Paleo Part 101: Top 3 Lab Markers for Going Paleo
By Dr. Justin Marchegiani
There are major lab tests you need to do if you’re starting with a poor diet and transitioning to a Paleo diet. In part 1 of this two-part series, I’m going to discuss the lab tests you need to be checking and the results you need to be aiming for in order to be successful with your Paleo diet. Part 2 of the series will cover roadblocks to your success and what those underlying barriers might be that are preventing you from getting to the next level. First, I’m going to discuss the Paleo diet, or as I like to call it—the Paleo template.
The Paleo Template
I don’t like the word diet, so while that may be the more common word, I like to use the word template instead. A template is less constricting and provides more flexibility. It also gives us the ability to adjust our macronutrients, which are proteins, fats, and carbs (PFC). So then we can adjust our template according to our energy levels and our metabolic needs.
Some patients are insulin-resistant and have blood sugar issues. They may really do well on a ketogenic style of Paleo template. Some are CrossFit types and may already be pretty healthy, meaning their body is able to process and handle blood sugar and insulin normally. So they could possibly handle a little more carbs. Their Paleo template can adjust to this.
When we talk about a Paleo template (or diet), really what we’re talking about is anti-inflammatory, nutrient-dense, low-toxin foods. Foods that we’ve had enough time to evolutionarily adapt to. However, our standard American diet today consists of grains and a lot of refined sugar (non-Paleo foods). So our goal is to go from pre-Paleo to post-Paleo. This is where we’re really one or two months in to our Paleo template and we’re seeing significant benefits, whether its energy, less inflammation, relief with joint pain, less brain fog, and so on.
We only started to consume grains about ten thousand years ago. So if you look at the start of the Paleo era, about 2 million years ago, we’ve been consuming grains for a very small percentage of that time. We’ve evolved away from hunter-gatherer societies, which consumed lots of meat and bone marrow, starchy tubers, and fruit and vegetable carbohydrates (not grain-based). But the evolution to grain-based diets has been at a rapid pace, which is highly problematic because our bodies haven’t had enough time to adapt to those things. Some people can handle it better than others, but in my opinion, for people who are sick or inflamed, grains are going to be their dietary kryptonite. A Paleo template will bring your body back in-line with its evolutionary expectations.
The Top 3 Lab Markers for Going Paleo
As my patients prepare for or begin a Paleo template, I will run lab tests to check for 3 key markers: inflammation, blood sugar, and lipids.
1. Inflammation Markers
Inflammation is just a sign that your body is breaking down faster than it’s building up because of some type of physical, chemical, or emotional stressor. These can include the following:
- Gluten in the diet
- Sleep deprivation
- Excessive exercise
- Toxin exposure (pesticides, herbicides, rodenticides, fungicides)
- Hidden infections
- Consuming high-glycemic index foods (lots of sugar and grain carbs)
When we cut these things out, we go Paleo and we put an emphasis on food quality. The toxins mentioned above have only been around for 40 to 80 years. Grains have been around for 10,000 years, and flour only for 200 years. People think organic food is a fad thing, but if you look at beyond 50 or 60 years ago, everything was organic. We didn’t douse our foods in pesticides. There was no GMO. So cutting out toxic foods will significantly help improve inflammatory markers.
When looking for inflammation markers through lab testing, I like to see:
- C-reactive protein (CRP): below 1
- Homocysteine: Agood sign of vascular integrity and vascular inflammation is below 7.5–8.
- B vitamins: Folate, B12, B6—can have a big effect on homocysteine. Inability to methylate, which is important for detoxification and brain health, and gut absorption issues can also impact homocysteine levels.
- Fibrinogen: It is a measure of our clotting factor, and elevations of it can make our cells “sticky” and cause occlusions and blockages. So the healthier and less inflamed we are, the smoother our blood flows. Also, the less chance of blockages and heart attacks, one of the great benefits of going Paleo.
2. Blood Sugar Markers
A lab test I like to look at for blood sugar markers are:
- A1C: A 90-day window of how our blood sugar fluctuates. When we are on the Paleo template, our blood cells get healthier because they’re exposed to fewer toxins. So we may see slightly high A1Cs, 5.6–5.7, though we may still be eating healthy. Maybe with a little bit of low-sugar fruit, so A1C isn’t the be all or end all, but keep an eye on it.
- Fasting insulin: It should be below 5. Insulin basically opens the door for blood sugar to come into the cell. And the more we spit out sugar, the more we spit out insulin and the more numb to insulin we get. This is called insulin resistance. There’s a strong relationship between high levels of insulin and tumors and cancer. We also see it in a lot of hormonal disorders like elevations in testosterone and androgens for women.When fasting insulin is below 5, it means our body is very sensitive to sugar. Then it’s more likely to take that sugar into the muscle and be able to burn it instead of storing it in fat. So when we are more sensitive to insulin, we make less fat and we burn our sugar for fuel.
- Fasting glucose: Below 100 is ideal, and some even say below 95 or even 90. This really depends on our stress levels and cortisol levels—glucose can go higher because cortisol can increase glucose. It may not necessarily be a bad thing if you have a healthy stress response in the morning, but we can even do what’s called a functional glucose tolerance. We would measure one to three hours after our regular meal and see how we do in those various intervals; ideally below 140 within an hour, 120 within two, and back below 100 within three hours is a pretty good measurement.
3. Lipid Markers
- Triglyceride-to-HDL: This is a really good marker of insulin resistance. Basically our triglycerides go high when we consume too much carbohydrate. Our HDLs go up when we’re consuming healthy quality fats, like fish oils, and good clean saturated fats, like coconut oil and butter. So as HDLs go up and triglycerides come down because we’re not consuming excess sugar, that’s a really good ratio. Ideally we like a 1:1 or so, but I’ll settle for a 2:1 ratio. This would be, for example, triglycerides at 100 and HDL at 50.
- Total cholesterol-to-HDL ratio: It should be around 4:1. So if your HDL is at 60, your total cholesterol should be under 240. Total cholesterol by itself is not that important when we look at inflammation markers like CRP and homocysteine and fibrinogen. If inflammation levels are low, but cholesterol’s on the higher side, 250–260, it may not necessarily be a bad thing, especially if we see something called LDL particle size.
- Particle size A (large) is good, and particle size B (small) is bad: The larger and fluffier and more buoyant our particle size is, the less likely it’s going to stick into the endothelial fissures and create various blockages and occlusions. We get more large particles with the healthy fats and by restricting a lot of the refined sugars and carbohydrates and grains and inflammatory foods.
To be successful on the Paleo template, it’s important to avoid the foods that humans have had less time to adapt to and eat the foods that we’ve had more time to adapt to, are going to be low in toxicity, drive less inflammation, and essentially have higher levels of nutrient density. Anything you can get in vegetables and meat and low sugar berries and starchy tubers, you’re going to be able to get every single nutrient in those food items that you would in grains and other refined products.
People may say, “You can’t cut out a food group,” but don’t look at your food as a category; look at it by the nutrients it contains. Ask yourself, “Can I get that from something else?” And if you can get that nutrient from another food without taking on the inflammatory compounds, like those you get with the gluten for example, then that’s a win-win in my book.
Healthy Eating Diet But Still Can’t Lose Weight? – Podcast #56
Dr. Justin Marchegiani and Evan Brand discuss about exercise and diet including the stress hormones and the thyroid connection. They talk about sleep and how it can affect blood sugar and insulin. Find out what are the things you need to get dialed in to get the results you want for fat loss and weight reduction.
Discover how functional medicine lab tests and blood sugar markers play an important role for burning fat in his podcast. Also find out why Dr. Justin recommends getting reverse osmosis countertop filters as part of his water filtration system to get rid of fluoride.
In this episode, topics include:
Dr. Justin Marchegiani: Hey there, it’s Dr. Justin Marchegiani and welcome to Beyond Wellness Radio. Feel free and head over to beyondwellnessradio.com where you can access our full podcast transcriptions. While you’re there, you can also sign up for our Thyroid and Female Hormone video series. This series goes into the root cause of why your hormones are out of balance. While you’re there, you can also schedule a functional medicine consult with Dr. Justin, myself, where we’ll dig deeper into the root cause of your health challenges. Feel free and think of sharing this podcast with at least one person. This podcast grows by people sharing it. Sharing is caring. If you can think of one person that can benefit from this information, please feel free and share it. If you’re enjoying the podcast, make sure you subscribe on iTunes. You can also click below the video or podcast where you’ll see the iTunes review button and leave us a review. You can also sign up for the newsletter at beyondwellnessradio.com where you’ll updates before anyone else. Thank you so much and enjoy the show.
Hello, ladies and germs. This is Dr. J here. I’m with Evan Brand, the one and only. Evan, what’s going on, man?
Evan Brand: Hey, not much. Did you just say ladies and germs?
Dr. Justin Marchegiani: I did. I’m sorry. It’s Friday. I’m actually heading out to Vegas tomorrow, so I’m feeling pretty good.
Evan Brand: Awesome.
Dr. Justin Marchegiani: Feeling loose.
Evan Brand: Awesome. You gonna have some fun down there? What are you gonna do?
Dr. Justin Marchegiani: Actually, when I go to Vegas, I like to eat really good rib eye steaks. I don’t gamble. I don’t stay out late. I go see really good shows and like sleep 10 hours a night.
Evan Brand: That’s awesome.
Dr. Justin Marchegiani: That’s super boring.
Evan Brand: You know I used to live there, right?
Dr. Justin Marchegiani: I know, you did. So Evan, today we’re gonna talk about diets and we’re gonna talk about people that have finally, you know, got themselves on a really healthy diet but they’re not losing weight. And again, I see this a lot more in my female patients. What’s your take?
Evan Brand: Oh, yeah. It’s very common. Yeah, men don’t seem to have as much of an issue which may be we get into why that’s the case. But it’s always the women, whether it’s a patience issue. Not patients as in people, but patience with C-E at the end.
Dr. Justin Marchegiani: Yup.
Evan Brand: Or it’s some hormonal stuff. I mean, there’s so many–there’s so many that, well, you know, we get to break down some of those today.
Dr. Justin Marchegiani: Yeah, I get a lot of patients that come on, you know, come under care and they’re going on Paleo or they’re going autoimmune Paleo or GAPs or SCD, and they don’t quite lose weight off the bat and the question is why? And what I find is that–great quote from Dr. Diana Schwarzbein in her book, The Schwarzbein Principle 1, 2–but she talks about you don’t lose weight to get healthy, you get healthy to lose weight. You get healthy then you lose weight. And that lag time between getting healthy and losing weight can vary a lot from person to person, especially if there’s a history of excessive exercise, starvation, lots of food allergies, chronic infections, it could be months or it could potentially even be years because of the damage to the metabolism via the thyroid, via the adrenals, and there can be a lot of delay or time gap in how that responds to you going on this new diet and to that weight actually coming off.
Evan Brand: Yeah and actually, you know, I’ve actually had some people at the other end of the spectrum where they started losing weight in the very beginning and actually have one lady right now who I’m trying to help train for a triathlon and it’s really tough for me as a coach to–to support that type of exercise wondering what her hormone test look, you know. It’s hard for me to say, “That’s okay for you to train that many miles,” and now she’s hit this weight loss plateau and it’s like, well, you cannot have cake and eat it, too. We kinda have to make a compromise together here if you wanna get results.
Dr. Justin Marchegiani: Exactly. So some of the big things off the bat, I can see patients–we get our patients literally lose weight off the bat and we get some that do great, and then we have some that flounder a little bit. I had one patient just the other day. She was about 2 months or a month and a half into her parasite-killing program. She–blasto–H. pylori and a month and a half, they’ve lost almost 20 pounds. So we see that time to time, could be inflammation thing–when we see it all just stress hormones, cortisol–resistance–with the cortisol levels, if it drops–the thyroid issues, all these things can be made issues from a hormonal perspective and just because you changed the diet, it doesn’t mean the hormones go right–if it were that way but if we do specific programs that push the adrenals and support the adrenals, support the HPA axis, and support the thyroid, we can promote healing fast. So that’s the goal of these.
Evan Brand: Yeah, and there–there is some variability with the speed, you know–one here, well, what the number–few weeks, how many months does it gonna take for me to lose those 20 pounds? My answer is always, it depends.
Dr. Justin Marchegiani: Absolutely. And I see some people actually gain weight until FYI, I did my blood sugar during the show, that was due–today I’m at 93, so pretty good. You know, under a hundred. I can feel adrenalin go through and I’m about ready to eat lunch–just a bit–5 hours from last meal so right on that blood sugar throw there. And blood sugar is probably the talk that we should go into, we did a whole podcast on it recently into weight loss. So we know blood sugar is really important because the higher our blood sugar is, the more insulin we make, and we know insulin primarily a fat-storing hormone, and when we make insulin, we also typically pump out leptin, too. So if we have something known as insulin resistance, we typically also have leptin resistance, and that can basically allow us to store more of our calories into fat and it can also keep us hungry. Keep from feeling satiated so we overeat.
Evan Brand: Yeah, and then kind of the–I don’t know if you’d call it the ozing hormone so to speak but then you have ghrelin, your hunger hormone.
Dr. Justin Marchegiani: Yeah.
Evan Brand: And if you look at studies in people’s leptin and ghrelin levels when they have sleep deprivation, ghrelin is elevated significantly. So think of ghrelin as growling, like your stomach–
Dr. Justin Marchegiani: Yeah, that’s ghrelin.
Evan Brand: And you’re gonna have, I mean, and I–I totally feel this, man, the nights that I try to–if I stay up too late for some reason. I–I usually never do but if I do, I regret it because the next day, I’m starving and no matter what I eat, I just can’t cure my appetite, you know. And so, I say cure it like appetite’s a disease or something, but–
Dr. Justin Marchegiani: Yeah, I know what you mean.
Evan Brand: I can’t satiate myself.
Dr. Justin Marchegiani: Right, and we see that a lot with sleep, right? You also have blood sugar issues with sleep. You actually become more insulin resistant. They took college students and they had them stay up, I think only sleep 4 hours a night for 2 weeks and within a couple of days, they were pre-diabetic regarding their blood sugar.
Evan Brand: Oh.
Dr. Justin Marchegiani: So if we do that, right? Sleep, that’s also gonna cause us to be more insulin-resistant, meaning we’re gonna store especially our carbohydrates more efficiently to fat and then number two, we’re gonna be over hungry which when we’re over hungry, what are the food we typically reach for?
Evan Brand: Probably the carbs, the quick–
Dr. Justin Marchegiani: The carbs?
Evan Brand: Burst of glucose.
Dr. Justin Marchegiani: Yeah, probably the carbs. So insulin-resistance, leptin, ghrelin, those are really key things. I don’t focus too much on the leptin because I find that like the first domino that knocks over is gonna be insulin resistance. So if you focus on the insulin resistance, it typically gets the leptin resistance dialed in. And simple thing like I’m doing right now, you can see on video, blood sugar test your fasting blood sugar. Test 1, 2, 3 hours post meals. See how your body’s dealing with sugar, also get a fasting insulin in the morning. Ideally, less than 7 should be where you be, ideally under 5 but less than 7. That means that your body doesn’t need that much insulin to soak up that sugar. Less insulin means less ability to store as fat and more ability to burn fuel and burn fat for fuel. Because insulin automatically blocks fat from being burned. So just kinda keep that in mind. High insulin means you’re a sugar burner, lower insulin’s gonna mean you’re a fat burner.
Evan Brand: Yeah, and I want to kinda repeat that in a different way just so people really get that through because I have to go through this explanation and if we can refer someone to this podcast instead of spending 20 minutes on a topic explaining it to a patient–you cannot burn fat when insulin levels are peaked.
Dr. Justin Marchegiani: Yeah.
Evan Brand: If your tank of insulin is full, fat loss is not going to happen until that insulin gets in check. I wish I could say it like 3 other ways or something–
Dr. Justin Marchegiani: Yeah.
Evan Brand: But I think that’s hopefully helpful for people, is that if insulin’s high, if you%