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Giveaway Time! Something a Little Different…

There is never a bad time for a Giveaway!…and this one is pretty cool IMO.

If you have followed me over time you may have read me mention an activity my family and I enjoy called Geocaching. What it is? Well, Geocaching.com defines it as “a real-world, outdoor treasure hunting game using GPS-enabled devices. Participants navigate to a specific set of GPS coordinates and then attempt to find the geocache (container) hidden at that location.” Basically, the point of the game is to find hidden treasure!

The website allows you to find caches in your area easily, and it is free to join.  There is an option for a Premium Membership at $30 a year that gives you access to more caches, and the app itself on iPhone or Android will cost around $10 one time.  As of this writing, there are well over 2 MILLION caches hidden WORLDWIDE.  Log on and check it out, you’ll be surprised to see what is just around the corner.

To play you find the cache you want to find on the net or on your phone, plug in the coordinates into your handheld GPS (or just click the “navigate to” button on your smart phone) and go to that location.  Once close you are at what we call Ground Zero, and it’s time to get looking.  Some are large and obvious, some are small and discrete.  Some are easily found, some take forever.  Some are easy to get to, some take a long walk.  Some are well hidden, some stick out like a sore thumb.  All are rated from 1-5 stars on Difficulty to find, and Difficulty of Terrain to reach it…that way you know what you are getting yourself into.  Once found you sign the log and record your find on the net or your phone which posts onto your Geocaching profile.  Larger caches have what is known as GeoSwag which you can trade.  Rules are simple: take something, replace it with something of similar value.  This is where the kids get very excited and mine love to trade swag and collect new things.  Here is an example of a cache of my own…And a few I have found recently.

Small bridge in the woods. It has several little support pieces like this one.

Small bridge in the woods. It has several little support pieces like this one.

Small Bison Tube, just big enough for a log book.  Gotta bring your own pen!

Small Bison Tube, just big enough for a log book. Gotta bring your own pen!

Can you see the Ammo Can hidden in the brush?!

Can you see the Ammo Can hidden in the brush?!

Looks like an ordinary piece of wood near a stump right?

Looks like an ordinary piece of wood near a stump right?

Flip it over and see what you find!

Flip it over and see what you find!

Another fun aspect of Geocaching is what are called “Trackables.”  These are items of your choice that you register at GC.com and assign a goal to.  You then release them into the “wild” and when found, they are logged as found, and moved on to another cache in hopes of achieving the desired goal.  Here is a link to one of my trackables named “One Nation Under God.”  It’s a good indication of how quickly something can move around the nation in this little underground society.  It’s fun to see your items move all over the world as it spreads from cache to cache.

So, why a post about Geocaching on my blog?  Simple…it gets you and your family outside.  My kids and I absolutely love heading into the woods to find caches nearby (although there are just as many, if not more in town known as Urban Caches).  We get time together, we see amazing new places we likely would have never found unless caching, and it gets us tromping around the woods staying active!  In addition, it takes on a whole new meaning when we are on vacation.  Finding new areas to cache in and searching out the most popular caches in that area has become one of the highlights of any family trip.  It’s something we love to do, and I believe strongly that if you try it, you will get hooked.  You’ll go to a beautiful location near your house and say “I can’t believe we have never been here” or “I had no idea this was here.”  Just try it and see!  Getting active, getting your muscles working, getting your mind working, creating quality family time, creating and hiding caches of your own…it’s all part of this wonderful game!

Lucky for you, this month may be the best time ever to start Geocaching for yourself! Geocaching.com is having a sweepstakes this month they are calling Gear Up For Geocaching! Three lucky entrants drawn at random will get a prize package with cool stuff from some of our favorite outdoor brands.  Each package will include some Swag (although this stuff is definitely better than anything you’ll find in a cache!) from Camp Chef, Mountainsmith, Greenlayer, 7eye, MHM, Kor, and Skratch Labs.  Also, each prize package winner will receive a one year Geocaching Premium Membership.  Three winners will be drawn and notified in early September. Share your stories and photos on Twitter @GoGeocaching with #GearUp.

Want more information? CLICK HERE! to visit the Geocaching.com Blog Info Page

Want to see an entry form? CLICK HERE!

So what does this have to do with you, and why am I mentioning it here??  The folks at Geocaching.com have given me one Premium Membership to give away to one of my readers!  To enter is simple.  Like my Facebook page and follow me on Twitter, once you do that comment to this post with your name.  At the end of the month one winner will be chosen at random and I’ll send you a code to cash in on your Premium Membership!

I’ll admit, not a traditional “Paleo” related giveaway, but I think it’s always good to mix things up a bit.  Living a healthy lifestyle is just is much about having fun as anything else.  If given the opportunity to stay active AND have fun, I’ll always choose both over one or the other.  I think you should to.  Step out of your box (to you CrossFit folks you can take that literally and figuratively) and try something new.  I dare you to go searching for a cache or two and not come back loving it.

I have no affiliation to GC.com, this all came about after one of their staff read a recent blog post.  He offered me a free Premium Membership in exchange for mentioning the sweepstakes on the blog.  I asked if I could just give it away, and he thought it was a great idea!  So here you go faithful readers, time to get out and go caching!

 
8 Comments

Posted by on August 1, 2013 in Uncategorized

 

An Update on Things!

Greetings everyone! Just a quick update on how things are going, since I totally suck at consistently updating the blog… I have to be honest, keeping up with posting on a regular basis while keeping up a full time medical practice, being a husband and dad, exercising when I can, and sleeping adequately is hard!! I’m on vacation right now in North Georgia and am enjoying relaxing!

Things are well, kids are growing, and this update will be short as I’m pecking away at my iPad keyboard which tends to aggregate me! So what’s going on?

-The family garden is going well. This is our first actual attempt to grow a garden and we are starting to enjoy the harvest. Regular tomatoes, cucumbers, okra, and ton of peppers so far. Also, our apple trees that we planted 5 years ago have applets this year! It takes years to produce, and you have to hope they cross pollinate….woohoo!!

-I continue to push the Paleo lifestyle in my traditional Internal Medicine practice…and of coarse many patients remain resistant (shocker). That said, I am very pleased that in my small Louisiana town the Paleo community is growing. My good friend and next door neighbor the Fit Paleo Mom even has a special Summer Cooking Series on a local TV station spotlighting Paleo cooking. Honestly guys, if you have not checked out her recipe blog DO IT, it’s great. In the last several years since I began my Paleo life, our small town has really come a long way, and I feel it is very much fueled by the Paleo community. We have two local farms producing grass fed beef, a local organic farm producing amazing produce they sell twice a week (they also sell pastured pork, fresh farm eggs, and are developing ducks to sell), and our local big chain grocery has tremendously expanded their organic produce and food area. Our community is passionate about sourcing our food, and local business has responded.

-I have personally started to push my road cycling. I dabbled in it a few years ago and bought a nice starter Specialized bike. I enjoyed it, but rode off and on. A few months ago I decided to push it, make goals, trying to get faster and better. More than anything the quiet time it gives me is amazing. I cherish alone time, and my bike has become a sanctuary. Cycling is now my main exercise, and I’m loving it. I’m doing what I normally do…reading all I can on improving my cycling and am already seeing the steady results. I entered a local race, the Tour de Bayou 2013 in November. This is very unlike me, as I’m not that competitive by nature. I’m pretty excited though, should be fun (I’ll get a T-shirt too :) ).

-Lastly I’m staring to make it a point to get my kids and I outside much more. With them small my wife and I’s enjoyment of hiking, camping, kayaking etc slowed down tremendously. They just could not enjoy these activities being so small. At Easter we went camping in Texas, and after a VERY cold first night we really enjoyed being outside. Nighttime fireside chats with my daughter were priceless. We are utilizing our love of Geocaching to get outside as well, and if you are looking for a way to get your kids excited about getting outside, CHECK IT OUT! On this vacation we took the kids on a 3 hour river Kayak trip and they absolutely loved it. Kourt and I are so excited as we feel we can start enjoying this part of our life again now that the kids are old enough to tag along, and most importantly enjoy it! We have many plans coming together, the first of which is a 4-5 night canoe camping trip next year…float by day, fireside by night :). This way the kids don’t have to carry much, the canoes can do that for us. Oh how I love being outside…

I’m honest, I’m not as good at updating the blog as I should be. I’ll get better, but I know it will be intermittent while my kids are small. If you want though, please follow my Instagram feed as I update it regularly with my meals and adventures. I really enjoy interacting with you all, and truly love our inspirational community. As always, you can find me on Twitter @PaleolothicMD.

Keep in touch, God bless, and stay safe.

Ernie

 
5 Comments

Posted by on July 26, 2013 in General Paleo Discussion

 

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Sous Vide Cooking – What a Warm Bath Can Do For Your Food

For those of you who have read my blog for some time, you know how much value I place on cooking.  In fact, one of my 4 Keys to Paleo Success is cooking at home!  I have a wife, two hungry kids, and a full medical practice.  I also happen to be the one and only cook in my home…so, I am always looking for ways to make easy and convenient food that my family enjoys.

Some may say I have a bit of an obsession with kitchen equipment (especially my wife).  That said, no matter how big your kitchen is you eventually run out of room to store things.  So a couple of years ago when I started to look into Sous Vide technology to say that my wife was a little cold on the idea would be an understatement.  She was convinced that this would be another high dollar toy to collect dust in the pantry (I would like to say, there are none of those to speak of…:).  After several years, my Sous Vide is still going strong, and even my wife has admitted to me that it was probably the most useful appliance we have ever bought to cook with!  Now that’s saying something.  I use my sous vide so much that it has a permanent place on our kitchen counter because it is pretty much always on!

If you have ever uttered the words “I just don’t have time to cook”, the sous vide could be the answer you have been looking for. When I mention the sous vide to others they are usually intrigued and completely in the dark about the technology.  That’s why I decided why not do a blog post on it and see if we can get more people perfectly cooking meals at home!

The Concept:  Sous Vide is French for “Under Vacuum.”  This method of cooking uses a precisely controlled water bath to cook food that is vacuum sealed in airtight plastic bags.  To do it you need a vacuum seal device like your typical Food Saver, and a way to precisely control a water bath’s temperature.  By cooking food in this way you assure that the food is always cooked to the precise temperature that you would like, and you never have to worry about ruining that expensive piece of meat you bought!  In the end it is a very simple concept: cook food to precisely the right temperature to get optimum results (oh, and it can’t be any easier to do).

All you do is decide on what you want to cook, soak it at the appropriate temperature for an adequate amount of time, and finish it off with a quick sear to achieve the crispy brown exterior that adds so much to the flavor of meat.  Now the science behind sous vide cooking is extensive, and can be very complex, but you can keep it pretty simple by experimenting with cooking times on your own and never rushing the process.  Check out this page at SousVideSupreme.com for specific cooking times, or totally geek out with the Sous Vide Dash mobile app to better control your cooking times!

The most important thing to remember is my opinion is to adequately season your food before vacuum sealing AND before searing.  This leads to the most consistent results and great flavor.  In addition, don’t forget to thoroughly DRY off your meat prior to searing or you just won’t get the amazing results your food deserves.

The Cost:  You can spend thousands on amazing sous vide systems, but unless you are commercial chef there is absolutely no need.  I use the Sous Vide Supreme Demi that I paid $329 on Amazon for (you can spend an extra $100 for the slightly larger standard side Supreme).  I also bought a Food Saver vacuum machine from Sam’s Club for around $130, and I was ready to go.  Is this equipment cheap? Absolutely not!  Is it worth it, I would have to say every penny.

Sous Vide Supreme has a home on my countertop.

Sous Vide Supreme has a home on my countertop.

The Convenience:  Most large pieces of meat take hours to cook in the oven, and the results are often variable.  You cook a Ribeye roast and the outer parts are overcooked while the interior can be a bit raw.  A very expensive piece of meat normally turns out good, but why risk it and instead always make it great!  Lets say you have a 4 pound Ribeye roast and you want to cook it perfectly rare/medium rare.  Hands on time includes getting it out of its packaging and seasoning it.  Next you place it in a Food Saver bag and seal it.  So far, total time, maybe two minutes.  Get your Sous Vide out, fill it with water, set it to your desired temperature (I prefer 130F for beef), and place your roast inside.  Using a chart or the mobile app you can easily determine the minimum time needed to cook your roast.  The key is that you find out the MINIMUM time, but that is not a MAXIMUM time!  You cannot overcook your meat, as it will never go above 130F no matter how long it sits in the water.  Let’s say it takes 5 hours to cook, you can leave it 8-9 hours until you get home from work without any issue whatsoever.  In fact, with tougher cuts of meat I often cook them for 24-72 hours.  I’m sure you can keep meat in too long and it will mess with the texture, but I have yet to have any major issues with that.  The key is that under most circumstances, the meat can wait for YOU to be ready to finish it off, not vice versa.  Once I get home I put a cast iron skillet on full blast gas to heat up while I take the roast out of the bag and thoroughly dry it.  I add a little more seasoning and brown it on each side in a little coconut oil for 30-45 seconds.  Total hands on time for the roast 10 minutes MAX, and the results are perfect.

Ribeye Roast drying off

Ribeye Roast drying off

Finished Ribeye Roast (Notice edge to edge perfection)

Finished Ribeye Roast (Notice edge to edge perfection)

This convenience aspect is why we love the sous vide so much.  The main part of our dinner many nights is perfectly cooked animal based protein, and the sous vide makes it amazingly easy to prepare with very little time invested.  I have cooked countless cuts of meat this way, and I am yet to have a problem with the results.

Here are two more things to keep in mind when it comes to the convenience of sous vide cooking.  Lets say you find a good deal and want to buy some meat in bulk…you are likely going to freeze some of your bounty.  Simply season the meat, vacuum seal it, label it, and stuff it in the freezer.  When it comes time to cook your meat no need to defrost it, simply stick it into the sous vide at the right temperature frozen, and add an hour or so to the cooking time.  Perfect meat, straight from the freezer, and no time consuming defrost!

Lastly, how many of you have had this happen?  You plan to make chicken thighs for dinner and they are soaking away in the sous vide.  For whatever reason you end up staying out later than you want, the kids get hungry, and you take them to a local eatery for dinner to less complicate your life.  What to do with the thighs?  When you get home take them out of the sous vide and dunk them in a cold water bath.  Once completely cooled place them, bag and all, into your fridge.  In the next day or two simply pop them back into the pre-heated sous vide for an hour to heat them through and proceed with dinner as usual!  I have even frozen completely cooked sous vide meat as an experiment and reheated it straight from the freezer.  Meat was perfect…you just can’t seem to go wrong.

The Consistency:  I can’t tell you how nice it is to know that what I cook will be perfectly cooked to my family’s liking every single time.  As many of you we spend the time to source our meat locally and make sure it is raised in a healthy and responsible manner.  Those of you who do the same no doubt know that this meat does come at a cost.  Nothing aggravates me more than taking an expensive piece of meat and not having it come out just right…or even worse, totally killing it!  That simply does not happen with the Sous Vide.  It’s 100% guaranteed to be perfect if you can just set the temperature right and cook it long enough.

This consistency also leads to enjoying meat at it’s best.  While beef is often cooked rare and enjoyed that way (my 7 year old daughter recently sent a steak back at a restaurant because it was medium…much to done for her!), other meats in particular pork are often overcooked for fear of food borne illness.  When you calculate the time to cook meats you can calculate the time for the core of your meat to reach a certain temperature, or you can calculate the time to Pasteurize the meat to the core.

Sous Vide Dash for iPad

Sous Vide Dash for iPad

That means you can cook a pork tenderloin or roast to medium long enough to kill any potential bacteria, and finally be able to enjoy amazingly juicy pork!  I had honestly given up on pork tenderloin as it always turned out too dry for my liking no matter what I did!  The sous vide has brought all pork back to my kitchen, and I am amazed at what I was missing with poor temperature control!

The Versatility:  To say you can cook anything in the Sous Vide is not an over-statement.  I have cooked just about every type of animal and cut of animal out there, and I have gotten amazing results.  Want to cook seafood? Go for it.  Veggies? Have at it.  You can even cook eggs in a sous vide!

The Results:  If you have not figured it out yet, the Sous Vide has led to some of the most amazing meat dishes I have every made, with little to no energy expended on my part.  I never have to worry about how dinner will turn out.  Here are some examples of dinners from my Sous Vide Supreme.

Searing off a roast in the cast iron skillet

Searing off a roast in the cast iron skillet

Sliced Roast, perfectly cooked

Sliced Roast, perfectly cooked

Sealed and ready for a dip!

Sealed and ready for a dip!

Steaks dried off before the sear

Steaks dried off before the sear

Finished Steak

Finished Steak

Grass Fed Chuck Roast

Grass Fed Chuck Roast

Finished Roast

Finished Roast

Chicken Thighs ready for searing

Chicken Thighs ready for searing

Chicken Thighs, Skin Crisped to Perfection

Chicken Thighs, Skin Crisped to Perfection

Crispiest Chicken Thighs ever

Crispiest Chicken Thighs ever

Grass fed roast being sealed

Grass fed roast being sealed

Roast out of the Sous Vide

Roast out of the Sous Vide

Finished and perfectly cooked roast

Finished and perfectly cooked roast

Pork roast completed

Pork roast completed

Perfectly cooked Pork Roast

Perfectly cooked Pork Roast

I hope this has given you even a little bit of interest in Sous Vide cooking!  There is no doubt that the cost of the equipment to cook this way can be hard to afford.  All I can tell you is that I have owned my fair share of kitchen equipment in my day, and I would be hard pressed to find a more valuable member of my cooking arsenal than my fancy water bath.  Have experience with a Sous Vide of your own?  Share your experiences and new ideas on what to throw in and at what temperature!  Here are some useful links for Sous Vide cooking!

Nom Nom Paleo – Amazing food blog that first peaked my interest in Sous Vide Cooking.  I really can’t tell you guys enough how much you need to check out Michelle’s blog.  It’s beautiful, witty, and delicious!  Check out her recipes and her iPad app that includes many recipes specific to Sous Vide.  The chicken thigh recipe above?  All Nom Nom!

Sous Vide Supreme – Makers of what I think are the most affordable and easy to use Sous Vide cookers for the home cook.

Douglas Baldwin – Expert if Sous Vide Cooking and Non-Linear Waves

Modernist Cuisine – Great article on “Why cook Sous Vide”

Sous Vide Cooking – A Blog all about Sous Vide Cooking!

 
4 Comments

Posted by on April 30, 2013 in General Paleo Discussion

 

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Restless Leg Syndrome: Is Your Diet Related?

As an everyday part of my sleep practice, I often see patients who complain of problems falling asleep due to symptoms in their legs when they get in bed. It can be anything from “restlessness” to “deep pain” in the legs, but almost always follows a typical pattern. What these patients suffer from is called Restless Leg Syndrome (RLS), and it is more common than you may think. Lets learn a little about it, and investigate whether or not diet can either lead to, or relieve the symptoms of this often misunderstood condition.

Epidemiology: The numbers vary widely in the literature as far as the overall prevalence of RLS across the population, but it’s safe to say 5-10% of Americans suffer from some form of RLS throughout their lives. Importantly, this is not just a disease of adults, as it is felt that the overall prevalence is similar in children as well. In these children, RLS symptoms are often misdiagnosed as “growing pains” and the sleep disruption it causes often leads to night after night of unrestful and disjointed sleep. When adults get tired we get sleepy, when kids get tired they get cranky, agitated, disruptive, and even hyper. Needless to say, many experts believe unrecognized RLS in kids could account for a good number of cases labeled as ADHD. As in many things in sleep medicine, this remains controversial.

Pathogenesis: RLS can be grouped into two main categories, as can many disease states; it is either primary or secondary.

-Primary RLS is idiopathic, meaning there is no real identifiable cause. Observational studies point to it being a genetic disease with autosomal dominant inheritance. The underlying genetic defect occurs somewhere in the metabolism of dopamine in the central nervous system, although imaging studies using SPECT and PET imaging of dopamine producing areas have produced often conflicting data. Given that Parkinson’s disease is clearly known to be related to dopamine defects in the CNS, and the fact that Parkinson’s medicines have been successfully used to treat RLS, this is an important area of current research in Neuroscience.

-Secondary RLS is felt to be caused by a number of other conditions; in other words, RLS is a symptom of these problems. Here are a few of the most common (and the one we are most interested in).

-Iron Deficiency – Since the original description of RLS, iron deficiency has been considered one of the most likely causes. Study after study have consistently showed decreased iron stores (ferritin) in RLS patients vs. controls. MRI estimates of brain iron concentration in the substantia nigra (the area that makes dopamine) have also been consistently lower in RLS patients. That said, these findings are FAR from universal, so it is only part of the story.

-End-Stage Renal Disease – If you take care of hemodialysis patients for very long, you quickly hear the same complaints of RLS pop up time after time. The cause of RLS in these patients has many theories, from iron deficiency to low parathyroid hormone (PTH) levels. Research is ongoing.

-Diabetes Mellitus – RLS often co-exists with peripheral neuropathy and can be quite debilitating.

-Multiple Sclerosis – The data on RLS and MS is in its infancy, but I can tell you that over half of my MS patients have clear RLS. There is a connection.

-Parkinson’s Disease – Although dopamine is related to both conditions, studies have failed to consistently find a link between RLS and Parkinson’s. This is frustrating as both disorders clearly point to the substantial nigra in the CNS as to location of disease. Our hope is that a breakthrough in one disease will lead to a ray of hope in the other. Only time will tell…

-There are many other disease states related to RLS, and often listed in the miscellaneous file are vitamin deficiencies and obesity. We’ll talk more about them later.

Clinical Manifestations and Diagnosis: Here is how UpToDate.com describes RLS.

Although the subjective symptoms of RLS are often difficult to describe, the clinical features are highly stereotyped. The hallmark of RLS is a marked discomfort in the legs that occurs only at rest and is immediately relieved by movement. The abnormal feelings are typically deep seated and localized below the knees. Distribution is usually bilateral, but some asymmetry may occur and the arms can be affected in more severe cases.

Terms that patients use to describe the symptoms include crawling, creeping, pulling, itching, drawing, or stretching, all localized to deep structures rather than the skin. Pain and tingling paresthesia of the type that occurs in painful peripheral neuropathy are usually absent, and there is no sensitivity to touching of the skin.

Symptoms typically worsen towards the end of the day and are maximal at night, when they appear within 15 to 30 minutes of reclining in bed. In severe cases symptoms may occur earlier in the day while the patient is seated, thereby interfering with attending meetings, sitting in a movie theater, and similar activities. In milder cases patients will fidget, move in bed, and kick or massage their legs for relief. Patients with more severe symptoms feel forced to get out of bed and pace the floor to relieve symptoms.

The International Restless Legs Study Group proposed the following four features as essential criteria for the diagnosis of RLS:

1) An urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs. Sometimes the urge to move is present without the uncomfortable sensations, and sometimes the arms or other body parts are involved in addition to the legs.

2) The urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting.

3) The urge to move or unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.

4) The urge to move or unpleasant sensations are worse in the evening or night than during the day or only occur in the evening or night. When symptoms are severe, the worsening at night may not be noticeable but must have been previously present.

Dietary Treatment: There are tons of resources on the internet about standard pharmacologic treatment of RLS, and that is not the main topic of this post. What we are going to look at now is common non-pharmacologic treatments for RLS, in particular diet related treatments. Let’s see where this takes us!

According to the RLS Foundation there are multiple foods that should be avoided in order to minimize or eliminate RLS symptoms. These include caffeine, alcohol, ice cream, as well as pasta and bread.

Now you all know this is a Paleo blog, and are you seeing what I just saw? Pasta and bread??? Why? We all know why…say it with me…GLUTEN!

Both Celiac Disease(CD) and Gluten Sensitive Enteropathy (GSE) lead to abnormal small intestine mucosa due to inflammation. This inflammation leads to malabsorption, and this is the pathway which connects it with RLS. We saw above that a classic cause of secondary RLS is iron deficiency anemia. We all know gluten is indigestible by the human small intestine, and it causes some degree of inflammation for anyone who eats it. People with CD or GSE have pathologic inflammation in their gut, thus making it impossible for them to appropriately absorb dietary iron. Give these people long enough and their ferritin and iron levels get low enough to put them at risk for developing RLS symptoms.

So how related are CD and RLS? Lets look at some clinical data for answers. One study showed the incidence of RLS in CD patients to be 35%, of these, 40% also had iron deficiency. In another study, 31% of CD patients had RLS vs only 4% of the control group. Also, iron levels in this study were statistically significantly lower in the CD patients with RLS than in those without the disease. BUT, after all was said and done, no clear correlation was found in this study between RLS and either a gluten free diet or iron metabolism.

Yet another study showed that GSE antibodies were NOT associated with RLS unless there was an associated underlying anemia. Everyone confused yet?! Let’s look at one more thing before we try to figure all this out.

Interestingly enough, another commonly recognized cause of secondary RLS is magnesium deficiency. Many people with RLS are amazed to see a rapid resolution of symptoms simply by taking OTC magnesium supplements…but not all get relief. Why do some get relief, and some not? Why do very controlled studies show some people get complete resolution of RLS symptoms when adapting a gluten free diet, and other get no relief at all?

Conclusion: Lets say your mom has RLS, and her mom had RLS, and her dad had RLS…what are your chances? I would say pretty good. In this case, there is clearly a autosomal dominant gene being passed down through the generations causing RLS. That gene leads to a yet unknown defect in dopamine metabolism in the substantia nigra of your CNS, and thus to your RLS. Gluten is no where in this picture! Although many want to believe that Paleo can fix everything, it simply can’t. Lets say one day your car stops running, and after checking it over you realize it’s just out of gas! You fill her up and she fires right up. I think we would all agree that your view is skewed if you believe that no matter what happens to your car, if it stops running, all you need to do is put gas in and it will work. Gas is not the only necessary part of your car to make it run! Likewise, gluten is just a piece of the puzzle.

That said, gluten can be and often is an important issue to address in RLS. What is the pathway to a gluten free diet improving RLS symptoms? First of all, you have to have RLS that is secondary in nature, not primary. Next, the cause of your RLS needs to be either iron deficiency anemia or magnesium deficiency. (I by no means believe these are the only two nutritional causes of RLS, but they are the most common and most studied) Now, if your iron or magnesium deficiency is caused by malabsorption from CD or GSE, you may be in luck! This pathway explains why we have such variable results in studies concerning gluten, iron metabolism, and RLS. For someone’s RLS to respond positively to a gluten free diet they not only need to have an underlying gluten problem, but that problem must also be leading to clinical iron or magnesium deficiency. If we look at one of the studies above where the incidence of RLS in CD patients was 35%, and only 40% of those had iron deficiency; that means a gluten free diet will likely only help 40% of 35% of the original study population! Even that is if you get 100% response to the diet in those who are “primed” to respond.

One of my biggest messages I try to get out through my blog is that although adapting a Paleo diet can do amazing things for your life and for your health, it can not substitute for traditional Western medicine in every instance. If your RLS is related to dopamine (in other words, genetically handed down), and you want relief of your symptoms, it’s best if you see your doctor and get a prescription for medicines that will increase dopamine in your CNS. You can go gluten free forever and never get the results that you need. Do not become single minded, it won’t get you anywhere but walking around at midnight again frustrated and tired.

In the end RLS is a very important cause of morbidity in America, and around the world. How do I use this information in my practice?

-In RLS patients I often recommend a trial of gluten free diet to see how symptoms respond, particularly in patients with no family history of RLS, or a positive family history of CD.

-In iron deficiency anemia patients who fail to respond to iron replacement, I often test them for CD as an underlying cause of malabsorption.

Think you may have RLS? Talk to your doctor or contact a local board certified sleep physician to get evaluated. I often used to tell patients that RLS would not kill them, it would just make them want to kill themselves. Recent data showing how short sleep times, in and of themselves, can increase overall mortality has me changing my tune. That topic though…is for another blog post in the future!

I hope this post finds you all well, God Bless.

Ernie

PS – Because it’s fun to share, I thought I might give yall my two favorite “home remedies” that I’ve heard over the years for treating RLS. Now please, I DO NOT RECOMMEND THEM, just sharing. One gentleman told me his best method was putting homemade charcoal in a sock, smashing it up a bit, and rubbing the sock all over his legs before bed time. The blacker his legs got, the better he said he slept.

This can only be outdone by the man who told me after years of experimenting, he found that rubbing paint thinner on his legs at bedtime led to a nice sound sleep…….. I quickly made sure neither he or his wife smoked! You just can’t make this stuff up…!

Sources:

Restless Leg Syndrome Foundation: About RLS

UpToDate.com Section on RLS

Dig Dis Sci. 2010 Jun;55(6):1667-73. doi: 10.1007/s10620-009-0943-9.

Celiac disease is associated with restless legs syndrome.

Weinstock LB, Walters AS, Mullin GE, Duntley SP.

Source Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63141, USA

Mov Disord. 2010 May 15;25(7):877-81. doi: 10.1002/mds.22903.

Restless legs syndrome is a common feature of adult celiac disease.

Moccia M, Pellecchia MT, Erro R, Zingone F, Marelli S, Barone DG, Ciacci C, Strambi LF, Barone P.

Source Department of Neurological Sciences, University Federico II and IDC Hermitage Capodimonte, Naples, Italy.

Acta Neurol Belg. 2011 Dec;111(4):282-6.

Prevalence of gluten sensitive enteropathy antibodies in restless legs syndrome.

Cikrikcioglu MA, Halac G, Hursitoglu M, Erkal H, Cakirca M, Kinas BE, Erek A, Yetmis M, Gundogan E, Tukek T.

Source Department of Internal Medicine, Bezmialem Vakif University, Medical Faculty, Fatih, Istanbul, Turkey

Sleep Med. 2009 Aug;10(7):763-5. doi: 10.1016/j.sleep.2008.07.014. Epub 2009 Jan 12.

Celiac disease as a possible cause for low serum ferritin in patients with restless legs syndrome.

Manchanda S, Davies CR, Picchietti D.

Source University of Illinois at Urbana-Champaign, College of Medicine, 506 S. Mathews Avenue, Suite 190, Urbana, IL 61801, USA.

 
8 Comments

Posted by on April 23, 2013 in General Paleo Discussion

 

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Miss Me?! I’m back…Here’s an update.

Well, it’s been around 8 months since I last posted, and I’m glad to be back! I’m sorry to all that I just kind of disappeared, but I hope this post explains what’s been going on, and I hope to be back to regular blogging now.

My wife and I have two beautiful children, now ages 4 and 7, and last summer we adopted a teenage family member from my wife’s side of the family. This child had been through a great deal in her young life including losing both her parents at a very early age, and being the victim of various types of abuse I’d rather not write about. To say that a teenager in the house changed things would be an understatement!

My life suddenly became very full, and any extra time I had was quickly eaten up by activities and working on moving our new child in the right direction. I won’t get into much, but I can tell you all it has been a very long year filled with highs and lows. My priority in life is leading my home in a Godly fashion, and given the new presence in the home, my roles quickly changed and required a lot more hands on approach. What did this do to “paleo”? It essentially put it on the back burner! Although I was able to maintain a primarily primal lifestyle, there were definitely more episodes of “stress eating” than I am used to having! It’s hard, if not impossible to try to teach someone all the lessons they need to live a good life in a matter of months, but none-the-less you try. In the end after approximately 9 months in our home, our adopted child decided to move back home out of state with her grandmother. It was hard to see her go, but I do believe God is in control and will guide her. It was a major period of growth for me personally, for my wife, and for our marriage.

As complex a situation as that was, it was only part of the story of the “PaleolithicMD’s” near demise. I’m not certain how many of my readers share my deep faith, but I am not afraid to say that my relationship with Jesus Christ takes priority in my life. I am a very blessed individual, and I try daily to give thanks to the one who blesses me through appropriate actions, attitudes, and commitment based on his teachings. One of the 10 Commandments states “Thou Shall Have No Idols Before Me.” So, what does Paleo have to do with that?

To put it plainly, Paleo became and idol. The PaleolithicMD became and idol! I started to prioritize my cooking plan, blog posts, twitter chatter, FB likes, Paleo networking, etc above my daily time studying scripture, as well as much needed time with my kids. I struggled with it for several months, and my loving wife called me out on it as gently as she could! Like many battles with pride, I did my best to ignore it. So what happened? The episode above happened! My home changed, my priorities were forced to change, and Paleo was essentially removed from my life for almost a year. I knew what I needed to do, I ignored what I should do, and God took care of it for me…

So why write about this? Well, first because I’ve been gone; second, because I’m human, and third, because it is a testimony to how you should not ignore where your heart leads you after deliberate prayer. I love my job, and one of the more important things to me is that I am always honest with my patients. Whether it’s me telling them the biopsy shows cancer and they are not going to live very long, or that the reason their test wasn’t done is because I simply forgot to order it, honesty is vital to a good relationship with my patients. Although you all are not patients, you do come here looking for some Paleo advice with a good dose of medical knowledge. I am who I am! I’m not perfect by any means… I’m human, I really like being human, and I want all of you to identify with me as fellow struggler in this thing we call life.

So where do I go from here? Well, my home has gone back to normal in the last few months, and slowly but surely my passion for the Paleo Lifestyle has been brewing up. More specifically, my passion for helping others through the blog has been rekindled. That said, I can’t make the same mistakes twice. So, I’m going in with some ground rules this time that I intend to keep!

  1. I plan on having only one major blog post per week, likely on Tuesdays. Before I was putting way to much pressure on myself to blog every day or two (because of coarse the best way to gain followers and subscribers is to publish, publish, publish!). I want to enjoy this blog, have time to put together my posts, and not have the blog be a burden or distraction to my life.
  2. I still plan on posting Twitter and Instagram posts frequently, so stay tuned to both those feeds for frequent pics of dinner at our house, and anything else I think may be the least bit entertaining of funny.
  3. I hope to develop more recipes in the coming months and emphasize what really got me into Paleo in the first place…cooking food!

So there it is, a long winded explanation of my absence. If you understand where I’m coming from…thanks. If you don’t, sorry, but it is what it is!

One last thing, while you are here, check out my newest venture called The Genesis Experience. In a nutshell, it’s a two month Paleo/CrossFit program I’ve put together with two good friends of mine designed to “shock” people’s systems. Away with the SAD diet and gym visits to watch TV on the stationary bike, and in with Paleo education and eating combined with tri-weekly CrossFit workouts. Results have been awesome!

Thanks for listening, and I look forward to interacting with ya’ll on into the future.

Ernie Garcia

 
10 Comments

Posted by on April 17, 2013 in Uncategorized

 

In Defense of Paleo: No WORDs Needed!

Courtesy of a Quick Google Images Search or Two…

Problem:

Cause:

SAD

Carb Consumption/Obesity DIRECTLY Proportional

Affect:

Adult Obesity Related Diseases

Incidence of Diabetes

Incidence of Childhood Diabetes

Incidence of Vascular Disease (Flat Line)

Incidence of Heart Attack (Flat Line)

How Many Are Diet/Obesity Related?

Solution:

P-A-L-E-O

The End…

-E

 
25 Comments

Posted by on September 10, 2012 in General Paleo Discussion

 

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A Real “Genesis Experience”: 6 WLS Patients and How Paleo Changed Their Lives

Well Hurricane Issac came our way and thankfully we were spared any significant weather.  Many folks south of us are still struggling, and I ask for everyone to pray for their safety and a quick resolution to the chaos that has come into their lives. On top of the hurricane, much has been going on…where to begin…

Several months ago two of my friends and I decided to try something new.  All three of us follow a Paleo lifestyle, participate in CrossFit (each on very different levels as William is part owner of our local gym and one of the it’s trainers, and Sam has been attending CrossFit for much longer than I) and have a passion for helping others.  William Albritton is an engineer by trade, but spends all of his spare time as a CrossFit trainer and health coach.  Sam Bledsoe is somewhat of a rarity as I’m almost certain he is the only Paleo Bariatric Surgeon in the country!  He identified a group of his successful weight loss surgery (WLS) patients who had stopped losing weight after surgery, or plateaued.  He and William devised a plan to put them in an 8 week program based on strict Paleolithic nutrition and consistent application of CrossFit…lucky for me they asked me to join in the fun!  In total, there were 6 lucky participants.

Looking back at our first meeting it was pretty comical.  They really did not know what they were getting into, and we had to completely define the term “paleo” to them.  We set about explaining to them what and why we eat the way we do, and in the process I think I may have broken a few hearts.  Who knew what a stronghold someone’s oatmeal could be!  Regardless, they are all people of integrity, and they committed to our program by trusting our judgement.

So lets just look at this for a moment.  How much more difficult of a challenge could we ask for?  Here are 6 individuals who have fought their weight their whole lives, and who have lifelong food relationships that often were unhealthy.  When you have WLS a certain amount of weight loss is almost automatic, but the last of the loss is much harder.  Here is the thing though, each of these individuals was working hard through traditional weight loss regimens.  Low calorie, low fat, exercise at the gym when you can, walk when you can’t get to the gym…it just was not working.  There is a misconception that overweight individuals are inherently lazy, and this group of people blow that mold out of the water.  They were all trying, they were just trying the wrong things.  One of our group members had already lost 120 pounds since surgery, but had only lost 5 pounds in the 6 months or so before our challenge.  Bottom line is that they did not necessarily “get” what we were telling them, but they were willing to try something new.

So began the process, some form of exercise 5-6 times a week, half of them being CrossFit WODs, and the other days much more light walks or runs.  All along we held them accountable to following a Paleo regimen by turning in weekly food logs and helping them sort through the best choices to make.  Each had their own issues at the start, but they all worked hard to get through the beginning, and quickly began to thrive.  Their group workouts became a source of encouragement and our consistent interaction with them kept their eyes open at all times.  Slowly the magic started to happen, but they did not know exactly how much magic.  Why?  We strictly prohibited them from weighing themselves over the 8 weeks.  It was time to worry about health, not weight!

The results of our 8 weeks was amazing, and I’ll let two things do the talking.  First is a chart of the results.

The numbers in the first row are where each person started, the middle row is their end measurements, and the bottom row is the difference between the start and finish of the 8 weeks.  You are reading right, each person averaged around 20 INCHES of loss over the program.  Now THAT is results!

Please notice that even though overall weight loss was not earth shattering for all, the number of inches lost and overall improvement in body “tone” was awesome.  We did not have one unhappy participant!

Second I’ll let everyone read an essay that one of our participants wrote at the end of the program.  He is an amazing gentleman whose transformation following WLS and our program is nothing short of remarkable.  Here is what he had to say…

At the end of our journey we had a little get together at my home where we were all able to talk and share about the program, and we enjoyed some amazing Paleo food (including a healthy dose of @FitPaleoMom’s Chocolate Chip Cookies).  It was so inspirational to hear everyone’s stories about the struggles over the years, and the positive light that our program was able to put on their circumstances.  All six participants have officially joined CrossFit, and the road ahead will be nothing but success for them.  As a physician is it easy to get discouraged in the day to day grind of taking care of people.  I can honestly say at the end of the 8 weeks we owed, and gave, a heartfelt thanks to each participant for giving their all, and reminding us how much of a difference we all can make.  It was one of the most enjoyable journeys in both my personal and professional life.

So what do we do from here?  We have decided to spread the wealth and open our program to all comers in our area. [www.Genesis-Experience.com] We want to keep attracting people who would never consider coming to the gym and helping them revolutionize their lives.  People looking to “forge elite fitness” will find the gym, we need to go out and FIND everyday people who stand to benefit so much from a dramatic lifestyle change.  As a physician this is what really excites me, changing lives that have been abandoned and failed by the “system”.  If 6 WLS patients can see these changes, anyone can!

Hope all are well…

-E

 
7 Comments

Posted by on September 3, 2012 in General Paleo Discussion

 

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