How I would fix AJ Vaynerchuk’s Crohn’s disease
(and many other inflammatory issues)
I want to help you. And 44 million other people, but that’s my legacy goal.
I’ve always felt an unrelenting need to accept big obligations and work on big problems. Having a PhD in Nutritional Biology I feel it would be a disgrace if I didn’t share; if I didn’t use this fat mass in my skull for meaning, use, and for the greater whole. I don’t know where this stubbornness comes from. It may be a “having not come from much” Polish thing, an inherent character thing, or the push from everyone else around me (or the un-belief maybe I should say), but I am unwilling to settle.
The first time I came to know more about Crohn’s was with my best friend’s mom in Poland. She told me about the issues with her problems with digestion and eating certain foods (nuts, bell pepper skins, too much fiber, etc), as well as the inflammatory issues that came along with it. She would take the train from Gdańsk, Poland and go to a clinic 5 hours away in the South, stay for weeks to try to better her physiology, only to have temporary relief.
Having family pass away from colon cancer, cardiovascular disease, and even suicide, I have come to appreciate the interconnectedness of all disease states — and the resulting realization that the answer lies in a greater WHOLE, not the minutia media spins as the next cure-all, nor even the nitty-gritty nutrition, such as vitamin/mineral supplements, etc.
I need to try to contribute to your wellbeing. I am sure I don’t know ALL of the answers, but I DO know ENOUGH. And as I’ve written about before, even though a disease revolves around inflammation — which can be fixed with nutrition — what I’ve come to realize over the last two decades is that food is actually the last piece of the puzzle. What we need, and what I propose to you, is an all-encompassing approach to health.
I am by no means a medical doctor, so please advise yours before making any dietary changes, but based on the scientific literature I’ve read, and the success I’ve seen with other clients, the outline below works. This is the long-term iterative process that is designed to lead you to a lasting solution (as defined by you).
In order of importance:
1. Baseline. Defining the Problem
a) Cortisol — measures stress response. Best is a measurement of a minimum of 3 time points: one upon waking, then 30 minutes after, and one in the evening; 3 non-consecutive days (most clinics only do 1, one time, which really means nothing).
b) High sensitivity C-reactive Protein (hs-CRP) — measures level of inflammation. Don’t go in and measure if you have other stressful things going on- i.e. physical (workout) and psychological (work).
c) Hemoglobin A1C (HbA1c )— 3 month look at plasma glucose concentration.
d) Palmitoleic acid (endogenous marker of de novo lipogenesis that is highly associated with inflammation and other disease-states). Shows if you’re carb intolerant.
e) Glucose Tolerance Test — Shows how you respond to a glucose bolus (and therefore how you manage and tolerate carbohydrates).
f) General blood work — endocrine- hormones, cholesterol, glucose, insulin. The regular blood panel.
g) Later: A Continuous glucose monitor might be great way to see how one responds to different foods.
2. Dispositional measures — The Goal
Think about and write these down:
a) What was your diet in the past; what is it now?
b) What was your level of stress in the past & now?
c) How much do you exercise? if you do, what kind/type of exercise is it and at what level of intensity and duration?
d) Most importantly: What is it that you want? How does ideal health look to you?
3. The 3M’s — Mindfulness, Mindset, and Mindlessness
The internal conversation about food, health, work, exercise
a) How do you currently think about your health? What is your internal conversation? (i.e. “I’ve always been good at…/recovered quickly from…” or “my genetics are just this way…” etc.)
The mental framework here is important because there is much research supported by Ellen Langer from Harvard, and Alia Crum from Stanford showing how mindsets — particularly in the context of the connection between body and mind, as well as imposed placebo effects — influence health. In nutrition research this connection is hardly ever talked about, and hence largely undiscovered.
b) Do you meditate or have any other intentional separation from engagement in your everyday life?
c) Setting up “mindless” defaulting mechanisms in your environment that support the changes you want to make is very important. Our limbic system (habits, impulse, emotionally driven systems) is a phylogenetically older structure than the decision making cortex portion of our brain. It’s also pretty exhaustible (this has been debated, but I still think it’s not to be relied on 100% of the time). It’s not realistic to think that you’re going to make conscientious “long-term self” food decisions all of the time- especially when you’re tired, stressed, frazzled, etc.
4. The Gut
“All disease begins in the gut” — Hippocrates
When you look at metabolic pathways, the root of ALL disease states — whether that be Crohn’s, diabetes, arthritis, cardiovascular disease, obesity — revolves in some way with the inflammatory response. Inflammation is deeply complex, but the most important aspects to focus on (aside from the above 3M’s) in changing/lowering it, is what we put in our mouth, and what is happening in our colon:
a) Nutrition = This part will take some messing with, depending on what you’re eating currently, what you’ve eaten in the past, and what works for your body; but ALL CHANGE here with the intention of improving your mitochondrial function/antioxidant support, shifting gut microbiota, and consuming foods that will keep inflammation on the lower side. For example, I wouldn’t want to suggest a highly fermentable food (fiber, resistant starch, pro- and pre- biotics; which are known to be beneficial to the inflammatory response and flourishing a healthy microbiome) without having to know your current consumption and knowing what aggravates your system.
Something you can start right away here is: write down exactly what you’re eating for >3 non-consecutive days (and send to me :)).
b) Changing Your Microbiome- Get u-biome or American Gut Project test done to see what bugs you have. Ultimate goal here is heal, change diversity/amount/kind of bacteria, and make sure your gut lining (the tight junctions in your epithelium that allow or don’t allow toxins to enter) is healed [In today’s world the type of nutrition, the environment, and unchecked stress are altering this].
One thing you can start right away here is a Probiotic blend. The best example is VSL3, which has 450 billion bacteria and has the most clinical research supporting decreases in inflammation.
5. Exercise — Any exercise helps, but especially exercise that will give you a Cortisol boost (this is sometimes actually hard to do as it takes an increased intensity and time to reach a higher VO2 max).
That is a high-level overview of the process. It is designed as a Feedback Loop, rather than a point-to-point method for finding your most optimal state — and staying there. This loop may have to be gone through several times (the “Rest & Repeat” in the middle of the triangle); re-checking biomarkers, re-confirming goals, and adjusting course as needed along the way.
This is something we can all do. We must take responsibility and ownership for our own unique state.
If we were to look at this as a roadmap, the map will be different for each of us depending on where we are (where our current health stands), where we want to be (what changes we want), and which road we want to take (Do we want to drive? Walk? Take the bus? Take the freeway? Take the side roads? Do we need to re-route depending on shifts in goals? We all have different paces, and different end-goals) [Got this wonderful analogy in a podcast interview I did with researcher Bruce German while I worked with Ample Foods].
Na zdrowie (“To Your Health”), Julita
About Julita Baker:
I help people align their current food choices with long term goals, values, and life visions. Through deconstructing complex nutritional and behavioral science into actionable tools, I design individualized roadmaps to health & wellbeing. My clients scale from individuals, to start-up companies such as Ample Foods. I’ve also designed and taught courses at Stanford and UC Davis. For my graduate work I studied palatable and convenient food intake in mindfulness and stress.
To learn more or get in touch, visit http://www.julitabaker.com or email: firstname.lastname@example.org