At a talk by Bruce Hirsch on FMT and he just said, referring to antibiotics, “What happens in the gut doesn’t stay in the gut.” I thought that was well put.
– Christian John Lillis on 3/9/2016
Well put indeed! Dr Hirsch succinctly summed up, in one short sentence, antibiotics’ huge, deleterious impact on the probiotic bacteria living in our gut microbes … and from there to the rest of the body. Wreck your gut microbiome and you’re wrecking your health.
Bruce E. Hirsch, MD
Specialist in Infectious Disease & Geriatric Medicine
The mission of the Peggy Lillis Foundation is to build a nationwide clostridium difficile awareness movement by educating the public, empowering advocates, and shaping policy.
The PLF envisions a world where C. diff is rare, treatable and survivable.
What is Clostridium difficile infection?
“Clostridium difficile [pronounced Klo-STRID-ee-um dif-uh-SEEL], also known as “C. diff” [See-dif], is a germ that can cause diarrhea. Most cases of C. diff infection occur in patients taking antibiotics. The most common symptoms of a C. diff infection include:
Watery diarrhea
Fever
Loss of appetite
Nausea
Belly pain and tenderness “
– Centers for Disease Control and Prevention, 2015
Updated 8/29/2014, 9/7/2015, and 4/15/2016. NOTE added at end of post on 9/6/2015. Last updated 10/22/2016.
In the global diabetes epidemic, rates of new cases are rising rapidly. I hope this post will help you avoid becoming one of them.
Number of People Diagnosed with Diabetes
Millions, by region
Source: IDF Diabetes Atlas, Sixth Edition; Managed Care calculation of percentages using data from The World Factbook, published by the CIA
TYPES 1 & 2 DIABETES: AUTOIMMUNE DISEASES
(Source: igennus.com)
During digestion, most of our food gets broken down into glucose (a form of sugar that’s the body’s main source of fuel), which then passes into the bloodstream. Insulin (a hormone produced by the pancreas) must also be present in the blood for glucose to be able to make it into our cells to nourish them.
Type 1 diabetes is known to be a serious autoimmune problem of the metabolism. An autoimmune disorder or disease is a result of chronic inflammation in the body’s immune system, causing it to turn against a part of the body – to attack it as if its cells were dangerous, invading pathogens. In Type 1 diabetes, the immune system attacks and destroys the insulin-producing cells in the pancreas. (WebMD, 2008)
Type 2 diabetes is now also largely viewed as the result of a different type of autoimmune reaction: one in which B and T immune cells cause inflammation in the fatty tissue surrounding organs in the body. The inflammation occurs when rapidly growing fat cells outstrip their blood supply and begin to die off. These dying cells spew out their contents, and macrophages (another type of immune cell) are called in to clean up the dead cells. “The resulting onslaught by the immune system inhibits the ability of the remaining fat cells to respond to insulin and causes fatty acids to be shed into the blood. This sets in motion a physiological cascade that leads to fatty liver disease, high cholesterol, high blood pressure and further insulin resistance throughout the body.” (Conger, 2011)
TYPE 1 DIABETES
(Source: www.imagekb.com)
In Type 1 diabetes, which used to be called juvenile diabetes, the immune system mistakenly kills off pancreatic cells that make the blood-sugar-regulating hormone insulin. The body’s immune system attacks and destroys these pancreatic cells so they no longer make enough insulin.
Type 1 diabetes accounts for about 10% of diagnosed diabetes in the US.
TYPE 2 DIABETES
In Type 2 diabetes, the pancreas usually produces enough insulin but the cells in the body have become unable to make effective use of the hormone, a condition called insulin resistance. Insulin production eventually decreases. So, as in Type 1 diabetes, glucose builds up in the blood instead of being properly delivered to the cells in the body where they’re needed for fuel.
(Source: www.webmd.com)
Type 2 diabetes is associated with obesity, older age, family history of gestational diabetes, and physical inactivity. About 80% of people with Type 2 diabetes are overweight. Unfortunately, Type 2 diabetes is also increasingly being seen in younger people, even children and teens.
PREDIABETES
(Source: prediabetescenters.com)
A prediabetic condition indicates the amount of glucose in the blood is above normal but not yet high enough to be called diabetes. Prediabetic people are at greater risk of developing Type 2 diabetes, heart disease, and stroke.
DIABETES STATISTICS IN THE US
Statistics from the American Diabetes Association Report, 2014 show the magnitude of the problem in the US:
PREVALENCE: In 2012, 29.1 million Americans, or 9.3% of the population, had diabetes.
Approximately 1.25 million American children and adults have type 1 diabetes.
UNDIAGNOSED: Of the 29.1 million, 21.0 million were diagnosed and another 8.1 million were undiagnosed.
PREVALENCE IN SENIORS: The percentage of Americans age 65 and older remains high, at 25.9%, or 11.8 million seniors (diagnosed and undiagnosed).
NEW CASES: The incidence of diabetes in 2012 was 1.7 million new diagnoses/year; in 2010 it was 1.9 million.
PREDIABETES: In 2012, 86 million Americans age 20 and older had prediabetes; this is up from 79 million in 2010.
DEATHS: Based on the 69,071 death certificates in which diabetes was listed as the underlying cause of death in 2010, diabetes was the 7th leading cause of death in the United States that year. In 2010, diabetes was also mentioned as a cause of death in a total of 234,051 certificates.
CAUSE OF DEATH UNDER REPORTING
Diabetes may be under reported as a cause of death. Studies have found that only about 35% to 40% of people with diabetes who died had diabetes listed anywhere on the death certificate and only about 10-15% had it listed as the underlying cause of death.
DIABETES IN YOUTH
About 208,000 Americans under age 20 are estimated to have diagnosed diabetes, approximately 0.25% of that population.
In 2008—2009, the annual incidence of diagnosed diabetes in youth was estimated at 18,436 with Type 1 diabetes, 5,089 with Type 2 diabetes.
Some other diabetes statistics showing the seriousness of the problem:
Below are diabetes prevalence data from the US Centers for Disease Control and Prevention. The number of reported cases tripled between 1980 and 2008. The CDC estimates that “the number of Americans with diabetes will range from 1 in 3 to 1 in 5 by 2050.”
And here’s information from the International Diabetes Federation comparing reported cases of diabetes in 2013 with projected cases by 2035 for countries around the world – an expected increase of 55%.
GUT BACTERIA & DIABETES
(Source: blog.medbiomarkers.com)
Researchers are discovering changes in normal gut bacteria that take place before either Type 1 and Type 2 diabetes turns into a clinical condition. Since we now know that 70-80% of our immune system is located in our GI tract, where digestion takes place, you can see how a serious imbalance in the bacterial make up of the gut microbiome could lead to the development of diabetes in people with a genetic predisposition for it.
“Mounting evidence suggests that the bacteria resident within our GI tract – and the immune response to those bacteria – influence the permeability of the gut mucosa. This idea — which has become to be known as the “leaky gut” hypothesis — proposes that a cycle of dysbiosis, dysregulated immune response, and unintended gut permeability leads to the peripheral host immune system being unbalanced towards a pro-inflammatory response. This in turn is suggested to lead to (some of) the imbalances that are thought to be causative of diabetes and other non-metabolic disorders.” (Moore, 2015)
GUT BACTERIA, ANTIBIOTICS & RISK FOR DIABETES
(Source: probiotics.org)
A team of scientists led by Dr Ben Boursi, a Post Doctoral Researcher in Gastroenterology at the University of Pennsylvania in Philadelphia, found people who have taken multiple courses of antibiotics were 37% more likely to develop Type 1 and Type 2 diabetes. The team also found the greater the number of courses of antibiotics, the higher the risk for developing diabetes.
Dr Boursi notes, “Our findings are important, not only for understanding how diabetes may develop, but as a warning to reduce unnecessary antibiotic treatments that might do more harm than good.”
(Source: www.asnailsodyssey.com)
Several studies in humans have shown that early childhood exposure to antibiotics is associated with increased risk of obesity in later life – and obesity has long been recognized as risk for developing diabetes.
There’s also growing evidence that imbalances in the gut microbiome’s composition contribute to the development of both Type 1 and 2 diabetes.
The Boursi team’s future research will focus on identifying the species of gut bacteria necessary to prevent and reverse diabetes, potentially working towards the possibility of transplanting prebiotic and probiotic microbes into the gut as a therapeutic strategy for diabetes. (Arendt, 2015) & (Davenport, 2015)
PREDIABETICS HAVE FEWER & LESS DIVERSE GUT BACTERIA
(Source: www.mayo.edu),
A research team led by Dr Elena Barengolts, an Endocrinologist at the University of Illinois College of Medicine, found irregularities in the composition of the probiotic bacteria in the guts of prediabetic patients: Compared with subjects whose glucose tolerance was good, the prediabetics had fewer and less diverse populations of bacteria living in their gut microbiomes.
There were 116 participants in the study, all African-American veterans. Their ages ranged from 45 to 70. Their intestinal bacteria were measured by stool samples at the start of the study and again 12 months later.
Participants were divided into four groups based on their body’s ability to regulate blood sugar:
Group 1 – Those with stable glucose tolerance (normal)
Group 2 – Those with stable impaired fasting glucose or stable impaired glucose tolerance
Group 3 – Those with worsened glucose tolerance
Group 4 – Those with improved glucose tolerance
The study found that men whose blood sugar control remained normal over the year (Group 1) had higher numbers of beneficial gut bacteria while the men who continued to be prediabetic had fewer beneficial bacteria and higher numbers of harmful bacteria in their guts.
Furthermore, the group whose blood sugar management improved over the course of the year (Group 4) had a higher number of a strain of healthy bacteria (Akkermansia) than the group who had maintained normal blood sugar control over the year (Group 1). (Gray, 2015)
(Source: humanfoodproject.com)
At the phylum level, this study found significant differences in the bacterial composition between Groups 1 and 2: Group 2 (people with impaired but stable fasting glucose or glucose tolerance) had higher levels of Bacteroidetes and lower levels of Firmicutes than people in Group 1.
The Bacteroidetes/Firmicutes ratio was 1.9 vs 0.9 respectively for Groups 1 and 2 and 1.9 vs 1.1 respectively for Groups 1 and 3.
The number of Proteobacteria decreased over the 12-month study period in Groups 2 and 4 compared with Group 1. Proteobacteria are a major phylum of gram-negative bacteria that include a variety of pathogens – such as Escherichia, Salmonella, Vibrio, Helicobacter, and Yersinia. (Wikipedia, 2015)
(Source: www.yourwildlife.org)
At the family and genus levels, Group 2 had fewer Prevotella and a higher Bacteroides/Prevotella ratio than Group 1: 5.6 vs 2.7. Group 2 also had fewer Enterobacteriaceae (a large family of bacteria that includes the pathogens Salmonella, Escherichia coli, Yersinia pestis, Klebsiella and Shigella) and more Ruminococcae and Veillonellaceae.
“We speculate that lower abundance of Prevotella may be associated with worsening glycemia, and, conversely, higher abundance of Akkermansia might be associated with improving glycemia, thus corroborating suggestions from previous studies,” the researchers said.
Barengolts notes, “Changes in the gut microbiota occur in the early stage of diabetes development. The gut bacteria signature — the composition and abundance — could be a useful tool in assessing a person’s risk for developing obesity and diabetes.” (Ciubotaru et al, 2015) & (Brown, 2015)
Other studies are currently underway in Italy and China investigating gut bacterial transplants as a treatment for diabetes.
ALTERED GUT BACTERIA PRECEDE TYPE 1 DIABETES IN CHILDREN
(Source: www.nlm.nih.gov)
A small study followed 33 babies from Finland and Estonia who were at increased genetic risk for developing Type 1 diabetes. Analysis of their stool samples charted changes in the multitude of microorganisms living in their guts.
By age three, four of the children developed Type 1 diabetes. Huge alterations in the gut microbes of those those four children were seen about a year before onset of the disease. As with the men in the veterans’ study, there was a marked drop in the diversity of the overall microbial community. This drop in gut diversity was accompanied by spikes in inflammation-favoring organisms, gene functions, and serum and stool metabolites. These changes in gut microbial levels did not occur in the at risk children who didn’t progress to Type 1 diabetes.
Researcher Dr Aleksandar Kostic, a Postdoctoral Fellow in Computational Biology and Experimental Biology at MIT and Harvard, hopes the study’s results will lead to an early diagnostic test for Type 1 diabetes. (Kostic et al, 2015) & (Norton, 2015)
PREVENTING & TREATING DIABETES VIA THE GUT MICROBIOME?
Bacteria in the Human Gut
(Source: ehp.niehs.nih.gov)
Given what we already know about the gut microbiome’s role in keeping the body in a balanced state so it remains healthy, it makes sense to focus on diet and nutritional supplements for preventing and treating diabetes.
For example, we know there is considerable variation among people in the microbes that live in and on us. We also know that an individual’s microbial populations are always changing.
The following is from an easy to read summary of changes in the various human microbiomes from birth through old age. It was prepared by the University of Utah’s Genetic Science Learning Center (2015). You might want to take a look at it – it provides useful information along with some delightful drawings:
“Before birth, we’re all more or less sterile—we have no microbes. Within a few years, we’re covered in thousands of different species of microbes, and they colonize every millimeter of the body that’s exposed to the outside world. By the time we enter kindergarten, we have vastly different populations living in the different habitats around our bodies. Even as adults and into old age, our microbiota continue to shift.
” … Because so many things affect our bodies’ ecosystems, there is a huge amount of variability in microbial populations even among individuals of the same age. Just like our fingerprints vary, we vary in the microbial species we have as well as their relative abundancies. Our microbes vary with gender, diet, climate, age, occupation, and hygiene. Even differences in our genes influence our microbial populations—indirectly by affecting things like the acidity of the digestive tract, and also more directly through variations in proteins on our cells that communicate with microbes.
“Even with all this variability, there are some trends. Microbial populations differ more among body sites than between individuals. For example, the microbes living on the forearms of two different people tend to be more similar than the microbes on the forearm and ear of the same person. And there are certain species of bacteria that will only live in the gut, others that will live only on the teeth, and so on.”
GENETICS VS EPIGENETICS
(Source: thescienceofreality.tumblr.com)
We also know this about autoimmune diseases: DNA IS NOT DESTINY
Chronic diseases, especially autoimmune ones, are only 25% determined by genetic inheritance. The other 75% is affected by other factors. It’s a matter of genetics vs epigenetics. You may have a genetic predisposition for diabetes but also have a large say in whether your DNA expresses that predisposition in your body.
“We know from twin studies, from identical twin studies, that 25% of autoimmunity is your genetics, and 75% is from the environment. … So that’s an enormous amount that we have control over and can influence.”
Amy Myers, MD. (Sanfilippo, 2015)
If we know that both the composition and abundance of micro-organisms living in our guts change over the course of a lifetime, shouldn’t it be possible to learn how to make deliberate changes to our gut microbiome – changes that prevent diabetes from developing even if we have a genetic predisposition for it?
TO AVOID OR REVERSE INSULIN RESISTANCE
These are Dr Robert Mercola’s suggestions for turning insulin resistance around (Mercola, 8/23/2015) & (Mercola, 8/27/2015):
AVOID SUGAR
(Source: www.sugarauthority.com)
EAT REAL FOODS INSTEAD OF PROCESSED ONES
Almost all so-called foods that come in a bottle, can, jar, bag, or box have had sugars added to them, usually in the form of high fructose corn syrup.
EAT FRESH FRUIT INSTEAD OF PURCHASED FRUIT JUICES
(Source: www.foodinsight.org)
Commercial fruit juices are loaded with added sugar.
AVOID “DIET” FOODS AND DRINKS
They promote insulin resistance and other health problems. “The artificial sweeteners saccharin, sucralose, and aspartame decrease function in pathways associated with the transport of sugar in your body, and can induce both gut dysbiosis and glucose intolerance. Research also shows that artificial sweeteners promote diabetes and weight gain by disrupting your gut microbiome. Sucralose (Splenda) was found to reduce beneficial gut bacteria by as much as 50 percent!”
AVOID GRAINS, ESPECIALLY WHEAT, BARLEY, OATS & RYE
(Source: www.thepaleomom.com)
Grains turn into sugar in your body, sharply raising your glucose and insulin levels, and contribute to insulin resistance. Many grains also contain gluten, which triggers inflammation in the intestines, leading to a state of chronic inflammation in the body and autoimmune diseases.
Consuming a lot of refined grains (and even whole grains) is also highly inflammatory for another reason: Humans are designed to eat a diet containing a ratio of 1 or 2 parts of Omega-6 essential fatty acids to every 1 part of Omega-3. This ratio is what we get when we eat real, unprocessed, highly nutritious foods – non-GMO veggies, fruits, nuts, seeds, and pastured animals. Our typical diet now has come to contain 10 to 20 parts Omega-6 to every part Omega-3 – producing a highly inflammatory state in the body. (Kratka, 2011)
“Grains are almost single-handedly responsible for the removal of omega-3 fatty acids in the modern diet…. There have been over 2000 studies done on omega-3 and for good reason: the omega-3s in our diet (or the lack their of) have massive implications on our health. It all boils down to ratios: the ratio of omega-3 to omega-6 fatty acids in your diet is so crucial, it goes down to the cellular level.” (Kratka, 2011)
Better alternatives to grains are non-GMO almond meal, coconut flour, buckwheat groats, and sweet potatoes. They are much gentler on your blood sugar than grains. Mercola points out that even these healthier alternatives will hamper your body’s ability to heal if you’re already insulin resistant. “Once the clinical signs of insulin resistance have resolved, you can relax your carb restriction.”
Eat fewer saturated and trans fats (unhealthy) and more mono and poly unsaturated fats (healthy). Examples of healthy fats include avocado, butter made from raw grass-fed organic milk, cheese, raw dairy, organic pastured eggs, raw nuts, grass-fed meats, and coconut oil.
(Source: www.familygonehealthy.com)
Due to the high percentage of nutrient-poor foods, refined carbohydrates, bad fats, and refined sugars in the Standard American Diet (SAD), along with consumption of multiple OTC and prescription pharmaceuticals, we are far from getting the optimal ratio of 1:1 for Omega-6s (inflammatory) and Omega-3s (anti-inflammatory). The ratio in our modern Western diet is often as high as 20:1, creating excessive, chronic inflammation in the body – and chronic inflammation is a precursor to many diseases.
(Source: www.betterhealthinternational.com )
GET ENOUGH VITAMIN D3
Having a sufficient blood level of Vitamin D is essential for maintaining good health and preventing a wide range of autoimmune and neurological diseases: Type 1 and 2 diabetes, asthma, allergies, cancer, Alzheimer’s, MS, susceptibility to infection (including viral respiratory infections) among them.
(Source: jdshometraining.com)
Vitamin D3 is vitally important for healthy immune functioning – and most of us are seriously D3 deficient. Unless we work mostly naked outdoors in a sunny climate without slathering our skin with sunscreen, we can benefit greatly from adding a high quality D3 supplement to our daily diets.
Some good sources of Vitamin D3 are:
Exposure of the skin to sunshine (without sunscreen), salmon, tuna, mackerel, sardines, cod liver oil, egg yolks, cheeses, butter, shiitake and button mushrooms, sunflower seeds and sprouts, and high quality supplements.
(Source: www.alzinfo.org)
Guidelines for the Recommended Daily Allowance (RDA) of vitamin D were updated by the Institute of Medicine (IOM) in 2010 and are currently set by age: For those 1-70 years of age, 600 IU daily; for those 71 years and older, 800 IU daily; and for pregnant and lactating women, 600 IU daily. This is thought by many as far too low.
Due to a mathematical error, the IOM’s widely cited RDA’s for Vitamin D underestimate the body’s need for it by a factor of 10.
The IOM recommends a Vitamin D serum level of 20 ng/ml but we should actually aim for a blood level of 40 ng/ml, supplementing with whatever amount is necessary to reach and maintain that level. (Mercola, 5/10/2015)
One of my alternative health care providers recommends 5,000 IU/day in the summer time and as high as 10,000 IU/day the rest of the year. (Miller, 2011). I like Metagenics, D3 5000, 120 Softgels (1 2X/day).
Vitamin D serum levels should be monitored with periodic blood tests.
(4/15/2016: I reduced my D3 intake to 5,000 IU/day after my D blood serum level was too high.)
(10/22/2016: A few months ago, I needed to reduce my D3 intake even further – to 5,000 IU/day during the darker months and the same amount every other day during the sunnier months.)
Over 10,000 studies show that prolonged sitting harms your health. 8-10 hours of sitting a day, even if you exercise 30-60 minutes daily and are very fit, promotes dozens of chronic diseases – including obesity and Type 2 diabetes.
“The reason for this is because, at the molecular level, the human body was designed to be active all day long. When you stop moving and sit still for extended periods of time, it’s like telling your body to shut down and prepare for death. As soon as you stand up, a number of molecular cascades occur that promote and support healthy biological functioning.
“For example, within 90 seconds of standing up, the muscular and cellular systems that process blood sugar, triglycerides, and cholesterol — which are mediated by insulin — are activated. Surprising as it may sound, all of these molecular effects are activated simply by carrying your body weight upon your legs. These cellular mechanisms are also responsible for pushing fuels into your cells and, if done regularly, will radically decrease your risk of diabetes and obesity.
“So, the remedy is simple: Avoid sitting and get more movement into your life. Ideally, aim to sit less than three hours a day. Also consider walking more, in addition to your exercise regimen. In short, rest is supposed to break up activity — not the other way around. This kind of non-exercise physical movement appears to be really foundational for optimal health, and if you’re currently inactive, this is the place to start even before you get going on a workout routine.” (Mercola, 8/23/2015)
Don’t let this be true for you:
(Source: http://www.medpagetoday.com)
NOTE ADDED ON 9/6/2015
I’d asked Warren Fraser, MD, to look over this post. Dr Fraser is an experienced board certified endocrinologist and Co-Chair of the Institutional Review Board at Pennington Biomedical Research Center in Baton Rouge, LA. He sent these helpful comments:
I think your post is very good.
I hadn’t thought of autoimmune diseases as being a result of chronic inflammation, but it makes sense. It’s seems as if more and more disorders are being linked to chronic inflammation. Cardiovascular disease has, and one of the studies I reviewed this week is looking at a drug which reduces chronic inflammation (the drug is already approved for use in Juvenile Rheumatoid Arthritis, now commonly called Juvenile Idiopathic Arthritis) to see if it will lower the incidence of a second cardiovascular event in people who have had one heart attack.
In reference to the TYPE 2 DIABETES SECTION:
The pancreas actually over secretes insulin in the early phases of the disease to combat the insulin resistance. This was quite a surprise to investigators when the insulin assay was developed (late 60’s or early 70’s I think). As you pointed out, insulin production eventually decreases, which may be due to, at least in part, pancreatic ‘exhaustion’ from chronic hypersecretion. High insulin levels are almost always seen in prediabetes (insulin resistance syndrome) and measuring insulin levels is useful in making the diagnosis.
In reference to the section on DIABETES STATISTICS IN THE US:
The increase in new cases may be due in part to a greater awareness of the disorder and more people being tested for it.
I certainly concur that diabetes is under reported as a cause of death. The cause is often attributed to a complication of the diabetes. Back in the 80’s, when Lee Iacocca addressed the annual meeting of American Diabetes Association, he said that he wanted his wife’s death certificate to tell the truth: she died from diabetes.
In reference to the section on GUT BACTERIA, ANTIBIOTICS & RISK FOR DIABETES:
I certainly agree with the harmful effects of excessive antibiotic use.
Again, this is a very good review and my comments aren’t meant to be suggestions to change anything.
– Fraser, 2016
GMO vs NON-GMO FOODS:
In the section AVOID GRAINS, ESPECIALLY WHEAT, BARLEY, OATS & RYE, I’d written “Humans are designed to eat a diet containing a ratio of 1 or 2 parts of Omega-6 essential fatty acids to every part of Omega-3. This ratio is what we get when we eat real, unprocessed, highly nutritious foods – non-GMO veggies, fruits, nuts, seeds, and pastured animals. Our typical diet now has come to contain 10 to 20 parts Omega-6 to every part of Omega-3 – producing a highly inflammatory state in the body.”
Dr Fraser also asked for clarification on the meaning of “non-GMO”. Here it is with respect to the foods we consume:
The short answer is that NON-GMO plant foods are ones that have not been genetically modified and NON-GMO animals are ones that have not been fed genetically engineered grains or other plants.
GMO foods have been genetically engineered, for reasons completely unrelated to health or nourishment, to withstand heavy applications of potent herbicides like Monsanto’s Roundup (a glyphosate-based weed killer). GMOs are created using the gene-splicing techniques of biotechnology to inject DNA from one species into another species, creating combinations of plant, animal, bacteria, and viral genes that don’t occur in nature or through crossbreeding methods.
Glyphosate causes serious damage to the beneficial microbes living in our guts (our gut microbiome) and is regarded by many scientists as the most important factor in the development of the many chronic diseases and conditions plaguing Westernized societies.
The process of genetically modifying foods is relatively new in agriculture. The first genetically modified seeds for commercial use were planted in the US in 1996. In 2014, 18 million farmers in 28 countries planted biotech crops, with the highest acreage by far here in the US. Worldwide planting of GE crops covered 181.5 million hectares (448 million acres) by 2014.
The Center for Food Safety estimates that about 3/4 of all grocery store products now contain one or more genetically modified ingredients.
England, France, Germany, New Zealand, Switzerland, China, Indonesia, and more than 25 other countries around the world require GE foods to be labeled so consumers can choose to avoid them. England, Japan, Brazil, Norway, India, Thailand and some other countries have even completely banned some GE food crops.
Monsanto and the other big biotech companies have joined together to spend huge sums of money to make sure these GMO foods remain unlabeled in the US.
The American Academy of Environmental Medicine (AAEM) has declared genetically engineered food unsafe for consumption. They cited animal studies indicating serious health risks associated with GM foods – “including infertility, immune problems, accelerated aging, faulty insulin regulation, and changes in major organs and the gastrointestinal system. The AAEM advised physicians to tell their patients to avoid GM foods.
“Before the FDA decided to allow GMOs into food without labeling, FDA scientists had repeatedly warned that GM foods can create unpredictable, hard-to-detect side effects, including allergies, toxins, new diseases, and nutritional problems. They urged long-term safety studies, but were ignored.” (Institute for Responsible Technology, 2014)
Studies of people in the US and Germany have found high levels of glyphosate in human urine, blood, and breast milk as well as in drinking water supplies.
Ciubotaru, I. et al. (2015). Significant differences in fecal microbiota are associated with various stages of glucose tolerance in African-American male veterans. ENDO 2015; Abstract FRI-597. See: https://endo.confex.com/endo/2015endo/webprogram/Paper21179.html
Kostic, A.D. et al. (2015). The dynamics of the human infant gut microbiome in development and in progression toward type 1 diabetes. Cell Host & Microbe, 17:2, 260-273. See: http://www.ncbi.nlm.nih.gov/pubmed/25662751
Very good news! An exciting new field of medicine is on the horizon: PSYCHOBIOTICS.
PROBIOTICS are micro-organisms that have beneficial effects on the body when consumed.
Ted Dinan, Catherine Stanton, and John Cryan, pioneering researchers in the field, define a PSYCHOBIOTIC as “a live organism that, when ingested in adequate amounts, produces a health benefit in patients suffering from psychiatric illness”. (Dinan, Stanton & Cryan, 2013)
(Source: www.youtube.com)
Scientists are discovering that some probiotic micro-organisms living in our guts are also psychoactive. That is, they deliver neuroactive substances such as gamma-aminobutyric acid (GABA) and serotonin that influence the brain via the gut-brain axis.
I’d say that the field of psychobiotics in the not so distant future will be understood more broadly to include all of us, not just those with diagnosable mental illnesses. For example, we’ll be able to fine tune our anxiety levels day to day – by taking particular probiotics before events we know make us anxious (public speaking, flying, big dates, exams). And, even better, we’ll be able to AVOID depression’s deep troughs of despair and the exhausting paralysis of anxiety by nourishing healthy populations of the appropriate probiotics in our guts.
(Source: http://www.maryvancenc.com/
As we understand the gut-brain axis at this point, communications between the gut and the brain (and vice versa) travel via the long vagus nerve, spinal cord, and/or neuroendocrine systems to mediate various physical and mental states – including anxiety, depression, obsessive-compulsive thoughts and behaviors, autism, chronic fatigue syndrome, and irritable bowel syndrome.
Here’s a diagram of the vagus nerve’s path, showing the organs it connects between the brain at its top end and the intestines at its bottom end. You can see what an important communication highway it provides for the body, allowing the brain, lungs, heart, spleen, liver, kidneys, pancreas, stomach, and intestines to ‘talk’ to one another.
THE VAGUS NERVE
It runs from the brain stem down each side of the neck, across the chest, down through the abdomen allowing the brain, lungs, heart, spleen, liver, pancreas, kidneys, stomach and intestines to communicate bi-directionally along its network.
(Source: emedicine.medscape.com)
“So far, psychobiotics have been most extensively studied in … patients with irritable bowel syndrome, where positive benefits have been reported for a number of organisms including Bifidobacterium infantis. Evidence is emerging of benefits in alleviating symptoms of depression and in chronic fatigue syndrome. Such benefits may be related to the anti-inflammatory actions of certain psychobiotics and a capacity to reduce hypothalamic-pituitary-adrenal axis activity. ” (Dinan, Stanton & Cryan, 2013)
Did you notice the mention of the anti-inflammatory actions of probiotics in the quote above?
Most physical and mental diseases have inflammation as their root cause. The vast majority of our immune system, about 70% of it, is located in the gut microbiome. Unbalance in the composition of microbes there creates inflammation inside the intestinal linings, increasing gut permeability, leading to chronic inflammation elsewhere in the body – and disease.
This is my short hand explanation for how the connection works:
Chronic imbalance of microbes in the gut –> chronic inflammation in the gut –>increased gut permeability –> chronic inflammation elsewhere in the body –> diseases in the gut and/or elsewhere in the body
(Source: www.nature.com)
These signaling irregularities affect our emotions, mental abilities, behaviors, and perception of and reactions to pain (nociception). The whole system is something like an enormous, highly complex switchboard. If something interferes with signaling somewhere in the system, a circuit can malfunction and perhaps cause the entire switchboard to break down.
(Source: en.wikipedia.org)
Chronic imbalances in our gut bacteria that lead to gut-brain axis signaling irregularities can also lead to a wide variety of other health problems – including diabetes, heart disease, stroke, migraines, thyroid problems, dental issues, cancers, degenerative neurological diseases, obesity, ADD/ADHD, allergies, asthma, autism, rheumatoid arthritis, chronic Lyme disease … and many, many more. And they all begin with the health of the several pounds of miniscule critters living in our gut microbiomes.
Our gut microbiome, the 100 trillion micro-organisms (500-1,000 species of bacteria, fungi, viruses, and other tiny life forms) living in our intestinal linings, is so important to the proper functioning of the entire body that many scientists now regard it as an organ in and of itself. The theory is that these micro-organisms communicate with the nervous system using some of the same neurochemicals the body uses to relay messages in the brain. (Smith, 2015)
These several pounds of micro-organisms in our guts secrete a large number of neurochemicals, including dopamine, serotonin, and gamma-aminobutyric acid (GABA), the very same chemicals our neurons use to communicate and regulate mood – and chemicals that also play a role in GI disorders, which, not strangely, are associated with high levels of depression and anxiety. (Smith, 2015)
(Source: www.itsokaytobesmart.com)
ANXIETY, OBSESSIVE BEHAVIOR, LEAKY GUT AND BACTEROIDES FRAGILIS
(Source: www.find-happiness.com)
In 2013, microbiology researchers Mazmanian and Hsiao published research results that linked a specific variety of probiotic bacteria with anxious behaviors in mice. The mice were known to have alterations in their gut microbiota and GI barrier defects (increased gut permeability, AKA leaky gut) and also exhibited anxious, obsessive behaviors (such as obsessively burying marbles). When they were given oral doses of one of two strains of the bacterium Bacteroides fragilis (probiotic bacteria found in normal gut flora), both their GI problems and maladaptive behaviors improved. (Hsiao et al, 2013) (Smith, 2015)
STRESS, DEPRESSION AND THE PROBIOTICS LACTOBACILLUS AND BIFIDOBACTERIUM
(Source: www.menshealth.co.uk)
A recent study found that a combination of the probiotics Lactobacillus helveticus and Bifidobacterium longum (probiotic bacteria found in healthy human gut microbiomes) reduced anxiety, depression, and stress levels and improved coping strategies. (Messaoudi, 2011)
Our psychological and physiological reactions to fear and stress play a large role in depression. People suffering from major depression also have elevated levels of cortisol, the stress hormone our adrenals release to get us ready to fight for our lives or flee from the danger. Back when we frequently encountered predatory animals and were often in a fight or flight situation, this elevated release of cortisol was a very useful thing.
What often happens now is that we live in a state of chronic cortisol overproduction, over stimulated, afraid, unable to calm down, wearing out our adrenals. Chronically elevated cortisol production interferes with learning and memory, lowers immune functioning, decreases bone density, increases weight gain, raises blood pressure and cholesterol levels, leads to heart disease, increases risk for depression and anxiety, decreases resilience – and is generally exhausting. A combination of the probiotics, Lactobacillus helveticus and Bifidobacterium longum, was found to reduce cortisol levels. (Berglund, 2013) (Davidson, 2014)
GABA (gamma-Aminobutyric acid) is our central nervous system’s chief inhibitory neurotransmitter, playing a central role in reducing neuronal excitability throughout the body and regulating muscle tone. (Wikipedia, 2015)
Many physiological and psychological processes associated with depression, including negative ruminations, can be traced to a deficiency in the neurotransmitter GABA. Microbes that actively secrete GABA in the gut have been identified by researchers. Chief among them are strains of Lactobacillus and Bifidobacterium.
Bifidobacterium longum has anti-inflammatory, anti-carcinogenic, and antimutagenic properties and may protect you from developing colon cancer. It’s present in breast milk and is one of the first probiotics to colonize a newborn’s gut.
Emmenthaler Cheese
(Source: cheesecrafters.ca)
Swiss and Emmenthaler cheeses contain Lactobacillus helveticus. (We’re talking about real cheeses, not the tasteless, processed kinds often found prepackaged in the US.)
(Source: draxe.com)
Bifodobacterium longum is found in unprocessed yogurts, various types of fermented dairy foods (kefir’s a good choice), and fermented vegetables such as sauerkraut.
(Source: www.rsc.org)
Good news for those of us who love dark chocolate: The plentiful polyphenols in dark chocolate serve as PREbiotics, nourishing the beneficial Lactobacillus and Bifidobacterium in our guts. (Davidson, 2014) The higher the cacao and lower the sugar content the better. Organic and fair trade also if possible.
Both L. helveticus and B. longum can also be taken as supplements.
MOOD, OXYTOCIN AND LACTOBACILLUS REUTERI
(Source: www.bbc.co.uk)
A team of biologists at MIT found that another probiotic strain, Lactobacillus reuteri, improved mood, restored a youthful appearance to the skin, and promoted general health by increasing levels of oxytocin, the love hormone. (Davidson, 2015)
L. reuteri is one of the fastest colonizing probiotic bacteria available. This is a good thing – colonizing probiotic strains of bacteria in your gut can restore your health.
Lactobacillus rhamnosus is a bacterial strain that has been shown to reduce anxiety and depression in anxious mice.
GABA, the central nervous system’s principal inhibitory neurotransmitter, regulates many physiological and psychological processes in the body. Alterations in GABA receptor expression are linked to the the development of anxiety and depression.
Study results published in 2011 shed light on exactly how L. rhamnosus in the gut impacts the brain’s chemistry.
The researchers found that the probiotic L. rhamnosus markedly affected GABA levels in certain brain regions and lowered the stress-induced hormone corticosterone, resulting in reduced anxiety- and depression-related behavior.
When the vagus nerve was severed, GABA receptor levels and the animals’ behavior remained unchanged after treatment with L. rhamnosus, confirming that the vagus nerve is most likely the primary pathway of communication between the bacteria in the gut and the brain.
The researchers allow that the vagus nerve is the obvious communication route but perhaps not the only one, that messaging may also occur via other nerves or chemicals in the blood.
If you doubt there’s a direct connection between the health of the gut microbiome and mental health, keep in mind that functional bowel disorders and mood disorders such as anxiety and depression are generally comorbid (they generally occur together).
Strains of L. rhamnosus are found in some dairy products such as live culture yogurts, cheeses (eg, real Parmigiano Reggiano), and kefir. They’re also found in fermented dry sausages and some fermented soy cheeses. (Panyko, 2015)
PAIN, CHRONIC FATIGUE, DEPRESSION, ANXIETY AND LACTOBACILLUS ACIDOPHILUS
(Source: www.slideshare.net)
Lactobacillus acidophilus improves the functioning of canabinoid receptors in the spinal cord that are important for regulating pain perception. (Davidson, 2014)
A 2009 study to see if treatment with live L. acidophilus was helpful for chronic fatigue syndrome and the depression that’s part of it showed promising results. When the researchers supplemented chronic fatigue syndrome sufferers with a live casie strain of L. acidophilus for two months, they saw a significant decrease in the subjects’ depression, anxiety, and general emotional distress. (Rao et al, 2009)
Food sources of L. acidophilus include live culture yogurt and other fermented foods such as sauerkraut, sauerkraut juice, kimchi, miso, chutneys, and kefir.
SEROTININ, CHRONIC INFLAMMATION AND BIFIDOBACTERIUM INFANTIS
(Source: www.amazon.com)
A number of microbes can produce other neurotransmitters, such as norepinephrine, serotonin, and dopamine. For example, Bifidobacterium infantis, taken as an probotic, alters serotonin levels – just like Prozac but without the undesirable side effects. (Davidson, 2014)
Bifidobacterium infantis has been clinically demonstrated to be very good at reducing the symptoms caused by chronic immune activation in the gut, autoimmune diseases, and excessive cortisol release. So it, along with some other probiotic bacteria, is a good choice for people with leaky gut, IBS, IBD, celiac disease, and Crohn’s disease. (Nootriment, 2015)
Infantis in this bacteria’s name indicates that it’s a strain vitally important for infant health. B. infantis is usually one of the first probiotics mothers pass on to their babies during vaginal births. Many scientists and doctors therefore recommend that pregnant women take it as a supplement.
The main benefit from B. infantis is to improve digestion and protect us against infection and sickness. It has also been shown to fight allergies and prevent kidney stones. It accomplishes all this by producing large amounts of acid to make our digestive tracts and vaginas inhospitable to pathogenic bacteria and parasites. (Jerkunica, 2015)
(Source: www.starrybrook.com)
FERMENTED FOODS
(Source: http://www.sacfoodcoop.com)
NOTE:
If you’ve decided to add ready-made fermented foods like sauerkraut or pickles to your diet for their probiotic benefits, remember it’s only the truly fermented versions that are helpful. The ones made with vinegar, although they may say ‘pickled’ on their labels, aren’t actually fermented and don’t offer any probiotic or enzymatic benefits. Look for the fermented versions in the refrigerated areas in stores.
Fermented foods contain living cultures. Refrigeration slows down the fermentation process. The brine may be cloudy – full of lactic acid bacterial growth (the desirable probiotics) created during fermentation. The jar lids may be slightly swollen from the ongoing fermentation process. Fermented pickles have a complex taste – they’re alive on your tongue. Pickles made with vinegar taste like vinegar.
Years ago, when I was living in Cambridge, MA, my neighborhood grocery store was Savenor’s. Mrs Savenor kept a huge, wooden pickle barrel next to the checkout counter. The top of the barrel was open. The brine was cloudy, sometimes scummy looking, and every once in a while the barrel emitted a big belch of gas. I thought the whole thing was unsanitary and never bought her pickles. Now I wish I’d known then what I’ve since learned about the benefits of that living culture.
Savenor’s was also where Julia Child shopped for her meats. The Childs lived in the neighborhood of beautiful big houses on the north side of Kirkland Street. I was in the neighborhood of old apartment buildings on the south side of Kirkland, where students and other people with little money lived.
Here’s a fond memoir about Mrs Savenor by one of her grandsons, Alan Savenor: How a Matriarch Ran Savenor’s. She was a character. Reputedly, she’d smuggled her young boys out of Lithuania by walking across the border with them under her voluminous, floor length skirt when the Nazis set about exterminating all the Jews there.
For those of you interested in improving your gut microbiomes and overall health by eating probiotic-rich foods, here’s a good article on Probiotics & Fermented Foods written by the Sacramento Natural Foods Coop.
(Source: fundrazr.com)
YOUR BRAIN ON BUGS
This is what pioneering Integrative Health doc J. E. Williams, OMD, has to say about psychobiotics and how best to get them into your body:
“Microbiota, those microscopic bugs that live in your body—mainly in the gut—can influence brain chemistry and consequently behavior. We know that Clostridium difficile, the nasty gut hospital-based gut infection that kills 14,000 people each year in the U.S., is associated with depression and dementia. Two antidepressants, mirtazapine (Remeron) and fluoxetine (Prozac), are linked to a nearly 50 percent increased risk for Clostridium difficile infection.
“Doctors have long known that foods and changes in the gastrointestinal system are associated with mood changes. Does the pathway to happiness actually exist in your gut?
Sources of Psychobiotics
“Probiotics come in a variety of forms, from powders and capsules to foods such as yogurt, dairy drinks, infant formulas, cheese, and even some energy snack bars. Any of these forms may be effective for digestive problems as long as they contain the right kind of beneficial organisms in adequate numbers.
“In my clinical experience, I’ve found that supplements with live friendly bacteria in high dosages are more effective for treatment of depression, immune deficiency, and gastrointestinal problems then consuming yogurt or fermented vegetables alone.
Friendly Psychobiotics
Bacteriodies fragilis
Bifidobacterium infantis
Lactobacillus rhamnosus
Lactobacillus helveticus
Bifidobacterium longum
Lactobacillus brevis
Brain-Immune-Gut Axis
“We’re finding that most diseases, including psychiatric illnesses, have inflammation as their root cause. Inflammation is associated with immune system imbalance and disruption of hormone activity. Probiotics may also influence how your genes work. Psychobiotics could target genes responsible influencing neurotransmitters like GABA that have a strong connection to mood and behavior.
“We know that “gluten brain” is a type of mental fog common in people with gluten sensitivity. People with gluten sensitivity feel better when eliminating wheat, but the benefit is limited. If you have tried the gluten-free diet and wonder what’s next, consider psychobiotics
“The autonomic nervous system links the brain and gut largely through the vagus nerve. More than 90 percent of the body’s serotonin, a feel good neurotransmitter, lies within the gut. In fact, your gut has a mind of its own and it’s called the enteric nervous system.
“Changes in diet have immediate effects on the bacterial composition in your gut. Antibiotics have disastrous effects on gut bacteria. Now we have good research and more than enough clinical evidence that specialized probiotic bacteria are essential for health, and also profoundly influence mood.
“So, it’s not surprising that when your gut is healthier, so is your brain and mood. Your immune system works better too, so you have fewer episodes of the cold and/or flu.”
– Williams, 2014
IS YOUR FATE IN YOUR GENES?: GENETICS VS EPIGENETICS
If there’s been mental illness – say depression, anxiety or panic disorder, OCD, autism, schizophrenia – in your family as far back as anyone can remember, you needn’t feel that you or your children are doomed. Genetics is the study of genes, heredity, and genetic variation in living organisms. Epigenetics is the study of factors that turn genes on and off and affect how cells read genes.
Your genetics account for only 25% of the chance you’ll develop a disease. The other 75% is environmental (both internal and external) and therefore largely up to you. So take very good care of your gut microbiome. Provide it with lots of good microbes (probiotics and psychobiotics) to keep a good balance in there and avoid the bad ones (bacterial pathogens and other toxins) as much as possible.
This is also true of genetic predispositions for heart disease, diabetes, Alzheimer’s, cancer, and pretty much every other illness. You are not a prisoner of your genes. Probiotics influence activity in our genes, allowing them to express their contents in a positive, disease-fighting manner.
Research has shown that probiotic bacteria produce positive changes in the mucosal lining of the small intestines which affect gene activity and cellular reactions.
“Consumption of a dairy drink containing three strains of probiotic bacteria was associated with changes in the activity of hundreds of genes, with the changes resembling the effects of certain medicines in the human body, including medicines that positively influence the immune system and those for lowering blood pressure.”
– Mercola, 2010
STAY TUNED! There’s lots of good research being done now on the relationship between probiotics in the gut, mood – and pretty much every other working of the body.
(Source: www.medscape.com)
Many thanks to both Liz Poirier and Alex Tatusian for pointing me to the New York Times Magazine article by Peter Andrey Smith, which prompted this post: Can the Bacteria in Your Gut Explain Your Mood? It’s very good and I recommend reading it.
Messaoudi, M. et al. (2011). Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects. British Journal of Nutrition, 105:5, 755-64. See
Rao, A.V. et al. (2009). A randomized, double-blind, placebo-controlled pilot study of a probiotic in emotional symptoms of chronic fatigue syndrome. Gut Pathogens, 1:6. See: http://www.gutpathogens.com/content/1/1/6
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