According to a recent study published in the journal Chronic Illness, women with celiac disease are more likely to report stress, depression and disordered eating, even if they are following a gluten-free diet.

The researchers found that women adhering to a gluten-free diet did experience greater vitality, lower stress, decreased depressive symptoms, and greater overall emotional health than those women not following the diet, but even so, they still experienced more stress, depression, and body dissatisfaction when compared to the general population.

I can see how people with celiac disease not following a gluten-free diet could have these issues. Gluten is a digestive tract’s nightmare in people with celiac disease (and most people, really), which would be enough to depress anyone. But I can also see how people adhering to the diet can struggle with stress, depression, and body image issues.

Eating gluten-free, even in today’s world of readily available gluten-free fare, is a big adjustment, even when you have been eating gluten-free for years. Food becomes a central focus, rather than an afterthought. Everyday meal planning is required to be sure you have access to the right foods. Shopping at multiple grocery stores becomes the norm. Eating gluten-free creates a whole new way of life. This has the possibility of becoming stressful—and even alienating, depending on the company you keep.

But eating gluten-free—especially in those with celiac, but even in those who are gluten sensitive—is also a ticket to freedom for many people. Freedom from constant digestive issues with seemingly no solution, freedom from wondering, “What the heck is wrong with me?” and freedom from a downward health spiral that itself can cause more stress, dis-ease, and depression.

If you have celiac and you tend to get down about it, take a moment to think about what a gluten-free diet has given you, rather than what it has taken away. Sometimes a shift in perspective is all you need.

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A recent study, published in the journal Nutrition, demonstrated the effect of broccoli and blueberries on bowel inflammation in an animal model of inflammatory bowel disease (IBD).¹ Researchers fed IBD mice either a control diet, or a diet with 10 percent broccoli or ten percent blueberries. Both the broccoli- and blueberry-fed mice exhibited similar changes in gut microbiota with one exception: the broccoli-fed mice had lower levels of the bacteria Faecalibacterium prausnitzii. Both diets also increased the size of colon crypt cells and number of goblet cells per crypt. (Intestinal crypt cells are located in the “valleys” of the intestinal villi.)

Differences between the broccoli- and blueberry-fed mice were also observed. Higher concentrations of butyric acid and lower concentrations of succinic acid were found in the broccoli-fed mice; the only diet to reduce inflammation in the colon was the broccoli-fed diet; and broccoli-fed mice exhibited less translocation of microbes to mesenteric lymph nodes than the blueberry-fed or control mice. (This means in the broccoli-fed mice gut bacteria stayed in the gut rather than translocating through a leaky gut into gut-associated lymph nodes.)

One reason the blueberry-fed mice may not have had as beneficial an impact as the broccoli-fed mice could be the high fructose content of blueberries. Foods high in fructose can produce fermentation in the gut.² Inflammatory bowel disease involves a gut sensitivity to the microbes residing there. Increased fermentation may further disrupt an already sensitive environment.

Blueberries have been found to benefit microbial metabolism in the colon, likely due to the anti-inflammatory effects of blueberry’s phenolic compounds.³ Broccoli is also well known for its protective effects in the large bowel, mostly attributed to the sulforophane and indole-3-carbinol (I3C) bioactives.⁴

This study is helping to prove that whole foods absolutely affect the microbial population. The moral of the story? Well, more studies need to be done to confirm the effects in humans, and to elucidate the mechanisms at work, but in the meantime, eat more broccoli! In fact, eat more vegetables (and fruits if you aren’t sensitive) in general. The thousands of phytochemicals found in vegetables and fruits have more beneficial effects in our guts—and our entire bodies—than we will ever know.

References

1. G. Paturi, et al., “Influence of dietary blueberry and broccoli on cecal microbiota activity and colon morphology in mdr1a(-/-) mice, a model of inflammatory bowel diseases.” Nutrition. 2011 Nov 22. [Epub ahead of print]
2. P.R. Gibson, et al., “Review article: fructose malabsorption and the bigger picture.” Aliment Pharmacol Ther. 2007 Feb 15;25(4):349-63.
3. W.R. Russell, et al., “Availability of blueberry phenolics for microbial metabolism in the colon and the potential inflammatory implications.” Mol Nutr Food Res. 2007 Jun;51(6):726-31.
4. E.H. Jeffrey and M. Araya, “Physiological effects of broccoli consumption.” Phytochem Rev. 2009;8:283-9.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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A recent study published in the Journal of the American Dietetic Association found a three-fold increase in the metabolic syndrome in children eating the least amount of dietary fiber when compared to the group eating the most. There were no differences when consumption of saturated fat or cholesterol was analyzed however.

The researchers recommend focusing on increasing fiber in the diet, and not worrying so much about finding low-fat foods. That does not mean teens should fill their diets with fat-filled foods, but it does mean seeking out nutrient-dense foods high in fiber.

This makes sense to me. Most low-fat foods today are those processed foods that have been filled with sugar to make up for lack of taste that comes with low-fat options. Replacing fat with sugar in foods is what has contributed to the current obesity and diabetes epidemic this country now faces. Up to 30 percent of teen’s dietary intake comes from beverages and sugary snacks. This has to change.

But change can be tough. Joseph Carlson, the lead researcher, stated, “The trick is getting people into the groove finding the foods that they enjoy and that are convenient.”

The statistics are screaming at us from many different sources. Our diets and lifestyle have to change in order for us to see significant health improvements. This begins in childhood. I recommend that adults consume at least 35 grams of fiber daily. For children and teens, I recommend adding 5 grams to their age. So a 13 year old should eat 18 grams of fiber daily. How can you add fiber back into your diet, and the diet of your family?

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Renew You Challenge

Let’s start this week off right!

Weekly challenge (I mean opportunity!) to help set you off on the right foot and in the right direction for bringing health to your week. You could even add it to your calendar.  Join us! 

Atrazine is the most widely used herbicide in the United States. Over 75 million pounds of it are applied to corn and other crops, many in the Midwest. Atrazine is the most common pesticide contaminant found in groundwater, surface water, and rain in the United States. A recent study has found that women living in areas where atrazine water contamination is found are more likely to experience menstrual irregularities than women living in regions where there is no contamination.

I have blogged on the adverse hormonal effects of atrazine before. It has been found to turn male frogs into females, even at low concentrations. In 2009 atrazine was also linked to low birth weight in Indiana newborns, and menstrual irregularities have been found in women exposed to atrazine through agricultural work.

In this new study, women from two different cities in Illinois were compared with women from two different cities in Vermont. Illinois has the highest rates of atrazine water contamination, though the levels found in the study were still under limits set by the Environmental Protection Agency. The women in the Illinois cities were almost five times more likely to report irregular periods than the Vermont women, and more than six times more likely to go more time between periods.

Emily Barrett, a reproductive health scientist at the University of Rochester in New York stated, “These types of changes to hormone concentration and ovarian function could potentially lead to problems with fertility.” The study did not look at fertility, but hopefully more studies will address this.

Atrazine is sprayed on 75 percent of corn, as well as other crops. Corn is used in so many foods, and is used to make so many different ingredients in foods. This week, start reading your food labels to discover how widespread corn is. Then, take measures to replace the largest sources of non-organic corn with organic corn in your diet. It’s worth it. We’ve got to reduce our chemical exposure. Eating organic when possible is a big way to do that.

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A new study, published in the European Journal of Clinical Nutrition, demonstrated a connection between diet, and stool pH and bacterial levels in adults.¹ The researchers studied stool samples from vegetarians, vegans, and omnivores. They found lower levels of potentially pathogenic bacteria, like E. coli, in people consuming the vegan or vegetarian diets. What they also found, in conjunction, was a decrease in stool pH level with decreases in consumption of animal proteins. Those on the omnivore diet had a stool pH of 6.9; those on the vegetarian diet (which included dairy and eggs) had a stool pH of 6.6; and those on a vegan diet (no animal proteins) had a stool pH of 6.3.

The higher pH in the omnivore diet is explained in part by an increase in the production of alkaline metabolites by enhanced growth of the protein-digesting putrefactive bacteria in the gut. That’s right—a diet high in animal protein promotes increased putrefying activity of gut bacteria, raising the pH of stool and making products like putracene, cadaverine, and nitrosamine, which could lead to colon cancer. Diets lower in animal protein and—this is key—higher in fiber promote gut bacterial activity that produces more acid via production of the beneficial short-chain fatty acids (SCFAs) butyrate, propionate, and acetate, promoting a more acidic environment in the gut.

The change in pH levels explains why potentially pathogenic bacteria were increased in the higher pH (more alkaline) stools of people consuming an omnivorous diet. Lower pH ranges do not support the growth of potential pathogens, which thrive in the higher pH range over 6.5.^2,3 So I say, stay alive under 6.5!  

Here is a major point. The lower pH may be mainly a biomarker indicating the production of the SCFAs, particularly butyrate. Butyrate is a major fuel for the colonocytes, and is critical for optimum colon health. Butyrate also affects nuclear transcription in a positive way. In other words, when colonic cells are under attack from absorption of free radicals from fecal material (more likely to happen with chronic constipation), the nucleus, under stress, sends a message to the cell: either commit suicide (apoptosis) or produce more damaged cells (cancer).  Butyrate is more likely to promote apoptosis, preventing cancerous cells and allowing new cells to come in and maintain a healthy colon lining.

However, we must always remember everything is a question of balance.  All of the SCFAs including butyrate come from the fermentation of soluble fiber from plants by commensal bacteria. Too much fermentation with too low of a pH (or too much acid) can damage the colonic lining creating increased permeability problems leading to numerous problems including immune imbalances which can have total body effects.

The researchers also found a decrease in levels of Bifidobacteria and Bacteroides in the people on a vegan diet. This is in contrast to other studies that have found increases in Bifidobacteria, and seems an anomalous finding, since high-fiber diets support the growth of Bifidobacteria, while suppressing the growth of potential pathogens. Perhaps a closer look at the diets would be in order. Many vegetarians and vegans eat high amounts of refined carbohydrates, and too much fats and oils which do not promote healthy Bifidobacteria levels.

The researchers state, “In addition to age, gender and diet, factors such as microbial interaction, food transit through different intestinal compartments with different bacterial colonization density, availability of nutrients, colonic supply, sulphate and bile acids, and bacterial adaptation may all be involved in the composition and activity of colonic microflora. This may help in understanding the lower abundance of Bifidobacteria and Bacteroides species in vegans and vegetarians, which was not linked to stool pH.”

At any rate, all diets—vegan, vegetarian, and omnivore—will benefit by adding probiotic-rich foods along with supplements to help replenish levels of the beneficial Bifidobacteria and Lactobacilli. These bacteria, along with a high-fiber diet high in vegetables and fruits, help to lower the pH in the intestines by producing the nourishing SCFAs.

Incidentally, this topic can confuse the message of the benefits of a high-alkaline diet. You may have heard that a diet high in animal protein, sugar, and refined carbohydrates creates acidity in the body. Yes, these foods do lower urine and salivary pH levels, which are thought to be associated with bone mineralization, a process that helps neutralize acidity by pulling alkaline minerals from bone.  Chronic low grade acidity (metabolic acidosis) also causes excess loss of calcium, magnesium and potassium in the urine. Diets high in vegetables and fruits, on the other hand, produce more alkaline urine and saliva levels, which is associated with reduced bone loss and reduced loss of minerals in the urine.⁴ These variabilities in optimum pH in different areas show the body’s ability to change based on local environment and physiologic and biochemical requirements.

The bottom line is, healthy pH levels, whether in the colon or systemic, are found when you eat a high-fiber diet, high in vegetables and fruits, healthy proteins, and healthy fats. Complement this with foods and supplements high in beneficial bacteria, omega-3 fatty acids, and digestive enzymes, and you will be supporting optimal health (which begins in the digestive system).

References

1.  J. Zimmer, et al., “A vegan or vegetarian diet substantially alters the human colonic faecal microbiota.” Eur J Clin Nutr. 2012 Jan;66(1):53-60.
2. J. Adler, “A method for measuring chemotaxis and use of the method to determine optimum conditions for chemotaxis by Escherichia coli.” J Gen Microbiol. 1973 Jan;74(1):77-91.
3. G.R. Gibson, et al., “Prebiotics and resistance to gastrointestinal infections.” Br J Nutr. 2005 Apr;93 Suppl 1:S31-4.
4. B. Dawson-Hughes, et al., “Treatment with potassium bicarbonate lowers calcium excretion and bone resorption in older men and women.” J Clin Endocrinol Metab. 2009 Jan;94(1):96-102.

Leonard Smith, M.D.

Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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People with high blood pressure are generally advised to reduce their intake of dietary salt. The average U.S. salt consumption is about 3,400 mg per day, but the latest Dietary Guidelines for Americans recommend keeping sodium intake below 2,300 mg per day for healthy people, and under 1,500 mg for people with high blood pressure and for those at risk of high blood pressure, most notably blacks and people over age 50. These groups make up about 70 percent of the U.S. population. The American Heart Association recommends that everyone should consume less than 1,500 mg of sodium per day.

These recommendations come from the results of the DASH (Dietary Approaches to Stop Hypertension) studies, which have found that a reduction of salt intake to below 1,500 mg per day is an effective method for reducing blood pressure.¹ Whether or not the reduction of dietary salt leads to further cardiovascular benefits has been a subject of debate, however.

In July of this year, a controversial² Cochrane Review published in the American Journal of Hypertension found that recommendations for a reduction in salt intake did lead to reduced salt consumption and a small reduction in blood pressure after six months, but that, “cutting down on the amount of salt has no clear benefits in terms of likelihood of dying or experiencing cardiovascular disease,” concluded the study.³ In fact, one finding of the study was an increase in the risk of death in people with congestive heart failure. The lead researcher stated, “We believe that we didn’t see big benefits in this study because the people in the trials we analyzed only reduced their salt intake by a moderate amount, so the effect on blood pressure and heart disease was not large.”

The saga continues with a recent Cochrane Review, also published in the American Journal of Hypertension, which reviewed 167 studies and found that reduction of dietary salt intake resulted in a modest 1 percent decrease in blood pressure in Caucasians with normal blood pressure and a 3.5 percent decrease in Caucasians with high blood pressure.⁴ Further, the study also found that salt reduction increased renin, aldosterone, adrenaline and noradrenaline (all hormones that affect blood pressure), in addition to raising cholesterol by 2.5 percent and triglycerides by 7 percent. These potentially harmful effects call into question the recommendation to reduce salt intake in Caucasians on cardiovascular risk overall.

The major source of sodium in the Standard American Diet (SAD) comes from processed food—cheese, bread, pizza, and grain-based foods and desserts being the main sources. This is a problem in itself. Perhaps it’s not the sodium that is the major contributor to cardiovascular risk, but rather the overall poor quality of the diet. Processed foods, refined grains, sugars, and chemical additives have turned the American diet into a ticking time bomb for heart disease—and most all chronic disease, for that matter. Remember that salt, in its natural form (from the sea) contains an array of minerals that help support nutrient sufficiency in the diet. Sea salt, like any salt, should be consumed in moderation—don’t overdo it, but you might not want to reduce levels as drastically as have been recommended.

The good news is there are other ways to eat a tasty (or even spicy) moderate amount of salt in your food:  Herbamare is a product which contains sea salt, lemon, fennel, leek, onions, chives, parsley, dill, basil, carrots, garlic, bay leaves,  marjoram, rosemary, thyme, chili, and kelp. Some varieties have hotter chili for those who like it. In addition, adding more kelp, nori, or dulse, all sea vegetables, adds more minerals (including iodine) in a natural form that would be beneficial for most everyone.  Through the use of medicinal foods like these, eating can be a joy that balances salt and herbs, providing much more than just table salt. And now for dessert:  It turns out that dark chocolate and almonds are quite beneficial in lowering blood pressure as well.

References

1. F.M. Sacks, et al., “Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group.” N Engl J Med. 2001 Jan 4;344(1):3-10.
2. F.J. He and G.A. MacGregor, “Salt reduction lowers cardiovascular risk: meta-analysis of outcome trials.” Lancet. 2011 Jul 30;378(9789):380-2.
3. R.S. Taylor, et al., “Reduced dietary salt for the prevention of cardiovascular disease: a meta-analysis of randomized controlled trials (Cochrane review).” Am J Hypertens. 2011 Aug;24(8):843-53.
4. G. Jurgens and N.A. Graudal, “Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride.” Cochrane Database Syst Rev. 2004;(1):CD004022.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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The human gut is home to thousands of different bacterial species, totaling 100 trillion bacterial cells—that’s about four pounds of bacteria, or the weight of a brick. The composition of this bacterial population (also known as the gut microbiota), is currently being studied. Dr. Smith recently blogged on it.

A new study by researchers from the University of Pennsylvania, published in Science, takes the findings further. This new study found two major gut types—Bacteroides and Prevotella—based on gut bacterial population groups in 98 healthy volunteers who were asked to fill out questionnaires that assessed dietary habits. Stool samples were collected to determine their gut microbiota composition.

The researchers found a link between dietary habits and gut types. People who ate a diet high in meat and saturated fat were higher in Bacteroides bacteria, and people who had a diet high in carbohydrates had more Prevotella bacteria. Researchers then took ten volunteers and fed half of them a diet high in fat and low in fiber, and fed the other half a low-fat, high-fiber diet. By the end of ten days the bacterial populations had begun to change, but were still predominantly the same Bacteroides and Prevotella groups. This indicates that it’s possible to change the gut microbiota with diet, but it will take more than a short term change to see any major difference.

Next steps will be to replicate these findings to confirm them, and to take the studies further by looking at whether these gut types are associated with health or disease. It’s an exciting area of research, working out the details of what I have said all along—your gut is the foundation of the health of the rest of your body. It all begins in the gut.

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The human genome was fully mapped in the year 2000, a feat thought to be one of the most important medical science breakthroughs in history. As it turned out, there were only 25,000 genes, and the research did not yield the medical advances anticipated. In 2008, the National Institutes of Health (NIH) began to fund a different genetic initiative; one that sought to understand the epigenome.

The epigenome is described as the expression of the genome. Literally, epigenome means “above the genome.” Epigenetics is the study of changes in gene activity that do not involve changes to genetic code. One example of epigenetics is the addition or subtraction of small molecules called methyl or acetyl groups, which attach/detach to certain genes in processes known as methylation or acetylation. In methylation of the genome some genes are silenced, and others are turned on. Methylation determines how genes will be expressed, and it is the expression of genes that has an effect on our health. Think of your genome like a piano, and methylation like the pianist’s fingers, playing in tune to your health—or not.

Scientists have long known that epigenetics existed, because it explains how certain cells have the potential to develop into different cell types, depending on what is needed at the time. But what scientists didn’t know then that they know now, is epigenetics plays a major role in our health, and the health of our children. Lifestyle factors, like what we eat, what we are exposed to, and how we live, can affect our gene expression, and even the gene expression of our children for at least four generations.

Randy Jirtle PhD, a radiation biologist at Duke University, was among the first to experiment with DNA methylation in ways that gained much attention. His team conducted an experiment in pregnant mice that found methylation of a particular gene, the agouti gene, by administration of a diet rich in the B vitamins folic acid and B12 (both critically involved in methylation), resulted in offspring that were lean compared to obese offspring of pregnant mice not fed the diet.^1,2

Dr. Jirtle stated, “The epigenome is most sensitive to perturbations in programming during the embryonic and the perinatal stages of development,”³ a statement highlighting the importance of healthy lifestyle of the mother before and during pregnancy and breast feeding, and of the children as they grow.

Puberty is another period when the epigenome is sensitive, especially in boys in whom sperm are beginning to develop (as opposed to in girls who carry eggs from birth). Toxin exposure plays a big role in epigenetics. Very early cigarette smoking in boys before age 11 has been found to later increase obesity in the sons of those men, illustrating the effects of the epigenome on the next generation.⁴

The message of epigenetic research is that we have more control over our genome, and thus, our health, than we once thought. Even small lifestyle changes can positively affect the expression of our genes in a way that results in positive health effects, in ourselves, in our children, and in our children’s children out several generations.

References

1. R.A. Waterland and R.J. Jirtle, “Transposable elements: targets for early nutritional effects on epigenetic gene regulation.” Mol Cell Biol. 2003 August; 23(15): 5293–5300.
2. R.J. Jirtle and M.K. Skinner, Environmental epigenomics and disease susceptibility.” Nat Rev Genet. 2007 Apr;8(4):253-62.
3. B.M. Kuehn, “Randy L. Jirtle, PhD: Epigenetics a window on gene dysregulation, disease.” JAMA. 2008;299(11):1249-1250.
4. M.E. Pembry, et al., “Sex-specific, male-line transgenerational responses in humans.” Eur J Hum Genet. 2006 Feb;14(2):159-66.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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The benefits of omega-3 oils from fish were first noticed in Inuit populations of Greenland. Researchers noticed that these people consumed high amounts of fat, yet did not develop heart disease or experience heart attacks like people in the Western world. Thus began studies of the Inuit diet in which beneficial omega-3 fatty acids from fish—EPA and DHA—were found to be the heart-protective components.

Many thousands of studies later, the benefits of omega-3 fish oil are still being found in many different areas of health. In a new study of Yup’ik Eskimos in Alaska, researchers evaluated the effects of a high-fat fish-based diet on disease markers in obese Eskimos. The rate of obesity in these people is similar to that in the lower US—the difference is the source of dietary fat. In the US, saturated and trans fats are high in the diet, and healthy polyunsaturated fats, like omega-3s, are low.  

In obese Yup’ik Eskimos with the highest blood levels of EPA and DHA, blood triglyceride and C-reactive protein (a measure of overall inflammation) were the same as normal weight people. In those Eskimos with the lowest EPA and DHA levels, however, blood triglyceride and CRP levels were high. High triglycerides and CRP levels are risk factors for the development of cardiovascular disease and possibly diabetes.

Results of this study suggest that omega-3 fatty acids EPA and DHA found in fish may have health protecting effects even in obese people. More studies are needed to confirm these results, but this study is promising.

Now, don’t get carried away and think you can eat all the fatty foods you want and just pop a fish oil supplement. Instead choose healthy fats as part of your diet with plenty of fish on the menu, and supplement that with omega-3s from fish oil to be sure you’re getting enough of these great fats. Just be sure to look for a fish oil that meets International Fish Oil Standards (IFOS—look for the IFOS seal on the bottle).

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Belly fat, or visceral adipose tissue (VAT), is the fat that accumulates around the organs in the abdomen. It is strongly related to metabolic disorders including insulin resistance, fatty liver and inflammation. Because of the close proximity of belly fat to the intestines, and the ability of gut bacterial toxins to affect inflammation outside the gut, the relationship of increased intestinal permeability, or leaky gut, to increased abdominal fat has been investigated. 

Indeed, previous studies in animals and in people with illnesses like Crohn’s disease¹ and non-alcoholic fatty liver disease (NAFLD), have found a link between leaky gut and belly fat. Until recently, however, no studies had been done in healthy humans. Now the picture is all coming together nicely, as a new study highlights.

In 55 healthy women, intestinal permeability was estimated by measuring urinary excretion of ingested nonmetabolizable sucralose and mannitol. (They measure the ratio of excreted sucralose to mannitol—if the sucralose level is high, it means it leaked through the gut, even though it shouldn’t.) Further, imaging was performed of subcutaneous fat (fat just under the skin) visceral fat, and liver fat. The researchers found that increased leaky gut was associated with increases in both visceral fat and liver fat content in healthy women.² This is important because previous studies have found this in people with illnesses, but it was not known if leaky gut could was associated with belly fat in healthy individuals. Now we have a better picture of this gut connection.

The women in the study had no history of gut disorders, yet some of them still had leaky gut, and those with the worst leaky gut also had the most belly and liver fat. The researchers stated, “The current findings suggest that even without pathologically compromised gut function, intestinal permeability still appears to play a role in visceral adipose and liver fat accumulation.” Importantly, they go on to mention the role that the gut microbiota plays in this picture. Alterations in gut bacteria composition has been associated with metabolic dysfunction,³ and gut bacteria help regulate gut barrier function,⁴ they mention.

They conclude, “Our data suggests that intestinal permeability may be an important part of the link between diet, gut microbial balance, inflammation, and metabolic disorders. The present findings are consistent with the emerging role of gut in metabolic health.”

Abdominal fat has even been considered an organ of its own, due to the many chemicals and hormones it produces, just as organs do. The role of VAT as a contributor to metabolic diseases is possibly the most important factor to consider when trying to reduce disease risk. That the accumulation of this belly fat is related to the gut, and might even originate in the gut, takes our search into the prevention of diseases yet one more step closer to the source. A healthy gut is truly the foundation of total body health.

References

1. Desreumaux P, et al., “Inflammatory alterations in mesenteric adipose tissue in Crohn’s disease.” Gastroenterology. 1999 Jul;117(1):73-81.
2. Gummesson A, et al., “Intestinal Permeability Is Associated With Visceral Adiposity in Healthy Women.” Obesity (Silver Spring). 2011 Aug 18. [Epub ahead of print]
3. Cani PD and Delzenne NM, “The role of the gut microbiota in energy metabolism and metabolic disease.” Curr Pharm Des. 2009;15(13):1546-58.
4. Sharma R, et al., “Molecular modulation of intestinal epithelial barrier: contribution of microbiota.” J Biomed Biotechnol. 2010;2010:305879.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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