GO WITH YOUR GUT

By Vicki Pepper MS, RD

Go With Your Gut 2018 Article with References

The need for a healthy gut and its impact on overall health is not a new concept. “All disease begins in the gut,” was penned over 2500 years ago by Hippocrates.  But unfolding research is redirecting our attention to just how important gut health is and how many aspects of your overall health it impacts.

Your digestive tract forms in the earliest stages of human development, when rapidly dividing cells of an embryo multiply around an empty space that eventually becomes a long tube surrounded by cells. This tube develops into your mouth, esophagus, stomach, small and large intestine. Almost every major organ connects to, or communicates with, your digestion tract ─ liver, pancreas, spleen, gallbladder, kidneys, even your brain. It is the highway through which everything you put in your mouth travels, where vital nutrition is absorbed, toxins are eliminated, and it is also home to a several trillion bacteria friends.

So small they can’t be seen by the human eye, bacteria catch a ride on the food you eat or drink and put down stakes in your GI tract and stay. Our germ-o-phobic culture may have led you to believe that bacteria are harmful, and while there are types of bacteria that can cause sickness, there are many, many strains of bacteria that play a beneficial, even vital role in your overall health. In fact, having healthy bacteria in your gut is so vital, nature is designed to inoculate us from birth.

In pregnancy woman produce hormones that cause the birth canal to become heavily populated with bacteria so newborns receive a healthy dose of good bacteria during birth.¹ Infants born by C-section, fail to receive this inoculation, and consequently, as adults they have higher risks of suffering from asthma, autoimmune disorders, heart disease, and diabetes compared to those born naturally.  You can’t change the way you were born, but there are lifestyle factors that you do have control over that can either harm or heal your gut health. Let’s look at some of these strategies.

The most important strategy keeping your gut healthy is to feed the beneficial bacteria that live in your GI tract. Fiber is food the bacteria in your gut needs to grow and multiply. Like any other living thing, if you want it to thrive and grow, you must feed it often and feed it good food. Fiber is the part of plant-foods we eat that we don’t digest and absorb. There are hard fibers like the strings on celery or the coating on corn kernels.  There are also soft gooey fibers like the pectin in apples or fibers found in vegetables and oatmeal. If the healthy bacteria in your gut don’t get enough fiber they die.  The type and number of healthy bacteria you have in your gut is directly related to the amount and variety of fibers you eat.

In rural Africa the occurrence of heart disease, diabetes, fatty liver, hypertension, irritable bowel disease, auto-immune disease, and many cancers are relatively uncommon.² Rural African’s consume 45-70 grams of fiber daily. Compare that to the average daily fiber intake for most American’s which is 15 grams a day, and then compare rates of diabetes, cancer, heart disease, etc., and you begin to appreciate the importance of a healthy gut.

In America, our high animal protein, sugar, and fat rich diets are starving our gut bacteria and we pay the price with our health.  A healthy gut needs lots of fruits, vegetables, nuts, seeds, legumes, and (if you tolerate them) grains.  Ideally, you want to get your fiber intake above 40 grams a day. What might that look like? Four servings of fruit, four cups of vegetables, ¼ cup of nuts or seeds, and one cup of beans totals approximately 40 -55 grams of fiber. Consuming a high fiber diet isn’t hard to do if you are eating a mostly plant-based diet.

Certain fibers are particularly helpful for promoting healthy gut bacteria. The fibers in beans are a desired food source by friendly bacteria in your gut.⁴   One quarter cup of beans a day dramatically increases healthy gut bacteria populations and decreases the number of harmful bacteria within just a few days of eating them.  This may be one reason why many studies indicate that people who eat beans daily, live longer and have much less occurrence of diabetes, cancers, and heart disease.

Choosing a rainbow of colors in your vegetables and fruits provides you with two advantages for gut health. Colorful produce provides a wide variety of fibers to encourage the growth of healthy bacteria populations in your gut. Secondly, the colored pigments in fruits and vegetables have powerful anti-inflammatory properties. If you suffer from bloating, frequent bouts of diarrhea, colitis, irritable bowel, heart burn, Celiac’ s or Crown’s disease, these pigments can help heal inflamed tissue in your digestion tract at the same time as feeding healthy bacteria.  There are some fruits and vegetables that have especially powerful anti-inflammatory properties and they include broccoli, Brussel sprouts, cabbage, cauliflower, kale, all types of sprouts (especially broccoli sprouts), all types of berries, kiwis, peppermint, and turmeric.

Another great source of the beneficial gut bacteria can be found in daily servings of fermented vegetables^.4   A long-time staple in all cultures, fermented foods like sauerkraut, tempeh, miso, kimchi, and kefir are already partially digested by naturally occurring bacteria. They contain large amounts of beneficial strains of bacteria and the fibers needed to encourage growth. They are the perfect probiotic.

Cooking your fruits and vegetables does not eliminate their healing properties, however there is good reason to eat at least ½ of your daily fruits and vegetables raw³, particularly if you are trying to heal from any disorders of the gut. Every type of produce naturally develops a unique collection of bacteria that thrive on the surface of the produce. When you eat raw vegetables and fruits you get healthy doses of beneficial bacteria. This is an inexpensive, easy, and safe way of taking in the right kinds of probiotics (bacteria). While over-the-counter probiotic supplements have become popular, the science behind how much and/or what strains of bacteria are needed for optimum health is still not well understood. Until healthy gut biome is better understood, it is better to get your probiotics naturally from food and probiotic supplements should be avoided.

Artificial sweeteners, highly processed foods, or high sugar content foods should be avoided. Artificial sweeteners are not digested or absorbed in your small intestine, instead they travel to your colon and are digested there by bacteria. Once thought to be a great tool for diabetics and obesity, research indicates that artificial sweeteners elevate blood sugars and aggravate obesity. More alarmingly, a few studies indicate artificial sweeteners may promote the growth of harmful bacteria in your gut.¹⁰ Processed foods are typically low fiber and high in sugar and has a negative effect on gut health as well.

Two Brains are Better Than One. The gut is often called your second brain because digestion in your gut sends signals to your brain, and influences a multitude of metabolic pathways in your body. As bacteria in your gut digest fiber, short chain fatty acids are produced. These fatty acids feed the cells that make up the delicate skin layer that lines your colon. This stimulates the cells to send signals along the central nervous system to your brain.  In this way, your gut directly influences many aspects of health.

Free fatty acids in the gut stimulate the release of hormones that control appetite and weight regulation. Studies indicate that unhealthy balance of gut bacteria (dysbiosis) is correlated with obesity. Dysbiosis in the gut has been found to cause weight gain even when calories and activity are controlled.  Anyone wanting to lose weight and keep it off, will need to work on lifestyle behaviors that support gut health. The production and release of many neurotransmitters are affected by gut signals as well, which affects mood, mental clarity, and behavior. Gut dysbiosis has been linked to depression, anxiety disorders, and autism. Fertility, erectile function, and heart health are also influenced by gut health and there may be links with certain cancers and gut dysbiosis is considered one of the initiating factors in autoimmune disorders.

Other lifestyle factors have a direct impact on the types and quantities of bacteria in your gut. Environmental toxins and pesticide residues on foods or leached toxins from plastic in food containers, cleaning solvents, stain and fire-resistant chemicals used in textiles, pollution in the air and water, all damage healthy gut bacteria and may cause harmful types of bacteria to proliferate. Certain drugs such as antibiotics, acid blockers, and anti-inflammatory drugs, have an adverse effect on gut health and should only be used when necessary. Studies show that interrupted sleep, lack of exercise, and stress affect hormonal balances that can negatively impact gut bacteria so these are important lifestyle factors to work on as well.

How do you know if your gut is in trouble?  Problems in the gastro-intestinal tract can be an indicator of possible poor gut health. If you suffer from chronic bloating, cramping, bouts of unexplained diarrhea, constipation, or irritable bowel, you should work on improving your gut health and get checked by your physician. These are signs that you may have gut dysbiosis. Because gut bacteria play such a role in many metabolic pathways, symptoms that don’t involve the GI tract may show up that you might not think would be related to your gut. Weight gain or difficulty losing weight, achy joints, chronic low-grade anemia, heart palpitations, mental fog, depression, chronic fatigue, headaches, acne, hair loss, arthritis, or auto-immune disease may be signs your gut is in trouble.

There are a few simple ways you can evaluate your gut health on your own. First, observe the volume of your stools. A healthy gut should produce twice the volume of stools than the volume of food eaten. How is that possible? Stools contain 55% dead bacteria cells. A healthy gut has a rapid turnover of bacteria cells and should produce a high volume of dead cells.  Remember Africa, where heart disease, fatty liver, and diabetes is rare? Rural Africans have 3-4 bowel movements daily. If you are not having at least one large bowel movement a day, your gut health needs work. Ideally, you should be eating enough fiber to become a super pooper – 2-3 bowel movements a day. Measure the transit time of your bowels. A healthy gut will eliminate in 12-24 hours. Try eating beets which stain the bowel movements red and measure how long it takes to eliminate. If you are taking more than 24 hours to pass a bowel movement, you need to work on your gut. Lastly, observe if your bowel movements have the shape of a soft banana. If you have small hard balls, compacted balls, or overly loose stools, you need to work on gut health.  If you want help improving your nutrtion, eating for gut health, increasing your fitness, and/or losing weight, consider attending one of our Free Nutrition/ Fitness Forums. Locations and times are listed on our website positivechoice.org/Nutrition Fitness Forum

If you are experiencing symptoms despite treatment from your primary care physician, you may want to try integrative medicine approach called the Elimination Diet. An Elimination diet is a diet rich in fresh fruits, vegetables, and legumes and removes foods that may aggravate the gut (some of the grains, dairy, soy, or eggs) for a period of 30 days or longer. People who are having severe symptoms may need to remove nuts, seeds, and nightshade vegetables for a while as well. Then each food group is slowly reintroduced and tested for tolerance. You can read more information on the elimination diet on our blog at positivechoice.org/blog/elimination diet. If you need more help you can schedule an appointment with one of our Integrative Medicine physicians. The appointments are $250/hr. and include a detailed review of your medical history, food records, medications and supplementation, sleep cycles, etc.

Lastly, if you are trying to lose weight, please consider making as many lifestyle changes for good gut health as you can.  Losing weight and keeping it off are hard enough and you don’t want gut dysbiosis to interfere with your hormones and make your progress harder. The Positive Choice Integrative Wellness Center offers comprehensive weight loss programs that don’t just end with weight loss. Long-term weight maintenance support is offered and we offer several different types of weight loss programs to accommodate different needs. Our weight programs help resolve type 2 diabetes (75% remission rate), hypertension (33% remission), hyperlipidemia (80% remission), and fatty liver disease. If you want more information you can download detailed information online at positivechoice.org or attend one of our weekly Information Sessions, call or see website for dates/locations and times. Look in the calendar section of website.

References:

1. Nuriel-Ohayon M, Neuman H, Koren O. Microbial Changes during Pregnancy, Birth, and Infancy. Frontiers in Microbiology. 2016;7:1031. doi:10.3389/fmicb.2016.01031
2. O’Keefe SJD, Li JV, Lahti L, et al. Fat, Fiber and Cancer Risk in African Americans and Rural Africans. Nature communications. 2015;6:6342. doi:10.1038/ncomms 7342.
3. David A. Relman: Nature551, 571–572 Microbiota: A high pressure situation for bacteria
4. Selhub EM, Logan AC, Bested AC. Fermented foods, microbiota, and mental health: ancient practice meets nutritional psychiatry. Journal of Physiological Anthropology. 2014;33(1):2. doi:10.1186/1880-6805-33-2.
5. AN Payne, C Chassard, C Lacroix– Obesity reviews, 2012 – Wiley Online Library
6. J Suez, T Korem, D Zeevi, G Zilberman-Schapira… – Nature, 2014 – nature.com
7. J. Turnbaugh, Peter J., Gordon, Jeffrey I.: The core gut microbiome, energy balance and obesity, The Journal of Physiology, 2009 587 – 17
8. An obesity-associated gut microbiome with increased capacity for energy harvest PJ Turnbaugh, RE Ley, MA Mahowald, V Magrini… – nature, 2006 – nature.com
9. Nuriel-Ohayon M, Neuman H, Koren O. Microbial Changes during Pregnancy, Birth, and Infancy. Frontiers in Microbiology. 2016;7:1031. doi:10.3389/fmicb.2016.01031O’Keefe SJD, Li JV, Lahti L, et al. Fat, Fiber and Cancer Risk in African Americans and Rural Africans. Nature communications. 2015;6:6342. doi:10.1038/ncomms7342.
10. A clinician’s primer on the role of the microbiome in human health and disease S Khanna, PK Tosh – Mayo Clinic Proceedings, 2014 – Elsevier