Transcript Gut Health - Naomi Ferstera

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Gut Health
Gut Health
 “All disease begins in the gut” (Hippocrates)
 Not quite accurate but a significantly profound
statement considering when it was said
 Many chronic diseases are though to originate in
the gut
 Unsurprisingly inflammation is implicated in them
Gut Flora
 Gut flora is crucial to a healthy gut
 It is estimated there are over 100 trillion
microorganisms in the gut (Backhed et. al., 2005)
 Chris Kresser puts it like this: “The human gut
contains 10 times more bacteria than all the human
cells in the entire body, with over 400 known
diverse bacterial species. In fact, you could say that
we’re more bacterial than we are human. Think
about that one for a minute.”
The Role of the Gut
 Healthy gut flora is crucial to normal gut functioning
 The gut plays a role in
 Immune function
 Psychological function
 Providing a barrier between what is inside the body
with what is outside
 Digestion
 Nutrient absorption
Disease linked to gut dysfunction
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Autoimmune conditions (type 1 diabetes, psoriasis, Coeliacs,
inflammatory bowel disease (Crohn’s, Ulcerative colitis), lupus
etc.)
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Irritable bowel disease
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Alzheimer's (interestingly referred to as type 3 diabetes in this
article)
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Major depression
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Fibromyalgia and chronic pain
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Obesity (an emerging area)
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Non-alcoholic fatty liver disease (NAFLD)
What Disrupts the Gut
 Seed oils
 Grain
 Diets high in processed foods (refined carbs, sugar, processed
meats and fats)
 Chronic stress
 Chronic infections
 Medications (antibiotics, NSAIDs, birth control)
 All of these factors are able to change gut flora and
potentially increase the permeability of the intestinal barrier
Increased Intestinal Permeability aka
Leaky Gut
 “There is growing evidence that increased intestinal
permeability plays a pathogenic role in various autoimmune
diseases including [celiac disease] and [type 1 diabetes].
Therefore, we hypothesize that besides genetic and
environmental factors, loss of intestinal barrier function is
necessary to develop autoimmunity.” (Fasano et. al., 2009)
Leaky Gut
 Not all gut bacteria is good
 The food we eat and our lifestyles play a huge role in which type of
bacteria grow in the gut and this directly affects both our physical
and mental health
 Some bacteria in the gut (gram negative bacteria) contain
compounds called lipopolysaccharides (LPS) also known as
endotoxins (Raetz & Whitfield, 2002)
 Endotoxins are capable of causing an immune reaction
 When your gut is inflamed, it increases the permeability of the gut
which allows these endotoxins to escape into the blood stream
 This is capable of stimulating a low grade immune response
Leaky Gut
 It is thought that leaky gut could be the stimulus of diet-
induced inflammation
 Metabolic endotoxaemia is when endotoxin levels in the
blood increase up to 2-3 times higher than normal
 Metabolic endotoxaemia has been shown to rapidly
induce insulin resistance and obesity
 Inflammatory markers also rapidly rise which means an
immune response has been initiated
 Diet plays a role in endotoxin formation
Leaky Gut
 “Placing 8 healthy subjects on a Western-style diet for 1 month
induced a 71% increase in plasma levels of endotoxin activity
(endotoxemia), whereas a prudent-style diet reduced levels by
31%.” (Pendyala, Walker & Holt, 2012)
 Many studies have linked long-term high fat diets to increased
endotoxin release but these studies failed to restrict the variables
and contained refined carbohydrates in them also (thereby
nullifying the results/conclusions)
 It is thought that refined carbohydrates are capable of producing
endotoxins and increasing gut permeability
 Gluten (via the activation of zonulin) appears to be able to increase
gut permeability regardless of whether someone has Coeliac
disease or not (Drago et. al., 2006; Fassano, 2011)
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Improving Gut Health
Nutritional Plan
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Glutamine
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Picking your fibre
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Resistant starch
Prebiotic fibres
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Low FODMAP (?)
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Elimination of pro-inflammatory stimuli
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Increasing anti-inflammatory foods
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Sugar
Excess caffeine
Seed oils (omega 6)
Processed foods
Omega 3 (fatty fish)
Fermented foods (prebiotics)
Foods rich in antioxidants
Hydration
Restoring the Barrier
Glutamine
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Glutamine has been the most extensively studied amino acid with regards to
its effects on GALT (gut- associated lymphoid tissue) and the intestine. In
health, glutamine is categorized as a non-essential amino acid and represents
the amino acid in highest proportions in the body. However, during periods of
stress and during critical stages of development the essentiality of exogenous
sources of glutamine is now well-established to support growth and health in
young animals (Ruth & Field, 2013)
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Glutamine is an important energy substrate and precursor for the production
of enterocytes
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Many immune cells require glutamine to function
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“In addition to its role as an energy substrate, glutamine is important for
intestinal development and function, including maintaining the integrity of
the gut barrier, the structure of the intestinal mucosa and redox
homeostasis” (Ruth & Field, 2013)
Glutamine
Foods rich in glutamine:
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Poultry
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Meat
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Seafood
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Dairy
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Eggs
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Think - animal protein
Cooking destroys the amino acid so consider also:
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Raw spinach
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Dried lentils, peas and beans
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Cabbage
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Kale
Types of Fibre
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Lignin
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Cellulose
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β-Glucans
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Hemicellulose
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Pectins
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Gums
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Inulin
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Resistant starch
Classification of Fibre
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Soluble vs insoluble
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Fermentable vs non-fermentable
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Some fibres will ferment in the gut and provide food for gut bacteria
Prebiotic fibres
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Soluble dissolves in water whereas insoluble does not dissolve in water
All prebiotics are fibres but not all fibres are prebiotic
Promote the growth of healthy gut bacteria (Jerusalem artichoke, chicory root,
garlic, raw bananas)
Resistant starch
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a third type of fiber that provides the benefits of both insoluble and soluble
fibers
The term “resistant” refers to this starch’s ability to resist digestion
Instead, it passes to the large intestine where it produces the same effects of
soluble and insoluble fibers
Effect is especially significant when the starch is cooked then cooled
Veggies high in soluble fibre
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Carrots
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Winter squash
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Summer squash (especially peeled)
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tarchy tubers (yams, sweet potatoes, potatoes)
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Turnips
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Rutabagas
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Parsnips
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Beets
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Plantains
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Taro
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Yuca
Source: ChrisKresser.com
Veggies high in insoluble fibre
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Greens (spinach, lettuce, kale, mesclun, collards, arugula, watercress, etc.)
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Whole peas, snow peas, snap peas, pea pods
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Green beans
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Kernel corn
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Bell peppers
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Eggplant
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Celery
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Onions, shallots, leeks, scallions, garlic
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Cabbage, bok choy, Brussels sprouts
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Broccoli
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Cauliflower
Improving tolerance to insoluble fibres
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Remove stems and peels
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Dice, mash, chop, grate or blend
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Cook completely
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These will assist the body in digesting them
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We don’t need 6-8 serves of veggies a day and this
recommendation can further aggravate people with an
inflamed gut
Prebiotics
 Prebiotics were first defined as “nondigestible food ingredients
that beneficially affect the host by selectively stimulating the
growth and/or activity of one or a limited number of bacteria in
the colon, thus improving host health” [2]. This definition was later
refined to include other areas that may benefit from selective
targeting of particular microorganisms [3]: “a selectively
fermented ingredient that allows specific changes, both in the
composition and/or activity in the gastrointestinal microflora, that
confer benefits.” (Slavin, 2013)
 Classification of a food ingredient as a prebiotic requires scientific
demonstration that the ingredient:
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Resists gastric acidity, hydrolysis by mammalian enzymes, and
absorption in the upper gastrointestinal tract;
Is fermented by the intestinal microflora;
Selectively stimulates the growth and/or activity of intestinal
bacteria potentially associated with health and well-being.
Probiotics
 Probiotics are live bacteria and yeasts that are helpful in
maintaining a healthy gut flora
 “Brenner and coworkers conducted a meta-analysis in
2009 that included 16 randomized controlled trials
evaluating the efficacy, safety, and tolerability of
probiotics in IBS patients. B. infantis 35624 was the only
probiotic that showed any significant benefit in the
composite symptom score of IBS patients.
Bifidobacterium likely has a beneficial effect in the
symptom relief of IBS either as a single agent or in
combination with other probiotics, though the available
data are inadequate and further well-designed trials are
still needed” (Aragon et. al., 2010)
Probiotics vs Prebiotics
 The combination of the both provides the best result
 Evidence exists that probiotics/prebiotics assist in
 Reducing inflammation (Lescheid, 2014)
 Weight loss (Angelakis et. al., 2013)
 Reducing anxiety and depression (Messaoudi et. al., 2011; Luna &
Foster, 2015)
 Lowering small dense LDL (Davy et. al., 2002)
 Reducing blood pressure (Khalesi et. al., 2014; Dong et. al., 2013)
 Improving immune function (King et. al., 2014; Ozen, Sandal &
Dinleyci, 2015)
 Improving skin health (Baquerizo, Yim & Keri, 2014; Bowe, Patel &
Logan, 2014)
 Reducing/preventing allergies (Kuitunen, 2013)
Resistant Starch
4 Major Types
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Type 1 is found in grains, seeds and legumes and resists
digestion because it is bound within the fibrous cell walls.
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Type 2 is found in some starchy foods, including raw
potatoes and green (unripe) bananas.
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Type 3 is formed when certain starchy foods, including
potatoes and rice, are cooked and then cooled. The cooling turns some of
the digestible starches into resistant starches via a process called
retrogradation.
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Type 4 is man-made and formed via a chemical process.
Resistant Starch
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The main reason why resistant starch works, is that it functions like
soluble, fermentable fiber.
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It goes through the stomach and small intestine undigested, eventually
reaching the colon where it feeds the friendly bacteria in the gut
positively effecting number and type
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When the bacteria digest resistant starches, they form several
compounds, including gases and short-chain fatty acids, most notably a
fatty acid called butyrate
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Butyrate is actually the preferred fuel of the cells that line the colon
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Butyrate suppresses inflammation in the gut and other tissues (thereby
aiding in the prevention of colon cancer)
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Butyrate Increases Resistance to Metabolic and Physical Stress (Guyenet,
2009)
Healing the Gut Game Plan
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Intermittently fast
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Remove all pro-inflammatory foods and increase anti-inflammatory foods
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Eat fermentable fibres (e.g. sweet potato)
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Consume resistant starch (e.g. potato that has been cooked then cooled)
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Include fermented foods such as kefir, yogurt, kombucha, sauerkraut, kimchi etc.
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Take a probiotic intermittently (i.e. 1 week of every month)
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Get tested for and treat any intestinal parasite
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Manage your stress levels
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Exercise
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Get enough sleep
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Hydrate!! (reduce caffeine intake)