After Surgery

Expect stay in the hospital one to two days after this procedure. On the morning after your procedure you will get a swallowing study to make sure everything is in the proper place. After that, you will start on a liquid diet.

This surgical procedure does require diet restrictions after surgery. You will need to stay on a liquid/soft diet for approximately 3 weeks after surgery. During that time, you can try or experiment with eating soft, mushy foods like tuna, mashed potatoes, eggs, cottage cheese, and thick soups. The reason for liquids is that there will be some swelling in your esophagus where your hernia was repaired. You may also notice that swallowing feels a little tight this will improves as the swelling goes down. With time, you will be able to digest foods normally. ALSO, DO NOT DRINK CARBONATED BEVERAGES FOR THREE WEEKS.

Some patients find that their appetite is poor or that foods dont taste well after surgery. This is a normal result of the stress of surgery and manipulation inside the belly your appetite should return in several weeks. If you do not eat, this is OK; the most important thing is to drink liquids. If you find you are persistently nauseated or unable to take in liquids, contact our office and let us know.

It is OK to shower starting around 36 hours after surgery. If you have little patches of white gauze or band-aides on the incisions, take off the gauze/band-aides before showering.

You might see little pieces of tape (called steri-strips) directly attached to your skin. It is OK to get these little tapes wet in the shower. The tapes will begin to peel up on the ends 7-10 days after surgery at this point they have done their job and it is OK for you to peel them the rest of the way off if you wish. You do not have to have them on when you come for your postoperative visit.

No baths, pools or hot tubs for two weeks.

We try to close your incisions to leave the smallest possible scar. Do not put any ointment or other medication on your incisions it will not make them heal better.

There are no significant restrictions on activity after surgery. That means it is OK to walk, climb stairs, have sexual intercourse, mow the lawn, or exercise as long as it doesnt hurt. In fact, returning to normal activity as soon as possible will most likely enhance your recovery. However, if it doesnt feel good, dont do it. Take it easy and let the pain be your guide. Avoid heavy lifting to aide in the healing of your incisions.

You may also feel easily fatigued and washed out for a week or two following the surgery. These factors will put some limitations on your activity, but you will not cause any damage even if some soreness is experienced.

Everyone has different motivations toward their job, and thus everyone returns to work at different times. As a rough guide, most people take at least 1-2 weeks off prior to returning to work. If you need particular documentation for your job, call the office.

You will usually be able drive when you have not needed the narcotic (prescription) pain medications for two days.

The first bowel movement may occur anywhere from 1-5 days after surgery as long as you are not nauseated or having abdominal pain this variation is acceptable. Remember that it is very common to pass a lot more gas from your rectum than you used to this is because you will not be able to really belch. Some patients also find that they have diarrhea or loose bowels for the first days after their hernia repair in the vast majority of cases, the bowel function normalizes with time. Constipation may also be common due to the pain medication. We recommend taking Milk of Magnesia (2 tablespoons; twice a day) while taking the pain pills to avoid constipation.

Call your surgeons office if any of the following occur:

Continue reading here:
Hiatal (Nissen Fundoplication, Paraesophageal) Hernias ...

Dietary Strategies to Help Manage and Reduce IBD Symptoms

Inflammatory bowel disease (IBD) is not caused, nor can it be cured, by what you eat. Doctors and dietitians agree, however, that food may play some role in the underlying inflammatory process that causes IBD symptoms.

Certain foods may aggravate symptoms, while others may calm them and promote healing. Therefore, paying attention to what you eat and how your body responds to different foods is an important component of a total treatment plan for IBD.

A diet plan can supplement but should never replace medical treatment for IBD. Always take your medications exactly as prescribed by your doctor.

Inflammatory bowel disease is often associated with malnutrition due to:

Malnourishment and weight loss in women and girls can impact hormone levels and result in menstrual changes or missed periods. In children and teenagers, it can slow their growth and development.

Patients should talk to a doctor or dietitian to create a well-balanced diet customized for them based on the disease they have (Crohns disease or ulcerative colitis); the location and extent of their disease; and whether their disease is active or in remission.

The dietary recommendations listed here are intended to provide some very general guidelines only. There is no single eating plan that works for everyone with IBD and an ongoing collaboration with a licensed dietitian or your doctor is recommended.

Even when your symptoms are inactive, it is very important to eat a balanced diet with lots of variety. IBD medications tend to be more effective in well-nourished individuals, so try to include the following in your diet every day:

Although what you eat will not completely resolve most IBD symptoms, eating or not eating certain foods can often help to minimize them and ease discomfort. It is also advisable to eat smaller portions, more frequently.

*Many people find that it is helpful to keep a food journal to track their bodys response to certain foods. This can help to identify trigger foods to avoid. However, you should always talk to your doctor before totally eliminating any foods or food groups from your diet as this can lead to nutritional deficiencies.

Excerpt from:
Diet Guide | Inflammatory Bowel Disease Center ...

Many people wonder what they can do immediately to manage their chronic health condition. The science can be confusing and complex, especially to those with Hashimotos hypothyroidism and other autoimmune diseases, because these disorders can lead to brain fog, fatigue, and loss of cognitive function that make it hard to figure out what to do next.

What people frequently fail to realize is that underlying all of these conditions is the most important foundation of all, and something you have the power to change right now your diet.

In this article, Ill give you the dietary basics for the autoimmune protocol (AIP). The autoimmune protocol is an effective diet and lifestyle protocol that helps autoimmune patients overcome the core underlying factors preventing recovery, including inflammation, leaky gut, hormone imbalances, blood sugar imbalances, micronutrient deficiencies, and immune system dysregulation.

The autoimmune protocol diet is an elimination and reintroduction protocol: For a time you eliminate foods that are known to drive inflammation and resulting symptoms, and then you reintroduce foods methodically to rule out reactivity.

The optimal end result is a diet and lifestyle that support your health while avoiding factors that undermine it.

The diet explained here is stricter than the one in my books. It became clear, based on the research and the experience of many people, that a more stringent approach is often necessary. The diet must be very basic and simple so as not to trigger inflammation in the intestines and further worsen leaky gut and autoimmune flare-ups.

The literature identifies nutritional and herbal compounds that can facilitate your gut-repair progress, which I will introduce in the second edition of the thyroid book, or which your practitioner can help you with. However, this diet is powerful therapy on its own.

In any autoimmune condition, there are several key problem areas that underlie symptoms. The autoimmune protocol seeks to address each of these, bringing the body back into balance so it can function properly.

These are always good basic guidelines with which to start whether you are waiting to work with a practitioner or are going it alone:

When considering this diet the fist thing people ask is what can they eat.In fact youll be eating the way people ate for most of human history theres plenty of food that doesnt come from a factory or an industrialized farm. Of course, if you have an intolerance to any of these foods, dont eat it just because its on this list.

Most organic vegetables:Include as much variety as possible, making sure to include the full color spectrum; anise, arrugula, artichoke, asparagus, beets and their greens, bok choy, broccoli, cabbage, carrots, cauliflower, celery, chives, cucumbers, garlic, kale, kohlrabi, leeks, lettuce, mustard greens, olives, onions, parsley, radishes, rhubarb, shallots, spinach, squash, sweet potatoes and yams (not true potatoes), water chestnuts, watercress, zucchini, etc. Vegetables from the brassica family (broccoli, kale, etc.) are no longer considered bad for thyroid function; please see this article for more information.

Quality meats:beef, chicken, bison, pork, lamb, turkey, and wild game. Select hormone-free and antibiotic-free chicken, turkey, and lamb. Chicken has high Omega 6 content; eat in moderation, and if you consume more, also eat a lot of Omega 3 oils to compensate (see bottom of this section for proper ratios). Select beef that is grass fed, hormone free, and antibiotic free. Best choice arelocally-raised grass-fed and pastured meats; second best is organic. Avoid factory-farmed meats that contain antibiotics and hormones.

Organ meats and offal: heart, liver, kidney, tongue, and bone broth. An important concentrated form of nutrients including vitamins, minerals, healthy fats, and essential amino acids.

Glycine-rich foods: Include foods containing connective tissue, organ meat, joints, skin, or bone broth.

Fish and shellfish: Seek out ocean-caught cold water, low mercury fish with high fat content. Swordfish, most tuna, and king mackerel are very high in mercury.

Quality fats: pasture-raised, grass-fed animal fats, fatty cold water fish, olive oil, avocado oil, coconut oil, low-mercury Omega 3 supplements.

Low glycemic organic fruits: apples, apricots, avocados, berries, cherries, grapefruit, lemons, peaches, pears, plums, etc. Keep sugar intake between 10 and 20g per day.

Edible mushrooms: Mushrooms are generally fine for most individuals. However, some people with autoimmune conditions may react to immune-stimulating fungi such as Maitake and mushroom-derived beta-glucan, so monitor your response.

Probiotic and fermented foods: sauerkraut, kimchi, pickled ginger, fermented cucumbers, coconut yogurt (guar-gum free), kombucha, water kefir, coconut milk kefir, supplements, etc. You may need to make your own or buy one of the few brands that are genuinely fermented and free of sugars or additives. Also, search for information about anaerobic fermented foods in air-tight containers; these ferments do not produce histamines that some people react to (including rashes, digestive upset, inflammation) commonly found in aerobic, or open, ferments typically using mason jars.

Coconut:coconut aminos, coconut milk (guar gum free), coconut water and coconut water vinegar, coconut cream (not concentrate), and coconut oil. Whole coconut products (coconut butter, coconut cream concentrate, coconut flakes and chips, unsweetened coconut yogurt, fresh coconut) have high inulin fiber and moderately high phytic acid, which causes some individuals digestive issues consume in moderation until you know your tolerance level.

Noodles:Shirataki yam noodles (sold in Asian grocery stores and some natural food stores) are fine, but avoid the noodles that contain tofu (soy).

Herbs and spices: basil, cilantro, cinnamon, coriander, clove, cumin, garlic, ginger, horseradish, lemongrass, mace, mint, oregano, parsley, rosemary, sage, saffron, sea salt, thyme, turmeric (black pepper is considered a reintroduction item). Avoid iodized salt unless you are deficient in iodine.

Vinegars: apple cider, balsamic, champagne, coconut, red wine, sherry, ume plum, white wine. Avoid grain-based vinegars: rice and distilled white.

Teas: black, green white, yerba mate (avoid caffeine if you have adrenal fatigue).

Other: herbal teas, carob, rooibos tea, deglycyrrhizinated licorice (DGL) (but not whole licorice root), vanilla extract (if cooked). In moderation: fructose (in fruit and starchy vegetables), pomegranate molasses. Very occasionally: maple syrup and maple sugar, honey, dried fruit, dates and date sugar, molasses, unrefined cane sugar (sucanat, evaporated cane juice, muscovado). Each person has unique tolerance to sugars monitor your response.

Grey areas depending on individual sensitivities: legumes with edible pods (green beans, snow peas). Whole bean coffee in moderation (caution: many instant coffees show gluten contamination). Sugars: Some people have strong reactions to even small amounts of sugars; monitor your response. Seaweeds (high in iodine): Some people with Hashimotos may not do well with additional iodine in the diet.

A note on fatty acids: Consuming a proper ratio of omega-6 to omega-3 fatty acids is key for minimizing inflammation in the body. Too much omega-6 is highly inflammatory, so its important to get enough omega-3 (anti-inflammatory) to compensate. The average American ratio is close to 25 parts omega-6 to 1 part omega-3, resulting in high levels of inflammation. Researchers recommend a ratio of omega-6 to omega-3 fatty acids that ranges from 1:1 to 4:1 for optimal health and prevention of disease.

The autoimmune protocol diet is an elimination and reintroduction protocol: For a time you eliminate foods that are known to drive inflammation and resulting symptoms, and then you reintroduce foods methodically to rule out reactivity.

Everyone asks how long the elimination phase might take, because nobody likes to make major changes in their habits. Timing on reintroductions depends on the individual. A good rule of thumb is to wait for reintroductions until you notice a marked improvement in your symptoms and quality of life; for some thats 30 days, for others its months or even a year.

It may take time to unwind the self-perpetuating inflammatory cycles that lie beneath your symptoms, and its important to not rush into reintroductions. If you begin reintroductions while you are still highly symptomatic you will not be able to gauge whether or not a reintroduced food is causing a reaction and youll need to start over again.

Your stress level, sleep quality, exercise level, nutrient intake, genetics, oral tolerance and underlying health issues will affect your reactions to foods. This affects when you can start reintroductions, and also means as your status with these factors improves over time, you may be able to reintroduce certain foods that previously tested as reactive.

Sometimes, one successfully reintroduces a food, then symptoms start to return. If this happens to you, it may mean you need to stay away from a food you thought was a good addition, until a later date or even permanently.

Symptoms can be represented by any change; digestive upset, mood changes, fatigue, pain, sleep issues, brain fog, skin rash, etc.

IMPORTANT: If you have a reaction to a food reintroduction, you must wait until those symptoms are completely gone before moving on to the next reintroduction.

For more details on how to manage reintroductions properly, please consult with your healthcare practitioner.

Some foods are more likely cause a reaction than others. Its best to reintroduce foods lowest on that list first, ending with the most-likely items. If you have had food sensitivity testing done, leave any foods you have a diagnosed sensitivity for until the end of reintroductions. A general order of reintroduction is:

Egg

Egg yolks first: Most people tolerate the yolks well; intolerance is more common to the whites. Research shows soy protein is transferred to eggs; soy is a common chicken feed, so if you are intolerant to soy, you may find soy-fed chicken eggs are reactive for you.

Seeds before nuts

Introduce one item at a time, not mixed: seed-based spices (no nightshades), oils, butters, flours; raw nuts (soaked); toasted (beware store-bought seeds roasted in non-compliant oils); cocoa; coffee (in moderation).

Dairy

Grass-fed ghee then butter; raw goat yogurt/kefir, milk, cheese; raw cow dairy in the same order. Why raw, why this order? Raw dairy has live enzymes that make it easier to digest. Dairy has three components; butterfat, lactose and casein. Butterfat doesnt cause a problem for many people; intolerance is more common for lactose and casein. Therefore ghee and butter come first. Goat dairy is easier to digest than cow dairy.

Nightshades

These come last because they are the most common food intolerance for those with autoimmune conditions, and if you have an inflammatory reaction, it takes longer to calm down and continue with reintroductions. Be sure to reintroduce one vegetable at a time. You might react to all, or only to some.

Consider never consuming

TomatoesNSAIDS (they disrupt gut health)Grains/Gluten (most reactivity is related to molecular mimicry).Reintroduction of other foods depends on your individual health history and needs.

Grains and legumes are high in proteins called lectins. Lectins have been shown to degrade the intestinal barrier, adding to leaky gut. They can also be transported through the damaged intestinal wall into the bloodstream, where they may bind to insulin receptors and leptin receptors. Some believe lectins may also have the ability to desensitize these receptors, thus contributing to insulin resistance and leptin resistance.

When transported through the gut wall into the blood stream, leptins can also set off an immune reaction that further damages the intestinal wall and sets off systemic inflammation, further supporting the autoimmune reaction.

Grains, legumes and some other foods present problems for other reasons. Research has shown that many gluten-intolerant people cross-react with other foods. In other words, their body erroneously recognizes other foods as gluten and reacts with an immune response that destroys not only the food proteins, but bodily tissue.

Not surprisingly, most grains fall into the category of top 24 foods most often to cause cross-reactivity, including amaranth and quinoa.

Other common cross-reactive foods include dairy, chocolate, sesame,and instantcoffee. Fortunately it is now possible to test which foods might be provoking a cross-reaction to gluten, which you can read abouthere.

I tell all my gluten-free patients to avoid corn, even though this contradicts the advice on many gluten-free websites. The protein in corn is similar enough to that in wheat and wheat-like grains that it can provoke an immune response. Also, corn has been bred over the years to resist pests. Unfortunately this bred into corn a compound called fucosamine, which is carcinogenic.

Tree nuts are one of the top allergens and food sensitivities. Leaky gut is exceedingly common in autoimmune patients, and it increases the likelihood of developing food allergies and sensitivities. By removing seeds and nuts from the diet during elimination phase, one is better able to determine if a sensitivity exists.

In addition, the fiber in nuts and seeds can contribute to gut irritation.

Nighshades contain digestion-resistant and gut-irritating lectins, saponins, and capsaicin (a steroidal stimulant) that can contribute to leaky gut, as well as pass through the gut lining and contribute to systemic inflammation and immune reactivity.

For those battling a history of weight issues or an eating disorder, this diet can be filled with emotional triggers. In these cases I highly recommendsupport for underlying subconscious beliefs about food, eating, and your body. Ideas include hypnotherapy, emotional freedom technique (EFT) workshops or instruction, guided meditations and visualizations. You will find plenty of instruction online.

Subconscious beliefs aside, many are pleasantly surprised to find cravings and obsessions with food diminish or disappear once they remove immune reactive foods, stabilize blood sugar, and eat a nutrient-dense diet.

Many embarking on this diet are entering new territories of food. You may need to shop at different stores or order things online. I have supplied a list of popular sources on theresourcepage.

The autoimmune diet protocol can seem daunting at first, and planning is essential to success. Fortunately, ample support exists on the internet today for a diet such as this. There are online tribes for many variations of diet including paleo, primal, GAPS, SCD, and AIP.

You must have the right foods on hand at all times; its helpful to batch cook so you have meals at hand and are not tempted to fall off the wagon. Thankfully, there are now plenty of great websites that offer recipes compliant with the autoimmune diet, also called the Autoimmune Protocol or AIP.

This dietary and lifestyle protocol is powerful on its own, however to boost the repair and recovery effects, please work with a qualified healthcare practitioner who understands the connections between gut health and the brain, immune system, and endocrine system. He or she can provide you with proven nutritional compounds that have been shown to significantly aid the process of repair and recovery and unwind self-perpetuating inflammatory cycles in the gut and body.

To learn more about why these foods are so important to include or avoid, please see my Oral Tolerance and Save Your Brain courses.

I am working on a book dedicated to leaky gut, gluten, and autoimmunity. I also highly suggest my newest bookWhy Isnt My Brain Working?to learn about ways your brain plays a role in your gut and immune health.

More here:
Autoimmune gut-repair diet Autoimmune protocol | Dr. K. News

The terms Paleolithic diet, paleo diet, caveman diet, and stone-age diet[1] describe modern fad diets requiring the sole or predominant consumption of foods presumed to have been the only foods available to or consumed by humans during the Paleolithic era.[2]

The digestive abilities of anatomically modern humans, however, are different from those of Paleolithic humans, which undermines the diet's core premise.[3] During the 2.6-million-year-long Paleolithic era, the highly variable climate and worldwide spread of human populations meant that humans were, by necessity, nutritionally adaptable. Supporters of the diet mistakenly presuppose that human digestion has remained essentially unchanged over time.[3][4]

While there is wide variability in the way the paleo diet is interpreted,[5] the diet typically includes vegetables, fruits, nuts, roots, and meat and typically excludes foods such as dairy products, grains, sugar, legumes, processed oils, salt, alcohol or coffee.[1][additional citation(s) needed] The diet is based on avoiding not just processed foods, but rather the foods that humans began eating after the Neolithic Revolution when humans transitioned from hunter-gatherer lifestyles to settled agriculture.[2] The ideas behind the diet can be traced to Walter Voegtlin,[6]:41 and were popularized in the best-selling books of Loren Cordain.[7]

Like other fad diets, the Paleo diet is promoted as a way of improving health.[8] There is some evidence that following this diet may lead to improvements in terms of body composition and metabolic effects compared with the typical Western diet[5] or compared with diets recommended by national nutritional guidelines.[9] There is no good evidence, however, that the diet helps with weight loss, other than through the normal mechanisms of calorie restriction.[10] Following the Paleo diet can lead to an inadequate calcium intake, and side effects can include weakness, diarrhea, and headaches.[2][10]

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According to Adrienne Rose Johnson, the idea that the primitive diet was superior to current dietary habits dates back to the 1890s with such writers as Dr.Emmet Densmore and Dr.John Harvey Kellogg. Densmore proclaimed that "bread is the staff of death," while Kellogg supported a diet of starchy and grain-based foods.[11] The idea of a Paleolithic diet can be traced to a 1975 book by gastroenterologist Walter Voegtlin,[6]:41 which in 1985 was further developed by Stanley Boyd Eaton and Melvin Konner, and popularized by Loren Cordain in his 2002 book The Paleo Diet.[7] The terms caveman diet and stone-age diet are also used,[12] as is Paleo Diet, trademarked by Cordain.[13]

In 2012 the Paleolithic diet was described as being one of the "latest trends" in diets, based on the popularity of diet books about it;[14] in 2013 the diet was Google's most searched-for weight-loss method.[15]

Like other fad diets, the paleo diet is marketed with an appeal to nature and a narrative of conspiracy theories about how nutritional research, which does not support the supposed benefits of the paleo diet, is controlled by a malign food industry.[8][16] A Paleo lifestyle and ideology have developed around the diet.[17][18]

The diet advises eating only foods presumed to be available to Paleolithic humans, but there is wide variability in people's understanding of what foods these were, and an accompanying ongoing debate.[2]

In the original description of the paleo diet in Cordain's 2002 book, he advocated eating as much like Paleolithic people as possible, which meant:[19]

The diet is based on avoiding not just modern processed foods, but also the foods that humans began eating after the Neolithic Revolution.[2]

The scientific literature generally uses the term "Paleo nutrition pattern", which has been variously described as:

The aspects of the Paleo diet that advise eating fewer processed foods and less sugar and salt are consistent with mainstream advice about diet.[1] Diets with a paleo nutrition pattern have some similarities to traditional ethnic diets such as the Mediterranean diet that have been found to be healthier than the Western diet.[2][5] Following the Paleo diet, however, can lead to nutritional deficiencies such as those of vitaminD and calcium, which in turn could lead to compromised bone health;[1][20] it can also lead to an increased risk of ingesting toxins from high fish consumption.[2]

Research into the weight loss effects of the paleolithic diet has generally been of poor quality.[10] One trial of obese postmenopausal women found improvements in weight and fat loss after six months, but the benefits had ceased by 24 months; side effects among participants included "weakness, diarrhea, and headaches".[10] In general, any weight loss caused by the diet is merely the result of calorie restriction, rather than a special feature of the diet itself.[10]

As of 2016 there are limited data on the metabolic effects on humans eating a Paleo diet, but the data are based on clinical trials that have been too small to have a statistical significance sufficient to allow the drawing of generalizations.[2][5][20][not in citation given] These preliminary trials have found that participants eating a paleo nutrition pattern had better measures of cardiovascular and metabolic health than people eating a standard diet,[2][9] though the evidence is not strong enough to recommend the Paleo diet for treatment of metabolic syndrome.[9] As of 2014 there was no evidence the paleo diet is effective in treating inflammatory bowel disease.[21]

The rationale for the Paleolithic diet derives from proponents' claims relating to evolutionary medicine.[22] Advocates of the diet state that humans were genetically adapted to eating specifically those foods that were readily available to them in their local environments. These foods therefore shaped the nutritional needs of Paleolithic humans. They argue that the physiology and metabolism of modern humans have changed little since the Paleolithic era.[23] Natural selection is a long process, and the cultural and lifestyle changes introduced by western culture have occurred quickly. The argument is that modern humans have therefore not been able to adapt to the new circumstances.[24] The agricultural revolution brought the addition of grains and dairy to the diet.[25]

According to the model from the evolutionary discordance hypothesis, "[M]any chronic diseases and degenerative conditions evident in modern Western populations have arisen because of a mismatch between Stone Age genes and modern lifestyles."[26] Advocates of the modern Paleo diet have formed their dietary recommendations based on this hypothesis. They argue that modern humans should follow a diet that is nutritionally closer to that of their Paleolithic ancestors.

The evolutionary discordance is incomplete, since it is based mainly on the genetic understanding of the human diet and a unique model of human ancestral diets, without taking into account the flexibility and variability of the human dietary behaviors over time.[27] Studies of a variety of populations around the world show that humans can live healthily with a wide variety of diets, and that in fact, humans have evolved to be flexible eaters.[28] Lactose tolerance is an example of how some humans have adapted to the introduction of dairy into their diet. While the introduction of grains, dairy, and legumes during the Neolithic revolution may have had some adverse effects on modern humans, if humans had not been nutritionally adaptable, these technological developments would have been dropped.[29]

Evolutionary biologist Marlene Zuk writes that the idea that our genetic makeup today matches that of our ancestors is misconceived, and that in debate Cordain was "taken aback" when told that 10,000 years was "plenty of time" for an evolutionary change in human digestive abilities to have taken place.[3]:114 On this basis Zuk dismisses Cordain's claim that the paleo diet is "the one and only diet that fits our genetic makeup".[3]

Advocates of the diet argue that the increase in diseases of affluence after the dawn of agriculture was caused by changes in diet, but others have countered that it may be that pre-agricultural hunter-gatherers did not suffer from the diseases of affluence because they did not live long enough to develop them.[30] Based on the data from hunter-gatherer populations still in existence, it is estimated that at age15, life expectancy was an additional 39 years, for a total age of 54.[31] At age 45, it is estimated that average life expectancy was an additional 19 years, for a total age of 64 years.[32][33] That is to say, in such societies, most deaths occurred in childhood or young adulthood; thus, the population of elderlyand the prevalence of diseases of affluencewas much reduced. Excessive food energy intake relative to energy expended, rather than the consumption of specific foods, is more likely to underlie the diseases of affluence. "The health concerns of the industrial world, where calorie-packed foods are readily available, stem not from deviations from a specific diet but from an imbalance between the energy humans consume and the energy humans spend."[34]

Adoption of the Paleolithic diet assumes that modern humans can reproduce the hunter-gatherer diet. Molecular biologist Marion Nestle argues that "knowledge of the relative proportions of animal and plant foods in the diets of early humans is circumstantial, incomplete, and debatable and that there are insufficient data to identify the composition of a genetically determined optimal diet. The evidence related to Paleolithic diets is best interpreted as supporting the idea that diets based largely on plant foods promote health and longevity, at least under conditions of food abundance and physical activity."[35] Ideas about Paleolithic diet and nutrition are at best hypothetical.[36]

The data for Cordain's book only came from six contemporary hunter-gatherer groups, mainly living in marginal habitats.[37] One of the studies was on the !Kung, whose diet was recorded for a single month, and one was on the Inuit.[37][38][39] Due to these limitations, the book has been criticized as painting an incomplete picture of the diets of Paleolithic humans.[37] It has been noted that the rationale for the diet does not adequately account for the fact that, due to the pressures of artificial selection, most modern domesticated plants and animals differ drastically from their Paleolithic ancestors; likewise, their nutritional profiles are very different from their ancient counterparts. For example, wild almonds produce potentially fatal levels of cyanide, but this trait has been bred out of domesticated varieties using artificial selection. Many vegetables, such as broccoli, did not exist in the Paleolithic period; broccoli, cabbage, cauliflower, and kale are modern cultivars of the ancient species Brassica oleracea.[29]

Trying to devise an ideal diet by studying contemporary hunter-gatherers is difficult because of the great disparities that exist; for example, the animal-derived calorie percentage ranges from 25% for the Gwi people of southern Africa to 99% for the Alaskan Nunamiut.[40]

Researchers have proposed that cooked starches met the energy demands of an increasing brain size, based on variations in the copy number of genes encoding for amylase.[41][42]

Read more:
Paleolithic diet - Wikipedia

Photo:Dimitri Otis / Getty Images

So you tried the ketogenic diet, the ber-popular low-carb, high-fat eating style. By focusing on high-fat foods (all the avocados!), this type of diet puts your body into a state of ketosis, using fat for energy instead of carbs. For many people, this switch results in weight loss, but most don't (or shouldn't) stick with the keto diet long-term unless they're on it for a medical reason. Here's why, plus how to transition off the diet safely if you're considering doing it.

"Life usually ends up getting in the way," says Shoshana Pritzker, R.D., C.D.N., C.S.S.D., a sports nutritionist and registered dietitian. For most people, how long you can stay on keto is however long you can say "no" to typical social munchies and drinks, she adds. Sometimes, you just want to be able to let loose and eat some processed carbs, right?

Plus, there may be health implications to consider. "We're really not sure what kind of health complications may arise from a long-term state of ketosis (i.e., years and years) if any," says Pritzker. And it's not just that. "One reason a person may want to stop keto dieting is if their lipid panel worsens," notes Haley Hughes, R.D."If a person who is at a high risk for heart disease is eating increased amounts of saturated fat and sources of cholesterol while consuming less fiber from whole grains, beans, fruits, and starchy vegetables, they may see increased cholesterol levels." There are also special concerns for those with type 1 diabetes and people taking insulin, who might not be a good fit for long-term keto dieting, she says. (Related: Healthy But High-Carb Foods You Can't Have On the Keto Diet)

Lastly, the reason for going off keto could be as simple as having reached your goalweight loss, performance, or otherwiseand being ready to get back to eating carbs. Regardless of why you want to stop following the keto guidelines, there are some key things you'll need to know ahead of time.

Sadly, shocking your system by downing a few slices of pizza is *not* the right way to come off of keto. Instead, you'll need to do a little mental prep work.

Have a plan. "One of the biggest problems with dieting altogether (whether keto or another diet) is that when you stop, what do you do next?" says Pritzker. "Most people just end up going back to the way they ate previously, which wasn't working for them before, so why would it work now?" This is especially true if you went on keto for weight-loss purposes. "Your best bet is to have a plan as to what you're going to eat and how you're going to start incorporating carbs back into your diet." If you're not sure what your goals are now or how to accomplish those goals with your diet, check in with a dietitian. (BTW, here's why the anti-diet is the healthiest diet you could ever be on.)

Get familiar with portion sizes. "As with any strict diet, transitioning back into your normal eating style can be difficult," says Keri Glassman, R.D., C.D.N., founder of Nutritious Life. "After restricting your carbs for so long, you're more likely to overdo them once you allow yourself to have them again." The first few times you eat carbs post-keto, look to see what one serving size is and stick to that.

Start with unprocessed carbs. Rather than going straight for pasta, doughnuts, and cupcakes, go for plant-based carbs first. "I would reintroduce whole grains, beans, legumes, fruits, non-starchy vegetables first versus processed foods and sugar-sweetened beverages," says Hughes.

Go slow. "Try introducing carbs slowly and gradually," advises Pritzker. This will help you avoid any G.I. distress (think: constipation) that could come along with reintroducing carbs. "Start with adding carbs in at one meal per day. Try this for a few weeks and see how your body responds. If things are going well, add carbs into another meal or snack." Continue adding carbs one meal or snack at a time until you're comfortable eating them throughout the day.

Even if you do everything right, there are some physical effectsboth positive and negativeyou should watch out for when stopping a ketogenic diet.

You might have blood sugar fluctuations. "It's hard to predict how someone will react to coming off the keto diet," says Edwina Clark, R.D., C.S.S.D., head of nutrition and wellness at Yummly. "Some may experience minimal effects, while others may find that their blood sugar spikes then crashes after their first carb-moderate meal." Roller-coaster blood sugar levels can cause jitteriness, mood changes, hyperactivity, and fatigue, so check with your doctor if you experience any of these symptoms.

You might gain weight. (But don't freak out.) You also might not! "Weight fluctuation is always a possibility, but weight gain will depend on many factors, including how your body metabolizes carbs, the rest of your diet, exercise, and more, says Glassman.

It also depends on how long you've been on keto. "Much of the weight lost when cutting carbs is water weight initially," says Pritzker. "When you reintroduce carbs you also introduce additional water; with every gram of carb, you get 4 grams of water. This can make you feel like you've gained a ton of weight rapidly, though much of it is probably water retention." This type of water weight gain applies to everyone coming off keto, but those who have been on it for a shorter period of time and lost just a small amount of weight on the diet may notice it more. (Related: 6 Unexpected Causes of Winter Weight Gain)

Bloating could happen. But it's temporary. "The most common issue that people deal with is bloating and intestinal issues because of the re-introduction of fibrous foods," says Taylor Engelke, R.D.N.Even though foods like beans and sprouted bread are good for you, your body may need to get used to digesting them again. You can expect this to subside in a few days to a few weeks.

You may have more energy. "People may have increased energy after adding carbohydrate back into their diet since glucose (which is found in carbs) is your body's main fuel source," says Hughes. You may also notice better performance in HIIT workouts and endurance training. Plus, you could feel better mentally, since the brain also uses glucose to function. "Many people report having a much better memory and feel less 'foggy' with concentration or functioning at work," says Engelke. (Related: 8 Things You Need to Know About Exercising On the Keto Diet)

You might feel hungrier. "The high-fat and moderate-protein combo of a keto diet make it super satiating," says Glassman. That's why a lot of people experience a suppressed appetite while trying keto. "It is possible that you might feel hungrier after each meal as they start to contain less fat and more carbs, which tend to be faster-digesting," she adds. To combat this and smooth your transition, Clark suggests pairing carbs with both protein and fat. "This can help slow down digestion, boost fullness, and limit blood sugar spikes and crashes as you reintroduce carbohydrates."

Link:
How to Safely and Effectively Come Off the Keto Diet ...