339: Are Keto Sweeteners Derailing Your Hormones, Microbiome, and Weight?

I'm excited to be speaking to Ali Miller today. Ali is a renowned expert in the ketogenic diet, author of Naturally Nourished and The Anti-Anxiety Diet Book, and a registered dietitian with a contagious passion for developing clinical protocols using food as the foundation of supporting thyroid, adrenal, and hormonal balance. Her food-as-medicine philosophy is supported by up to date scientific research for a foundational approach to healing the body.

More about Ali Miller:

Ali Miller, RD is a Registered Dietitian with a contagious passion for developing clinical protocols and programs using nutrients and food as the foundation of treatment. Her FoodAs-Medicine philosophy is supported by up-to-date scientific research for a functional approach to healing the body. Ali is a renowned expert in the ketogenic diet with over a decade of clinical results using a unique whole foods approach tailored to support thyroid, adrenal and hormonal balance.

Ali’s message has influenced millions through media with television segments, features in MindBodyGreen, O, The Oprah Magazine, Women's Health, and Prevention Magazine, her award winning podcast, Naturally Nourished and within the medical community. Ali’s expertise can be accessed through her website: www.alimillerRD.com offering her blog, podcasts, virtual learning, and access to her practice and supplement line Naturally Nourished. Integrative functional dietitian, author of Naturally Nourished (2016), The Anti-Anxiety Diet (2018) and her newest book The Anti-Anxiety Diet Cookbook (2019).

Show notes:

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Transcript:

Dr. Pompa: 

In this episode, I interview Ali Miller, the author of The Anti-Anxiety Diet. Okay, anxiety today, how many people have it? She gives you some really clear answers and some really hidden causes, but most importantly, what you can do about it.

 

Listen, I had a pen in my hand; I couldn’t keep up. That’s how many good tips that she gives in this episode. One of the things as we look at, gluten-free in keto. She talks about some of the big pitfalls that so many people are making that are actually making them more sick. Stay tuned. We even jump into kids’ health here this episode.

 

Ashley Smith:

Hello, everyone. Welcome to Cellular Healing TV. I’m Ashley Smith. Today, I’m excited to introduce Ali Miller, who is a renowned expert in the ketogenic diet. She’s the author of Naturally Nourished and The Anti-Anxiety Diet book and a registered dietitian with a contagious passion for developing clinical protocols and programs using nutrients in food as the foundation for supporting thyroid, adrenal, and hormonal balance. Her food-as-medicine philosophy is supported by up to date scientific research for a foundational approach to healing the body.

 

You know we love this topic. I’m excited to get started. Let’s welcome Ali Miller, and of course, Dr. Pompa to the show. Welcome both of you.

 

Dr. Pompa:

I have to say I hear all types of different conditions because I still coach on unexplainable illnesses. Anxiety, unexplainable anxiety, is always a part of it. It literally is something that—I don’t know; it seems like every condition, whether it be thyroid conditions, diabetes, sleep problems, hormone dysregulation, low energy, and anxiety, can be tapped into it. All right, well, look, obviously for you to title a book The Anti-Anxiety Diet, it shows how prevalent this is.

 

Ali Miller:

Yes, it is.

 

Dr. Pompa:

You and I resonate with so many of these topics that you have in your book. I just feel like so many people need to know this. What inspired you? Let me start there. What inspired you to write the book?

 

Ali Miller:

I actually talk about in the opening of the book my personal experience with mental health, and panic attack, and anxiety. When I was at Bastyr University, which is a naturopathic college of medicine, that’s where I did most of my education background. I was a full-time student. I am a Type-A individual. I wanted to not just get As, but I wanted to master biochemistry and anatomy and physiology. I wanted to ensure that I just exuded excellence through all of the topics that I had.

 

I took on any elective I could. I was working at an organic farm at 7 AM, doing farm deliveries downtown in Seattle. I was also working another side job in full-time nannying and literally fitting 80 hours into a 40 hour week.

 

This is on the heels of a vegan diet and following a period of time that I was raw vegan for four months. In that window, doing this diet that I thought was optimal food-as-medicine, going to fight cancer, and all of the things that I had heard in the nuances, I was the most sick that I have ever been. I was dealing with shortness of breath; I was dealing with severe brain fogs which was only frustrating me more to want to memorize and conceptualize these really complex topics; I was dealing with heart palpitations so severe that I remember one time driving this farm truck and had to pull off on the expressway because I wasn’t sure if I could handle it.

 

I went into the same naturopathic clinic in which I was practicing as a student clinician for treatment. I started to do acupuncture and started to work with TCM herbs. It came down to functional labs. I had a Ferritin of 2, which is your iron stores in the body: very low. I was anemic; I had clinical B-12 deficiency because I was not supplementing and was a raw vegan, so virtually no sources of B-12 in the diet. I was confronted at that moment of really breaking up with the dogma that I had allotted as my doctrine of a perfect diet and to really breakdown some of the nutritional deficiencies that I had and redefine my relationship with food.

 

I started learning about the GAPS diet. I really jumped into Weston A. Price and ancestral traditions of health. I started healing my body from the inside out, working with a lot of gut therapy. In 2009, I became a clinician and had my baby in 2016.

 

It was in that year that I had this aha moment of, oh, whether I’m working with like you said, autoimmune disease, whether I’m working with hormone balance, metabolic health and stubborn weight-loss issues, or whether I’m working with inflammation, if anxiety or chronic stress response, whether we don’t want to deem it anxiety, maybe we just want to say mismanaged chronic stress, rumination about what was, or anticipatory stress of what could be, if that isn’t harnessed, that will constantly be the Achilles heel to wellness. I put this book together to really unpack the HPA Axis. I determined six Rs just because it’s a sexy literation of different entry points that were chicken and egg that either drive anxiety or propitiate the chronic stress response.

 

Dr. Pompa:

Yeah, and we’ll discuss those Rs. Just showing you how prevalent this is hearing your story. Then mine is almost polar opposite. Every blood test I ran was normal. I looked at nutritional deficiencies and every doctor looked and was like, man, you’re the healthiest guy we know, and yet, I was having debilitating anxiety, insomnia, energy, gut problems. Yet, I just wanted to find something that was wrong.

 

Like you, we both found—I said, gosh, I’m just going to get rid of all grains and sugar. I started realizing about different things about grains, etcetera. Some of my symptoms got much better just eliminating grains and sugar out of my diet.

 

Then, of course, no one really talked about gluten back then, but there was a host of five different proteins that were in grains that made this condition worse. Gluten just being one of the five. I was like, okay, I’m going to start here. If I can control my glucose even more and some of these inflammatory reactions, then I’ll feel a little bit better. I did.

 

We both came from different areas and realizing, okay, great, this diet can actually be part of the answer. My HPA, hypothalamus-pituitary-adrenal axis, was shot. I was downstream trying to deal with my adrenals, my thyroid for so many years with every bit of knowledge that I had. I never got well until I got to the upstream cause, which mine ended up being mercury in my pituitary hypothalamus.

 

Again, the diet was a big player on me being able to have some handle on controlling the symptoms. We came about it, the nutritional deficiencies caused by your diet, no nutritional deficiencies, but we both had anxiety. We both had a lot of the same symptoms. We both led to the same diet. Interesting, I think. Let’s talk about the Rs maybe because you discuss it in your book.

 

Ali Miller:

Sure, so—

 

Dr. Pompa:

It’s funny because I have the five Rs that came out of my illness of how to fix the cell. We learned that from Cellular Healing. You have the five Rs here—or the six Rs, sorry. Two very different Rs, but needless to say, a great teaching part. What are they?

 

Ali Miller:

Yes, and I’m sure there will be some Venn diagram within all of this, some overlap. The first R is to remove inflammatory foods. In that chapter, I’m unpacking the trend of individuals that have elevated C-reactive protein, which is that systemic marker of inflammation.

 

We do see higher susceptibility to mental illness. I liken that to the idea that our neurotransmitters—if we have a lot more oxidative stress in the brain, an inflammatory path of physiology in the body, our neurotransmitters are not firing and docking as adequately as they would in an individual that has optimal lower state of inflammation. Then there’s the connection to the gut in an inflamed state and how that houses so much of our neurotransmitter communication bilaterally with the central nervous system.

 

I demonize in that chapter corn, gluten, soy, dairy, and sugar. We can unpack those in a moment, but I’ll name the first—the six Rs. We remove inflammatory foods. Right away with sugar, I set the stage of the ketogenic diet as a foundation of my anti-anxiety diet protocol.

 

Then the second R is to reset the microbiome. In that chapter, I talk about symbiosis versus dysbiosis and how different neurotransmitters are made and manufactured based on the status of our gut health, which is a really important area to unpack. I work clinically with so many individuals that have parasite, candidiasis, or some form of a dysbiotic strain of gut flora. That puts out more epinephrine. When you’re in this state of imbalance, your body is actually sending signals saying, this isn’t right; we’re not safe. Often that can be a perpetuating component.

 

Then the third R is to repair the GI lining. Here we start to talk about the gut-associated lymphatic tissue. Once we’ve removed the inflammatory foods and reset the biome, now we’re looking to really seal the tank of the gut to maintain optimal status in both of those areas.

 

The fourth R is to restore micronutrients. Sometimes I have to think through my Rs because they—all the words sound alike. Restore micronutrient status, so I talk about the importance of methylated B vitamins. I talk about mood-stabilizing minerals, strategic amino acids that actually make our neurotransmitters.

 

Then the two final Rs are to rebound the adrenals. That’s where I start to unpack they hypothalamic-pituitary-adrenal axis. The sixth R is to rebalance our neurotransmitters. In that chapter, I give a deep dive on seven focus neurotransmitters, the impact of them on the brain and the body, and then different influencing factors in the diet.

 

Dr. Pompa:

If you look at our one here, removing these inflammatory foods, it’s so simple what you state there just giving those foods. A lot of people today, it’s very in vogue to do food allergy testing. I don’t even bother with it anymore. You know what I tell people? Exactly what you said, just remove these foods because 9 times out of 10, that’s basically what’s going to come up in the severe allergies. Now, of course, you might have something that’s very odd, but fact is typically people know it once they start examining their diet a little closer. It’s like, gosh, when I eat this, I don’t feel well.

 

Removing those foods that you mentioned, that’s where you start because a lot of the food allergy testing is very inaccurate. We did some testing where we would run tests on people and a week later run them. It was always Number One, all the foods that most people were eating. If they changed the foods, then new ones come up because leaky gut was the problem. It was very inaccurate even. What we found that was—that came on the first test versus the second test in a week now—in a week later, I mean. The test results would be different, so I just really stopped running most of those tests and tell people exactly what you said: these five foods. Just briefly break those five down a little bit and why they’re problematic.

 

Ali Miller:

Sure, and I think that’s a really good point because if you’re removing those first three, corn, gluten, and soy, that means you’re removing almost all processed foods because it’s darn near impossible to shop anything in the middle of the grocery store that is free of soy lecithin, or maltodextrin, which is a corn derivative. If you are really tight on eliminating those, what you’re doing is resetting so that you’re giving your body more clear cut data and less white noise as far as what it is reacting to. It’s the intro of an elimination diet. Then if you do have a true inflammatory food response to something unique like cauliflower, or pork, or x, y, z, at least you’ve reset the playing field so you should be able to more clearly hear that feedback. It really starts with a single ingredient whole food diet to be able to have that one plus two equals three connection with the body. I think that’s a great point.

 

I do remove them for various reasons. One is that some of them are high in omega-6 fatty acids. When we see inflammation in the American diet, once we went to industrialized seed oils, that was a big misnomer when we’re talking about—

 

Dr. Pompa:

Yeah, and I want to be clear I’m a big pro-omega-6 guy because the membrane, but it’s these—

 

Ali Miller:

Okay, but the source.

 

Dr. Pompa:

The adulterated omega-6 is devasting. The seed oils are a huge thing because they make them—these adulterated seed oils, fats make their way into the cell membrane and drive inflammation.

 

Ali Miller:

Right, because they’re oxide and they’re rancid. Our cell membranes are bilipid. We want to ensure that the fats that we’re eating are in the closest to a whole form.

 

That’s one of the reasons why we’re pulling out the soy and the corn. Also, both of those two are high genetically modified crops; 93 +% of both of those crops in the states are going to have higher glyphosate residue from Roundup, which is a neurotoxin. Obviously, if we’re working on neurological health and brain health, we want to ensure that we would remove any residue that would have a neurotoxin in it.

 

I remove the gluten and the dairy for their inflammatory properties in the sense—of course, we could go on. I’m sure you have episodes of episodes on gluten and the inflammatory protein in there. We know that also the gliadin in our gluten is going to disengage our zonulin, which plays a rule with our gut integrity of our gut lining, thus driving leaky gut on a timestamp when you’re consuming the gluten. That just exacerbates these larger particles getting into the bloodstream.

 

Also, on our brain, if we’re talking about bipolar, mania, and really significant mental illness, we do see that gluten and dairy cross the blood-brain barrier. They interfere with opioid receptors. When we’re talking about addictive tendency, impulse control, irritability, a lot of times, the casing and the gluteomorphin from those two different food groups can be a big irritant when we’re looking at mental illness. That’s some of the logic behind that.

 

Then the sugar is really the first place to start actually with anyone. If you are a parent of a toddler all the way through geriatric care and we’re talking about Type III diabetes and Alzheimer’s connection, blood sugar regulation is really the first foundation I would say for everyone. We need to get off of the blood sugar spikes and crashes.

 

Dr. Pompa:

Absolutely.

 

Ali Miller:

I have a four-year-old. I will say that I am known to travel with grass-fed meat sticks, and the Pederson’s nitrate-free bacon, and nut butter packs because when a child is having a tantrum, they need protein and fat. That is what they need to mellow out their brain. Unfortunately, carbohydrates are just so aggressively consumed or incorrectly I believe in way too high of amounts. They’re such a driver of processed foods and they’re heavily marketed to our children. When we have blood sugar spike—

 

Dr. Pompa:

By the way, even in health food stores.

 

Ali Miller:

Oh, yeah, most definitely. You have to watch out for the halo foods like the concentrated grape juice, which is essential fructose as a sweetener in foods and such. By just getting the person off of the blood sugar spikes and crashes, we can start to see some level of regulated behavior, regulated energy, which also helps with mood stability. We’ve all been hangry where we’re hungry and angry from a low blood sugar crash. It makes us irritable. It makes concentration and focus very difficult. Going low glycemic to bring the blood sugar into a speedbump world is the first step. Then you can—

 

Dr. Pompa:

Oh, I agree. It’s the first step. My very first book was the Cellular Healing Diet, which get rid of grains and sugar. In the book we talked about—I talked about corn, and the dairy, what’s happened to these products. It is that simple. If you control glucose spikes and insulin spikes, you’ll control inflammation. If you control inflammation, you’ll control the brain. You will help the microbiome, all of it, which brings us to the next R, which is basically the microbiome: reset your gut microbiome.

 

You bring out a great topic here that I think every parent, every human needs to hear. A lot of people go to these diets, paleo, keto, but they’re gravitating to a lot of these non-glucose rising sweeteners, which you and I agree, can actually be even worse, especially for the microbiome. That’s why you talk about it like that, especially for kids. Talk about these sweeteners: what to avoid, and what you like.

 

Ali Miller:

Yes, I am not a fan of sugar alcohols as—really any kind of caloric sweeteners.

 

Dr. Pompa:

Yeah, me neither. They upset your stomach. They create bloat.

 

Ali Miller:

Yeah, they’re not metabolized by the body. They’re excreted in the urine in the same molecular structure from consumption. They create a lot of gas, a lot of bloating, so distention, belching, flatulence, loose stool, which can upset electrolyte stability in the body. Many of them are bacteriostatic, meaning they are sterilizing. That includes Stevia, which is not a sugar alcohol. Now, there’s some hybrid products like Erythritol-Stevia blends, but Stevia tends to get the “halo effect” because we think of that green leaf growing in the garden bed. I do believe that a small amount of true Stevia leaf is somewhat reasonable.

 

Dr. Pompa:

Yeah, I do, too. I think it’s okay, a little bit.

 

Ali Miller:

Yeah, but the bitter alkaloids in the leaf won’t allow you to consume as much that would really drive that Pavlov’s dog effect of tasting sweet and having an insulin response. That’s the other concern is we have a taste receptor in our tongue called GLP1, glucagon-like peptide. This actually creates a psychosomatic response. When we taste that sweet, we actually do have influence with glucagon which is a signal to the body that we do not have glucose levels. We can put out more blood sugar, so we can have blood sugar spikes, or on the other end, we can actually release insulin in some individuals where they’ll have blood sugar lows and then be gauged to eat more frequently.

 

Then the fourth reason aside from the bacteria, the GI distress, and the blood sugar regulation on a true metabolic level is just the fact the behavior. I really feel that if you want to break up with sugar, I’m a huge propionate of channeling savory. I really want my clients and my household to experience the natural sweetness of a Marcona almond or to really be able to appreciate bitter alkaloid anti-inflammatory flavonoids. When you eat these non-caloric sweeteners, even if you’re taking a probiotic, and you’re  minding your biome, and you’re not having any—you’ve tested your glucose, you’re not having any insulin or glucose spikes in your body, every time you’re in line at Starbucks or every time you’re at a wedding, you’re going to be white-knuckling the behavior shift of wanting that cake. I can tell you as someone that uses only whole food sweeteners, which is radical in the keto space, I actually use things like dates, banana, berries. We can unpack that further in a moment.

 

In that world, I keep my portions so small that my pallet stays savory. I actually have a visceral reaction to those types of foods that like disgusting. It’s not that it’s a behavior that I’m telling myself I don’t want it; it’s truly that physiologically, my body rejects sweet now. I feel like you can’t get to that place of pallet shift for true sustainable behavior change if you’re eating non-caloric sweeteners because you’re continuing to wire that sweet as a good reward.

 

Dr. Pompa:

Yeah, like you said, it’s the moderation is the key. The Bible says a little bit of honey; Hell, it’s like it’s good. Like I said, that’s—the Stevia people are dumping it on, all of those sweeteners. They’re so excitatory. Then it can raise that insulin response. Then you’re right back to square one. I think we’re going to have—someone’s going to ask the question, okay, well, how much? You mentioned honey.

 

Ali Miller:

Banana.

 

Dr. Pompa:

I think maple syrup, date. I don’t know which ones you mentioned there; maybe I missed a few. How much of those things, and when, and how? Do you give those—you give those directions in your book but touch on it.

 

Ashley Smith:

Yes, in the cookbook, The Anti-Anxiety Diet Cookbook actually has a whole section on this because this is discussed in the anti-anxiety diet, but then I really unpacked it when I have a chapter on why I hate non-caloric sweeteners and then a table of actually the health-supporting benefits of the raw unfiltered honey, banana, berries. I do use the more robust maple. When we’re talking about how much, for example, my low-carb zucchini collagen muffins, which makes 12 muffins in a recipe, uses one banana, a banana. You’re getting a 12th of a banana. That’s what again disassociates this doctrine mode of that’s not a keto food, so that must not be keto back into a reasonable, critical thinking application of, oh, let’s look at the distribution and the synergy of what’s going on in that one muffin that you would consume.

 

The recipe has things like coconut oil, and almond flour, and zucchini, and collagen, and six eggs in the recipe. You’re getting a lot of fat; you’re getting protein; you’re getting fiber, and then it has that one banana mashed throughout. That 12th of a banana is providing you 3.5 grams of total carbs, not even net. In that composition of that delivery in your body through the muffin which you might top with almond butter or something as well even is really not going to have a blood sugar impact.

 

My philosophy is that we should eat things to make things palatable and balance out that bitter, salty, sweet flavor balance in the body so things are desirable. We’re enjoying our foods, but that we’re not creating glycemic spikes. The how much would have to do with your muscle mass, and your activity factor, and your own level of insulin resistance.

 

Dr. Pompa:

Yeah, and also looking at your carb intake for that day because you know where that is. If your desire is to stay in keto for that time, how much can you take of that and stay in keto? Remember, keto is, it’s a low-carb. We bring the carbs down and we force the body to burn fat and make ketones. It would determine by that as well.

 

One of the things I totally agree, I’m not—when people go gluten-free then end up with eating these gluten-free products that have super sugars in them: the Sava flowers, tapioca flowers, there’s so many. They’re super sugars. Here you and I are saying, look, we have to control glucose. I can tell you that most of these products, the gluten-free products, are not going to do that; it’s quite the opposite. As well as keto, you get a lot of the alcohol sugars. Be careful with the keto products that—what’s the word I’m looking for? The box products or the—

 

Ali Miller:

I think so. I think honestly when something says keto on it, I’m usually very hesitant.

 

Dr. Pompa:

What’s in it. Gluten-free, I’m—

 

Ali Miller:

Same.

 

Dr. Pompa:

I don’t even remember—I don’t ever buy gluten-free products because if they’re marketing gluten-free, it’s typically some type of junk food; I don’t know.

 

Ali Miller:

Right, and that’s where we have to really watch again these tunnel-vision approaches to diet, especially if we’re looking to use food-as-medicine. It’s always understanding how does this alternate work in the body? Is it superior? Because food-as-medicine is a double-edged sword; it’s equally about the removal of the said inflammatory ingredient or irritant as well as the abundance of so what are you consuming?

 

Again, in the idea of full-circle of the banana in this muffin, you’re actually getting some tryptophan. You’re getting some pyridoxine or B-6, which is a cofactor for your neurotransmitters. You’re getting a prebiotic in that banana which supports the microbiome. It’s this double-edged sword of both removal but also equally, what are you then replacing with? Does that provide therapeutic benefits?

 

Dr. Pompa:

All right, the third one is repairing the GI or the gut lining, which is huge because that’s ultimately how you’re going to fix the gut. The lining is everything on what nutrients pass into the body, what toxins do or don’t. What are your tips here?

 

Ali Miller:

I am a huge propionate of supporting the gut lining with therapeutic foods. The connection is that this is the enteric nervous system or the second brain of the body. It connects bilateral through your central nervous system as well as our periphery nervous system. When we’re talking about our gut, this is what is going to determine a lot of the stress response, the inflammatory activity, and then, of course, also immunological response because we have that gut-associated lymphatic tissue or the GALT housed there.

 

I’m going to be recommending in this space now that you’ve removed your inflammatory foods and you’ve already worked with good gut bacteria flourishing, I’m going to be recommending things like gelatin and collagen as well as bone broth. Then therapeutically, even considering things like agglutinin, and DGL, deglycyrrhizinated licorice root if there are known ulcerations or if the individual has known leaky gut. This is one of the exceptions to the rule where N equals one. If we know that leaky gut or we’re an individual with inflammatory bowel condition like Crohn’s, ulcerative colitis, then this is an area where we may consider working with a component of dairy like colostrum which can have really fantastic immunoglobulin support especially in someone that has an immunodeficiency. That’s where we would—after that 12 weeks of removal of dairy, we’d maybe bring in something like that as a consideration to support the immunoglobulin levels.

 

Dr. Pompa:

Yeah, no, I couldn’t agree more. A lot of people are reaching for the powdered bone broth. What’s your feeling on that versus actual bone broth?

 

Ali Miller:

Yeah, a, pallet wise, I’m a foody first and foremost. I do eat for optimal health, but I really enjoy the experience of food. I’m also someone that does a slow simmer bone broth for that reason versus even the instant pot. A lot of people love the convenience factor of that, but I just love a slow-simmered stovetop bone broth and done with a mirepoix of the classic onion, celery, garlic, and a little bit of carrot in there.

 

I find that if the broth doesn’t re-gelatinize or have that collagen impact, I have question of, are we really getting all of the therapeutic properties from that? I am a big proponent of make your own; if not, buy frozen. I’m not even a big fan of a lot of the heat aseptic ones. There are some that you can get at your Farmer’s Market which may be canned if you will or pressure sealed. Those could still maintain the integrity of the ingredients.

 

I use bone broth on a daily basis, whether I’m deglazing a pan or sipping on it. I’m in Austin, Texas, where it is already triple digits. A lot of times, people say, Ali, you want me to sip on hot meat juice now, really? How could I do that?

 

I do have a table in The Anti-Anxiety Diet Cookbook called Bone Broth Five Ways. It includes things like a bone broth bloody mary; it includes things like a cream of kale soup made with coconut milk, and shallots, and Lacinato kale that’s in a blender. It makes a really vibrant, rich, green sipping broth. Other things that can brighten up, adding acid to your bone broth as a finish. You want to add a little bit of acid in the cooking process to aid in the leaching of the nutrients out of the bones, but also as a pallet to cut that heavy fat flavor profile to add acid to your broth like a little bit of lemon or lime can really help to make it more palatable as well and enough salt.

 

Dr. Pompa:

I just need to hire you. If you would see how simple I eat because I’m a foodie as far as my philosophy, but I just don’t like cooking. I don’t like doing anything. I don’t like planting flowers or plants and I don’t like cooking. These are things I hire people for because I just absolutely don’t like it.

 

I love food. I grew up in an Italian—I think because I had an Italian mother who cooked for me all the time. She did. It was like my value for cooking went downhill. Anyways, she needed me to make the food is what happened. Yeah, no, these are—that’s why you have your book because all these recipes, everything you’re talking about are in her book, folks, right here, The Anti-Anxiety Diet. There it is. We will put the link in here for sure.

 

All right, let’s go to the fourth one, restore micronutrient status. Obviously, this was a big deal for you, especially coming out of the vegan diet for that long or vegetarian. Talk about what micronutrients that you feel most people have to restore.

 

Ali Miller:

Yeah, I go a little bit—I’m nerdy overall, but I go a little bit nerdy in this chapter on SNPs or single-nucleotide polymorphisms and genetic factors of anxiety. I do highlight MTHFR, so working with our folate in the body, as well as COMT, catechol-O-methyltransferase. It’s important to note that’s a big element of nutrient density because I recommend against four to five foods, which is important for new moms when we’re talking about formula, when we’re talking about cereals, and oatmeal, and the idea of needing iron in the diet.

 

When we choose four to five foods, they always have folic acid in them. A part of this emphasis in this chapter is about the impact of B vitamins as our neurotransmitter activators as well as a contributing factor in neurotransmitter production. We think of B-6, folate, and B-12 as big factors, but really every B vitamin from riboflavin to biotin to pantothenate, all of them when clinically deficient can have a huge role in depression and anxiety.

 

I had to bring up the COMT piece of the puzzle because when we just focus on methylation, I think MTHFR is now “sexy enough” that people are proactively asking their doc, am I MTHFR, or what does that mean. My first two recommendations are remove four to five foods regardless of if you know because you have to assume that folic acid, with an I-C, versus methylfolate, or folinic acid, or nature folate found in liver and leafy greens, the folic acid can work against someone that has that genetic mutation. They’re not able to methylate.

 

Dr. Pompa:

By the way, I’m not a big tester with that any longer because I just say like you, just assume you are.

 

Ali Miller:

Assume it.

 

Dr. Pompa:

Treat everyone as if they are because the testing is—it’s inaccurate, honestly. Just because you have the SNP doesn’t mean you have a problem. Just treat it like you are; avoid those foods, to your point.

 

Ali Miller:

Yeah, and my concern is if you go to high methylfolate—you know I’ve been in this world of mental health for a while where you Deplin is a pharmaceutical drug which is a high dose methylfolate. A lot of people will go after five milligram plus doses of methylfolate. If they have COMT, which is a genetic SNP which impacts our catecholamines, which are our stress responding neurotransmitters, these are individuals that tend to run high estrogen or deal with estrogen dominance. They tend to deal with anxiety and depression as well because what happens is they may be methylating, especially if they’re driving that wheel in access through high methylfolate supplementation. Then they’re missing that secondary wheel of the COMT, so they get this damming build up. All of their catecholamines are really elevated because that methylation wheel helped to produce.

 

Now, they’re dealing in this area of having a difficult time with pivoting from what they’re doing in work. They get tunnel-vision. They have a difficulty with multitasking. They can deal with panic attack or really severe anxiety. I do present that as a preface in the B vitamin world as an important piece of the puzzle.

 

With COMT, the biggest intervention is SAMe, S-adenosyl-L-methionine, which is made in the liver and supplementary a fantastic mood stabilizer, also very strong clinical evidence on support with Rheumatoid arthritis and inflammatory conditions. We know that if there are elevated liver enzymes, SAMe is a really powerful intervention as well, so supports the detox pathways as well. That’s one area.

 

I focus on minerals as well, so iron, which was the one that really hit me, as well as zinc as a big focus and chromium. We see when zinc and cooper relationships are off that we can see more clinical anxiety. Then I hit amino acid.

 

I start to identify things like L-theanine which can work as a modulator for our neurotransmitters aiding in alpha-wave activity of the brain. I highlight tyrosine which supports dopamine levels. I call it the, I was a good girl, what do I get, kind of thing where if you’re in a high-stress day at work and you are going to show up at the end of that day depleted in dopamine and serotonin because we burn through dopamine and serotonin from our stress demands. You’re showing up with a void. That’s why you’re going to your pantry, or your wine cabinet, or your ice cream tub before you’re even registering if you are hungry. We’re looking for a dopamine boost to reset the button from that stress response.

 

Instead, I like to really do a dopamine boosting snack. I’ll do things like seaweed. Nori sheets are really fantastic for dopamine response for tyrosine as is dark poultry, so like chicken thighs. I have a lot of chicken thighs in my cookbook for that reason. If you’re getting protein and you’re able to incorporate avocado or seaweed at a 4 PM snack, chances are that’s going to help you to not have to white-knuckle the discipline when you get home to wait for your dinner time.

 

Dr. Pompa:

Yeah, honestly, a lot of people would be listening to this going, oh my God, how do I keep it all straight. Here’s the good news: you don’t. When you’re eating a whole food real diet like you talk about in your book, it’s there in the right proportions. The problem is the processed foods. The problem is all of the fortified foods. The problem is the imbalance oftentimes even created by toxicity. Because again, I deal with people who are very neurotoxic that end up with deficiencies and they eat perfect, but because they can’t even absorb nutrients.

 

Their cells can’t even hear the nutrients or even get the nutrients in the cells, which brings me to the next topic. It’s the adrenals. How do we rebound the adrenals?

 

Again, I tried; I did everything, but yet toxicity was just whipping my adrenals, is keeping me under the [00:39:56] dominant state. It wasn’t until I got upstream to my toxic source that my adrenals normalized. I didn’t do anything; they fixed themselves. What are some of your rebounding adrenal solutions?

 

Ali Miller:

Yeah, and I do in the nutrients address glutathione and antioxidants in that area as well for that reason because if the liver is taxed, both the SAMe and the antioxidants can be very helpful in that process as well. The adrenals, I give you a quiz actually in every chapter of the book because people are going to be entering this in different ways. I don’t feel that you have to all start in the order that I’ve set up these Rs. That was the way that my brain conceptualized this. When we’re talking about the timestamp current with pandemic, this is probably a highlighted chapter for people because we’re probably dealing with a lot of a chronic stress response.

 

I was in Houston during the time of Hurricane Harvey. We called it the Harvey 15. We know that this corticosteroid response can be really impactful in not just metabolism, but also the way that the brain is wired to respond to stress. It can interfere with our sleep patterns, which is when we’re supposed to be the metabolically sound and see the most neurogenesis.

 

We can be in overdrive mode stressed and wired or after the buzzing bee or fly has been going and going and going, they’re going to hit that wall and collapse. Then we’re in that adrenal insufficiency place or the stressed and tired world. It’s interesting because even symptoms that some people associate with dysbiosis, for instance, belly bloat that is not resolving, that can often be from too low of cortisol levels in the body. Histamine reactivity can be associated with inadequate cortisol because cortisol is an antihistamine.

 

Everything in the body has a sweet spot and an optimal place. Too much cortisol is going to make us irritable like Incredible Hulk mode, have insomnia, and be more keyed up if you will physiologically at an unrested place. Also, with high cortisol, we can see glucose abnormalities, elevations in blood sugar. Then when cortisol levels plummet, that’s when we can see the belly bloating, we can see chronic fatigue, we can see severe brain fog, and we can see more of that histamine response.

 

Dr. Pompa:

Yeah, had all of those. I was like, oh God, remember those days. Okay, the last one is rebalancing neurotransmitters. For those people, neurotransmitters are brain chemicals, so to speak. They make you feel good, make you feel normal, make you sleep, anti-anxiety, make you happy. These are all neurotransmitters. How do we rebalance them?

 

Ali Miller:

I unpack in that chapter the inhibitory versus excitatory neurotransmitters. I mention that big word, catecholamines. Those are actually made by the adrenal glands. In the cortex of the adrenals is where we make that cortisol and DHEA, which does play a role with ketosis as well as our aldosterone for blood pressure control. In the medulla of the gland is where we make our dopamine, norepinephrine, and epinephrine. Those are those catecholamine, excitatory, stress responding neurotransmitters.

 

When we’re looking at the balance of anxiety, we want to see where we’re falling in all of these levers. Unfortunately, with modern-day medicine, the first go-to of any sign of depression or anxiety is giving an SSRI without digging in any of these Rs. They’re right away going to that not even rebalance neurotransmitters; they’re going to manipulate the receptor function a neurotransmitter. It’s not as simple as that. It’s not a dart on a bullseye.

 

Serotonin is the most known or “famous” I would say of our neurotransmitters in the world of mood stability, but I’ve worked with hundreds of clients that have normal serotonin levels and are still dealing with debilitating anxiety. It can be just like a symphony. If one instrument is playing too loud or one instrument is not getting expressed, the imbalance of the outcome of the song or of our day to day functionality. It could be that an individual for instance is putting out too much epinephrine, which in layman’s terms is adrenaline. That can perpetuate panic attacks or chronic anxiety.

 

It may be that they’re not putting out enough GABA. GABA is an inhibitory compound. Serotonin and GABA live in that space. I think GABA is equally as important in the world of anxiety and more so in the physiological sense.

 

When we think of Parkinson’s disease, that’s a wide scene impact of not having optimal GABA receptor function where individuals have uncontrolled tremors. Even if we think of first date, or public speaking, or anytime truly that I have to speak to a crowd that’s larger than 250, I take a bioidentical GABA chew because I know that I’m keyed up for adrenaline. That’s that performance anxiety that’s very classic. I know that when I’m holding a microphone, I don’t want that shake, I don’t want that dry mouth, I don’t want that palpitation in the chest. We’ve seen that GABA when optimized is not inhibitory in a sedative way; it can actually help we’ve seen in academic performance. It can help also athletes to get in the zone. We’re talking about free throws and such.

 

We do see that GABA aids in concertation and focus, but it is anxiolytic or it is calming. It’s especially expressed in the peripheral system. That’s where again the physiological responses can mellow out because often if we’re physiologically experiencing some of these signs of stress, that plays then the chicken and egg of the brain saying, oh gosh, calm down. What’s going on? You notice these feedback things. Then it just can go off-kilter.

 

Dr. Pompa:

It’s amazing; when I was sick, my neurotransmitters were so off. Obviously, insomnia, depression, panic attacks, anxiety, just absolute imbalance was incurring in my body. Because of my brain, I literally at one point was trying to balance it all. I would be like okay, it’s this, my GABA receptors. I’m taking this. I don’t remember when it happened, but man, it’s like something made me realize my own philosophy is remove the interference, the body can fix it.

 

Many people are out there going, oh my gosh, how do I do that? The body can do it. The body does it better than any doctor. Honestly, it knows what genes you have; it knows what SNPs you have; it knows [00:47:09]. It has all of that hormone imbalance, neurotransmitter imbalance.

 

It has it figured out, but we have to get upstream. The first thing you need to do, change the diet. Ali and I both discovered that we had to change the diet. For many of you, that may be all, but for many of you, you may have an upstream neurotoxic issue like I did which is throwing you out of balance. Get to the cause. I’ll tell you; your body’s doctor, scientist, will figure it out. Ali, I think that like I said, you give so much great advice.

 

Ali Miller:

Thank you.

 

Dr. Pompa:

I think your book is great. I know Ashley could speak for it, too. Your recipes, I love your basic approach to it. I couldn’t agree more. Thank you so much for coming on.

 

This is a big topic. People need to start with what you say here. Breaking it down in those things, yeah, that’s what’s going wrong with people today. Thank you again for being here. We’re going to put the link for Ali’s books. Ali, going to give any last word of advice for the people watching with anxiety and sleep problems and all those things we mentioned.

 

Ali Miller:

Sure, the only one outside of food that I will give you because I think that lifestyle has to meet as well, I’m a huge propionate—because like you said, we can get enounced into the seaweed does this, but this and that. There are, there are absolutely. I think it’s good to be empowered in the nerd eliminate of incorporating choline-rich foods for acetylcholine and glycine for the GABA and all these things, but at the end of the day, it’s really important that we also work proactively to harness the wild stallion of the brain.

 

I’m a huge propionate of breathwork and mantra in that space. With breathwork, something I just want to leave as an action tip that everyone can do literally right now as we’re listening and watching is the 4-7-8 breath that Dr. Andrew Weil uses and has been studied in a lot of clinical research studies. It’s one of the only forms of breathwork that actually can get us into a parasympathetic state, so that regulator from that sympathetic fight or flight mode, with just three cycles of use which can take less than a minute and a half’s time.

 

Dr. Pompa:

That’s great.

 

Ali Miller:

Yeah, and so it’s inhaling for four through the nose with sealed lips. It’s holding for seven. Then it’s exhaling for eight with a whooshing, like a shh. When you do that, that process of four in through the nose with sealed lips, holding for seven, and shh-ing out with the mouth as eight out, that two to one exhale to inhale, it’s like you’re pressing the air out of a tire.

 

That release actually allows the body to feel safe and can like a light switch allow us to get into that parasympathetic space. That’s a huge thing that I’d leave you with. Then I would just say that the book has a lot of mantra. We even nerd out on things like the nocebo effect, the fact that negative thoughts can harm you and can create perpetuated stress response.

 

Dr. Pompa:

You are so right about that. What a great way to cap it off. Geez, Ali, just a wealth of knowledge on these subjects. You live it; that’s why you own it. Thanks again for being on Cell TV.

 

Ali Miller:

My pleasure.

 

Ashley Smith:

That’s it for this week. I hope you enjoyed today’s episode which was brought to you by Fastonic Molecular Hydrogen. Please check it out at getfastonic.com. We’ll be back next week and every Friday at 10 AM Eastern.

 

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