“In the future, when you walk into a doctor’s surgery or hospital, you could be asked not just about your allergies and blood group, but also about your gut type.” This is a quote from ScienceDaily (Apr. 21, 2011) referring to a recent article in Nature Magazine. The study, published in Nature, also uncovers microbial genetic markers that are related to traits like age, gender and body-mass index. These bacterial genes could one day be used to help diagnose and predict outcomes for diseases like colorectal cancer, while information about a person’s gut type could help inform treatment.  Researchers found that the combination of microbes in the human intestine isn’t random, and that human gut flora can settle into three different types of communities or ecosystems. 

I would call this important work just “a start,” and would like to present some basic molecular biology to indicate the magnitude of the problem of trying to classify bacterial communities.   We now know we have over 1000 species of bacteria in our intestinal tracts, all of whom have their own thousands of genes as well as their own epigenetic codes regulating their genes. 

Here’s a primer on the epigenetic code: The epigenetic code (or epigenome) is in part a group of enzymes and methyl groups that attach to, and act on, genes. This ongoing active process allows some genes to be expressed, and other genes to be silenced. 

The epigenome responds to most every stimulus coming to the gut bacterial cell’s surface receptors, ranging from food (which can be beneficial or harmful), good or poor hydration, eustress (good stress) or distress; other stimuli include competing or complementary bacteria, viruses and fungi which can team together in biofilms (like a microbial city) in the gut lumen. Other major factors which could affect epigenomic actions are the hormones, growth factors, vitamins, immune factors, and  cytokines which continuously send signals into the bacterial cells to affect epigenetic expression. The resultant expression of genes will then direct the bacterial cells to do what they were meant to do: namely, live in a harmonious symbiotic relationship with us, the host, or remain in a state of alert, which may cause them to stop aiding the host, and become more parasitic in nature.

The above mentioned article did not in their paper find a significant connection between diet and gut bacterial balance.  However, there are many studies that do.  I found one as recently as May 2011.  Here is the summary of the article: “After 4 weeks, weight-loss diets that were high in protein but reduced in total carbohydrates and fiber resulted in a significant decrease in fecal cancer-protective metabolites and increased concentrations of hazardous metabolites. Long-term adherence to such diets may increase risk of colonic disease.”¹ 

The article points out that a low fiber, high protein diet causes biochemical changes to occur on a bacterial level.  First, without adequate amounts of soluble fiber the beneficial gut bacteria cannot produce short chain fatty acids (SCFAs), especially butyrate, which is the choice food of the colonic lining epithelial cells, and a preventer of damaged colonic cells from becoming cancerous.  In addition, the action of the gut bacteria on cooked meat creates increased proportions of branched-chain fatty acids, and concentrations of phenylacetic acid and N-nitroso compounds, which can lead eventually to inflammation and cancer of the colon. 

The source of bacterial production of both beneficial SCFAs as well as harmful chemicals comes from epigenetic and genetic changes which lead to the production of these chemicals. I believe we are proving daily that lifestyle changes including: a healthy, 80 percent plant-based diet, good hydration, sleep, exercise, elimination, and stress reduction all help to program our bacterial biomass as much as it does our bodies. Remember there are about 100 trillion bacteria and we have only about 10 trillion cells so we are outnumbered at least 10 to 1 in terms of genes and metabolic activity, so we need to take care of our “guests” as well as ourselves! Just as important as what bacteria are in our guts, is what else passes through and affects our guts. We must be able to step back and look at the entire picture, rather than simplifying it to “three gut types.”  

1. W.R. Russell, et al., “High-protein, reduced-carbohydrate weight-loss diets promote metabolite profiles likely to be detrimental to colonic health.” Am J Clin Nutr. 2011 May;93(5):1062-72. Epub 2011 Mar 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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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!

An interesting study published last year found that optimism boosts the immune response. That’s right—filling your half empty cup to half full can improve your immune system’s response to infection.  Who knew it could be that easy?

Study participants were law students. They were found to have increased immune response when their outlook about law school was more positive, and decreased response when they were feeling more pessimistic about it. Though the students’ general outlook on life (optimistic or pessimistic) did not have an effect on results, having an optimistic or pessimistic disposition with regard to specific, important events was associated with immune function.

This doesn’t mean that you need to go about your day being cheerful and optimistic about every little thing. There is a need to be realistic at times. But if you find yourself getting caught up in something that might not be as bad as it seems, try to cultivate a little optimism—for your immune system! It may even lead to a solution that you hadn’t considered.

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“It is possible for a person to be too clean for their own good.” This is a recent quote from Allison Aiello, visiting associate professor of epidemiology at Harvard, who is studying the effect of frequent handwashing with antimicrobial soap containing triclosan, or 2,4,4’-trichloro-2’-hydroxydiphenyl ether. Her research has shown an increase in allergies and hay fever in children and teens with chronic use of soap products containing triclosan.

Handwashing with a powerful soap containing triclosan brings up two questions:

1. What is the effect of chronic removal of hand bacteria? We know where these hands go, especially in children (the mouth, for starters).

2. What could this chemical be doing to our body from a metabolic/hormonal perspective?

My input:
1. Science has now discovered that people normally have over a 1000 different species of bacteria not only in our intestinal tract, but also on our skin. This fact points out the normal symbiotic balance with microbes that we have evolved with for millions of years. The human/microbe symbiosis is especially important in childhood immune development. Research and clinical observations support the “Hygiene Theory,” which states that a lack of early childhood exposure to infectious and symbiotic microorganisms and parasites increases susceptibility to allergic diseases (like allergies, asthma, dermatitis, and autoimmune diabetes) by disrupting the natural development of the immune system. Children living in non-industrial countries and closer to nature generally don’t have these problems.

2. Triclosan is also used in toothbrushes, ice-making machines, and in pesticides! This type of exposure has led to research by concerned individuals who have now shown significant evidence that it is yet another toxin with hormone-disrupting qualities which could majorly affect immunity. Due to the increase in negative evidence, the FDA has decided to thoroughly investigate triclosan, but not until 2013—a decade earlier than previously planned!

So what are the solutions? First, take a high quality probiotic and also make your own cultured foods. We may soon find topical probiotics could be beneficial, as well. Second, find safe soaps and use them mostly after exposure to public places. Safe soaps (or hand sanitizers) can be found at www.ewg.org, under cleansing products – hand sanitizers. Third, get involved in social networking by joining “green”groups to help educate and promote the changes we desperately need.

http://www.epa.gov/oppsrrd1/REDs/factsheets/triclosan_fs.htm

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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If you’re reading this blog, chances are good you’ve heard of probiotics. Probiotics are beneficial bacteria that are known for supporting digestive and immune health. From my perspective, probiotics are as important as a daily multivitamin and have many healing properties. I have seen so many people get well while taking probiotics.

When people think of probiotics, the first thing that comes to mind is usually yogurt. It’s true that all yogurt is cultured with probiotics, but not all yogurt contains live cultures in the finished product. This is because yogurt must be pasteurized, or heated, to kill off potentially pathogenic bacteria. Unfortunately, this also kills off the beneficial bacteria the yogurt was cultured with. Some yogurts do contain live cultures that are added back in after pasteurization. Next time you buy yogurt, be sure to look for the “live cultures” label.

The limitation of yogurt, however, is the amount of probiotics in yogurt—it’s low. It may not be enough, especially if your gut is out of balance. Unless you want to eat a gallon of yogurt each day, a probiotic supplement is best.

A recent study found that a high-potency (450 billion), multi-strain probiotic was able to ease irritable bowel syndrome (IBS) symptoms in children and adolescents who took the supplement for six weeks. This is a very high dose, but it can take that much (even in children) in certain conditions to rebalance the gut.

On the other hand, a lower dose (even that found in yogurt) can be beneficial for certain health concerns. Another recent study found that a particular probiotic yogurt containing Lactobacillus acidophilus and Bifidobacterium lactis decreased cholesterol and increased HDL (“good”) cholesterol in women when eaten for six weeks.

It’s a fact: Bacteria are everywhere. It’s just a matter of striking the right balance. Yet another study found that household dust even contains up to 1,000 different microbe species per gram! (No wonder no one likes to dust!) We can only do so much to reduce our daily exposure to harmful toxins and pathogens, but we can do a lot to improve our health by choosing the right foods and nutrients to optimize the body’s functions.

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I read recently that more and more Americans aren’t getting enough vitamin B12 in their diet, and that older Americans are more likely to suffer from vitamin B12 deficiency than their younger counterparts. But why should we be concerned about B12 in the first place? I’m glad you asked!

Vitamin B12 is an essential vitamin needed for healthy cells—especially red blood cells and the cells that make up our brain and nervous system. It also plays an important role in energy production, which is why it’s sometimes called the “energy vitamin”. We get vitamin B12 from protein-rich foods like meat, fish and dairy products, but a lot of folks just aren’t getting enough through diet alone…and that’s where probiotics come in!

As you know, probiotics are the good bacteria in your gut that help crowd out harmful microbes that can cause poor digestion and disease. And in addition to their proven digestive and immune health benefits, studies show that probiotics play an important role in the manufacturing of certain vitamins needed by the body (vitamins like B12) and that they work to help the body use those vitamins more efficiently to ensure better health and energy.

So there you have it—just one more reason to add a high-potency probiotic to your daily health regimen!

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“Renew You” Challenge – Be a part of my Weekly Challenge (I mean, opportunity!) to help set you off on the right foot for bringing health to your week.

So here we are right smack in the middle of another cold and flu season, and all I can hear in my head is mom telling me to eat my fruits and veggies. Why? Well, you know how a lot of folks take multivitamins every day? Fresh fruits and vegetables are like nature’s multivitamin—chock full of important nutrients and natural antioxidants proven to boost immune function and help keep you healthy—which brings me back to cold and flu season.

The best way to ward off seasonal illness is by being proactive. Don’t wait until the first sign of a sneeze or sniffle, but instead practice good habits all year long, and that includes (and you knew this was coming) eating more fruits and veggies. So that’s your challenge this week!

Now before you start to groan, just bear with me. The CDC has this great new website that helps you calculate how many servings of fruits and vegetables you need each day based on your age, sex and activity level, and from there it’s just a matter of being creative. And parents, pay attention—getting kids to gobble up their fruits and veggies may not be as difficult as you think. Just plan ahead, spend a little time at the beginning of the week slicing and storing, and soon the whole family will be on their way to better health. Here are some tips to help you get started!

 Dip bite-size veggies in low-fat dressing
 Spread natural peanut butter on celery sticks
 Spread hummus on celery, carrots or even whole-wheat pita
 Add pre-sliced veggies and even fruit to sandwiches & wraps
 Prepare individual salad servings for a quick grab-and-go lunch
 Top natural tortilla chips or pita chips with fresh, homemade salsa
 Mix berries or other fruits with yogurt, oatmeal & cereal
 Keep frozen fruit on hand for shakes & smoothies

For more simple, healthful snack ideas and recipes using fresh fruits and veggies, be sure to visit www.fiber35diet.com.

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Here’s something I thought you might find interesting: researchers at Harvard University Medical School recently discovered that bacteria in the gut can trigger the autoimmune response associated with rheumatoid arthritis.

In simple terms, an autoimmune response means that there’s an immune response in the body that goes astray, causing the body to attack its own tissues instead of a foreign invader, in this case causing the breakdown in healthy joint cartilage seen in people with rheumatoid arthritis.

So what does all this mean when it comes to the trillions of bacteria living in your digestive tract every day? It means that they can affect your whole body, sometimes even causing conditions nowhere near the gut, and it’s something I’ve been saying for years! Not only that, but more and more studies these days are proving me right, showing that many autoimmune conditions begin right in the gut.

This isn’t surprising, since more than 70% of your body’s immune defenses are found in the gut—and when things like digestive problems, gut bacteria imbalance and toxin overload put a strain on the immune system, it often leads to the development of autoimmune conditions. 

The folks at Harvard are planning to look at the effects of intestinal bacteria on other autoimmune conditions as well, including type 1 diabetes, so stay tuned! And remember to take good care of your gut!

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This past Saturday, we filmed my newest PBS special about probiotics called The Road to Perfect Health, and what a great time everyone had! Okay, so it can be a little exhausting making sure all the technical stuff gets done right, and sure, there were some do-overs, but the energy from the audience was so positive, and I can’t wait for everyone to see the show when it airs on PBS later this year. Check out these photos for an exciting sneak preview!

For those of you who may not know, probiotics are what I like to call your Gut Protection System, or GPS. That’s because all those friendly bacteria in your digestive tract make up a huge portion of your body’s natural immune defenses, so keeping your gut in balance has a lot to do with how you feel every day. Not only that, but probiotics play a key role in good digestion and manufacturing important vitamins, which is why taking a daily probiotic supplement is so important. Be sure to tune in to PBS beginning this November to find out more about the benefits of probiotics—and what you can do every day to keep your GPS in tip-top shape!

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We all know how uncomfortable constipation can be, so imagine what it must feel like for little kids…ugh! That’s why a recent study published in the American Journal of Gastroenterology caught my eye.

The study suggests that a combination of two things may be involved in higher incidences of constipation in children: 1. introducing gluten in the first year of life, and 2. an allergy to cow’s milk.

This is not surprising when you consider that the digestive tracts of infants are still very sensitive, especially in the first months of life. Not only that, but their immune systems are weaker, which means they are more susceptible to pretty much everything.

So the bottom line? When it comes to little tummies, it’s better to wait on the gluten and cow’s milk until they are more ready to handle it. And yes, some children may eat it and be fine (or appear fine), but I say better safe than sorry! There are plenty of substitutes for gluten and cow’s milk these days, even for infants.

All this is important because childhood constipation has been linked to irritable bowel syndrome (IBS) in adults, so if your child has chronic constipation, be sure to take a look at his or her diet. Other dietary factors to think about are fiber intake (since fiber helps promote regular bowel movements) and intestinal balance. In babies who are not breast fed, who were delivered by cesarean section, or who have been treated with antibiotics, there is a greater risk for an altered intestinal flora balance, so a daily probiotic supplement may be helpful in these situations.

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It’s a subject you’ve heard me talk about before, but considering new research it’s definitely worth repeating. A recent CBS news segment revealed that not one but five new studies showed that using acid-blocking drugs called proton pump inhibitors (PPIs) can be potentially dangerous to your health, and that “more than half of prescriptions for these drugs are unnecessary”. Folks, this is an eye-opener if there ever was one!

Every year more than 100 million Americans are prescribed PPIs to help relieve symptoms of heartburn and acid reflux, but what many people don’t know is that these drugs often come with some pretty serious side effects—including a nearly 75 percent greater risk of developing a severe intestinal infection known as C. diff, according to new evidence. Essentially, taking PPIs upsets the healthy bacterial balance in your intestines (which is where the majority of your natural immune defenses can be found), leaving your body vulnerable to illness and infection.

Widespread PPI use has also been linked to higher rates of pneumonia, as well as esophageal candidiasis (yeast overgrowth), inflammation of the stomach lining, increased permeability of upper GI tract lining, and even osteoporosis-related bone fractures due to the fact that PPIs block calcium absorption in the body. Because long-term PPI use also leads to hypochlorhydria (low stomach acid secretion), bacterial overgrowth and acetaldehyde production, PPI users have an increased risk of developing gastric cancer. 

The good news? There are simple things we can do every day to help prevent heartburn and acid reflux without relying on harmful drugs. Diet changes like limiting our intake of caffeine, alcohol, chocolate and fatty or spicy foods can make a big difference, along with maintaining a healthy body weight, getting plenty of exercise and quitting smoking—all pretty good advice if you ask me! Natural supplements made with ingredients such as ellagic acid (from raspberries and pomegranates) can also provide soothing relief for occasional heartburn, and digestive enzymes with added HCl can help ensure complete digestion and reduce the chances of heartburn and acid reflux happening in the first place.

The bottom line is this: why take a potentially dangerous drug when smarter, safer alternatives exist? My hope is that the more people learn about PPIs and their side effects—including why they may not even need them in the first place—the more people will take steps to improve their digestive health naturally.

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