Inflammatory bowel disease, or IBD, is characterized by inflammation of the intestines, and is most notably represented as Crohn’s disease, which usually affects the small intestine, but may affect other areas of the digestive tract, and ulcerative colitis, which usually affects the large intestine, or colon.

Two recent studies, presented at the American College of Gastroenterology’s 76^th Annual Scientific Meeting, discovered a connection between IBD and vitamin D status, or with latitude of geographic location at age 30. Latitude has been found to be strongly correlated with vitamin D status, because vitamin D is most commonly obtained through UV sun exposure. Those people living at higher latitudes are more likely to have insufficient vitamin D status; thus, the vitamin D connection to IBD.

In one study, it was found that people who lived in northern US latitudes at age 30 were more likely to later develop IBD. The researchers stated, “This differential risk may be explained by differences in UV light exposure, vitamin D status, or pollution.” The risk of developing Crohn’s disease was 50 percent lower in those people living in southern latitudes at age 30, and for ulcerative colitis, it was 35 percent lower.

In the second study, vitamin D3 supplementation was given to Crohn’s patients with low blood levels of vitamin D. The low-dose group received 1,000 IU daily, and the high-dose group received 10,000 IU daily. After 26 weeks of supplementation, there were differences in vitamin D levels, but more importantly, there was a significant improvement of disease symptoms in the high-dose compared to the low-dose group.

So many conditions are affected by insufficient vitamin D levels. If you do not know your vitamin D level, get it checked, even if you live in the south. Most integrative doctors recommend a vitamin D level of at least 50 ng/dL.

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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!

Many people who have arthritis take non-steroidal anti-inflammatory drugs (NSAIDs) to manage pain. NSAIDs can wreak havoc on the stomach lining, however, so acid-suppressing drugs are often prescribed along with the NSAIDs to help protect the stomach (note the Band-Aid on top of Band-Aid method of medicine here).

The acid-suppressing drugs, or more specifically, proton-pump inhibitors (PPIs), have been found to protect the stomach of people on long-term NSAIDs, yes. But from the results of a new study, it appears that the damage is only displaced further down the digestive tract—to the intestines. So instead of stomach ulcers, intestinal damage occurs, increasing the risk of developing intestinal ulcers, which can be more dangerous and difficult to treat.

The dangers of acid-suppressing medications are many. It’s a topic I’ve touched on before. I’ve even video-blogged about it. So many people are taking these medications long term when they aren’t designed for such use. If your doctor has given you acid-suppressing medications, be sure to inform yourself about the side effects of taking these drugs long term.

This week, if you know someone on acid suppressors for heartburn, open up the dialogue about how dietary and lifestyle factors may be at the root cause of upper digestive symptoms. If you pay attention to what you eat and how you eat, for example, you may be able to make changes that relieve your heartburn. If you know someone on these medications to protect against NSAID damage, they may want to think twice, based on this recent study.

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The immune system is a complex organization of coordinated responses to “foreign” invaders in the body. Foreign invaders include microbes—bacteria, fungus, parasites and viruses—as well as toxins and even food. As a matter of fact, one major role of the immune system is to not respond to food. As is seen with food allergies, however, the immune system is not always successful at this. Food allergies involve an overactive immune response to certain foods, which would normally be recognized as harmless. 

The immune system is comprised of two main branches: the innate immune system and the adaptive immune system. The innate immune system, also known as cell-mediated immunity, involves an immediate non-specific immune response, often against pathogens. The adaptive immune system, also called humoral immunity, involves a delayed, specific, organized response involving the production of antibodies that later recognize invading microbes so that a more effective immune response can be mounted. The innate immune system involves the production of cells called T helper 1 (Th1) cells, and adaptive immunity involves the production T helper 2 (Th2) cells. T helper cells are lymphocytes, a type of white blood cell. They are like the messengers of the immune system, sending signals that stimulate various immune responses.

Th1 and Th2 responses are joined by another type of T helper cell known as Th17. Th17 and Th1 responses are both associated with over-active immune responses, as is seen in autoimmune conditions, in which the body mistakenly attacks its own tissues. Both these responses produce inflammation by way of cytokines, the immune equivalent of hormones. These three types of T helper cells are all regulated and balanced by cells known as T regulatory cells, or Tregs.¹

Are you confused yet? Think of all these T cells as a four-way seesaw.  Th1 and Th17 are on two prongs of one end, and Th2 and Tregs are on two prongs of the other. When all is well, this seesaw is in balance, like a harmonized symphony responding appropriately to that which the body comes into contact.  If out of balance, you may see higher levels of Th1 and Th17, an indication of underlying autoimmunity as is seen with type 1 diabetes, celiac disease, rheumatoid arthritis, psoriasis, multiple sclerosis and systemic lupus erythematous. In contrast, higher levels of Th2 and Tregs are characteristic of allergic conditions like asthma, food allergies and hay fever, and with immune suppression.

How can we balance immunity? Well, probiotics are one solution. Since over 70 percent of the immune system is in the gut, probiotics are in the right terrain for immune system communication. Probiotics help balance immune response.  Gut bacteria essentially “prime” the immune system,² educating it so that it responds appropriately to what passes through the digestive tract—and to what may ultimately pass through the small intestine and into the body.

Omega-3 fatty acids also affect immunity, largely by helping to balance the inflammatory response—an important aspect of immunity. You see, inflammation is a necessary physiologic occurrence.  But too much inflammation spells trouble.  The omega-3 fatty acids EPA and DHA found in fish oil help to quell inflammation at the right time.  They help stimulate the production of resolvins, chemicals knows to help “resolve” inflammation—or end it at the appropriate time.³ 

Further, the proper digestion of food is necessary so the immune system doesn’t have to work too hard.  When food is not broken down properly, undigested food particles can aggravate the gut, causing inflammation and even leaking through a permeable intestine (also known as leaky gut) and entering circulation where yet more inflammation is triggered, in a downward spiral of excess inflammation (which is at the basis of most, if not all, chronic disease).

Also important is regular bowel elimination, which can be attained by the consumption of dietary fiber—at least 35 grams per day. A diet rich in fruits, vegetables and whole grains is essential, and a fiber supplement can help reach 35 grams, which can be difficult to obtain through diet alone.

In essence, the HOPE Formula—High-fiber, Omega Oils, Probiotics and digestive Enzymes—can help improve digestive health and improve immune balance. Brenda and I have been recommending this formula for years for many good reasons. With the HOPE Formula, there is hope that your health will improve. 

References

1. Cooke A, “Th17 cells in inflammatory conditions.” Rev Diabet Stud. 2006 Summer;3(2):72-5.
2. Round JL and Mazmanian Sk, “The gut microbiota shapes intestinal immune responses during health and disease.” Nat Rev Immunol. 2009 May;9(5):313-23.
3. Serhan CN and Savil J, “Resolution of inflammation: the beginning programs the end.” Nat Immunol. 2005 Dec;6(12):1191-7.

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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I recommend eating natural foods all the time because I know foods that don’t contain toxic ingredients are better for our bodies. If you eat meat, choose natural meats from animals that haven’t been treated with growth hormones and antibiotics.

Now there are even more good reasons to go all-natural. A recent study found certain strains of E. coli bacteria that were causing urinary tract infections (UTIs) in women were the same strains found on antibiotic-treated chicken at the local grocery store.

Yeah. Gross.

Are you wondering, “how the heck?” Well, antibiotic-treated chicken may actually harbor bacteria that are more resistant because some bacteria can survive antibiotic treatment. These resistant bacteria live on the raw chicken and can be consumed if cross-contamination prevention is not practiced while preparing and cooking food. The bacteria can pass through the digestive tract without causing an infection in the gut, but these same bacteria can migrate to the urethra where they are not as easily tolerated, triggering a UTI.   

What to do? Here are some tips:

• Buy chicken raised without antibiotics.  If you can get organic, that’s even better.
• Prevent cross contamination by cooking chicken thoroughly, washing your hands before and after handling chicken.  Thoroughly clean all utensils, cutting board and countertops with hot soapy water after preparing food (of any kind for safe measure).
• Do not use the same cutting board or utensils for raw vegetables that you used for the raw chicken
• To avoid UTIs, wipe from front to back, urinate after intercourse, and keep your gut balanced with a healthy amount of beneficial bacteria

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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!

The digestive tract is about 30 feet long, and it takes anywhere from 24 to 72 (or more, yikes!) hours for food to travel all the way through. If you experience constipation, exercise can really help get things moving. I recommend aerobic exercise at least three times a week for 30 minutes. Find some aerobic activity you enjoy to help you stick to the routine, and try to change it up so you don’t get bored.

Stretching exercises are also helpful. This week, for stimulating digestion, try this yoga sequence I found on health.com. You could add this to the end of your routine to help get things moving.

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Recent findings by Harvard researchers in the Women’s Health Study (which involved more than 17,000 female health professionals) indicate that women whose work is highly stressful are at a 40 percent increased risk of developing heart disease compared to their less-stressed colleagues. The study also showed that women who worry about job loss are more likely to have high blood pressure, unhealthy cholesterol levels and be obese.

More studies back this up. A large study in Denmark found a higher risk for heart disease among women aged 51 and older who were under greater work pressure. Another study in Beijing found that women with job strain had increased thickness of the carotid artery—a sign of cardiovascular disease.

The effects of stress, and especially chronic stress, are far-reaching. The body is designed to respond to stress by increasing blood pressure, speeding heart rate, quickening breathing, and slowing digestion. Did you know that stress even alters the microbial balance in the digestive tract? Chronic stress has these same effects, but over a longer time period. The result? Chronic disease.

There are some aspects about work-related stress that cannot be changed. We all know that. How we handle the stress is another story. Stress-reducing therapies such as relaxation techniques, meditation, or yoga can be helpful. Regular exercise is another stress reducer, and is also good for the heart. Reducing stress outside of work can also help lessen the stress load.

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Omega-3 fatty acids are wonder nutrients that offer many benefits to the body, from head to toe. Now, even the mouth is included in the long list of body areas that function better after intake of omega-3s.

A recent study found that a moderate, daily intake of the omega-3s DHA and EPA (found in marine sources, usually fish oil) was associated with up to a 20 percent decreased risk of gum disease (periodontitis).

Gum disease is an inflammatory disease that is caused by microorganisms like the bacteria Streptococcus mutans, Candida albicans and Porphyromonas gingivalis. Usually antibiotics are prescribed in an effort to eliminate these bacteria, but other treatments have been used that target the inflammation of gum disease, like scaling and root planing (ouch!) and in extreme cases surgery.   

Omega-3s are most known for their anti-inflammatory effects, so it is not surprising that they would help quell inflammation in the mouth. Additionally, this study also found that omega-3 fatty acids also demonstrated antibacterial activity against oral pathogens.

The mouth is the very beginning of the digestive tract, and the bacterial balance in the mouth is proving to be more important than previously thought. In fact, gum disease is also associated with the development of heart disease! Everything is connected, folks, and it all goes back to the gut!

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To me, a very interesting gut connection is that of microbial gut balance to obesity, a condition plaguing one-third of Americans. Studies are very new on this subject of the link between the gut and obesity. In fact, there have only been a few. But boy are they changing how the world looks at the gut—namely, they’re really starting to look!

This new study builds on previous animal studies by looking at the effect of a probiotic (Lactobacillus plantarum) on weight loss. It is already known that there is a difference in the gut flora between obese and lean individuals. This new study found that when rats fed a high-energy-dense diet (high fat, high calorie) were also given L. plantarum, they did not gain as much weight as the animals who did not receive the probiotic. Another group received the less-friendly E. coli bacteria and gained more body fat than those who didn’t.

That’s right—changing the gut bacteria influenced the amount of weight and fat these animals gained. This is an exciting study, because it is just the beginning of what will be a fascinating journey linking the gut to obesity, and all the many conditions related to obesity.  

I’ve known for a long time that in order to heal the body, you have to first heal the gut. In order to heal your gut, however, you have to understand the importance of its function. The gut is not merely a food processor—food in, poop out—but rather gut function is the very foundation upon which your health is built. With an unhealthy digestive tract—and there are many different ways the digestive tract can be unhealthy—you will be less able to heal your body. So start with your gut. What are you waiting for?

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It is well known that probiotics are beneficial for the digestive tract. Indeed, these beneficial gut bacteria outnumber cells in the body (and their genes GREATLY outnumber our own genes).

Scientists have taken the research of probiotics beyond the gut lately, finding that their effects are far reaching. A recent study in pregnant women found that daily administration of two probiotic strains—Lactobacillus rhamnosus and Bifidobacterium lactis—along with dietary counseling during the first trimester of pregnancy resulted in reduced waist circumferences six months after giving birth.

Three groups were involved; one taking probiotics along with counseling, one taking a placebo along with counseling, and one taking a placebo without counseling. The probiotic + counseling group had the lowest percentage of women with waists measuring over 31.5 inches at the end of the study.

It has long been known that probiotics are beneficial during pregnancy, both for mom and baby, and studies continue to support their many advantages.  I recently talked about probiotics protecting against development of gestational diabetes.

Research of probiotics and metabolic outcomes like abdominal fat and weight loss is relatively new. With obesity rates at an all-time high, going back to the gut in order to build a strong foundation of health is essential. Whether pregnant or not, when our guts are out of balance, the rest of the body suffers. Begin with balancing the gut, and good health for the rest of the body will follow.

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Exciting news! If you live in the greater Tampa Bay area, be sure watch me LIVE on WEDU-TV tonight from 8:00 to 10:00 p.m. for my NEW PBS special, The Road to Perfect Health.

A lot of folks don’t realize that a healthy body begins with a healthy gut. That’s because your digestive tract is where more than 80 percent of your body’s natural defenses are found, and it’s where trillions of bacteria live in a delicate balance to help you absorb nutrients, defend against toxins, and fight off illness and disease—not to mention help with bowel regularity!

But what may surprise you is that even things you wouldn’t normally associate with digestive health—everything from anxiety, joint aches and food sensitivities to fibromyalgia and even high cholesterol—they all start in the gut. That’s how important it is to keep your digestive system running smoothly.

Join me to learn the secret to balancing your gut and healing your body, beginning with the power of probiotics. Those are the beneficial bacteria in your intestines that help with healthy digestion and immune function, and they are the key to a strong GPS, or what I like to call your Gut Protection System. From there, I’ll give you the keys to rebuilding your health from the inside out and finally living the life you’ve always wanted. See you there!

If you don’t live in the Tampa Bay Area, The Road to Perfect Health is also airing nationwide right now through mid-December. Visit PBS for air times and station in your area.

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