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Food Plan Prepared for [XX] on [xx-xx-xx]Requirements: Wahls Paleo Plus (Level 3) + MDLSuggested time on therapeutic food plan: [x] weeksQuick overview of plan: The focus of your food plan should be on high amounts of fats and oils, low glycemic vegetables, high quality meats and fish, as well as some nuts and seeds, herbs and spices, and low glycemic fruits. The plan eliminates all grains, legumes, soy and white potatoes; it limits starchy vegetables to two servings per week and fruit to 1 cup of berries daily. Depending on your size and gender, protein intake will range from 6-12 oz. per day. Special considerations on this plan: Wahls Paleo Plus is considered a ketogenic diet. On a ketogenic diet, the majority of your caloric intake will come from fat (50%+, depending on your specific needs). This plan also requires 6 cups of vegetables daily for nutrient density. A ketogenic diet allows your body to transition from using glucose as a primary cellular fuel to using ketones, which are produced from fats. This has been shown to aid in weight loss and also produces an anti-inflammatory effect in the body. After a few days on this diet, hunger should stabilize and you should feel satiated, even if you are eating less food. To maintain ketosis, you will need to incorporate at least 5 tablespoons of healthy, high-quality oils/fats per day (e.g. flaxseed oil, olive oil, coconut oil, avocado oil, nut/seed oils). Other high-fat foods such as oily fish, macadamia nuts, hazelnuts, avocados and olives are also beneficial. Animal fats can be included, ideally from grass-fed/organic sources. For the first two weeks, it will be important for you to track calories, carbohydrates, proteins and fats while you get used to following the diet. You should also track how effectively you are achieving ketosis by monitoring your urinary ketones first thing each morning with urine ketone strips available at most pharmacies. After the first two weeks, you may be able to rely on just using the urinary ketone test as a guide to whether you are on the right track, rather than tracking your daily intake.We have also highlighted sources of vitamin B5 (pantothenic acid) which we would like you to focus on incorporating into your plan while you are on a ketogenic diet. B5 is essential for your body to properly use ketones for fuel, and we have found emphasizing it to be helpful.Carnitine is important on the ketogenic diet for metabolizing/utilizing fats. Animal products like meat, fish, poultry, and milk are the best sources. A variety of protein (including red meat, organ meats, and game) will help optimize carnitine levels. Daily goals:Aim to drink half your body weight (lbs.) in fluid ounces of water each day.Aim for 6+ cups of varied and colorful, non-starchy vegetables per day:2-3 cups of dark leafy greens2-3 cups of colorful, non-starchy or raw starchy vegetables (1 cup can be berries)2-3 cups of sulfur rich vegetablesChoose organic produce whenever possible.Choose grass-fed, free range, antibiotic / hormone free animal products whenever possible.Include non-dairy foods that are high in calcium, including almonds, bok choy, broccoli, dark leafy greens, fish (with bones) and sesame seeds/tahini. Choose calcium-fortified non-dairy milks. When opting for packaged foods, choose the least processed options available (e.g., short ingredient list, natural / recognizable ingredients, minimal preservatives / additives / flavorings / colorings). This table specifies what you can include and exclude as part of your Food Plan. Foods in bold are high in one or more of the Methylation Diet and Lifestyle (MDL) nutrients and adaptogens. Methylation is a foundational metabolic process necessary for healthy cellular function, detoxification, hormone balance. Read more about methylation here. Food Include Exclude Vegetables Choose organic produce whenever possible. Serve raw, steamed, sautéed, blended, or lightly-roasted. Dark leafy greens (2 cups/day): Arugula, beet greens, Bok choy, cilantro, collard greens, dandelion greens, kale, mustard greens, parsley, purslane, rainbow / Swiss chard, spinach, turnip greens, watercress. Colored vegetables (at least 3 colors/day): Green: Artichokes, asparagus, bamboo sprouts, broccoli, broccoli rabe, broccoli sprouts, Brussels sprouts, celery, chives, cucumbers (with skin), escarole, green bell peppers, green cabbage, green cauliflower, green olives, kohlrabi, lettuce (Bibb, endive, green leaf, red leaf, romaine), okra, scallions, tomatillo, zucchini (with skin NOTEREF _Ref478385312 \f \h \* MERGEFORMAT 1). Red: Beets (up to 2 servings per week), radicchio, radish, red bell peppers, red onion, rhubarb, tomatoes. Blue/Purple/Black: Black olives, eggplant, purple cabbage, purple carrots (up to 2 servings per week), purple cauliflower, purple kale.Orange: Orange bell peppers.Yellow: Summer squash (up to 2 servings per week), yellow bell peppers. White/Tan/Brown: Cauliflower, celeriac, daikon radish, garlic, jicama, leeks, mushrooms (shitake and portabella), onions(limit to ? cup per day), rutabaga, shallots, sprouts, turnips, water chestnuts. Sulfur-rich vegetables (2 cups/day): Asparagus, bok choy, broccoli, Brussels sprouts, cauliflower, chives, collard greens, daikon radish, garlic, green cabbage, kale, leeks, mushrooms, onions, radish, rutabaga, scallion, shallots, turnips, turnip greens.Starchy vegetables (up to 2 servings/week after ketosis is achieved): Carrots, parsnips, pumpkin, sunchoke, sweet potatoes, winter squash (acorn, butternut, delicata, kabocha), yams. Sea vegetables: Seaweed (dulse, kelp, nori, wakame), algae (blue green, chlorella, spirulina).Fermented vegetables: Kimchi, pickles, sauerkraut.Wahls: Cassava / tapioca / yucca, green beans, peas, potatoes (blue/purple, fingerling, red, Russet, white, yellow), snow peas, sugar snap peas, sweet corn. Animal protein Choose organic/free-range/grass-fed/wild/hormone-free/antibiotic-free/lean products whenever possible. Grass-fed/wild animal products are leaner and have higher omega-3 content. Fish in italics are good low-mercury, high omega-3 choices. Choose eggs that are omega-3 enriched whenever possible.Wahl’s Paleo Plus includes 12 ounces of organ meat/week, 16 ounces of fish/week, and 6-12 ounces of other meats/day. Animals protein is a great source of carnitine.Fish: Low mercury: Anchovies, catfish, flounder, haddock, herring, mackerel (Atlantic), salmon, sardines, sole, tilapia, trout, whitefish.Moderate mercury: Bass (black, striped), carp, cod, halibut (Atlantic, Pacific), mahi mahi, monkfish, sablefish, skate, snapper, tuna (canned chunk light, Skipjack). High mercury (in very limited quantities, 1x per month): Bluefish, Chilean sea bass, grouper, mackerel (Gulf, Spanish), tuna (canned albacore, yellowfin). Shellfish: Crustacea (crab, crawfish, lobster, shrimp) and mollusks (clams, mussels, octopus, oysters, scallops, squid).Red meat: Beef, bison / buffalo, elk, goat, lamb, veal, venison.PorkPoultry: Chicken, Cornish hen, duck, pheasant, quail, turkey. Organ meats: Liver, marrow, sweetbread, tongue. Eggs including chicken, duck and goose.Processed meats: Canned meats (except for fish or seafood), cold cuts, frankfurters, sausage. Highest mercury fish: Mackerel (King), marlin, orange roughy, shark, swordfish, tilefish, tuna (Ahi, Bigeye). Vegetable protein Protein powders: Chia, hemp, pumpkin seed. Wahls: All soy products including fermented soy (miso, natto, tamari, tempeh) and non-fermented soy (soybean oil including in processed foods, soy milk, soy sauce, textured vegetable protein, tofu); all legumes including beans (adzuki, black, butter, cannellini, garbanzo / chickpeas, lima beans, mung, navy, pinto, red kidney, refried), hummus, lentils, peas. Pea and rice protein powder. Nuts & seeds Choose raw nuts and seeds whenever possible. Choose unsweetened nut and seed butters whenever possible.Nuts (in moderation): Almonds, Brazil nuts, cashews, coconut (unsweetened), hazelnuts, macadamia nuts, pecans, pine nuts, pistachios, walnuts.Nut butters (in moderation): Almond, cashew, coconut, hazelnut. Nut flours (in moderation): Almond, Brazil nut, cashew, chestnut, coconut, hazelnut, macadamia nut, pecan, pistachio.Seeds (in moderation): Chia, flax, hemp, poppy, pumpkin, sesame, sunflower.Seed butters (in moderation): Hemp, pumpkin, sunflower, tahini (sesame paste). Wahls: Peanuts, peanut butter, peanut flour.Highly processed nut / seed products: Nut or seed butters made with hydrogenated oils or added sweeteners.Oils Choose cold-pressed, organic, unfiltered oils whenever possible.Low heat (<225 °F, for finishing): Extra virgin olive oil, flax, hazelnut, macadamia nut, MCT, walnut.Medium heat (~250-350 °F, for sautéing): Coconut, hazelnut, macadamia nut, pastured animal fats (duck, lard, tallow), olive, sesame.Medium–high heat (~350-425 °F, for roasting, baking and pan / stir frying): Almond, avocado, coconut, olive, palm, sunflower.High heat (>425 °F, for broiling and grilling): Avocado, safflower.Wahls: Butter, ghee, peanut oil.Highly processed fat products: Hydrogenated fats (in many condiments, packaged goods and fast foods), processed vegetable fats (margarine, shortening), processed vegetable oils (canola, corn, cottonseed, soybean).Fruits Choose organic produce whenever possible. Choose unsweetened whole fruits, either fresh or frozen. With the exception of avocado, berries, lemons, limes and olives, all fruit should be avoided for the first two weeks. After that, slowly incorporate up to 2 servings of fruit per day, closely monitoring its effect on ketosis.Be mindful of your total amount of net carbs coming from this category.High Fat Fruits: Avocado, Coconut meat, olivesUse in moderation (1/4 cup, 2 servings per day total)1: Aronia berries, blackberries, black raspberries, blueberries, cranberries, currants (red/black), elderberries, lemon, lime, raspberries, strawberriesUse sparingly only once keto adapted ( 1 serving per day): Cherries (5 whole), green kiwi (1/4 cup), guava (1 whole), mango (1/4 cup cut pieces), plum (1/2 cup cut pieces), papaya (1/4 cup cut pieces), pomegranate (1/4 cup). Superfruits (Acai berries (1 cup) , camu camu, Goji berries (2 Tbsp), goldenberries (1 Tbsp), mulberries). Wahls: Green (green apple, green grapes, green kiwi, green pear, honeydew, melon), red (blood orange, cherries, cranberries, guava, pink / red grapefruit, plum, pomegranate, red apple, red currants, red grapes, watermelon), blue / purple / black (black currants, Concord grapes, plums, purple grapes), orange (apricots, cantaloupe, clementine, mandarin, mango, nectarine, orange, papaya, peach, persimmon, tangerine), yellow (Asian pear, passionfruit, pineapple, starfruit, yellow apple, yellow watermelon), white / tan / brown (dragonfruit, lychee, pear, white peaches, white nectarines). Higher glycemic fruit including banana, dried fruit (dates, dried currants, figs, prunes, raisins), plantain. Fruit juice.Highly processed fruit products: Fruit juice, fruit snacks. Grains None.Flours: Arrowroot, kuzu, nut flours (listed above), tapioca.Wahls: All gluten-free grains, including amaranth, buckwheat, corn, millet, oats (must specify gluten-free), quinoa, rice (basmati, black, brown, red, wild), sorghum, teff; all gluten-containing grains including barley, oats, rye, triticale, wheat (durum, farro, kamut, spelt), wheat products (bulgur, couscous, semolina).Highly refined grains (often in packaged foods): Cakes, cereals, cookies, crackers, dough, instant oatmeal / rice, mixes (desserts, pancakes, waffles, etc.), muffins, packaged snacks, pastries, white bread, white pasta, white rice. Dairy & Dairy substitutes Non-dairy alternatives: Coconut milk kefir, non-dairy unsweetened milk (almond, cashew, coconut, hemp), non-dairy yogurt (almond, cashew, coconut).Wahls: All dairy products including butter, buttermilk, cheese, condensed milk, cream, cream cheese, cultured dairy (cottage cheese, cow’s milk kefir, sour cream, yogurt), evaporated milk, flavored creamer, frozen desserts (bars, cakes, ice cream, yogurt), half & half, milk (cow, goat, sheep), powdered milk, whey, whipped cream.GheeDrinks Coconut water, non-caffeinated herbal teas (chamomile, ginger, hibiscus, mint, peppermint, rooibos; hot or cold), water (mineral, filtered or distilled; still or carbonated). Limit (max amount): Alcohol (1 for women or 2 for men x 5-oz glasses of wine or 12 oz gluten-free beer or 1.5 oz spirits, for special occasions), club soda / seltzer (1 cup per day), green/oolong tea or coffee (1-2 cups per day).Wahls: Fruit juice, vegetable juice. Highly caloric, high glycemic or caffeinated drinks: Caffeinated tea, coffee drinks, energy drinks, juice drinks, soft drinks, sports drinks.Condiments All spices and herbs (ensure no gluten-containing fillers are added): Allspice, anise, basil, black pepper, cardamom, carob, cayenne, celery seed, chili powder, cilantro, cinnamon, cloves, coriander, cumin, curry, dill, fennel, garlic, ginger (dried and fresh), marjoram, mint, mustard seed, nutmeg, oregano, paprika, parsley, rosemary, sage, salt (preferably Celtic sea salt or Himalayan pink salt), spearmint, tarragon, thyme, turmeric. Sauces: Apple cider vinegar, coconut aminos, guacamole, mustard, pico de gallo / salsa (sugar-free)Wahls: Dairy-based sauces, soy products. Highly processed sauces: Barbecue sauce, chutney, fruit sauces, horseradish, jam/jelly, ketchup, mayonnaise, pesto, relish, salad dressing, soy sauce, steak sauce, tartar, teriyaki, and other condiments with undesirable additives.Sweeteners In moderation: Monk fruit/luo han, stevia.Erythritol, Lakanto (monk fruit & erythritol) if tolerated.Cocoa powder (75% dark, not Dutch Processed).Wahls: Blackstrap molasses, coconut sugar, dried fruit, erythritol / xylitol, honey, maple syrup.Highly processed sweeteners: Agave, artificial sweeteners (acesulfame-K, aspartame, saccharin, sucralose), brown rice syrup, candy, fruit juice concentrate, high fructose corn syrup, sugar.For Further Resources on Wahls Paleo PlusThe Wahls Protocol by Terry Wahls, MDThe Wahls Protocol Cooking for Life: The Revolutionary Modern Paleo Plan to Treat All Chronic Autoimmune Conditions by Terry Wahls, MDWhat to ExpectDietary changes can be a difficult and sometimes confusing process. We’re here to guide you through the changes and give you the support you need to be successful. Some tips and tricks from others who have done this before are:You may use leftovers for the next day’s meal or part of a meal (e.g., leftover cooked salmon and broccoli from dinner) as part of a large salad for lunch the next day.It may be helpful to cook extra protein (e.g., chicken, beef) and vegetables (e.g., sautéed greens, roasted mushrooms, etc.) that can be reheated for snacking or another meal.Many foods freeze well and can be frozen in individual portions for easy combining and taking “on the go.”Try to plan ahead so that you are not caught out in situations where the only food available does not fit your food plan. Keep suitable snacks on hand and bring meals with you if needed.You may find it useful to invest in portable food containers that keep food cold/hot; choose stainless steel or glass if possible.If eating out, call restaurants ahead of time to discuss suitable menu choices. You’ll likely find that restaurants that cook from scratch with fresh/local ingredients are most able to meet your needs. In our experience, we have found the process of dietary change to be overwhelmingly well tolerated and extremely beneficial. We hope that you will find it useful too. There is really no “typical” or “normal” response. Different responses to dietary change can be attributed to biochemical differences among individuals as well as lifestyle factors. Most often, individuals report increased energy, mental alertness, decreased pain, improved skin conditions, improved metabolic markers (such as fasting glucose, insulin, cholesterol), and a general sense of improved well-being. However, some people report some initial reactions to dietary change, especially in the first week, as their bodies adjust to a different dietary program. Symptoms you may experience in the first week or so can include changes in sleep patterns, fatigue, lightheadedness, headaches, joint or muscle stiffness, and changes in gastrointestinal function. Such symptoms rarely last for more than a few days, so persevere! Always let Dr. Fitzgerald, Dr. Litwin or the nutrition team know if you experience any negative symptoms. ................
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