Wheat Belly by Dr. William Davis can make such a difference to people’s health.  And while some of the other “blacklisted” foods are okay for occasional consumption (like dairy, beans and rice), I suggest a lifelong dedication to gluten and wheat avoidance.  It can take up to six months for your gut to fully heal after a single gluten exposure (see How Long Does it Take the Gut to Repair after Gluten Exposure?).  Beyond the fact that some lectins are more problematic than others, dose is another important factor here.  The vegetables and fruits that our prehistoric ancestors ate in large quantities are generally very low in lectins (and typically contain lectins that interact much less strongly with the gut barrier than those in grains).  Grains (especially wheat) and legumes (especially soy) are very high in prolamins and agglutinins, the two sub-classes of lectins with the greatest negative impact on the barrier function of the gut (where the gut is supposed to selectively allow digested nutrients from our foods into our body and keep out everything else).  And, if damaging your gut lining and causing systemic inflammation isn’t enough, lectins are also anti-nutrients, which means that they stop you from absorbing many of the vitamins and minerals in your food (like calcium!).  

On top of all this, grains are highly acidic foods (at the level of your kidneys, not your stomach).  Another aspect of paleolithic nutrition is to balance your intake of acidic and alkaline foods (I will expound on acid-base balance in a future post).  Generally, meat, eggs and fish are acidic and we balance this with lots of vegetables and some fruit, which are alkaline.  When grains are in our diet, it is nearly impossible to eat enough alkaline foods to balance this out and the result is strain on the kidneys, liver and pancreas. 

If all this just whets your appetite for more detailed information, I suggest starting with Dr. Loren Cordain’s website http://thepaleodiet.com/ and The Paleo Answer.

Why Grains Are Bad–Part 2

In my opinion, the two most important facets of paleolithic nutrition are to avoid foods that irritate your gut and to balance your omega-3 to omega-6 fatty acid ratio (aiming for 1:1 to 1:2).  Grains have a negative impact on both of these aspects of a paleo diet.  

After reading my post on fat, you might have picked up on an important detail about grains.  Not only do they contain lectins (like gluten) that damage the cells that line your gut, but they are also very high in omega-6 fatty acids.  Grains (including corn) and legumes are high in linoleic acid, the omega-6 fatty acid that seems to be at the root of many modern diseases.  Remember that omega-6 fatty acids contribute to pro-inflammatory pathways in your body and that the huge increase in the proportion of our dietary fat that now comes from omega-6s (instead of omega-3s) is a major player in a wide range of diseases.  

But it gets worse.  These omega-6 fatty acids are concentrated in modern vegetable oils.  Oils derived from grains and legumes (soy, canola, safflower, sunflower, peanut, corn, etc) didn’t exist until the process of mechanical extraction was invented.  So, not only are you consuming omega-6 fatty acids directly from grain-containing foods, but also from the vegetable oils that they are cooked in.  

Another insidious way that grains have negatively impacted human health is with farmed meat.  Cows, pigs, sheep, chickens and even some farmed fish are fed grains.  The meat from these animals no longer contains a balanced 1:1 ratio of omega-3 to omega-6 fatty acids (which they did prior to agriculture).  Instead, it is typically closer to 1:10!  It is not enough just to avoid grains in your diet; you need to be mindful of what you eat that eats grains too.   In a perfect world, we would all eat pasture-fed beef, free-range poultry, wild-caught fish and wild game meat, while also avoiding all grains, legumes and modern vegetable oils.  

When budget becomes an important consideration (like it does for me), I suggest removing sources of omega-6 where affordable, but also focusing more on increasing your intake of omega-3 fatty acids.  One inexpensive way that you can do this by eating omega-3 eggs (the ones I buy have 660mg of omega-3 fatty acids per egg and only cost $2.79 per dozen at my local Kroger) or free-range eggs (which typically have a 1:1.5 omega-3 to omega-6 ratio).  Another way to increase omega-3 in your diet is to eat more wild-caught fish (canned salmon and sardines are a great inexpensive option).  You can also take a fish oil supplement (usually liquid oils are much cheaper than capsules and look for the highest EPA and DHA content for the price).  However you choose to increase your omega-3 consumption, omitting grains from your diet is critical.  There are no mammals in the wild that have grains as part of their diet.  The only group of animals that do well eating grains is birds, which we are not.  

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Modifying Paleo for FODMAP-Intolerance (a.k.a. Fructose Malabsorption)

One of the many challenges that people face when adopting a paleo diet is dealing with the confounding factor of additional food sensitivities. Sometimes these sensitivities are known (perhaps you had allergy testing done at some point or react so violently to certain foods that it was a no-brainer). Sometimes these sensitivities are unknown and make it frustrating when we don’t experience the instant improvements to our health touted by so many paleo enthusiasts. One such sensitivity is FODMAP-intolerance (also referred to as fructose malabsorption). This isn’t a food sensitivity in the sense that there is any sort of immune reaction to these foods. Instead, it is a case of a person who cannot properly digest the fructose (and longer sugar molecules containing fructose) in these foods.

The term FODMAP is an acronym, derived from “Fermentable, Oligo-, Di-, Mono-saccharides and Polyols”. FODMAPs are short chain carbohydrates rich in fructose molecules which, even in healthy people are inefficiently absorbed in the small intestine. I know you’ve heard the limerick “beans, beans, the magical fruit…”; the punchline refers to the large amount of FODMAP carbohydrates in beans (or any of other vegetable that has a reputation for being “gassy”) that are only partially absorbed in the small intestine. When this excess fructose enters the large intestine, which is full of those wonderful beneficial bacteria we love so much, they feed the bacteria allowing for overgrowth of bacteria and excess production of gas. The presence of FODMAPs in the large intestine can also decrease water absorption (one of the main jobs of the large intestine). This causes a variety of digestive symptoms, most typically: bloating, gas, cramps, diarrhea, constipation, indigestion and sometimes excessive belching. In individuals with FODMAP-intolerance, a far greater portion of these sugars enter the large intestine unabsorbed, causing exaggerated symptoms. In fact, some researchers believe that Irritable Bowel Syndrome is purely a case of FODMAP-intolerance 1,2.

Carbohydrates, which are just chains of sugar molecules, are broken down into individual monosaccharides (a single sugar molecule) by digestive enzymes in the small intestine (actually, this sugar digestion process begins with the salivary amylase enzyme in the mouth when you chew, but it continues all the way through the small intestine). Monosaccharides are then absorbed into the blood stream by first being transported through the cells that line the small intestine, the enterocytes. Enterocytes have specialized transporters, or carriers, embedded into the membrane that faces the inside of the gut. These carriers bind to specific sugar molecules and transport them into the cell (where the cell can either use those sugars for energy or transport those sugars to the other side of the cell where they can easily enter the blood stream). FODMAP-intolerance may be due to lack of digestive enzymes required to break longer chains of carbohydrates down to their individual monosaccharides and/or due to an insufficient amount of these carbohydrate carriers, specifically the carrier called GLUT5, which is the specific carbohydrate carrier for fructose (why this is also called fructose malabsorption).

FODMAP-intolerance means that large amounts of dietary fructose and longer carbohydrate chains that are rich in fructose are problematic. These longer, fructose-rich carbohydrate chains are called fructans (inulin, which is a type of fiber, is also rich in fructose and problematic for those with FODMAP-intolerance). Sugar alcohols, called polyols, (sorbitol is an example) are additionally problematic because these sugars have the ability to block GLUT5 carriers (and if you’re working with a deficiency, that’s really not helpful!). Why do some people develop FODMAP-intolerance? Researches don’t know yet. It may be a reaction of the body to high fructose and fructan consumption with the Standard American Diet. It may be a side effect of a very distressed and/or leaky gut. There are also very likely to be genetic factors at play. The good news is that, for many, as their gut and bodies heal, their ability to digest and absorb these sugars improves.

When it comes to modifying your diet to address a suspected FODMAP-intolerance, dose is the key. The type of FODMAP may be important for some people. Some people are more sensitive to the fructose and polyols (due to GLUT5 carrier deficiency) while some are more sensitive to fructans (due to digestive enzyme deficiency). Some people are sensitive to both. How much you can handle is very individual and is likely to change as your gut heals. There are medical tests available to diagnose fructose malabsorption, however an elimination diet approach is more reliable. Research has shown that the removal of FODMAPs from the diet is beneficial for sufferers of irritable bowel syndrome and other functional gut disorders 1.

The following table was created by Aglaée the Paleo Dietitian, and is posted with her permission. It breaks down common foods into three categories: safe (very low to no FODMAP), be careful (low to moderate FODMAP), and avoid (high FODMAP). It also contains which kind of FODMAP is richly present in each food in parentheses (helpful for those who are more sensitive to one versus the other). (Aglaée told me that this table is likely to be updated in the near future. I will repost the edited version when it becomes available.   You can see the original table here: http://www.eat-real-food-paleodietitian.com/support-files/paleo-fodmap-food-list.pdf)

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 As you can see from this table, many of the moderate to high FODMAP foods are foods that we typically increase consumption of when adopting a paleo diet. How frustrating for those who experience an increase in gastrointestinal symptoms when they adopt a paleo diet compared to so many who find instant alleviation of symptoms! If you suspect (or know you have) FODMAP-intolerance, I recommend eliminating all food sources of FODMAPs from your diet for a couple of weeks. If you are sensitive, you should notice a fairly dramatic effect on your digestive symptoms. You can try reintroducing some of the lower FODMAP fruits and veggies and see if your symptoms return. In many cases, following a gut-healing protocol (as outlined in this post, this post or in the book Practical Paleo) will improve digestion of FODMAPs and they can be reintroduced carefully but successfully.

It is very important to note that the symptoms of FODMAP-intolerance are virtually identical to the symptoms of Small Intestinal Bacterial Overgrowth (SIBO). The reason for this is that these two conditions are highly related. The difference is simply a matter of location, larger versus small intestine. Without testing it can be difficult to discern which of these paleo diet modifications to try first (for more information on SIBO, read this post and this post). Even more confusing, FODMAP-intolerance may or may not be linked to Small Intestinal Bacterial Overgrowth. In some cases, the unabsorbed sugars caused by FODMAP-intolerance will lead to an environment in the small intestine where bacteria will grow, thus causing SIBO. So, you may have SIBO without FODMAP-intolerance, you may have FODMAP-intolerance without SIBO, or you may also have both. If you have digestive symptoms and are unsure which condition is the problem, then, I’m sorry to say that you’ll need to either have some tests done or follow the diet restrictions for both. After a period of a couple of weeks, you can try adding in either the starchy vegetables eliminated in the modification for SIBO or some of the FODMAP fruits and veggies (choose whichever food you miss the most). It should be clear fairly quickly which foods are problematic. Also note that both of these conditions are likely to resolve completely with continued elimination of these foods (although in some cases this will take 6-12 months or even longer), so you may find that you can add everything back in and your symptoms don’t return (fingers crossed!)

1 Gibson PR and Shepherd SJ. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. J Gastroenterol Hepatol. 2010. 25(2):252-8.

2 Born P Carbohydrate malabsorption in patients with non-specific abdominal complaints World Journal of Gastroenterology, 2007, 13(43): 5687-5691

Why Is Sugar Bad?Or maybe this should be titled, “Why Are Carbohydrates Bad?”.  Carbohydrates take the form of either sugars or starches (“complex carbohydrates”); but, a starch is simply a long chain of sugar molecules strung together, so they both end up as the same thing once they enter your blood stream (the only difference is that you need digestive enzymes to break up a starch).  Most carbohydrates break down to approximately half glucose and half fructose (let’s ignore fiber and some of the other less common monosaccharides, for now).  Glucose is then directly used by your cells for energy, whereas fructose must first be converted into glucose or fat by your liver.

Before we go further, let me say that carbohydrates, specifically glucose, are critical for life.  Glucose is energy and your cells need energy to live.  BUT, they don’t need anywhere near the amounts typically consumed in the modern Western diet (often in excess of 500g per day!).  In fact, the high sugar consumption in our diet is the direct cause of the increase in cardiovascular disease, diabetes and obesity seen in the last three decades (since the move toward low-fat, high-starch diets, which we now know are terrible for our health).

How can sugar be both essential and cause disease?  Like so many things, it comes down to dose.  Think of the analogy of alcohol:  a glass of red wine a day can help prevent cardiovascular disease, stroke and even Alzheimer’s disease; whereas a 24oz bottle of scotch a day will destroy your liver and then kill you.  You might think this is a drastic example, but it’s actually a very apt analogy since ethanol is processed by your liver in a very similar way to fructose.  In fact, high fructose intake causes fatty liver disease, which is the precursor to cirrhosis.

The problem comes when a person consumes more sugar than they need for immediate energy usage or large doses of fructose.  When this happens, a cascade of hormones are stimulated so that the extra sugar can be converted into glycogen or fat for storage.  First, the amount of sugar in your blood rises.  This sugar reacts with other components of your blood to produce Advanced Glycation End products, which cause oxidative damage to your tissues and increase inflammation in your body.  High blood sugar can be life threatening and cause permanent brain damage, so your body has a mechanism to deal with this: the hormone insulin.  Insulin helps shuttle glucose into your cells (and when glucose is really high, insulin helps get glucose to into your liver cells to be converted into fat for storage).  When your blood sugar levels are chronically high, your cells can become insulin resistant, leading to more insulin production.  This is what eventually leads to type II diabetes.  Chronically high insulin levels have also been shown to dramatically increase the risk of some cancers.  Some other hormones are stimulated as well, like leptin, a hunger hormone… yes, eating sugar makes you hungrier.

Your liver is responsible for converting excess sugar into glycogen or fat for storage.  But, toxic byproducts (like triglycerides, which are linked to increased risk for heart disease) are produced as part of the conversion of either glucose or fructose into glycogen or fat for storage.  If you consume relatively low carbohydrates, the amount of toxic byproducts is low enough that your body can deal with it easily.  When you consume high levels of carbohydrates, the toxic byproducts build up and contribute to oxidative stress, inflammation, tissue damage and disease.

Most of the cells in your body can easily use fat or ketone bodies (produced by your liver when it breaks down stored body fat) for energy.  The only cells that absolutely need glucose are neural cells.  Although an exact lower limit to glucose consumption is still being debated, there is evidence that a person can survive on as little as 15g of carbohydrates per day.

This doesn’t mean that you have to do a low-carb diet.  When you choose low- and moderate-glycemic load foods (that’s all fruits and vegetables, by the way), blood sugar levels are very well regulated even when carbohydrate intake is very high (upwards of 300g per day).  This is about avoiding added sugars and high glycemic load foods (like grains, refined and processed foods, and junk).  Clinical trials actually show that avoiding high glycemic load foods is far more important than exactly how many grams of carbohydrates you consume.  The American Heart Association now recommends that we consume only five percent of our calories as added sugar (this doesn’t include the sugars in whole fruits and vegetables, for example).

One of the tenants of paleolithic nutrition is to remove all added and refined sugars from our diets and get all of our carbohydrates from whole fruit and vegetable sources.  I would even add that we should focus on consuming large portions of non-starchy vegetables (with more moderate intake of starchy veggies and fruit), which is the ideal situation for liver, kidney and pancreas health.

Sugar Vs. Sweeteners

You may have noticed that when I am making some paleo version of a food for my kids (like Paleo Snickerdoodles), I use actual sugar (or honey or molasses) in my recipes.  Your saying to yourself “Wait!  I thought we were supposed to avoid refined sugars!”.  We are.  Research is now showing that it is sugar and other carbohydrates (and not saturated fat!) that are the cause of the current rise in cardiovascular disease, diabetes and obesity.  I don’t eat much of these sweet recipes myself.  But I think that kids don’t function that well on too low of carbs and as I transition my kids to paleo foods, it helps to feed them something really yummy!   Now you ask “so, why not use a sugar substitute?”.  Good question. My answer is that I just don’t like them.  I definitely fall under the Julia Child philosophy of I’d rather eat an occasional little piece of the real thing than a giant bowl of the imitation (I think she was talking about mashed potatoes made with butter versus milk, but I can’t quite remember).

Why am I so suspicious of sweeteners?  Well, different sweeteners cause me different heebee geegies, but it boils down to how sugar substitutes affect insulin and hunger hormones.  Some of the natural sweeteners, like agave syrup, contain a large percentage of fructose.  While it is true that this is a low glycemic load sweetener, it’s also true that consuming alot of fructose completely messes with your insulin, leptin and other hunger hormones.  Fructose makes you hungrier.  Artificial sweeteners and some natural sweetners have been shown to do something similar.  For some people, they elicit an insulin response (basically, they taste sweet so your body releases some insulin before it realizes there isn’t actually any glucose in there!), which drops your blood glucose, so your body tells you to consume more glucose, so you feel hungry.  I just don’t like messing with this.

So why don’t I stick with honey and maple syrup?  I do in some cases, but I’m not opposed to small doses of white or brown sugar.  All of these sugars are basically half fructose and half glucose, so they have nearly identical effects on your body chemistry.  There is some benefit to using raw, unprocessed sugars (like Blackstrap Molasses or Tropical Traditions Organic Whole Cane Sugar or  Dark Muscovado Sugar ) since these sugars do have some valuable trace minerals.  I generally choose which sugar (yes, these are all

sugar) to use in my recipes based on chemistry (desired texture, other binders, etc.).  BUT I have to tell you one very important thing.  When you stick to a strict paleo diet, your sugar taste buds get REALLY sensitive.  This means that eating something that wouldn’t have tasted very sweet to you before, tastes GREAT!  Some of my sweet recipes are Kid Friendly (like my Paleo Snickerdoodles), which means there’s more sugar than most adults would want to consume except for very special occasions (or maybe this is a good post work-out food?).  I have other recipes that qualify as Paleo Treats (like my Almond Coconut Bars), which means maybe not sweet enough for the kids, but probably okay for a more frequent treat for adults. So, when you go to do some paleo baking, don’t worry so much about which form of glucose and fructose I’m using in my recipes so much as how much of it you eat.

Another KEY POINT here is that a lot of the sugar substitutes out there are quite a lot more expensive than the old standbys.  And I am doing this on a tight budget (and I’d rather put that extra cash toward some really good quality almond flour).  But, by all means play with other sweeteners, if that floats your boat.  I like the look of a lot of recipes from www.elenaspantry.com (and love the recipes that I’ve tried so far) and she often uses substitutes like stevia and yacon syrup in her baking.

Nut-Free Paleo Bread

Ingredients: 4 eggs 4 Tbsp grass-fed butter (you could use Refined Coconut Oil or Palm Shortening as an

alternative) ¼ cup Tapioca Flour ¼ cup Coconut Flour 1 tsp Apple Cider Vinegar ½ tsp Cream of Tartar ¼ tsp Baking Soda

1.    Preheat oven to 350F.  Line a 7.5″x3.5″ Loaf Pan with wax paper.  Grease the wax paper with coconut oil (if you have a good non-stick pan, you should be able to get away with just greasing it really well).2.    Melt the butter (or coconut oil if using) in the microwave and let cool slightly.3.    Beat eggs in a blender or food processor until frothy, about 30 seconds.  Add the remaining ingredients and process again until smooth.  Let the batter sit for a minute to thicken.4.    Pour batter into prepared loaf pan.  Spread it out so that the surface is even.  Bake for 35 minutes.  Enjoy!

Coconut Milk Kefir “Yogurt”

Ingredients: Milk Kefir Grains 1 can full-fat Coconut Milk or a double batch of Homemade Coconut Milk

Equipment: A glass jar or two Metal Sieve One of the following: Cheesecloth , muslin, linen, Yogurt Cheese Strainer . Alternately, you could use a Kefir Cheese Strainer

1.    Place room temperature coconut milk into a glass jar.  Add kefir grains.  Cover with paper towel or cheesecloth secured with the ring of a mason jar lid or an elastic band.2.    Let the kefir grains do their thing for 24-48 hours (tasting periodically to see if the culture has reached your desired sourness).3.    Strain the kefir culture through a metal strainer.  Place the strained kefir grains into fresh milk to start the next culture.4.    Line a metal sieve, colander or funnel with 12-14 layer thick cheesecloth (alternately you could use a yogurt cheese bag, a kefir strainer, a piece of muslin cloth or a clean linen tea towel).  Place sieve over a medium-sized bowl to catch the whey.5.    Pour strained kefir culture into the cheesecloth-lined sieve and place the entire bowl and sieve into the refrigerator.  After 1 hour, check the liquid in the bottom of the bowl and make sure that it is mostly clear (it will have a little opaque white swirling around in it, but it should look alot like the liquidy whey from the top of a yogurt container).  If it isn’t clear, dump it back into the cheese cloth and add another few layers of cheese cloth or a second nut-milk bag or even a coffee filter to strain out the whey.6.    Check how thick your yogurt is after about 4 hours.  It will take anywhere between 4-24 hours to strain enough whey to have thick, creamy yogurt consistency (you can actually continue straining to make a fresh kefir cheese, although if you are going to attempt this, it’s better to strain at room temperature).  Once the desired consistency is reached, scrape the yogurt into a bowl or container for storage and discard the whey (or better yet, use for another purpose).  The yield is approximately 1 cup of yogurt for 1 can of coconut milk.7.    Enjoy the yogurt plain (maybe with some berries or paleo granola) or flavor with honey, vanilla and/or pureed fruit.  To make a lovely vanilla yogurt, add 1 Tbsp honey and 1 tsp alcohol-free vanilla extract.  For fruit yogurts, I typically add ¼ cup pureed fresh or frozen fruit to 1 cup of yogurt.  Stir to incorporate and enjoy!

Note on straining kefir when using homemade coconut milk:  The curd/fat layer of my kefir can be so solid when I use homemade coconut milk that the straining step can be avoided.  Instead, I carefully spoon the thick top layer into my metal sieve, and push the curd through to separate out my Kefir Grains for the next batch.  If the curd is really thick, I might even thin a bit with the whey that naturally separates out to the bottom (I always save this whey for smoothies).  If the yogurt has a bit of a curdled texture (this can happen in a cooler kitchen), a quick blend in a blender will smooth it out.  So, not only is homemade kefir “yogurt” cheaper and better tasting when made with homemade coconut milk, but it’s easier too!

Ginger-Lemon Jasmine Kombucha

If you have decided that you are interested in growing your own kombucha, the fastest way to get started is to either get a Kombucha Scoby (also known as the kombucha starter, kombucha mushroom or the kombucha mother) from a friend or buy one online (some Health Food stores may carry them).  You can also start kombucha from a store-bought bottle, which sets you back about 2 weeks, but costs substantially less than buying a scoby (I followed the directions on this site).  This is what I did, and while it only cost about $4 to grow my initial scoby compared to about $20 if I had bought one off amazon, I was drinking store-bought kombucha the entire time I was waiting and easily drank $20 worth in that 2 weeks. You can also buy a kombucha starter kit which has everything you need, including detailed directions.

The process of growing kombucha is actually verysimple.  Make some hot tea (any black or green tea works well) and add sugar while it’s hot (you can either do this right away or after the tea has steeped a while).  Let the tea cool.  Pour into your big glass jar (Half Gallon Wide Mouth Canning Jars are perfect; I use half gallon cracker jars that I bought at Target for about $6 each), top up with some water, put your scoby in with a little of the previous batch of komubucha tea.  Secure some cheese cloth, muslin, or paper towel over the top of the jar with an elastic band and place the jar somewhere out of the way where it won’t be disturbed (it doesn’t need to be in the dark, although a cupboard or pantry shelf will work just fine, but it doesn’t like direct sunlight).  I let my kombucha culture for 14-17 days so that there will be very little sugar in the finished product.  You can let your kombucha culture for as little as week, if you want sweeter tea.  I think culturing for about 10-12 days replicates the sweetness of store-bought kombucha fairly well.  I’ve let it go as long as 23 days before (I don’t know how I forgot about it for so long, but I did!) and it was still fine (not sure it would take this abuse every time, though).  After it’s done culturing, you set-up the next batch, but the cultured tea isn’t quite ready to drink.  It needs to go through a second, anaerobic fermentation to get bubbly (you can skip this if you prefer).  This is also where you get to add something to flavor the tea, if desired.  You can pour the tea into small glass Mason Jars or Glass Bottles (I kept a bunch of glass bottles from the store-bought brand while I was growing my first scoby and have used those ever since), add a little juice, herbs, spices and/or fresh fruit, screw on the lid and let it sit for 3-5 days.  Put it in the fridge until you are ready to drink it!

Tools specific to growing kombucha:

1.    ½ gallon glass jar with a wide opening (Half Gallon Wide Mouth Canning Jars are perfect or something like a glass cracker jar; you can also double this recipe and grow your kombucha in a 1-Gallon Jar)2.    16 oz Glass Bottles for secondary fermentation (I get three 16oz bottles to 1 half gallon primary culture)3.    Kombucha Scoby (start your own with a store-bought bottle or purchase one ready to go)

4.    Some kombucha tea from the previous culture (if you buy a scoby it comes packaged with this, don’t throw it out!)5.    Teapot of similar to brew tea6.    And electric or stovetop kettle7.    Some cheese cloth, muslin, or paper towel and an elastic band to cover the jar so the kombucha can breathe but bugs don’t get in.8.    Sugar and Tea

I use regular old refined white granulated sugar to feed my kombucha.  It just wants sucrose and doesn’t care that it’s refined.  It’s much cheaper than using my evaporated cane juice for it (although I suppose if I did use evaporated cane juice, I would add some trace minerals to my tea).  There is so little sugar left in the finished product (if you culture as long as I do), that I really don’t worry about the carbohydrate load of this beverage.  Most of the caffeine is typically degraded during culturing as well.  I even let my 2.5-year old drink it (she loves it!) and haven’t noticed any of the typical symptoms of giving a child caffeine (whereas I do notice effects if she has chocolate).  I did try growing a scoby in rooibos tea to try and get a completely caffeine-free tea, but it tasted disgusting.  I don’t know if it wasn’t acidic enough or if the caffeine is actually important for the health of the scoby, but it did not work!

Kombucha is grown as a continuous culture.  So, every time you are ready to put the tea into a secondary fermentation you are starting a new primary fermentation.  And, every time you make a batch of kombucha, you get an additional scoby (a new one forms on the surface and the old ones stack underneath).  I typically move 1-2 scobies from the old batch of tea to the new jar of tea that I am growing and compost the oldest scoby (or scobies, which are the ones on the bottom).  This website has some neat ideas for what you can do with the old scobies (the ones closest to the bottom).  I have eaten them and they are not tasty.

My favorite kombucha is ginger-lemon jasmine.  I grow the scoby in sweetened jasmine tea (tea quality makes a big difference to the final taste).  During the second fermentation, I add fresh ginger juice and fresh lemon juice.  It’s so refreshing and light, kindof like lemonade, kindof like iced tea, kindof like a wine spritzer, and completely unique all at the same time.   Here are the directions once you have your scoby for a half gallon jar (which yields three 16 oz bottles).

Ingredients (Primary Fermentation):

    5 Jasmine Tea Bags (or about 5 tsp Loose Leaf Tea)     ¾ cups Sugar     1 Kombucha Scoby     ½ cup of previous batch of komucha tea

1.    Pour boiling water over teabags in a large teapot (make 4-6 cups of tea).2.    When tea has steeped (preferably about 20 minutes), stir in sugar until dissolved.3.    Allow tea to cool to room temperature.  Remove tea bags or pour tea through a sieve to remove leaves.4.    Place tea in ½ gallon jar.  Place scoby in the tea (it’s okay if it sinks, it will typically float up in a couple of days).  Add the ½ cup of the previous batch of kombucha tea to the jar (this helps get the culture going more quickly).  Top up with room temperature filtered water until just before the jar narrows at the top.5.    Cover with cheese cloth, muslin or paper towel held on with a rubber band.6.    Allow to ferment for 14-17 days.

Ingredients (Secondary Fermentation):

    ½ lb Fresh Ginger (this makes enough ginger juice for 12-16 bottles)     2 lemons

1.    Cut ginger up into 1” chunks (you don’t need to peel it) and place in your blender.   Fill with water until the ginger is just covered (about 1½-2 cups water).  Blend on high for 3-4 minutes.  Filter ginger pulp by straining through a metal strainer.  This ginger juice can be frozen in ice cube trays for future batches of kombucha (also lovely to add to hot water for ginger tea).2.    Juice lemons.3.    Prepare three 16oz bottles or mason jars each with 1½-2 Tbsp of ginger juice and 1½-2 Tbsp of lemon juice.4.    Remove the kombucha scoby from the jar with clean hands (place into a new ½ gallon jar of sweetened tea that is ready to go for the next batch, remembering to reserve ½ cup of this batch of kombucha to add to the new batch).5.    Stir the tea with a wooden spoon (this gets all the dead yeast that sinks to the bottom back into the tea, which is very nutritious).  Pour into prepared bottles (I find it easier to pour into a large measuring cup and then use the measuring cup to pour into the bottles).6.    Tighten the caps on the bottles and allow to ferment for 3-5 days.  Place in the fridge until you are ready to enjoy!7.    Finish up your new culture as per the Primary Fermentation directions above.