Disclaimer: I did my best to take notes at the NTA conference but there may be errors in either my comprehension or transcription of the points presented. I am publishing these without any commentary on my part and these do not necessarily represent my beliefs.

• Julie Matthews, CNC – Nourishing Hope for Autism
• Beverly Teter, PhD – Ketogenic Diets & Brain Inflammation
• Denise Minger – One Size Does Not Fit All: Variation in Our Dietary Needs
• Dr. George Birnbach – Simple Steps to Doubling Your Practice While Doubling Your Time Off

Julie Matthews, CNC – Nourishing Hope for Autism

• specializing in autism for 13-14 years
• much that can be learned from autism that can be applied to other conditions
• 1 in 2 children have a chronic health condition, rates are increasing
• 1 in 5 have allergies, 1 in 6 developmental delay, 1 in 88 autism
• cause of autism: genetic disposition combined with environmental assaults
• 3 main body systems – immune (inflammation, pathogens), digestion, detoxification – these affect neurology
• autism often has methylation cycle defects
• glutathione needed to mediate inflammation and detoxify
• sulfation impairment is also common
• autism – decrease in glutathione and sulfation pathways
• autism cases some may have autoimmune conditions because autoantibodies are present
• why diet helps – reduce gut inflammation, increase nutrient density (reduce nutrient deficiencies)
• look at yeast overgrowth – removing sugars, maybe starches
• reduce toxicit of foods
• improve detox pathways – reducing stressors and increasing nutrients that support methylation and sulfation etc
• healing diets – part 1 – removing harmful substances – part 2 – increase healthy foods
• no 1 diet, uses 13 diets, finding which diet will work for which person
• bioindividual nutrition is the goal – addressing the individual needs of each person
• consider many factors which effect the individual
• 1. clean up the diet
• 2. clean up the home
• 3. supplementation
• deficiencies stem from poor digestion, dysbiosis, biochemical and cellular issues, depletion from toxins, poor diet
• food is the foundation for getting proper nutrition
• for most children, additional supplementation may be required
• first supplenents to consider – digestive enzymes with DPPIV, probiotics, calcium, magnesium, b6 (pyridoxine or P5P), b12 (methylcobalamin), b9 (folate, folinic or 5-MTHF), cod liver oil or fish oil, multivitatamin/multimineral
• nourishing hope food pyramid – with closer to the base being most digestible, least reactive
• protein (foods for growth) and vegetables (foods for health) at the base, then healthy fats (brain food), then fruits
• foundations – ferments, broths, juices, high quality water and salt, preparation (soaking, sprouting)
• choosing a healing diet – GFCF a good place to start, several grain free diets, low oxalate and fodmap diets, and others
• harmful assumptions – 1 diet fits all (GFCF might not work due to increase in salicylates), grains and starches are main problem, more vegetables/fruits/spices are always good,
• gluten/casein/soy + insufficient DPPIV enzyme + leaky gut = opioid activity = food addiction
• opioid peptides can cause many symptoms seen in autism
• all dairy is not created equally – very often autistic children cannot handle casein so no animal milk
• more diets – soy-free, corn-free
• specific carbohydrate diet – removes disaccharaides and polysaccharides but allows monosaccharides (honey, fruit, non-starchy vegetables) – lack of carbohydrate digesting enzymes
• SCD studies on celiac and IBD
• SCD and GAPS share no grains and no sugars and no starchy vegetables
• GAPS promoted bone broths and fermentation
• paleo – like GAPS/SCD but no beans, maybe some potatoes
• low FODMAPS diet – FODMAPS are fermented by bacteria creating gas/bloatins and draw water in leading to diarrhea – helpful for chrohn’s and colitis
• should consider FODMAPS if grain free diets not sufficient
• phenols and salicylates – aromatic benzene ring bound to OH – almond flour, honey when switching off grains – often need to be removed and build up detox pathways, sulfation
• 10 year old boy case study – severe aggression (injured therapists) disappeared when salicylates removed – tomato sauce, olive oil, avocado
• better to remove foods than life of other treatments
• FAILSAFE diet – removes salicylates and amines – these tax sulfation pathway – bone broth and ferments – these are not always good
• amine issues – wetting, rashes, sleep issues, inattentiveness
• low oxalate diet – oxalates are anti-nutrients – bind to useful nutrients (Ca, Mg) and pulls them from the body
• spinach is very high in oxalates – will bind Ca in meal
• extremely high oxalate foods – spinach, swiss chard, peanut and cashews, chia seeds, almonds and almond flour
• oxalates when bound can form crystals with sharp edges causing inflammation
• unbound oxalates impair mitochondrial function, disrupts minerals, creates oxidative stress
• Autism Oxalate Project – improvements reported when oxalates are a problem
• children with autism have a 3-fold greater plasma oxalate levels – 2012 study on oxalates and autism
• oxalates can be generated by the body, low b6, so diet may not be sufficient
• substituting nut flours for grains is not always good
• diet strategy – start with nourishing diet (GFCF), consider and adjust other factors, tailor to individual needs
• launching BioIndividual Nutrition Institute – training certification, software platform

Beverly Teter, PhD – Ketogenic Diets & Brain Inflammation

• americancollegeofnutrition.org – ACN – associate membership available
• undergrad at GWU in chemistry
• Ireland Research Lab on Cancer Lipids, then Gillette Research Lab on Skin Lipids
• PhD from U of MD in nutrition sciences
• human nutrition lags animal nutrition sciences
• dissertation on mice – cis-9 or trans-9 fatty acids – 35 deg C difference in melting point
• studying effects on lactating female rats during nursing
• much higher transfats in milk of trans fed mice – pups also weighed less
• human milk fat study – milk collected from mothers fed trans-fats – same results – appearance of trans fats in milk, milk fat reduced
• reduction in milk fat hypothesized to lead to greater hunger in nursing infants
• repeated in cows – partially hydrogenated vegetable oil in cows
• chemical vs bio hydrogenation – fat loses some or most of the polyunsaturated bonds
• bio-hydrogenation produces very specific isomers – 11t-18:1 and 9c,11t-18:2 (CLA)
• trans-palmitic (t16:1) has some health benefits – present in whole cow’s milk but not skim or reduced fat
• most isomers created by chemical hydrogenation are not found in nature, broader range of isomer distribution
• small differences can have large effects – cis vs trans, location of double bond
• JAMA 2012 – total plasma transfats have been reduced since labeling of transfats – also reduced trigylcerides
• labeling – anything below 0.5g / serving can be labeld 0g – so serving sizes reduced to prevent labeling of presence of transfats
• current diet recommendation (percent calories) – 60% carb, 20% protein, 20%% fat
• ketogenic – 60% fat, 20% protein, 20% carb
• obesity rates in US increase began around 1980 after low fat recommendations released
• CHD has not decreased
• ketones burn clean – no nitrogenous wastes, no reactive oxygen species
• mitochondria and ER dysfunction present in obesity and triggers inflammation via nfKb
• It is likely that natural metabolic state in prehistory time was metabolic ketosis
• people still confuse metabolic ketosis with diabetic ketosis / ketoacidosis
• ketoacidosis is a response to hyperglycemia – causes severe dehydration of tissues
• high insulin levels prevent fat from being released from adipose tissues
• diet is ketogenic when ketones levels are high enough to fuel mitochondria to make ATP
• key to metabolic ketosis is low carb intake and enough dietary fat to allow the liver to make ketones to supply all of the tissues
• kidney, liver, and heart always run on ketones regardless of diet – protective mechanism
• 3-4 days for body to convert, brain takes a little longer
• 2 metabolic ketosis 100 mile runners set world records – don’t hit “the wall” because they do not run out of glucose
• “the wall” may be due to brain not getting sufficient glucose
• metabolic ketosis very effective for long endurance athletes
• can test for metabolic ketosis with urine strips for higher ketone output in urine
• more diet fat leads to less body fat – body is burning fat instead of storing it
• ketogenic diet benefits – blood sugar goes down, blood cholesterol goes down
• saturated fat is more stable so better to eat – less prone to oxidation
• small dense LDL type B are responsive to carb intake
• essential fatty acids should be in the ratio of 3:1 o6 to o3
• ketogenic diet – the switch can be difficult for some but after a few days people generally feel better, become ketoadapted, can then eat carbs, just not so much to lose adaptation
• ketogenic diet – people report they do not feel as hungry, this is key to the ease of the diet
• cancer cells cannot use ketones for energy
• ketones can cross any cell membrane – do not need carrier or transporter
• some alzheimer’s patients have responded well to ketogenic diet
• statins reduce cholesterol production at liver – cholesterol is precursor to all steroid hormones, bile, etc, important to brain function (prevents memory loss and confusion) and wound healing

Denise Minger – One Size Does Not Fit All: Variation in Our Dietary Needs

• forced into world of health and nutrition to save her own health
• allergies, chronic sickness,
• vegetarian → vegan → raw food → omnivore
• 80/10/10 diet – losing hair in clumps, 16 cavities
• research interest began with The China Study
• 3 months analyzing the raw, original data – animal protein not associated with heart disease, wheat linked to heart disease and stroke
• inland vegetarian communities had highest mortality
• correlations in The China Study were cherry-picked
• posted critique on blog – rawfoodsos.com
• belief across diets that there is 1 perfect diet
• best sales are books that promote a cure-all/panacea/holy grail – promotes one-size-fits-all
• many trend diets have success initially
• weston a price found a wide variety of native diets which were health-promoting
• genetic changes may happen relatively fast
• what to do when ancestral lines are so mixed – what foods will people do best on
• genetic factors influencing starch tolerance, fat metabolism, vitamin A conversion
• salivary amylase – saliva contains alpha amylase – coded by AMY1 humans have between 1 and 15 copies, chimps have 2
• amylase can be barely detectable to 50% of human salivary
• high starch populations tend to have more AMY1 copies than low starch populations
• people with high vs low amylase levels will respond very differently to starch based foods
• 2012 study – Mandel and Breslin – seperate high vs low amylase producers – gave them 50g pure starch and later 50g of glucose and measured blood sugar levels after feeding
• low amylase producers reach higher peak blood glucose an maintained higher levels over time
• glucose did not have these results – glucose may be better than starch for low amylase producers
• AMY1 copy number may be linked to development of insulin resistance
• can test with crackers – chew, and how long does it take to get sweet will indicate AMY1 copy number
• ApoE phenotype – why do people respond differently to high fat diets
• some people on saturated fat heavy diet see blood lipids normalize and improve – others will see worsening blood lipids
• 2 copies of APOE gene which codes for Apolipoprotein E – immunity, neurobiology, fat and cholesterol metabolism
• ApoE2, ApoE3, ApoE4 variants
• ApoE4 – emerged before human-chimpanzee split evolutionarily – other variants not seen in other species, much newer
• ApoE4 – evolutionary context: emerged when low or sporadic access to animal foods, cycles of famine and abundance, high parasite load and infection disease
• today – hunter-gatherers, unreliable food supplies, extreme climate/latitudes
• 20% has 1 ApoE4, 2% has 2 – 20x higher alzheimer’s disease risk if 1 copy – most significant genetic factor in alzheimer’s disease, higher risk of heart disease, slower healing, but can hoard nutrients efficiently, can protect against certain diseases (Hep C), keeps cholesterol levels up during times of stress
• ApoE4 does not do well with sustained abundance, does not support longevity, does not help cholesterol into brain, does not heal brain injuries well
• 50-90% have ApoE3
• ApoE4 carries may do poorly on saturated fat, cholesterol, fat in diet
• ApoE4 do not do well with alcohol – heart disease and alheimers risk
• ApoE4 do not seem to get the benefits of omega-3’s – do not do well on seafood
• ApoE4 dietary guidelines – leaner animal products, cyclic eating and intermittent fasting, lower saturated fat intake, minimal refined carbohydrates, minimal heavy metal exposure (cannot detox efficiently), alcohol abstinence
• vitamin a conversion – why people crash and burn quickly on vegetarian/plant-based diets while others fare better for longer
• no plant foods contain vitamin a, must be converted
• retinol absorption is 70-90%, carotenoids is only 3%
• BCM01 polymorphism – conversion of carotenoids goes to almost 0
• nearly half the population carries a polymorphism that reduce conversion of carotenoids
• people with poor dietary conversion on plant-based diet have several common symptoms
• for those committed to plant-based diets – combine beta-carotenes with fat, fix low stomach acid, fix food allergies, fix other digestive issues, lightly cook beta-carotene rich vegetables
• we’re too different for one true diet
• one person’s success does not negate another’s failure/struggle and vice-versa
• personal experience cannot be generalized to others
• respect yourself and individuality
• 23andme.com for $99 genetic testing
• gene mutations that seem problematic today probably have had survival benefits historically or in other parts of the world

Dr. George Birnbach – Simple Steps to Doubling Your Practice While Doubling Your Time Off

• right things in the right order for the right amount of time
• hardest thing to do is to get people off the couch, into the car, and into the office
• NTPPractice.com
• don’t write goals that you can forget about
• is your practice as fun as buckets of kittens – if not, why not?
• Pretend you just accomplished your goal and tell people/yourself how you got there – the brain will fill in the details
• you can’t beat tincture of time, it takes time to get to vision
• pit of distraction – too much to know – current learn it fast enough and other priorities
• excited but not profitable stage – communication feels like wrestling
• acknowledge the objection (I understand), investigate it (ask a question, what, how long, what have you done up til now = positional history), master pronouns to master repor
• skill levels at speaking, history,
• most invalidated group women 35-55, with or without children, want to feel healthier and have more energy
• why is what I’m doing relevant to the client, to moving them forward, this is going to move you forward and this is why
• people bond to misery, not to success
• need to know failure stories more than success stories
• people sometimes don’t believe they can be better than they are
• motivation and discipline are inversely proportional – motivation is what you want, not discipline
• make appointments relevant
• 5 components to service business – marketing, delivery, money, admin systems, personal skills
• finding people, deliver care, getting money, admin systems (how practice works around you, roles), personal skills (communication, listening)
• start-up NTP – 2000 per month, part time work
• survival NTP – 4000 per month, full time work
• stability NTP – 6000 per month, overtime work
• success NTP – 12000 per month, all the time – burnout – need balance
• scale – office of people
• impact – vision of having an impact in helping people
• stress can be good, friction is bad
• retention works because of relevance
• attraction 1.0 – patient is the prize / attraction 2.0 – you are the prize
• let the passion drive the practice and let the systems drive the profit
• who you are, what you do, and why it matters to people
• patients are smart, evaluating validity, also looking for leadership
• marketing should be fun and automated
• 1 signature talk that represents you and your philosophy
• nextscripts.com – wordpress plugin to post fo facebook and twitter
• conversion 1.0 – hoping the client buys and stays engaged / 2.0 illustrate your philosophy to get people engaged in their care
• engagement instead of compliance
• “unfolding the napkin” – how to draw
• clients want certainty, simplicity, affordability
• delivery 1.0 all your time and energy / 2.0 skills, boundaries, relationships, learning and leading
• leading without caring is just manipulating, caring without leading is just irrelevant
• helping more people, having more fun, making a bigger difference
• eating habits set at age 9 according to the Rand corporation
• instead of writing and sharing goals, share frustrations instead – keep goals to yourself
• our skills and habits hold us back – unable to explain positions or relevance
• you are not your statistics, your statistics reflect your habits
• attraction – philosophy you can explain and put on the wall
• conversion – future pacing vision, this is where we are, this is where we’re going
• relevance and consistency
• draw what you believe in healthcare and why you believe it