5 Things I Got Wrong About Nutrition, Food Sensitivities, and Hormones

When you have metabolic dysfunction, when you are insulin resistant, your body is craving sugar on a regular basis. So you can't just listen to your body and think that that is going to lead you to the place that you're going to get to with achieving any kind of health goals and actually feeling good in your body and not having the symptoms that are so commonly tied to food. A caloric deficit alone will not guarantee results, not just for your body composition, but if we're thinking about using food as medicine and food as information, this is much more than just a calorie-focused approach. So even if you're in a caloric deficit, you may struggle with not only losing weight but improving symptoms. If you have blood sugar imbalances and insulin resistance, if you are in a chronically stressed state, all of these things can make these issues even worse by increasing more stress on the body. Food sensitivity testing we used to do all the time, and I realized that it created so many food fears, it created so much food restrictions. And I'm like, I cannot believe how many food sensitivity tests we ran and how limited people's diets were, we would always say it was for a short period, and then we would go through the reintroduction process. And there were so many people who we completely changed their lives. This topic feels uncomfortable to dive into today because I'm going to discuss 5 things that I got wrong in the field of nutrition over the last 12 years. I'd like to say that I got a lot right as far as things that I was out of the box with as a dietitian in at the time that many other dietitians were still recommending obsessive calorie counting and strict macro counting and really not thinking about food as medicine. But there are many things that I got wrong, and I think that it's important that as we become better clinicians, as we work with more women, that we're able to have conversations about the things that we got wrong or that we wouldn't recommend today. Because there is certainly advice that I gave 10 years ago that I would not necessarily give in the same way today. And the people, the practitioners that I trust the most, are the ones who are able to say, yes, the science is always evolving, and I myself am always evolving, instead of thinking about the practitioners who are still stuck in what they learned in dietetic school or in medical school. We have to continue to be able to embrace the fact that as the science continues to come out and as we get more experience with the people that we work with, that our minds can change, and that it's important to recognize what we did get wrong. So I am going to go through 5 places that I genuinely believed were important and right at the times that I would recommend them, and then talk about why I've changed my mind. Number 1, hormones. Now, I have recognized the importance of hormones for the duration of my functional medicine training. Thankfully, functional medicine does put a large emphasis on hormones. So I started the Institute for Functional Medicine's first training in 2014, which is like your 5-day 5-day advanced practitioner training that's 5 days long. It's mostly doctors that are there, and I was part of their advanced training that I went through and completed. That's their board certification in functional medicine. Now, as I was going through, then you have to go back— at the time they were in person, so I would go back for each of the different modules. Some— one was on detox, another was on metabolic health, another was on the gut microbiome, and then they had a hormone module. The hormone module was one of the last modules that I completed, and I remember it was in Washington, D.C. Or right outside of Washington, DC, and thinking like, as a dietitian, I don't— I'm not going to be prescribing hormones, so I don't need to pay as close of attention in this. And I would like take breaks and leave for longer periods of time during the training because it seems like, oh, this is just about how you prescribe estrogen or progesterone. But really, nutrition and hormones are so dynamically interrelated that one, I think I underestimated at the time— this was back in 2015— how much of a role nutrition plays and how important it is as a dietitian to understand the large fluctuations that women are going through as they go through perimenopause and menopause, and then also how nutrition relates to various hormones when— even for PCOS, for postpartum, etc. Interestingly, I will say that at the time there wasn't as large of an emphasis. They, they did recognize in the trainings, you know, that estrogen, bioidentical hormones is what they would typically not recommend, but say you could think about for your patients, since the room was mostly doctors. But I would say that I walked away with an underappreciation for, one, the role that nutrition plays in hormones, two, the drastic changes that women are experiencing as they go through perimenopause and menopause, and three, the fact that nutrition can't always change as much as you think as a woman is going through perimenopause and menopause. So if a person was coming to me in 2014 and I would have started them on a specific nutrition protocol and not even thought about the fact that maybe they were going through perimenopause or menopause and that the decline in estrogen was making their symptoms worse, and that combining it with estrogen or progesterone, referring to a hormone specialist, would be additionally advantageous. That like nutrition alone was not going to do enough for some of these women. Now, I still had incredible results, and a lot of it was because the patients that I was working with when I was working at the Cleveland Clinic were working alongside amazing functional medicine doctors. So they would go through their doctor's appointment with the functional medicine doctor, and a lot of the doctors were prescribing hormones— estrogen, progesterone, etc.— and then they would come to me for their nutrition. And I was not paying as close of attention to the hormone piece itself and how the hormones were likely also contributing to improvements that people were experiencing. Now, not always, because I would say that across the board, even though functional medicine was very ahead of the curve on hormones, I would say that today I would expect that a lot of the same doctors are probably prescribing hormones even more because of how much, you know, the, the role of estrogen and progesterone can play on improving symptoms. And at the time, I also remember there being arguments between the doctors that we like worked in— we had our desks next to each other, so I worked alongside two other doctors whose desks were right next to mine, and they would be getting messages from other doctors within the same hospital saying, no way can you recommend that this patient go on hormone replacement therapy, that's going to increase their risk of cancer. And the back and forth in the battle that, that existed between the functional medicine doctor trying to explain that it would not increase cancer and that the Women's Health Initiative was so wrong and misinformed on a lot of the takeaways that they created that increased the fear within hormones. And I did not have a full appreciation for how pervasive that was until the last 5 years, and especially the last 3 years of understanding the fact that perimenopause can start as early as 35 years old. That was a statistic that I did not realize until about 3 years ago how early perimenopause can start and how much, you know, that initial drop in progesterone can really impact the anxiety and insomnia and other things that blood sugar balance plays an incredible role for in decreasing inflammation. Your food can so much impact your hormone health. And we've had many women who are on hormone replacement therapy that come into the Blood Sugar Reset or into the Being Collective membership and their symptoms get so much better that they were still experiencing even on hormone replacement therapy. But I think that the, the two really are going to be most effective when combined, especially looking at the studies on decreased risk of cardiovascular disease, osteoporosis, and so much more. The research shows that only about 5 to 7% of postmenopausal women are on hormone replacement therapy, and in the UK it's up to 14%. So there's a lack of recognition of it across the board. Studies show that 60 to 86% of women seek medical care for persistent symptoms but feel that their concerns were not addressed. And research also shows that in one study, 6.8% of physicians in training felt prepared to help with managing menopausal symptoms. So 6.8% of physicians felt— reported feeling prepared to help women with menopause because of the lack of awareness across the board. It's getting so much better thanks to a lot of— honestly, thanks to social media and books that have become very popular, that have helped women better understand what's happening in their bodies. But I would say that my appreciation for it and understanding of it has very much evolved over these last 12 years. Okay. Number 2, GLP-1s. So GLP-1s, my mind has changed since they first came out. I remember when they were first coming out, an interview that was done on 60 Minutes, so horribly done with a doctor that they were interviewing. Who was paid by one of the companies that— one of the GLP-1 companies that had said that basically obesity is just a medical condition and that there's nothing that we can do about it. And that's why the medications are necessary. And statements like that that were, one, paid for by pharma and two, not really prioritizing the role of nutrition and lifestyle made me so upset because it seems at the time like, oh, this is just like another pill for every ill and conditioning people to think that anything that's wrong with them, that they need to jump to the prescription pad for instead of having agency over their health and doing the hard work that it takes to improve their weight and improve their metabolic health. Now, I still feel that way. I still feel that everything that we can do to improve our health and our weight is important. But I would say that my mind around GLP-1s has shifted a lot and that I think they can be incredibly beneficial for some people. And I probably would not have said that when they first came out. GLP-1s, especially for, uh, people who have been struggling with weight for a long time, whose weight is contributing to worsened type 1 diabetes, type 2 diabetes, heart disease, etc. That could be really amazing. I am friends with Dr. Natalie Crawford, who's an incredible fertility doctor, who's a reproductive specialist, and she even talks about, um, how much GLP-1s have been shown in her practice and in people that she's worked with to improve fertility outcomes. And the research is very new on this, but there is potentially an underlying mechanism that GLP-1s are targeting that has yet to be discovered and can impact the body in really incredible ways. Obviously, we can produce our own GLP-1s, and I do believe in doing the work to help to improve your intrinsic GLP-1 production and decrease inflammation and improve your microbiome, because really so much of this is targeting the gut microbiome in order to optimize your own intrinsic GLP-1 production. But I think that when you take the drugs, you know, the, the level that you're getting on a 24-hour basis is considerably higher than what you would be able to do with improving your own naturally. So for someone that has severe metabolic dysfunction, this can be a great way to jumpstart their health journey. I also have clients who have really struggled with motivation and consistency and accountability who use the GLP-1s, and then they get more consistent with the habits like strength training and eating well because they feel more motivated and they're seeing results. So they continue to lean into those choices that help them feel better. So it can be a nice kickstart for some people. When I was at the Institute for Functional Medicine conference in May, there was also a really great lecture on GLP-1s that— from a functional medicine nurse practitioner who talked about that in her patient experience, that you don't actually need to be on them forever in order to continue to see benefits that she's able to get people on GLP-1s and then modify their nutrition and lifestyle and then work with certain bitters, which I'm going to get into more. We're working on kind of like the overview of what the evidence shows with supplements and other more quote unquote natural approaches for people that don't like the idea of GLP-1s, but being able to wean them off of the GLP-1 using certain supplements and bitters that have been shown to improve the food noise. And she said herself, like, I as a practitioner, people would come in and say that they have so many cravings and they can't stop themselves from eating and that they never feel satiated. And she said, I as a practitioner never understood how much satiety or lack of satiety and that food noise impacts ability— a person's ability to stay consistent. And I have always— I feel like I've always given people the benefit of the doubt. I used to get in arguments with my ex-boyfriend who was in— he's an orthopedic surgeon— and my ex-roommate who was a very good friend of mine who was going through her— who's a urologist today— and a friend and Johnny's best friend, who's a, um, who's a hand surgeon, like, all these arguments with some of our friends that are doctors being like, no, you don't understand, it's not just calories in, calories out. Because they would say, the people that are coming to you, they can't lose weight, they're lying to you, they just are like eating more than they say. And I'd be like, no, they're not. There's, there's changes that are happening to their body. Like, there's too many women that are saying, I have not changed anything that I'm eating and I am still experiencing shifts in my body. And some of that is because of changes that are happening with estrogen and hormones as you're going through perimenopause into menopause that change the fact that what used to work is no longer working, which is why you need a more supportive approach to, to decreasing insulin resistance and decreasing inflammation. But across the board, I think that the conversation around the food noise and satiety piece— that I've always given people the benefit of the doubt, like, yes, that you are doing your best and that you have not changed the way that you're eating, and that food satiety lack of food satiety and food noise is, is crippling for a lot of people. So I've always understood that, and I do believe so strongly just in seeing— we've had more than 30,000 people go through the Blood Sugar Reset now, which is absolutely incredible and blows my mind. And within the third day, the number of people who start saying, wow, I have no food noise, this is the first time ever, wow, I have so much more satiety, this is the first time ever, is extremely high. So what I believe is the importance of really modifying your diet to a super blood sugar balanced approach and not just like making sure you're eating protein, but comprehensively doing it like we do in the Blood Sugar Reset so that you give yourself the ability to see what that can feel like. And sometimes that's enough for people where they're like, okay, I have so much more control over the choices that I'm making that I don't need to have the snacks at night and other things that were derailing me. And then sometimes people may still need that additional GLP-1 support, and I am not opposed to that. Not only am I not opposed to that, but I am supportive of that if that is in the best interest of some people. And there have been clients that I work with who I say, like, I think that the GLP-1 and losing the weight will decrease your risk of so many different other conditions that it's beneficial. Now, what I also think GLP-1s are playing a huge role in is highlighting the importance of metabolic health because we have doctors now who are saying like basically that in 20 years from now everyone will be on a GLP-1 because of how much GLP-1s are going to be able to decrease risk of every cancer and blah, blah, blah and every disease. And I think that sounds so unbelievably scary. But at the same time, I think that what GLP-1s are doing is highlighting the importance of metabolic health and how much that how much having healthy body weight, having enough muscle, not experiencing that natural 3 to 10% muscle decline every decade, how much that plays a role in reducing every single risk of chronic disease. So that's a great benefit of GLP-1s because for a long time there, it would drive me crazy how many dietitians, especially dietitians, there's this whole camp of dietitians that are— they believe that all foods fit. To the like intuitive eating dietitians. And then they basically say like, just listen to your body, listen, listen to what works for your body and eat according to that and don't count any calories and all foods fit and there's no bad foods. Eat the Oreos when you crave the Oreos. And it's supposed to be an approach for people that have dieted or have disordered eating in the past to be able to allow them to have food freedom so that it decreases their, their risk of like bingeing on food and staying more consistent. And so the intuitive eating camp, I've always had such an issue with that. Not that I'm against intuitive eating, but when you have metabolic dysfunction, when you are insulin resistant, your body is craving sugar on a regular basis. So you can't just listen to your body and think that that is going to— that is going to lead you to the place that you're going to get to with achieving any kind of health goals and actually feeling good in your body and not having the symptoms that are so commonly tied to food, like the fatigue, the mood swings, the cravings, etc. So I— we have a lot of people who come into our programs after doing intuitive eating approaches, and we are so much about, okay, let's balance your blood sugar, but then let's also create a super, super healthy relationship with food at the same time. I believe you can have both at the same time. You can have discipline with your food and have a healthy relationship with food. You can be consistent with your nutrition and also give yourself opportunities where you're eating out and doing things that aren't 100% on your plan and are less optimal choices.. But I don't believe in the idea that you need to just listen to your body at all times and give your body whatever it craves, because if I did that, I would have a hard time managing my weight too. I would have a hard time decreasing my risk of so many other conditions and managing my own autoimmune disease and other symptoms that I have to work hard to, to help to offset from a symptom standpoint. So all of that to say, I think that the GLP-1s are going to highlight the role that one, blood sugar balance plays in improving our overall health, and two, the role that weight and improved body composition plays in decreasing our risk of all these other diseases. Because carrying excess weight, especially more visceral fat— and when I say weight, I really mean when, if you do a body composition test and you're carrying more fat, that is what increases our risk of inflammation. Because you have, especially with the visceral fat, it increases your cytokine release, which increases your risk of heart disease because of those cytokines being so close to those vital organs and other things that have been very closely shown in research. So I see— I think that the GLP-1 craze will only highlight that. Now, with that said, would I recommend a GLP-1 for someone who's just trying to lose 5 pounds, or that is using it to be obsessively lean, or other things that have become very common and are extremely concerning? No, I absolutely would not. Do I think that if you can achieve the body composition that you're working towards with the hard work and effort that comes in with nutrition and exercise, that you should go in that approach first? I personally do, because of always thinking about unknown side effects to any drugs. As more things are being discovered, are the side effects of continuing to carry excess weight probably larger than the side effects for GLP-1s for some people? Probably for some people, but I also know a number of people who try GLP-1s and they can't stay on them because of the, the hair loss and thinning and the exhaustion and the, the diarrhea and other GI symptoms that they experience. So, and then does going on a GLP-1 make it that much more important to do all the things that we recommend with the strategies that we use in our nutrition plans? Absolutely, it makes it that much more important. So GLP-1s should never be seen as like a shortcut to not having to do the hard things. They should be seen as a way to maybe help you get more consistent with the things that are going to move the needle on your health so that you're not losing more muscle and you're losing primarily fat. Number 3, calories. Okay, so this is a big topic because one of my first blog posts I ever wrote was about why I don't count calories. And I feel, I feel proud that I have pushed against the idea of rigidly counting calories, going into large caloric deficits in the way that I have, because was absolutely going against the grain for the majority of time that I have been recommending that to clients. And I have seen incredible results in the women that I work with who have not been able to lose weight for a very long period of time and then finally are able to achieve that. Do calories matter though? I would say that one of my first blog posts when I said why I don't count calories, I was like, food is information and the quality matters so much more than the quantity, which is true. I still stand be behind that. But I will say that my approach has changed in a bit. My approach has changed in that I do recommend slight caloric deficits for people who are trying to achieve certain body composition goals. Unless you're, you know, strength training a lot and trying to build muscle, then you have to have enough calories on board in order for that to happen. But calories do matter more than I previously admitted. And that would lead to a lot of arguments in, you know, a lot of the friends of mine that were doctors who were just so insistent, like, calories are the only thing that matter. And so that I always disagreed with for many reasons that I'll talk about. But I think that when it comes to if you are trying to maintain a certain weight or decrease weight, that calories do matter. And you, if you are eating 3,000 calories of nut butter, then that will make you gain weight. If you're eating 3,000 calories of sugar, that will make you gain weight. And there was a time that, especially like in my 20s, where I would be like, okay, let me just eat this— these paleo pancakes that are made from, you know, like ghee and almond flour and these very calorie-dense ingredients, and then add some nut butter on top because I'm not going to do the syrup because I don't want to have the added sugar. And that was probably like a 1,000-calorie breakfast, which in my 20s was not as problematic. Now at almost 36 is— has much more of an effect, especially with trying to just get back to my regular body composition postpartum, where I not only have I seen it personally in myself that what, what worked in my 20s does not work in my 30s after really post-kids is the— it's not even just being in my 30s, but for me it's post-kids. So much has shifted. But also in the women that I work with, where if we're really trying to dial in that body composition and lose that fat and improve the muscle, then calories do matter. Now I had Dr. Tim Spector on my podcast in March, one of my favorite episodes. If you go back to it, the title is The Number One Gut Microbiome Doctor, and he talks about how in their research they have shown that long-term calorie deficits do not actually help with weight loss because eventually you go back to eating the same. And so you can only sustain the calorie deficit for so long, and then people go back, and then basically your metabolism goes back to— your metabolism slows down in that calorie deficit, and then you end up gaining the weight back. So his point is that calorie deficits have not been shown in long-term research, meaning like 10 years later, to actually move the needle on weight loss. And so his approach is very much centered, similar to mine, around increasing fiber and increasing fat and helping to design meals that are— that help to improve satiety so that you're naturally consuming fewer calories throughout the course of the day. And in that way, that's where I think that I, I always say to our members in my community, the focus is on being calorie aware, not calorie obsessed. So I am not a person— even in the last 2 years of losing 40 pounds, I have not counted calories doing that. I'm calorie aware, where I understand the number of calories, generally speaking, that are in my meals. Not always, but, you know, kind of for the most part. And I've been able to do that so that I'm balancing the meals with enough fiber and enough protein to help me feel satiated, so that I'm eating the portions that we plan for, and then I'm not overeating at my meals. And so you don't have to count calories obsessively in order to see the results. And I think that that is a lot of the work that Dr. Tim Spector does, is that focusing on the nutrient density, focusing on the fiber, the protein, higher volume meals meals is what helps to naturally improve satiety through so many different hunger hormone balances and the, the changes in your, your, your stretch receptors that help with you just feeling like your body recognizing how much you've eaten and not needing to continue to overeat so that you don't have to count calories. But I do think that calories matter. Now, at the same time, I still stand by the fact that restriction slows your metabolism. So your body is designed to resist weight loss, and when you cut calories drastically, your metabolism compensates by lowering your energy expenditure, which means that you're burning fewer calories at rest, and by reducing your muscle building capacity because muscle requires energy in order to maintain itself. So in a calorie deficit without adequate protein and without strength training, your body preserves fat while breaking down muscle instead. So over time, this can lead to lower resting metabolism, which makes weight regain much more And at the same time, restriction ignores your hormonal fluctuations. So women in particular experience hormonal shifts that impact their metabolism and their fat storage, like postpartum, perimenopause, and menopause, cortisol dysregulation that can happen at the same time, insulin resistance. And all of these can make weight loss so much more complex than just a simple calorie counting equation. This is why I still stand by the fact that a caloric deficit alone will not guarantee fat loss, which is a very important differentiator. Calories do matter. A slight caloric deficit is important so that you are not in a large caloric deficit that drastically lowers your metabolism. But at the same time, a caloric deficit alone will not guarantee results, not just for your body composition. But if we're thinking about using food as medicine and food as information, for the women who have been able to reverse their prediabetes and improve their inflammatory markers and improve their autoimmune disease and improve their and their, their mood swings and so many other things. Insomnia. This is much more than just a calorie-focused approach. So even if you're in a caloric deficit, you may struggle with not only losing weight but improving symptoms. If you have blood sugar imbalances and insulin resistance, if you are in a chronically stressed state where you are just high cortisol all the time, if you have thyroid dysregulation, if you are experiencing hormonal dysregulation where your estrogen is dropping, your testosterone is lower, you're chronically inflamed, you have gut microbiome imbalances. All of these things— large caloric deficits can make these issues even worse by increasing more stress on the body. But at the end of the day, I still do believe in all of those things and think that that's an important differentiator. But calories do matter, and being in a slight caloric deficit is important if you're trying to change your body composition. What I got wrong number 4: super low carbohydrate diets. So there was a time in the early days of me being a dietitian around 2017, 2018, where the ketogenic diet was extremely popular and we were doing different programs. I had created a group medical appointment for diabetes patients. They were type 2 diabetics that were resistant to their medication, meaning that they were taking insulin and other drugs, but they were not able— they weren't sensitive to those drugs. So their hemoglobin A1C was staying super high. Even with taking the drugs and their doctors continuing to increase it. So in order to get into this group for the protocol that I created in the program that I ran, you had to be resistant to the, the medication and uncontrolled diabetes. So in these cases, I created a curriculum around a low carbohydrate diet, and it was pretty low, pretty low carbohydrate, and it was really effective. Not only that, but also I was doing the, the weekly coaching in person. I was creating the material for, um, the presentations and then having the coaching breakouts that we were doing in a group fashion at one of the satellite hospitals. And it was so effective. And a ketogenic diet— I actually went on a ketogenic diet myself because I was seeing so many great results in our, in our patients and had great results as far as like my energy. My energy is always my number one focus for changing my diet in any way. I care way more about my energy and brain health than I do my composition, but I also experienced very impressive body composition results. I was actually doing a lot of HIIT training at the time, and the combination of HIIT training with the low carbohydrate/keto diet worked for a few months, and then I totally crashed, where I really sent myself into an adrenal burnout situation where I like couldn't— in the afternoon I was so tired, it was so hard for me to get out of bed in the morning. I started having like weird almost like not full panic attacks, but just a lot of anxiety in the afternoon that came out of nowhere that I typically don't experience. And that made me so much more aware of how much super low carbohydrate diets are a hormetic stressor, that women in particular are much more sensitive to this hormonally than men. So I was working with a lot of males at the time, and they would have great results result, but then it wouldn't always transfer to the same results when I was working with women who were going through like perimenopause or menopause, and it would lead to more binging, more anxiety, more insomnia, and sometimes even weight gain. And at the same time, I saw one woman actually who was doing a program that's very well known. It's an online keto program for type 2 diabetes. They have shown in research that they're able to reverse type 2 diabetes through their keto approach, and they were company, the first virtual company on the market to be able to do this in an evidence-based way. And she was following their exact protocol, but not only was she gaining weight, all of her lipid markers were moving in the wrong direction and her hemoglobin A1C was going up. And she had reached out to me and said, like, this coach that I'm working with keeps telling me that I just must be doing something wrong, that I must be lying about what I'm eating. And the coach hadn't factored in that maybe that approach just didn't work for her, because some people do better do better on super high fat, and some people do better on lower fat. And then some people are— women in particular are more sensitive to the stress of not having enough carbohydrates. And the fact that when you don't have enough carbohydrates as a woman, it can increase nervous system dysregulation, which means that you— your cortisol levels are higher on a regular basis. And when your cortisol levels are high on a regular basis, it not only makes you more insulin resistant because it increases glucose in your bloodstream through gluconeogenesis, but it also can lead to intense symptoms outside of that. So it didn't mean that she wasn't following the protocol close enough. It's just that the coach needed to understand that low carbohydrate diets are not effective for a lot of women when you go too low in carbohydrates. And so I at the time was all about low carbohydrate diets. I thought that they were amazing because I was seeing those results in certain situations. And then in myself. Until then, I crashed. And that helped me understand the importance of, one, nervous system regulation for women, and how when we push our bodies into too much stress with a low carbohydrate diet or a low calorie diet or too much high-intensity interval training, that it absolutely can backfire. And how much we have to be regulated with our nervous system, incorporating the meditation, the breathing, working with someone if you have had trauma in the past to, to work through that trauma, and other things that really help. At the same time, I also did not understand the importance of the research on the gut microbiome and how much having the variety, having at least 30+ plants per week, was so crucial for the gut microbiome. Now, I will say I was very early into understanding that. That was 2018 that I really was diving into that research and doing interviews for other publications about the importance of variety in your diet, but I hadn't fully connected understood why we needed to be able to add that element until doing that. And then it came full force again when I worked with all of the clients that I worked with through Levels. Levels is a company, it's a software company that gives you access to continuous glucose monitors. And when they first came out on the market, I started working with a number of their clients. So in the app, when you would spike, when your glucose would spike, then my face would come up and it would say, you want to work with a dietitian? Here's how you can work with a dietitian. And then they would refer to working with with me. And so I worked— I looked at hundreds of CGM data, and that was another thing that I found at that time, is that women especially that were like postpartum or perimenopause who were eating, they were trying to like fast for 16 hours, and they were also eating low carb. They weren't having large spikes in glucose after each of their meals, but their, their fasting glucose was elevated always, where it would never get down to 70 to 85. They were hovering around like 100 and so they'd schedule a call with me and be like, I'm doing everything right, I don't understand why I can't get my fasting glucose down. And it was because they were eating so low carb, they were adding the hormetic stressor of the intermittent fasting, they were working out a lot, they weren't sleeping because they were postpartum and going through a stressful period and needed to prioritize actually getting enough carbohydrates and getting enough rest and enough, you know, meditation and grounding in order to improve their nervous system support to improve those results that they were getting. And as they increased carbs, actually improves their blood sugar control. So this is why I'm not a fan of low carbohydrate diets like I used to be, but I still very much in our nutrition protocols am lower in carbohydrates than what the recommendations are. So some people will still say, oh well, Brigid is, uh, you know, her approach is low carb, um, because 100 to 130 grams of carbohydrates per day is more like moderate carb. But in some people's mind, that's a low carb diet. When I say a low carb diet, I mean 50 grams of carbohydrates carbohydrates a day, which is typically what you would aim for in a ketogenic approach. Okay, number 5, food sensitivity testing. Food sensitivity testing we used to do all the time with so many different patients, and I realized that it created so many food fears, it created so much food restrictions. And I look back and I'm like, I cannot believe how many food sensitivity tests we ran and how limited people's diets were, we would always say it was for a short period, and then we would go through the reintroduction process at that 6-week mark or at that 3-month mark. And there were so many people who we completely changed their lives, going from— like, one person going from insane acid reflux to the point that he would literally pass out. He, like, couldn't even eat garlic and onion and would have to travel with his assistant at all times so that she could try his meals because he would be, like, in a full-body breakout sweat with horrible acid reflux and like passing out at all of his business meetings. And by doing a food sensitivity testing, removing foods from his diet, and being like very aggressive with that, he was able to reverse all of his acid reflux and those instances. And of course, he was also doing supplements alongside his doctor that helped with improving, repairing his gut microbiome. They gave him his life back. But I would that looking back, so much of what we start with today is a blood sugar balanced approach because blood sugar imbalances can also drive a lot of symptoms similar to food sensitivities that sometimes remove foods that are more problematic, like gluten being number one food that is most problematic for people. And then combining that with focusing on healing the gut so that it's— because you have to have a healthy gut in order to improve the tolerance to the foods that you're experiencing. So if you have issues with certain foods, I understand why the idea of food sensitivity testing can be helpful, because it removes that, like, increase in inflammation that may be happening when you have foods that you're more sensitive to, that are generating more of that IgG food response from the immune system. But at the same time, I think that by focusing on anti-inflammatory and removing certain foods that are the big ones like gluten, and then working on healing your gut, that, that will improve symptoms for the majority of people, or going on a targeted elimination protocol based on the symptoms, etc., that you're experiencing. So there was a time in the very early days that I would do— we would recommend the same elimination diet for every single person. And when I started my own business, I was like, I am not doing that. I am not recommending the same elimination diet for every single person because some people need low FODMAP, some people need low histamine, some people need thyroid support. Like, there's so many different iterations of that, which we focus on when we're working more one-on-one with people. People. But that is extremely important to me because I do look back and I'm like, we probably created more food fears than were necessary. And that probably took people— even though I would like incorporate so much mindfulness and coaching around relationship with food and other things, because I experienced this in myself. I did food sensitivity testing when I was 15, and it created a lot of food fears for me. And I then thought like, well, because I've removed these foods and have so many benefits, let me try removing more foods. And more removal is not always better. Um, we want to be really responsible. Having variety is the end goal. Improving your gut microbiome so that you can tolerate more foods long-term is the goal. So food sensitivity is my number 5 thing that I have changed my mind about in the field of nutrition. I hope that this episode was valuable for you, for me to be able to unpack these 5 things, why I've changed my mind and what I believe now. As I All practitioners that are great practitioners are ever evolving. So I actually love this format and would love to be able to read other practitioners' things that they've changed because I think that it shows a level of growth and also reliability that I don't have an ego around telling you the things that I got wrong because everyone gets some things wrong. So thank you for being here with me on the Being Brigid Show, and I will see you next time.