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Thursday, August 1, 2013

Inside Our Gut Feelings

I'm incredibly hyped about this post. I've seriously lost sleep thinking, reading and working on it! What I'm about to write, and I actually started to brush upon it in my last post, is the future. It's where conventional and alternative medicine, science, cuisine and of course, the industry, will head to for the upcoming years, and hopefully converge. 

Let's start with some good news: your body (and mine) weighs 4 pounds less than the number that the scale registers! 

Now that I've captured your attention, I'll explain. There's no new theory of gravity. What happens is that we have an extra organ in our body, that is not really part of our body (nor an actual organ) that weighs a bit more than 4 lbs. This organ is our intestinal (gut) flora, aka microbiome, biome, biota, friendly or good bacteria.
And why do I keep referring to it as an organ if it isn't one? Because the trillions of microorganisms (mostly bacteria, but there also are yeasts and other beings, which vary from person to person,) that populate our GI tract have such vital functions in our bodies, that they are as important as an actual organ. And we should take care of them!
Lately, more and more findings have been taking place regarding the amount, variety and actions of the microbiota, although a lot is still unknown. There's some exciting research going on, such as the American Gut Project,  which attempts to map all the microbes living in the bodies of the thousands of subjects of the general public (anyone who desires to participate in the study can do so, click on link above if you're interested) to understand the correlation between people’s lifestyle, diet, and health status with the makeup of their microbial community.
In past posts I've mentioned pro and prebiotics (just look at the previous entry), which are the stage names assigned to the friendly or good microorganisms that populate our gut (probiotics) and the food (prebiotics) that nourishes and helps them proliferate. So, to make it clear, probiotics are the bugs and prebiotics are their food.

So, what's the big deal? Here's what we already know about the functions of the gut flora:

  • PROTECTIVE: The biota keeps at bay pathogenic microorganisms in various ways:
- It occupies the physical space in our gut
- It consumes the nutrients that the pathogens may need
- It produces anti-microbial factors that would attack the unwanted bacteria, viruses and/or funghi. 

This explains why tourists may get Moctezuma's Revenge on their Mexican vacation (or anywhere else...), while the locals, whose floras are populated differently, can eat/drink the same things without suffering from food poisoning. Remember the scene in the Sex and the City movie (part 1) after Charlotte accidentally drinks water from the shower in Cabo?   

  • STRUCTURAL:
- The biota strengthens the host's immunity by triggering the secretion of IgA, a relatively non-inflammatory antibody that prevents foreign substances from being absorbed into the intestinal cells.

- It forms a physical barrier between the inside of the gut and the bloodstream.

- It tightens the cell junctions (space between intestinal cells), so no unwanted compounds can permeate in between cells, avoiding leakage. A leaky gut is when certain particles that shouldn't permeate from the intestines into the bloodstream, do make their way into the blood and cause reactions that could end up in inflammation, and therefore, disease, such as metabolic syndrome, eczema, allergies, asthma, celiac disease, Crohn's disease, IBD, other autoimmune diseases, even autism. 

  • METABOLIC: The microbiota is involved with our digestion, absorption and metabolism of certain vital substances. 
- It helps break down foods we can't digest
- It synthesizes vitamin K, B1, B2, B3, B6 and B12, certain neurotransmitters (including "feel-good" serotonin), enzymes, and other essential nutrients, such as amino acids and short-chain fatty acids, some of which play a role in brain function, and may even modify our temperament. 
- It produces signaling chemicals that regulate our appetite, satiety and digestion.

All this has such a powerful impact, that it's been suggested that the composition of our biota may be as, or even more important, than our genetic makeup. The most promising part is that although we are pretty much stuck with the biology we inherited from our parents, the composition of our biota can be modified, restored (or damaged) and cultured. And since microorganisms' adapt and multiply way faster than our bodies, this might work in our favor to help us adapt to changes in the environment and increase our immunity.

To understand a bit better all this impossible-to-understand stuff, let's talk about how we get our specific gut flora: While we are in our mother's womb, we are sterile, but during birth, we pick up our first batch of microorganisms from our mother's birth canal (OK, vagina). Then, breast milk follows. Once thought to be sterile, mother's milk contains both, pre and probiotics, which stimulate the colonization of the baby's gut (it's been shown that C-section and formula-fed babies' biota doesn't resemble as much to their parents' gut flora, but more to their skin's, which might not be as protective as the former). Then, during the first 3 years of life, with the introduction of solid foods and the environment (remember?, those are the years during which babies and toddlers put everything into their moths and you pray that she survives after licking everything in the playground's sandbox), the biota shapes into a more stable, adult-like microbioma, that could still change, but not as readily as in the first 3 years, because the flora is more strongly established, and the new microorganisms would have to fight harder for a spot in our gut. All those practices of  boiling the baby's pacifier every time it falls (best results are when the parents lick it!) and spraying all the toys and surfaces with Lysol after a play date, although well-intentioned, might not be for the best (not judging, I did it myself!). Why? Because by wanting to kill the bad germs, we're wiping out too the ones our little ones need, and we're interfering with the development of their bioma. I have nothing against cleanliness, but we might have to chill a bit in the antibacterial end, and learn when we should resort to Clorox, Purell or boiling water, and when just a milder way of cleaning would be best. 
A factor that interferes severely with the composition of our bioma at any age is the use of antibiotics; which are some times necessary to preserve our health, but the abuse of them might put it in danger. Antibiotics kill the bad, but also the good  microorganisms inside us. It's a good idea to make an effort to restore and replenish our flora after using antibiotics. This is easier said than done, as we don't know exactly what kinds and amounts of bugs we should ingest as probiotics (and variety seems to be key in a healthy flora), because we don't know with precision which ones we had before the antibiotics, and because often, probiotic supplements are not really what they state they are (no regulation!), or they don't survive the stomach's acidity. Although there are some proven to work. So far, diet might be the most controllable tool we have to work on our gut microcommunity from home and easily. Since foods are complex compounds, not isolated beings or nutrients, and are influenced by the environment where they were produced, non-industrialized foods might be the best vehicles of diverse good bacteria we have.
It's important to include:
  • Fermented foods (the fermentation process is caused by good bacteria and in some cases yeast), so they contain the actual bugs (probiotics). The most widely available are: kefir, yogurt (both with "live cultures," don't bother if the label doesn't state they are live this), and raw (again, don't bother if they're pasteurized) kimchi, sauerkraut, kombucha, miso, tempe and some pickles. Or, venture into making your own!
  • Prebiotics (mainly fiber): Different microorganisms eat different foods, so a variety of types of fiber (plant foods) is key to support a diverse community of microbes: whole grains, root vegetables, nuts, beans, bananas and other fruits, bran, leafy greens, Jerusalem artichokes, asparagus, garlic, onions, and avocados. For more on fiber, click here. Among other prebiotics are raw honey and raw apple cider vinegar.
  • Unprocessed foods: Quoting Michael Pollan (my favorite activity, and I must say I was tempted to just copy and paste the whole article!) in The NY Times magazine: "The less a food is processed, the more of it that gets safely through the [entire] gastrointestinal tract and into the eager clutches of the microbiota." Processed foods have been "predigested" for us, by removing layers of compounds and nutrients that our bodies and our biota need. A diet rich in processed foods with no fiber (or artificially added fiber that doesn't contain all kinds of fiber), lots of refined sugar, artificial chemicals and fats, doesn't feed our microbiota what it needs, so we're not only depriving our body from nutrients, but we're being rude hosts! Besides variety and nutritional structure of the food, the preparation (less is more) of it also affects the flora. As Pollan writes, "al dente pasta, for example, feeds the bugs better than soft pasta does; steel-cut oats better than rolled; raw or lightly cooked vegetables offer the bugs more to chomp on than overcooked, etc." So be gracious to your gut when you prepare a meal!
Scientists claim they are still far from completely understanding all the implications and mechanisms of our microbiota, thus refuse to make statements and reach conclusions too early. However, while researching this fascinating topic, I found out about Dr. Natasha Campbell-McBride. She became a medical doctor in her native Russia, practiced as a Neurologist and Neurosurgeon and later moved to the UK, where she earned a postgraduate degree in Neurology and another one in Nutrition. After her own child was diagnosed with autism, she developed a diet to treat him. Her results where so amazing, that she ended up "working with hundreds of children and adults with neurological and psychiatric conditions, such as autistic spectrum disorders, attention deficit hyperactivity disorder (ADHD⁄ADD), schizophrenia, dyslexia, dyspraxia, depression, OCD, bi-polar disorder and other neuro-psychological and psychiatric problems," and published her first book with the diet protocol (followed by 2 more books ), called Gut and Psychology Syndrome (GAP Syndrome or GAPS)™. The term refers to  "a condition which establishes a connection between the functions of the digestive system and the brain." She believes that an intestinal flora that is not well balanced or is damaged is to blame for for an endless list of diseases and conditions (that start with a leaky gut). One of the reasons why she caught my interest when I first read about her was that her diet is a modification of the SCD (Specific Carbohydrate Diet), a diet I'm familiar with through a client of mine who's been able to control his Crohn's disease completely (no medication whatsoever) by following the SCD, which is a restrictive diet, that offers great results for many digestive disorders. It requires lots of will power, organization and commitment, but it works! Dr Campbell-McBride's version aims to detoxify the body and once it's clean, to the biota (she claims that plant foods detoxify and cleanse our bodies, while animal foods help build and feed them...). Her method differs a lot from conventional medicine and she encourages, among other things, the consumption of homemade fermented foods, including the use of raw dairy transformed into yogurt, kefir and butter, as she claims pasteurization deprives the food from its probiotic qualities. As it happens every time a new idea is introduced in a field, some members of the scientific community criticise her, while others praise her, but I find interesting that her third book is a compilation of personal stories of patients documenting how the GAPS diet healed them....
This video is a brief explanation of her theory. And this is a list of all the diseases she says we can heal through her dietary protocol.

Bottom Line: There's a lot coming regarding our microscopic tenants. Perhaps the American Gut Project can help us understand Dr Campbell-McBride's theories (and demonstrate if they do work or not). While we wait, let's be super good hosts and take care of our flora. Let's encourage breast feeding, use antibiotics only when truly needed, eat lots of different kinds of fiber, learn to ferment foods, take preventive measures in case of a C-Section*, not go crazy with sanitation, decrease our processed food consumption, and love our gut!  
Plus, now we know that if we sit in a restaurant by ourselves, we will never be dining solo!

* Pollan writes that the head of the sequencing and analyzing lab he met, used a cotton swab to inoculate his newborn infant’s skin with the mother’s vaginal secretions to "insure a proper colonization after an emergency C-section. A formal trial of such a procedure is under way in Puerto Rico."

Recommended reading:

  • Dr. Campbell-McBride: http://www.doctor-natasha.com/index.php
  • Review article: Ecology of Host-Associated Microbial Communities: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2937523/
  •  Diversity, stability and resilience of the human gut microbiota:   http://www.nature.com/nature/journal/v489/n7415/full/nature11550.html
  • Pollan's article: http://www.nytimes.com/2013/05/19/magazine/say-hello-to-the-100-trillion-bacteria-that-make-up-your-microbiome.html?pagewanted=all&_r=0 

  • American Gut Project: americangut.org

  • Lisa Rose's Sauerkraut tutorial: http://www.realfoodkosher.com/simple-sauerkraut-a-probiotic-superfood/
  •  Boyd, C. Love Your Gut: The Startling Role of Intestinal Flora in Food Allergy and Celiac Disease. Living Without. USA August/September 2013
  • Egan, S. Making the Case for Eating Fruit in the NYT:  http://well.blogs.nytimes.com/2013/07/31/making-the-case-for-eating-fruit/?_r=1&

     
Pre and Probiotic Chilled Soup

This recipe is much better than the name I decided to assign it! Since there's no cooking involved, the bugs are still intact and quite delicious, plus there's plenty of fiber for them to enjoy the meal as much as you do. I made it with SO Delicious Dairy Free Cultured Coconut Milk, as kefir, because I was serving the soup during a meat meal. This product is a descent option when dairy is an issue, although it contains carrageenan, a sea vegetable extract that might trigger inflammation, and other additives so I wouldn't recommend it for daily use. Plain kefir from cow or goat's milk, preferably organic, are great options, or a homemade version with those milks or coconut milk (although I haven't found a pareve kefir starter with certification just yet, but will report if I do).


Ingredients

2 cups plain kefir (see note above)
30 green seedless grapes,
plus more for garnish

3/4 Brazil nuts (or almonds), preferably soaked overnight in water, drained and rinsed before using
1/4 cup original raw kombucha, optional

1 mini cucumber
3 dates, pitted
2 cloves garlic
1 tbsp  + 1 tsp white miso paste

2 tablespoons extra virgin olive oil, plus more for garnish
6 leaves fresh mint, more to taste and for garnish
1 tbsp raw, organic apple cider vinegar,
or more to taste
Sea salt
, to taste

Water, if needed

Method
Whiz everything, except the water, in a blender until completely pureed. If too thick, thin with a bit of water or more kombucha. Adjust seasoning, cover and refrigerate overnight.
Serve with sliced grapes, fresh mint and a drizzle of extra virgin olive oil.
Enjoy!

Serves 4. Can be doubled.

Mickey and his biota loved it!