 Whether its an experiment or doctor’s orders, going gluten-free is an adjustment. Removing gluten may mean eliminating not only some of your favorite foods, but possibly a good portion of your current diet. What foods will you eat in their place? How will you fill the gluten void?
Most likely, there’s no lack of “gluten-free” versions of your favorite foods on your grocer’s shelves. In fact, the number of gluten-free packaged foods is exploding to keep up with consumer demand. Going gluten-free may be as easy as buying and opening a different box—or bag or carton. But are gluten-free packaged foods the answer? Possibly not. In fact, they may be the surprising reason behind many go-gluten-free resolutions. Here’s why.
There’s a better way. Don’t just swap out one package for another. Relying on gluten-free packaged foods can be taxing on your budget, blood pressure, waistline, and digestion. Rather, consider this an ideal time to shift your diet away from processed foods and toward more whole foods. Instead, give your diet a bona fide upgrade. Reference: Financial Times, Going gluten free: one of 3 trends shaking up commodities https://www.ft.com/content/5348432e-1a13-11e7-bcac-6d03d067f81f, Accessed December 9, 2017.
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 By Noelle Patno, PhD
When you get “the runs,” you need to know what is actually causing the excess stool and how to control it. Diarrhea (“flow through” from the Greek), by definition, is frequent loose stools of small to moderate volume typically during waking hours, in the morning or after meals.1 Often there is a feeling of extreme urgency along with the sense of incomplete evacuation. If diarrhea is accompanied by blood or grease or is of large volume, this is cause for extra concern, and you should consult your doctor as soon as possible. Diarrhea may be due to multiple causes such as dysbiosis or alteration of the intestinal microbiota which lead to changes in the usual bacterial composition. The ABCs and more of diarrhea causes
Chronic diarrhea is a decrease in fecal consistency lasting for four or more weeks, which requires further investigation by medical personnel. If you have any concerns related to diarrhea, you should discuss them with your healthcare practitioner. References:
 Gut health is important for overall health, and there are many wide-ranging causes that can change and affect gut health. These changes can be from acute causes, such as gastrointestinal surgeries, to others, such as the normal aging process, which may affect gastrointestinal motility. Regardless of the cause, the intestines usually experience changes during the healing or aging process.1
That said, despite any shifts, it’s important to get back on track as soon as possible and make the gut the best it can be.1 Here are a few things to consider. What are the implications of changes in the gut? The gut has trillions of bacteria that help to digest food, absorb nutrients, and manage our wellbeing.Many of these bacteria are beneficial, and evidence has shown that good gut health is linked to supporting general health, including the immune system and brain. However, certain gastrointestinal conditions can lead to changes in the gut’s microbial environment and result in poor health and wellness.2 Common sources of gut-health changes include shifts in gut immunity, stomach acid, and gastrointestinal flora (that is, the ecosystem of over 400 bacterial species that make up the microbiome).2,3 Some digestive changes—including compromised gut function—are simply caused by the aging process.3This is because our natural metabolic processes slow as we grow older. Are there ways to support common gastrointestinal changes? You’ve probably heard the expression, “prevention is the best form of medicine.” Prevention is admittedly king in a healthcare setting, but it also involves hard work and dedication. So how can we avoid intestinal changes that may affect gut health? Here are some preventive strategies that may help keep your gastrointestinal health in check:4
Which ingredients can enhance gut health?Many foods and supplements are connected to a healthy gut and a strong digestive tract.4 Some options to explore include: 1. Probiotics Probiotics are “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.”6,7 They offer a number of benefits, including supporting digestion, and data suggests a gut-brain connection exists.8 While only strain-identified probiotics have been researched extensively for specific health benefits, fermented foods, such as kimchi, miso soup, kombucha, and kefir are popular dietary sources of probiotics. Most probiotics come from one of the following genera of bacteria:8
2. Prebiotics Prebiotics are fibrous carbs the human body cannot digest (but certain bacteria in the gut can). They serve as food for probiotics and include oats, garlic, onions, apple skin, beans, and chicory root.5 Much like probiotics, prebiotics encourage healthy digestion.8 3. Fiber When it comes to improving our digestive health, fiber—also known as roughage—is crucial.13 It cannot be digested by the body; rather, it passes through the stomach, small intestine, and colon more or less intact.9 Fruits and vegetable, whole grains, beans, and legumes are all rich in fiber.14 Fibrous ingredients are generally full of nutrients as well, which may enhance our absorption abilities.13 There are two types of fiber, one of which is more closely linked to the digestive system:13
Be sure to discuss your fiber intake with your healthcare practitioner to minimize chances of discomfort.13 4. Glutamine This amino acid provides both a source of fuel and precursors for growth to the rapidly dividing cells of the intestinal lining.15 5. Inner-leaf aloe Sourced from the aloe vera plant, inner-leaf aloe has been shown in studies to support temporary digestive symptoms such as cramping, bloating, and flatulence.16 It has also been shown to a support a healthy intestinal lining.17 6. Zinc-carnosine Ideal for gastric comfort, zinc-carnosine works by supporting the healthy ecology and integrity of the stomach lining.18,19 Always consult your healthcare practitioner before making any adjustments to your diet or adding any supplements. For more information on nutrition and gut health, please visit the Metagenics blog. References
 By Robert Silverman, DC, DACBN, DCBCN, MS, CCN, CNS, CSCS, CIISN, CKTP, CES, HKC, FAKTR In a perfect world, we would garner all the vitamins and nutritional minerals we need from the foods we eat. We’d also be able to maintain robust, resilient immune systems to fight against all toxins and disease. Unfortunately, that’s not the world we live in. The nutrients we need to maintain our day-to-day health, like magnesium, vitamin D, and omega-3 fatty acids, are also critical for maintaining our health over the long term.1 Yet Americans on average get about 11 percent of their daily calories from low-nutrient fast food.2 Even when we skip fast food and junk food, we aren’t always as careful about our diet as we should be. Stress and poor lifestyle behaviors, including smoking and alcohol use, reduce our ability to absorb nutrients. Taking a daily multivitamin can help when your food isn’t as nutritious as it should be, but is that enough—even if you lead a generally healthy lifestyle? Aside from specific dietary needs that should be addressed with your functional health practitioner, here are five instances when I recommend leveraging the power of supplements. To aid healthy sleep patterns Among the many reasons to get a good night’s sleep is the link between sleep deprivation and negative health consequences. For example, people with high blood sugar often don’t sleep well. There’s evidence that not sleeping well can increase your risk of developing more serious complications. When choosing supplements for quality, restorative sleep, look to ingredients that help ease tension, support deep sleep, and promote physical regeneration during sleep. L-theanine enables the body to produce other calming amino acids, such as dopamine, GABA, and tryptophan and helps support concentration, focus, deep muscle relaxation, and improved quality sleep. Ashwagandha, another sleep-supporting supplement, contains active constituents called glyco-withanolides, which mimic certain corticosteroids, supporting healthy cortisol levels and the circadian rhythm. The best-known ingredient, melatonin, supports sleep onset, quality of sleep, increased REM time, deep sleep, and dreaming—all factors that lead to better quality sleep and produce greater mental, physical, and emotional rejuvenation. Melatonin can decrease the amount of time required to fall asleep, increase the number of sleeping hours, and support daytime alertness. I recommend taking just 5 mg of melatonin, as taking too much can impair the body’s natural production of it and may cause us to become dependent on the artificial form. Magnesium, a calming nutrient, can also help induce a deeper sleep, especially when taken together with calcium. Research from the Biochemistry and Neurophysiology Unit at the University of Geneva, Department of Psychiatry indicates that higher levels of magnesium helped provide better, more consistent sleep.3 Other natural supplements containing lavender oil work to encourage a restful night’s sleep by modulating the metabolism of melatonin and promoting relaxation.4 To support your brain health Getting consistent, sufficient sleep lays a solid foundation for your brain’s health, but how you feed your brain plays a critical role in its wellbeing over time. By combining a brain-healthy diet with nutritional supplements, you’ll provide your brain with the fuel it needs for optimum levels of functioning. Here are four supplements I’d recommend to support brain health:
To feed your gut We all know the old adage: “go with your gut.” But it turns out listening to your gut is much more than following your natural instinct. To support your gut’s health, start first with prebiotics—ingredients that induce the growth of beneficial microorganisms in your gut. You’ll also want to consume foods packed with probiotics. The combination of prebiotics and probiotics can help keep your microbiome in a healthy balance, with a good diversity of intestinal bacteria in your gut. When you have plenty of good bacteria, the harmful ones get crowded out. Your digestion also improves, because your ability to absorb macronutrients and micronutrients is better when your beneficial bacteria are diverse and balanced. To properly rehydrate after exercise After exercising, proper fueling requires more than just replenishing calories and fluids; it also involves consistent and adequate electrolyte support. Electrolytes are substances that are utilized by the body to create electrically charged fluids. Many bodily functions depend on electrolytes, especially in muscle and nervous system tissue. Major electrolytes found in the body include sodium, chloride, potassium, magnesium, calcium, phosphate, and bicarbonate. The right rehydration supplements are scientifically designed to help support fluid balance; supply sodium and potassium to help replenish the electrolytes lost during exercise; deliver key electrolytes to help replace those lost through sweating during exercise, activity, or hot weather conditions; and support hydration during exercise.5 Whether you practice health-forward habits—like consuming gut-healthy prebiotics and probiotics and exercising regularly—or your diet consists of mostly empty calories and low levels of nutrients, incorporating supplements can help. In our fast-paced, modern world, supplements provide the support our bodies need to keep up—and sustain our health for the long run. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. References:
 Inflammation is a popular buzzword these days. But what causes it exactly? How can you know you have it, and if it’s something your body does naturally to help you heal, then what’s the big deal?
We’ve all been there: It’s late, you’re tired, and you don’t feel like turning the lights on just to cross a room…then bam! Shin finds coffee table. The resulting egg-shaped lump is formed when blood flow increases to the area, bringing with it neutrophils and macrophages as part of the immune response. Symptoms of this acute inflammation are typical: redness, swelling, heat, and pain. The swelling that occurs as fluid collects in the area is also called “edema.” The symptoms last for a limited period of time—minutes to days—as the body heals itself. Acute inflammation vs. chronic inflammation When the body isn’t given enough time, or if the body is unable to resolve the immune response due to deficiency of certain nutrients, it can lead to chronic inflammation. This can also be caused by untreated infectious pathogens such as bacteria or viruses, as well as the adverse effects of long-term exposure to pollutants or chemicals, including smoking.1,2 Stress and obesity are also known factors that lead to chronic inflammation.3,4 Common symptoms of chronic inflammation include:
What can we do?While acute inflammation is one way your body can heal itself, chronic inflammation should be avoided, as a prolonged inflammatory response can cause damage to healthy cells and tissue. Consider adopting a few simple ways to decrease inflammation. If you have been experiencing the symptoms described herein and are concerned you may have chronic inflammation, make an appointment with your healthcare practitioner. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. References:
 When your body’s gut microbiome falls out of balance, there are many ways it can affect your health.
What’s a microbiome? It’s the genetic material of all microbes—bacteria—that live on and inside your body. The good bacteria that contribute to your intestinal microbiome are essential to your health, development, immune function, and nutritional status. Sound complex? It is! And it’s a delicate balance that can easily be disrupted. Here are five key ways your gut microbiome may be negatively impacted:1
*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. References:
 Nowadays, detoxing is on everyone’s mind, especially when living in increasingly toxic environments and experiencing negative health effects. If you think that a detox might be right for you, there’s a way to do it right and ensure you are safely achieving the results you are looking for. Here are three easy tips to keep in mind to make the most out of your detox:
In summary, if you feel tempted to try out the latest detox program, keep this checklist in mind. It’s designed to help you know how often to do a detox, the importance of targeted nutrients, and, most of all, how to ensure your chosen detox is safe and based on good science. [i]Klein AV, Kiat H. Detox diets for toxin elimination and weight management: a critical review of the evidence. J Hum Nutr Diet. 2015 Dec;28(6):675-86. doi: 10.1111/jhn.12286. Epub 2014 Dec 18. [ii]Lamb JJ, Konda VR, Quig DW, Desai A, Minich DM, Bouillon L, Chang JL, Hsi A, Lerman RH, Kornberg J, Bland JS, Tripp ML. Altern Ther Health Med. 2011 Mar-Apr;17(2):36-44. [iii]Bland JS, Barrager E, Reedy RG, Bland K. Altern Ther Health Med. 1995 Nov 1;1(5):62-71. 
Dining out should be relaxing. But if you have a gluten sensitivity, a bit of skepticism should be on the menu. Typical recommendations, such as seeking a gluten-free menu and letting the server know about one’s dietary restrictions, may give the diner a false sense of assurance.
Here’s why—and how—gluten digestive enzymes can improve your dining experience. Is the Gluten-Free Menu Really Enough? First, consider economics. While awareness for the concerns of gluten-free customer is growing, the restaurant industry is challenged by slim margins and regular employee turnover. Further, appropriately accommodating these customers requires much more than simply stocking gluten-free breads and pastas. So, if a restaurant invests in the training and infrastructure to adequately support the needs of these customers, it will likely promote its efforts and will welcome questions. Second, not all restaurants have a gluten-free menu, leaving the diner to navigate the standard menu. Unfortunately, it’s not a good idea to assume anything about the ingredients on any menu, especially those of chain restaurants, often the only option for a traveler. Discerning gluten-free diners need to ask some very specific questions to determine the risk for gluten exposure from raw ingredients or cross-contamination. But will a well-meaning airport restaurant manager have the answers? Some Questions to Determine Possible Gluten Exposure
How Can the Right Enzymes Help? Gluten-sensitive patients will always need to wear their detective hat when dining out. However, medical professionals can support them by recommending targeted support to break down hidden gluten enzymatically. But which gluten enzymes might help the most? SpectraZyme Gluten Digest is a bacterially derived, clinically researched prolyl endoprotease (AN-PEP). It has many advantages over popular market offerings that feature exoprotease proteolytic enzymes, also known as didpeptidyl peptidase IV (DPP-IV). In short, the AN-PEP is more effective in the low pH environment of the stomach with or without the other enzymes naturally present in the digestive tract. SpectraZyme Gluten Digest is also a proline-specific endoprotease. This means it can specifically cleave the gluten and gluten peptides after any of the many proline residues, breaking down protein over the entire length of protein and peptide chains, not just at the ends. As a result, the enzyme breaks up the gluten more completely. So less hidden gluten will reach the duodenum 
Gluten-sensitive individuals can’t avoid all gluten exposure. But, with SpectraZyme Gluten Digest, they can minimize their risk when dining away from home.
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About Maribeth Evezich
Maribeth Evezich, MS, RD is a functional nutrition and therapeutic lifestyle consultant. Maribeth is also a graduate of Bastyr University and the Natural Gourmet Institute. Whether she is in her kitchen experimenting, at her computer researching, or behind the lens of her camera, she is on a mission to inspire others to love whole foods. as much as she does. She lives in Seattle and is the founder of Lifestyle Medicine Consulting, LLC and the culinary nutrition blog, Whole Foods Explorer. Maribeth Evezich is a paid consultant and guest writer for Metagenics. 
A Guide to the Scientifically Based, Functional Medicine Approach
People either swoon or cringe when they hear the word “detox.” Those who stand behind it claim it gets rid of their symptoms—everything from brain fog to joint pain and fatigue—while others strongly assert there is no need to detox, and it is just marketing hype. Why such polarized views?
“Detox” used to mean many things, which may be part of the reason for the discrepancy. To some, it might simply be drinking lemon juice in water, sitting in a sauna, or maybe doing a juice fast. However, within Functional Medicine, detox has a specific definition: it is the process of reducing the body’s toxic load by lessening exposure to harmful chemicals we are taking in, while simultaneously implementing nutrition and lifestyle strategies to promote efficient elimination of toxins from the body1. The first step of detoxification can be done, in part, by lessening the immune system load by removing reactive foods from the diet. The gold standard for this removal is the aptly named “elimination diet”, which is a simplified list of foods to eat and foods to exclude as part of a detox program. Typically, common allergenic foods and beverages containing corn, soy, wheat/gluten, eggs, dairy, shellfish, and peanuts are omitted from the daily diet in conjunction with caffeine, sugar, alcohol, and red meat for 10 to 28 days, depending on the duration of the program. In scientific literature, using an elimination diet in various formats has historically been used to address various conditions2,3,4,5,6 with differing levels of success. In Functional Medicine, the elimination diet is often used as the first line of therapy for immune and gastrointestinal issues since it can help with reducing toxic load and cooling down any immune reactivity to foods. In conjunction with removal of foods, it’s best to take a complementary approach to bolstering the body with specific nutrients to help fortify its pathways of detoxification in the liver, so toxins can be easily removed. For example, it is well known that certain vitamins and minerals—like B vitamins and iron—are required to assist in the activity of these enzymes7. Coupling nutrients together with an elimination diet (through their inclusion as whole, plant-based foods and as scientifically formulated dietary supplements) is perhaps the most robust protocol for a medical detoxification regimen. In support of this approach, Lamb et al8. showed that a 4-week elimination diet? together with nutrient supplementation ? was helpful in reducing symptoms in women with fibromyalgia. In conclusion, detox has a very specific and science-based definition within Functional Medicine. In practice, Functional Medicine programs that modify dietary intake and supplement nutritional co-factors that support the body’s endogenous detoxification pathways can mitigate toxic burden to reduce incoming toxic exposures, and, at the same time, equip the body with nutrients known to support the body’s natural capacity to shuttle toxins out. 1 Institute for Functional Medicine. https://www.functionalmedicine.org/ 2 Warners MJ, Vlieg-Boerstra BJ, Bredenoord AJ. Elimination and elemental diet therapy in eosinophilic oesophagitis. Best Pract Res Clin Gastroenterol. 2015 Oct;29(5):793-803. 3 Kim J, Kwon J, Noh G, Lee SS. The effects of elimination diet on nutritional status in subjects with atopic dermatitis. Nutr Res Pract. 2013 Dec;7(6):488-94. 4 Alpay K, Ertas M, Orhan EK, Ustay DK, Lieners C, Baykan B. Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomised, cross-over trial. Cephalalgia. 2010 Jul;30(7):829-37. doi: 10.1177/0333102410361404. Epub 2010 Mar 10. 5 Bunner AE, Agarwal U, Gonzales JF, Valente F, Barnard ND. Nutrition intervention for migraine: a randomized crossover trial. J Headache Pain. 2014 Oct 23;15:69. doi: 10.1186/1129-2377-15-69. 6 Pastorello EA, Stocchi L, Pravettoni V, Bigi A, Schilke ML, Incorvaia C, Zanussi C. Role of the elimination diet in adults with food allergy. J Allergy Clin Immunol. 1989 Oct;84(4 Pt 1):475-83. 7 Textbook of Functional Medicine. Institute for Functional Medicine. Gig Harbor, WA. 2006. 8 Lamb JJ, Konda VR, Quig DW, Desai A, Minich DM, Bouillon L, Chang JL, Hsi A, Lerman RH, Kornberg J, Bland JS, Tripp ML. . Altern Ther Health Med. 2011 Mar-Apr;17(2):36-44. About Deanna Minich
Guest blogger Dr. Deanna Minich is an internationally recognized health expert and author with more than 20 years of experience in nutrition, mind-body health, and functional medicine. Dr. Minich holds Master’s and Doctorate degrees in nutrition and has lectured extensively throughout the world on health topics, teaching patients and health professionals about nutrition. She is a Fellow of the American College of Nutrition, a Certified Nutrition Specialist, and a Certified Functional Medicine Practitioner. Currently, Dr. Minich teaches for the Institute for Functional Medicine and for the graduate program in functional medicine at the University of Western States. Her passion is bringing forth a colorful, whole-self approach to nourishment called Whole Detox and bridging the gaps between science, soul, and art in medicine. 
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