Ask the RD: Post Meal Sugar Cravings and Overdosing on Liver

Join Kelsey Kinney, MS, RD and Laura Schoenfeld, MPH, RD, as they answer your questions about ancestral and Paleo nutrition. A must-listen for anyone new to the Paleo diet or looking to improve their current Paleo diet based on their personal needs and health goals. 

The content on this show reflects the opinion of Kelsey and Laura and does not represent the opinions of Chris Kresser, who has not reviewed the content of this podcast.

We have another Q&A episode this week! Thank you to everyone who has submitted questions so far, and we hope you’re enjoying the podcast.

Here are the questions that Laura and Kelsey address in this episode:

1. I would like to know more about cravings. I cook all my meals from scratch at home using the best ingredients I can find and following paleo/WAPF/PHD type foods. My husband however gets cravings for sweet things after meals (i.e. not when he is hungry) and buys himself processed foods: cakes, chocolate, biscuits etc… and ends up eating more than one portion at a time when he has them at home. Why does he get these cravings after meals? He’s already eating full fat nutritious meals with carbs.
2. I have heard from other paleo gurus that eating more than a quarter pound of organ meat per week can actually cause a person to take in too many vitamins/minerals. Is this ‘overdose’ of offal a real problem if you eat more than a quarter pound per week?

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Links Discussed:

• Chris explains how to monitor your blood sugar
• Diane Sanfilippo’s 21-Day Sugar Detox
• Chris explains vitamin A toxicity
• Chris Masterjohn discusses the synergy between vitamin A and vitamin D

About Laura: Laura is a Registered Dietitian with a Master’s degree in Public Health from UNC Chapel Hill. She is passionate about making traditional diets healthful and accessible for all her clients. You can learn more about Laura by checking out her blog or visiting her on Facebook.

About Kelsey: Kelsey is a Registered Dietitian with a Master’s degree in Human Nutrition and Functional Medicine. She works in private practice and recommends individualized dietary therapy focusing on biologically appropriate diet principles to aid her clients in losing weight, gaining energy, and pursuing continued health. You can learn more about Kelsey by visiting her website.

TRANSCRIPT

Thanks to Amy Berger of TuitNutrition.com for the excellent transcript!

LAURA: Hi everyone, welcome to Ask the RD. I’m Laura Schoenfeld and on the other end of the line is Kelsey Marksteiner. How are you doing today, Kelsey?

KELSEY: Doing well, how are you, Laura?

LAURA: Good! We had a 78 degree high in Raleigh yesterday, so it was kind of amazing.

KELSEY: Lucky. We had 50s here and I thought that was amazing, so you’re doing better than me.

LAURA: Yeah, we’re dropping into the 40s tomorrow, though, so it was a short-lived experience.

KELSEY: Okay, that’s a pretty big difference.

LAURA: I know, it’s kind of crazy. But we’re getting there, slowly but surely, so I’m looking forward to the weather warming up and being able to spend some more time outside and not be cooped up inside all the time.

KELSEY: I agree.

LAURA: Yeah, I bet you guys are—are you guys getting snow soon again?

KELSEY: Um, we’re getting rain today. I don’t think there’s supposed to be much snow coming up, but I don’t pay too much attention to the weather, except when it’s nice out, so…

LAURA: Right, right. Hopefully no more snow for you guys.

KELSEY: Right.

LAURA: Yeah, I mean, I’m quite the outdoors person, myself, so when it’s bad weather it kind of starts to get draining on me, so I’m looking forward to it warming up.

KELSEY: Yep, ready for spring, for sure.

LAURA: Definitely. Okay, so we have two questions today, and the first question’s for Kelsey. Kelsey, you ready?

KELSEY: I am.

LAURA: Okay. So this one is from a listener who asks: I would like to know more about cravings. I cook all my meals from scratch at home using the best ingredients I can find and following Paleo/WAPF/PHD type foods. My husband however gets cravings for sweet things after meals (i.e. when he is not hungry) and buys himself processed foods: cakes, chocolate, biscuits etc… and ends up eating more than one portion at a time when he has them at home. Why does he get these cravings after meals? He’s already eating full fat nutritious meals with carbs.

KELSEY: All right. Thank you for that great question. I think it’s pretty clear, probably Laura, you realize this too, that a lot of people deal with cravings on a daily basis. Specifically when they’re first starting, but people deal with it even years after they’ve been on a Paleo-type diet, so I’m really glad that this issue is brought up by our listeners. And we’ll dive into that now.

So when we’re talking cravings, there can be a couple of things going on. I’m going to walk through this problem as if I don’t know some of the background from this person, just to give everyone out there who might be dealing with cravings some idea of what they might be able to do. But then we’ll go a little bit deeper and talk about some things that might be going on in this particular situation, too.

So first of all—and this is usually the first thing I look at when I hear that someone’s having cravings—it can be simply that they’re not eating enough calories overall, and I see this all the time with my clients. They tell me that they’re getting these cravings for sweet, or salty, or any kind of food after their meals, or in the afternoon, and they just can’t figure out why. And sometimes they don’t even have to feel hungry, necessarily, though usually they might be starting to feel hungry when they’re getting these cravings. So one of the first things I look at if I’m wondering about this is how much they’re eating overall. And more often than not, they’re intake—it really doesn’t quite match how they’re living their lives, like how active they are, and generally it’ll just seem a little bit low to me. So that’s what we address first. And when they end up increasing their overall caloric intake during meals, that definitely can help reduce some of those cravings.

So this woman’s husband may just not be getting enough calories, though I think that’s maybe the least likely problem that’s going on here, since she says he’s not hungry when he’s eating these things, but it’s a pretty common thing that tends to happen, especially if a couple is eating at home together, because I know with my boyfriend and I, we just tend to make the same size portion meals a lot of the time, even though we’re both very different people, we have different calorie requirements, and just generally we live our life a little bit differently. But it’s pretty common for people to just eat the same amount of food as the other person, just because when you’re making two meals, you tend to make it that way, with the same portion sizes.

So if he’s eating those meals with you and perhaps he’s not getting enough calories when you’re eating together, his body might just need to make up that caloric difference, and the way it chooses to do that is to give him cravings for high-calorie foods like sweets. So that’s definitely one of the first things that comes to mind when I’m hearing about someone that has craving issues. But it doesn’t sound like this is maybe the most likely for this person, just because he’s not necessarily hungry when he’s eating these things, so we’ll dive into some other potential issues, too.

So once we’ve determined that the caloric intake is in the right range—so perhaps for this person we’ll just assume it’s in the right range—if the cravings persist, then I start to look at macronutrient ratios. Now, most people with significant cravings are often restricting at least one of their macronutrients. And that not only tends to reduce their calorie intake, but it can also lead to cravings for many different kinds of foods, just as the body is looking for something when we’re restricted somewhat.

Now, it sounds like this person is eating plenty of fat and carbohydrates, and usually those are the first main issues for someone who’s eating a Paleo-type diet that I would worry about restricting, because usually they’ll either forget to add in the fat when the switch from a standard American diet, because that tends to be fairly low-fat, or just not eating fat is so ingrained in our mind that when they switch to a Paleo diet, some people just don’t tend to add in the fat when they really should.

Or, on the other side of that, they can go crazy with the carb restriction, since that’s usually how a lot of people hear about Paleo—that it’s a restricted carb diet. So if anyone with cravings is out there listening and you feel like fall into any of those craving categories, and you’re either restricting carbs or you’re restricting fat, even if it’s by accident, try increasing the macronutrient that you’re restricting with healthy, real food choices and see if that helps.

Now just because fat and carbs usually tend to be the issues with Paleo eaters, that’s not to say that I don’t see my fair share of people who aren’t eating enough protein. So since cravings can often be a sign of blood sugar imbalance sometimes, it’s no surprise that eating extra protein can help reduce cravings since protein stabilizes blood sugar. And it’s not uncommon to see those with cravings eating fairly small portions of protein at each meal. So if everything else is looking good in your diet but your protein intake is on the lower side of things, definitely try increasing that. And that might be what’s more likely to be the case for this person. It sounds like they’re eating a good amount of everything else, eating full-fat, eating some carbs, but I didn’t hear anything about the protein. So, obviously since I don’t know everything about this person’s diet, I would probably want to see their food diary or something like that just to see what the protein serving sizes look like.

So those are my food-related answers to this question. But the other thing I want to mention is that the mind-body connection plays a really big part here. And if you’ve tried all the food-related things I’ve mentioned and you’re still having trouble kicking those cravings, it’s likely that there’s some amount of a psychological component to them for you. Now mind-body activities help us to cultivate awareness, and this can be especially helpful if you feel like you’re someone who eats very mindlessly, and when you’re truly not even hungry.

And these activities can also reduce stress, which absolutely can increase the amount we eat. They’ve done studies on this, where people just tend to eat a lot more when they’re stressed out. SO these types of activities include things like deep breathing, meditation, yoga, mindfulness-based stress reduction, tai chi…there’s a lot of different options out there. So I would suggest finding something that you enjoy doing and keep doing it, because the benefit of mind-body activities amplify over time. The longer you practice them. So keeping up with it and having a daily practice, even if it’s one minute a day is really important, versus doing an hour of meditation once a week or something like that.

So even if you don’t feel like you’re a particularly stressed out person, these activities can really help reduce cravings, so I would encourage you to try them, even if you’re kind of averse to them. And especially to people who are averse to them, I would recommend even more strongly that you do them, because usually the people who don’t want to do them the most that they’ll benefit the most.

So definitely get a mind-body activity in your schedule. I suggest them to all my clients, whether they have cravings or not, because they’re so important to overall health. So if you’re not already practicing one of them, it’s definitely time to start. Hopefully that helps to answer this question.

I think there are a lot of food related answers to it, but for a lot of people, if they don’t work on that mind-body connection too, sometimes they don’t get over the cravings. So if you’ve tried everything food related, you can’t think of anything else, and you’ve really been putting off that mind-body connection, even if you don’t feel like it’s a necessarily psychological issue, I would still incorporate the mind-body activities into your life, because they’re great for overall health and can really help your cravings as well.

LAURA: Yeah, that’s a really good point to make, because I think a of times people don’t necessarily think about the non-food related issues, and the mindfulness when it comes to eating can definitely change how you perceive being full after a meal and feeling like you’re satisfied, even it’s just a mental fullness, rather than a physical fullness, because sometimes it doesn’t matter how full people are in their bellies; they might still feel like they’re mentally craving more.

And I do think it’s important to talk about the issue with blood sugar control, because I don’t know if this man that this woman is talking about is thirty years old and a CrossFitter, or he’s sixty years old and somewhat overweight, or anywhere in between. So if he has some level of blood sugar issues where he’s having a rise or dip in blood sugar, those dips can actually lead people to feel cravings for sweet foods just because they body’s looking for an external source of glucose.

Like you said, eating more protein can definitely help with blood sugar control. Also, there are some supplements and nutrients that can make a difference. I’m not going to get into detail, but there are various amino acids that can be helpful, some things like chromium, I know is supposed to help with blood sugar control in people who are struggling with that as an issue. My thought would be if the person’s eating a pretty balanced meal, and eating enough calories, and also eating a decent amount of protein, then we might think about adding in a couple of supplements that can help with cravings related to blood sugar issues.

KELSEY: Yeah, it’s probably checking out the blood sugar level is worth it if you’ve never checked that before.

LAURA: Right.

KELSEY: Maybe just grabbing a blood glucose monitor and I know Chris has an article about this on his site that we can link to, just about getting an idea of what your blood sugar level looks like before and after a meal, all that great stuff, and just seeing if you’re on the right track there.

LAURA: Yeah, I think he’s got some information about buying a glucometer and using it to determine if your blood sugar is dropping after a meal. There are some people who have reactive hypoglycemia, which means after you eat, your blood sugar drops, so it’s perfectly reasonable that this man could be dealing with that, and if he’s getting that low blood sugar after a meal, that’s actually when he’ll want to eat the sugar and sweets.

If it is simply a mental…like an attachment to sweet foods, then there are some programs that can help with that. I know Diane Sanfilippo has the 21-Day Sugar Detox, which I’ve heard a lot of people have had success with that as far as getting over the mental cravings for sugary foods, so…and the one thing is, and this going to sound kind of weird, but the fact that it’s the wife writing in about the husband makes me a little concerned, just because I wouldn’t necessarily want to work with somebody unless they were interested in making changes, so this man, if he wants to make a change, then there’s a lot of stuff he can do to improve his satiety and his ability to turn down these unnecessary processed foods. But if it’s like his wife is forcing him into a diet that he’s not interested it—and I’m not saying that’s what’s happening, but it’s a fairly common occurrence that one partner is interested in nutrition and the other one isn’t…you obviously care about the person and you want them to be healthy, but if they’re not interested, then it’s not necessarily going to be something that they’re willing to make significant changes with. And a lot of these recommendations we’re making could potentially be significant if the person is completely disinterested.

KELSEY: Right.

LAURA: It’s also possible that he’s going out and buying these processed foods when he’s not hungry, it could also be that he’s wanting to have some level of control over his diet. And I know that sounds, again, a little ridiculous, but this is the same thing for children, but also for someone who’s kind of being forced into something they’re not on board with, they might be doing it out of slight rebellion or just trying to have some level of control in their own diet. So that’s another thing to consider. Like I said, I’m not saying that’s this person’s situation, but if that’s an issue that you’re dealing with with your husband or wife or your children, it could be that you might need to cool off the nutrition intensity for a little bit until they get more on board with what you’re trying to accomplish with the way your family eats.

It’s a difficult balance to strike, and I don’t envy people who have significant others that are not interested in the nutrition and diet changes the person has made.

KELSEY: Right. Yeah, maybe take that first step: ask yourself is this person really interested in what we’re trying to accomplish here, or if not, maybe back off a little bit. And if so, work with them to go through all these different things that we’ve mentioned—so making sure they’re getting enough calories overall, and that could be in relation to if you’re making meals together, making sure that they’re getting more food than you are if they need more. That’s the first step. And then finding out if they’re accidentally or purposefully restricting any particular macronutrients. Obviously carbs and fat tend to be the first ones that someone coming from a SAD would be restricting, but protein can definitely be an issue, and it can particularly become an issue when there are blood sugar imbalances, so checking your blood sugar if you haven’t before to see if there’s anything wrong there, and then finally, if you’ve done all that, you could really work on the mind-body connection by doing some meditation, yoga, that kind of thing, and also doing programs that help cut the cravings, like Diane Sanfilippo’s 21-Day Sugar Detox.

LAURA: Great!  Well, hopefully that’s a good amount of recommendations for this person. It really does depend on what the person’s issue is as far as what kind of changes they need to make. So kind of doing a little bit of research to see what is actually at the root of the issue is important before you start trying to make changes.

KELSEY: Definitely. All right! Are we ready to move on?

LAURA: Yeah, let’s do it.

KELSEY: All right, this one’s for you. I have heard from other Paleo gurus that eating more than a quarter pound of organ meat per week can actually cause a person to take in too many vitamins/minerals. Is this ‘overdose’ of offal a real problem if you eat more than a quarter pound per week?

LAURA: All right, so I find this question to be awesome and hilarious at the same time, because I’ve gotta say, as a dietitian, this is rarely the issue that you would see in the normal population. If anything, I usually struggle to get people to eat even one serving of liver a week. But I have had clients before that were eating lots and lots of liver and maybe not more than a quarter or a half pound per week, but it’s certainly possible that a person could be eating too much. So the question is, is it really a problem if you’re eating too much liver, and possibly even how much is too much? Because somebody might say a quarter of a pound, somebody might say a pound, and it really just depends on the person’s genetics, and the general nutrients that were present and which ones we’re concerned about.

For me, I would say that copper and vitamin A toxicity are the two biggest concerns you might have with eating too much liver. As far as the other organ meats, there are some nutrients in those items, and I’m not saying they’re not nutrient dense, but they’re not usually as chock-full of vitamins and minerals as liver is. Liver is one of the few foods that’s out there that’s pretty high in a lot of nutrients in general. So I’m going to keep talking about liver. I’m not really talking about things like kidneys, or tongue, or tripe, which is the stomach, so a lot of those other offal pieces are not necessarily ones you have to worry about.

So speaking of liver, like I said, copper and vitamin A toxicity are the biggest issues here. But even as far as vitamin A toxicity goes, you’d really have to eat a lot of liver and have pretty poor vitamin D status for that vitamin A toxicity to be an issue. So in general, sigs of toxicity from vitamin A are associated with long-term consumption of vitamin A in excess of ten times the RDA. So that ends up being 25,000-30,000 IU per day. And that is what is in two ounces of liver. So these numbers are not taking into account the protective role of vitamin D against vitamin A toxicity, and there are studies that show that supplementing with vitamin D actually significantly increases the toxicity threshold of vitamin A. And

Chris did write an article about the concerns over vitamin A toxicity, and he suggested that you could eat 22oz of beef liver a day if you’re adequately supplementing with vitamin D and you’d still be able to avoid vitamin A toxicity. So I certainly would not recommend experimenting with that level of liver intake, but it does go to show you that your vitamin D status is really important in assessing your risk for overdosing with vitamin A. So if your vitamin D level is below 30, I would recommend being cautious about eating a lot of liver until you get those levels up to, say, around 35 or 40. But certainly a couple of ounces a week can be an issue, and like I said, the established toxicity threshold ends up being 2oz per day, long term, so hypothetically, you could eat 14oz per week and still stay under the toxicity threshold.

So as I mentioned, the real concern I have over eating excessive amounts of liver is actually the risk for copper toxicity. An ounce of beef liver contains 4128mcg of copper, which is over 4 times the RDA of 900mcg. And if you have a normal sized piece of liver, which that might be around 3-4oz, that means you’ll be getting 12-16 times the RDA for copper, and possibly even more, depending on the size of the liver.

The upper limit for copper intake is 10,000mcg per day, which you’ll reach that upper limit if you eat 2.5oz of liver, so if you’re eating more than 2.5oz per day, you may be putting yourself at risk for toxicity. Again, that works out to about 15oz a week, so maybe up to a pound per week is okay, and then once you start going over that you’re putting yourself at risk for copper toxicity. And copper toxicity is pretty rare, and typically people who are eating a Western diet are getting very low levels of copper. Copper deficiency may be more common with people eating a high processed food diet, but there are some people who have actually have genetic disorders that affect their metabolism of copper, so that includes things like Wilson’s disease, and there’s also something called idiopathic copper toxicosis (ICT). So idiopathic means it’s coming from an unknown cause, so you may be someone who’s prone to developing ICT and you would never actually know it until you expose yourself to an excessive amount of copper. But the people with Wilson’s disease and these copper toxicosis issues, they may be at risk for the effects of chronic copper toxicity at significantly lower intakes than the average person, so while a normal person might be able to eat 2oz of liver on a daily basis, somebody with one of these diseases could actually easily go over their copper threshold with just a few ounces a week.

From a nutritional standpoint, the biggest concern with long-term exposure to high doses of copper is the possibility of liver damage. Copper is an oxidant, and it’s similar to iron, so having too much copper in your diet can add oxidative stress in your body from that excessive copper intake, and that’s not something you want to be putting yourself at risk for. But the biggest issue with copper is that it actually needs to be balanced with zinc in order not to become toxic at the higher doses, even the ones that aren’t going over the upper limit threshold of 10,000mcg/day. This is because high zinc intake actually stimulates production of a protein called metallothionine, which binds certain metals in the diet and prevents their absorption by trapping them in the intestinal cells. And it specifically binds to copper more so than a lot of the other minerals, and that can prevent the absorption of copper when it’s eaten in excess. So if you’re eating a zinc-rich diet and you end up eating a lot of copper—potentially more than you should be eating—you’ll be protected against toxicity compared to someone eating a low zinc diet.

So beef liver does have some zinc in it, but not nearly as much as copper. Just to give you perspective on that, one ounce of beef liver has 1.5mg of zinc, which is only about 1-% of our daily needs. And if you compare that to copper, an ounce of liver provides 207% of our copper needs, so you can see that it’s somewhat unbalanced toward the copper end of things, and if you’re only eating beef liver to get your copper and zinc, you’re not going to be getting enough zinc to balance that copper. So I would say in order to make sure you’re not putting yourself at risk for copper toxicity by eating too much liver, I would say that folks should aim to take in less than the 10,000mcg/day upper limit, so I think I said that was 2.5oz of liver a day, but if you’re only eating it once or twice a week, that just means that you need to be eating less than a pound of it per week.

And also I think people should make sure they’re including plenty of zinc-rich foods, like oysters, muscle meats from things like beef, lamb, chicken and pork, are high in zinc, spinach, pumpkin seeds, and nuts are some plant foods that are high in zinc, and these are all foods that are found in abundance in a properly prepared Paleo diet, so it shouldn’t be too difficult to keep your zinc intake high, but if you’re eating a lot of liver you’re going to have to pay close attention to it.

And lastly, I’d like to point out the fact that excess of iron intake from high organ meat consumption may also be an issue in the case of iron storage diseases, like hemochromatosis. So if you have either heterozygous or homozygous hemochromatosis, meaning you either have one or two of the genes for that condition, I would say that you probably want to significantly limit your liver intake, if not avoid it entirely until you get your iron levels down to a safe level. And this is because organ meats in general are high in iron, so this is going beyond liver. This can be talking about things like heart; I’m not sure about kidneys, but I do know the organ meats tend to be higher in iron than the muscle meats. So you need to be careful with eating these foods if you have levels of ferritin, or a high iron saturation, or if you’ve genetically tested positive for hemochromatosis, and as I mentioned that can be either the homozygous or heterozygous type.

Otherwise, I would think most people could probably eat a pound a week of liver comfortably, but I do think that half a pound a week is all you would need to get the nutritional benefits, and eating much more than that may not make a huge difference in your nutritional status. And a lot of our listeners may agree with me that liver isn’t exactly the most delicious food on the planet, so I don’t want people to feel like they have to eat it daily, or even more than, say, twice a week to reap the benefits.

And I do think it’s important to remember that organ meats were only eaten any time an entire animal was killed in traditional cultures. So if you go out and you kill a moose, or a caribou, you’re only getting one liver out of that animal, and you’re getting hundreds of pounds of other types of meat, so those groups might not have had unlimited supply of liver to them, but they also had to share the organs among the group members, and that was actually a pretty traditional practice, to make sure that everyone got a little bite of the organ meats, just to make sure that everyone was kind of getting a little dose of nutrition.

So even though organ meat is an important component of an ancestral diet, I think eating multiple ounces of it on a daily basis isn’t something that would’ve happened in most hunter-gatherer societies, simply due to the amount of organs available. So it’s not really something that is based on…if people are thinking about human evolution or traditional diets as far as guiding what they’re eating, then eating lots of liver every day is not actually something that would’ve been possible in a traditional society. So that said, you can do it if you want, but I don’t think it’s necessary, and it may be harmful for certain people, so you just have to be really careful about it.

KELSEY: Yeah, I would definitely agree with that. I think that half pound goal—and maybe not even a half pound, maybe six ounces or so—is a really good goal to aim for, especially if you’re someone who really doesn’t love organ meat, so you’re trying to work up to that.

LAURA: What? Who doesn’t love organ meat?! Come on, Kelsey.

KELSEY: I know, I have a lot of trouble getting enough organ meats in my diet, so I can certainly understand other people having the same issue.

LAURA: Yeah.

KELSEY: And when I was reading this question, first of all, my immediate thought was the same as yours: wow, this is a total change of pace coming from having been in hospitals, working with people on a standard American diet who eat zero organ meats, but second, I was just wondering why someone is curious about eating a lot more than that. What’s the reasoning for wanting to eat a ton more? And I definitely think you’re right in saying that’s just not something that would have happened for our hunter-gatherer ancestors. They wouldn’t have been eating organ meat probably every day at all. And like you said, it just happened when they killed a whole animal and they’re eating that entire animal, and when you think about the percentage that is organ meat compared to everything else, it’s pretty small.

LAURA: Right.

KELSEY: So trying to emulate that, I think, is your best bet.

LAURA: Yeah, and I just feel like sometimes people get this perspective that more is always better when something is healthy, and unfortunately, I think it can actually lead to some problems, even if you don’t realize that the food you’re eating is causing your problems. I’ve had clients before that, if you just look at their diet, you might think that they’re eating the perfect Paleo diet with all sorts of organ meats and fermented foods, and everything is super nutrient-dense, and everything fits the bill for Paleo, and then they’re still having health problems because maybe they’re getting too much of certain nutrients, or maybe they’re getting types of foods that are actually exacerbating certain conditions they have. So Something like bone broth, people might think is an amazing food that everyone should be eating all the time. But if you have, say, histamine intolerance, that can actually be a bad food for you.

KELSEY: Right, yeah.

LAURA: I wrote a little editorial article on my blog a couple weeks ago about how most foods could actually be considered gray area foods, just because people vary in their tolerance, and what might be super healthy for one person—like liver is super healthy for a woman who’s anemic, or a woman that’s not menstruating and wants to increase their fat-soluble intake through foods—but then if somebody is homozygous for hemochromatosis, or they have Wilson’s disease, then liver is potentially a lethal food that they can eat if they’re eating a lot of it.

KELSEY: Right.

LAURA: So I just think it’s really important for people to keep things in perspective when it comes to foods that you would consider a “superfood.” I think it’s good to include them on a semi-regular basis, but try not to go overboard. Try not to make your entire daily meal plan a bunch of superfoods and not balancing it out with some foods that are either just providing macronutrients, so maybe you’re eating something that’s pure carbs because you need the carbs, even if it’s completely nutrient depleted. So even something like white rice would be an example, and yeah, I’m not saying it’s a nutrient dense food, but sometimes people really just need the carbs, so in that situation, it’s a good food to eat. It does make me concerned when I hear people eating diets that are so intensely “Paleo,” and I put “Paleo” in air quotes, but people can’t hear that over the radio. I’m concerned that if people are trying too hard to make their diet perfect that they’re actually going to potentially be causing harm, even just from a biochemical standpoint, not even considering the potential for eating disorders, or adrenal fatigue and that kind of stuff that can be exacerbated by paying excessive attention to diet.

KELSEY: Yeah. I think something I see a fair amount of in my practice is people who…they pick out these foods that they think are super nutrient-dense and they’re basically, like you said, only eating those foods, and what that ends up looking like is them pretty much eating the same things over and over and over again. And something that you have to consider in the scheme of a healthy diet that’s really important is variety. If you’re eating the same things over and over again, you’re just constantly exposing yourself to the same antinutrients, so of course we’re trying to minimize those things as much as possible, but there are still those things in everything. They’re in vegetables; they’re in everything we’re eating. So by just eating the same things over and over again, you don’t mix up what you’re being exposed to on a regular basis, and that in and of itself can cause problems, never mind that certain foods have high amounts of particular micronutrients that if you don’t mix that up, you’re getting more of some things and less of others on a regular basis.

LAURA: Right. And it’s funny—I’m working with a naturopathic doctor in Raleigh, and she was telling me the other day that her recommendation is for people to eat 20 different varieties of plant foods to help ensure that they’re feeding the best variety of their gut bacteria. And I had never thought that…it’s not just about eating vegetables. It’s about eating different types of vegetables, because maybe there’s compounds in the Brussels sprouts that are going to feed one type of bacteria, but then the asparagus is going to feed another type of bacteria, and lettuce will feed another type of bacteria, so as far as keeping your gut bacteria pretty diverse, the more diversity in your diet, the better, and that’s actually something that would have been the typical way for an ancestral population to be eating, because they had a lot more variety as far as the type of plant foods, and even the animal foods they were eating. They probably would’ve gotten a lot more variety than us.

KELSEY: Yeah. I think I’ve seen statistics on how our food supply is so dumbed down in terms of variety compared to our hunter-gatherer ancestors that even if we’re eating a varied diet, or what we would consider a varied diet today, it’s still not even close to what they would have considered a varied diet. So if you’re even within that still eating the same things over and over again, really consider mixing it up. It’s so much better for you, and I think that’s something that’s really often forgotten in the Paleo world.

LAURA: Yeah. I think this went down a bit of a sidetrack, but I think it’s important just because…

KELSEY: It is.

LAURA: Anyone that’s asking about eating more than a quarter or half pound of liver a week is probably going to be focusing pretty heavily on those foods that are supposedly superfoods. And I’m not saying they’re not, but just because a food has a lot of nutrient in it doesn’t mean you should be eating your entire diet made of that food. And it’s funny—when my naturopath told me about her recommendations for the 20 different types per week, I was like, I don’t even think I do that, because I end up buying food for a week for myself, and then maybe I get a week’s worth of oranges, or a bag of spinach. I made a point of it the last time I went shopping to get two turnips and two rutabagas, and two carrots…

KELSEY: Right.

LAURA: And I’m going to hopefully cook them all together in a big vegetable dish. But it’s something that you wouldn’t even realize you’re just eating a very monotonous diet until you actually look at what you’re eating and it’s like, “Wow I had kale for eight of my meals this week, so maybe I should use a different type of vegetable.”

KELSEY: Yeah, we get stuck in patterns. It’s really, really easy, and I think unless you’re looking at the food that you’re eating right in front of your face for an entire week, you tend not to realize that you’re just eating the same things over and over again.

LAURA: Right, and especially when you’re eating a pretty specific diet, like Paleo, it can be kind of a comfort to stick to a general pattern, but I don’t want people to freak out and get upset that they’re only eating ten types of vegetables a week. That’s certainly better than what most people in this country are doing, but just keeping your diet as high in variety as possible, and trying to make sure you’re not whittling down your intake into kale, butter, and liver, and that’s it, because those are the best foods you come across.

KELSEY: Absolutely.

LAURA: Anyway, so hopefully that makes sense to people, and liver is certainly a good food to eat. I would love to know if any of you out there ever even considered eating more than a pound of liver a week. I think we should give you some kind of medal. But now, make sure you’re getting some oysters with that liver if you’re going to be eating that much. But anyway, that’s all I have to say about liver for now, maybe we’ll have some more to talk about if anyone has any questions.

But thanks for joining us, everyone. We hope you enjoyed this episode of Ask the RD, and if you want to submit a question, you can do so using the link in the text above the podcast. So we may be changing up our podcast publication in the next couple of weeks, so keep an eye out for that. We’ll announce that when we make the decision, but until then, you can find us here at Chris’s website. So thanks for joining us, and we’ll see you around next time.

KELSEY: All right, take care, Laura.

LAURA: You too, Kelsey.