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Nutrition for Autoimmune

You can reach our guest for this podcast, Eleni Ottalagana, through her website (www.thehealingroots.com), Instagram at thehealingroots and on Facebook as well!

Eleni, welcome to the podcast!

Thank you. Thanks for having me.

One of the first questions I have for you, I wanted to understand the difference between a dietician and a nutritionist. I hear the phrase used interchangeably, but really they are very different. Is that correct?

Yeah, they are. So, as a dietician you do have to go through an undergraduate training of four years and that program has to be accredited by the Academy of Nutrition and Dietetics. And then from there you have to be accepted into an internship and it usually ranges from nine months to a year. That’s about 1200 hours. You do a clinical rotation, a community rotation and a food service rotation. Not every Undergrad is accepted into that. It’s actually pretty highly competitive. So it is a lot of training, you know, five years. Then after that you sit for a board exam. So it was a long winding road, but I’m happy I went through it. Not to discredit nutritionists at all, you can still go through some sort of training, but the Dietitian title it’s a nationally recognized title and you do go through some significant education to achieve that.

So you would perhaps work with doctors who are prescribing nutrition as part of a therapy to figure out exactly what to change about their diet, nutrition and those sorts of things, right?

Exactly. And that’s called MNT or Medical Nutrition Therapy. We’re licensed to provide that sort of health care to patients and especially working with doctors.

What got you interested in the field of nutrition to start with?

Ever since I was young, I always enjoyed food coming from an Italian and Greek family, and understood what it meant to really truly be healthy, eating a Mediterranean diet. And then I also had my own personal struggles with autoimmunity and some other health concerns. Just utilizing food and the more holistic approach to personally heal that really interested me and I became really passionate and that’s why I want to help others and give them those tools because I know you really can truly heal the body with this system approach.

Tell us if you can about your own autoimmune story. We see and talk to a lot of people with autoimmune conditions who are going through trying to figure out what they can eat, how to modify their diet. Tell us a little about, about your challenge?

When I was younger I was about 12 or 13. They found antibodies on my thyroid and, you know, I’m still young, but then it probably wasn’t even as popular yet. And so I was aware of it. Didn’t do much about it. The doctors just told me, don’t worry. So I just went about, you know, a western diet, eat your whole grains, you know, high carbohydrates and with a lot of that spurred on polycystic ovarian syndrome. So then I was struggling with a more complex hormonal issue within my body, and by the time I got to college I was just really frustrated. I was on three different medications and I’m like, I’m so young, this doesn’t make sense, know I grew up with a relatively healthy diet. So then I put myself on an elimination diet. I did work with some more functional oriented doctors to help guide me as well. I also worked a lot on the stress component, so I really took a mind body approach to really heal my body and with that and eliminating certain foods, I was able to bring my body back into balance. I think healing is a longterm thing, right? So now I have to do certain things to maintain my health, but I’m really happy that I was able to understand it at a younger age and address it in the right way so that I can lead the lifestyle I live medication free now. And that’s really liberating.

That’s great that you went from taking three medications to none though those sorts of methods. Any foods in particular that you found, you’re really intolerant to?

Yeah. So gluten, right? It’s like the one where people are, I would say kind of skeptical too, but especially the way it’s grown in our society and how it can directly have that “molecular mimicry” to the thyroid. I found that was huge. Especially with the PCOS that I had, you know, cutting out those refined carbohydrates were really big and also just genetically modified foods in general because you’re getting a lot of the pesticides. That’s most of the corn, the soy and again, like I said, the gluten and other grains. So more of that Paleolithic approach I found personally really worked well for me and cutting out a lot those inflammatory foods.

In one of our earlier episodes, Jason had talked about his journey with his autoimmune and starting out kind of with the Whole 30 diet and eventually transitioning into more of a Paleo Diet. What does a relatively strict autoimmune protocol diet look like for people?

So the AIP, it can definitely be, like you said, a little more restrictive at first and then the goal is to bring back foods in once we’ve healed the gut and healed the body a little bit. So initially that looks like eliminating all grains and definitely gluten, cutting out dairy, corn, soy, processed sugar, usually caffeine. So that morning cup of coffee, also legumes and nuts and seeds. So really anything that could be detrimental to the gut because we really focus on healing the gut first before healing the whole body as a system.

What about, I’ve heard, I think Jason in particular avoids nightshades in his diet.

Nightshades could be another one, especially for individuals that deal with joint pain or arthritis. So depending on who you see or who you talk to, some people eliminate nightshades right away. Others like to then explore the nightshades if it’s something they feel like might be triggering for them.

It seems like there’s almost two categories of people that do autoimmune diet those who include rice and those who don’t. It’s almost like two camps it seems like.

I think what I found personally and working with a lot of different patients is you have to meet someone where they are and you do really have to take an individualized approach because everybody truly is different. It’s kind of like trying to fit everybody into a box, right? If they’re not necessarily that box shape. So you have to take in consideration the emotions, you know, hormonally what they’re made up of and just what their day to day life is like and then go from there. So I think the structure of it could always be a little bit different for the person.

Let’s talk about gluten real fast. What’s going on inside the body when you ingest in your body’s trying to process gluten for anybody, whether you are intolerant or not. What were the mechanisms happening there?

So with gluten there have been studies to show that it can promote that “leaky gut syndrome.” And it’s a component in the gluten that creates that barrier to open. And supposedly from these studies, it’s technically happens to everybody. Some people are more reactive than others and then what you get with the gluten is also the glyphosate. So this really toxic pesticide that’s sprayed on a lot of the wheat and that glyphosate in and of itself can affect the gut which can then affect other parts of the body. You know, kind of interesting, it’s a specific pathway that it blocks, so in your gut, you produce neurotransmitters and the glyphosate actually blocks that pathway. The Shikimate pathway (might be pronouncing it a little bit wrong), but I find that really interesting because with leaky gut and autoimmunity, I think we also see mood disorder sometimes like anxiety and depression. And it’s interesting, you know, what’s causing that? Is it the glyphosate, is it the gluten, is it the leaky gut? So I think with gluten you just get a whole host of issues that could come with it.

So why has it modern medicine just come up with a magic pill that makes all that much better.

I know there are a few supplements on the market that, you know, say they can reduce the glyphosate in the body or some supplements that help the body to break down gluten. So I know there are some tools out there to support it. I think it’s just, you know, getting most of society to maybe understand it a little bit better. Um, it’s more of a cutting edge topic, I would say. The whole gluten free phenomenon and just getting people to be more educated until we can really create something new in the medical system to understand it.

What are some common myths around nutrition? I think we’ve seen the food pyramid in this country get turned completely upside down. What are some of the common misconceptions that maybe you battle when you’re working with some of your clients?

Yeah, I think a few that particularly stick out to me is the eating six meals a day for better metabolism. It’s not something I necessarily believe in. I think it’s really great to give our body those breaks and give our digestion the break between meals. It actually helps with metabolism. So, you know, eating three meals a day instead of eating six small meals, I think that’s a big myth that I come across a lot. Another one is going sugar free or low sugar and in that case a lot of individuals are using the artificial sweeteners like sucralose or aspartame and there’s studies that link those to Metabolic Syndrome, glucose intolerance, weight gain, even cardiovascular disease. So it’s really scary that people feel like they’re doing better by not eating white sugar. But in many cases I would say I think these artificial sweeteners are a lot worse. So that’s a big one I really like to work with patients and clients on right away. So I would say those are two really big myths and another one is the whole low fat. I think we’ve gotten better and understanding how fat is actually good for us because the ketogenic diet has become popular. But eat full fat. Like have the olive oil, have the avocado, if you are having dairy, just eat full fat dairy, you know, it’s just the low fat it’s not necessarily good. We need fat for our hormones and for our brain. So I would say those are the top three myths that really stick out to me.

So not all plants in a diet (fruits, vegetables) are created equal. Some people call some of them like super foods and things. Any of your favorite things that really act as superfoods that you like and prescribe to people you work with?

So I would say my number one or just leafy greens. I think we live in a society where we’re chronically deprived of fiber. And so the leafy greens give you lots of fiber, lots of nutrients. Some of them can even help promote better digestion, so I’m always saying to add more of those into your diet. You know, some examples would be Swiss chard, collards arugula, broccoli raw, spinach or anything of that nature. And they’re also lower in carbohydrates. You know, some vegetables are actually pretty high in sugar that you still want to watch. Another group that I would consider a superfood are berries, you know, some organic berries are high in antioxidants. You know, we’re facing a society where there are so many environmental toxins on a daily basis and some of these foods can actually help promote the natural detoxification process within our body, especially these berries [and] these leafy greens. So I really like to focus on those as some good foods to incorporate in your diet, you know, even daily if you can.

Let’s talk about fish. Sometimes people who described themselves as Pescatarians, talk about how lean fish can be. On the flip side, people talk about some of the bioaccumulation of toxins and fish. What are your thoughts on that?

So I think with fish, unfortunately it is a concern today we have to watch a little bit more, but I really preach quality so, you know, wild caught options because unfortunately the farm raised fish do have a lot of chemicals in them. And I know there was a finding, I think it was a little over a year ago, they found farm raised salmon had over 80 different medications and people are eating this, which is unfortunate. So I always say, you know, wild caught fish, if you live coastal, that’s great. Sometimes you get those under loved species. When I was up in New Hampshire I ate the best seafood, I definitely miss that. Even smaller fish like sardines, mackerel, herring. sardines in a way are actually a superfood. I do educate clients around that and making them taste better. So the healthy fats from the fish, the vitamin D, all really important. It’s just watch the quality. But I think if you can get fish in a few times a week, that’s great.

I’ve heard from some people sometimes that they worry about going with a plant based diet because they won’t get enough protein in their diet. I need some animal protein to make sure I get enough protein. I once asked a general practitioner, I said, have you ever seen a patient come in the door who is suffering from not enough protein in their diet? And they said never. Broccoli has tons of protein. Like all these things have protein. Any thoughts around supplementing with animal based protein because there’s not enough protein, or how do you make sure that if you’re on a plant based diet itself, that you’re getting enough protein?

I think that’s a really good topic and there’s a lot of controversy around it, right? Because some people feel really great when they go plant based others don’t feel so good. So I think there’s a happy medium. Having protein from an animal source provides certain essential amino acids that you just won’t get from plants in order for the body to heal. You know, especially somebody with autoimmunity, it’s really important you have those amino acids. So, again personally, I like to meet patients where they’re at, but you know, getting eggs in the diet if they can tolerate that or seafood and then ideally doing some sort of, you know, whether it’s chicken or bone broth or collagen powder, just getting in some of those amino acids. I really feel like they are important in order for the body to heal. But I think what we also do in this society is we overdo it too, right? It doesn’t mean you have to have eight ounces of steak at every meal, just have a few ounces of high quality protein, but you can still fill your plate of vegetables and other whole foods sources.

In working with clients of yours who are working on elimination to try to figure out what’s going on with them, what do you advocate, going back to the basics and then adding in slowly over time? What’s your approach to that?

So I take a little more of a conservative approach. I usually pick four or five foods, like let’s start there. Gluten, eggs, dairy, corn, soy, sugar [and] let’s see how you do. I always educate around gluten longer term. I think everybody could really benefit from keeping it minimal or out of the Diet. There’s always a more nutritious carbohydrate alternative. And when patients start to feel better than I say, okay, let’s bring in one food at a time, let’s see how you feel. Let’s give it a few days. So I would say that’s typically the approach I take. But again, keeping in mind what longterm for this individual really makes sense. So once I get an idea of who they are, there might be foods I suggest. Let’s just really keep these out and find you healthier alternatives.

Tell us a client success story, maybe someone you’ve worked with before, where they started and where you were able to take them through their work with you.

I had one client, she had two autoimmune conditions. It was celiac and Hashimoto’s, and she was also a vegetarian, so we talked a lot about the daily symptoms she was going through, digestive issues, mood disorder, lack of energy, just really not feeling like herself. So I put her on a simple elimination diet. We also identified the root nutrition deficiencies she had because she actually did have a few as a vegetarian, she really wasn’t getting enough protein. And then after about a month we kind of reassessed where she was and her bloating had gone away. Her digestion had increased. She had a lot more energy. Her mood got better to the point where she’s working with her psychiatrist to get off of her depression medication. So, that was really great to see her get her life back, you know, I think a lot of us put our health on the back burner because we’re so busy, but you really can’t lead an authentic full life without your health. So it was really rewarding to see her turn around so quickly and she was just so grateful to feel good again.

Any tips that you’ve learned on foods that are both healthy as well as quick or easy to prepare or make? I know the temptation of fast food is that I can just drive through it and grab it and then it’s done.

What I tell my clients personally is think of a balanced plate first, so a quick check in is make sure you get a good healthy fat, some good source of protein and some good vegetables. And then from there, let’s think about some healthy options. One would be a smoothie. I love doing smoothies. I think that’s a great way if you’re on the go, or you need something quick. Another option is, you know, roasting vegetables and roasting some chicken or fish because these things don’t really take time, but you’re still getting a lot of quality nutrition out of it. So I say try to do a check in, is my plate balanced and then what’s a quick way to prepare it? And usually it’s putting a few whole foods together so it’s still simple and tasty and you’re getting the good nutrition.

I know one challenge with healthy food is that it seems to be much more expensive than very unhealthy food. Any tips you’ve learned on how to deal with that?

Yeah, I think so. It’s a little bit of navigating in the beginning. It can feel overwhelming because you do have to go through a little bit, a little bit more effort. But after that, I mean, I personally, I like going to Trader Joe’s for certain vegetables. It’s much more affordable. Using the dirty dozen list could be helpful. So it teaches consumers to prioritize what you’re buying organic versus what you can buy conventional just depending on price ranges. And then I always say also prioritize your meats organic if you can. So if you’re thinking price wise, meats and then produce, and then from there, if you’re thinking, well, how can I actually get them, you know, what grocery store is closest to you. I also say if you can order your groceries and that works for you, you know, do that. Just keep things really simple like don’t overcomplicate meal prep. You know, you don’t have to menu prep these really elaborate recipes. They can just be simple whole foods and write a list and just go to the store.

So you work with clients independently, this is what you do. Tell us a bit about how people who are listening might reach out to you to work with you?

So, they can find me through a few different platforms. My website is www.thehealingroots.com. So if they want to set up a discovery call and chat and see if it’d be a good fit, I’m happy to do that. That’s one way to schedule an appointment. I’m also on instagram. I know my followers like that because I give some good recipes also on the website, I get recipes, blogs, just some good information and facebook. So that’s a good way to stay in touch. If you want to reach out and yeah, if you want to work together.

You can work with people who are anywhere around the country or the world, they don’t have to be close by to you. You would prefer to work with people in person, but you can work with folks anywhere, right?

Yeah, totally. And what I found is even the local clients, you know, they really liked meeting for the first time. I think there’s something to be said about face to face or video call and then after that, you know, we can talk on the phone or video conference and it fits some people’s schedule and I just want to make this as seamless of a transition. I want to make this easy and help them and what’s most convenient for them. So that’s been a really great tool.

It seems women’s health is a unique concern. Tell us what might women do, as autoimmune obviously strikes many more women than men. Tell us some things that are unique about women and women’s nutrition that could be useful for them?

So I think with women, because we’re so much more hormonally complex, it’s kind of like a more, it’s a delicate balance. I find that when women try to do these extreme fasts or these extreme diets, sometimes it kind of goes the opposite of what we want. So I think there’s a balance of being more nurturing to ourselves because we’re so often caregivers, so how can we nurture ourselves nutrition wise, but also through stress management. So again, really that mind body connection, and that’s really important. And also knowing certain foods. So to some degree, sometimes women need a certain amount of carbs. So bringing education around, getting enough of the right carbohydrates, eating enough protein, enough healthy fats for regulating hormone function, the right type of exercise, because exercise can affect women negatively if we do too much, you know, the right amount of sleep. So it’s all about balance and I’m really passionate about meeting different women because everybody’s an individual and finding that balance with them and for them longterm.

Great. Well thank you so much for coming on the podcast.