Part 6: Fiber, Protein, Fat, and Meal Timing

Part 6: Fiber, Protein, Fat, and Meal Timing

There are two types of fiber, soluble and insoluble. Soluble fiber, found within foods such as oatmeal, barley, chicory root, bananas, psyllium husk, legumes, and many fruits and vegetables, acts by drawing water into your GI tract, forming a gel like substance that slows down your digestion. This can help to soften your stool, slow down digestion, increase satiety (keep you full), reduce your blood sugar response to a meal, and aid in binding excess cholesterol, bile acids, and estrogen in your gut. These benefits may help in lowering your risk for cardiovascular disease, diabetes, and estrogen dominance. It has been shown that the intake of soluble fiber can help to lower A1C levels in type 2 diabetics, reduce blood sugar response to meals, and lower LDL (aka bad) cholesterol levels in the blood. Soluble fiber is also mostly highly fermentable, aka gas producing. This is why “too much fiber” can cause you to be gassy and bloated, as the fiber contributes to fermentation and gas production in your GI tract. Insoluble fiber is found in whole wheat products, nuts, beans, brown rice, and various different vegetables such as cauliflower, green peas, leafy greens, and prunes. Unlike its sister fiber, it does not dissolve in water, hence “insoluble”- not soluble in water. Instead of slowing down digestion and drawing water into the stool, insoluble fiber works by adding bulk to the stool, allowing for faster transit time and helping to prevent and treat constipation. It has little effect on satiety markers (feeling of fullness) and most forms are poorly fermented, however this is not always the case (and keep this in mind). Essentially what this means for you is that you should be focusing on consuming most of the grains that you eat as whole grains. Make sure to read labels and don’t fall for marketing gimmicks of “made with whole grain” or “multigrain.” The food industry will prey on your confusion. To avoid insulin resistance and enhance insulin sensitivity, you should consume a balance of healthy, whole grains or complex carbohydrates, avoid constantly spiking your insulin (aka no snacking all day), and focus on lifestyle and exercise techniques such as incorporating resistance training, cardio, and your NEAT levels in order to enhance insulin sensitivity. 

Amino Acids:

Tryptophan: a precursor to serotonin and epinephrine- low amounts can affect mood and increase risk of depression. If low, sleep may also be hindered. 

Tyrosine: a precursor to dopamine, norepinephrine, and epinephrine and is required for the creation of thyroid hormone. Too little tyrosine can lead to hypothyroidism or cause adrenal imbalances and an insufficient stress response. Dopamine helps to control memory, thought, and emotions and is heavily linked to the reward systems in your brain. Low tyrosine and low dopamine can increase risk of Parkinson’s disease. 

Arginine: forms nitric oxide and citrulline in the body which is required for the maintenance of your blood pressure, inhibition of platelet aggregation, and vasoconstriction and dilation of your smooth muscle cells. Arginine is a common amino acid consumed by bodybuilders or weight training to help increase cellular swelling, producing a “pump” in the gym. 

Glutamine: the most abundant amino acid that serves as a metabolic fuel for your immune cells and gut cells. Glutamine supplementation can be beneficial for enhancing recovery from an injury or poor gut health, as it helps to maintain a healthy gut lining. Glutamate: an excitatory amino acid and major brain neurotransmitter that is important for brain development and memory. It serves as a precursor to GABA in the body. GABA is an inhibitory neurotransmitter that plays major roles in brain cell communication, cognition, the stress response, and fear/anxiety. 

More on Protein:

In general, you want to focus on consuming protein that has: A high biological value, essentially, this marker reflects how readily a consumed protein can be used for protein synthesis. High protein digestibility, aka the protein is able to be digested, broken down into amino acids, and used. If you can’t digest it, you can’t use it. Animal-based proteins have the highest digestibility (90-99%), with plant sources falling short (60-80% depending on type). This is because plants contain fiber and “anti-nutrients” such as phytates and tannins that can inhibit digestion and absorption. Good news, cooking can help reduce these anti-nutrients, however it doesn’t fully eliminate them and doesn’t impact the fiber content. Plant-based protein powders tend to have a higher digestibility in relation to the whole food based plant protein itself, as the anti-nutrients are mostly removed. For example, pea and brown rice blend protein can stimulate MPS (muscle protein synthesis) just as much as whey protein. All needed amino acids. Though you can simulate MPS and get protein from vegan or vegetarian sources that may not have all amino acids, ensuring to get multiple sources throughout the day to ensure daily consumption of all amino acids is important. Why? If your body needs an amino acid and can’t get it from the diet, it will take it from the organs and tissues in your body. This means you break down body tissue to make new proteins. This is where consuming multiple sources of protein with vegan or vegetarian diets becomes even more crucial. Hormones that increase protein synthesis include: insulin, growth hormone, and testosterone. Hormones that decrease or halt protein synthesis include: glucagon, catecholamines (including cortisol), glucocorticoids, and thyroid hormone. Adequate protein intake can ensure sufficient dietary amino acids to help regulate the immune system, fight off infections, and plays a critical role in DNA creation and repair. DNA damage and oxidative stress can contribute to cancer proliferation. Don’t skimp on your protein- skimp on the lies the media tells you. 

Fats:

During exercise, fats are your primary energy source during low-intensity activities or when your heart rate is approximately less than 70%. However again, just because you use fat, does not mean that you will lose fat. Fat loss requires a caloric deficit. Omega-3 fats help to reduce inflammation, support healthy hormones, and maintain cell membrane integrity. They have been shown to help reduce pain, aid in recovery, and even reduce symptoms of PMS and arthritis. Omega-3s help produce anti-inflammatory prostaglandins (PGE1) that can help to combat inflammation in your body! This is why they can be highly beneficial in chronic inflammatory conditions and diseases. The 3 types of Omega-3 fatty acids include: ALA (alpha linolenic acid)- found in plant-based foods such as flaxseed, chia seeds, hemp seeds, walnuts. ALA can convert to EPA and DHA in the body. EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid)- found in fish oil and fatty fish such as salmon, anchovies, sardines, mackerel, and herring

-These omega-3s (as well as omega-6s) are essential to your body. You have to consume them in your diet or your health will take a hit. Cue PMS problems, chronic pain, and increased risk of illness and infection. Vegans and vegetarians need to be super careful here, as the conversion of ALA to EPA or DHA is limited. Omega-6 fats also help to support your hormones and regulate inflammation. However, not all omega-6 fats are created equal. Highly refined processed vegetable oil and omega-6 based fats can easily become rancid and oxidize in your body, leading to chronic inflammation and tissue damage. Unlike omega-3s, they produce proinflammatory prostaglandins (PGE2). Chronic inflammation greatly increases your risk of chronic diseases such as cardiovascular disease (CVD), diabetes, fibromyalgia, and cancer. Chronic inflammation also spells a recipe for disaster on your hormones, mood, and pain levels. Examples of omega-6s to avoid include: corn, soybean, safflower, cottonseed, grapeseed and sunflower oils, they are commonly used by restaurants to cook (as they are cheap) and within packaged foods. Omega-6s to include: coconut, pistachios, pumpkin seeds, sunflower seeds, evening primrose oil, and borage oil. Monounsaturated fats: These contain one double bond in their structure. Examples include: olive oil, avocado, nuts, seeds, and olives. Monounsaturated fats may help to decrease your risk of cardiovascular disease (CVD), as they can help to increase good HDL cholesterol levels. Saturated Fats: These contain no double bonds in their structure and are solid at room temperature. Their skeletal carbon chains are “saturated” with hydrogens, allowing them to easily stack on top of each other in your tissues. Examples include: animal meats, egg yolks, coconut oil, dairy products, lard, and palm oil.

Meal Timing:

While meal timing may only have a small impact on your physique, it can have a big impact on your energy levels, gym performance, and blood sugar regulation. Meal timing is of utmost importance when it comes down to training performance, especially in the case for endurance training and team sports. However, since most people are not marathon runners or football players, the focus is on practical meal timing strategies for the everyday person. Poor meal timing can leave you with imbalanced blood sugar, low energy levels, poor adherence due to insatiable hunger, and increase your risk of overeating and binge eating. The goal is to provide a steady source of fuel for your body and brain throughout the day, optimize muscle protein synthesis for building or preserving muscle, and prevent rapid spikes and dips in your blood sugar, which can influence your hormonal and adrenal health.

Remember these facts when planning out pre and post workout meals: 

If you eat within a few hours pre workout: muscle protein synthesis is STILL elevated right when you finish, so getting in your protein immediately post workout isn’t necessary. You won’t lose your gains. Your pre workout meal may just be a pre workout snack, and that’s okay. Your pre workout helps to fuel for energy, stabilize your blood sugar, and preserve your muscles. Find a meal or snack that you enjoy, that digests well, and helps you feel your best when training. Protein’s goal: spike muscle protein synthesis, aid in growth and recovery, preserve lean muscle tissue and build new muscle tissue.

Carb’s goal: immediate energy for training, fills glycogen stores (which are not fully depleted post workout if you’re just lifting, they are for endurance training), cause insulin spike, and help to reduce cortisol.

Fat’s goal: slower digesting form of energy; helps to stabilize and prevent the blood sugar response to a carbohydrate; and slows digestion when added to a protein or carbohydrate (which may or may not impact your digestion in a pre workout meal).

Part 5: Endocrine Disruptors and More About BMR

Part 5: Endocrine Disruptors and More About BMR

Endocrine Disruptors and Mold:

Endocrine disruptors have been defined by the US Environmental Protection Agency (EPA) as “exogenous agents that interfere with the synthesis, secretion, transport, metabolism, binding action, or elimination of natural blood-borne hormones that are present in the body and are responsible for homeostasis, reproduction, and development process.” In simpler terms- they disrupt your hormones. Endocrine Disrupters include: BPA and BHT, Dioxin, Atrazine, Phthalates, Perchlorate, Fire Retardants, Lead, Arsenic, Mercury, Perfluorinated chemicals, Organophosphate, Glycol, ethers, Plastics, Parabens, and Fragrances. Assessing for the common endocrine disruptors that may be within product ingredient profiles include websites such as Skin Carisma, EWG (the Environmental Working Group), GoodGuide, and Think Dirty which can be extremely helpful. Mold is also important to watch out for. Symptoms of both acute and chronic mold toxicity include: Fatigue and weakness, Headaches, light sensitivity, Poor memory, difficulty finding words or concentrating, Mood swings, Sharp pains, morning stiffness, joint pain, Unusual skin sensations, tingling and numbness, Shortness of breath, sinus congestion, or a chronic cough, Appetite swings, Issues with body temperature regulation- includes night or cold sweats, Increased urinary frequency or increased thirst, Red eyes or blurred vision, Abdominal pain, diarrhea, bloating, Metallic taste in your mouth, Static shocks Vertigo,  and feeling lightheaded.

More about BMR:

Your nutrition and diet will need to be transformed as you grow, and change throughout your lifetime. Nutrition is never static, and neither are you. The foods that you eat can tell your body: “Hey, we’ve got enough fuel” or “Hey we need more fuel!” If you eat too much, too little, make poor food choices, or are unable to digest and absorb your food efficiently, this then impacts your energy, motivation, stress, sleep, libido, hormones, digestion, and overall health. Food also talks to your epigenome (a group of chemical compounds that tell your genes what to do), helping your body turn on or off genes! You heard that right- Food is code. Just like a computer writing code, your body is always writing. The truth is- all food is fuel. However, how our body responds to this fuel can either harm or help our health. Your body is an ever-changing organism, not a car with one set fuel-need and way to run. You have hormones that can increase or decrease your metabolism, specifically thyroid hormone. Just because you eat a calorie, does not mean that you properly digest and absorb it. Calories are not created equal. Yes- all calories are technically equal, as all measures of energy are equal, however the nutrients that come from the calories you eat differ in quality, digestibility, and can have different impacts on your immune response. We each need a certain amount of calories per day to survive. This amount is known as your basal metabolic rate, or BMR. Your BMR makes up about 60-75% of your TDEE (total daily energy expenditure) and in general, it depends on your body weight, height, age, and lean body mass (aka muscle mass). In simple terms, metabolic adaptation is your body’s survival response to dieting. It does not want to diet. Your body will decrease hormones (such as your sex hormones and thyroid hormones) in an attempt to maintain body weight and survive. These changes can lower your metabolic rate and BMR, which is why, as you diet, you have to continue to drop food or add cardio in order to lose weight. Not only do you lose body fat that burns calories, lowering your BMR, but your body’s metabolic thermostat is downregulated. NEAT, or non-exercise activity thermogenesis, includes activities that you do that are not workout or exercise activity. These include activities such as walking throughout the day, playing with your kids, cleaning, making dinner, using the stairs to get to work, or random fidgeting. NEAT can range from 300 up to 1000 calories, depending on the person. NEAT is the most common neglected component of energy balance, and many times is not taken into account with online calculators. TEF (thermic effect of eating) is the amazing component of your TDEE that includes the calories that you burn from eating. About 10% of your TDEE comes from your TEF. Though you can’t adjust this much, some foods do require more energy to break down, increasing the caloric burn when eating. For example, it takes more energy to digest an ounce of almonds than it does to digest two tablespoons of almond butter. Overall- your calories needs are based on: TDEE = BMR + NEAT + TEF + PA. The scale will bounce up and down based on markers such as stress, lack of sleep, hormonal changes like during your menstrual cycle, digestion, and changes in your salt and water intake. What about fasted cardio? Fasted cardio does not have any benefits over fed cardio and can be detrimental if you are trying to preserve muscle mass or if you have adrenal imbalances. Performing all cardio AFTER resistance training to ensure all energy and strength is utilized in the weight training prior. Remember these principles of metabolic adaptation: Dieting decreases your BMR as thyroid and sex hormones drop; The calories you burn from PA (physical activity) go down as you lose weight (less mass to require energy); Your NEAT drops down with dieting and less body weight further lowering your TDEE Hunger hormones go up as a safety mechanism, making it harder to eat less. Benefits to reverse dieting may include: More food intake, Higher energy levels, Improvements to your metabolism, Improvements to sleep & stress levels, Ability to lose weight at higher calories in the future, Improvements to your menstrual cycle, thyroid, and adrenal health, Less restriction and food focus, Less cardio and more time to do what you love, Increased strength and gym performance, Better mood and libido, Increased TEF (thermic effect of food), and increased NEAT (non exercise thermogenesis), therefore increasing the amount of food you can eat while maintaining your body weight. If you have been in a dieting phase for more than 3 months and stalling, despite refeeds and diet breaks, You are starting to see signs and symptoms of a hormonal imbalance despite being in a mild deficit or maintenance calories, You’re always hunger, energy is low, sleep and recovery are suboptimal, and your motivation is trash, You have reached your goal physique or goal weight and you’re ready to focus on maintaining or adding back in more food, You have been yo-yo dieting for months to years and can’t seem to see progress, then you should be reverse dieting. The author suggests following these 3 tips to get started reverse dieting: Establish your maintenance calories. If you were dieting, up your foot right away to an estimated maintenance (a good 100-250 calories up is a good start). If you were undereating, you may have to bump this even to 500 more calories. Find what caloric and macro intake you can maintain for 2 weeks without adjustments. Portion sizing with your hands may be used if you don’t track, however this is not best for accuracy. Bump your food first by about 50-100 calories and wait till you maintain for a full week to add more. I suggest not changing your protein intake if you can- instead, add carbs or fat. Track your progress with a coach, app, or spreadsheet. Look at your biofeedback and symptoms, your measurements, bodyweight, and physique photos. Don’t get stuck in the “spinning your wheels” part of reversing due to fear of increasing too quickly or too slowly. Ask for help.

We look at a few areas when reverse dieting:

1. State of insulin sensitivity- the more insulin resistant someone is, the more fat you should increase vs carbohydrates 

2. History of dieting- if someone has a history of under eating or having lower fats, then the first step should be to bring these back to a healthier level to support healthy hormones 

3. Training type and intensity- higher volume and more intense training relies on glucose vs fatty acids for fuel. Increasing carbohydrates will help to fuel workouts and replenish muscle glycogen. The increase of carbohydrates will also be likely less stored as body fat, as long as insulin resistance is not present 

4. Personal preference- some people may want more fats in their diet vs carbohydrates. What someone can stick to with a reverse should come first, as sustainability in reverse diet and consistency is key to success

The magic of body recomposition lies in a combination of nutrition at maintenance, a mild deficit or slight surplus, a high protein intake, and the proper progressive overload resistance training program. The ability to “recomp” your body also depends on your ability to manage sleep, stress, and your nutrition quality. Plateaus are a natural response to dieting and are largely due to metabolic adaptation. With dieting, decreases in BMR, NEAT, and PA lead to decreases in TDEE, taking you out of a negative energy balance or caloric deficit. Not only that, but you have several hormonal adaptations that contribute to your plateau as well. These include drops in thyroid hormones, sex hormones, leptin, and increases in ghrelin and cortisol. If cortisol remains elevated for a long period of time, whether due to chronic stress, extended fasting, inflammation, illness, or infection, it can cause your protein stores to start to whittle away.

 

Part 4: PCOS and Menopause

Part 4: PCOS and Menopause

What are common symptoms of PCOS? Weight gain or trouble losing weight, irregular menstrual cycle or fertility issues, blood sugar imbalances, ovarian cysts, oily skin and acne, increased facial or body hair (hirsutism), hair loss from the head, mid-cycle spotting, heavy menstrual bleeding, heavy menstrual cramps, low sex drive, and chronic fatigue. Note- not all women have the same symptoms, as symptoms depend on the root cause of the condition! There are 4 main types of PCOS:

1. Insulin Resistant PCOS (includes Androgen dominance): With insulin resistance PCOS, the body becomes resistant to the hormone insulin. This means that the body is unable to utilize carbohydrates for energy sufficiently, which can result in weight gain, hormonal imbalances, blood sugar dysregulation, and inflammation. When you have elevated blood sugar, this causes your pancreas to secrete more and more insulin. This is an attempt for your body to get your blood sugar levels back down to normal. However, if insulin can’t do its job, blood glucose remains elevated, and the pancreas continues to output insulin. The extra insulin plus the high levels of blood sugar lead to hormonal and metabolic chaos in your body. This causes inflammation along with abnormal fat and glucose metabolism, which contributes to weight gain, fertility issues, the development of Type 2 diabetes, as well as cardiovascular disease.

A few suggestions for helping to increase insulin sensitivity and making sure to follow the overall PCOS suggestions include: Stay Active: Incorporate weight training and moderate intensity cardio into your life at least three times a week. This will enhance insulin sensitivity in your body, specifically by increasing the amount of GLUT4 receptors (what helps glucose enter your cells) in your cells and number of mitochondria. What does this mean for you? Help with insulin sensitivity, fuel utilization, and a happy metabolism. Fix your diet: Avoiding refined carbohydrates, added sugars, processed vegetable oils, and trans fats. Pay attention to what foods you are eating and focus on filling up your plate with ½ fruits and vegetables at each meal, the other ¼ complex carbohydrates, and then ¼ lean sources of protein. Strive to follow a whole foods, anti-inflammatory diet. Balance your blood sugar: This is essential to help regulate your blood sugar and insulin levels. To do this, make sure to always pair a carbohydrate with a good source of protein (about 15 g) and/or a fat (about 10 g). A great smart snack idea would be half of a banana with 1.5 tbsp almond butter, or 3 oz berries with ½ cup low fat Greek yogurt. Find foods that you enjoy and that make you feel good. Try to eat every 4 hours unless you practice a specific type of intermittent fasting. Supplement smartly: My favorite supplements for blood sugar include Myoinositol (6 g/day), Berberine (500-1000 mg/day), Magnesium (300-400 mg/day), Chromium (200-400 mg/day), Zinc (20 mg/day), Alpha lipoic acid (100-200 mg/day), Vitamin D (2000-5000 IU/day) and Gymnema Sylvestre (500-1000 mg/day) ****Remember to work with a healthcare practitioner***. Many companies make “glucose disposal agents” that incorporate insulin sensitizing herbs and dietary ingredients that may help the body to use glucose. These can be helpful and some are clinically effective. Supplements, especially those that enhance insulin sensitivity, can have undesired side effects, including gastrointestinal upset, headaches, fatigue, and may cause low blood sugar. 

2. Post- Pill PCOS: Step 1- Replenishment: This includes replenishing the micronutrients that are commonly depleted by hormonal birth control. This includes: Zinc, Magnesium, B6, Vitamin C, and Folate. An anti-inflammatory diet with sufficient energy intake is imperative, as under-eating (i.e. dieting) for many can hinder your cycle from returning. A great way to replenish is to take a prenatal supplement (with methylated folate which is more readily absorbed) and to optimize your diet with plentiful (and a variety of) fruits and vegetables. Step 2- Removal: This is where you want to focus on removing the synthetic estrogens and/or progestins within your BC. Natural foods that help enhance liver detoxification include: cruciferous vegetables, garlic, onions, raw carrots, berries, citrus fruits, leafy greens, flaxseed, walnuts, beets, green tea, and apples. Herbs can be powerful aids as well, including milk thistle, rosemary, fennel, turmeric (active component is curcumin), parsley, ginger, dandelion root, mustard seeds, goldenseal, artichoke, chicory, and wormwood. Again, please speak with a healthcare professional before starting any new supplement. You also want to focus on removing your specific food intolerances as well as endocrine disruptors from your environment. Endocrine disruptors include: BHA, BHT, BPA, parabens, phthalates, fragrances, sulfates, sulfites, plastics, and dioxins.

3. Adrenal PCOS: this dysfunction can result from either high cortisol, low cortisol, or a combination of the two, called adaptive cortisol. Symptoms of adrenal dysregulation include: trouble falling or staying asleep, feeling “tired but wired” at night, chronic and constant fatigue, blood sugar crashes, mood swings, body fat concentrated around your abdomen, and constant salt or sugar cravings. In general, addressing stress, ensuring adequate sleep, prioritizing your diet, and balancing your blood sugar can be critical in helping bring cortisol levels back to a healthier place. Using adaptogens can also be extremely helpful, however you can not “out-adaptogen” or out-supplement adrenal dysfunction. You have to make sufficient dietary and lifestyle changes.

4. Inflammatory PCOS: In this case, inflammation is the root cause of your menstrual cycle irregularities. Inflammation can come from the diet via: poor micronutrient intake, inflammatory foods (such as processed vegetable oils, fried foods, excess added sugars, processed meats, too much saturated fat), intake of individual food intolerances (or supplement intolerances- yes they exist!), or excessive food intake. Inflammation can also come from gut dysbiosis or infection, as well as your environment, endocrine disruptors, heavy metals, mold, pollution/exhaust, and excess minerals such as fluoride, calcium, or iron. Infections or viruses, especially stealth infection like Epstein Barr or Lyme disease, can cause underlying low-grade systemic inflammation. Commonly, inflammation does not have one sole root cause. Inflammation is like a little cup that will continue to fill up, then produce havoc and symptoms when the cup overflows. The key is to reduce what you can from adding into your cup. The treatment for inflammation depends on the source. However, it’s also important to follow an anti-inflammatory diet, focus on stress management, ensure adequate sleep, balance your blood sugar, and use exercise to help instead of harm your body (as inflammation can be from overtraining or under-recovering). Helpful supplements for lowering inflammation include: curcumin, omega-3s, N-acetyl-cysteine, glutathione, bromelain, ginger, alpha-lipoic acid, resveratrol, Boswellia (frankincense), cat’s claw, vitamin E, and pycnogenol. Having low levels of vitamin D and magnesium may also contribute to inflammation

Menopause:

Peri menopause is referred to by many women as “the years of hell.” From mood swings, hot flashes, and difficulty sleeping, to chronic fatigue, the symptoms can be quite crippling. Diet also plays a huge role, and ensuring to eat an anti-inflammatory diet with a focus on reducing added sugars and processed vegetable oils can help to reduce inflammation, which can exacerbate symptoms. Focusing on nutrients such as omega-3s, B-vitamins, zinc, magnesium, and vitamin E is also important. The author found in practice that some women also benefit from a moderate to low-carb diet as estrogen levels drop because low estrogen decreases your body’s ability to utilize glucose. Remember the roles of both estrogen and progesterone in your body beyond their functions for reproduction? Estrogen is powerful in preserving bone mineral density and reducing the risk of cardiovascular disease. Progesterone increases your metabolism, helps your body use fat for energy, and enhances your sex drive. Losing the power of these two hormones naturally results in an increased risk of cardiovascular disease and osteoporosis, which estrogen levels protect during reproductive years, as well as an increased risk of endometrial cancers and reduced metabolic rate, which result from the reductions in your progesterone levels. Additional changes common during menopause include increased levels of abdominal body fat, loss of lean muscle mass, increased levels of cholesterol, higher blood pressure, increased occurrence of UTIs (urinary tract infections), and urinary incontinence. 

Part 3: PMS and Estrogen Dominance

Part 3: PMS and Estrogen Dominance

Just because PMS is common, does not make it normal. PMS is defined as any physical or behavioral symptom that significantly impairs your daily life during the 2 weeks before your cycle starts. It commonly includes alterations in pain levels, energy, mood, and motivation. PMS is greatly associated with hormonal imbalances such as estrogen dominance, low progesterone, nutrient deficiencies, inflammation, as well as serotonin and GABA dysregulation (two of your relaxing brain neurotransmitters). This is why some women are prescribed SSRIs (serotonin reuptake inhibitors) to aid in the management of PMS. Some potential causes include high estrogen, low progesterone, hypothyroidism, heavy metal toxicity, cortisol dysregulation, endocrine disruptors, inflammation, stress, gut dysbiosis, infection, illness, or nutrient deficiencies. Key strategies for being a PMS conqueror include: 

1. Focus on color: Fill up on all the colors of the rainbow in your fruits and vegetables to increase the amount of antioxidants and polyphenols in your diet. This will not only help you achieve optimal nutrient status, but combat inflammation, which is a heavy contributor to PMS problems. 

2. Power up the cruciferous veggies: These superpowered veggies can help you to detoxify excess estrogen. They contain indole-3-carbinol, which converts to DIM in your body, which helps to push your estrogen through Phase 1 of estrogen detoxification. Broccoli sprouts are another fantastic addition to your diet, as they contain high amounts of sulforaphane. Sulforaphane helps to combat free radical damage and inflammation in your body, as well as helps to move estrogen through phase 2 detoxification. 

3. Fix your fats: Focus on consuming healthy fats such as avocado, fatty fish such as salmon, eggs, olive oil, nuts, and seeds. These foods contain rich sources of essential fatty acids (omega-3s and omega-6s) that you can only get from your diet. Lack of essential fatty acids puts you at risk for heavy PMS as well as a whole host of hormonal chaos. These fats are anti-inflammatory and work to combat inflammation in your body, which can decrease PMS symptoms. Try to reduce processed vegetable oils that are easily susceptible to oxidative damage and rancidity, which can cause inflammation in your body. These processed vegetable oils include corn, canola, soybean, sunflower, and cottonseed. 

4. Cut the crap: Avoiding excess added sugars, alcohol, and removing your own food intolerances is crucial to decrease inflammation, which can make PMS a demon. A great goal for sugar is under 10g added sugar per serving for a food, with a total of around 60g per day of sugar total. Reading nutrition labels will allow you to get a better idea for what is in your food and focus on the quality. Note- natural sugars from fruits are always welcome. Eat them to your heart’s content! Try to keep your alcohol consumption to 2 drinks per week, though I suggest minimizing this as much as possible. Common food intolerances include gluten, wheat, eggs, nuts, dairy, and soy. Only restrict what you need to and work with a registered dietitian to make sure you are on the right path for a sustainable nutrition plan that is best for you. 

5. Focus on fiber: Fiber helps you to naturally detoxify your estrogen and helps to feed your gut microbiome by feeding your good gut bugs. You need a healthy microbiome for optimal metabolism, mood, and immune function. There really isn’t anything your gut can’t impact. Make sure to utilize different sources and types of fiber based on your needs. A messed up gut can contribute to heavy PMS and pose a threat to your overall health, so make sure to prioritize your fiber. 

6. Drink your water: Your body is approximately 60% water. Dehydration leads to dizziness, headaches, increased hunger, cravings, and can even be life-threatening. Aim for at least 1 gallon of water per day. Being properly hydrated can positively impact your energy, mood, and metabolism. Set a timer on your phone to drink water if you struggle with getting it in. You can also try flavoring your water naturally with fruit.

7. Balance your blood sugar level: An imbalance of blood sugar in your body can leave you hit with hanger. Ever noticed periods of shakiness, sweaty palms, anger, irritability, and brain fog? That’s a sign of low blood sugar. Going up and down in a blood sugar rollercoaster can heighten your PMS. Especially if you are progesterone-sensitive. Be mindful of your carbohydrate sources and choose whole grains if possible. Always pair your carbs with a fat or protein to help stabilize your blood sugar and avoid skipping meals or going more than 4 hours without eating.

8. Remove endocrine disruptors: these chemicals will disrupt your hormonal symphony and wreak havoc on your health. Hands down, they can cause and worsen PMS.

9. Supplement Smartly: Supplements can be highly beneficial to help reduce your risk of PMS and decrease inflammation. Any nutrient deficiency will wreak havoc on your health, so ensuring to supplement smartly is critical. My favorite supplements for PMS include: There are many other herbs, vitamins, and minerals that may help to decrease symptoms of PMS. Make sure to always speak with your dietitian or medical professional before starting or stopping a supplement. 

10. Manage Stress: High stress levels and lack of self-care will lead you to PMS problems. Focus on ensuring you have proper stress reduction practices in place, practice healthy sleep hygiene, and make sure to allow yourself periods of rest and relaxation. Stress is one of the most common culprits leading to PMS problems.

Estrogen Dominance:

If you have estrogen dominance you may experience: painful periods, heavy periods, bad PMS or PMDD, tender breasts, mood swings, migraines and headaches (especially the week before your period), abnormal weight gain, bloating or water retention, acne, and fibroids. There are many reasons you can become estrogen dominant. These include: endocrine disruptors, nutrient deficiencies, poor diet (high in added sugars, refined carbs, and alcohol being the most common diet culprits), heavy metal toxicity (especially copper toxicity), high histamine levels, excess aromatase activity (your conversion from testosterone to estrogen in fat cells), poor liver health, defects in estrogen detoxification (can be Phase 1, 2, or 3), high insulin levels, Hypothyroidism Infections (such as Epstein Barr Virus, Lupus, Lyme disease, or even mold), gut dysbiosis, inflammation, low progesterone, hormonal birth control or post birth control rebound, and obesity or high body fat levels. 

The Estrogen Dominance Solutions: 

1. Fix your diet: Reduce the amount of added sugars and refined grains in your diet that don’t provide you with enough vitamins and minerals and may cause blood sugar imbalance. Focus on whole grains, a variety of fruits and vegetables, and healthy sources of dietary fat. If you can, choose organic over conventional meats, as they have been shown to be higher in essential fatty acids. 

2. Reduce alcohol: Alcohol can disrupt both your hormones and liver function. If you are going to drink and have estrogen dominance, stick to 1-2 glasses of wine per week. I suggest eliminating alcohol if possible. 

3. Reduce environmental toxins: Reducing endocrine disruptors will reduce inflammation, help to balance your hormones, and support your liver (helping to reduce its toxic burden). 

4. Focus on Fiber: Aim to consume at least 25 g fiber per day with 35-45 g being an even better range. Adequate fiber intake helps you to detoxify and eliminate excess estrogen. It also helps to reduce the levels of intestinal beta-glucuronidase activity that can cause havoc with your phase 2 estrogen detoxification (preventing it from being excreted). 

5. Promote a healthy gut microbiome: This is where fiber plays a major role to help your good gut bugs produce short-chain fatty acids, B vitamins, and vitamin K. Why is this important? They help modulate your immune system, protect your gut lining, reduce inflammation, combat pathogens, promote healthy cholesterol levels, and enhance your mood and cognitive function. Other adjustments to help promote a healthy gut include diversity in the plants in your diet, reducing intake of artificial sweeteners, and removing food intolerances. 

6. Prioritize sleep: Lack of sleep will disrupt both your hormones and adrenals. Focus on getting at least 7-8 hours of sleep per night. Make sure to have a healthy sleep routine, which includes blocking blue light at least 2 hours before bedtime, stopping electronics 30 minutes before sleep, sleeping in a cool, comfortable environment, and avoiding high strenuous exercise before bed. 

7. Focus on self care: You need to fill up your cup to be able to pour out into others. Lack of self care will wreak havoc on your mental, physical, and emotional health. 

8. Supplement smartly: Just like with PMS, supplements can help you in rebalancing your hormones and fixing nutrient deficiencies. With estrogen dominance, the author likes to see her clients do a DUTCH test to look at their Phase 1-3 estrogen detoxification. Why? There are certain supplements that can downregulate or upregulate specific pathways. For example, DIM and Indole-3-carbinol help to push you down Phase 1. If you have trouble with phase 2 and phase 3, then you can’t get rid of your estrogen, and taking these supplements can make your estrogen dominance worse. 

9. Reduce Inflammation: Inflammation will upregulate cytokines and prostaglandins in your body, causing increased period pain, body aches, and increase the risk of heavy menstrual bleeding. Inflammation also further increases aromatase activity in your body, which converts your testosterone to estrogen. This can further drive estrogen levels higher. You can reduce inflammation by following all the previous tips suggested, plus making sure to incorporate omega-3 fatty acids, reduce caffeine intake, and add anti-inflammatories such as curcumin (the active component of turmeric), Boswellia, or cat’s claw in your life. If you carry excess body fat, losing weight will also help to decrease aromatase activity and decrease inflammation. 

10. Exercise for energy: Yes, you read that right. Your exercise and workouts should not drain, but instead energize you. Focus on finding a fitness routine that you enjoy and that you can stick to. Moderate intensity weight training is a great option, as it will help to increase insulin sensitivity and preserve lean muscle mass. These include yoga, power walking, and small amounts of running or high intensity cardio. Be cautious on the runs and cardio because if you have adrenal imbalances, this can cause even worse hormonal chaos. 

The Three Estrogen Phases/Liver detoxification:

There are three main phases of estrogen metabolism in your body. These phases follow your body’s natural detoxification process. Our bodies do great things for us including the detoxing of drugs, environmental toxins, hormones, chemicals, water, air, and even the food you eat is mostly performed in your liver, but detoxing also occurs through your digestive tract, kidneys, skin, and lungs. Each phase requires specific vitamins and minerals to power various enzymes that transform toxins (and estrogens) in your body from their fat soluble forms to water-soluble forms, allowing them to be excreted through your bile, urine, and feces. Your liver is critical to maintaining a healthy immune system, metabolism, and digestion. It plays the superhero role of detoxification. Without your liver, you cannot convert food into energy, make immune system molecules, or process and eliminate medications or environmental toxins. Let’s dive into the three phases of liver detoxification. Phase 1 detoxification involves a process called “bioactivation” and is largely performed by hepatocytes, aka the cells of your liver. During this phase, a series of reactions occur including oxidation, reduction, hydrolysis, hydration, and dehalogenation. During these reactions, Cytochrome P450 enzymes (CPY450) convert fat soluble toxins and various “materials” mentioned, including estrogen, medications, environmental pollutants, and waste materials into more water-soluble metabolites. Your diet can ensure that this phase is performed properly. Antioxidants in your diet are the true superheroes that come in to prevent damage from the reactive intermediate This includes something called glutathione, which can be considered your master antioxidant. These super hero antioxidants include: Riboflavin (Vitamin B2), Niacin (Vitamin B3), Pyridoxine (Vitamin B6), Folic acid, Vitamin B12, flavonoids, Vitamin A, ascorbic acid (vitamin C), and tocopherols (vitamin E). Nutrients such as selenium, copper, zinc, manganese, Coenzyme Q10, thiols (found in cruciferous vegetables), and silymarin (better known as milk thistle) also play a role. An easy way to help ensure Phase 1 detox is achieved is to get a wide variety of nutrients in your diet with lots of colorful fruits and leafy greens and to help your liver by lowering your overall toxic burden, including limiting exposure to environmental toxins, not overloading your body with supplements or medications, and eating a balanced healthy diet. Please note- there are also many substances, nutrients, and drugs that can influence the function of the CYP enzymes that are in charge of Phase 1. This can be from the inhibition or induction of their activity, and can greatly influence how you detoxify, CYP Inducers include: soy, curcumin, garlic, fish oil, rosemary, resveratrol, chicory, and astaxanthin. CYP Inhibitors include: raspberries, blueberries, black currants, pomegranate, peppermint, quercetin, daidzein, grapefruit, and dandelion. Just like Phase 1, Phase 2 requires specific nutrients in order for the enzymes within each reaction to perform optimally. You need to get through Phase 2 in order to get to Phase 3, where the toxins and estrogen in your body can be fully excreted. These nutrients include glycine, taurine, glutamine, N-acetylcysteine (NAC), cysteine, and methionine. They also require choline, inositol, and sulfur-containing compounds such as MSM and Sam-E. Adequate protein intake is required (as many require Phase 2 nutrients come from protein), as well as dietary fat, which is needed to mobilize the required fat-soluble vitamins used. Though diet plays a key role for ensuring adequate nutrients to perform Phase 2, just like in Phase 1’s enzymes, problems can arise if there are “roadblocks” affecting any of the methylation steps. Glutathione is your master antioxidant and works to combat free radical damage, protect your tissues, and enhance your immunity. Phase 1 and 2 detoxification are like a bathtub. Phase 1 involves the filling of your bathtub, while Phase 2 involves draining. You have to get Phase 2 to occur in order for the “water” in Phase 1 to get out. If both Phase 1 and Phase 2 occur, then Phase 3 can happen. The final step in Phase 3 estrogen detoxification involves the neutralization of metabolites and excretion through your bile, feces, or urine. Both constipation and lack of bile flow are additional contributing factors to estrogen dominance. Therefore, it’s essential that you focus on getting adequate fiber intake (in general 25-45g per day), prioritize your gut health, and be kind to your liver.

Diet Modulators of Estrogen Metabolism: from Metagenics 

Production to support body function and phase 3: flaxseed, flavonoids, zinc, soy, calcium-d-glucarate, dietary fiber, prebiotics, probiotics

Systemic pool to circulate: fiber, flaxseed, soy

Receptor Sensitivity and binding: Isoflavones, lignans, indole-3-carbinol, DIM, hops, curcurmin, B6, rosemary, resveratrol 

Detoxification for Phase 1-3: cruciferous veggies, I3C, rosemary, isoflavones, curcurmin, vitamin A, E, and C, NAC, green tea, alpha lipoic acid, flavonoids, superoxide dismutase, folate, B vitamins, glycine, magnesium, adequate dietary fat and protein