In an earlier post, I discussed the importance of maintaining a healthy microbiome – i.e., the population of microscopic organisms that live symbiotically in our small intestines and colons. They aid in digestion, help regulate metabolism and hormone levels, support immune function, protect the gut lining, and ward off harmful microorganisms. Diversity is the hallmark of a healthy microbiome with no more than 15% of its residents deemed potentially harmful.

When our microbiome is out of balance, we are far more susceptible to chronic illness and disease. According to Dr. Josh Axe, author of Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems, a number of factors compromise our microbiome:

• A poor diet characterized by excess sugar and nutritionally bankrupt processed food
  (Note: A test subject’s biodiversity dropped by 40% after eating a diet based wholly on fast food for 10 days!)
• Dietary gluten that triggers production of zonulin, a hormone that causes the tight junctions of our gut lining to loosen up
• Overuse of antibiotics and antimicrobial sanitizers which kill off good bacteria with the bad
• Environmental toxins
• Stress

Microbes die off and must be replenished. To nourish the good microbial population, we need regular exposure to the soil-based microbes found in dirt and other plant life. While it isn’t necessary to serve ourselves daily spoonfuls of dirt, it certainly doesn’t hurt to leave a little bit of dirt on the fruits and vegetables we consume. Microexposures reinforce good bacteria and help our bodies respond appropriately to pathogens. Those of us who own dogs and cats get a little dose of dirt every time we handle their dirty paws!

As an aside: I’ve always noshed on baby carrots at parties to keep me away from higher calorie snack foods. Until reading this book, it never occurred to me that packaged carrots tend to be bathed in chlorine to increase their shelf life. Chlorine kills bacteria in the gut!

Other than becoming a pet owner, what dietary and lifestyle practices support the cultivation of a healthy microbiome?

Dr. Axe favors getting back to nature. A few simple lifestyle adjustments might include: (i) walking barefoot on the ground daily; (ii) working in the garden; (iii) showering with water and no soap a few days per week to help maintain beneficial microorganisms on the skin; (iv) washing hands with water and certified organic therapeutic oils (e.g., tea tree, orange, melaleuca, rosemary) or Dr. Bronnor’s Pure Castile Soap; and, (v) swimming in the ocean.

As for food, Dr. Axe offers the following recommendations:

• Eat probiotic rich foods such as kefir, yogurt, and fermented vegetables.
  (Note: Commercially prepared sauerkraut may or may not have been fermented; it could just be cabbage seasoned with vinegar.)
• Drink raw, fermented, organic goat or sheep milk and cheese.
  (Homogenization destroys essential enzymes and probiotics as well as oxidizes fats and creates free radicals.)
• Substitute coconut flour or almond flour for wheat-based flour.
• Use extra virgin coconut oil for cooking and ghee, olive oil, or flaxseed oil for dressings, et al.
• Use bone broth and collagen powder to repair the gut’s mucosal lining and provide a rich source of minerals that the body can readily absorb.
• Avoid sugar and artificial sweeteners.

In 1955, American physiologist Ancel Keys delivered a presentation to the World Health Organization that linked coronary artery disease (CAD) to blood serum cholesterol based on epidemiological data from seven industrialized nations. His research turned the tide of American eating habits away from saturated fats toward diets rich in protein and carbohydrates.

British physiologist and nutritionist John Yudkin was not convinced that eliminating saturated fats from the diet would lower rates of CAD. For one thing, two independent examinations of epidemiological data from 20+ industrialized countries failed to support Dr. Keys’ findings. Since affluent populations tend to consume more fat and sugar, smoke more, and lead more sedentary lives, one could argue perhaps that all of these factors contribute to CAD, not just fat consumption. Moreover, Dr. Yudkin claimed that no one has been able to demonstrate that people with CAD on average consume more fat that people without it. He did, however, have his suspicions about the relationship between sugar and CAD, and chased that theory by conducting his own research and reviewing a host of studies by peers.

Yudkin published his findings in Pure, White, and Deadly: How Sugar is Killing Us and What We Can Do to Stop It, my latest bedside read. The book warns that excess consumption of sugar produces a host of unpleasant biological responses that are detrimental to our health, including:

• Elevated blood serum cholesterol and triglycerides
  (How about that? Sugar holds the smoking gun on cholesterol!)
• Hormonal imbalance cause by increased blood serum levels of insulin, cortisol, and estrogen
• Increased “stickiness” of platelets
• Increased acidity and digestive activity of the gastric juices
• Enlargement of the liver and kidneys
• Elevated risk of CAD, hypertension, diabetes, insulin resistance, gall stones
• Tooth decay

Dr. Yudkin also theorized that excess sugar interferes with the balance of good and bad bacteria in the gut microbiome – a theory that has subsequently proven correct.

Dr. Yudkin is quick to point out that his research on sugar should not give rise to a new wave of simplistic advice regarding CAD. People with coronary artery disease tend to have multiple “disturbances” that impact their conditions – e.g., genetic predisposition, unhealthy diets, excess body fat, tobacco use, physical inactivity, stress. So giving up sugar is not a “silver bullet”… even though abstinence comes highly recommended.

So with all this bad news regarding sugar, why do we eat so much of it? One clear answer lies in the fact that sugar tastes good. It makes foods highly palatable and motivates us to eat more and more of it. As such, U.S. food manufacturers have found ways to add sugar into nearly everything they produce. Is it any wonder that our per capita sugar consumption is skyrocketing?

A second major factor lies in the fact that most of us are unaware of how much sugar we’re eating. Very little of Americans’ daily sugar intake comes from table sugar. Most of us aren’t diligent about reading labels and may not even recognize the various forms of sugar that are listed there. And, we may be so used to food tasting sweet that we don’t even register the presence of sugar anymore.

The good news: If you choose to eat whole foods, you won’t have to worry about reading labels, and you won’t ingest hidden quantities of sugar, salt, or fat. And as I’ve learned over the past couple of years, there are lots of ways to make whole foods highly palatable while benefitting from all that good nutrition. Once you’ve broken the sugar cycle, you’ll start to notice all the subtle flavors… and, perhaps, not miss it so much.

I love bread. I absolutely love it! Slather it with butter or dip it into extra virgin olive oil, and I’m in seventh heaven. So I was relieved years ago when a food allergy test came up negative for gluten sensitivity. That being said, I’ve read books by a number of folks who recommend jumping on the “gluten free” bandwagon, especially if you’ve received any form of autoimmune diagnosis.

A gluten-free diet is a no-brainer for folks with celiac disease (~1% of the population). Gluten wreaks havoc on their intestines and impairs their ability to absorb nutrients from foods. An even smaller percentage of the population tests positive for a food allergy to wheat and should avoid eating it. Moreover, wheat-related antibodies may cross-react with dairy proteins, oats, brewer’s yeast, baker’s yeast, sorghum, millet, corn, rice, and potatoes, causing an allergic response to these foods as well. Other folks claim to be “gluten sensitive” – i.e., they report feeling better when avoiding gluten even though blood tests do not suggest an autoimmune or allergic response.

Common symptoms of food allergies and sensitivities include bloating, abdominal pain, bowel habit abnormalities, headaches, fatigue, depression, joint and muscle pain, numbness in one’s extremities, dermatitis, and anemia. These symptoms are also associated with small intestine bacteria overgrowth, fructose intolerance, lactose intolerance, microscopic colitis, and other causes. By eliminating the offending foods (including junk food) and increasing consumption of fruits, vegetables, whole grains, and lean proteins for an extended period of time, the body’s adverse response can be avoided.

The prevelence of gluten-related disease, allergy, and sensitivity may seem odd given that wheat, barley, and rye have been staples in the human diet for centuries. Why are we having so much trouble with them now?

According to autoimmune disease pundits, today’s breads have far more gluten than the ones our ancestors ate. This deluge of gluten comes with an excess of prolamins (a type of lectin) and protease inhibitors that challenge our standard complement of digestive enzymes. So when we eat modern day wheat-, barley-, and rye-based products, our bodies can’t break the complex proteins apart into essential amino acids from which they synthesize fuel. And when undigested food hangs around the gut, it feeds unhealthy pathogens which deprive our life-sustaining bacteria of vital nutrients. Gluten also has the ability to permeate the gut wall in between and through the cell lining. In fact, intracellular transport of prolamins has been associated with a dying back of cells in the lining, leaving a hole. Leaks and holes allow partially digested foods and pathogens to enter the bloodstream, giving rise to an immune response.

In Wheat Belly, Cardiologist William Davis, MD makes the connection between wheat consumption and the rise of obesity in the United States. He claims that processed wheat has a high glycemic index with elevates blood sugar, stimulates appetite, and generates withdrawal symptoms upon its removal. It is associated with a rise in visceral fat accumulation (a.k.a., belly fat) which engenders a host of inflammatory responses. Its production of Advanced Glycation End (AGE) products also accelerates aging.

Finally, famed neurologist Dr. David Perlmutter tells us that gluten sensitivity damages neural networks. Since the brain lacks pain receptors, gluten-induced cognitive impairment might be taking hold without an obvious physical trigger to alert the affected individual of a problem.

Having taken in all this information, I decided to visit nutritionfacts.org, a non-commercial, science-based public service provided by Dr. Michael Greger, MD that offers the latest in nutrition research via bite-sized videos. His gluten-oriented videos offer a different perspective:

• A small percent of the population has celiac disease, a wheat allergy, or gluten sensitivity. For the ~98% of us who fall outside that circle, gluten is perfectly safe to consume.
• Whole grains are health promoting. They’ve been linked to reduced risk of coronary artery disease, cancer, diabetes, obesity, and other chronic diseases.
• According to Dr. Yolanda Saz of IATA, a gluten-free diet may adversely affect gut health and immune function for those who do not have celiac disease or non-celiac gluten sensitivity. In fact, a study by Drs. Horiguchi, Horiguchi, and Suzuki showed that gluten consumption is associated with a significant increase in NK cell activity, which improves the body’s ability to fight tumor development and viral infections.
• High gluten bread showed a greater positive impact on triglycerides than regular bread.
• A self-prescribed gluten-free diet impedes the detection of bona fide celiac disease. When this disease is present, even a seemingly miniscule amount of gluten can have a severe impact. When sufferers do not know they have it, they could be taking in these miniscule helpings through an unintentional lack of vigilance.

As I said, I love bread, so it’s far from easy for me to give it up. I haven’t had a bite for 10 weeks and 4 days (but who’s counting?) Still, I haven’t closed the door on gluten. I’ll likely explore options for adding whole grains into my diet while leaving the processed stuff out.

Bibliography:

Go to www.nutritionfacts.org and then type “gluten” in the search box!

The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body, by Sarah Ballantyne, ©2016

Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health, by William Davis, MD, ©2011

The Autoimmune Fix: How to Stop the Hidden Autoimmune Damage That Keeps You Sick, Fat, and Tired Before It Turns Into Disease, by Tom O’Bryan, MD, ©2016

Grain Brain: The Surprising Truth About Wheat, Corn, and Sugar – Your Brain’s Silent Killers, by David Perlmutter, MD, ©2013

A couple of startling facts open Dr. Tom O’Bryan’s book The Autoimmune Fix: How to Stop the Hidden Autoimmune Damage That Keeps You Sick, Fat, and Tired Before It Turns Into Disease:

• By 2030, half of the population will be diagnosed with chronic disease.
• By 2044, the cost of Medicare and Medicaid to treat chronic disease will exceed all the taxes collected by the government.

Yikes! If those two statistics don’t ring the clarion call for making Americans healthy again, I don’t know what does!

I stumbled upon Dr. O’Bryan’s book a little over a month ago when I found out that my body produces antibodies consistent with Hashimoto’s thyroiditis. I was really surprised by the diagnosis given that I’m generally quite healthy. I’ve made the necessary diet and lifestyle changes to eliminate potential triggers for inflammation and establish an uber-healthy gut. Based on everything I’ve read, I’m confident that I’ll get this condition to go into remission. Along the way, I’ve learned a fair amount about how the immune system works.

We have two types of immune responses. Our innate immunity swings into action whenever a pathogen hits the body. These cells are the first responders at the initial site of attack – e.g., the skin, nose, and mouth. As they fight invaders, the associated tissue swells up. They also call for reinforcements via cytokines, blood-born messengers that communicate between different immune cell types. Antibodies are the heavy artillery that target specific intruders. They’re an adaptive response with primary responsibility for keeping us safe from disease. For example, when vaccinated against polio or the flu, we take in a small amount of the virus so that we can develop antibodies to defeat it. We also develop antibodies to foods and environmental elements (e.g., plastic, heavy metals) to which we are sensitive. Repeated exposure keeps the immune system on full alert status with the troops in active combat. When that occurs, the gang is apt to make mistakes.

Autoimmunity – i.e., a condition in which the body attacks its own tissue – reflects an immune system that has gone awry. Sometimes it happens because our tissues become collateral damage while the immune system rages a battle against something else. Sometimes our tissue reacts to an external stimulus – e.g., a food allergen – causing it to imitate a substance that our immune system has already deemed toxic (a.k.a., “molecular mimicry”). Sometimes the body’s native mechanism to clean up and remove old cells (autoantibodies) goes overboard and attacks healthy tissue. And sometimes the body’s naturally occurring chemical processes lack all of the requisite nutrients to clean up unhealthy byproducts, so the immune system goes after the tissue that started the reaction in the first place.

Antibodies are vigilant little creatures. They’ll hang around for 3-5 months after a threat has been neutralized to make sure it’s safe to leave. Even when they’re down to minimal reserves, our bodies have the capacity to ramp up production on a dime. One seemingly inconsequential exposure can reactivate a particular strain of antibodies; it can take 3-5 more months to calm them down. Yep – even one bite of bread for a gluten-sensitive individual can wreak havoc!

Fortunately, we have the power to make adjustments to help our immune system work in our favor, not against us. We can change our diets, eliminate external triggers, and bolster our intake of vital nutrients to keep our bodies healthy and balanced. And since our bodies regenerate every 7 years, there’s hope that we can remedy some or all of any autoimmune damage that has gone undetected.

Dr. O’Bryan’s recommended dietary changes include:

• Eliminate gluten. Our genetically engineered grains have far more gluten than our forbearer’s wheat, rye, and barley. Dr. O’Bryan claims that our digestive systems do not have the proper enzymes to digest them fully.
• Eliminate sugar and processed foods (which turn into sugar quickly in the bloodstream). They disrupt insulin regulation, interfere with calcium absorption, feed bad bacteria, and cause premature aging.
• Avoid artificial sweeteners. In one study, Splenda increased the growth of calorie-hoarding bacteria in the gut, leading to weight gain, loss of beneficial bacteria, and poor absorption of prescription drugs.
• Eliminate dairy. Pasteurization eliminates good bacteria, digestive enzymes, and vitamins. Homogenization transforms the fat, making it more likely to enter the bloodstream and stick to arteries. Moreover, the principal protein (casein) is difficult to digest.
• Avoid other foods for which you might be sensitive. The resulting inflammation sets off a cascade of reactions that kills off good bacteria, weakens the intestinal lining, and adds undue stress and strain on the body’s immune system.
• Eat pasture-raised, grain-fed meats and free-range poultry. That approach avoids exposure to antibiotics, GMO grains, and other food products of questionable nutritional value. (We eat what our food eats!)
• Eat food high in polyphenols (e.g., colorful fruits and vegetables, garlic, almonds, dark chocolate). It reduces risk of cardiovascular disease by 75%.
• Eat fermented food to contribute good bacteria to the gut that will unlock nutrients from foods while drawing out a range of toxins from the body.

According to the U.S. Department of Health and Human Services, 23.5 million Americans are affected by one or more autoimmune diseases. These are conditions for which the body’s immune system mistakenly considers its own organs or tissues foreign invaders and attacks them. Of the 80+ known conditions, familiar variants include celiac disease, diabetes type 1, Grave’s disease, Hashimoto’s thyroiditis, multiple sclerosis, psoriasis, rheumatoid arthritis, and lupus.

So how does someone wind up with an autoimmune condition?

The latest research suggests that these diseases manifest as a result of a “perfect storm” of the following three elements:

• A genetic predisposition for the condition
• One or more “triggers” for which the affected individual is sensitive – e.g., food allergies, chronic inflammation, nutrient depletions, infections, toxins
• A “leaky gut” that allows bacteria and dietary antigens (i.e., molecules capable of producing an immune response) into the bloodstream.

To date, there is no permanent cure for an autoimmune condition. However, through lifestyle and dietary changes, the “triggers” can be eliminated, and the “leaky gut” repaired. With no trigger(s) and “leaky gut,” the autoimmune condition can go into remission.

Different people have different triggers for their conditions. It can take time to figure out the root cause of an autoimmune response. Food allergies are common irritants, with milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat accounting for 90% of all sensitivities. Chronic inflammation is another common trigger. It occurs when the immune system is constantly fighting allergies, infection, and/or toxins. When the immune system gets stressed, it can “go rogue” and start attacking the body’s own tissues. These triggers must be eliminated to eradicate inflammation and allow the immune system to become calm, strong, and responsive.

Intestinal health is paramount for persons affected by autoimmune disease… and everyone else, for that matter. The intestines break down the food we eat to extract nutrients that fuel our bodies. They keep our water and electrolytes in balance. They also play a big role in the proper functioning of our immune system. Three conditions impair gut function:

• “Leaky Gut”: When healthy, the small intestines maintain tight junctions in the endothelial lining that block all but the smallest of food particles from passing through the intestinal wall. When these junctions become loose, forbidden substances make their way out of the gut. Common factors that increase intestinal permeability include: alcohol, food allergies, gluten, NSAIDs (e.g., Advil, Motrin, ibuprofen), psychological stress, surgery/trauma, and unsaturated fats.
• Imbalanced Bacteria: The gut needs a strong population of friendly bacteria to help break down food. Antibiotics kill off good bacteria along with the bad, leaving undigested food in its wake. That residue provides the breeding ground for unhealthy bacteria. The resulting small intestine bacterial overgrowth (SIBO) can cause or exacerbate “leaky gut.” Excess estrogen and undigested seeds also precipitate SIBO.
• Compromised Nutrient Absorption: The gut uses hair-like projections called microvilli to extract nutrients from our food. Foods high in lectin – e.g., grains, legumes, and nightshade vegetables – may interact badly with the brush border, causing it to flatten. With reduced surface area for food interaction, fewer nutrients get absorbed. (Note: Proper food preparation can eliminate lectins from foods.)

In The Autoimmune Solution, Dr. Amy Myers, MD provides a four-step process to remove the autoimmune triggers, restore digestive enzymes, re-inoculate healthy bacteria, and repair the gut. The following dietary precepts form the foundation for her protocol:

• Work with a physician (preferably one trained in functional, integrative, or naturopathic medicine) to diagnose the condition(s), render lifestyle and dietary recommendations, prescribe medication and supplements (as needed), and monitor progress.
• Eliminate all sources of gluten (including food and personal care products) and all forms of processed carbohydrates, sugar, and starch.
• Eliminate soy, grains, legumes, and nightshade vegetables (e.g., potatoes, tomatoes, eggplant, peppers).
• Eliminate Genetically Modified Organisms (GMOs) from the diet. They’re bred to resist pests, diseases, pesticides, and herbicides; they may resist our digestive processes, too.
• Use grass-fed beef/pork, free-range poultry, and wild-caught fish as sources of protein. When eating non-organic meat or farm-raised fish, we’re feasting on the GMO-based grains that they were fed.
• Buy organic produce to maximize the nutrient content of the food. Organic produce benefits from the farmer’s attentive care of the soil and natural remedies for pests and disease.
• Get rid of Teflon cooking surfaces; avoid plastic for food preparation or storage.
• Consider installing air and water filters for the home.

Autoimmune disease prevents challenges for those afflicted, but there is a message of hope. By getting rid of the “triggers” and healing the gut, the antibodies that are destroying healthy tissue can go away, and the body can repair the affected areas.

Resources:

• The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body, by Sarah Ballantyne, PhD
• THE AUTOIMMUNE SOLUTION: Prevent and Reverse the Full Spectrum of Inflammatory Symptoms and Diseases, by Dr. Amy Myers, MD
• HASHIMOTO’S THYROIDITIS: Lifestyle Interventions for Finding and Treating the Root Cause, by Dr. Izabella Wentz, PharmD, PASCP
• HASHIMOTO’S PROTOCOL: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back, by Dr. Izabella Wentz, PharmD, PASCP