As we approach 2025, are you exploring a Functional Medicine approach, but not sure where to start?
Great! We have an easy solution–Fusion Integrative and Functional Medicine is excited to offer a 1-hour private InBody Analysis session with our Certified Functional Medicine Health Coach Cortney Goodstadt, DPT, AFMHC.
Using the simple but effective InBody device, this health diagnostic evaluation goes beyond basic metrics to provide a deeper understanding of:
Body Composition
Muscle Mass
Fat Percentage
Water Balance
What Is the InBody Device?
The InBody device is a state-of-the-art body composition analyzer that provides precise and detailed insights into your physical health. Using advanced bioelectrical impedance technology, the InBody measures key overall health metrics without invasive procedures.
Unlike traditional scales that only show weight, InBody offers a complete picture of your internal health, helping you and Cortney formulate a realistic wellness plan that works for your lifestyle. This cutting-edge tool is invaluable for anyone seeking to optimize health, manage chronic conditions or achieve specific fitness goals.
Paired with a personalized one-hour consultation and actionable strategies, this session is your first step toward better health and wellness. Whether you’re managing chronic conditions or looking for tailored lifestyle recommendations, Cortney will provide a roadmap to improved health in 2025 and beyond, regardless of age or health status.
Reserve Your Appointment
We are accepting appointments beginning Monday, January 6, 2025. Email our Practice Manager Mara at mara@fusionifm.com or call 732-631-4410 to sign up or receive more information. We’re excited to partner with you on your new health journey. Let’s GO!
“In 2019, after exhausting every traditional medical option—including visits to our allergist, dermatologist, and primary care physician—I took my 14-year-old daughter to see Dr. Jessica Miller at Fusion Integrative and Functional Medicine in Marlboro. My daughter’s “head-to-toe” eczema left her physically and mentally in distress, but Dr. Miller’s expertise and holistic approach made all the difference.
Dr. Miller began with a comprehensive history and engaged my daughter directly, ensuring her thoughts and feelings were heard. She used clear, visual language to explain potential triggers, ordered thorough lab work, and guided us through a challenging but necessary dietary change. Identifying food allergens and incorporating specific dietary supplements provided significant relief, even though my daughter’s flare-ups persisted due to her year-round swimming.
It was Dr. Miller’s insight that led us to seek further specialist care, and her collaboration with Dr. Jason Miller, a well-known dermatologist, helped us finally understand and address the triggers behind my daughter’s eczema. Dr. Miller’s dedication to treating the root causes and willingness to seek additional support were invaluable.
Jessica Miller, MD, talks with a patient.
Her impact didn’t end there. In 2022, my 22-year-old son, who had struggled with ongoing health issues, was initially skeptical about functional medicine. Yet, after meeting with Dr. Miller, he was impressed: “She connected the biology and the systems; it made sense.” He continues to work with her, making diet changes and seeing a specialist she recommended.
Most recently, in July 2024, my husband was diagnosed with Parkinson’s Disease. The first person I thought of for guidance was Dr. Jessica Miller. As a medical doctor with a background in Physiology and expertise in functional medicine, she gave my husband a comprehensive evaluation. Her approach included lab tests that considered both biological and environmental factors—crucial for a lifelong firefighter. Dr. Miller’s proactive care and compassion address the whole person, not just their symptoms.
Our family’s journey with Fusion Integrative and Functional Medicine has been life-changing, and I’m endlessly grateful for the support and expertise of Dr. Miller and her team.”
Start your Functional Medicine Approach to Health & Wellness
Ready to take control of your health with a compassionate, whole-person approach? Connect with Dr. Jessica Miller, MD, a highly trained integrative and functional medicine doctor, for a free Discovery Consultation.
This article is for informational purposes only and should not be used in place of an individualized healthcare visit.
Our thanks to Janine for her thoughtful and detailed review of her health and treatment experience with Functional Medicine specialist Jessica Miller, MD, Practice Manager Mara, and our entire Fusion IFM team.Patient outcome and satisfaction are paramount to everything we do.
“I have been a patient of Dr. Miller‘s for over five years. I have a complicated medical history, including autoimmune, fibromyalgia and an array of chronic illnesses, which ended my career over 12 years ago.
I have been to every healthcare specialist, including conventional and holistic-minded doctors in New York and top-notch hospitals. While some offered relief, none of them ever really got to the root cause of my myriad issues. I was often recommended antidepressants and more prescriptions.
Dr. Miller did extensive bloodwork and left no stone unturned. She takes the time to listen carefully and spends an entire hour not only going over my medical history and any recent changes, but also listening to personal issues affecting my health, wellness and ability to heal.
Because of Dr. Miller’s extensive experience, she does not hesitate to research everything, including any conventional medications and treatments, and will give her highly educated opinion. She is always learning and keeping up with the newest advances in not only Functional Medicine but also conventional medicine to stay informed and offer her patients the highest level of treatment.
I also attended a very informative wellness workshop with her Health Coach team consisting of Brianna and Cortney. It was a four-week series, and it included a wealth of information including dietary changes, gut health and more to encourage simple lifestyle changes to improve overall wellness.
Her team at Fusion IFM is so empathetic and truly treats every patient like family. I cannot say enough about her Practice Manager, Mara. From the first day I met her, she truly took an interest in knowing me personally and going above and beyond to always make sure she was available to help. Our visits always start and end with a hug, and I truly cannot imagine where I would be today without Dr. Miller and her staff.
Mara Munoz
Cortney Goodstadt, DPT, AFMHC
Honestly, it feels like I am talking to a friend, not my Doctor, and I feel the same way about her team, especially Mara.
Today, I feel for the first time in many years, I have a better understanding of my conditions and what my triggers are and can address my issues with a plan put in place by Dr. Miller to keep me on the path to optimal health. I would highly recommend Dr. Jessica Miller and her team. I am extremely grateful for the excellent care and compassion I have received.”
We’d love to speak with you about your health and wellness goals and challenges. Call our friendly team at 732-631-4410 or click below to speak with our team or schedule a Free Fusion Discovery Session with our team:
It is no secret that the microorganisms living in our gut play a crucial role in our overall health, influencing everything from our digestion and immune system to our mood and brain function. In fact, there are between 10 and 100 times MORE microbes than human cells in our body, and approximately 70% of our immune system lies within our digestive tract.
Research shows that “diet has the most powerful influence on gut microbial communities in healthy human subjects.” The majority of the Standard American Diet (SAD) is of limited or no benefit to the microbiota in the lower gut.
Since most of the SAD diet consists of refined carbohydrates, it is readily absorbed in the upper part of the GI tract, leaving minimal amounts of minerals, vitamins and other necessary nutrients available for our microbiome.
Constipation is an issue many people struggle with on a daily basis. Part of our treatment approach is to prescribe personalized dietary modifications including a decreased intake of refined carbohydrates and the addition of 30 plant foods weekly. We have noticed that this has changed patients’ microbiome in a beneficial way.
As an example, my patient had been having difficulty with constipation. Her microbiome began to shift after prescribing a decrease in refined carbohydrates and adding 30 plant foods weekly.
The increase in fiber (from the plant food consumption), various phytonutrients feeding the beneficial species residing in her gut and structured water obtained from these plant foods began to “wake up” her digestive system to function the way it was designed.
Keep in mind that increased fiber and plant food consumption is not appropriate for everyone, depending on where they are in their healing journey. Always consult with a health and nutrition specialist for customized treatment if you are experiencing digestive dysfunction.
Below, I’ll explain how and why to incorporate 30+ plant foods into your weekly routine to significantly improve the diversity and health of your microbiome.
Gut and Immune Health
Eating 30 or more plant foods per week provides a variety of phytochemicals, polyphenols and other bioactive compounds that can inhibit the growth of pathogenic bacteria while promoting beneficial bacteria growth, provide anti-inflammatory benefits, improve gut-barrier function, and aid in the production of beneficial metabolites such as butyrate, acetate and propionate to name a few.
Mental Health
In addition to improved digestive and immune health, a healthy microbiome has been linked to improved mental health outcomes, including:
1. Reduced symptoms of depression and anxiety: A study published in the journal Psychosomatic Medicine found that patients with depression had improved symptoms after receiving a fecal microbiota transplant (FMT) (2).
Research published in the journal Neurogastroenterology and Motility found that individuals with irritable bowel syndrome (IBS) experienced reduced anxiety symptoms after receiving FMT (3).
2. Improved cognitive function: A study published in the journal Neurology found that older adults with higher levels of certain gut bacteria had improved cognitive function and reduced risk of dementia (4).
3. Increased production of neurotransmitters: The gut microbiome produces neurotransmitters such as serotonin and dopamine, which are essential for mood regulation.
Five Tips to Build 30+ Plant-Based Foods into Your Diet:
Vegan tacos with baked chickpeas, avocado, sauce and vegetables.
1. Start your day with a savory/plant-rich breakfast: Incorporate leafy greens, cruciferous vegetables, fruits, nuts and seeds into your breakfast routine.
2. Eat various colorful vegetables: Aim for at least 5 servings of different colored vegetables each day. EAT A RAINBOW!
3. SPICE IT UP! Fresh herbs and spices count toward your 30. The more variety of herbs and flavors, the better!
4. Incorporate legumes into your meals, if you tolerate them. Legumes are rich in prebiotic fiber and can be added to soups, salads, and stir-fries.
5. Emphasize eating WHOLE FOODS and plant-rich dishes, which can account for 6+ plant foods in one meal. Think salads topped with legumes/fruits/nuts/seeds, vegetable medley soups with fresh herbs and spices, creative smoothies and stir-fry with fresh herbs and seeds.
The Best Plant Foods to Improve Your Microbiome
Prebiotic-rich foods: Asparagus, bananas and plantains, onions, garlic
As a functional medicine nutritionist, I am passionate about the incredible impact that a diverse, plant-based diet can have on our gut health, immune function and mental well-being. By incorporating 30 or more plant foods into your weekly routine, you nourish your body with essential nutrients and foster a thriving and balanced microbiome.
This simple yet powerful dietary shift can improve digestion, immunity, and even cognitive function. I invite you to take the first step on this transformative journey today. Don’t forget to download your 30 Plant Food Weekly Tracker to start your journey to improved health and wellness TODAY!
To learn more about Functional Health and Functional Nutrition, request your free Discovery Session with us below:
This article is for informational purposes only and should not be used in place of an individualized healthcare visit.
1. **Suez et al. (2014)**: “Microbiome analysis reveals large interindividual variation in the gut microbiota of healthy individuals.” Nature Reviews Gastroenterology & Hepatology.
2. **Collins et al. (2013)**: “Fecal microbiota transplantation for recurrent Clostridium difficile infection.” Psychosomatic Medicine.
3. **Bergmann et al. (2018)**: “Fiber-rich diets are associated with improved gut health.” Journal of Agricultural and Food Chemistry.
4. **Cryan et al. (2019)**: “The gut-brain axis: The role of gut bacteria in neurodegenerative diseases.” Journal of Neurology.
5. **Kong et al. (2019)**: “Dietary fiber intake and risk of depression.” Journal of Affective Disorders.
Six reasons why eating the whole foods of the season can optimize your health and keep more money in your wallet
New seasons bring on changes. And those changes should include what’s on your plate. You may have heard that eating locally and seasonally is a good thing, but with all these convenient options, is shlepping to the farmers market actually worth it? Short answer: Yes.
Eating seasonal fruits and vegetables throughout the year benefits your health and saves you money, and is kinder to the environment. Eating in harmony with the seasons may seem like a trendy health fad, but it’s actually been a way of life for humans for thousands of years—and for good reason. Here are the many reasons to make seasonal foods an integral part of your diet this fall:
🧄Seasonal produce is fresher and healthier. Time is the enemy of fresh produce: As soon as they leave the vine or tree, fruits and vegetables start to lose their nutritional value. Some produce—such as spinach and broccoli—begin to lose nutrients within hours of picking, while others—such as apples, carrots, and potatoes—stay fresher longer. Produce that’s not in season is picked, stored, and often transported, which affects the quality.
Seasonal produce is more flavorful. Vine-ripened tomatoes are often prized for their flavor, as they have a richness from fully maturing in the sun. That’s because the freshest, best-tasting produce comes right from the vine or tree. Foods grown out of season are typically picked before they are ripe, so they can be transported and stored without spoiling. Out-of-season produce may look good, but the flavor can be bland compared to a crop picked at high season.
Seasonal produce can help broaden your horizons. Let the season’s fresh produce inspire you to try some new foods. Some fruits and vegetables may only be available certain times of the year. What a great opportunity to test out a new recipe?!!
Seasonal produce suits the season Don’t you crave pumpkin-flavored, well, everything in the fall? The traditions that surround food that are in season are not by accident. These foods follow their natural growing and ripening rhythms. When certain fruits and vegetables are not in season, post-harvest treatments, known as ripening agents, are used to make them available year-round. These include chemicals, gases, and heat processes. So avoid the extra chemicals and take advantage of what Mother Earth is producing.
Seasonal produce is plentiful and therefore cheaper!
When a fruit or veggie is in season, it’s abundant and available at a lower price. Eat well and save money- it’s a WIN WIN!
🍎Seasonal produce is environmentally friendly
Environmentally, seasonal foods typically require less transportation and less intensive farming methods. Less travel and imports mean fewer fuel emissions.
Fatty acids have many important uses in our bodies. Fatty acids come in different shapes and sizes, and are named based on their size and chemical structure. Omega-3 fatty acids are a specific class of fatty acids that are utilized by our bodies and are used as the precursors for anti-inflammatory compounds.
Essential Fatty Acids are those that cannot be made by our bodies and must be consumed as part of our diet. The name Omega -3 Fatty acid describes a class of different length fatty acids which all contain a similar chemical structure.
The most well-known Omega 3 fatty acids are ALA (alpha linolenic acid), EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).
ALA is found in:
Flaxseed
English walnuts
Brussel sprouts
Salmon
Sardines
Chia
Hemp
Tofu
Spinach
Other plant foods
The body in theory has the ability to convert ALA into DHA and EPA. However, this pathway is influenced by dietary intake and does not work optimally in all people. Therefore, it is often helpful to consume foods with DHA and EPAin case the body is unable to make these compounds in the needed amounts. There are multiple studies that have shown the health benefits of DHA and EPA and I will describe these in more detail later in this article.
EPA and DHA are more difficult to obtain with a strict vegetarian diet.Sea plants and certain fermented foods do contain small amounts of DHA, but DHA is not found in land based plants. DHA makes up about 20% of the brain by weight, and is found in most fish, eggs, and milk and cheesesobtained from grass fed animals. EPA is found in most fish, especially salmon and sardines. The amount of EPA and DHA in fish is dependent on their diet. Farmed fish are sometimes supplemented with processed Omega-3 fatty acids to increase the concentration found in these fish.
Multiple studies have demonstrated the beneficial effects of Omega-3 fatty acids, specifically EPA and DHA, for our general health and well-being. Below is a summary of my review of the literature, and the findings in various studies:
Fish oils lower blood sugar and decrease liver fat stores
Increasing DHA and EPA decreases the incidence of metabolic syndrome by 20%
EPA and DHA supplementation helps to lower blood pressure (at approx. 1gm/day)
In obese patients, insulin sensitivity is improved with supplementation of EPA and DHA (at approx. 1 gm/day)
Higher levels of EPA consumption lower risk of CHF (congestive heart failure) and increase survival in patients with heart failure by 35% – thought to be because of the effect on the heart muscle pumping ability
Omega-3 fatty acids improve exercise-induced asthma and increase pulmonary function 5-fold based on pulmonary function tests
Fish oils help to slow neuro-inflammation and may slow progression of neuro-degenerativedisorders (eg. Alzheimers, Parkinson’s)
Mild cognitive dementia improves with supplementation of 900mg of DHA
Omega-3 Fatty acids may slow or reverse nerve damage from diabetes
So what should you do? All fish oils are not created equally. Fish oil in its natural state obtained directly from the diet is probably best, but it is difficult to eat the amount needed by our bodies. The next best option is supplementing our diet with at least 2.5 grams/day of EPA and DHA in the form of a pharmaceutical grade, highly refined Omega-3 fatty acid supplement (if ok with your doctor). Unrefined fish oils can have many contaminants such as PCBs and Mercury. Most fish oils sold over the counter have a very low concentration of EPA and DHA and contain “other Omega-3 fatty acids” which require our bodies to convert them into an active form. As was stated earlier, ALA intake is important, but this needs to be converted into DHA and EPA in order to be effectively utilized in the anti-inflammatory pathway.
One final note is that while Omega-3 fatty acids such as ALA, EPA, and DHA are the precursors of anti-inflammatory mediators in our body, Omega-6 fattyacids such as AA (arachidonic acid) are the precursors of the pro-inflammatorymediators in our body. Omega-6 fatty acids are found in many cooking oils such as corn, palm, sunflower, safflower and soybean oil. The western diet is very high in omega-6 fatty acids and relatively low in omega-3 fatty acids. By increasing the amount of omega-3 fatty acid consumption and decreasing omega-6 fatty acid consumption, the inflammatory state of the body is improved. This is thought to have a beneficial effect of chronic inflammatory disease states such as arthritis.
Our bodies primarily run on two sources of fuel, carbohydrates and fats.
Carbohydrates provide us with readily available energy and are used as our default fuel. Carbohydrates fuel our workouts and allow for muscle growth. In addition, carbohydrates cause a spike in insulin levels which in turn promotes fat storage. Carbohydrates are stored as glycogen by the liver and in the muscles. When your carbohydrate intake is high, these stores fill up. In this case, carbohydrates are converted to fat and stored by the body as potential energy.
The ability for the body to store excess energy is endless. Your body will simply continue to store fats in the fat cells if there is an excess of energy intake. Fat cells release leptin. As was stated in a previous article, leptin is a hormone that regulates energy expenditure and appetite. When circulating levels of leptin are high, your appetite will decrease and your energy expenditure will go up. Conversely, when leptin levels are low (as with a high carb, low fat diet), your body increase your appetite and decrease your resting metabolic rate to store energy.
The caveat to the above statement is that in people with significant obesity, their leptin sensitivity decreases. Because circulating leptin levels are directly proportional to the amount of fat or adipose tissue present, obese individuals have consistently high circulating leptin levels. The constant elevation of leptin results in decreased sensitivity to leptin, or leptin resistance. The result is that despite high levels of fat, these individuals are still hungry and continue to store fat.
Fat metabolism is turned on by the body when glycogen stores get low or circulating levels of leptin decrease. Compared to carbohydrates, fat provides the body with a more sustainable form of energy. About 100 grams of glycogen is stored in the liver and the rest is stored in the muscles. These glycogen stores in the liver can be depleted in just one day of fasting. When glycogen levels drop, it takes different individuals varying amounts of time before their body can efficiently metabolize fat to makes ketone bodies. Ketone bodies can then be used as a form of energy.
The theory behind carb cycling is to provide the body with the beneficial effects of carbohydrate intake (i.e. muscle growth, fuel workouts, gut health) without the drawback of increased fat storage due to elevated levels of circulating insulin.
By eating a low carb diet, insulin sensitivity is increased and glucagon (a hormone which increases the synthesis of glucose from glycogen) production is increased as well. The ultimate result is more efficient fat burning for energy. In theory, a prolonged low carb diet can lead to decrease in thyroid hormone production, elevated cortisol levels (a stress hormone), loss of periods (amenorrhea), bowel dysfunction and immune dysfunction. According to Paul Jaminet, PhD, low carb diets can also cause the body to decreases production of certain proteins and molecules resulting in symptoms of dry eyes, dry mouth, and decreased healing times in superficial wounds. Persistent low carb diets also can stress the liver. When needed, the liver synthesizes glycogen from proteins (or fats) in a process called gluconeogenesis.
Carb cycling is used to allow the beneficial effects of low carb dieting, but to offset or prevent the above mentioned potential side effects. In individuals consuming a consistently low carb diet, the body becomes very efficient at burning ketone bodies(fat). Often these individuals reach a plateau or stall with their weight loss attempts. By adding in a higher carb meal or “cheat meal” this essentially jump starts your metabolism and up-regulates the fat burning process through the effect of leptins.
It is important to note that using complex carbs such as sweet potatoes, brown rice, slow cooked oatmeal, yams, etc. is more beneficial than using simple carbs such as breads, sugary foods, candies etc during your high carbohydrate days. This is because complex carbohydrates are digested more slowly and do not cause as much of an insulin spike. Complex carbohydrates that are not processed also contain vital vitamins, minerals and nutrients your body requires. In addition, it is felt that the undigestible (resistant) starches found in certain plant-based complex carbohydrates may have a beneficial effect on gut flora and increase mucin (one of the main parts of mucous, which helps to lubricate/ moisten body surfaces) production to offset symptoms of dry eyes or dry mouth.
The timing of carb cycling is very important. For example, eating a meal high in carbohydrates before bedtime will promote fat storage due in increased insulin levels and decreased energy demand. At this time, research indicates that the best time to increase carbohydrate intake is after a heavy training, lifting or sprinting day when the glycogen stores are depleted. The carbohydrate influx will be used by the body to refuel the glycogen stores instead of stored as fat. This increase of carbohydrate intake will also raise the leptin levels transiently. The rise in leptin levels will result in a decrease in hunger cravings and prevent down-regulation of hormones which would otherwise decrease the overall metabolism.
The reason for fat cycling or decreasing fat intake on the high carb days is to allow an individual to maintain a fairly consistent calorie intake. On the lower carb days, high quality fats can be eaten to increase calorie intake and stimulate satiety. On higher carb days, fats should be limited so that overall calorie intake for the day remains constant. In addition, the combination of high carb and high fat intake can result in an unfavorable changes in the type of fats found in the blood stream.
In summary, carb cycling is a way to allow an individual the benefits of eating a low carb diet, without the potential drawbacks of a persistently low carb diet. Intermittent carbohydrate “refeeding” helps to prevent “stalls” in weight loss, refuel glycogen stores in the liver and muscles, regulate leptin levels and prevent possible thyroid or immune consequences of continuous low carb diets. If one suffers from symptoms of worsening hypothyroidism or adrenal fatigue, it may indicate that more complex carbs should be added into the diet. In those individuals with significant obesity, carb cycling is often not as effective in “jump starting” the metabolism due to persistently high levels of leptin, or leptin/insulin resistance. To help decrease insulin resistance and increase leptin sensitivity, a low carb diet coupled with adequate sleep, routine exercising and stress relief is recommended.
Gluten is one of the proteins found in wheat (durum, emmer, spelt, farina, faro, KAMUT ®, Khorasan wheat, and einkorn) as well as rye, barley and triticale. Gluten is commonly found in breads, baked good, sauces, salad dressings, cereal, pasta, soups and sauces. Barley is commonly used in malt, food coloring and beer as well.
Gluten has been around for only about 10,000 years. Its use in food dates back to the Industrial Revolution where it was used as a type of food glue to help foods maintain their shape. Because gluten was not part of our evolutionary diet, our bodies are not equipped with the proper enzymes to fully digest this protein. There are no nutritional benefits derived from eating gluten. In addition, though the quality of the gluten in our foods has not changed significantly over the past few centuries, the quantity found in foods has increased significantly.
Approximately 70-80% of the population are able to tolerate gluten with no problem. Because we all lack the enzymes to fully digest gluten, gluten is only partially broken down by the GI tract. According to studies done by Dr. Alessio Fasano, the head of the Department of Pediatric Gastroenterology and Nutrition at Mass General Hospital for Children, the undigested fragments of gluten and gliadin cause transient intestinal inflammation and can release a molecule called zonulin.
Zonulin causes an opening in the barrier of the GI tract. Essentially the spaces between the cells lining the gut wall open up and allow foods and other toxins to cross into the blood stream, which would not normally get through. In 70-80% of the population this is not a problem because the immune system works properly and can remove any offending bacteria, toxins, etc.
The immune system is remarkably complex, however essentially it is composed of two branches. The innate and adaptive immune system. The innate immune system is the first line of defense in the GI tract. The innate immune system is immediate and is not very specific. It will release molecules that destroy or eliminate anything it thinks is foreign. For example, when the innate immune system is exposed to gluten and gliadin fragments, cytokines (small proteins released by cells that are important in cell signaling and can affect the behavior of other cells) are released in an attempt to breakdown these gluten and gliadin fragments. Cytokines can induce an attack on the gluten, but can also cause a local inflammation in any tissues nearby. This can cause very microscopic damage to the gut wall which is not always seen on biopsy because repair occurs fairly quickly.
If the innate immune system is unable to handle the “foreign invader”, then the adaptive immune system takes over. This branch of the immune system is much more specific, sophisticated and takes more time. The adaptive immune response can lead to either an antibody-mediated attack or to a cell-mediated attack.
In the case of the antibody-mediated the body customizes antibodies to attack the gluten and gliadin protein fragments. Occasionally, the immune system malfunctions and the antibodies customized to attack the gluten and gliadin can cross-react or get activated by cells in our body. When this happens, in addition to destroying the gluten fragments, these antibodies also destroy important tissues in our bodies. Depending on which tissue is being attacked will determine a person’s symptoms. For example, if the antibodies cross-react with joint tissue, a person can develop arthritis.
According to Dr. Fasano, there are three scenarios which could occur when you eat gluten.
The gluten is eaten and partially digested. The undigested gluten causes the release of zonulin which opens up the spaces between the gut lining and these protein fragment breach the intestinal barrier. The innate immune cells respond appropriately and eliminate the fragments and the tiny amount of local inflammation is repaired quickly and the person has no consequences from eating gluten.
A person eats gluten and the partially digested fragments activate the immune system as above. However, the innate immune system is unable to eliminate the protein fragments and the adaptive immune system gets activated. There is a miscommunication between the two branches of the immune system. The adaptive immune system builds antibodies (or cells) to attack the gluten and gliadin fragments which cross-react with the cells found in the intestinal tract. The immune cells stay locally in the gut and inflammation persists. In this scenario the person will develop celiac disease.
The third possibility is that the scenario 2 occurs, except that instead of the antibodies (or cells) staying the in the gut and cross-reacting with tissues in the GI tract, the antibodies and/or activated cells travel throughout the body and cross react with different body tissues. In this case, there will be minimal damage in the GI tract, but the personal will have chronic inflammation elsewhere in the body. Depending on the tissues which cross-react with the antibodies or activated cells, will determine the person’s symptoms. This scenario is termed non-celiac gluten sensitivity.
Non-celiac gluten sensitivity can cause multiple symptoms. Symptoms can often be vague, such as abdominal pain, headaches, foggy mind, chronic fatigue, and depression.
People can live for years without any issues with gluten intolerance. However, it appears that a change in gut flora (as was addressed last week) can be one of the inciting event which can activate gluten intolerance. There are no nutritional benefits from ingesting gluten, in addition, it causes inflammation in the gut and the release of zonulin leading to increased intestinal permeability. Interestingly, it appears that zonulin also causes an increase in permeability of the blood brain barrier and may be associated with inflammatory disorders of the brain.
Vegetarians are at risk for certain nutritional deficiencies if you are not careful about selecting nutrient dense foods for your diet. It is common for vegetarians to be deficient in B12, zinc, calcium, iron and essential fatty acids. In addition, sources of protein are more limited.
B12 is mainly found in animal products but may be found in fortified tofu and fortified cereals. It is not always well absorbed and if you are feeling tired or fatigued often, it is a good idea to have your B12 level checked. Low B12 levels are also associated with nerve pain, numbness and tingling of the hands and feet. Some people have problems with B12 metabolism and may benefit from methyl-B12 which is one the active forms of B12 used in our bodies for multiple pathways.
Calcium does not need to be obtained from Dairy, and can be found in may fortified foods, or occurs naturally in collard greens, broccoli, edamame, kale, bok choy, figs, oranges and white beans. Calcium is important for a multitude of functions in the body. Just a few of roles that calcium plays is to help maintaining strong bones and teeth, nerve signal transmission, muscle relaxation and contraction, modulating hormonal release, maintaining a regular heart rate.
Zinc can be found in beans, legumes, mushrooms, spinach, broccoli, kale, garlic, pumpkin seeds, pine nuts, chia seeds, steel cut oats, and brown rice. Zinc is important for proper immune system functioning. It also plays a role in cell division, wound healing, cell growth and carbohydrate metabolism (breakdown). Zinc is needed during pregnancy and childhood for proper growth. In addition, Zinc is enhances the action of insulin.
Some recommendations for sources of protein for Vegans include: Chia seeds, pumpkin seeds, spinach, broccoli, asparagus, tahini, Spirulina, Chick Peas, almonds, oatmeal, hemp seeds, peas and eggs (if you eat these).
Fish is a very good source of omega 3 fatty acids (essential acids that the body cannot make), therefore, if you are not eating fish, it is important to supplement your diet with either fish oils (if you will use these), walnuts, flaxseed, flax seed oil and leafy vegetables. Omega three fatty acids play numerous roles in the body. They are important for brain function, cardiac function, and are anti-inflammatory.
