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Epidode 04 - On Athlete Longevity

Epidode 04 - On Athlete Longevity

In this conversation, Dr. Robert Pastore talks in depth about how to optimize for longevity in high performing athletes, the importance of diet and nutrition and the role of dietary intolerances, and protein dietary requirements for optimal recovery. 

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Transcript

Lexie: Welcome back to The Modus Movement, whether this is your first time joining us or not, we're thrilled to have you here.

My name is Lexie and as always we are joined with modus nutrition CEO and chief science officer, Dr. Robert Pastore. He's here today and we're going to talk about something very near and dear to my heart.

Now, Dr. Pastore, I'm really excited to learn from you today. As you know personally but I'm sure the audience does not, I spent 12 years as a competitive trampoline gymnast and then three years ago I made the switch to weightlifting and physique competitions so I am constantly pushing the limits with my body and even now in my mid-20s, I've had some serious injuries. I've had joints and aches and pains and things like that so I am curious.

You have worked with a ton of professional athletes in baseball and hockey and endurance sports. So, first, let's kind of talk about being a professional athlete or someone that works out 3, 4, 5, 6, 7 times a week, how does that tax your body?

Dr. Pastore: It's a great question, Lexie, and it's great to be back with everyone of our listeners today.

I sat down with some colleagues of mine a couple of years ago and we were just having a conversation about the professional athletes that we were seeing in practice, not by name, just by that broad statement, professional athletes. It's people that put their body on the line for their occupation to perform extremely high level at a specific sport. It is remarkable.

Now, the theme that we have seen, my colleagues and myself, is if it doesn't hurt, something's just not going right. And that's sadly how the athletes would come to us in our offices and I first hand heard that. Some of the top baseball players in the world would come to me and say, "Well, I accept this type of back pain, shoulder pain, etc."

The first thing I'd like to state is these are extreme, repetitive, not normal movements that professional athletes are doing with their body. And that just in and of itself is going to sadly tip the scales more towards injury that not. We see phenomenal gymnasts like Simone Biles and what she can do is off the charts. As physically fit as she is, and as well trained as she is, she is never going to completely escape injury due to her sport and how her sport makes her body punish itself. So, she can do everything she possibly can to tip the scales more in favor of more rapid recovery, etc.

So, just examining baseball, what comes up a lot when I'm talking with my peers is, think of a pitcher out there on the mound, strong individual, training well, hopefully well nourished and properly hydrated, having a whipping motion with one arm, twisting motion of the hips and pelvis, everything, while it looks beautiful to watch, it's like a symphony, sadly that is abuse of that individual's body and you will-

Lexie: Especially with it being on one side, only-

Dr. Pastore: Exactly.

Lexie: -you don't have a double handed pitcher.

Dr. Pastore: I'm so glad you said that, they switch hitters at the plate, right? I'm batting lefty, I'm batting righty and I've always been so impressed by those hitters and the stats. I'm following the stats with those hitters, but correct, pitchers are not doing that. If there is one, someone please respond to the podcast and enlighten us. I can tell you during my tenure in practice, particularly in the last 8 years where I practiced up to 2013, I didn't see anyone that had that ability.

I saw an enormous amount of relief pitchers that were prone to injury, because think about it, you're sitting there and you're trying to "warm up" in the ball pin but come on, you're sitting there for god knows how long until you get that call and you have to get out there and you have to be phenomenal and if you're like one of the greats like, so grateful I got to see him perform, like Mariano Rivera who just had this gift beyond, he could just turn it on.

There are a lot of other people that really had to work up to that and still had their phenomenal talents but they were incredibly at risk for injury. And you kind of got a theme like again, with the relief pitcher I know I was dealing with a shoulder injury, I know I was dealing with more than likely hips out of alignment, which could interfere and cause a shoulder problem, which is really interesting when it comes to the topic of body mechanics and how we all work together and syncopate, and then how that ends up affecting the athlete from a nutritional perspective.

Typically, these injured athletes were having an increased demand for either specific nutrients or specific amino acids. We could talk about, a little bit touch upon on this episode and I'd love to do a whole independent episode just on amino acids and requirements therein. But it really is just the exaggerated motions of movement.

And then if we move along to golfing and you see someone ... God there's so many great golfers that we could talk about but I've always been a big fan of so many and I'd love to watch Tiger Woods. I think that he had the combination of strength and precision accuracy. Kind of like a weightlifter, so to speak Lexie, that could walk up and just really, my goodness, clobber a ball.

That exaggerated movement of swinging the clubs, I'm sad to report that one birthday my wife bought me golf lessons at Chelsea Piers here in New York City and I showed up for the lessons by this phenomenal, well educated individual that his whole life was ... He even worked with pros, and he's rattling off the pros he's worked with. All he did was get me into the position I needed to be in to properly hit the ball and I turned at him and I turned at my wife and, I'll tell you, I wasn't as old then as I am now, and I said, "All right, something's wrong because I'm in pain just right now before you want me to hit the ball." Just, it felt so uncomfortable.

So, we get used to ... The professional athlete gets used to being uncomfortable, being in a moment of discomfort. That's one thing that I would see.

The other thing I would see that also I found fascinating in baseball ... Let's just move from that position of the relief pitcher that's sitting in the ball pin, have to warm up, don't know if they're gonna get called in, they may get called in. Let's switch to the really long inning. I've sat through many of those, watching my favorite athletes that I was treating perform.

You have the very long inning and you have your poor right fielder just standing there and there's so many in field place, changing of pitchers, balls and strikes, nothing coming to them. And then all of a sudden, there's either a [inaudible 00:06:34] or a [inaudible 00:06:36] to the wall and they're so well trained they know who's at the plate, they know the position and distance, they want to be, but no matter what, they have to move and boy oh boy, I could tell you stories your toes could curl about collisions I've watched between athlete and wall, athlete and left fielder and center fielder, I could go on. And some serious ones at that.

But it's that time of you have to go now that is so taxing on the body particularly when you're so fit. I've had some athletes that are well into the 200 pounds, extremely low body fat and very tall and then standing there doing nothing for 18, 20 minutes, have to explode and try to save the day and make that fateful catch. It's remarkable what they can do with their bodies. Sadly, that increases the risk for injury.

Lexie: Now, one of the things that you've talked about off microphone, I guess, with us is the multi million dollar athletes that you worked with and how they were concerned about longevity in their career. So, in your experience, what does it take for a professional athlete to stay on top of their game in terms of training and nutrition?

Dr. Pastore: That's a great question. And there's been a saying for years, I've heard Oprah say it, I've heard Hillary Clinton say it, I've heard it repeated by Michelle Obama and I'm sure many other people have said the same thing and I used to say it in my practice. It takes a village. It's more than just one person. I have found historically it's more than just communicating with your own coaching staff on the team. That you need others, new eyes, really looking in that are experts in each individual aspect of their careers.

So for an athlete to stay incredibly healthy and have a long career they really need to be doing a lot right. They need to be making sure that they're recovering appropriately, working with someone that's an expert in body physiology. I was blessed for years to have a very dear friend and colleague who will be a guest on this podcast, Dr. Keith Pyne who's basically the Director of Medicine to the Washington Nationals and has worked for so many different teams, and I go way back with Keith, basically 2 decades where he was just in private practice at the time before he spent so much time with one specific team.

And we would collaborate a lot on professional athletes and I would make sure their nutritional chemistry was 100% on point. Hydration, protein requirements, individual amino acids, food mediated reactions, inflammation status. Oh my goodness, I could go on and on. It was just enormous amount of work. When I would write a summary on an athlete from a work up that I would do it would take me 3 hours and it would be multiple pages. I basically was writing a thesis for each athlete, which was a playbook for this year and time, and looking backwards what we needed to do to get them back on track.

But if they're not training right, they're at risk for injury. If they're not recovering right, they're at risk for injury. Even if I'm doing all my work. And then on the flip side, if they're doing everything right with the aforementioned Dr. Keith Pyne, training right, getting body work, making sure he's physically working on them in an osteopathic way, what happens if they're not sleeping? What happens if they're not hydrated? What happens if their nutrition is poor?

You know, Lexie, in my career I watched the rise of, the slow rise of the knowledge of nutrition and awareness by teams even though these athletes were making incredibly millions of dollars to perform so well and bring home a championship for their city or their state, what I would watch is sometimes fast cooks would be in charge of the team's nutrition. I've watched that tide turn into Michelin star chefs, chefs of specific types of training with health foods, making plant based foods taste better, increasing the quality of the animal proteins they were consuming, making the shift completely from traditional factory farming beef to grass fed meat, removing all as many pesticides and hormones from what they were consuming as possible 'cause if you're playing at the top of your game you should be nourished as such.

Lexie: And that's a great transition into our next question. So we're seeing more professional athletes make the announcement that they've switched to some sort of wholesome diet, so whether it's paleo or vegan or plant based or just eating more raw foods, we'll get more into those specific nutritional diets in future conversations but just as a general concept, why do you think that these athletes are making the switch?

Dr. Pastore: You know, I believe it's several things that I've witnessed over my career. One, which you can never ignore. As much as I would preach science either in the locker room or facing the one athlete and maybe some of their other doctors in the same room, and I'm preaching on an individual level, and I'm so passionate about it and I'm showing clinical research, nothing was as strong as having that athlete who listened apply those principles, go back to the locker room, go back to the games and have everyone else say, "What did you do? How do you look so even more so physically fit," which you'd think is just not possible. Seemed to be less injured. Wait, weren't you the hamstring guy? Didn't you always pull ... Hey, what happened to all those abdominal rolls you were having over the years? How did that abate? How did that truncate? What was the story behind it?

And then that is what opened up ... I could tell you my practice exploded just by getting some key guys extremely fit, extremely healthy, thus playing better, recovering better and then moving onto more lucrative contracts in their careers speaks volumes.

While I think that's great, the truth behind all of that is there was science at work. You know, I always wanted to know when an athlete walked in and sat across from me as they're talking and we're having a wonderful introduction, I'm thinking in my mind, "I wonder what this individual's immunological relationship is to what they're nourishing their body with." That was always the starting point. Yes, of course I did the whole medical history, food health history, you name it. Nutritional history, medical nutritional therapy. That's all great stuff and then measuring data to prove upon a hypothesis or enlighten all of us in the room, myself included.

I had professional athletes with full on clinical deficiencies of a key nutrient. If that doesn't blow your mind, how someone could perform at such an amazing level, win a world series, but you know the press and the TV shows don't show the injuries, they don't talk about the personal histories that these individuals have felt and I would hear that and those are remarkable and touching stories. So, it really was at the start of my day, what was that individual's immunological reaction to food.

So, I think the movement towards eating more cleanly, I would say if we're putting all that into one category being paleo, being keto, being more vegan or whatever it is, more plant based, more plant based proteins, is the search to eat more cleanly for that individual. To reduce inflammation for that individual, which is a driving factor in the healing process. It's also a driving factor on how well we absorb the nutrients in the foods that we are consuming.

I was talking to an individual on a podcast recently where I was a guest and we were talking about food mediated reactions and deficiency states, and I brought up a reference that is so critical and I don't know why we ignore it when we're dealing with adults and particularly when we're dealing with professional athletes. But look at the long history on PubMed.gov of infants with severe cow's milk allergies being anemic.

It's just always been well known that when infants were consuming something they were allergic to, they could become deficient in a key nutrient. And I just never understood. I'd studied nutrition throughout a lifespan and could never understand how we just said, "Well, then that obviously magically went away as the individual became older." And I've never believed that.

What I saw on my side, which you don't see in the peer-reviewed literature because you're just not gonna do an n of 1 study. It just doesn't ... I guess you could write up a case study but I'm working with some of the top athletes in the world, I'm sure as heck not going to reveal that personal information. But when you would see the, "Oh, doc, I was severely allergic to that food when I was a baby. Doctor said I grew out of that," says the now asthma prone athlete that's overly exceeding the quantity of Albuterol he's supposed to take at a 24 hour period of time and then remove food A B and C, and oh wow, isn't it shocking how said athlete no longer requires that inhaler, or drastically reduced that inhaler.

And then there's some individuals that have told their own story, and one that I've always found touching, which is on just a total body inflammatory perspective and what this young man ... What led him to drink at the fountain of trying to get more natural foods in him, less processed foods to him and foods that were not immunologically stimulating inflammation in him is Colin Greening.

Colin Greening was at Toronto Maple Leaf and he was a great athlete, very physically fit guy and he personally tells his story, he shared it with me privately and he shared it publicly and he's written and talked about his story in multiple areas. And no one can say it better than Colin but I would just say that Colin absolutely, without a matter of doubt said, "Here's the situation. I would consume a dairy based protein shake to be more fit to fortify my body with the amino acids and proteins that I needed to recover and be excellent and great at my sport, and I had this whole list of symptoms that I found associated to that food in my own body. And when I eliminated that, these are the benefits that I found."

So, I think a lot of people are looking for that, they're trying to see is there something out there that could be problematic, and one of the things we're gonna be doing, Lexie, that I'm so excited about is talking to some people on this podcast that may have really sought out an extreme pathway that then gave them wonderful benefits and went off and on my side, the PhD side, researchers that then went out and actually published about those effects. So those are leaders in the field that I wanna talk about 'cause I think it's important for a full blanketed education, not just an endorsement of one specific pathway, because we are all biochemically unique.

Lexie: Absolutely, and we will have those coming up in the future of course. Now, I do wanna jump back to something that you said a little bit earlier. With moving and exercising and pushing their bodies multiple times a day sometimes, are there specific dietary requirements that athletes need under this blanket of whatever they're consuming, whatever diet they're following, to stay on top of their game in comparison to the general public or weekend warrior?

Dr. Pastore: That's a great question, and while I'd love everybody to find their path and eat extremely well and eat a predominantly wholefoods diet that works for them, for the professional athlete whose career is on the line, right? They're getting paid to be excellent, you would be surprised how much lack of nutritional education, at least when I first started my career, they were exposed to and it's not their fault. It's actually, they were being proactive and seeking it out so they could get better help. It was basically just eating your three meals a day and having some snacks and now in my practice it was, what are you not immunologically reacting to? Let's build a whole foods diet around that.

But here's some key pearls I like to call them, clinical pearls that I've discovered out of practice. I shockingly would find some professional athletes that weren't even on target for consuming enough protein for their bodies. So, while my mantra will always be we are all biochemically unique and this should be the determined between you and your medical care, professional nutritional health care professional, and that's directed towards the listening audience and of course any professional athletes that also happen to be listening. There's just some basic rule of thumb that I have had and I have learned in my graduate education.

For example, for strength athletes, for me it was a no brainer that my starting point was they needed approximately 2 grams of proteins per kilogram of body weight. So, just quick math. If there was 180 pound [inaudible 00:19:14] receiver in my practice, or I should say more in hockey, 'cause hockey got a lot lighter, Lexie, since my career. I'm back from the days where the Rangers were just these really big guys into the 220 range that could just knock you into the boards and they became really slimmer and super fast is what I have witnessed.

So, let's just say 180 pound professional hockey player should basically be getting a minimum of 163 grams of protein per day based on that math. And with endurance athletes, I always had a benchmark of between 1.5 and 1.7 grams of protein per kilogram of body weight and I'm sorry, I'm gonna keep having a disclaimer. Everybody's biochemically individualized and biochemically unique so this is ... I'm not prescribing diagnosis or saying, "Hey, everybody run out and do this," but this is some really cool ... You're hearing clinical pearls from someone that treated some of the top athletes on the planet. I think you definitely should listen to what I have to say.

And even for ultra endurance athletes who I would see them come into me and be broken, like running ... I've so many people that would run Death Valley every year as a hobby. I actually knew a professor that had a full lipid laboratory, PhD, and this is what he would do.

Biggest thing I noticed in him was I was like, "Oh my goodness, you're not gonna believe this. First you have a bad actual true dietary allergy to a specific food," and we were able to prove that in his medical doctor's office, and then I was able to do some math and I saw over a period of 30 days he was consuming point 8 grams of protein per kilogram of body weight where my starting point for an ultra endurance was between 1.5 and 2.0 grams per kilogram.

So, if you're under consuming dietary protein you can't stay in positive nitrogen balance and that means you're actually going to start breaking down your own body protein to try to do other things, which is an exercise of futility and you're more at risk for injury.

And of course, all total calories I'm looking at. Please don't think I'm just picking on protein but I could tell you why I'm bringing it up and emphasizing it. I've never met an endurance athlete that came in under caloric consumption. On a university level, I did see an unexpected female athlete triad where they just were doing incredible endurance sports, weren't getting enough dietary calories, were experiencing some changes in hormone status, were experiencing some early onset osteopenia, which is the precursor to osteoporosis at extremely young age and this is very well known, very well researched and you can fix that, you can tweak that, adjust that, typically they're low in vitamin D at that point, they're not getting enough dietary calcium, they're not getting enough total calories and of course proteins, carbohydrates, fats, all that. Very important.

But for all intents and purposes, I would see these meticulous ultra marathoners come in, ultra endurance athletes come in and really have the whole calorie thing down. They didn't have the macro nutrient percentage ratio optimized, and that's a real critical component.

The last point I wanna say about weekend warriors, and I'm on the higher end compared to some of the other groups but what I am saying has been verified in my clinical practice, endorsed by former professors I have had in human nutrition, one of my favorite professors, Dr. John Carbone who I personally and humbly see as one of the people who really put protein science and protein knowledge in the forefront of my mind, and I had him as a professor at Eastern Michigan University, and he kind of rewrote the rules for protein.

So, for weekend warriors, I would calculate just slightly little lower between 1.2 and 1.5 grams of protein per kilogram of body weight and I just feel that if we're under that at that first point we're really just setting our bodies up for disaster.

So, you could have an athlete that is eating just a ton of guacamole and chips. "They're organic chips doc, they're really good and they're part legume and they're not just a refined carb," and I'm like, "Okay, go on." "And I had 4 avocados." And I'm like, "Well, that's a lot of good fats there, but that's a lot. And if we do the math, look how low your protein is and that." So if we can make that plate look a little better, what a dramatic effect it would have on the athletic performance.

The last thing I'd like to mention on this topic regarding protein and looking at macro nutrient percentage ratio and how it can affect the professional athlete, the endurance athlete and of course the weekend warrior. Also it can affect the scientist.

I have read about, known, talked to individuals that are PhDs, brilliant researchers, became endurance athletes because it's so exciting to study nutritional science and human physiology, ate the way that a dogma said to eat, they actually developed type 2 diabetes. Looking fit, looking fit.

So, it's really not just how the individual looks. A mistake people make is to look at their hero athlete on the field and I'm not blaming or naming any names and say, "Wow, look how physically fit that person is. Everything must just be amazing-

Lexie: When behind the scenes, everything is going wrong and they're working-

Dr. Pastore: Everything is going wrong. Everything is going wrong. I've had athletes sitting in my office, their career is going to end the end of that season. I'm seeing them January 5th. They are told already, "This is your last run through." And they are incredibly physically fit. Body fat 5%, musculature second to none. They look like they're chiseled by Michelangelo. That's artistic. That's not biochemistry.

And then you look underneath that, and you start revealing how many problems they were actually having. Their long history of suffering. The medications they needed on a daily basis that maybe they didn't need all of those because there was perhaps a nutritional or training problem that was behind that.

But I think we've all seen people in the gym doing the quick sway back S curve while they're curling. Doing bicep curls. And I'm like, "Wait, what is that S curve movement you're doing? You're destroying everything and probably putting the least amount of taxation on your biceps."

The same thing can be done for nutrition. You know, while I'm so physically fit, I was talking to a researchers, a doctor who works with some of the top athletes in the world, works with some of the best boxers in the world and actually had a boxer that won championship bouts. Sick. Body falling apart. Eats one meal a day. You can't possibly recover that way. You can't possibly recover that way.

Lexie: And the transition for boxers to try and make weight as well and water load and shed, and eat as little calories as possible, so they can make weighing, that is a taxing process on your body that you're doing time and time and time again, every time you step into the ring.

Dr. Pastore: Right. And people don't spend enough time understanding how harmful that is to their bodies. That does over time have this yo-yo effect on your chemistry and it's highly disrupting.

Dr. Pastore: I had a very interesting theory that I used to use when I've had these athletes to try to reset the sodium potassium pump, just how they were hydrating themselves and not only looking at electrolytes but stepping outside that realm and looking at interesting dipeptide combinations that would help hyper hydrate the cell based on clinical research and clinical study and that's one of the things, as we progress we might wanna do an entire show on just hydration or touch upon that when we do a show on amino acids but it's really interesting, like a substance known as L-Alanyl-L-Glutamine has such a profound effect at hydration in pro sports and I've seen it in basketball and looking how hydration increased secondary to just being focused on your electrolytes, secondary to just sodium and just chloride.

So, I love that interesting science, it's why my brain is so obsessed with proteomics, protein science in general is so important. And it's why when I'm talking to an athlete, yes, I promise you nothing gets past me when I was in clinical practice I was obsessed with my job and combed over everything with a fine tooth comb. A nano scope, if I may be so bold, but I really was hyper focused on protein because when you hear something or you see something for 8 years straight out of 18 years of clinical practice, you don't forget that, and in those 8 years of just really pro sports for me it was under consuming of protein and consuming foods that the athlete was immunologically reacting to in a negative way, either self reported or I would identify it and then report it to them. We were both looking for evidence is the bottom line, right?

Let's just say I was the detective and the athlete came in to report a crime and wanted to know what was the causality of this crime and all the evidence and that's what we were basically doing and then came up with a master plan to solve that crime.

Lexie: Now, for the listeners that aren't professional athletes but they do care about their health and their longevity, aside from the protein aspect, if they don't have a medical team or a super knowledgeable doctor like yourself to visit, what are your recommendations for them to be able to move and perform at their best for as long as possible?

Dr. Pastore: That's a great question and it's a tricky one to answer. I think the most important thing, when I see these people that are so focused in their physicality and how they train and they keep journals, I would always ask them to do the same for what they were nourishing their bodies with.

I think it's so important to have a journal and I don't know why this also fell out of favor because it comes from real solid science. Yes, when you're studying nutrition, dietetics, anything like that, of course the journal is so critical. There's tools we would use, 3, 4, 5, 10, 30 day food frequency questionnaires, journaling breakfast, lunch, dinner, snacks, everything that's consumed in a 24 hour period of time, etc.

But also in medical nutritional therapy, it's been so important in diet induced migraines. You would have doctors from some of the best institutions in the country asking patients to please, log every single thing they consume and when they would have a migraine and doctors would try elimination diets. That's still very in vogue for this day and it's how clinical science has identified some foods as being triggers.

Like tyramine sensitivity, being known medical fact and trigger for migraines and foods rich in tyramine were really identified firstly and foremost, if you look at the medical history on this, asking patients to record.

I feel that individuals have a phenomenal understanding of what just makes them feel right. And if we have a better education about our relationship physically to food, I think then the journal thing really starts to make sense. I was on a podcast and I said to this individual, "What did you have for breakfast Dr. Pastore?" "I had a 30 gram protein shake with some almond milk, it was loaded with 7 grams of branch chain amino acids, I pummeled it, and I'm sitting at my desk and I'm ready for this podcast, my belly's just ... I feel nothing, I don't even know I ate anything."

Digestion is an autonomic system response triggered by a division of the nervous system that you don't close your eyes, cross your fingers and your toes and say, "I'm gonna digest now." Something automatically happens and to be quite honest you really shouldn't feel it if you're doing ... Look, on Thanksgiving we're all gonna feel it but you shouldn't ... At least here in the States, right? So, you shouldn't feel it.

I didn't have a clue that I did anything other than I now feel satiated, I feel nourished, I could slowly feel my energy getting better and I'm a pretty hyper guy to begin with because I was consuming something that was just so right for my body and then this gentleman responded, "Wait, so there was no bloating or distention or burping or belching or gas?" "No." "Well, what happens if I do feel that?" "I would write that down and I would wanna see if that happened again a week from now."

Could there have been something else? Of course, we don't live in a vacuum. Let's talk about something that could happen in life that can actually disrupt digestion and would prove me wrong. But I'm covering myself for it so I'm gonna prove myself right.

Let's say that you just had a horrible argument with your spouse, your co worker. There is a problem at your child's school and that gets you so stressed out and oh my god, you're vibrating with stress, we've all had one of those horrible moments and may you listeners never have those except for few and far between in your life. That is absolutely going to tax digestion. You're going to have a fight or flight response, we're going to move the blood flow from the digestive organs to the muscles so we could fight or flee this horrendous situation, unless you are a master yogi that meditates and you can control that stuff, god I'm envious is part one I would say and I want you on my podcast, and part 2 is you're then gonna succumb to, to quote Deepak Chopra, "You can turn nectar into poison with your emotions."

So, let's just say you did not have that type of day and you're consuming things in your life and you're recording your journal, "I'm feeling these set of symptoms," or like Colin was, "Gee, every time I do this, this hurts, but when I was on vacation and I didn't have my whey shake, that didn't hurt. I think I'm gonna not do that and see what happens." That's pretty smart.

And I'm answering for people that did not have a a me in their life when I was practicing. Like, what I did in my practice is people would come to me and of course I would ask them all these things, but then I would always like I said, "Look, I wonder what this individual's immunological relationship is to what they're consuming." And you would see really wild things.

And I don't wanna just demonize ... I think I mentioned whey a couple of times in this, not just demonizing that. It's all walks of life. One person's food could truly be another person's poison.

I actually had someone in my practice that had a long problem that doctors could not help regarding irritable bowel syndrome and I found it was a rice allergy. True story. And it was a true allergy. Immunoglobulin IGE allergy, like American Medical Association stamp of approval allergy.

There are other things, like intolerance, insensitivity, delayed food mediated reactions which have great medical data behind them. One is a condition known as eosinophilic enteritis, which is this erosive base condition in the upper gastrointestinal tract. It's horrendous. Sometimes there's regurgitation that's present with it, I used to see it a lot in clinical practice, there's a delay of the pyloric sphincter, the valve that opens up in the pyloric region of the stomach that then empties the contents into the first part of the small intestine after the bicarbonate wash happens at the same as that time, known as the duodenum. It's a horrible, medical, gastrointestinal condition.

Well, a really powerful medical journal published that - it was the journal Nature and was their subset known as the journal of gastroenterology and hepatology and I believe the year was 2014. But what they published in there was non IGE food mediated reactions were behind this gastrointestinal condition. So, that's where the doctor would want to just not have the blinders on and only look for an immediate allergy known as a true traditional historic real medical allergy. Peanut allergy, swelling of the throat, shellfish allergies, eye swell up, can't breathe, I'm then getting into the realm of this other type of immunological response. And that would cause a whole host and history of symptoms.

So, journaling, listening. She came in not knowing the food but knowing the symptoms. What do I eat on a daily basis? Record that. How am I feeling after each of my meals? How am I feeling historically days later? And examining that. I think it's critical.

Lexie: For just a little bit of an anecdote, yesterday I went out for dinner with my family and I decided to have the special for the restaurant, which was butternut squash soup and I absolutely love soup, I don't make it at home very often but I knew that there was going to be milk in that soup and I made the conscious decision anyways to order the soup because it's once in a while and me being lactose intolerant, I did not have a good time at the restaurant afterwards. I was already burping up a storm coming home, just like, I had to lie down, I woke up this morning feeling a little bit better but still not great.

But it did take a couple of years for me to identify that it was milk and dairy products for me personally that made me feel this way and I just thought I was going about my life, this is normal, I've been this way since I was a child. But eliminating dairy and focusing on other foods to nourish me has made the world of a difference.

Dr. Pastore: And that is so great to hear and you know what, Lexie, that means you're actually now absorbing more of the nutrients and the foods that you're using to replace dairy. We're brainwashed in this country as to what a healthy diet is because it's generalized. So, right there is brainwash fact number 1.

Here's a great point. You're listening to someone, the listeners are, who has one of the worst cases of celiac disease I've actually ever seen in practice, and I have it. It is a permanent condition where I will never be able to consume gluten containing grains ever and my reaction is unbelievably a medical emergency.

Was diagnosed and proven by a biopsy, everything of course 100% through proper medical diagnosis and I was diagnosed 29 years ago. It saved my life, it changed my life, it gave me life, it gave me a passion, it gave a deep desire to do what I'm doing today.

I just happen to mention and rip apart one of the number 1 recommendations by the United States Dietary Association, which is consuming grains. You should have X amount of grains per day and they should be whole grains. Sure, you could say, "Well, Robert, you could do that at the gluten free counterparts." Can I? You guys should see how much studies ... I don't know if any of you listeners read Thompson's works. Thompson's got a ton of data on cross contamination of gluten free grains for all intents and purposes being gluten free, like quinoa and brown rice, and actually being contaminated with gluten.

The listeners may know oats are always on the list to avoid if you have celiac disease because they're produced in a same processing plant that also manufactures gluten and there's 99% of the time always this cross contamination. So, it's really not that easy. I mean, lentils, for the love of god, can be grown in a field where rye is or barley, and then when they're processing it you have this presence of this gluten.

So, one person's food can really be another person's poison and it changed my life. I was consuming dairy like nobody's business, found out I was very allergic to dairy. Haven't consumed dairy in 29 years. Have the skeletal system of a tank, knock on wood. And I've never had milk, cheese, you name it. I've just never consumed anything from the udder of an animal, if I can put it that way. Even butter, no thank you.

There's still trace amounts of the dietary allergen casein in there, which is without a doubt reactive for me and we all have different levels of reactions. But I love that you shared that story and listeners should know that you can live a very healthy life consuming other foods. Just take collard greens. An enormous amount of calcium, 400 plus milligrams of calcium in a cup of collard greens when you compare that to 350 milligrams in milk, and there's some great data that you're actually absorbing a greater amount of the calcium that you would find in collard greens because it's an easier to digest food.

Subtract that conversation. You, Lexie, being reactive to the milk. If you were to drink milk with your lactose issues and reaction to it, you're really not going to get that benefit of the calcium and the vitamin D and that goes back to the original statement I said of infants and cows' milk allergy and how they were showing up being more anemic, so to speak. That's frightening. And the solution isn't fortification, it's elimination and then finding the best way to fortify that individual.

Lexie: And I think with the standard American diet and even the education content of it, it's just a lot of North Americans don't know that whey or dairy or gluten can be harmful to them because we grew up with the food guide of make sure you're getting your 4 food categories, your dairy, your greens, your meat and your, oh gosh, what's the last one ... Oh, fruits and vegetables. Right? So, two of those main food ingredients that we were taught to eat growing up in school are potentially dangerous and can cause inflammation to your body.

Dr. Pastore: It's true and you just actually - synaptic tendency - you just triggered a memory in my brain that is quite remarkable and I'd love to share it if you don't mind.

Going back to journaling and how I really believe our bodies will tell us something and yes nothing can beat the diagnostics of a medical doctor's office or seeing an expert in human nutrition that's certified and well credentialed, that's really going to help you, but don't deny you. When I was 5 years old in kindergarten I made every excuse in the world to not drink my milk. In the public school system for kindergarten where I grew up in Queens, New York, my mother had to pay a nickel a day ... That's how old I am, to get my little container of milk and I would ... God, I would like to think I'd unconsciously lie but I just felt so sick from it and I have the memory back then that I would get caught by the teacher dumping it down the sink or by the teachers aid and then they wrote a letter home to my mother, and my mother, I come from really lower middle class family, my mother was a bank teller and my father was a post office employee and a nickel a day was a lot of money, I'm dumping it down the sink and getting in trouble. Mom it spoiled ...

I found out I had 17 years of migraines and was on multiple prescription drugs including injectable drugs. Hey, I was a healthy guy, right. This really nasty. But then, this completely separate condition. Lovely. So, yeah, from the age of 5 to 22 I had just these migraines which were awful. I mean, I took my college entrance exams with one eyeball covered because the pain was just so severe from these migraines. I was injecting myself with Imitrex and whatever new drug would come out the doctors were giving it to me, prior to that I would finish a bottle of Tylenol a week. The punchline is, it was dairy.

When I just pulled the plug and gave up dairy I had one last blockbuster migraine, which I knew was kind of like a detox reaction of getting this garbage immunoglobulin reaction out of my body ... by the way there's some antibody responses that are beneficial, it's our body even forming antibodies around something to protect ourselves, so when you remove that away you're no longer having the masking phenomenon effect. It's kind of like a cigarette smoker smokes the first pack, the first cigarette of their pack of their life, they start coughing up a lung. Oh my god, what is this toxic crap I'm putting in my body. By pack 25 or year 5, guess what? They're masking. They're poisoning themselves but our bodies are unbelievable. We just detoxify, detoxify, detoxify, we're dealing with it and then sadly that smoker ends up getting a disease and the masking phenomenon ceases and unfortunately we all know the outcome there.

We all ... What's the data right now? More than 50% of individuals that take up smoking will die of that habit. And that's a medical fact, I believe it's higher than that but we'll just go by the statistics.

So, listening to my body at age 5, I could have told you, "This is just bad for me mommy," and I knew. It's funny, I wouldn't let my daughter get away with that with broccoli but I kid you. She loves her vegetables. And even there, even in vegetable kingdom, there can be people reacting to specific foods, right? In the fruit kingdom, there's people who react negatively to avocados, cilantro, tomato.

The moral of what Lexie and I are saying is, listen to your body, record it. Don't go on your memory. Lexie, you train phenomenally and meticulously and you coach people training and we need to talk about you one day and your phenomenal career that you had as this competing ... What you did in trampolining was phenomenal, I'm in awe of your abilities. I'm pretty sure you recorded down what you did, what sets, how you did them, how that muscle felt. You would think I was nuts if I told you never to do that and then compete in your types of competitions.

Lexie: Yeah.

Dr. Pastore: Right?

Lexie: Absolutely.

Dr. Pastore: Why do we ignore the fuel we're putting in our body and how we feel when we put that in there? Don't we take our car to the auto shop if it has a certain knocking or dinging or banging noise? We could rattle off, "Oh yeah, I filled it up over down there with unleaded at this top and that," and you know everything about your car. Know everything about your body. Write down how you feel, write down what you eat. Don't stop. That should be your food gratitude journal.

Lexie: And it does come down to treating food as fuel for your body. It's not just something you're gonna put in your mouth to taste good. It's not the emotional relationship you have with food, and I know a lot of people that struggle with that emotional relationship but when you start to educate them on the nutrients and the quality of food that's going into their body, they start to understand more and there's more of a shift towards wholesome foods that make them feel better and they start to enjoy the taste of real foods. Fruits, vegetables, because it makes them feel better on the inside long term.

Dr. Pastore: Absolutely. And your gustatory receptors change tremendously. How you taste salt, sugar, sour, all of that changes when you just give your body a chance. Your body has to go through a metamorphosis.

One person said to me, "Dr. Pastore, I tried your food journaling thing, I got you." I said, "How did you get me?" "Well, my doctor diagnosed me with SIBO, Small Intestinal Bacterial Overgrowth, it can cause irritable bowel syndrome." I said, "I'm very aware of it, you were probably prescribed Xifaxan for 2 pills twice a day for 10 days?" "Yes, yes, exactly." "Okay." "And I increased my plant based intake and guess what? I had gas and bloating for the first 15 days, it wasn't bad, it wasn't terrible I could live, and then I felt better but I just wanted you to know, I got you." And I said, "What you were doing was actually receding your microbiota, the microbes that are natural and should be present in your small intestine and large intestine are there to help you and your small intestinal bacterial overgrowth of the bad guys now needed the new guys to come back.

So, just as if you had a plot of beautiful soil in a front yard and you wanted to plant grass but you wanted to old school, you didn't wanna lay sod and be lazy and have a gorgeous lawn in a half hour, you were like, to hell with this, I'm gonna measure the PH, I'm gonna get a perfect soil, it's gonna be beautiful and nourished and have all the minerals that these beautiful grasslings will need, then I'm gonna sprinkle my seeds and water it and watch it. That's what you did in your intestines.

Eating all these wonderful fruits and vegetables and plant based compounds were giving you the fiber and the prebiotics that were the food for the probiotics and hopefully you were being nourished with some fermented foods and maybe even a probiotic by the doctor." And he goes, "Yes I was. The doctor made me eat sour kraut once a week and he gave me a probiotic once every nice." I said, "Well there you go."

So, those rules are extraneous from outside what I'm saying. If you're a healthy individual and you saw your physician and everything checks out and you say, "you know what, I wanna take a challenge. I wanna eat really healthy and journal myself every day for the next 21 days." You know what? That's where you're really gonna have the truth come out in your writings and in your recordings.

Lexie: Absolutely. So, we are running close to time here. So just recap the take aways for our audience 'cause I know that was a lot to handle, so protein. How many grams for a weekend warrior?

Dr. Pastore: Grams for a weekend warrior would be 1.2 to 1.5 grams of protein per kilogram of body weight. Divide your weight by 2.2. Those are your basic grams.

Lexie: And then for someone that's in the gym or exercising a little bit more, 4 or 5 times a week?

Dr. Pastore: If you're a strength training athlete I highly recommend starting with 2 grams of protein per kilogram body weight so that you could maximize your gains.

Lexie: And then of course, breakdown your food, listen to your body, see how it's feeling. It is not going to be a quick fix just like having a salad once isn't going to help you lose 10 pounds or eating Mcdonalds once in a week is not gonna make you gain 30. It is all about balance, it is a slow transition over time, just listen to your body, give yourself at least 3 weeks in a new challenge to see how you truly feel because it's not going to happen overnight.

Dr. Pastore: Absolutely. And I would like to add, one butternut squash soup with milk for Lexie will make her sick that one day that week.

Lexie: I'm back to normal. Feeling better slowly but it's gonna take a couple of days for sure. As always if you guys have questions about anything that we talked about today, send us an email, help H-E-L-P at modusnutrition.com, any questions that we can't answer directly we will pass directly onto Dr. Pastore and he can answer either via email or if it's something that we get a lot of questions from we can talk about it in a podcast. Thanks so much for listening guys and we will see you next time on The Modus Movement.

Dr. Pastore: Thank you so much, take care.

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