Healthy nutrition plans are not one-size-fits-all (Lauren Kelley-Chew & Brigid Titgemeier)
There is no single diet or lifestyle that will unequivocally work for everyone. Nutrition isn’t a one size fits all fix for your health. Everyone is going to have different diets and philosophies when it comes to food. The key is to make sure people are eating the right things for their bodies. In this episode, Lauren Kelly-Chew of Levels interviewed Brigid Titgemeier, a functional nutrition dietician, about functional medicine and how to improve your metabolic health.
13:00 – Nutrition impacts health
Evidence of the importance of the gut microbiome has proven that nutrition can’t be ignored.
We’re getting to the point where it’s nearly impossible for a doctor to say that nutrition has nothing to do with their health or their physiology. Maybe 20 years ago that was the case because physicians weren’t being taught about the gut microbiome and sorts of things as a medical doctor. Especially now that we have so much more research coming out about the gut microbiome, and the fact that nutrition is really one of the only levers that we currently know about in research that influences the gut microbiome directly. Within three days of changing your diet, research shows you can change your gut microbiome. And the fact that every area in medicine is researching the gut microbiome to look at how certain microbes in their gut are influencing different disease states that their patients are experiencing, it really pulls together the fact that we can’t continue to ignore nutrition and to help people improve their health.
15:49 – Don’t underestimate people
Brigid said people do want to take control of their health and nutrition, they just have to be given the proper guidance to know what’s available.
The mistake that we make in medicine is that we assume that people just want the quick fix, and that they don’t want to take a proactive approach to their health. But we don’t even give them the opportunity to make that decision for themselves. So it shouldn’t really be up to the physician of whether the patient wants that for themselves, it needs to be an opportunity that’s presented at the table to say, “Food can change your physiology. It has the ability not only to directly impact your blood glucose levels, but it also modulates your inflammatory pathways. It directly feeds your gut microbiome, and influences the bacteria that you’re living with inside of you. And all of these things can help to not only prevent disease and create health. And if this is a path that you want to choose, then this is what we suggest.”
18:58 – People need to start listening to their bodies
Symptoms are often the body’s way of communicating that something is wrong.
It all starts with helping people understand that they need to start to listen to their body, and the signs and symptoms that they’re experiencing. Seeing those as the body communicating that something is off, and being able to understand how to use nutrition and lifestyle to correct course when you are experiencing those symptoms. And a lot of times people think their migraines, or their constipation, or their acid reflux are just randomly happening to them. And they don’t stop and pay attention to the root causes that are impacting and exacerbating those symptoms on a daily basis. So we really start with teaching people how to take ownership of their health, to pay attention to these signs and symptoms, and to not outsource their health so much. And instead to take more of a proactive approach to listening to internal signs and symptoms, to be able to navigate what works best for them versus what the experts are saying.
22:22 – Understand what the individual needs
Everyone has a unique blueprint of how their body works, so a personalized approach is the most effective for helping people.
Probably the most important thing is going back to personalization, as it’s the most critical piece to being able to understand what a person needs, which is why using a continuous glucose monitor can be helpful, which is why trying to pay attention to signs and symptoms, and what style of eating makes you feel best is that the best way to go about it. Because people get so caught up in the labels of how they should be eating that they often miss the benefits of biochemical individuality, which essentially means that you have one unique blueprint and it looks different than all of the people around you.
29:43 – Weight loss isn’t the goal
People can get frustrated if they aren’t losing weight. But shedding pounds isn’t the only sign that your diet is improving your metabolic health.
A lot of times when I’m working with people, even who have been doing something, and then they reach a weight loss plateau that are like, “I’m in this weight loss plateau, what should I do?” And often I’m like, “I want you to keep doing exactly what you’re doing, and to stop thinking about the weight loss plateau.” I want you to stop sabotaging yourself by thinking that something isn’t working because you’re not seeing the direct feedback. You need to continue to remind yourself that you’re improving your metabolic health. You’re feeding yourselves with optimal nourishing information, and that over time you’ll continue to see the results, but you have to stick with it for long enough in order for you to get the return on investment, essentially.
43:35 – Food is medicine
Brigid said food can improve your health, but that doesn’t mean eating has to be a chore. You can continue to have an enjoyable relationship with food while doing what’s best for your body.
Food is medicine. It can help improve your health, but that doesn’t mean that you have to eat lettuce every day. I’ve had people say to me, “I care so much about my health and I want to improve my health, but I don’t want to just eat lettuce.” Because food provides so much joy and that connection factor and the emotional factor sometimes that you need. And so being able to really marry the two to have peace with your food relationship, and also make choices that aren’t sabotaging your health is the ultimate win in my book.
47:15 – Get rid of limiting beliefs
Coaching is an important part in helping people get rid of limiting beliefs. For the best chance of success, give yourself a fresh start.
People need to be led through a lot of those limiting beliefs, and that’s where the coaching part can be so huge in improving their results and their outcomes, and helping them lean into their potential and possibility, versus thinking about all the reasons that they can’t do something because of who they have been in the past. So giving yourself a fresh start is a hugely important thing that a lot of people struggle with because they hold onto the identity of who they were yesterday, or who they were last week, or who they were last year. And if that identity is someone that has always had difficulty with their weights, that has always struggled with diets, that has always been an emotional eater, then guess what? You never give yourself the opportunity to lean into what becomes possible if you can remove those labels from yourself, and be completely open to the unlimited potential that human being has.
53:17 – Lead by example
You can’t berate people into following the same healthy lifestyle you have. Lead by example instead of trying to drag other people along for the ride.
I always say to the people that go through our programs that you’re not going to lead others in your lives by trying to beg them or convince them to do the things that you want them to do. If you’re choosing to stop eating sugar, nagging other people about eating sugar is not the way to do it. But simply leading by example is the most powerful way to get buy-in from other people around you. And so initially that’s hard to have to be the leader, and to have to say, “Even though other people around me aren’t choosing to take the path of most resistance, I choose to do that because I know at the end of the day, it will create a path of least resistance that we either pay now or repay later. So I’m choosing to pay now, and to hopefully save my family from having to pay later with all of the healthcare burden costs, the emotional strain of going through diagnoses in order to help prevent as many things that I can prevent.”
58:28 – Think food-first
Brigid said you can’t supplement your way to health. You have to take a food-first approach to truly get yourself healthy.
I always advocate for a food first approach because you can’t supplement your way out of a high glycemic inflammatory diet. So trying to get as many micronutrients and phytonutrients from the foods alone I think is critical, you could say. And also thinking about the fact that we often will take one specific nutrients like vitamin C for instance that we extract from a food, and then we expect to have the same impact as eating that whole food. But what we miss is the fact that the whole food actually not only has the vitamin C, but it has thousands of biochemicals, some of which we still have yet to discover because there’s thousands of new phytochemicals and polyphenols that are being discovered every year that we don’t even know about today. So you’re able to get all of those intact nutrients that have that synergistic effect on your health, your cells, can modulate inflammation. And so I’m a big advocate for trying to use a food first approach as much as possible.
Brigid Titgemeier (00:00:06):
Most people think I just need to go on a diet to change my weight, and they don’t understand how much food is impacting every single cell in their body. So it becomes easy when they’re not losing weight to say, “Oh, I give up.” And they miss a lot of the other implications of changing their diets when they’re able to show up in a better way in their lives.
Ben Grynol (00:00:32):
I’m Ben Grynol part of the early startup team here at Levels. We’re building tech that helps people to understand their metabolic health, and this is your front row seat to everything we do. This is a whole new level. Nutrition is not this category, this idea that we can extrapolate and say, “Hey, this thing will work for everyone.” When it comes to things like diet, well, different people will metabolize things in different ways. What works for one person won’t work for another person. So Brigid Titgemeier a functional nutrition dietician, friend of Levels, she and Lauren Kelley-Chew head of clinical product at Levels, the two of them sat down and discussed this idea of personalized nutrition. Why it’s so important, and why it’s integral to getting people on the right path. Ensuring that people really understand what’s going to work for them when it comes to diet and lifestyle choices.
Ben Grynol (00:01:39):
You can’t be prescriptive and say, “Hey, go have this one thing, it’s going to work for you.” The key is to make sure that people are eating the right things for their body, and things that align with their food interests. Everyone is going to have different diets, different philosophies when it comes to food. Food is a very sensitive thing, and it’s something that everybody has to ensure works for them. So Brigid works with many different clients, many different people to find what works for them from a personalized nutrition perspective. So Lauren and Brigid sat down and they discussed this philosophy of personalized nutrition. What works, why it works, and how can people think about nutrition moving forward? It was great conversation, here’s where they kick things off.
Lauren Kelley-Chew (00:02:29):
Brigid, I am so excited to be chatting with you today. For our listeners I’ll just give a brief background and then we will jump into it. Brigid is a functional medicine registered dietician nutritionist and health advocate. And she’s really been a pioneer in personalized nutrition and functional medicine. She has a master’s in public health nutrition, and is board certified in integrative and functional nutrition. During her career she’s worked with thousands of clients, was a co-founding dietician at the clinic Center for Functional Medicine working with Dr. Mark Hyman, and is the founder of BeingBrigid Nutrition. You might have seen her name in publications from Mindbodygreen, U.S. News & World Report, Huffington Post, and many other places. So with that, let’s jump into it. So excited to have you here.
Brigid Titgemeier (00:03:13):
Thank you. I’m so excited to be here.
Lauren Kelley-Chew (00:03:15):
Maybe to start, I know that you entered into your career really based on your experience as a patient, would you be able to talk about what that experience was, and how learning to use food for healing led you really into an entire career in functional medicine, and helping other people transform their lives with food?
Brigid Titgemeier (00:03:32):
Yeah, I’d love to. So my health journey as a patient really started about 17 years ago. I was falling asleep at nearly every second of every day, and just struggling to be awake for my life, essentially. I would be eating and sleeping at the same time sometimes where I’d be sleeping with my eyes open and eating. Or when I ran track and cross country at practice when we would run like 800 meter repeats, I would fall asleep in the three minutes in between in the grass. And someone would pick me back up to keep running. Just really struggling to stay awake in addition to having about 20 to 30 mini seizures per day that lasted for about five to 10 seconds.
Brigid Titgemeier (00:04:17):
I ended up being diagnosed with narcolepsy and cataplexy which is a neurological autoimmune condition, it’s also a sleep disorder. And I remember in the appointment my doctor diagnosing me, and then essentially pulling out his prescription pad and saying, “Here’s the rest of your life. We’re going to mask these symptoms with these drugs. You’re going to continue to need more as you age because your symptoms will only get worse, and that’s the plan.” And my parents were really concerned because I was 15-years-old and these drugs were extremely new to the market. There was no long-term research on the safety and side effects, and they just asked, “Is there anything that we can do to improve how she’s functioning on a day-to-day basis before we jump to the medication?” And the answer was very clearly no.
Brigid Titgemeier (00:05:11):
So my parents still ended up pursuing another opinion and took me to a functional medicine doctor. It wasn’t called functional medicine at the time because in 2005 there was not a lot of information out there. About 2005 my parents had flip phones, no one had social media. Amazon didn’t exist for food delivery. There were no whole foods or natural health food chains. It was a really different time. And we went to this functional medicine doctor who put me on an elimination diet. She did several labs to look at nutrient deficiencies and other things, put me on a strict elimination diet, added supplements, and breathing techniques and sleep hygiene. And within about four weeks of making the changes, it was pretty undeniable that I was improving where the frequency of the cataplexies that I was having were becoming less often. And I remember vividly driving home from school with my dad one day and staying awake from the entire car ride, and crying because that had been the first time in several years that I had stayed awake for an entire car ride from school to my house.
Brigid Titgemeier (00:06:22):
So we were so excited to go back to the neurologist to tell him about the progress that I had made, and he not only wasn’t excited, but the easiest way to explain it is that he was upset. Visibly upset, didn’t look at us at all throughout the appointments. And adamantly stated, “Nutrition has nothing to do with your condition, we have no scientific evidence to show any correlation.” And there was a nurse practitioner that worked in the department that had narcolepsy. He brought her into the room and essentially had her gang up against my mom. So she said to me… My mom and I are both sitting in the room because I’m a minor still. And she said to me, “I really hope your parents let you take the medication. I know what it’s like to be suffering with what you’re suffering, and it’s a real diagnosis that you need real medication for it. And I just really hope that they let you take the medication because they don’t understand how hard it is for you.”
Brigid Titgemeier (00:07:20):
And my mom is just sitting there. I have no idea how my parents had the grit to be able to endure what they did, because they made so many sacrifices financially to see this functional medicine doctor. My mom was going to four different grocery stores a week, and both of my parents worked. And they’re feeding five people in the family, feeding me something completely different. So they did, and fortunately that really influenced the rest of my journey. I remember my doctor actually was the only pediatric neurologist in the department and he refused to continue seeing me at the time, so I then started seeing an adult neurologist in the department.
Brigid Titgemeier (00:08:02):
And my parents are the most respectful, kind, non-confrontational people, so it’s not like we were causing a scene or anything but he just didn’t agree with the approach that we were taking. And they weren’t against medication they just said, “Can we try a few other things before we start on medication since she’s so young.” And the irony isn’t lost on me, that this doctor was willing to put me on medications that there was no long-term research on the safety of, but dismiss the impact of nutrition because there also wasn’t any research on it. So that ended up, I remember about a year after that saying to my mom, “There has to be a million other people are just like me who are going to their doctor and being diagnosed with a condition that’s either created by or exacerbated by nutrition and lifestyle, and who aren’t being given the opportunity to take their health into their own hands, and I’m going to help those people.”
Brigid Titgemeier (00:08:58):
And that was really when I decided to become a dietician, not because I was interested in helping people learn how to count calories for weight loss, but really because I believed that food is medicine, it needs to be a central part of people’s treatment plans, and it impacts how we feel on a daily basis, and the capacity and energy that we have to show up for the world in all the things that matter in life. And that really set the tone for everything that happened after. And I think I loved so much of the work that you’re doing at Levels, it’s such important work. And I think it’s important that you’re highlighting the fact that only 12% of Americans have optimal metabolic health. That 88% of Americans have at least one risk factor like high blood pressure, high glucose levels, et cetera.
Brigid Titgemeier (00:09:48):
But I always think about the 12% of people that have optimal metabolic health, and when you layer in autoimmune disease, GI issues, arthritis, and joint pain, you’re left with virtually 0% of the population that doesn’t have a symptom or condition that is not influenced by nutrition and lifestyle. And the fact that we continue to pour more money into this healthcare system where we’re spending $3.8 trillion on healthcare, more than any other developed country in the world, and we have the worst health outcomes, really shows the fact that we need to be thinking differently about the way that we’re helping people. Because it’s not just my story, it’s hundreds of thousands, if not millions of other stories that are experiencing the same thing that I did that really deserve access to a holistic approach that looks at them as a human being, and thinks about things of how we can improve not only their labs, but also how they’re feeling and how they’re able to show up for their lives.
Lauren Kelley-Chew (00:10:52):
Yes. And well, first of all, thank you for sharing your story. I think it’s so important to have a voice put to those kinds of experiences. And I know it’s really been the mission of your career in many ways to take that voice and empower other people to have their own journey with medicine and food. But like you say, where they’re at the center of it. And I think something that really excites me about Levels and your work is, as you shift to a more holistic approach, and of course there’s an entire tradition of Eastern medicine, if we can call it that. That I think is now coming to interface more with traditional Western medicine. But in many ways, I think your approach, the kinds of tools that Levels provides, it really shifts more autonomy and sense of control to the individual as well.
Lauren Kelley-Chew (00:11:34):
Because the way this traditional medical system is it’s really a dependency in many ways on doctors. It’s reactive. Something is wrong, and then I won’t be able to fix it till I go to the doctor. And one thing that I love about what you do is, it’s like, actually you can start healing yourself right now through choices that are available to you at your fingertips. It’s really about what you choose to select when you eat and how you move your body and everything. I’m curious, given those early experiences you had in interfacing with the medical system, and now you have really collaborated with and worked closely with physicians. How have attitudes towards function medicine and changed, and do you still experience friction, and what is the kind of language that you use to be able to translate all of the knowledge and wisdom, and power that you know from the work you do to physicians who may be more anchored to a traditional way of thinking about prescription drugs, specific interventions, and reactive treatment rather than proactive?
Brigid Titgemeier (00:12:32):
Yeah. There’s a lot to unwrap in that.
Lauren Kelley-Chew (00:12:35):
Brigid Titgemeier (00:12:35):
But I would say that we’ve come a long way since 2005 when I experienced what I did as a patient, especially because of pioneers like Dr. Hyman and so many courageous voices that have questioned the traditional way that we’re treating chronic disease, and autoimmune diseases, and GI issues, and a bunch of adverse symptoms that people are having. I think that we’re getting to the point where it’s nearly impossible for a doctor to say that nutrition has nothing to do with their health or their physiology. Maybe 20 years ago that was the case because physicians weren’t being taught about the gut microbiome and sorts of things as you know as a medical doctor. Especially now that we have so much more research coming out about the gut microbiome, and the fact that nutrition is really one of the only levers that we currently know about in research that influences the gut microbiome directly.
Brigid Titgemeier (00:13:32):
Within three days of changing your diet, research shows you can change your gut microbiome. And the fact that every area in medicine is researching the gut microbiome to look at how certain microbes in their gut are influencing different disease states that their patients are experiencing, it really pulls together the fact that we can’t continue to ignore nutrition and to help people improve their health. And even just large studies like Lancet paper in 2017 that came out that showed that 11 million deaths worldwide are attributable to poor nutrition. So it’s not like it was where there was maybe an argument for saying there isn’t enough research. We don’t know enough to say that we would recommend this basic intervention with very little risk that just makes common sense.
Brigid Titgemeier (00:14:25):
So I think that’s an exciting part, and we work with several amazing physicians that are so open-minded and they see the results in the transformation that their patients are having. And they want to continue to collaborate because they know that it’s in the best interest of their patients. If we can both be on the same page, and we can utilize the best of the doctor’s knowledge and training, and those sorts of things, and then we can also work with them on the nutrition side. It’s like the best of both worlds, and what it truly creates is the optimal scenario of health for the patient. So there’s a lot of amazing doctors that we work with. There’s a lot of frustrating doctors that our clients have who are continuing really stuck in the way that they learned about disease in medical school, and refuse to be open-minded about certain aspects of basic health.
Brigid Titgemeier (00:15:22):
We have plenty of patients who tell us that their doctors tell them when they’re going through chemotherapy that nutrition doesn’t matter. Or people who are diagnosed with the diabetes and their doctor is telling them, “Just count your carbohydrates, that’s all that matters. You can take more insulin to offset more carbohydrates if you want to have more cake and those kinds of things in your diet.” Without even giving the patient the opportunity to make an informed choice for themselves.
Brigid Titgemeier (00:15:49):
I think that the mistake that we make in medicine is that we assume that people just want the quick fix, and that they don’t want to take a proactive approach to their health. But we don’t even give them the opportunity to make that decision for themselves. So it shouldn’t really be up to the physician of whether the patient wants that for themselves, it needs to be an opportunity that’s presented at the table to say, “Food can change your physiology. It has the ability not only to directly impact your blood glucose levels, but it also modulates your inflammatory pathways. It directly feeds your gut microbiome, and influences the bacteria that you’re living with inside of you. And all of these things can help to not only prevent disease and create health. And if this is a path that you want to choose, then this is what we suggest.”
Brigid Titgemeier (00:16:36):
I worked with a doctor recently that had said he was previously an ER doctor, and he has now started a precision medicine business because he was in the ER and reading all these research studies coming out. He’s like, “This is next thing in medicine that we have to be addressing, and I want to be a part of.” And he said to me, “Sometimes it’s cowardly for us to wait until there’s enough randomized control trials to show that something works before we’re going to recommend it when it’s a low risk intervention, and we’re seeing actual change in front of us in the patients that we’re able to implement this with.”
Brigid Titgemeier (00:17:14):
And I really appreciate that approach. I think that the more that had I not changed my diet 15, 17 years ago, I would be in a completely different place if I waited until the research to catch up to that. And I think that it’s important for healthcare practitioners to continue to stay open to new ways of thinking, new advances in science that really can change people’s lives.
Lauren Kelley-Chew (00:17:41):
I completely agree, and I think it’s really exciting that we’re starting to see that shift because like you say, let’s call it traditional medicine, has done amazing things-
Brigid Titgemeier (00:17:50):
Lauren Kelley-Chew (00:17:50):
… and there have been amazing things to come from that. And also there’s a lot of evidence that many of the things we’re doing are not working. So even from that perspective, and if we take on the startup mindset of experimentation, there’s something to be said for doing things differently. Of course, I agree with you, there is large amounts of evidence to suggest that these kinds of diet lifestyle, other interventions in that same umbrella are hugely powerful. But even in the absence of that, I think there’s an argument to be made that it’s time to start trying different things when we think about what healing and medicine are. I know that traditional physicians think in terms of vital signs like temperature, blood pressure, heart rate. When you are evaluating and measuring someone’s holistic health, are there additional vital signs that you use in your practice to get a sense of how someone is doing?
Brigid Titgemeier (00:18:42):
Yes. So we do look at certain labs to be able to see what the role that food is playing in… I’m not a doctor. But there’s a lot that you can learn from how a person would benefit from changing their nutrition by looking at their labs. But I think that it all starts with helping people understand that they need to start to listen to their body, and the signs and symptoms that they’re experiencing. Seeing those as the body communicating that something is off, and being able to understand how to use nutrition and lifestyle to correct course when you are experiencing those symptoms. And a lot of times people think their migraines, or their constipation, or their acid reflux are just randomly happening to them. And they don’t stop and pay attention to the root causes that are impacting and exacerbating those symptoms on a daily basis.
Brigid Titgemeier (00:19:37):
So we really start with teaching people how to take ownership of their health, to pay attention to these signs and symptoms, and to not outsource their health so much. And instead to take more of a proactive approach to listening to internal signs and symptoms, to be able to navigate what works best for them versus what the experts are saying. And we look at that through a few different ways. One is food symptom journaling to help them understand the foods that they’re putting into their body, how it affects how they feel, and the energy that they have since every meal that you eat is going to impact your energy to some extent. And then looking at CGM data is so incredibly helpful. We’ve been using Levels, and continuous glucose monitors for a while now, but especially in the last year have been working closely with a lot of people to better understand their data, and what seems to be working and not working for them.
Brigid Titgemeier (00:20:37):
And then we look at the energy levels that people are having on a daily basis, and where they are having the most fatigue, what they’re doing around those times. And also looking at their bowel movements, because I believe that bowel movements are one of the greatest indicators of a person’s nutrition. I actually recommend people to start tracking their bowel movements before they start weighing themselves on the scale, because it tells you so much about what you are absorbing and digesting from the foods that you’re eating. And then another common thing that we look at with females in particular is their menstrual cycle. So whether they’re having a regular menstrual cycle, how many symptoms they’re having around their menstrual cycle because all of those things are also impacted by a person’s food and lifestyle choices.
Lauren Kelley-Chew (00:21:23):
It makes so much sense. And I especially appreciate that the bowel movement and the menstrual cycle tracking because I think those are things that often get overlooked, a traditional physical exam. In part just because of embarrassment, which I think actually plays a larger role in healthcare than we think in terms of both the questions that physicians ask, and the information that patients will supply. At least that was my experience. I’m curious. So then as you get to the step of intervention, and there’s been so much talk of which diet is the healthiest or not, and as we all know there was phases of Atkins, and keto, and paleo, and vegan, and plant-based. Based on your experience, how do you select the diet that you think will work best for the person, or if someone is doing this on their own, how should they think about how to make sense of all of these options available? And honestly, if you Google any one of those and you are looking for supporting information, you can probably find something to convince you to either do or not do it. How do you make sense of all of that?
Brigid Titgemeier (00:22:22):
Probably the most important thing is going back to personalization, as you know it’s the most critical piece to being able to understand what a person needs, which is why using a continuous glucose monitor can be helpful, which is why trying to pay attention to signs and symptoms, and what style of eating makes you feel best is that the best way to go about it. Because people get so caught up in the labels of how they should be eating that they often miss the benefits of biochemical individuality, which essentially means that you have one unique blueprint and it looks different than all of the people around you. And when you do a diet or start a diet, you’re going to have different results than your best friend who starts the exact same diet, eats the exact same meals as you do, where one may lose more weight, one may have more bloating, one may have more energy. The other might have more fatigue.
Brigid Titgemeier (00:23:18):
All of these things are very real experiences that we see on a regular basis. And when you just think about the fact that we have a hundred trillion microbes living inside of us, and that food is directly impacting each of those microbes, it would be impossible for every person to have the same reaction because of how complex each individual organism is. So I think that going back to personalization can sometimes also decrease the overwhelm that people feel from the sense of like, there’s so much information, “There’s so many different paths to choose. I feel like I’m sitting at the base of Mount Everest and I don’t even know which step to put first.” And so being able to understands that there’s things that are going to work better for you can, I think, be fairly freeing and liberating instead of getting in this religion of diets to say what’s the best religion.
Brigid Titgemeier (00:24:13):
And instead asking what’s the best religion for me, because different people will need different things at different times in their life. So people that do well on something like a carnivore diet, it might because they have insane CIBO or bacterial overgrowth where they just need to stop eating so many of those fiber rich foods to help improve the composition of their gut microbiome so that then they can reintroduce those foods back into their diet. Or something like a plant-based diet might be appropriate for certain individuals. And that’s something that I had to really learn through my experience, where I used to be like, “What is the best diet? I just want to know that.” And if you look at the ranking of US News and World Report, every year it’s the Mediterranean diet that comes in either first or second, because there’s the most research behind it.
Brigid Titgemeier (00:25:02):
But I think it’s helpful to have research guide and then have a deeper layer into what works best for that person. And I saw that when I was working as a graduate student in a department that was running Dr. Caldwell Esselstyn programs… Dr. Caldwell Esselstyn is a cardiologist. He was the first to show in a research study in the 1980s that changing your diets can prevent and reverse heart disease. And he wrote a book about preventing and reversing heart disease. And his approach is no fats and oils, no animal meats, it’s a vegan fat free diet where you’re basically using water to cook your vegetables. And there’s not as much of an attention to carbohydrates. At least there wasn’t at the time, maybe it’s changed since.
Brigid Titgemeier (00:25:52):
But as a graduate student, I’m looking through the pre and post lab data of people that are going through the program, and there was really significant improvements in some areas. And a lot of the people that were attracted to the diet they had severe heart disease that were trying to reverse. And at the same time there were people whose hemoglobin A1C went up significantly that I was thinking to myself like, “Oh, it’s interesting that it’s not all the same. That not everyone has the exact same results and that this approach might be really beneficial for some people, but not so much for others depending on their genetics, primarily in their gut microbiome.” And then I went to work for Dr. Mark Hyman, and he is an incredible role model and has taught me so much.
Brigid Titgemeier (00:26:39):
But I remember one of the first patients that I saw of his, that had high cholesterol and a few other things, and he was eating very plant based. I think he might have been vegan. And I was sitting in on Dr. Hyman’s appointment with him. We walked out of the room and in the hallway Dr. Hyman is like, “Okay. I want you to increase his meat intake.” And I’m like, “You want me to do what?” This is crazy compared to what I had just come from. And that was when I had to really surrender that person, actually, his cholesterol levels came down from us increasing his meat intake, decreasing his carbohydrate intake. And I started to understand the methods that are used in functional medicine in real time to say the recommendations we’re going to provide are going to be different from person to person. And some people will have great results, other people your cholesterol levels might go up, and then we’re going to course correct. We’re going to learn from that, and then we’re going to change the recommendations that we make moving forward.
Lauren Kelley-Chew (00:27:39):
That makes so much sense. And as you think about what sounds like just a natural trial and error process to some extent, informed of course by the diet that you think is likely to be best. But then like you say, course correcting once things get started. What is your expectation in terms of how long someone should be trying a diet before they know whether it’s working or not working? And I’m curious even just for the layperson. I have so many and I’ve experienced this myself where they, for example, start a keto diet or… And this is oftentimes accompanied when they start Levels, for example.
Lauren Kelley-Chew (00:28:11):
And they’re trying to optimize their blood sugar and to do that they’re trying all kinds of diets. And a common experience that I’ve had friends share with me is, for example, they’ll start a diet, a week goes by, they’ve lost no weight. Maybe their blood sugar is controlled, maybe no, not if they’re not on Levels, who knows. But essentially they get to a week or two weeks and they’re like, “I’m doing everything right, but I’m not seeing any weight loss.” Or whatever the objective might be. Is there a time period in which you say, “Okay. Course correct.” Or is it stick with it? How do you balance that?
Brigid Titgemeier (00:28:41):
Yeah. That’s a tricky one because sometimes it is just a matter of needing to give it more time, that the human body physiology, the gut microbiome, it doesn’t completely change overnight, although we know that it will adjust itself even within three days of changing your diets. That for changing true biomarkers and sometimes seeing changes in glucose levels, it will take several months for people to see those results. And everyone is so quick to put the investment in, and then expect the return. It reminds me of a medical assistant that I used to work with, and I had helped her with her nutrition. She came into me a week later and she was like, “Brigid, this diet is so hard, and I’ve only lost two pounds.” And I said, “Oh, actually that’s great.” She said, “No. The level of effort and energy that I’m putting into this, it should be way more than two pounds. The energy to benefit ratio does not match.”
Brigid Titgemeier (00:29:41):
I think a game of patience, and a lot of times when I’m working with people, even who have been doing something, and then they reach a weight loss plateau that are like, “I’m in this weight loss plateau, what should I do?” And often I’m like, “I want you to keep doing exactly what you’re doing, and to stop thinking about the weight loss plateau.” I want you to stop sabotaging yourself by thinking that something isn’t working because you’re not seeing the direct feedback. You need to continue to remind yourself that you’re improving your metabolic health. You’re feeding yourselves with optimal nourishing information, and that over time you’ll continue to see the results, but you have to stick with it for long enough in order for you to get the return on investment, essentially.
Brigid Titgemeier (00:30:21):
And for other people they might not have the approach that’s working best for them. It’s hard to say because it depends on each person and what they’re doing. There was one client that I worked with that was using Levels. And she had been doing for the whole previous year a strict ketogenic diet, and working with a really popular and well established diabetes reversal coaching program using a ketogenic diet. And her cholesterol levels continued to go up. They were at 270 when I started working with her. Her insulin levels continued to go up. Her hemoglobin A1C continued to go up, and she was told, “You’re probably just not doing it right. You’re probably not in ketosis.”
Brigid Titgemeier (00:31:05):
And she showed me all of her ketone markers. And I think sometimes too people just dismiss others because they’re like, “Well, if my approach isn’t working for you, then you must be the problem.” Instead of us needing to figure out what isn’t working for you, and why the plan isn’t working for you. So for her within about a six week period of time after increasing her carbohydrates, decreasing her saturated fat intake, her insulin went down by about five points, and her cholesterol levels came down by over 30 points. So it wasn’t necessarily that she needed to change what she was doing, and really figure out what worked best for her instead of following that exact plan that isn’t going to work well for everyone.
Lauren Kelley-Chew (00:31:51):
It’s so interesting because when we zoom out, and we think about nutritional guidelines that have traditionally been given in the country where it default assumes that all of our bodies will respond in the same way, which really I sure many people remember as children, for example, drawing the food pyramid. And getting quizzed on it in school and knowing that the base is carbohydrates, and all of those things, and then that was then replaced by my plate. I’m interested given your commitment to personalized nutrition and all of the evidence that you’ve seen and all of the clients you’ve seen with stories like you just shared that it has to be tailored. How do you think about those standardized recommendations, and how to really move our collective mindset away from that towards really eating for optimal health as it is for each individual?
Brigid Titgemeier (00:32:38):
Yeah. It’s tricky because I feel like you have to have some level of guidelines based on… Generally speaking we know that increasing fiber intake is going to work really well for everyone, unless they have small intestinal bacterial overgrowth and it’s creating more bloating. So that’s a great sign, if you’re increasing fiber in your diet and you’re getting more bloating from onions, and garlic, and broccoli, and cauliflower then it’s probably a sign that you have some imbalances in your gut microbiome that need to be addressed. But for everyone else, fiber is an essential component that is hard to argue against. Things like phytonutrients, getting more color in your diet, vegetables, fruits, nuts, seeds. It’s hard to argue against the benefits of those foods. And so I think that to some extent, we do need some national recommendations. But the question really is, are the guidelines that we have today based on true evidence that isn’t swayed by industry.
Brigid Titgemeier (00:33:38):
And that’s where food science becomes more tricky because so much of the research is actually funded, 70% of the nutritional research is funded by the top processed food companies, essentially, in the country. They call themselves the leading nutrition companies, but they sell primarily processed foods, which is why I refer to them in that way. And this was something that I experienced was in graduate school getting my master’s in public health nutrition when I was in Washington D.C. And I went to the Dietary Advisory Committee meeting. So the Dietary Advisory Committee is appointed by the USCA, and the department of health and services. Every five years, they take the leading new nutrition experts, put them on a committee and basically say, “Sort through all the latest research and tell us your advice and recommendations on how we should change the guidelines that influence not only what’s recommended to the public, but also it informs our every nutrition organization that accepts federal funding.”
Brigid Titgemeier (00:34:41):
So the SNAP program, which used to be referred to as the food SNAP program. Women and infants and children, the school lunch and breakfast program, where taxpayer dollars are supporting the rollout of these foods that are based on the guidelines that are established by the dietary guidelines for Americans that are released every five years. The Dietary Advisory Committee meeting that I attended, they had approximately 75 people in the room, and they were each given about two to three minutes to speak on behalf of whatever food they were there to represent. So you had people there from the American Beverage Association, the American Dairy Association, the National Dairy Council, the American Candy Association. These are organizations that I honestly did not know existed before being at this meeting.
Brigid Titgemeier (00:35:31):
And there was one doctor, and there was one dietician that stood up for the two to three minutes to talk about the importance of nutrition interventions. Everyone else was there to say, “Here’s the reason that candy should be included in the dietary guidelines, because it helps bring people joy, and people are stressed, and people have a sense of pleasure from eating candy.” You hear the research that they’re using to influence their recommendations that they’re giving to the advisory committee meeting or to the advisory committee. And I remember in that meeting just questioning so much, are the recommendations that are nationally given, are they based solely on evidence? And are they really in the best interests of Americans, who 60% of Americans in the latest dietary guidelines for Americans reported adhering to the nutrition recommendations? So when you think about the fact that 60% reported that they adhere to the recommendations, and then that we have 60% of Americans that have at least one chronic disease, and 40% of Americans that have two or more chronic diseases, it’s like, is this really working? Is the way that we’re approaching things really working?
Brigid Titgemeier (00:36:41):
Because right now in the recommendations it states that 50% of a person’s grain consumption should be whole grains. That means 50% of people’s grain consumption can be refined grains based on the national dietary guidelines that are not only informing what people think is healthy, but it’s influencing what is covered in food stamps, and in WIC, and is fed in the school lunch and breakfast program. And it just makes you question the way that we’re doing things. Not only in the way that we’re not addressing nutrition in medicine, but also then on the other side, how the processed food industry is feeding into many of these recommendations, and they spend over $50 million annually in lobbying to influence health experts in the federal nutrition guidelines, and it’s really concerning.
Lauren Kelley-Chew (00:37:34):
Absolutely. And when you stack on top of that many of these foods that are being lobbied for are really pretty addictive. That’s a strong word to use, but I think there’s good evidence that they are. So then you have a situation where even if someone starts by following the guidelines, like you say, now they’re eating foods that they actually really like, and then have an addictive feedback loop. So there’s a lot of then momentum for people to continue following those guidelines because it’s foods that are enjoyable to eat. And even if then someone says, “Well, actually these guidelines aren’t really working, want me to try something else out?”
Lauren Kelley-Chew (00:38:05):
At that person is already pretty hooked on the foods that they thought were healthy, that they now have a dependency on. And I’m curious, this is shifting gears a little bit, but we’ve talked a lot about the food aspect of the work you do. I’m really curious to talk about all the other things that inform someone’s ability to make behavioral change when it comes to choosing what they eat. So for example, mental health, their state of emotional wellbeing, self-limiting beliefs. What kinds of barriers do you see when you work with people in terms of really moving from that stage of, “Okay. I want to make a change and I know what I should be doing.” To actually doing that in a sustainable way.
Brigid Titgemeier (00:38:43):
Yeah. I’d love to address that. I just wanted to add one other thing from the last question is that this is why I think the work that you’re doing at Levels is so important because it helps cut through some of the noise of those recommendations to say, “Oh, actually these foods are causing large blood sugar increases.” And 35% of the population has pre-diabetes since 10% of the population has type 1 or type 2 diabetes. And more than 50% of American adults have abnormal blood sugar levels. So if we can understand this data on an individual basis, it not only helps people have that health transparency, but then you get into a layer that informs policy in the future in my minds that says, how can we change the way that foods are being marketed to people? And instead of making the person feel like it’s their own fault for not having enough willpower, understanding through feedback tool like Levels CGMs, “Oh, I’m actually hijacking my physiology every time that I eat. And it’s driving more of these cravings and this addictive response. And that’s why I feel exhausted. And that’s why I can’t lose weight. And that’s why my blood sugar levels go up every year at the doctor’s office.”
Brigid Titgemeier (00:39:53):
And it starts to all connect to where it’s not your fault, it’s actually better understanding how to make choices that are in the best interest of your physiology, so that you don’t feel like you’re working against yourself so much, and you don’t feel like you’re white knuckling your way through the process. And I really think that’s the huge difference between the diet industry, which is a whole nother industry that’s problematic. But how can we remove people’s dependence on the diet industry by bringing food back into the equation in their healthcare. And I think that that’s a huge part that then helps them see the direct feedback so that they’re not just looking at food as a weight loss tool, they’re able to look at food as so much more than that, because that truly is what food is.
Lauren Kelley-Chew (00:40:39):
Completely. And I think that’s such a powerful way of looking at it. And really I love what you said about taking away this sense of fault, I guess, would be the way to put it. And I know this is something that, for example, Dr. Rob Lusting spoke about on a recent podcast as well. This idea that if someone is overweight, it’s their fault. They’re just making all the wrong decisions, or they’re not exercising enough. And really understanding the body is much more complex than that. And not just the body, but that the body exists in a really complex ecosystem of guidelines, incentives, availability, for many people access to eat specific foods. There’s so many things that go into this to create whatever the outcome is that you’re experiencing on the day-to-day. So again, I mean I just am so appreciative of your work because I think so much of this is not just redefining, helping people understand what to do, but also helping them understand their relationship with their bodies and their choices.
Brigid Titgemeier (00:41:32):
And the relationship with their bodies that are holistic in nature, that don’t just isolate their weight. Because most people think I just need to go on a diet to change my weight, and they don’t understand how much food is impacting every single cell in their body. So it becomes easy when they’re not losing weight to say, “Oh, I give up.” And they miss a lot of the other implications of changing their diets when they’re able to show up in a better way in their lives. I always say that when you’re sitting on the couch and there’s a bag of Cheetos in front of you, trying to think about the number of pounds you want to lose is not enough of a motive as thinking about how you want to feel after you’ve eaten those Cheetos.
Brigid Titgemeier (00:42:15):
Do you want to have the energy to play with your kids? Do you want to have the energy and the cognitive ability to show up for your job that brings you meaning and purpose? Do you want to have the ability to have the energy to engage in other aspects outside of work and family like church, or giving back to your community, and other organizations? That literally allow us to be better people and to show up for others in a fuller more vibrant way. And that makes it a lot easier to say no to the Cheetos. But because everyone is so wired to think about this food is going to make me gain weight, they’re eating half the bag of Cheetos, and then they feel horrible about themselves for doing it.
Brigid Titgemeier (00:42:58):
And then it leads to this, what I call the, what the hell effect, where they’re like, “Okay. Well, I had the Cheetos, so what the hell I might as well have the donut, and the pasta, the soda. And then I’m going to wait a few more days until I energetically am able to get myself the back on track, instead of just pulling myself back on track, and increasing my bounce back ability at the next meal.” Or what I call your BBA. And the more that you can increase your BBA, the easier it becomes to take control of your health, because no one is perfect in the dietary choices that they make.
Brigid Titgemeier (00:43:31):
And I think that’s a hugely important part of the conversation that food is medicine. It can help improve your health, but that doesn’t mean that you have to eat lettuce every day. I’ve had people say to me, “I care so much about my health and I want to improve my health, but I don’t want to just eat lettuce.” Because food provides so much joy and that connection factor and the emotional factor sometimes that you need. And so being able to really marry the two to have peace with your food relationship, and also make choices that aren’t sabotaging your health is the ultimate win in my book.
Lauren Kelley-Chew (00:44:07):
I agree. And I think it’s so complicated because so many people, and I think all of us experience this at different times in our lives, this love, hate really with food where it’s what you’re describing. On the one hand, we need it to fill our bodies, we enjoy it, it has a lot of emotional weight. On the other hand, it’s often linked to feelings of guilt, and shame, and self-hate, or a sense of being at fault. And I think those dual tensions are a narrative that actually takes up an immense amount of emotional energy for many people all throughout the day, year after year after year, as they go through different life phases.
Lauren Kelley-Chew (00:44:41):
And I love the way you’re describing that. You’re helping people to unpack that a little bit and to find ways to navigate that towards something that is much more about the humanity of making the best choices you can, knowing that there’s variation and every day will be a little bit different. And like you said, you can always bounce back. I’m curious in your experience with all of the people that you’ve worked with, does this tense relationship with food, if we can call it that, is it more common in women? I know that women get a lot of… There’s a lot of talk about this when it comes to women, but is it also something that men experience? And what has been your experience with the overlay of gender with all of this complex relationship with food?
Brigid Titgemeier (00:45:26):
Yeah. I think it’s a great point to bring up because I was shocked when I started working with a lot of males in my own nutrition business that are executives who stress eat, and have a lot of feelings of guilt and shame around food, and don’t feel good about themselves when they’re on camera being interviewed for an interview for work or something. But they don’t talk about it as openly as females. I think that the shame around food and feeling bad about yourself related to how you look and feel is happening in both males and females, but females are more willing to admit that it’s something that they experience and deal with.
Brigid Titgemeier (00:46:13):
And men it’s happening behind closed doors, where they have a stressful day and they go home and they stand in front of the pantry, and they stress eats when no one else is around. And then they feel really bad about themselves, but it’s the only coping technique that they know of at that time in their life. And so it’s a repeated pattern that they continue to do that they feel bad about, but they don’t really know how to escape from.
Lauren Kelley-Chew (00:46:38):
Yeah. That makes so much sense. And are there self-limiting beliefs that you come across commonly that get in the way of people achieving what they’d like to achieve when it comes to food and their health?
Brigid Titgemeier (00:46:48):
Oh my gosh, so many. So many. That’s why I think it’s so important in the work that we’re doing to marry the idea of being a supplement to what a person doctor is providing to them in conventional care, and being able to layer in that personalized nutrition, food is medicine approach. But equally important, the community aspect and the coaching aspect. Because people need to be led through a lot of those limiting beliefs, and that’s where the coaching part can be so huge in improving their results and their outcomes, and helping them lean into their potential and possibility, versus thinking about all the reasons that they can’t do something because of who they have been in the past. So giving yourself a fresh start is a hugely important thing that a lot of people struggle with because they hold onto the identity of who they were yesterday, or who they were last week, or who they were last year.
Brigid Titgemeier (00:47:47):
And if that identity is someone that has always had difficulty with their weights, that has always struggled with diets, that has always been an emotional eater, then guess what? You never give yourself the opportunity to lean into what becomes possible if you can remove those labels from yourself, and be completely open to the unlimited potential that human being has. And so we see a lot of limiting beliefs. So we see people that are told that their genetics are the cause of their condition. That because their dad had a heart attack at 50, that they’re going to as well, and that’s why they need to be on these medications. A lot of people who have limiting beliefs surrounds the time that they have, where somehow they find 45 minutes to scroll through social media throughout their day, but they don’t have the time to think about what they’re going to prepare for dinner.
Brigid Titgemeier (00:48:37):
People who think they don’t have enough energy to commit because they don’t understand easy repeatable cycles for meal prepping and planning, and those sorts of things, because it’s a lot of energy when you’re starting something new to learn a new habit, skill, anything. And once it becomes more routine, it’s actually not a lot of energy at all, it’s just your default. But it’s that initial on-ramp that I compared to like water skiing, where you have to pull so hard in order to just get up from the water and that’s the absolute hardest part. And then once you’re in a good routine, it becomes a lot easier, and it doesn’t require nearly as much strength.
Brigid Titgemeier (00:49:16):
It actually is a very different part of your body that you’re working that’s more of the endurance factor of staying up above the water and holding on, versus trying to pull yourself up. So I think that trying to debunk those is really helpful. And also helping people be open to trying something new when something has failed them in the past. A lot of people that come to us have tried several different diets, and feel like they are failed by those diets. And being able to give yourself the opportunity to try again, just one limiting belief that typically is difficult for people to overcome.
Lauren Kelley-Chew (00:49:55):
How do you think about… You were talking about identity, and being able to grow beyond what your concept of your previous identity was? How do you think about identity when it comes to the community and the context within which the person is living? So for example, a situation where the individual is ready to take on a new identity when it comes to their health, but their family is still living in the past identity, or their friends are.
Lauren Kelley-Chew (00:50:19):
And I’m thinking of scenarios where, for example, when I stopped eating sugar, and I have a sweet tooth, I love sweet. But I stopped doing it for my health. And many of my friends knew me as the person who loves a cookie. And so when I first started that, and we’d go, and we’d be hanging out and there would be a cookie, and I was like, “Oh, I’m not going to.” There was actually a lot of friction where people were like, “What? You love cookies. This is crazy. You’re being so intense about this.” How do you help people navigate when their identity is in some ways changing faster than the collective identity around them?
Brigid Titgemeier (00:50:51):
That’s a challenge. When people say that you are a product of the five people that you surround yourself with most closely, it’s not just as far as your business, and your family, and those sorts of things. It’s also about the way that you choose to take care of your health. And I understand and recognize how important it is just in my own health journey. I was talking to my mom actually on the phone last night because we still sometimes reflect on everything that my parents went through. And I consider them to be my health heroes. Had it not been for them I would’ve just said, “I want the medication.” I argued against the approach that they’re were trying to take. And my mom did all the grocery shopping, she made all the meals.
Brigid Titgemeier (00:51:32):
I don’t know if I would’ve had the energy to actually do that for myself, and I also wouldn’t have had the buy-in. She held the belief for me until I could hold the belief for myself. And I think sometimes I was just talking to someone that was recently diagnosed with Parkinson’s disease, and I said to him, “The hardest part at first is holding the belief that what you put into your body will impact how your disease progresses.” And that’s a hard thing for people to acknowledge. So I think that you need some form of community. For me I was so fortunate to have my family who made so many financial and energetic sacrifices. And if that’s not your family for you, then this is why something like our group coaching programs can be so effective because it puts you in the room with other people through Zoom. But puts you around people who have made the choice to say, “I no longer choose to continue doing this to myself, and I want more for myself. And even if my family can’t accept that that’s the place that I’m at, or my friends can’t accept that’s the place that I’m at, being around like-minded people who are committed to this reinforces to me that I’m not crazy. That this is worth pursuing.”
Brigid Titgemeier (00:52:47):
And then when you see other people who making changes and seeing progress and results, and they share on a group coaching call like, “Yeah. My doctor just decreased my medication, cut my blood pressure medication in half. Or my endocrinologist just cut my Hashimoto’s medication.” Then people are like, “Whoa, that’s amazing that that happened to them, I need to continue going against the resistance or friction that I’m facing in my own life because I want to lead by example.” And I always say to the people that go through our programs, that you’re not going to lead others in your lives by trying to beg them or convince them to do the things that you want them to do.
Brigid Titgemeier (00:53:28):
If you’re choosing to stop eating sugar, nagging other people about eating sugar is not the way to do it. But simply leading by example is the most powerful way to get buy-in from other people around you. And so initially that’s hard to have to be the leader, and to have to say, “Even though other people around me aren’t choosing to take the path of most resistance, I choose to do that because I know at the end of the day, it will create a path of least resistance that we either pay now or repay later. So I’m choosing to pay now, and to hopefully save my family from having to pay later with all of the healthcare burden costs, the emotional strain of going through diagnoses in order to help prevent as many things that I can prevent.” So I think that what it comes down to is continuing to reinforce yourself that you’re doing something that’s in your own best interest, and that unfortunately that’s not the norm in society.
Lauren Kelley-Chew (00:54:26):
Yeah. And if some friends have taken inspiration from the changes that someone is making, and I’m thinking I have friends who have asked me, “Okay. Well I want to start doing something, but I don’t really even know what I’m supposed to eating, what I’m supposed to be doing.” And for example they say, “I look at the nutrition labels. I know that there’s things on there.” And for a while, of course everyone was like, you want it to say zero grams of fat. That was a fad and everyone understood you can look at the fat grams and it tells you something. But as we’ve been talking about it since gotten a lot more complex than that, lots of different types of guidance. In your opinion, are there one or two things that people can look at on a nutrition label when they’re at the grocery store, and get just an 80/20 idea of is this something that I should be eating or not?
Brigid Titgemeier (00:55:07):
I’d say the first place to look is always the ingredients. The advice that Michael Pollan gave so many years ago in the books that he wrote really, I think, was such a pioneer with. He recommends looking at the food label and paying attention to ingredients that are recognizable that you can pronounce for the most part, that don’t have 50 ingredients in them. And that’s really the best place to start because you could have a keto product that has zero grams of added sugar, but is filled with processed ingredients. And even if it’s creating a great glucose response, it’s not necessarily feeding health. And so I think that trying to incorporate more foods that have those ingredients, that you can recognize that are shorter lists, and are things that you know can help to improve health, just generally speaking is really the best place to start.
Brigid Titgemeier (00:55:58):
And I’m always amazed at how much people say that they pay attention to the ingredient list, but then don’t when it comes down to them asking me about certain products that they’re eating. And this is the same person that told me that they’re reading the ingredient list of everything that they consume. And even I myself, I love these apple cider vinegar drinks, and my husband and I went to the grocery store and I thought that I was buying the lime, but I bought the honey one that has seven grams of added sugar in it. And I was like, “Oh my gosh, this even happens to me on a regular basis sometimes when I’m just not paying enough attention each time that I’m at the grocery store.” Because even foods that are all under the same brands and have the same labeling will have different flavors that have different nutritional profiles. Some that are more optimal than others.
Brigid Titgemeier (00:56:48):
And so I think just really paying attention to that is extremely important. And not going overboard to the point that it interferes with your quality of life, which I think is really important because sometimes I see people in the clean eating mood movement, which I don’t really love the term clean eating, because it’s actually more eating dirt that can help to improve the diversity of the microbiome. But the idea of trying to eat only organic ingredients that can lead to a lot of disordered eating, where you’re packing your own keto snacks for a family barbecue, and you’re not eating the burger that everyone else is eating because it’s not organic and grass fed and up to your standard. So instead you’re choosing to eat these processed keto snacks instead of just enjoying the meal with everyone and then moving on. Now, of course, everyone has to have food non-negotiables, I think, for their different health conditions, but it’s just an example to not let reading the label take you too far, that then it actually takes away from your health.
Lauren Kelley-Chew (00:57:51):
We need to have you on for another podcast episode in which we specifically talk about all of these things related to disordered eating, eating habits, how people… Like you said, non-negotiables versus getting overly neurotic about things. I would love to hear all of your thoughts on that. In our last couple minutes, two more questions for you. The first one is supplements as part of on this theme of our discussing simple things that people can do to improve their health tomorrow. What is your approach to supplements? Are they required? Are they helpful? Are they just not really good to or bad? How do you think about them?
Brigid Titgemeier (00:58:28):
So I always advocate for a food first approach because you can’t supplement your way out of high glycemic inflammatory diet. So trying to get as many micronutrients and phytonutrients from the foods alone I think is critical, you could say. And also thinking about the fact that we often will take one specific nutrients like vitamin C for instance that we extract from a food, and then we expect to have the same impact as eating that whole food. But what we miss is the fact that the whole food actually not only has the vitamin C, but it has thousands of biochemicals, some of which we still have yet to discover because there’s thousands of new phytochemicals and polyphenols that are being discovered every year that we don’t even know about today. So you’re able to get all of those intact nutrients that have that synergistic effect on your health, your cells, can modulate inflammation. And so I’m a big advocate for trying to use a food first approach as much as possible.
Brigid Titgemeier (00:59:28):
Now for supplements, I do find them to be fairly necessary for a lot of people, because it can be difficult to get all of your nutrients through food alone. This is something that I see even in looking at people’s food intake, not just their macronutrient, but we use a tracker called protometer that actually looks at people’s micronutrients as well. And it can be difficult to meet 100% of what the recommendation is for potassium, and for some of the B vitamins, and those sorts of things through diet alone. And then you factor in the fact that when you are in a high stress state you burn through certain nutrients faster like magnesium and B vitamins, and vitamin C. And also when you’re sweating more, that you’re going to burn through more nutrients and electrolytes.
Brigid Titgemeier (01:00:17):
And the fact that when you’re eating a whole food diet, you’re actually not able to retain as much sodium and other electrolytes that sometimes increase the need. So there’s a lot of factors that create an argument for supplementation. Now, the problem is on a national level and on a lot of the headlines that you see in the news, they’ll take one study that looks at usually like an observational trial that looks at a large population sample size and says, “Taking supplements didn’t improve their life expectancy.” For instance. Or didn’t reduce risk of heart disease. So then the takeaway becomes supplements don’t provide any value. And that’s a real tricky and slippery slope to go down and similar to my doctor saying that nutrition had nothing to do with my condition simply because he couldn’t see a randomized trial sitting in front of him.
Brigid Titgemeier (01:01:10):
Where we have to look at it on an individual basis a lot of times to say, “What are your nutrient deficiencies that are coming up?” Some of those you can get done in labs like vitamin D is an easy one. 25-hydroxy vitamin D is an easy one to have your doctor check. But some of the others are a bit more difficult to convince your doctor to test for. And so I think that supplements, I typically recommend that at least a high quality multivitamin as a safety, as a preventative to help to decrease risk of any nutrient deficiencies. As an insurance policy, I recommend a prenatal for any woman of childbearing age that’s sexually active because 50% of pregnancies are unplanned, and the three month preconception window is actually the greatest opportunity to impact reduction in DNA damage and improved egg health. So there’s a lot of factors, I think, that influence supplements, but I incorporate them into the approach that I use in my practice regularly. And that the dieticians that are in my practice also use because I think that supplements can play a very valuable role.
Lauren Kelley-Chew (01:02:21):
You have such a wealth of information and knowledge about this, and I have so appreciated all of your insights on this. For people who don’t have access to an amazing expert like you to work with one-on-one, and maybe even don’t have access to lab testing or to really specialized foods or anything like that, are there still ways that they can personalize their nutrition and start on this path?
Brigid Titgemeier (01:02:44):
Yes. I would say that working with Levels can be a great opportunity that you can get a continuous glucose monitor. You don’t have to beg your doctor to have access to this information, and provides the ultimate level of health transparency. And helps get you started especially if you struggle with pre-diabetes, type 2 diabetes, which we work with people that have type 2 diabetes whose doctors still refuse to write a prescription for a CGM. So being able to… For PCOS it’s incredibly valuable for pregnant women that we work with. I mean, I think that there’s a lot of benefits to a lot of populations, but those in particular are the times that we are actively, actively recommending that someone use a wearable technology like Levels has to offer to create that health transparency.
Brigid Titgemeier (01:03:35):
I would also say that we created a CGM guide that people can download, that I can send you the link to better understand their data. And we also are going to be doing a blood sugar reset in the spring. That’s just a 10-day free nutrition recipes and shopping list to at least get a person started. And in addition to that, I would say start paying attention to what you eat and how you feel, and using that as your guidance. Because we’re so quick to use external data, and not quick enough to use those internal signals that we’re getting from our body to really be the guide. And I think that that at the end of the day has to trump all.
Lauren Kelley-Chew (01:04:20):
Such great suggestions and recommendations. Is there anything I haven’t asked that you want to make sure to share with the listeners?
Brigid Titgemeier (01:04:27):
I think we covered it all.
Lauren Kelley-Chew (01:04:29):
Sounds great. Well, like I said, I’ve learned so much from this. I think it will be really interesting for everyone listening, and I hope we can have you back to… Really we could do a podcast on any one of the answers you gave and just dive really deeply into it. And so-
Brigid Titgemeier (01:04:42):
Lauren Kelley-Chew (01:04:43):
Right. So we’ll put that for something in the future to look forward to. I so appreciate your chatting. And Brigid, for people who want to learn more about your work and follow what you’re doing and join some of your offerings, how can they reach you?
Brigid Titgemeier (01:04:57):
They can go to my website, which is beingbrigid.com. Being, and then my name is called B-R-I-G-I-D. Like rigid with a B at the front of it. And that’s the same for all of my social media handles as well.
Lauren Kelley-Chew (01:05:10):
Amazing. I’m sure many people will be checking you out because this has been so helpful.
Brigid Titgemeier (01:05:14):