The Elimination Diet with Tom Malterre − By Dr. Alan Christianson
For more information about The Elimination Diet and an ‘In The Kitchen’ peak into Tom’s life, click here.
Dr. C: I’m here with Tom Malterre. Seriously, he is one of my favorite people in this health space and also, just in general. Tom is such a cool guy. I get to spend a lot of time hanging out with the world’s best health experts, and here is one of the brightest ones I ever get to talk to. So much of what happens in health, nutrition and fitness are like fads and trends, and Tom does not follow those. He reads things firsthand and draws incredibly insightful conclusions. He lives this stuff to a perfect tee. He has a new book coming out, which I am real excited about. I had a chance to look over it a bit. I wanted to have him on to just talk about some of the concepts in the book. Welcome, Tom.
Tom: Thanks, Alan. I have to say the feeling is mutual, my friend. I really enjoy the depth and breadth you go into, looking at the scientific data, but, then, also listening to your clients. The reality is science can direct us in so many different ways. Until we can actually see those scientific principles alive in front of us in case studies, and we can prove if they are either correct or incorrect — because you and I have both seen trends in our clients before they ever appear in the research. I have to commend you for all your hard work, my friend. I have been inspired by you many, many times.
Dr. C: So, in terms of your books, your cookbooks – we have had them all in our practice and have used them over the years and just love them. This is a new one – a new direction. So tell me what prompted THE ELIMINATION DIET book.
Tom: We’re functional medicine practitioners. We have been trained in this whole system of looking at the gut first – definitely taking into consideration the entire system of life. What is happening outside will be happening inside. One of the things we are seeing now (and have been seeing for the last decade) is that more and more people are responding negatively to foods. I am reading and learning from Dr. Joe Pizzorno and Dr. Alan R. Gaby – all the people at the Bastyr University in Kenmore, WA, who are absolutely incredibly intelligent. They have these phenomenal case studies. They say, “Look! We are able to help people with arthritis – not with these heavy medications but by limiting their intake of certain foods.” Dairy, for example. They are able to help people with migraines by looking at these 10 different foods. You name the condition, and they start to see these patterns, saying, “We really help these people when we remove certain foods from their diet.” I was, like, “Wow! This is fascinating.” In 2004, I was doing my own elimination diet, which was basically a raw food diet. I was taking out all the grains and everything, and all of a sudden — I did not even know, Alan, that it was not normal to have these terrible outbursts of gastric cramping, pain and bouts of diarrhea. I didn’t know that it was not normal to be huddled up on the couch for days at a time and not really want to move – to just kind of feel like you have this fog over your head, and you cannot really put thoughts together. Sometimes, your memory is super sharp, and other times, you cannot even remember what happened yesterday. I did not know this stuff was not normal, but when I went on this diet and removed all the grains and the dairy simultaneously from my life, it was like I got this shot of focus. I had this shot of energy. When I was in those fetal-type positions on the couch wanting to sleep all the time – that was gone. I had joint pains, and that joint pain was gone. It turns out all the symptoms came back when I had a whole wheat chapati. I had this healthy burrito wrapped in a chapati, and all the symptoms came rushing back. I was like, “Oh, my gosh – it’s the food!” So, when you experience something like that, and you are living life on a certain level, and then, you ramp up that level exponentially, I had to share it, right? I am that type of person, and you’re that type of person. We are givers. We find something, and we’ve got to share. “Come, check this out! Look at the sky. Hey, everybody! Come out and look at the sky! I had this lifting experience, and it is like an epiphany, and come, check this out!” So, I started telling my family and my friends. When I was at the clinic at Bastyr University, I would say to clients, “Okay, you have your arthritis and your migraines, and you should really try this.” Boom, boom, boom. Person after person – whether it was my niece or my brother or my mother-in-law or the clients in the clinic – they all got better. Then, all of a sudden, I started racking up these case studies of people that had rheumatoid arthritis for 30+ years and were on a 9 out of 10 pain scale, and then, they went down to a 2 out of 10 pain scale. They started taking up yoga and went dancing with their wives. I have these people who have this terrible carpal tunnel or trigger finger, and all of a sudden, that is gone, and now, they feel twenty years younger. I felt like I had this magical gift. It was not a gift, though. I mean, Dr. Jeffrey S. Bland, Dr. Joe Pizzorno and Dr. Alan R. Gaby had been telling us about this for decades. They are like, “By the way, you look at food sensitivities.” I did not believe it until I felt it myself and until I saw it hundreds and now, thousands of times in front of me. Now, I just go, “Oh, the world has to know about this!” No one has published a book on the elimination diet. There are these little workbooks, but no advanced, functional medicine practitioner that I know of has put out a book that’s called THE ELIMINATION DIET. So, here is the book.
Dr. C: That is incredible. You mentioned a couple big conditions, like the arthritis and the headaches. What are some other big things that are strongly affected by these reactions?
Tom: Migraines are 90+ efficacy. It’s phenomenal. Of course, you can add in supplementation, like riboflavin and magnesium and other things, as well, but the dietary intervention is phenomenal for migraines. Skin disorders. When someone’s gut calms down – when they are not irritating their gut with terrible food reactions – the skin calms down a lot. Because I have five children, I love when I see these people come into my practice and they say, “What can I do for my son’s autism?” or “What can I do for ADD, ADHD?” The elimination diet is phenomenal for mood disorders. I do not know if you recall Peter Green shocking us all in the New England Journal of Medicine? He said 50 percent of gluten-associated reactions are extra-intestinal – they happen outside of the intestines. He said the prime symptom in children is behavioral disorders. So, you kind of go, “Oh, are you kidding me? So, we are on these heavy medications and are doing lots of interventions in school, and we are falling behind and are frustrated, and the child is tearing up the house plants.” You can change the diet and change all the behaviors, and it is absolutely amazing, but it is not just with kids. Not at all. You can have adults with anxiety and depressive disorders – atypical, bipolar disorder, and they will come off their meds. They come off their meds! Now, I do not recommend you come off your meds, but what happens is you go on the diet, and your symptoms become so much better that you go to the doctor. They reevaluate you, and they say, “I don’t know if these meds are necessary anymore.” I mean, it is so wonderful, right? It is the simplest intervention. You just change some of your food. So, that is another one. Mood, skin, headaches, behavioral disorders – those are probably the big ones. I have not really seen a condition that has inflammation behind it that does not get better on the elimination diet.
Dr. C: That is a big part of so many chronic diseases, and that is one of the big, unifying theories in medicine, right?
Tom: Right. Right. It’s true.
Dr. C: What percentage of the population do you think could be having some of these reactions on an ongoing basis?
Tom: Well, just with the elimination diet alone, I have seen significant differences. People come in to see me, and they have an illness. They are complaining about something, and if they’re not, they do not take the time, money and energy to come see me. When somebody has an inflammatory disorder, and they come into my practice, and I put them on the elimination diet, 80 percent get better just from the diet alone. Eighty percent get better just from the diet alone! You say, “Wow, how can this be possible and why wouldn’t everybody be talking about this intervention?” That is my question out to the general populous, but I also think they are talking about it. They may not know they are talking about it, but think about it: What are a lot of the successful diet programs out there? What are a lot of the autoimmune paleo diets out there? In essence, they’re modified elimination diets. You are eliminating the most irritant foods that we know of in the United States population. They will take out the dairy. They will take out the gluten. They will take out the nightshades, nuts and other things, and it can stimulate immune cell response. Then, everyone will say, “Oh, the autoimmune paleo or paleo diet is the answer,” but maybe it’s because these people are finding out which foods do not work well in their system.
Dr. C: So, you give a list of foods to avoid in the book. Are there any particular foods you feel are best for someone to focus on?
Tom: Well, it would depend on that particular person, but in general, gluten, dairy, yeast, corn and soy are some of the top, reactive substances. If someone has joint pain, I am considering nightshades. There are certain symptoms that fit with certain foods. Alan, if you have a kid with constipation and a parent with sinus congestion, what food do you think of?
Dr. C: Dairy comes up.
Tom: You did not even hesitate. This is the thing about functional medicine practitioners – we know! You look at the literature, and you say, “Well, 40 percent of children who are consuming cow’s milk proteins will have cow’s milk enteropathy. They will upset their intestinal tract so severely that they will end up with occult intestinal bleeding. They will have blood in the stools when they consume dairy.” Why every pediatric practitioner is not looking for constipation or sinus congestion or blood in the stool with dairy does not make any sense because the literature is extremely clear. Thankfully, I got a chance to go through historical literature to do this elimination diet book. Dr. Rowe published an entire book on the elimination diet back in the early 1900’s. Then you go way back to the 1700’s, and you start seeing trends in a lot of the people who were looking at allergies and what not, and they were all doing elimination diets, but they were not saying they were limited to IGE-mediated reactions. You do not have to have the hives. You do not have to have the anaphylaxis. They were looking at gastrointestinal issues. They were looking at mood issues and food. You go way back to 790 AD and start getting into Hippocrates’ work. He was mentioning things, like “Some people find strength from dairy products while others find tremendous illness.” He saw portions of the population had food sensitivity. It’s amazing, and it has been around forever.
Dr. C: That is the thing. There is this huge schism still, and there is an allergy world that still denies all of this and argues that a lot of this is not real.
Tom: It’s so true. I find myself butting heads with the conventionally-trained practitioners. They say, “Well, I cannot believe this person put you on this diet. Sure, your laboratory analyses are all normal now for your autoimmune disease, and we are no longer going to give you the diagnosis of MS, but we’re not thinking it was actually the diet changes that did it. We’re thinking it is something else.” Kid you not, I had this one client where the neurologist said, “Let’s send you over to the Mayo Clinic.” She had severe, atypical, bipolar disorder. She had irritable bowel. She had sleep apnea. She had asthma.All these conditions were going on simultaneously, and after 12 days on the elimination diet, her chronic fatigue changed so much that no one was believing what happened. They were like, “How is this even possible?” So, at the end of six months, she had lost around 26 pounds and was coming off all meds. All the specialists were like, “Well, I do not know if I need to see you anymore.” This brain doc was like, “Oh, no. It could not be the diet. Let’s send you down to the Mayo Clinic, and let’s get a $20,000 workup.” So, he sent all her current laboratory analyses down to Mayo, and he says, “I have this client. Let’s get her checked out.” They came back and said, “We are not going to see her. She does not have any disease. We looked at her labs, and don’t see any disease.” You get to a point where you let the results speak for themselves.
We have to come to another part then, Alan. Most people who go on the elimination diet do not succeed, and here is why: They do not truly go on an elimination diet. Ninety-nine percent of the people that I do intake evaluation on, I can find hidden sources of corn, soy or gluten in their intake. It may be a pharmaceutical they are taking, a supplement they are taking or a food they are consuming that they do not understand. Maybe it’s a cross-contaminated food. Part of the reason autoimmune paleo and paleo diets are so amazing is because most people do not understand that if you are going to avoid gluten, you cannot eat most grains. You can’t. You cannot do sorghum, millet or buckwheat. Oftentimes, these – their flours – are produced in a facility that is not a dedicated, gluten-free facility, so there will be cross-contamination. Trisha Thompson, a very well-known RD, has been publishing on this stuff for over a decade about oat cross-contamination, and now with standard flours: sorghum, buckwheat, millet and others. So, you kind of say, “Oh, alright. Unintentional cross-contamination is what happens quite frequently on this elimination diet.” The data will be all over the place. They will say autism and gluten-free/casein-free diets are incredibly effective in this cohort, and in this other one, they are not effective at all. Then, you start looking at the methods, and you say, “Oh, come on! I know that the food they are consuming is cross-contaminated, but why does the person doing the study not know this?” You just observe over time. Now we know there is this whole population of refractory celiac patients, and you see those articles, and it is amazing. They say, “Well, we do not know why these people are not responding well to their gluten-free diet, but we are going to put them on a lamb, rice-based, vegetable diet for a while and see what happens.” Their symptoms go away because they were getting cross-contamination, so it is just a matter of doing it and doing it well. So, that is the biggest barrier in this situation.
Dr. C: It can be done well. If someone gets proper guidance and some proper perspectives, they can really see through those type of issues and avoid those hidden sources.
Tom: Yes, absolutely. You know how I am, Alan. I am a people guy, so I love to talk to people. I love to hang out with people. I love to call them and see how they’re doing on this program and what is going on. You know, “How can I help you?” I drove my wife nuts over the years by coming home late. I would call her and say, “I am going to be at the office a little longer,” and she would say, “Why?” I would say, “I gotta’ run.” I would take groups of my clients over to the local co-op, and I would walk them through the store and say, “Okay, this food is probably cross-contaminated,” or “You’ve got to make sure you get this.” I would do these grocery shopping tours, and then, I would coach people on all the things I would want them to have in their kitchen. “Make sure you get a high-powered blender,” etc. I could not do that in the book. I gave the kitchen essentials. I gave a lot of the information and the details, but I could not communicate it all. So, what I have done is put together an online-support program where you actually get to see me. I do webinars with you, and I talk to you about the little tips and tricks that will bring you that success you are looking for. My wife gives you these 24 cooking videos, so you can feel really comfortable in the kitchen. She is beautiful and one of the most eloquent chefs -well, she is a whole foods cook that is exponentially better than anyone I have ever seen at adapting any recipe at all to be elimination-diet friendly. So, we give you those instructional cooking videos. Then, I give these little, audio, mp3 files. I had to do this. You just open them up on a daily basis and listen. So, the week before you start your program, you hear me talking to you saying, “I bet you have little butterflies in your stomach, and these are the things you are thinking. Go sprout some broccoli sprouts right now. Let’s get your fermented vegetables started, and let’s make sure you’re taking Epsom salt baths a priority when you are feeling stressed out.” Then, on day one I say, “Alright, let’s do this. Here we go. Let’s buckle down. Let’s gets these broths going.” I talk to you the entire time. I give you these little coaching tips. I had to do it. I cannot just say “Go!” and let go. I am one of those connective, emotional people who wants to have that interaction. So, people can come on the webinars and ask me questions.
Dr. C: How do we get access to this stuff? How do we find this?
Tom: It’s on our site. So, go on our homepage, and you just log in, and we will give you some information about who we are and what we do and where the essence of disease is. Then, we will send you information about the book, about the program, and it’s incredible. Go to www.wholelifenutrition.net, and it’s super easy to get there.
Dr. C: Do you have some links for people?
Tom: Yes, absolutely. The reality is I want people to succeed. Really, Alan, the whole reason you and I are here is because we know there is a lot of unnecessary suffering out there, and we know how good life can be, and it gets lonely when you are the only person who is happy. You want people in life at that level with you. So, I want my kids to have friends that are super fun and happy. I want my friends and neighbors and people on the street — I want more people whistling, Alan. That is my goal. Do you remember 20 years ago when you could literally walk down the street and hear people whistling? My Grandpas used to whistle all the time. Do you hear that anymore? I just don’t. I want more of that. I think it’s partially because people just don’t feel good. They are not having this welling up of exuberant energy where they just express it, and that is what I think whistling is – an expression of joy.
Dr. C: Awesome, and I am so excited about this and cannot wait to share this. It is going to be totally life-changing, transformative and incredible.
Tom: That’s the plan, man. That is why we did it.
Dr. C: Thank you so much for taking the time, Tom. I know you are busy getting ready for all this. I will get this information out, and I look forward to talking again real soon.
Tom: It’s always a pleasure, Alan. Thank you so much for taking the time. We will talk again real soon, my friend.
Dr. C: Sounds good. Good-bye.