A few months ago I listened to Dr Neal Barnard on the Rich Roll Podcast, talking about hormonal balance. When his new book, Your Body in Balance was released, I was keen to read it and learn about this area of health that is not talked about enough. Barnard asserts the importance of hormonal balance, highlighting that when we achieve balance it can help prevent and cure a lot of serious health issues but that conversely, hormonal imbalances can be the cause of many health problems.
These problems include many common health issues such as weight problems, infertility, menstrual cramps, diabetes, erectile dysfunction, thyroid problems, acne and hot flashes, not to mention impacting our moods. Perhaps most notably, hormonal balance is central to some forms of cancer such as breast, testicular and pancreatic cancers.
The book covers a lot of health issues individually, but there are common themes that tend to span across multiple issues. Here I have tried to summarise those key themes, as well as highlight a few notable exeptions.
Barnard is tough on fat for a number of reasons, but the central reason is that fat cells stimulate hormone production in the body, particularly estrogen. In effect, excess body fat inherently leads to excess estrogen production, which is bad news not just for women but also for men. In fact, it’s the reason that overweight men grow man boobs.
That’s not the only reason that excess fat is bad news for hormone balance though. Fat cells capture and store toxic chemicals, which to some extent is your bodies way of protecting you from toxins, but in a world full of synthetic toxins that distupt hormonal balance, it means trapping more of these chemicals inside our bodies.
Fat is also central to type-2 diabetes as it causes insulin resistance. It is true that carbohydrates stimulate insulin release, however so do proteins. In fact, fish and beef stimulate insulin release to a higher degree than pasta and popcorn! Sugar is bad in that it is calorie dense and has no fiber, but the main problem with sugar is that it usually comes packaged inside fatty foods, and it is the fat that damages the body’s insulin receptors and reduces its ability to regulate blood sugar levels.
In pregnancy, saturated fat is strongly linked with morning sickness and is far less common in cultures that eat few animal products. The reason for morning sickness is that the mother’s immune system is weakened during pregnancy in order to minimise the risk of her body rejecting the embryo. To protect the mother from infection while her immune system is compromised, the body triggers the her to feel sick when she is exposed to things that have a high risk of causing infection, which mostly applies to animal based foods. That way, she will naturally avoid them and reduce her exposure to infection.
Fiber is central to good hormonal balance. It is a key part of the bodies system for flushing out excess toxins and hormones because it soaks them up in the intestinal tract and expels them. Without fibre, excess hormones get reabsorbed back into the bloodstream through the gut wall and since we are unable to get rid of them, they accumulate in our bodies.
Whole plant foods are all high in fiber, whereas animal foods and refined foods have no fibre.
Dairy has a big impact on hormones and Barnard is perhaps tougher on dairy than he is on fat.
Dairy contributes to hormal imbalances in a number of ways. Firstly, dairy itself contains hormones from the mother cow, which tend to be exaggerated because dairy cows are kept pregnant for nine months out of every twelve. Cheese is particularly bad because it is literally concentrated dairy, which concentrates the hormones such as estrogen.
It also stimulates excess hormone production in our own bodies, partly through contributing to excess body fat (see above), and partly by stimulating production of insulin growth factor 1 (IGF-1), which is strongly linked to cancer cell growth.
Plus, lactose is believed harmful to ovaries because the body breeds it into galactose, which is toxic to the ovaries. Lactose-free milk doesn’t help reduce this issue because it is simply milk where the lactose has been pre-digested into the glucose and galactose. Barnard makes the powerful assertion that being lactose intolerant is not a defect of the human body but is actually nature’s correct way of keeping us healthy and weaning us off dairy.
He also emphasises that dairy is a really bad way to get calcium. It’s much better to get it from plants such as green leafy vegetables.
Contrary to popular belief, soy foods such as tofu, miso and edamame do not contribute to hormone related cancers but in fact do the opposite. Soy beans reduce breast cancer risk in particular, because they contain high levels of isoflavones, which are chemicals similar to estrogen and testosterones, but which behave in a protective way. The isoflavones attach to estrogen beta receptors in the body, helping to inhibit cancer cell proliferation.
Exercise significantly reduces the risk of female infertility. It is reduced by about 5% per hour of vigorous exercise each week, so if you do four hours of vigourous exercise per week, the risk is reduced by 20%. That’s significant.
What is fascinating though is that jogging and running are far more powerful than most other forms of exercise. They reduce the risk of infertility by 22% and 34% per hour per week respectively. What better clue is there that we really are born to run!?
One important caveat applies here, which is that the benefits apply only up to the point that the individual remains a healthy weight. Being a little bit underweight is optimal for hormone balance, but significantly underweight can lead to problems. The fact that being slightly underweight consistently shows to be best for hormonal health may suggest that our measure of optimal body weight needs to be recalibrated and adjusted ever so slightly downwards.
Think twice before taking any form of synthetic hormone, including birth control pills and hormone replacement therapy. All of them have very real side effects, some more significiant than others. Barnard’s recommendation is to do everything you can naturally to get your own body in balance and look to synthetic solutions only as a last resort to real health problems. If you are considering it, read the manufacturers notes list of potential side effects of the specific drugs and do your own research before making a decision.
One notable item here is menopause, which Barnard highlights as a natural process that has been branded as a disease by the pharmaceutical industry. Absolutely, people should do what they need to do to minimise stress, pain and discomfort, but we should not try to fight the bodies natural process. He explains that menopause is in fact an essential process for the female body to recalibrate its hormonal balance once the ovaries have run out of eggs. Failing to do so would lead estrogen levels to rise, putting health at risk. Working with the body and not against it is therefore crucial.
Popular hormone replacement drugs for menopause have been proven to have dangerous side effects, including cancers, stroke, heart attacks and dementia. Particularly notable are Premarin and Prem Pro, manufactured from horse urine. Plant-based hormone replacement therapy drugs are generally better in the sense that that they are a biological match to human hormones. However, they’re safety is still unknown. Just because a hormone is bioidentical doesn’t make it safe. To illustrate this, even an excess of our own bodily hormones is dangerous to our health, so why should it be any different for hormones that we are taking as medication?
Fruits and vegetables are mood boosting and help reduce the risk of anxiety, depression and hostility. The opposite is true of meat and dairy, while high fat, low carb diets (even plant based) also have the opposite effect.
The benefits of whole plant foods are likely due to reduced inflammation in the body and brain, as well as fiber improving the health of the gut microbiome. Furthermore, micronutrients in plants such as isoflavones and folate can have a mood boosting effect.
Whole plant foods in general are good for skin health and low GI, high fiber foods have been found to be best for preventing and reducing acne.
An interesting anomaly however is that chocolate has been proven to cause acne. This is true even for 100% cocoa. However, nobody knows why!
In our modern world, we are exposed to synthetic chemicals that do not exist in nature and which can disrupt our hormone’s.
One of the most notable is BPA, which is found in the lining of most food cans. Unless a can states that it is BPA free, it almost certainly contains BPA. BPA disrupts hormones in both men and women. Bizarrely, one of the main sources of BPA exposure other than canned foods is thermal till receipts from shops. BPA used in the paper and is easily absorbed through the skin. Reciepts have therefore been proven to be a signficiant source of exposure for those who handle a lot of reciepts, such as shop attendents and book keepers.
Phthalates are also hormone disruptors found in most plastics and they leak into food and drink especially when the plastic is heated. this could be heating food in the microwave or simply leaving a bottle of drink in a hot car. They dissolve particularly well into fat, so heating fatty foods in plastic containers is best avoided.
If possible, buy food that is fresh, dried, or packaged without plastic, especially if it is wet, fatty food.
We should also minimise exposure to synthetic chemicals in food additives, household cleaning products, soaps, shampoos, toothpaste and if possible, also our drinking water.
It is worth noting that chemicals accumulate in fat cells, not just in the human body, but also inside animals, so fatty meat and fish, as well as dairy, also increase our exposure to environmental toxins. On the same note, it’s interesting that chemical levels have been found to be significantly lower in the breast milk of vegan women than meat-eating mothers.
Plant foods are not completely innocent though. Pesticides can have hormonal effects in the human body, so avoiding sources of pesticide exposure is recommended. The best way to do this is to choose organic foods. However, this is not always possible, so Barnard recommends prioritising organic for the foods listed in the Dirty Dozen, a list published each year showing which foods have the highest pesticide exposure. The 2020 list is:
Read more about the 2020 Dirty Dozen here. You’ll also find here the list of the Clean Fifteen, which are the foods with the lowest pesticide levels.
The best eating plans for hormonal health of all of are those that skip animal products and focus on the healthy food groups of fruits, vegetables, whole grains and legumes, including soy.
Barnard also highlights the importance of keeping overall micronutrient levels optimal, particularly vitamin D and B12, which for most people (even meat eaters) should be supplemented. He also highlights the importance of optimal Omega-3 levels, but warns that Omega-3 DHA supplements have been found to sometimes do more harm than good and should be avoided until this is better udnerstood. It’s also important to have a regular source of iodine for optimal thyroid function, either through iodised salt or sea vegetables such as nori and wakame, but too much iodine can be problematic so don’t over do it.
Also, avoid refined sugar, chocolate, caffeine and alcohol. They are not the worst offenders for hormonal health, but the less we consume of them the better.
Clearly there is benefit to taking regular, vigourous exercise, particularly running. It is also important to get plenty of sleep to allow the body to recover and rebalance. Thankfully, a healthy diet and plenty of exercise also contribute to better sleep.
Finally, in getting our hormonal balance in order, Neal Barnard emphasises that we should focus on diet and exercise first, and chemical exposure second. The chemical impact of our diets themselves is so significant that it would make no sense to do it the other way around.
Once again, it is interesting to note how the scientific evidence for optimal hormonal health points us to almost exactly the same lifestyle choices as we see for other health issues such as Alzheimer’s.