Before the Diets: Whole Food and the Gut

• What "whole food" means
• The great fat debate
• Sugar and refined carbohydrates
• Coaching the whole-food plate
• Safety notes: whole food
• How digestion works
• The microbiome
• "Leaky gut": what is known and what is debated
• The gut-healing toolkit
• Red flags: when it is not a coaching matter
• Safety notes: the gut

Every diet in this book, from kosher to keto, sits on top of two foundations: the food itself, and the gut that digests it. This opening chapter covers both.

What "whole food" means

A whole food is close to the way it came from the farm, the sea or the field: meat, fish, eggs, milk, vegetables, fruit, nuts, seeds, grains and beans, prepared in a kitchen. A simple test: would your great-grandmother recognize it as food?

Researchers sort food into four groups, called the NOVA system:

Ultra-processed food (UPF) is made from refined starches, sugars, oils and protein isolates, held together with emulsifiers, flavors, colors and sweeteners. In a 2019 study at the U.S. National Institutes of Health, Dr. Kevin Hall had 20 adults live in a clinic for four weeks. For two weeks they ate ultra-processed meals, and for two weeks minimally processed meals, matched for calories, sugar, fat, fiber and salt as offered. They could eat as much as they liked. On the ultra-processed diet they ate about 500 more calories a day and gained about 2 pounds; on the whole-food diet they lost about the same. It was a small, short study, but it shows clearly that ultra-processed food makes it easy to overeat.

Reading a label. A short ingredient list of words you recognize is a good sign. Long lists with words like hydrogenated, maltodextrin, high-fructose corn syrup, natural flavors, carrageenan, polysorbate 80 or artificial colors point to an ultra-processed food.

The great fat debate

For about 50 years, public health advice said to eat less fat, especially saturated fat from meat, butter and cheese. Journalist Nina Teicholz spent nearly a decade researching that advice for The Big Fat Surprise (2014). Her argument:

• The diet-heart idea won by force, not proof. In the 1950s, physiologist Ancel Keys argued that saturated fat raises cholesterol and causes heart disease. His Seven Countries Study became famous, and in 1961 the American Heart Association first advised cutting saturated fat. Teicholz argues that Keys's data were selective; for example, some of the Greek diet records were taken during Lent, when people were avoiding meat and dairy.
• The early trials did not show the expected benefit. Large trials that replaced saturated fat with vegetable oil lowered cholesterol, but did not lower overall deaths.
• Low-fat advice pushed people toward carbohydrates and vegetable oils. Americans did cut fat, ate more sugar and refined grains, and obesity and diabetes rose.

The other side. Teicholz's work is debated. When she criticized the U.S. dietary guidelines in the BMJ in 2015, more than 100 scientists asked for the article to be retracted. The journal did not retract it, but published a correction. A 2020 Cochrane review of 15 trials (more than 50,000 people) found that cutting saturated fat lowered combined heart events by about 17%, with little or no effect on deaths. Current guidelines still advise limiting saturated fat.

Seed oils. Soybean, corn, canola, cottonseed, sunflower and safflower oils are high in omega-6 linoleic acid and are made with heat and solvents. Arukah counts too much seed oil as a toxin, especially in processed form: refined, heated and reheated in fried and packaged food, where it oxidizes and feeds inflammation. Anyone seeking optimal health or healing avoids seed oils or keeps them to a minimum; Do This, Detox That (Chapter 6) explains why. The conventional view is different: mainstream reviews find linoleic acid neutral to helpful for the heart. Both sides agree on one point: most seed oil in the modern diet comes inside ultra-processed and fried food.

The course position. Cook with stable traditional fats (butter, ghee, tallow, olive oil, avocado oil and coconut oil), get omega-3 fats from fish, and cut ultra-processed and fried foods, which carry most of the seed oil people eat. Clients seeking optimal health or healing go further: no seed oils in the kitchen, and as few as possible from restaurants and packaged food.

Sugar and refined carbohydrates

• Added sugar is sugar put into food: table sugar, syrups, honey, juice concentrates. The American Heart Association advises no more than about 6 teaspoons (25 g) a day for women and 9 teaspoons (36 g) for men; the average American eats about 17.
• Sugary drinks are the biggest source. Liquid sugar does not fill you up, so the calories add on top of meals.
• Refined grains (white flour, white rice, most packaged cereals) act much like sugar in the body. The whole-food answer is whole grains prepared traditionally (sourdough, soaked oats) for those who tolerate them, or fewer grains for those who do not.
• Blood sugar and hunger. A breakfast of sugar and refined starch raises blood sugar fast and often leaves people hungry and tired a few hours later. Protein, fat and fiber slow this down.

Coaching the whole-food plate

A simple whole-food plate:

• Protein at every meal: meat, fish, eggs, dairy if tolerated, or beans prepared well.
• Vegetables and some fruit, as tolerated, including something fermented.
• A traditional fat for cooking and flavor.
• Whole-food carbohydrates as the person tolerates and needs: root vegetables, fruit, properly prepared grains and beans.
• Water and unrefined salt; broth often.

How to coach it:

• Start with the client's goal and their current day of eating. Ask what they ate yesterday, without judgment.
• One change at a time. Swap the soft drink for sparkling water, or the cereal for eggs, before overhauling everything. Small wins build trust.
• Crowd out, don't just cut out. Adding a real breakfast often does more than banning snacks.
• Make it affordable. Eggs, ground beef, chicken thighs, canned sardines and salmon, liver, cabbage, carrots, potatoes, frozen vegetables and homemade broth are inexpensive whole foods.
• Teach cooking. Many clients do not know how to roast a chicken, make broth or cook eggs. A simple weekly plan and a shopping list do more than a lecture.
• Use a food journal for a week: what, when, how much, and how the person felt (energy, mood, digestion, sleep). It shows patterns and becomes the starting point for every Lesson that follows.

Safety notes: whole food

• Food allergies: a true allergy (hives, swelling, trouble breathing) is a medical matter. Never suggest "testing" a food a client is allergic to.
• Raw milk and raw-milk cheese: not for pregnant women, babies and young children, older adults, or anyone with a weakened immune system.
• Liver and cod liver oil in pregnancy: both are very high in preformed vitamin A (retinol), which can harm a baby in high amounts. Pregnant clients keep liver small and occasional, and keep cod liver oil within the safe limit in From A to Zinc.
• Fish and mercury: pregnant women and young children choose low-mercury fish (salmon, sardines, anchovies, trout) and avoid shark, swordfish, king mackerel and tilefish.
• Blood thinners: clients on warfarin (Coumadin) keep their vitamin K intake (leafy greens, natto, liver) steady from week to week. A big change in vitamin K changes the warfarin dose they need, so the prescriber checks their INR before the change.
• Heart disease and high LDL: teach clients to order a lipid panel before and after a change in fats, and to read the results.
• Kidney disease: protein and potassium often need limits; check the client's kidney results and any limits they have been given before raising either.
• Eating disorders: if a client has, or may have, an eating disorder, do not put them on a restrictive plan. Refer them to an eating-disorder specialist.
• Children: children eat a varied whole-food diet. Therapeutic diets for children, such as keto for epilepsy, are medical treatments run by their medical team.

How digestion works

1. The head and mouth. Digestion starts before the first bite: the sight and smell of food start saliva and stomach acid. Chewing well and eating calmly, not in the car or at the desk, give the rest of digestion a head start.
2. The stomach. Stomach acid and the enzyme pepsin begin breaking down protein, and the acid kills many germs that arrive with food. Acid also helps release minerals and vitamin B12 from food.
3. The small intestine. The pancreas adds enzymes, and the gallbladder adds bile to break down fat. Here, through a lining one cell thick, nearly all nutrients are absorbed.
4. The large intestine (colon). Trillions of bacteria ferment the fiber and starch we could not digest, making short-chain fatty acids such as butyrate that feed the colon lining. Water is absorbed, and what is left leaves as stool.

Signs digestion may need support: bloating, gas, reflux, feeling overly full after meals, undigested food in the stool, constipation or loose stools, and fatigue after eating. These signs have many causes, so they are reasons to look closer, not a diagnosis.

The microbiome

The gut holds trillions of microbes, mostly bacteria, along with yeasts and viruses. Together they help digest food, make some vitamins (such as vitamin K and some B vitamins), train the immune system, crowd out harmful germs and send signals to the brain.

What harms the microbiome: antibiotics (sometimes necessary, but they disrupt it for weeks or months), a low-fiber, ultra-processed diet, some food additives (emulsifiers and artificial sweeteners have shown harm mainly in animal studies), heavy alcohol use, chronic stress, poor sleep and some medications.

The Stanford fermented-food study (2021). Researchers led by Drs. Justin and Erica Sonnenburg randomly assigned 36 healthy adults to eat either more fermented foods or more fiber for 10 weeks. The fermented-food group worked up to about six servings a day (yogurt, kefir, kombucha, sauerkraut, kimchi, fermented vegetable brine). Their microbiome became more diverse, and 19 markers of inflammation went down, including IL-6. The high-fiber group, on average, did not see the same drop. It was a small study, but well designed, and it supports the traditional place of fermented foods.

"Leaky gut": what is known and what is debated

The gut lining is a barrier one cell thick. The cells are joined by "tight junctions" that let nutrients through and keep most other things out. Researchers call the leakiness of this barrier intestinal permeability.

• What is established. Permeability really does increase with anti-inflammatory painkillers (NSAIDs such as ibuprofen), heavy alcohol use, very intense endurance exercise and some infections. It is higher in celiac disease and inflammatory bowel disease (Crohn's disease and ulcerative colitis).
• What is debated. Many holistic practitioners teach "leaky gut syndrome" as a root cause of allergies, autoimmune disease, skin problems and mood problems. Researchers agree that permeability and these conditions are linked, but not that one causes the other, and there is no proof yet that healing the barrier cures them.
• How to say it to a client. "Your gut lining is a real barrier, and diet and lifestyle affect it. Supporting it is a sensible goal. It is not a diagnosis; it's something we can support every day."

The gut-healing toolkit

Rubin, Campbell-McBride, Fallon and most holistic practitioners share a common set of tools. A useful way to remember them is remove, repair, repopulate, support:

• Remove what irritates: ultra-processed foods, sugar, alcohol, and foods the client reacts to (a food journal shows these). The Carnivore Diet entry teaches a full elimination diet.
• Repair the lining: meat stock and bone broth, gelatin and collagen, cooked vegetables, and enough protein, zinc and vitamin A.
• Repopulate the microbiome: fermented foods, introduced slowly, and probiotics when there is a reason. Probiotic benefits depend on the strain. The American Gastroenterological Association (2020) recommended probiotics for only a few uses, such as preventing C. difficile infection during antibiotics, and rated the evidence as low quality; for most gut conditions the evidence is still thin.
• Support digestion: chew well, eat calmly, and don't drink large amounts during meals. Some practitioners use apple cider vinegar, digestive enzymes or betaine HCl (stomach acid) with meals; these have real cautions (see From A to Zinc).

When the tools backfire. Some people feel worse on broth, ferments and probiotics:

• Histamine intolerance: long-cooked broth, fermented foods, aged cheese and leftover meat are high in histamine and can cause flushing, headaches, hives or a racing heart. Short-cooked meat stock and fresh or frozen meat are gentler.
• SIBO (small intestinal bacterial overgrowth): bacteria growing too far up the small intestine. Prebiotic fibers, some probiotics and high-FODMAP foods (onion, garlic, beans, wheat, some fruits) can make bloating much worse. SIBO is confirmed with a breath test. A coach does not order or interpret it, but you can teach clients how to order their own test and read their own results.
• Fiber: many people do better with more vegetables and fiber; some, with IBS or SIBO, do better with less for a time.

Red flags: when it is not a coaching matter

Refer the client to their doctor promptly for:

• Blood in the stool, or black, tarry stools
• Unexplained weight loss, fever or night sweats
• Trouble swallowing, persistent vomiting, or severe or worsening belly pain
• Anemia (low iron) without a known cause
• A lasting change in bowel habits, especially after age 45
• A family history of colon cancer, celiac disease or inflammatory bowel disease
• Symptoms that wake them at night

Test for celiac disease before going gluten-free. Celiac disease is an autoimmune reaction to gluten. The blood test and biopsy only work while the person is still eating gluten, so a client with suspected celiac disease gets tested first.

Safety notes: the gut

• Red flags (Red flags: when it is not a coaching matter) always go to the doctor first.
• Acid blockers (PPIs) and other medications: a client never stops or changes a medication on their own; stopping acid blockers suddenly can cause rebound reflux.
• Betaine HCl: not with ulcers, gastritis, NSAIDs, aspirin or steroids, or acid blockers. Stop at any burning.
• Probiotics: not for people with a severely weakened immune system, a central IV line or critical illness, or for premature babies. Take them 2 hours apart from antibiotics.
• Histamine and SIBO: if broth, ferments or probiotics make a client feel worse, stop and reassess: histamine intolerance or SIBO is likely (The gut-healing toolkit), and the client can order a SIBO breath test.
• Children and GAPS: restrictive diets for children, including GAPS, mean watching growth and weight closely.
• Inflammatory bowel disease (Crohn's, ulcerative colitis): these clients work with their gastroenterologist; diet supports, never replaces, their care.
• Celiac disease: test before removing gluten.
• Raw eggs (GAPS stage 2): raw egg yolks carry a small risk of Salmonella; pregnant women, young children, older adults and anyone with weakened immunity use cooked eggs or pasteurized eggs.