Finding the right nutrition plan can be frustrating. Many people tell me they are fed up with trying to feed their health correctly and just want someone to tell them exactly what to do. This is why fad diets come and go and often leave people more confused than before. The truth is there is no one-size-fits all diet. But it doesn’t have to be difficult to find the right nutrition plan if you know how to personalize elements of the plan for you and your goals. Follow this step by step guide to get started.
1. Food Hygiene
Before we get to what to eat, we need to talk about how to eat it. Good food hygiene is a commonly overlooked way of improving digestion and nutrition status. But the truth is, when you’re stressed you can’t digest well, because your blood is shunted away from your digestive organs to your lungs and extremities so you can run away from or fight the threats your body is perceiving. To digest all the good stuff you are eating you need to be in a state of parasympathetic “rest & digest” relaxation. Many people with health concerns and chronic illnesses, live in a state of sympathetic “fight or flight” overdrive. We have to disrupt the vicious cycle of stress, especially at meal time.
Here’s how to decrease stress and improve digestion when you sit down to eat:
- Eat your meals at home. Cooking and smelling the food as it cooks starts the digestive process.
- Sit down and take 9 deep breaths before beginning your meal.
- Save stressful conversations for another time. Don’t eat with people you don’t like. Meal time is for relaxing.
- Limit liquids with meals to avoid diluting stomach acid. Enjoy 1 cup before and ½ after your meal or ½ cup during your meal with apple cider vinegar to aid digestion (optional).
- Chew your food.
- Put your fork down in between bites.
- Go for a leisurely walk after dinner.
2. Eliminate Inflammatory Foods For 21 Days
An elimination diet removing common inflammatory foods for 21 days is more than a diet. It’s a treatment and a test. This is the best way to begin personalizing your nutrition plan so you can get clarity on which foods are helping you and which foods are hurting you.
For this simple, yet powerful process to work you have to commit to avoiding these foods 100% without a single cheat for 21 days. (Don’t blame me, I didn’t make up the rules of the immune system.) 21 days is the amount of time it takes for your immune system to stop producing antibodies that attack a food that it has tagged as an invader. Taking a break from inflammatory foods gives your immune system time to heal and reduces inflammation. Later in this process, you will systematically reduce foods to figure out which foods you are sensitive to.
Eat High Quality, Nutrient Dense Foods
Yes: High Energy, Nutrient Dense Foods
- Vegetables: Eat a variety of vegetables, covering the color spectrum. Ideally organic and in season.
- Healthy Fats: Pastured/grassfed clarified butter or ghee, coconut oil, olive oil, avocados/avocado oil, lard, and tallow.
- Fish & Animal Protein: Raised without antibiotics and added hormones. Ideally wild caught or wild fish and pastured/grassfed chicken, beef, lamb, pork, or wild game.
- Eggs: From chickens raised without antibiotics and hormones, ideally pasture raised.
- Nuts & Nut Butters: Nuts ideally raw and unsalted. Nut butters made without hydrogenated oils or added sugar.
- Fruit: Enjoy fresh fruits in season and in moderation. Think of them as desert vegetables. (Avoid dried fruit and drinking fruit juice, due to the high sugar content).
- Spices & Flavorings: Vinegar, all spices, sea salt, pepper, seaweed, herbs, and mustard.
- Fermented Foods: Kombucha, Raw Sauerkraut.
No: Low Energy, Nutrient Poor Foods, & Common Allergens
- Processed Foods: Eat food from farms, not labs. If it wasn’t grown or raised, don’t eat it. If the ingredient list is long and difficult to pronounce, don’t eat it.
- Rancid Oils: Seed oils like canola/rapeseed oil, vegetable/soybean oil, and safflower oil.
- Grains: Wheat, rice, corn, oats, rye, millet, bulgur, sorghum, buckwheat, sprouted grains and all gluten-free grains, including quinoa and amaranth.
- Legumes: Beans, lentils, soy, peanuts, and peanut butter.
- Soy: Soy sauce, soybean oil in processed foods, tempeh, tofu, soy milk, soy yogurt, soy miso.
- Avoid trying to re-create baked goods and treats with approved ingredients.
- Nightshade Family Vegetables: White and red potatoes, tomatoes, peppers, and eggplant.
- Sugar, Alcohol, and Sweeteners: Maple syrup, honey, agave, coconut sugar, Splenda, Equal, Sweet’N Low, Nutrasweet, xylitol, or stevia.
- Avoid iodized salt, which contains sugar as a preservative.
- Dairy: Butter, cheese, yogurt, cream, and milk.
- Read labels carefully and make sure to avoid added sugars, soy, carrageenan, MSG or sulfites.
3. Clean Up Your Gut
All chronic disease either begins or is exacerbated by leaky gut (intestinal permeability). Leaky gut is a condition where inflammation that begins in the gut due to poor nutrition, environmental toxicity, stress, or digestive organ infections allows food particles, pathogens, and antigens to pass from the small intestine into the bloodstream on the other side of the intestinal lumen. These intruders that should stay in the digestive tract to be dealt with and not present themselves in the blood, triggering an inflammatory response. If leaky gut is not addressed, this inflammation becomes chronic and is triggered every time you eat.
4. Paleo, Mediterranean, or Vegetarian? It Depends!
There is no one size fits all diet. What the paleo, mediterranean, and vegetarian diets agree on is that processed foods will wreck your health and whole foods that were grown or raised on a farm are the best. In a population of patients with thyroid disorders, autoimmunity, difficulty losing weight, and other chronic illnesses, I have found that a diet focused on vegetables, protein, and healthy fats with minimized grains in ratios that fit the person’s specific health goals and conditions is the most effective. We will get to how to customize your nutrition plan in just a moment, but for now, here’s what we can all agree on:
- Fill your plate with as many vegetables as you want (especially at breakfast). Eat half a plate of vegetables or more with each meal.
- Eating 9 cups of vegetables a day in an array of colors is the best way to maximize your micronutrient intake.
- Eat leafy greens with every meal (Yes, breakfast too!)
- Eat cruciferous vegetables with every meal (broccoli, cauliflower, kale, brussels sprouts, cabbage, etc).
- Eat protein with every meal. A portion about the size of your palm is ideal.
- Enjoy healthy fats by cooking with grass fed butter or ghee and coconut oil. Olive oil is best served cold and excellent for salad dressings.
- Enjoy fruit in moderation. Berries are lower in sugar and contain incredible antioxidants.
5. Identify Food Sensitivities
To identify food sensitivities you must have eliminated the food that you want to test for at least 21 days, without exceptions. You most likely will have experienced exciting results from the inflammatory food elimination and focus on high quality, nutrient dense foods. Using the elimination diet alone I have seen skin problems improve or disappear, 10 lbs or more fat burned, increased energy, elimination of pain and headaches, improved mood, and better sleep. All from using food as medicine.
Now that you have created a clean slate, it’s time to find out what foods are a problem and which foods are not. To do this, you need to systematically reintroduce each food or food group 72 hours apart. Unlike food allergies which cause an immediate reaction, food sensitivities are mediated by different immune cells that can take up to 72 hours (3 days) to fully react.
Reintroduction Example: Testing Nightshades
The day after completing the elimination diet eat one serving of nightshades (eggplant, peppers, potatoes, and tomatoes) at breakfast, lunch, and dinner. Then go back to eating according to the elimination diet for 2 days. This way you haven’t changed anything except for the nightshades for a total of 3 days (72 hours). If you experience a return of old symptoms that improved with the elimination diet or new symptoms in that 3 day period that is a positive sign that you are sensitive to that food.
Example Reintroduction Schedule (In order of least likely to cause problems to most likely to cause problems)
- Day 1: Legumes (Beans, Humus).
- Day 4: Nightshades (Eggplant, Peppers, Potatoes, and Tomatoes).
- Day 7: Peanuts & Peanut Butter (Not a great food, best to avoid and replace
- with Nuts and Nut Butters).
- Day 10: Non-Gluten Grains (White rice, quinoa, gluten-free oats, gluten free
- Day 13: Corn (Frozen or fresh corn, corn chips).
- Day 16: Soy (Tamari)
- Day 19: Dairy (Can individually test ghee, goat cheese, hard cheese, yogurt, butter, cheese, milk/cream).
- Day 22 Gluten: (Wheat, rye, or barley. Sprouted rye bread is best for testing.)
Getting the right amount of protein is crucial for stabilizing blood sugar, weight loss support, increasing muscle mass – and the metabolism of our organs, muscles, hormones, and neurotransmitters.
Choosing the right protein intake should be individualized for your goals.
- 10-25% protein daily calorie intake for for general maintenance.
- 25-30% protein daily calorie intake for weight loss.
- 30-35% protein daily calorie intake for intensive weight loss.
Many people mistakenly assume that eating too much protein will hinder their weight loss efforts, when in reality it is just the opposite. Protein is lower in calorie density, which will make you feel full while spontaneously lowering your overall caloric load without counting calories.
The value of carbohydrates is often lost in translation, as our culture is shifting from fat-phobic to low carb popularity. A very low carbohydrate diet is not always the right approach for an individual and a paleo template diet is not necessarily low in carbohydrates. Refined carbohydrates like bread, pasta, and baked goods should be avoided, because they are very high in carbohydrates that convert into sugar and very low in nutrients. However whole food carbohydrates like potatoes, sweet potatoes, squash, beets, carrots, plantains, parsnips, turnips can be helpful to keep from going too low carb in the case adrenal, thyroid, or weight maintenance problems.
Carbohydrate intake needs to be customized to each individual’s health goals. Here are some examples: *In these examples, non-starchy vegetables are not counted. Count only starchy vegetables like the ones listed above.
- <10% carbohydrate daily calorie intake. A very low carb approach is best for people with severely high blood sugar and neurological conditions.
- 10-15% carbohydrate daily calorie intake. A low carb approach is best for people with high blood sugar and difficulty losing weight.*In addition to reducing carbs, weight loss in enhanced by eating 25-30 grams of protein in the morning and eating most daily carbohydrates in the evening.
- 15-30% carbohydrate daily calorie intake. A moderate carb approach is best for people with adrenal problems, hypothyroidism, and maintenance health and weight plans.
Healthy fats like grass-fed butter or ghee, coconut oil, olive oil, lard from organic, grass-fed animals, and fats naturally found in whole foods like fish, nuts & seeds, avocado, eggs, and full-fat dairy (if tolerated) are essential for our cellular health, mitochondrial function (energy production), hormone health, cardiovascular health, and brain health.
For people who are seeking increased brain function, grass-fed butter and coconut oil (or MCT oil derived from it) added to food, smoothies, or coffee can provide the brain fuel needed. However, if gallbladder function is compromised or if you have reached a weight loss plateau – focusing on whole foods with fat in them and minimizing added and cooking fat is a helpful strategy.
*If you are going to add extra fat for brain function and ketosis, make sure you are getting enough protein, especially in the morning.
Meal timing is an important part of any nutrition plan and is commonly overlooked. General guidelines for meal timing are to eat 2-3 meals per day with little to no snacking in between meals. But if you’re hungry – eat!
Healthy snacks focus on protein, fat, and vegetables. Examples are a small handful of raw nuts/seeds, avocado with Himalayan salt, guacamole and veggies, hard-boiled eggs with veggies, fermented foods (pickles, olives, sauerkraut).
Snacking a lot between meals or grazing all day inhibits intestinal motility that is necessary for the digestive tract to clean house and prevent overgrowth of fungi and bacteria in the small intestine.
However, meal timing can be adjusted to promote specific health goals. Intermittent fasting is appropriate for weight loss, but only if you are eating a paleo diet focused on starchy vegetables as carbohydrates. This approach doesn’t work well if you’re eating a lot of refined carbohydrates (even if they are gluten free), because the high intake of sugar can cause spikes and drops in blood sugar.
Intermittent fasting is also inappropriate for people with uncontrolled autoimmunity, thyroid problems, and adrenal dysfunction due to the stress it can cause the body under the wrong conditions.
Intermittent Fasting for Weight Loss & Digestive Health (check with your physcian first)
- *Contraindicated for patients with autoimmunity and non-paleo (processed food) diets.
- *Contraindicated for thyroid and adrenal problems
- Limit the amount of time during the day that you’re eating and digesting
- Start with an 8-11 hour eating window and work towards 6-8 hours – noon to 6pm or 8pm.
- After dinner until breakfast the next day, the GI tract will rest and repair.
Meal timing for adrenal health requires more frequent meals 3-5x per day to balance blood sugar and prevent cortisol from spiking. While insulin captures glucose in the blood and brings it into the cells for use or to the fat tissue for storage, cortisol dumps glucose into the bloodstream when blood sugar drops too low. This is one of the reasons healthy sleep habits and stress reduction has such a profound effect on blood sugar problems and diabetes.
11. Advanced Nutrition For Specific Health Conditions
- Arthritis & Joint Pain: Avoid nightshades (potatoes, tomatoes, peppers, eggplant).
- Acid Reflux: Avoid sugar, grains, chocolate, peppermint, coffee, acidic foods.
- Digestive Disorders: Cabbage for gastritis. Bone broth for leaky gut.
- Respiratory Problems: Avoid citrus and dairy.
- Low Thyroid Function: Add Brazil Nuts (rich in selenium) and oysters (rich in zinc).
12. Next Steps
Now you have a crash course in individualized nutrition and an overview of all the essential elements that need to be considered when customizing nutrition to your personal needs and goals. Good nutrition and digestion are foundational strengths for optimal health. It’s a process to find the right formula. Be patient with yourself and consider seeking expert help for the fastest path forward.
Dr. DeFrancesco partners with patients seeking a smarter & sustainable approach to health by doing the detective work to uncover root cause(s) and design a personalized and comprehensive plan that includes nutrition, lifestyle, functional medicine, and root cause therapies.
This approach benefits people who are seeking help with chronic inflammatory conditions, autoimmunity, thyroid conditions, digestive problems, brain health, and health optimization.